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Exenatide For Weight Loss In Hypothalamic Obesity



sharma-obesity-hypothalamusObesity caused by disruption of the hypothalamic centres that control body weight are among the most challenging forms of obesity to treat. Patients often experience relentless appetite with loss of satiety resulting in often dramatic weight gain. Causes can range from physical trauma to tumors that impact on the functioning of the hypothalamus.

Now, a study by Jefferson Lormenick and colleagues from Vanderbilt University, Nashville, Tennessee, published in OBESITY, describes the use of the GLP-1 analogue exenatide for weight loss in individuals with hypothalamic obesity.

The baseline weight of the 10 participants (7 female) was about 140 kg.

Overall, 8 individuals completed the 52 weeks of study.

Although the average weight loss of the entire group was not significant, 6 of the 8 participants, who did complete the 52 weeks of treatment, did lose about 6 kg.

While these results may sound disappointing, even this modest degree of weight loss in some patients, given the complexity of hypothalamic obesity, is remarkable, especially as participants were not offered any additional diet or lifestyle modification during the study.

It is also worth noting that untreated participants continued to gain weight over the study period.

As for the limitations of the study the authors also note that,

“Medication adherence was moderate and it is possible that long-acting GLP1RA could have better efficacy. HO is a heterogeneous disorder and better understanding of each patient’s hypothalamic damage may identify patients with improved responsiveness to GLP1RAs. The majority of our patients developed HO in childhood and longstanding obesity may be more refractory to treatment.”

Clearly, the use of GLP-1 analogues deserve further study for use in this patient population.

@DrSharma
Edmonton, AB

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