Is my rapid weight gain due to hypothalamic damage?

Question

Hello doctor,

I had brain surgery three years ago to remove a large tumor near my hypothalamus. Since the surgery, I have gained 95 pounds rapidly despite dieting and exercising. The weight gain is uncontrollable, mostly in my stomach and trunk.

I am constantly hungry with intense food cravings day and night, and never feel full no matter how much I eat. I am also exhausted, weak, and cold all the time; severely constipated; and unable to concentrate; and my periods have stopped.

The rapid weight gain is ruining my health, mobility, self-esteem, and life. I am now developing high blood pressure and prediabetes. My thyroid, cortisol, and growth hormone levels are all low.

Could the brain surgery and tumor damage be causing this obesity?
What is hypothalamic obesity?
How is it different from regular obesity?
Why can I not lose weight no matter what I do?
Is this permanent?
What hormones are affected?
Do I need hormone replacement?
What medications suppress appetite in this condition?
What about weight loss drugs?
Would bariatric surgery work for me?
Is this type of obesity treatable?
What is my prognosis?
Will I keep gaining weight?
Can this be reversed?
Are there specialists who can help?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

Craniopharyngioma is a tumor of the pituitary gland in the brain. Usually, during tumor removal, the hypothalamus, which is connected to the pituitary, is damaged, and this damage can be short-term or even temporary.

As a result, there is improper regulation and release of hormones from the pituitary, leading to deranged levels of insulin, growth hormone, and other hormones in the body. It also leads to symptoms such as excess hunger and excessive weight gain, which is called hypothalamic obesity. There are multiple hormonal deficiencies.

Treatment is generally symptomatic and aims to improve diet and lifestyle, along with medicines to address hormonal deficiencies. Medicines like GLP1 (glucagon-like peptide) analogues can be used long-term to enhance satiety and help with obesity.

FDA (Food and Drug Administration)-approved newer drugs are also available. You can discuss these with your treating physician. It is essential to monitor hormone levels regularly and adjust medications as needed. This is how doctors also monitor your progress.

Fertility again depends on your hormone levels. You may share the recent hormone panel report that your doctor ordered.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.