Pathophysiological mechanisms, clinical manifestations, and methods of therapy of hypothalamic obesity

The authors present the current literature data concerning pathogenesis and clinical manifestations of hypothalamic obesity along with methods of its treatment. Lesions in the hypothalamus associated with infiltrative processes, neoplastic growth, and consequences of medical interventions not infrequently lead to the development of obesity characterized by the rapid gain of body weight. The major factor contributing to this increase is the compromised function of the regulatory hypothalamic centres controlling the sense of hunger and satiation and the energy balance. This dysregulation is responsible for hyperphagia, vegetative disorders, reduced energy expenditure, and hyperinsulinemia. It is extremely difficult to control the body weight only by adhering to diet guidelines and altering the lifestyle. The weight-losing efficacy of the present-day pharmacotherapy targeted for modulation of insulin secretion and activation of sympathetic nervous system is rather low and does not ensure the desired prevention of the weight gain. More detailed information about the risk factors and pathogenetic mechanisms of hypothalamic obesity is needed to develop efficacious therapeutic strategies for the treatment of this condition.