Semaglutide treatment of hypothalamic obesity – a real-life data study

Abstract

Purpose Patients with tumors involving the hypothalamic region are at high risk of developing morbid obesity due to disturbances in the appetite regulative nuclei in hypothalamus. We evaluated the effect of Glucagon-like peptide 1 (GLP-1) analogue treatment in patients with hypothalamic obesity.Methods We recorded weight changes from real-time data before and after treatment with the GLP-1 analogue semaglutide in patients hypothalamic obesity from our outpatient clinic at the Department of Endocrinology at Rigshospitalet, from September 2020 to November 2023.Results A total of 26 patients were included in this study (15 females, median age at initiation of semaglutide was 52 (18–65) years). Body weight at initial diagnosis was median 80 kg (range 50–140) while body weight at initiation of semaglutide was median 116 kg (range 76–175). All but one patient lost weight during semaglutide treatment with a mean weight loss of 12.5 kg (95% CI 8.4–16.5 kg, p = < 0.001) after one year (median 11.4 months) with an average dosage of semaglutide of 1.6 mg (range 0.5–2.5). There was no significant difference in weight loss between patients previously treated with liraglutide and patients naïve to GLP-1 analogues (p = 0.35). Fifteen patients (58%) lost more than 10% and 2 patients (8%) lost more than 20% of initial body weight, respectively.Conclusion Treatment with semaglutide shows promising results in reducing body weight in patients with acquired hypothalamic obesity. Whether the weight reduction remains stable after long time follow-up needs further investigation.