Recognizing BBS

The importance of early diagnosis for people living with BBS

People with early-onset obesity due to BBS are at risk of long-term health complications1

Recognizing Bardet-Biedl syndrome (BBS) icon

Identifying the type of obesity in your patient can:

  • Help you determine the optimal management of their specific disease2
  • Reduce the cumulative impact of their obesity, especially if diagnosed early1,3
  • Bring a sense of relief to patients4

People living with Bardet-Biedl syndrome (BBS) and their families often gain a sense of relief in knowing there is an underlying cause of their symptoms unrelated to environmental and lifestyle factors.

Early identification allows patients and families to plan, prepare, and better manage their disease.2.5

Diagnosing BBS

BBS is a ciliopathy with a highly variable phenotype and clinical features that vary greatly across individuals and evolve over time. Some features may present more mildly or slowly depending on gene variant and other factors.2,6–9

See full list of symptoms

Boy sitting under a table and eating at a birthday party. Actor portrayal.
Actor portrayal

Recognizing BBS in Children

  • Due to the progressive onset of clinical symptoms, patients may not meet the diagnostic criteria early in life, leading to a potential delay in diagnosis10
  • Therefore, genetic testing may play a critical diagnostic role in young children10

Diagnosing patients as early as possible is key to reducing their weight gain trajectory and managing associated obesity outcomes. It may also help reduce the burden of hyperphagia.10

Man lying in a bed. Actor portrayal.
Actor portrayal

Recognizing BBS in Adults

Many people over 30 with BBS may not have been diagnosed as children due to the following limitations11,12:

  • Clinical diagnosis: Clinical diagnosis criteria were newly defined when they were children. Clinical recognition of the syndrome also remains low due to variability in phenotypical presentation10
  • Genetic confirmation: In 1999, only 4 of the current BBS genes had been identified. Also, there has been historically low genetic-testing utilization due to a lack of availability, insurance coverage, and treatment for BBS9,11

It is important to recognize the symptoms of BBS in adults to ensure they are diagnosed appropriately.

Genetic testing can be integrated into the overall clinical assessment of the patient and does not equate to a diagnosis on its own.

Additionally, variant interpretation may change over time as the information about the genetics of BBS continues to evolve.

Uncovering Rare Obesity icon
Genetic testing through the Uncovering Rare Obesity® program is available for eligible patients.

UncoveringRareObesity.com

Get connected. Find resources and get more information.

Managing obesity and hyperphagia due to BBS

Patients may experience short-term weight loss with some interventions, but these approaches have shown limited efficacy in producing sustained results as they do not address the underlying pathophysiology.7,12,13

Diet & Behavior Modifications14,15

Diet behavior icon

Diet and exercise may have little impact for people living with a rare genetic disease that causes obesity, like BBS

Pharmacotherapies2,16

Pharmacotherapies icon

The goal of treatment for obesity due to BBS should be individualized and tailored to each patient and address the underlying cause

Bariatric Surgery14,17

Bariatric surgery icon

There is a lack of robust, long-term efficacy of bariatric surgery in people living with BBS. Significantly, they may not be considered suitable candidates due to common features such as hyperphagia or cognitive impairment

Find out about a treatment option for obesity due to BBS.

Learn more

Support for BBS

Patients living with BBS may not understand the full impact of their disease, so informational resources and one-on-one education can make a meaningful difference.

BBS Resources

MC4R pathway video thumbnail

MC4R pathway video Watch the role of the MC4R pathway in BBS

Amy, a caregiver of a child living with Bardet-Biedl syndrome (BBS)

Amy and Alex’s Story View Amy and her children’s life with BBS

Child with glasses glueing on paper

Olivia, Adalissa, and Solomon’s Story Hear from Olivia, a mother to Adalissa and Solomon who are living with BBS

Leigh and Izzy’s Story video

Leigh and Izzy’s Story Watch Leigh and Izzy’s story of what living with BBS is like

Sign up to receive educational resources for your patients and practice, as well as updates about BBS.

