Hypothalamic obesity in pediatric vs. adult craniopharyngioma: mechanisms, management, and cardiometabolic outcomes
Authors' conclusion
HO following CP shows distinct age-dependent trajectories in prevalence, underlying mechanisms, and clinical course; suggested age-related differences in treatment response remain to be confirmed in direct comparative studies.
Study context
- Population
- Craniopharyngioma (CP) survivors with hypothalamic obesity (HO)
- Comparison
- Pediatric vs adult-onset CP
- Outcome
- Obesity prevalence, pre- to post-treatment
Methodological detailsstudies published 2000–2025
- Studies published 2000–2025
Main finding
As reported in the abstract
Pediatric
5.7% pre-treatment to 57% post-treatment
Adult
19.2% to 29.2%
Further findings
| Outcome | Values |
|---|---|
| 5-year weight loss after SG, CP vs non-CP controls | CP 21.7% · Non-CP controls 21.8% |
| Weight loss after RYGB, CP vs controls · 5 years | CP 22.7% · Controls 32.0% |
Weight loss with GLP-1 RA (exenatide, semaglutide), small case series · 6 months
- Weight loss up to 17% with semaglutide
- RCTs did not meet primary weight outcomes; direct pediatric vs adult comparisons lacking
Weight loss after RYGB, CP vs controls · 5 years
- RYGB less effective than in controls
Long-term cardiometabolic risks
- All-cause mortality in adults
- 2.2-fold higher
- Diabetes risk in adults
- 9.3-fold higher
- NAFLD in pediatric survivors
- 47%
- MASLD in adults
- 67.4%
- Insulin resistance in pediatric patients
- ≈30%
Original publication
Hypothalamic obesity in pediatric vs. adult craniopharyngioma: mechanisms, management, and cardiometabolic outcomes. Pituitary. Published 27 September 2026. doi:10.
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