Recognizing Acquired HO

Early identification and proactive intervention can help patients

Screening for acquired HO is critical in cases of hypothalamic injury

Many patients may not be aware of acquired hypothalamic obesity (HO) as a risk following hypothalamic injury or may only be focused on other post-treatment concerns.1
Talk to your patients about signs and symptoms.

Clinical Diagnosis2-7

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A clinical diagnosis of acquired HO is characterized by accelerated and sustained weight gain, most often within the initial 6 to 12 months following injury to the hypothalamus.

Variable Presentation3,8

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Acquired HO can have variable time to onset and progression of weight gain due to type, location, and extent of hypothalamic injury.

Confounding Factors9

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Recognizing acquired HO may be confounded by temporary weight gain from medications or hormone replacements.

Identifying acquired HO

Minimize diagnostic delays due to competing medical needs or other confounding factors. Stay alert for signs that could indicate acquired HO at different stages.3,10
Screen All Patients3,10–13

Screen patients with a history of hypothalamic injury, including from:

  • Brain tumors
  • Brain tumor treatment
  • Traumatic brain injuries
  • Stroke
Monitor Proactively In New Patients3,10–12

Early signs and symptoms that can help identify patients with acquired HO include:

  • Accelerated and sustained weight gain, even in the absence of increased caloric intake
  • Increased hunger or hyperphagia
  • Decreased physical activity
  • Increased levels of fatigue or daytime sleepiness
Follow Up With Existing Patients2,3,14

Patients with a past brain injury may:

Experience persistent obesity that is resistant to calorie restriction, exercise, or other weight loss interventions.

Make a decisive diagnosis. Find resources and get more information.

Managing acquired HO

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Diet

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Exercise

Pharmacotherapies icon

Anti-obesity medications

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Bariatric surgery

There is a critical need to recognize the urgency to diagnose and manage acquired HO due to its impact on patients and families.2,7,10,15–17

Patients may experience short-term weight loss with:

  • Lifestyle modifications
  • Anti-obesity medications
  • Surgery

However, these approaches have shown limited efficacy in producing sustained results in acquired HO.2–7,18

While acquired HO can be challenging to manage, early identification and proactive intervention may help to slow the progression of weight gain and help patients better understand their disease.2,7,13,19

Join a searchable directory of healthcare professionals who treat acquired HO. Register Here

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Currently there is no FDA-approved treatment specifically indicated for acquired HO.1,7,9

Educational support for acquired HO

Many patients may be unprepared for the impact of acquired HO. Accessing tailored informational resources and one-on-one education can make a meaningful difference.

Acquired HO Resources

Sign up to receive educational resources for your patients and practice, as well as the latest updates about acquired HO.

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Personalized one-on-one educational support* for your patients living with acquired HO

Rhythm InTune provides educational resources, wellness tips, and connection to a community for people living with acquired HO

Patient Education Managers are employees of Rhythm Pharmaceuticals and do not provide medical care or advice. We encourage patients to always speak to their healthcare providers regarding their medical care.

