Liraglutide for the Treatment of Hypothalamic Obesity

ABSTRACT Objective Hypothalamic obesity (HO) is an intractable form of obesity syndrome occurring in patients following hypothalamic insults. It is characterized by significant polyphagia, lack of satiety, and rapid weight gain not usually responsive to caloric restriction or lifestyle modification. There are no established treatment modalities for HO. Liraglutide, a glucagon-like peptide-1 analog, has been approved for long-term treatment of obesity. We present a case of successful treatment with liraglutide of HO following resection of craniopharyngioma. Methods We present a case report and review of the literature. Results A 23-year-old female had developed panhypopituitarism and HO immediately following resection of a craniopharyngioma at age 8. She complained of poor quality of life due to weight gain from excessive hunger and lack of satiety. A trial of triiodothyronine at age 9, and dextroamphetamine starting at age 13, in addition to lifestyle modification had had limited efficacy. She began treatment with liraglutide at age 21 with a starting body mass index of 35.3 kg/m2, and noted marked improvement in polyphagia, began to recognize satiety after meals, and was able to lose 20 pounds over 6 months. She felt remarkably well both physically and emotionally, and no adverse effects of the medication were noted. Weight reduction has been maintained over 27 months with liraglutide use. Conclusion Significant reduction in weight and recognition of satiety without adverse effects is noted in a young woman with HO with extended use of liraglutide. The use of glucagon-like peptide-1 analogs may represent attractive treatment options for treatment of HO.