Skip to main content
Article
Licensed
Unlicensed Requires Authentication

Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma

  • , , , and EMAIL logo
Published/Copyright: December 13, 2014
Journal of Pediatric Endocrinology and Metabolism
From the journal Journal of Pediatric Endocrinology and Metabolism Volume 28 Issue 1-2

Abstract

Background: As a result of hypothalamic involvement and/or treatment-related hypothalamic damage, up to 75% of childhood craniopharyngioma patients develop hypothalamic obesity.

Methods: Eating behavior was analyzed in 101 survivors of childhood craniopharyngioma, recruited from 1980 to 2001 in the HIT-Endo multicenter study, and in 85 body mass index (BMI)-matched healthy controls using the Inventory for Eating Behavior and Weight Problems (IEG) and the Inventory for Eating Disorders (ESI).

Results: Severely obese patients (BMI>8 SD; n=9) presented with pathological eating behavior, more weight problems, and eating disorders, as compared to obese (BMI 3–8 SD; n=44) and normal or overweight patients (BMI<3 SD; n=48). Craniopharyngioma patients with different degrees of obesity showed similar or even less pathological findings as compared to BMI-matched normal controls.

Conclusion: Severe obesity is associated with pathological eating behavior/disorders in craniopharyngioma patients. As these disorders are not disease-specific, risk factors for hypothalamic obesity should be the focus of further craniopharyngioma research.

Keywords: craniopharyngioma; eating behavior; eating disorders; growth hormone; hypothalamus; obesity
Corresponding author: Hermann L. Müller, MD, Department of Pediatrics, Zentrum für Kinder- und Jugendmedizin, Klinikum Oldenburg, Medical Campus University Oldenburg, Rahel-Straus-Strasse 10, 26133 Oldenburg, Germany, Phone: +49-441-4032013, Fax: +49-441-4032887, E-mail:
aH.L. Müller is supported by the German Childhood Cancer Foundation, Bonn, Germany.

References

1. Bunin GR, Surawicz TS, Witman PA, Preston-Martin S, Davis F, et al. The descriptive epidemiology of craniopharyngioma. J Neurosurg 1998;89:547–51.10.3171/jns.1998.89.4.0547Search in Google Scholar

2. Muller HL. Craniopharyngioma. Endocrine Rev 2014;35:513–43.10.1210/er.2013-1115Search in Google Scholar

3. Muller HL. Consequences of craniopharyngioma surgery in children. J Clin Endocrinol Metab 2011;96:1981–91.10.1210/jc.2011-0174Search in Google Scholar

4. Muller HL. Childhood craniopharyngioma – current concepts in diagnosis, therapy and follow-up. Nat Rev Endocrinol 2010;6:609–18.10.1038/nrendo.2010.168Search in Google Scholar

5. Bereket A, Kiess W, Lustig RH, Muller HL, Goldstone AP, et al. Hypothalamic obesity in children. Obesity Rev 2012;13:780–98.10.1111/j.1467-789X.2012.01004.xSearch in Google Scholar

6. Lustig RH. The neuroendocrinology of childhood obesity. Pediatr Clin North Am 2001;48:909–30.10.1016/S0031-3955(05)70348-5Search in Google Scholar

7. Muller HL, Gebhardt U, Faldum A, Warmuth-Metz M, Pietsch T, et al. Xanthogranuloma, Rathke’s cyst, and childhood craniopharyngioma: results of prospective multinational studies of children and adolescents with rare sellar malformations. J Clin Endocrinol Metab 2012;97:3935–43.10.1210/jc.2012-2069Search in Google Scholar PubMed

8. Muller HL, Gebhardt U, Teske C, Faldum A, Zwiener I, et al. Post-operative hypothalamic lesions and obesity in childhood craniopharyngioma: results of the multinational prospective trial KRANIOPHARYNGEOM 2000 after 3-year follow-up. Eur J Endocrinol 2011;165:17–24.10.1530/EJE-11-0158Search in Google Scholar PubMed

9. Puget S, Garnett M, Wray A, Grill J, Habrand JL, et al. Pediatric craniopharyngiomas: classification and treatment according to the degree of hypothalamic involvement. J Neurosurg 2007;106 (1 Suppl):3–12.10.3171/ped.2007.106.1.3Search in Google Scholar PubMed

