There are hundreds and thousands of reasons for weight gain. Each one of us has a different genetic makeup and we all have different life experiences. Please click here to see the 100 causes for weight gain. We will describe in detail each one of them. In this blog I will describe briefly about hypothalamic obesity. The number of people living with hypothalamic obesity is estimated to be around 20,000 in the U.S. However most of them remain undiagnosed.


What is hypothalamic obesity?

Hypothalamic obesity is a condition when people gain weight due to improper functioning of the hypothalamus.

The hypothalamus is small structure, located at the base of the brain, and it regulates many important functions of the body:

  • Produces releasing hormones which act on the pituitary gland
  • Controls appetite
  • Maintains fluid balance,
  • Controls body temperature
  • Regulates sleep cycles
  • Maintains metabolic rate.

Abnormal hypothalamic function can contribute to weight gain either by

  • Increasing appetite (Abnormal drive to eat more of hyperphagia)
  • Slow down metabolism and reduce energy consumption

In addition, sleep disturbance abnormal hormone production and fatigue can also contribute to weight gain.


Causes of Hypothalamic Obesity 

There are several reasons for hypothalamic dysfunction leading to obesity. Below are listed some of the causes:

  1. Brain tumour like craniopharyngioma
  2. Brain surgery
  3. Traumatic brain injury due to accidents
  4. Genetic disorders
  5. Radiotherapy to brain
  6. Infections
  7. Infiltration
  8. Loss of blood supply or infarction
  9. Increased pressure in the brain or hydrocephalus


Signs and Symptoms of Hypothalamic Obesity

Hypothalamic obesity should be suspected when there is rapid, sustained and excessive weight gain. A striking feature is excessive uncontrollable hunger and ability to eat large portions of food.  People with hypothalamic obesity fid innovative ways to get hold of food to satisfy their hunger.

In addition, they are less active and are noted to have day time sleepiness.

When hypothalamic obesity is due to brain injury or tumour pituitary function can also be altered. As pituitary controls the functioning of several organs including thyroid, testies, ovaries, thirst and steroid production. People with hypothalamic obesity may manifest problems with all these endocrine organs.

It is important to seek a consultation from an endocrinologist and investigated.


Is there any treatment for Hypothalamic Obesity?

In July 2021, the FDA granted orphan drug designation for an investigational therapy for the treatment of hypothalamic obesity. Tesomet (Saniona), is a fixed-dose combination therapy of tesofensine, a triple monoamine reuptake inhibitor, and metoprolol, a beta-1 selective blocker. It is the first and only investigational treatment for hypothalamic obesity to receive orphan drug designation.

Currently there are no approved medicines for hypothalamic obesity. Endocrinologist have been managing the symptoms and the underlying pituitary problems.

Participants in a 24-week randomised trial, who received Tesomet demonstrated significant reductions in body weight and improvements in waist circumference.


What is an Orphan drug?

Orphan drug designation is a special status granted by the Food and Drug Administration(FDA) to medicines and biologics intended for the treatment of rare diseases that affect fewer than 200,000 people in the U.S.

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