References
  1. Roth CL, Zenno A. Treatment of hypothalamic obesity in people with hypothalamic injury: new drugs are on the horizon. Front Endocrinol (Lausanne). 2023 Sep 13;14:1256514. doi:10.3389/fendo.2023.1256514.23
  2. Abuzzahab MJ, Roth CL, Shoemaker AH. Hypothalamic obesity: prologue and promise. Horm Res Paediatr. 2019;91(2):128-136. doi:10.1159/000496564
  3. Roth CL. Hypothalamic obesity in craniopharyngioma patients: disturbed energy homeostasis related to extent of hypothalamic damage and its implication for obesity intervention. J Clin Med. 2015;4(9):1774-1797. Published 2015 Sep 9. doi:10.3390/jcm4091774
  4. Rosenfeld A, Arrington D, Miller J, et al. A review of childhood and adolescent craniopharyngiomas with particular attention to hypothalamic obesity. Pediatr Neurol. 2014;50(1):4-10. doi:10.1016/j.pediatrneurol.2013.09.003
  5. Lustig RH. Hypothalamic obesity after craniopharyngioma: mechanisms, diagnosis, and treatment. Front Endocrinol (Lausanne). 2011 Nov 3;2:60. doi:10.3389/fendo.2011.00060
  6. Van Roessel IMAA, Van Den Brink M, Dekker J, Ruitenburg-van Essen BG, Tissing WJE, van Santen HM. Feasibility, safety, and efficacy of dietary or lifestyle interventions for hypothalamic obesity: a systematic review. Clin Nutr. 2024;43(8):1798-1811. doi:10.1016/j.clnu.2024.05.028
  7. van Iersel L, Brokke KE, Adan RAH, Bulthuis LCM, van den Akker ELT, van Santen HM. Pathophysiology and individualized treatment of hypothalamic obesity following craniopharyngioma and other suprasellar tumors: a systematic review. Endocr Rev. 2019;40(1):193-235. doi:10.1210/er.2018-00017
  8. Müller HL. Craniopharyngioma and hypothalamic injury: latest insights into consequent eating disorders and obesity. Curr Opin Endocrinol Diabetes Obes. 2016;23(1):81-89. doi:10.1097/MED.0000000000000214
  9. Shoemaker AH, Tamaroff J. Approach to the patient with hypothalamic obesity. J Clin Endocrinol Metab. 2023;108(5):1236-1242. doi:10.1210/clinem/dgac678
  10. Kayadjanian N, Hsu EA, Wood AM, Carson DS. Caregiver burden and its relationship to health-related quality of life in craniopharyngioma survivors. J Clin Endocrinol Metab. 2023;109(1):e76-e87. doi:10.1210/clinem/dgad488
  11. van Santen HM, van Schaik J, van Roessel IMAA, Beckhaus J, Boekhoff S, Müller HL. Diagnostic criteria for the hypothalamic syndrome in childhood. Eur J Endocrinol. 2023;188(2):lvad009. doi:10.1093/ejendo/lvad009
  12. Kim RJ, Shah R, Tershakovec AM, et al. Energy expenditure in obesity associated with craniopharyngioma. Childs Nerv Syst. 2010;26(7):913-917. doi:10.1007/s00381-009-1078-1
  13. Rose SR, Horne VE, Bingham N, Jenkins T, Black J, Inge T. Hypothalamic obesity: 4 years of the International Registry of Hypothalamic Obesity Disorders. Obesity (Silver Spring). 2018;26(11):1727-1732. doi:10.1002/oby.22315
  14. Haliloglu B, Bereket A. Hypothalamic obesity in children: pathophysiology to clinical management. J Pediatr Endocrinol Metab. 2015;28(5-6):503-513. doi:10.1515/jpem-2014-0512
  15. Bereket A. Postoperative and long-term endocrinologic complications of craniopharyngioma. Horm Res Paediatr. 2020;93(9-10):497-509. doi:10.1159/000515347
  16. Craven M, Crowley JH, Chiang L, et al. A survey of patient-relevant outcomes in pediatric craniopharyngioma: focus on hypothalamic obesity. Front Endocrinol (Lausanne). 2022;13:876770. Published May 9, 2022. doi:10.3389/fendo.2022.876770
  17. Roth CL, Eslamy H, Werny D, et al. Semiquantitative analysis of hypothalamic damage on MRI predicts risk for hypothalamic obesity. Obesity (Silver Spring). 2015;23(6):1226-1233. doi:10.1002/oby.21067
  18. Dimitri P. Treatment of acquired hypothalamic obesity: now and the future. Front Endocrinol (Lausanne). 2022;13:846880. Published 2022 Apr 6. doi:10.3389/fendo.2022.846880
  19. Dogra P, Bedatsova L, Van Gompel JJ, Giannini C, Donegan DM, Erickson D. Long-term outcomes in patients with adult-onset craniopharyngioma. Endocrine. 2022;78(1):123-134. doi:10.1007/s12020-022-03134-4