10. Elowe-Gruau E, Beltrand J, Brauner R, Pinto G, Samara-Boustani D, et al. Childhood craniopharyngioma: hypothalamus-sparing surgery decreases the risk of obesity. J Clin Endocrinol Metab 2013;98:2376–82.10.1210/jc.2012-3928Search in Google Scholar PubMed

11. Harz KJ, Muller HL, Waldeck E, Pudel V, Roth C. Obesity in patients with craniopharyngioma: assessment of food intake and movement counts indicating physical activity. J Clin Endocrinol Metab 2003;88:5227–31.10.1210/jc.2002-021797Search in Google Scholar PubMed

12. Muller HL, Bueb K, Bartels U, Roth C, Harz K, et al. Obesity after childhood craniopharyngioma – German multicenter study on pre-operative risk factors and quality of life. Klin Padiatr 2001;213:244–9.10.1055/s-2001-16855Search in Google Scholar PubMed

13. Rolland-Cachera MF, Cole TJ, Sempe M, Tichet J, Rossignol C, et al. Body mass index variations: centiles from birth to 87 years. Eur J Clin Nutr 1991;45:13–21.Search in Google Scholar

14. Kersting M, Sichert-Hellert W, Vereecken CA, Diehl J, Beghin L, et al. Food and nutrient intake, nutritional knowledge and diet-related attitudes in European adolescents. Int J Obes (Lond). 2008;32(Suppl 5):S35–41.10.1038/ijo.2008.181Search in Google Scholar PubMed

15. Diehl JM. Inventar zum Essverhalten und Gewichtsproblemen IEG. Neue Normen. Fachbereich Psychologie (Abteilung Mmethodik). Giessen 2006 (ST-2006-B).Search in Google Scholar

16. Muller HL, Emser A, Faldum A, Bruhnken G, Etavard-Gorris N, et al. Longitudinal study on growth and body mass index before and after diagnosis of childhood craniopharyngioma. J Clin Endocrinol Metab 2004;89:3298–305.10.1210/jc.2003-031751Search in Google Scholar PubMed

17. Hoffman HJ, De Silva M, Humphreys RP, Drake JM, Smith ML, et al. Aggressive surgical management of craniopharyngiomas in children. J Neurosurg 1992;76:47–52.10.3171/jns.1992.76.1.0047Search in Google Scholar PubMed

18. Ahmet A, Blaser S, Stephens D, Guger S, Rutkas JT, et al. Weight gain in craniopharyngioma – a model for hypothalamic obesity. J Pediatr Endocrinol Metab 2006;19:121–7.10.1515/JPEM.2006.19.2.121Search in Google Scholar PubMed

19. Muller HL. Childhood craniopharyngioma. Recent advances in diagnosis, treatment and follow-up. Hormone Res 2008;69: 193–202.Search in Google Scholar

20. Poretti A, Grotzer MA, Ribi K, Schonle E, Boltshauser E. Outcome of craniopharyngioma in children: long-term complications and quality of life. Dev Med Child Neurol 2004;46:220–9.10.1111/j.1469-8749.2004.tb00476.xSearch in Google Scholar

21. Holmer H, Pozarek G, Wirfalt E, Popovic V, Ekman B, et al. Reduced energy expenditure and impaired feeding-related signals but not high energy intake reinforces hypothalamic obesity in adults with childhood onset craniopharyngioma. J Clin Endocrinol Metab 2010;95:5395–402.10.1210/jc.2010-0993Search in Google Scholar PubMed

22. O’Gorman CS, Simoneau-Roy J, Pencharz P, MacFarlane J, MacLusky I, et al. Sleep-disordered breathing is increased in obese adolescents with craniopharyngioma compared with obese controls. J Clin Endocrinol Metab 2010;95:2211–8.10.1210/jc.2009-2003Search in Google Scholar PubMed

23. Muller HL, Heinrich M, Bueb K, Etavard-Gorris N, Gebhardt U, et al. Perioperative dexamethasone treatment in childhood craniopharyngioma – influence on short-term and long-term weight gain. Exp Clin Endocr Diab 2003;111:330–4.10.1055/s-2003-42722Search in Google Scholar PubMed

24. Lek N, Prentice P, Williams RM, Ong KK, Burke GA, et al. Risk factors for obesity in childhood survivors of suprasellar brain tumours: a retrospective study. Acta Paediatr 2010;99:1522–6.10.1111/j.1651-2227.2010.01867.xSearch in Google Scholar PubMed

