Metabolic consequences: Obesity and energy expenditure, can they be treated?

Obesity and hypopituitarism are major side effects of craniopharyngiomas. Awareness of the presence of obesity and/or food-seeking behavior in patients affected by acquired pathologic processes damaging the hypothalamic centers is highly recommended. The craniopharyngiomas cause structural damage to the hypothalamus before or, more often, after surgery. These tumors may occur at any age but are more common in childhood and adolescence. Obesity may often appear before any therapeutic approach is attempted. Obesity and hyperphagia as a consequence of surgical or radiotherapy treatment must be managed with particular care. This chapter will try to highlight the potential medical and surgical treatments to limit obesity, hyperphagia, and alterations in energy expenditure often described in patients affected by craniopharyngioma, elucidating at the same time the mechanisms by which all these metabolic alterations may occur.