Bariatric Surgery for Hypothalamic Obesity in Craniopharyngioma Patients: A Retrospective, Matched Case-Control Study

Selveta S. Van Santen, Peter Wolf, Natalia Kremenevski, Cesar L. Boguszewski, Hannes Beiglböck, Marta Fiocco, Mark Wijnen, Ville R. Wallenius, Marry M. Van Den Heuvel-Eibrink, Aart J. Van Der Lely, Gudmundur Johannsson, Anton Luger, Michael Krebs, Michael Buchfelder, Patric J.D. Delhanty, Sebastian J.C.M.M. Neggers, Daniel S. Olsson

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)


Context: Craniopharyngioma is a sellar tumor associated with high rates of pituitary deficiencies (∼98%) and hypothalamic obesity (∼50%). Objective: This work aims to determine the efficacy regarding long-term weight loss after bariatric surgery in obese craniopharyngioma patients with hypothalamic dysfunction. Methods: This retrospective, case-control, multicenter, international study included obese craniopharyngioma patients (N=16; of whom 12 are women) with a history of bariatric surgery (12 Roux-en-Y gastric bypass, 4 sleeve gastrectomy; median age 21 years [range, 15-52 years], median follow-up 5.2 years [range, 2.0-11.3 years]) and age/sex/surgery/body mass index-matched obese controls (N=155). Weight loss and obesity-related comorbidities up to 5 years after bariatric surgery were compared and changes in hormonal replacement therapy evaluated. Results: Mean weight loss at 5-year follow-up was 22.0% (95% CI, 16.1%-27.8%) in patients vs 29.5% (95% CI, 28.0%-30.9%) in controls (P=.02), which was less after Roux-en-Y gastric bypass (22.7% [16.9%-28.5%] vs 32.0% [30.4%-33.6%]; P=.003) but at a similar level after sleeve gastrectomy (21.7% [-1.8% to 45.2%] vs 21.8% [18.2%-25.5%]; P=.96). No major changes in endocrine replacement therapy were observed after surgery. One patient died (unknown cause). One patient had long-term absorptive problems. Conclusion: Obese patients with craniopharyngioma had a substantial mean weight loss of 22% at 5-year follow-up after bariatric surgery, independent of type of bariatric surgery procedure. Weight loss was lower than in obese controls after Roux-en-Y gastric bypass. Bariatric surgery appears to be effective and relatively safe in the treatment of obese craniopharyngioma patients.

Original languageEnglish
Pages (from-to)E4734-E4745
JournalJournal of Clinical Endocrinology and Metabolism
Issue number11
Publication statusPublished - 1 Nov 2021


  • bariatric surgery
  • case-control study
  • craniopharyngioma
  • hypothalamic dysfunction
  • hypothalamic obesity
  • weight loss


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