25. Srinivasan S, Ogle GD, Garnett SP, Briody JN, Lee JW, et al. Features of the metabolic syndrome after childhood craniopharyngioma. J Clin Endocrinol Metab 2004;89:81–6.10.1210/jc.2003-030442Search in Google Scholar PubMed

26. Elliott RE, Jane JA, Jr., Wisoff JH. Surgical management of craniopharyngiomas in children: meta-analysis and comparison of transcranial and transsphenoidal approaches. Neurosurgery 2011;69:630–43.10.1227/NEU.0b013e31821a872dSearch in Google Scholar PubMed

27. Muller HL, Handwerker G, Wollny B, Faldum A, Sorensen N. Melatonin secretion and increased daytime sleepiness in childhood craniopharyngioma patients. J Clin Endocrinol Metab 2002;87:3993–6.10.1210/jcem.87.8.8751Search in Google Scholar PubMed

28. Holmer H, Ekman B, Bjork J, Nordstom CH, Popovic V, et al. Hypothalamic involvement predicts cardiovascular risk in adults with childhood onset craniopharyngioma on long-term GH therapy. Eur J Endocrinol 2009;161:671–9.10.1530/EJE-09-0449Search in Google Scholar PubMed

29. Mong S, Pomeroy SL, Cecchin F, Juraszek A, Alexander ME. Cardiac risk after craniopharyngioma therapy. Pediatr Neurol 2008;38:256–60.10.1016/j.pediatrneurol.2007.11.007Search in Google Scholar PubMed

30. Pereira AM, Schmid EM, Schutte PJ, Voormolen JH, Biermasz NR, et al. High prevalence of long-term cardiovascular, neurological and psychosocial morbidity after treatment for craniopharyngioma. Clin Endocrinol 2005;62:197–204.10.1111/j.1365-2265.2004.02196.xSearch in Google Scholar PubMed

31. Visser J, Hukin J, Sargent M, Steinbok P, Goddard K, et al. Late mortality in pediatric patients with craniopharyngioma. J Neurooncol 2010;100:105–11.10.1007/s11060-010-0145-5Search in Google Scholar PubMed

32. Tomita T, Bowman RM. Craniopharyngiomas in children: surgical experience at Children’s Memorial Hospital. Childs Nerv Syst 2005;21:729–46.10.1007/s00381-005-1202-9Search in Google Scholar PubMed

33. Fisher PG, Jenab J, Gopldthwaite PT, Tihan T, Wharam MD, et al. Outcomes and failure patterns in childhood craniopharyngiomas. Childs Nerv Syst 1998;14:558–63.10.1007/s003810050272Search in Google Scholar PubMed

34. Habrand JL, Saran F, Alapetite C, Noel G, El Boustany R, et al. Radiation therapy in the management of craniopharyngioma: current concepts and future developments. J Pediatr Endocrinol Metab 2006;19(Suppl 1):389–94.Search in Google Scholar

35. Lin LL, El Naqa I, Leonard JR, Park TS, Hollander AS, et al. Long-term outcome in children treated for craniopharyngioma with and without radiotherapy. J Neurosurg Pediatr 2008;1:126–30.10.3171/PED/2008/1/2/126Search in Google Scholar

36. Kalapurakal JA, Goldman S, Hsieh YC, Tomita T, Marymont MH. Clinical outcome in children with craniopharyngioma treated with primary surgery and radiotherapy deferred until relapse. Med Pediatr Oncol 2003;40:214–8.10.1002/mpo.10247Search in Google Scholar

37. Scott RM, Hetelekidis S, Barnes PD, Goumnerova L, Tarbell NJ. Surgery, radiation, and combination therapy in the treatment of childhood craniopharyngioma – a 20-year experience. Pediatr Neurosurg 1994;21(Suppl 1):75–81.10.1159/000120866Search in Google Scholar

38. Khafaga Y, Jenkin D, Kanaan I, Hassounah M, Al Shabanah M, et al. Craniopharyngioma in children. Int J Radiat Oncol 1998;42:601–6.10.1016/S0360-3016(98)00257-0Search in Google Scholar

39. Lustig RH, Post SR, Srivannaboon K, Rose SR, Danish RK, et al. Risk factors for the development of obesity in children surviving brain tumors. J Clin Endocrinol Metab 2003;88:611–6.10.1210/jc.2002-021180Search in Google Scholar

40. Swaab DF, Gooren LJ, Hofman MA. The human hypothalamus in relation to gender and sexual orientation. Prog Brain Res 1992;93:205–17; discussion 17–9.10.1016/S0079-6123(08)64573-2Search in Google Scholar

