Hypothalamic Obesity

checkorphan

Synonyms

HyOb,

Overview

Hypothalamic obesity (HyOb) is a complicated medical condition. It can happen from the growth of rare brain tumors. It can also happen from other types of injury to the hypothalamus. Craniopharyngioma (krā’nē-ō-fə-rĭn’jē-ō’ma) is one of the tumors that can cause HyOb.

When the hypothalamus is injured, the brain and the gut have a hard time understanding each other’s signals. The brain cannot “hear” the messages from the body fat, trying to tell the brain to turn off hunger. This mix up in the brain leaves the person always feeling hungry. Because the person is hungry, they will eat more and more. The body will store the extra energy from the food as fat. This can cause one to two pounds of weight gain a week.

As more and more weight is gained, the body begins to store fat in places that it usually does not, like muscles, the liver, and in and around other important organs in the belly. This can make it hard for these important organs to work right and it can harm the person’s health.

Symptoms

Besides the feeling of non-stop hunger, the person may feel short-tempered or grouchy because the body makes more insulin.

Signs and symptoms include:

  • Rapid weight gain.
  • Uncontrollable hunger.
  • Low metabolic rate (how your body burns calories and stores fat).
  • Gaining weight despite limiting calories or food intake.
  • Being tired or having insomnia.
  • Having a limited ability to do physical activities (exercise intolerance).

Causes

Damage, trauma or injury to your hypothalamus causes the condition. Because your hypothalamus regulates your appetite and affects how you burn calories and store fat, damage to it can lead to weight gain.

Some of the specific causes are:

  • Tumors like craniopharyngiomas, gliomas, hamartomas and pituitary adenomas. It can be from the tumor itself or from complications of removing the tumor. A craniopharyngioma causes over half of all cases of HyOb.
  • Brain injuries like bleeding, infection or swelling (for example, from a car accident or a fall).
  • Genetic conditions like Prader-Willi syndrome or being born with hypothalamic dysfunction.

Everyone reacts differently to HyOb. You might always be hungry, despite eating appropriately sized meals and snacks. You may gain weight even when you reduce how much food you eat and increase how often you exercise.

Prevention

No, you can’t prevent it because things like injuries, trauma or a tumor cause it. But you can take steps to reduce your risk by:

  • Wearing a helmet and protecting your head to avoid brain injuries.
  • Getting routine medical care. Seeing a healthcare provider regularly is a great way to detect health condition

Diagnosis

A healthcare provider will review your symptoms, perform a physical exam and ask you for your medical history. They may suspect HyOb if you tell them you haven’t been able to lose weight with lifestyle changes like getting exercise and eating healthy. Your provider may ask you if you’ve had any head injuries.

Then, they’ll order:

  • Blood tests to check hormone levels: Irregular levels of certain hormones may point to hypothalamus damage.
  • Imaging tests of your brain: A CT scan (computed tomography scan) can check for signs of brain damage. This is especially important if you’ve recently been in an accident or experienced head trauma.

Prognosis

Having hypothalamic obesity can be extremely challenging. There’s no treatment for it, so it often involves working closely with your healthcare team to find different ways to manage your symptoms and improve your quality of life. It can be frustrating to try traditional treatments for obesity, only to find that they don’t work. Know that your symptoms aren’t happening due to something you did or didn’t do. Work closely with your healthcare providers to find the support you need, even if that support includes talking to a psychologist about ways to cope.

Treatment

Some medications have been used with some success with hypothalamic obesity.

Gastric bypass surgery has also been found to help with weight loss and managing hunger in people with hypothalamic obesity.

After surgery, the person loses weight. The body makes less insulin. The constant feelings of hunger are under better control.

Weight loss surgery is not the best option for everyone. It is recommended only after all other weight-loss plans have failed.