A US Real-World Study of Weight Trajectory and Hypothalamic Damage Among Patients With Acquired Hypothalamic Obesity
Author(s)
Jacqueline Chan, MD1, Jieruo Liu, PhD2, Samy Gallienne, MA3, RALUCA IONESCU-ITTU, PhD3, USHA G. Mallya, MS, PhD2, Gauri Malthankar, PhD, BPharm2, Rachelle Haber, MS3, Sriram Machineni, MD4;
1University of Utah, Pediatric Endocrinology, Salt Lake City, UT, USA, 2Rhythm Pharmaceuticals, boston, MA, USA, 3STATLOG Inc, Montreal, QC, Canada, 4Albert Einstein College of Medicine, Bronx, NY, USA
1University of Utah, Pediatric Endocrinology, Salt Lake City, UT, USA, 2Rhythm Pharmaceuticals, boston, MA, USA, 3STATLOG Inc, Montreal, QC, Canada, 4Albert Einstein College of Medicine, Bronx, NY, USA
Presentation Documents
OBJECTIVES: Acquired Hypothalamic Obesity (aHO) is a rare form of obesity characterized by accelerated and sustained weight gain following damage to the hypothalamus. Classically injury occurs due to the presence of a tumor and/or the associated treatment. Other forms of hypothalamic injury leading to aHO such as traumatic brain injury or stroke are less commonly reported. We aim to assess patient characteristics and causes of the hypothalamic injury in adult patients with aHO in a real-world setting.
METHODS: A large US-based claims/electronic medical records database (2010-2023) was utilized in selecting patients with clinical evidence of brain tumor/trauma related hypothalamic insult (potentially resulting in hypothalamic damage) followed by accelerated weight gain.
RESULTS: Ninety-four adult aHO patients were identified (mean age [standard deviation] 46.2 [13.2] years; 56% female and 68% white). Forty-nine had tumor-related aHO (22%, 59% and 37% had craniopharyngeal, pituitary gland or other non-specific tumor respectively [not mutually exclusive] with majority tumors treated surgically) and 45 trauma-related aHO. Almost half of the patients (n=46) had a BMI below 30 around the time of hypothalamic insult. Within 12-months of hypothalamic insult, patients had a mean BMI increase of 5.2 (16% increase from 32.2 to 37.4) and patients with normal/underweight pre-insult BMI, trauma-related aHO, or radiation treated tumor-related aHO showed the highest BMI increases of 6.3 , 6.5 or 6.7 points respectively. Weight gains were also observed beyond 12-month period. Hypertension (48%), pituitary dysfunction (31%), visual impairment (35%), depression (33%) and fatigue (29%) were the most common comorbidities prior to hypothalamic insult.
CONCLUSIONS: This is the first US real-world research characterizing the weight gain trajectory post hypothermic insult among tumor- and trauma-related adult aHO patients. The significantly higher frequency of trauma related injury leading to aHO as compared to the reported literature suggests this population may be unrecognized and likely underdiagnosed.
METHODS: A large US-based claims/electronic medical records database (2010-2023) was utilized in selecting patients with clinical evidence of brain tumor/trauma related hypothalamic insult (potentially resulting in hypothalamic damage) followed by accelerated weight gain.
RESULTS: Ninety-four adult aHO patients were identified (mean age [standard deviation] 46.2 [13.2] years; 56% female and 68% white). Forty-nine had tumor-related aHO (22%, 59% and 37% had craniopharyngeal, pituitary gland or other non-specific tumor respectively [not mutually exclusive] with majority tumors treated surgically) and 45 trauma-related aHO. Almost half of the patients (n=46) had a BMI below 30 around the time of hypothalamic insult. Within 12-months of hypothalamic insult, patients had a mean BMI increase of 5.2 (16% increase from 32.2 to 37.4) and patients with normal/underweight pre-insult BMI, trauma-related aHO, or radiation treated tumor-related aHO showed the highest BMI increases of 6.3 , 6.5 or 6.7 points respectively. Weight gains were also observed beyond 12-month period. Hypertension (48%), pituitary dysfunction (31%), visual impairment (35%), depression (33%) and fatigue (29%) were the most common comorbidities prior to hypothalamic insult.
CONCLUSIONS: This is the first US real-world research characterizing the weight gain trajectory post hypothermic insult among tumor- and trauma-related adult aHO patients. The significantly higher frequency of trauma related injury leading to aHO as compared to the reported literature suggests this population may be unrecognized and likely underdiagnosed.
Conference/Value in Health Info
2025-05, ISPOR 2025, Montréal, Quebec, CA
Value in Health, Volume 28, Issue S1
Code
RWD153
Topic
Real World Data & Information Systems
Topic Subcategory
Health & Insurance Records Systems
Disease
SDC: Diabetes/Endocrine/Metabolic Disorders (including obesity), SDC: Injury & Trauma, SDC: Oncology, SDC: Rare & Orphan Diseases