41. Kreier F, Fliers E, Voshol PJ, Van Eden CG, Havekes LM, et al. Selective parasympathetic innervation of subcutaneous and intra-abdominal fat—functional implications. J Clin Invest 2002;110:1243–50.10.1172/JCI0215736Search in Google Scholar

42. Roth C, Wilken B, Hanefeld F, Schroter W, Leonhardt U. Hyperphagia in children with craniopharyngioma is associated with hyperleptinaemia and a failure in the downregulation of appetite. Eur J Endocrinol 1998; 138:89–91.10.1530/eje.0.1380089Search in Google Scholar PubMed

43. Sterkenburg AS, Hoffmann A, Gebhardt U, Waldeck E, Springer S, et al. Childhood craniopharyngioma hypothalamic obesity – No long-term weight reduction due to rehabilitation programs. Klin Padiatr 2014;226:344–50.Search in Google Scholar

Received: 2014-10-6
Accepted: 2014-10-30
Published Online: 2014-12-13
Published in Print: 2015-1-1

©2015 by De Gruyter

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Childhood Craniopharyngioma
  3. Selected papers from the 3rd International Multidisciplinary Postgraduate Course, April 24–27, 2014
  4. Childhood craniopharyngioma – current status and recent perspectives in diagnostics and treatment
  5. The importance of interdisciplinary communication with patients about complex, chronic illnesses: our experiences as parents of a child with a craniopharyngioma
  6. Adamantinomatous craniopharyngioma: pathology, molecular genetics and mouse models
  7. Endocrine aspects and sequel in patients with craniopharyngioma
  8. Surgery for pediatric craniopharyngiomas: is less more?
  9. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma
  10. Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children: single institution experience
  11. Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity
  12. Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment
  13. Review article
  14. Association study of TAC3 and TACR3 gene polymorphisms with idiopathic precocious puberty in Chinese girls
  15. Images in pediatric endocrinology
  16. Intestinal invagination in diabetic ketoacidosis: case report
  17. Original articles
  18. Managing incidental findings and disclosure of results in a paediatric research cohort – the LIFE Child Study cohort
  19. The heterogeneity of hyperinsulinaemic hypoglycaemia in 19 patients with Beckwith-Wiedemann syndrome due to KvDMR1 hypomethylation
  20. Gender differences and age-related changes in body fat mass in Tibetan children and teenagers: an analysis by the bioelectrical impedance method
  21. A study of genes involved in adipocyte differentiation
  22. Initiation of growth hormone therapy in idiopathic short stature: do gender differences exist?
  23. The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance
  24. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees
  25. Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions
  26. Variability of lipid and lipoprotein concentrations during puberty in Brazilian boys
  27. Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth
  28. Can optical coherence tomography predict early retinal microvascular pathology in type 1 diabetic adolescents without minimal diabetic retinopathy? A single-centre study
  29. Decreased levels of homoarginine and asymmetric dimethylarginine in children with type 1 diabetes: associations with cardiovascular risk factors but no effect by atorvastin
  30. Influence of catch-up growth on abdominal fat distribution in very low birth weight children – cohort study
  31. Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents
  32. Pulmonary function in children with type 1 diabetes mellitus
  33. Identification of deletions in children with congenital hypothyroidism and thyroid dysgenesis with the use of multiplex ligation-dependent probe amplification
  34. Effect of l-thyroxine supplementation on infants with transient hypothyroxinemia of prematurity at 18 months of corrected age: randomized clinical trial
  35. Vitamin D-containing supplements for children between 1–3 years of age: Are they essential for bone health?
  36. Anti-Mullerian hormone levels in American girls by age and race/ethnicity
  37. The effect of tailoring of cornstarch intake on stature in children with glycogen storage disease type III
  38. Thyroid disease in Chinese girls with Turner syndrome
  39. Patient reports
  40. Pure gonadal dysgenesis (Swyer syndrome) due to microdeletion in the SRY gene: a case report
  41. Hypophosphatemic rickets caused by a novel splice donor site mutation and activation of two cryptic splice donor sites in the PHEX gene
  42. Novel heterozygous IGF1R mutation in two brothers with developing impaired glucose tolerance
  43. A case of pediatric ectopic thyroid in lateral lymph nodes
  44. Hyperostosis-hyperphosphatemia syndrome (HHS): report of two cases with a recurrent mutation and review of the literature
  45. Needle detachment from the Sure-T® infusion set in two young children with diabetes mellitus (DM) treated with continuous subcutaneous insulin infusion (CSII) and unexplained hyperglycaemia
  46. Familial dysalbuminemic hyperthyroxinemia in a 4-year-old girl with hyperactivity, palpitations and advanced dental age: how gold standard assays may be misleading
https://doi.org/10.1515/jpem-2014-0415
Keywords for this article
craniopharyngioma; eating behavior; eating disorders; growth hormone; hypothalamus; obesity

