Energy balance in hypothalamic obesity in response to treatment with a once-weekly GLP-1 receptor agonist

Background/Objectives Hypothalamic obesity (HO) frequently occurs following suprasellar tumors from a combination of decreased energy expenditure and increased energy intake. Glucagon-like peptide-1 receptor agonist (GLP1RA) therapy is associated with increased satiety and energy expenditure. We hyp...

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Bibliographic Details
Published in:International Journal of Obesity 2022-03, Vol.46 (3), p.623-629
Main Authors: Shoemaker, Ashley H., Silver, Heidi J., Buchowski, Maciej, Slaughter, James C., Yanovski, Jack A., Elfers, Clinton, Roth, Christian L., Abuzzahab, M. Jennifer
Format: Article
Language:English
Subjects:
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Adolescent
Adult
Agonists
Body composition
Body fat
Child
Energy
Energy balance
Energy expenditure
Energy Intake
Energy Metabolism
Epidemiology
Exenatide - therapeutic use
Food intake
GLP-1 receptor agonists
Glucagon
Glucagon-like peptide 1
Glucagon-Like Peptide-1 Receptor - agonists
Health Promotion and Disease Prevention
Humans
Hypothalamus
Internal Medicine
Leptin
Medicine
Medicine & Public Health
Metabolic Diseases
Obesity
Obesity - complications
Obesity - drug therapy
Patients
Physical activity
Placebos
Public Health
Receptors
Satiety
Tumors
Young Adult
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Summary:Background/Objectives Hypothalamic obesity (HO) frequently occurs following suprasellar tumors from a combination of decreased energy expenditure and increased energy intake. Glucagon-like peptide-1 receptor agonist (GLP1RA) therapy is associated with increased satiety and energy expenditure. We hypothesized GLP1RA therapy in patients with HO would cause both lower energy intake and increased energy expenditure. Subjects/Methods Forty-two patients aged 10-26 years (median 16 years) with HO with suprasellar tumors were randomized to GLP1RA (exenatide extended release once-weekly, ExQW, n  = 23) or placebo ( n  = 19). Thirty seven (81%) patients completed the 36-week double-blind placebo-controlled trial. Total energy expenditure (TEE) was measured with doubly labeled water, physical activity was assessed with actigraphy, and intake was estimated with ad libitum buffet meal. Results are presented as adjusted mean between-group difference. Results As compared with treatment with placebo, treatment with ExQW was associated with decreased energy intake during a buffet meal (−1800 kJ (−430 kcal), 95% CI −3 184 to −418 kJ, p  = 0.02). There were no significant differences in physical activity between groups. ExQW (vs. placebo) treatment was associated with a decrease in TEE (−695 kJ/day (−166 kcal/day), 95% CI −1 130 to −264 kJ/day, p  
ISSN:0307-0565
1476-5497
DOI:10.1038/s41366-021-01043-6