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

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

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. Hampl SE, Hassink SG, Skinner AC, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics. 2023;151(2):e2022060640. doi:10.1542/peds.2022-060640
  2. Eneli I, Xu J, Webster M, et al. Tracing the effect of the melanocortin-4 receptor pathway in obesity: study design and methodology of the TEMPO registry. Appl Clin Genet. 2019 Jun 5;12:87-93. doi:10.2147/TACG.S199092
  3. Manara E, Paolacci S, D'Esposito F, et al. Mutation profile of BBS genes in patients with Bardet-Biedl syndrome: an Italian study. Ital J Pediatr. 2019;45(1):72. Published 2019 Jun 13. doi:10.1186/s13052-019-0659-1
  4. Phillips C, Parkinson A, Namsrai T, et al. Time to diagnosis for a rare disease: managing medical uncertainty: a qualitative study. Orphanet J Rare Dis. 2024;19(1):297. Published 2024 Aug 14. doi:10.1186/s13023-024-03319-2
  5. Forsythe E, Mallya UG, Yang M, et al. Burden of hyperphagia and obesity in Bardet–Biedl syndrome: a multicountry survey. Orphanet J Rare Dis. 2023 Jan 16;18(1):12. doi:10.1186/s13023-023-02723-4
  6. Blaess S, Wachten D. The BBSome: a nexus controlling energy metabolism in the brain. J Clin Invest. 2021;131(8):e148903. doi:10.1172/JCI148903
  7. Forsythe E, Kenny J, Bacchelli C, et al. Managing Bardet-Biedl syndrome–now and in the future. Front Pediatr. 2018;6:23. doi:10.3389/fped.2018.00023
  8. Florea L, Caba L, Gorduza EV. Bardet-Biedl syndrome–multiple kaleidoscope images: insight into mechanisms of genotype-phenotype correlations. Genes (Basel). 2021;12(9):1353. doi:10.3390/genes12091353
  9. Beales PL, Elcioglu N, Woolf AS, Parker D, Flinter FA. New criteria for improved diagnosis of Bardet-Biedl syndrome: results of a population survey. J Med Genet. 1999;36(6):437-446.
  10. Van Roy N, Heerwegh S, Husein D, Ruys J, Coremans P. A diagnostic conundrum in Bardet-Biedl syndrome: when genetic diagnosis precedes clinical diagnosis. Endocrinol Diabetes Metab Case Rep. 2023;2023(4):23-0055. Published 2023 Nov 24. doi:10.1530/EDM-23-0055
  11. Suspitsin EN, Imyanitov EN. Bardet-Biedl syndrome. Mol Syndromol. 2016;7(2):62-71. doi:10.1159/000445491
  12. Ganawa S, Santhosh SH, Parry L, Syed AA. Weight loss with glucagon-like peptide-1 receptor agonists in Bardet-Biedl syndrome. Clin Obes. 2022;12(5):e12546. doi:10.1111/cob.12546
  13. 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
  14. Huvenne H, Dubern B, Clément K, Poitou C. Rare genetic forms of obesity: clinical approach and current treatments in 2016. Obes Facts. 2016;9(3):158-173. doi:10.1159/000445061 
  15. Poitou C, Mosbah H, Clément K. Mechanisms in endocrinology: update on treatments for patients with genetic obesity. Eur J Endocrinol. 2020;183(5):R149-R166. doi:10.1530/EJE-20-0363
  16. Kenny J, Forsythe E, Beales P, Bacchelli C. Toward personalized medicine in Bardet-Biedl syndrome. Per Med. 2017;14(5):447-456. doi:10.2217/pme-2017-0019
  17. Vos N, Oussaada SM, Cooiman MI, et al. Bariatric surgery for monogenic non-syndromic and syndromic obesity disorders. Curr Diab Rep. 2020;20(9):44. Published 2020 Jul 30. doi:10.1007/s11892-020-01327-7