title: Hypothalamic obesity in patients with craniopharyngioma: treatment approaches and the emerging role of gastric bypass surgery.
abstract: Hypothalamic obesity is a potential sequela of craniopharyngioma, arising from hypothalamic damage inflicted by either the tumor and/or its treatment. The marked weight gain that characterizes this disorder appears to result from impaired sympathoadrenal activation, parasympathetic dysregulation, and other hormonal and hypothalamic disturbances that upset the balance between energy intake and expenditure. Given hypopituitarism is commonly present, careful management of hormonal deficits is important for weight control in these patients. In addition, diet, exercise, and pharmacotherapy aimed at augmenting sympathetic output, controlling hyperinsulinism, and promoting weight loss have been used to treat this disease, but these measures rarely lead to sustained weight loss. While surgical interventions have not routinely been pursued, emerging data suggests that surgical weight loss interventions including Roux-en-Y gastric bypass can be safely and effectively used for the management of hypothalamic obesity in patients with craniopharyngioma.
authors.affiliation: Department of Medicine, Columbia University College of Physicians and Surgeons, William Black Medical Research Building, 650 West 168th Street, Room 905, New York, NY 10032, USA.
authors.forename: Gabrielle
authors.initials: G
authors.lastname: Page-Wilson
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Wardlaw
authors.forename: Alexander G
authors.initials: AG
authors.lastname: Khandji
authors.forename: Judith
authors.initials: J
authors.lastname: Korner
mesh_terms: D000293:Adolescent; D003397:Craniopharyngioma / Q000601:surgery*; D005260:Female; D015390:Gastric Bypass; D006801:Humans; D009765:Obesity / Q000601:surgery*