Endocrine Abstracts

Introduction:: The hypothalamus is intimately involved in weight homeostasis. Pituitary tumours and treatment for pituitary tumours has been well described to induce obesity in certain subjects presumably due hypothalamic irritation or dysfunction. This is often very challenging to treat.

GLP-1 analogues have direct central effects and have been shown to be effective for weight loss in obese patients with and without diabetes mellitus.

Aims: To perform a pilot study to look at the effectiveness of GLP-1 treatment in patients with hypothalamic obesity secondary to pituitary pathology.

Method: We treated six patients and looked at weight loss, tolerability and safety.

Results: six patients received GLP-1 analogue. three had pre-existing type 2 diabetes mellitus. Mean age of the subjects was 49±8.8 years. Mean BMI was 45.3±11.7 kg/m². All patients but one had pituitary surgery for various pituitary tumours. All patients had a large increase in body weight following the development or treatment of pituitary pathology four patients had liraglutide and two had exanatide. Duration of treatment ranges from 2 months to 47 months. Net weight loss ranges from −4.7 to −16.6 kg. An average weight loss was 8.5 kg per subject over a variable duration of treatment. All subjects tolerated GLP-1 analogue well. In those subjects who had diabetes mellitus, all subjects were well controlled prior to GLP-1 intiation (HbA1c 53 mmol/mol) and this did not change

Discussion: To our knowledge, the use of GLP-1 analogue in patients with pituitary pathology and hypothalamic obesity has not been reported before. Our experience showed that GLP-1 analogues are not only effective but also clinically safe in managing obesity in pituitary patients with or without diabetes mellitus. Further research into the use of GLP-1 analogue in pituitary patients may be useful.