The Effect of Treatment With Octreotide on the Nutritional Status of a Patient With Hypothalamic Obesity Associated With Brain Tumors and/or Cranial Irradiation

Abstract

LEARNING OUTCOME: To evaluate nutritional status during weight loss treatment with octreotide. Approximately half of all survivors of brain tumors and acute lymphocytic leukemia who have undergone cranial irradiation become obese. It is postulated that the obesity is due to damage to the hypothalamus. This study examined the effect of weight loss treatment with octreotide, a somatostatin analog, on the nutritional status of a patient with hypothalamic obesity associated with a brain tumor and/or cranial irradiation using a prospective, single-subject, experimental design. The subject was selected based upon meeting several criteria indicative of hypothalamic obesity and placed on octreotide for 6 months. Monthly measurements of weight, body mass index, fat and lean body mass using bioelectrical impedance analysis, and serum albumin levels were obtained to assess nutritional status. A weight loss of approximately 2% per month was seen with a corresponding decrease in body mass index. Serum albumin levels remained stable within the normal range during treatment. Bioelectrical impedance analysis revealed a loss of both fat and lean body mass within safe ranges. This study indicates that octreotide may be a safe and effective treatment for hypothalamic obesity. However, there is need for further research using a more comprehensive, randomized, placebo-controlled trial with appropriate size and power.