Hormonal
GLP-1 receptor agonists (specifically exenatide) reduce body fat and waist circumference in patients with hypothalamic obesity, with greater adiposity reduction observed in those with more extensive hypothalamic damage.
For patients with hypothalamic obesity, weekly exenatide injections (2 mg) can significantly reduce body fat and waist circumference, even if BMI changes are modest. This treatment is particularly effective for those with severe hypothalamic damage, likely because it works through brain pathways outside the damaged area. Side effects are mostly gastrointestinal.
Modest effects were seen on BMI reduction, while there was a significant reduction of body fat measured by DXA and waist circumference in the exenatide group vs placebo after 36 weeks... Patients with more extensive hypothalamic damage with involvement of the mammillary bodies showed greater reductions in adiposity following GLP1RA treatment
Why this rating
Based on a small multicenter randomized controlled trial (n=10-25 range implied, specific N not fully detailed in snippet but described as 'multicenter, randomized, double-blind, placebo-controlled clinical trial').
Source
Treatment of hypothalamic obesity in people with hypothalamic injury: new drugs are on the horizon
Christian L. Roth et al. · Frontiers in Endocrinology · 2023
DOI 10.3389/fendo.2023.1256514
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