Articles in the same Issue

  1. Frontmatter
  2. Highlight: Childhood Craniopharyngioma
  3. Selected papers from the 3rd International Multidisciplinary Postgraduate Course, April 24–27, 2014
  4. Childhood craniopharyngioma – current status and recent perspectives in diagnostics and treatment
  5. The importance of interdisciplinary communication with patients about complex, chronic illnesses: our experiences as parents of a child with a craniopharyngioma
  6. Adamantinomatous craniopharyngioma: pathology, molecular genetics and mouse models
  7. Endocrine aspects and sequel in patients with craniopharyngioma
  8. Surgery for pediatric craniopharyngiomas: is less more?
  9. Eating behavior, weight problems and eating disorders in 101 long-term survivors of childhood-onset craniopharyngioma
  10. Carbohydrate-lipid profile and use of metformin with micronized fenofibrate in reducing metabolic consequences of craniopharyngioma treatment in children: single institution experience
  11. Effects of T3 treatment on brown adipose tissue and energy expenditure in a patient with craniopharyngioma and hypothalamic obesity
  12. Hypothalamic obesity after treatment for craniopharyngioma: the importance of the home environment
  13. Review article
  14. Association study of TAC3 and TACR3 gene polymorphisms with idiopathic precocious puberty in Chinese girls
  15. Images in pediatric endocrinology
  16. Intestinal invagination in diabetic ketoacidosis: case report
  17. Original articles
  18. Managing incidental findings and disclosure of results in a paediatric research cohort – the LIFE Child Study cohort
  19. The heterogeneity of hyperinsulinaemic hypoglycaemia in 19 patients with Beckwith-Wiedemann syndrome due to KvDMR1 hypomethylation
  20. Gender differences and age-related changes in body fat mass in Tibetan children and teenagers: an analysis by the bioelectrical impedance method
  21. A study of genes involved in adipocyte differentiation
  22. Initiation of growth hormone therapy in idiopathic short stature: do gender differences exist?
  23. The influence of puberty on vitamin D status in obese children and the possible relation between vitamin D deficiency and insulin resistance
  24. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees
  25. Effect of growth hormone deficiency on brain MRI findings among children with growth restrictions
  26. Variability of lipid and lipoprotein concentrations during puberty in Brazilian boys
  27. Skin advanced glycation endproducts are elevated at onset of type 1 diabetes in youth
  28. Can optical coherence tomography predict early retinal microvascular pathology in type 1 diabetic adolescents without minimal diabetic retinopathy? A single-centre study
  29. Decreased levels of homoarginine and asymmetric dimethylarginine in children with type 1 diabetes: associations with cardiovascular risk factors but no effect by atorvastin
  30. Influence of catch-up growth on abdominal fat distribution in very low birth weight children – cohort study
  31. Thyrotoxic, hypokalemic periodic paralysis (THPP) in adolescents
  32. Pulmonary function in children with type 1 diabetes mellitus
  33. Identification of deletions in children with congenital hypothyroidism and thyroid dysgenesis with the use of multiplex ligation-dependent probe amplification
  34. Effect of l-thyroxine supplementation on infants with transient hypothyroxinemia of prematurity at 18 months of corrected age: randomized clinical trial
  35. Vitamin D-containing supplements for children between 1–3 years of age: Are they essential for bone health?
  36. Anti-Mullerian hormone levels in American girls by age and race/ethnicity
  37. The effect of tailoring of cornstarch intake on stature in children with glycogen storage disease type III
  38. Thyroid disease in Chinese girls with Turner syndrome
  39. Patient reports
  40. Pure gonadal dysgenesis (Swyer syndrome) due to microdeletion in the SRY gene: a case report
  41. Hypophosphatemic rickets caused by a novel splice donor site mutation and activation of two cryptic splice donor sites in the PHEX gene
  42. Novel heterozygous IGF1R mutation in two brothers with developing impaired glucose tolerance
  43. A case of pediatric ectopic thyroid in lateral lymph nodes
  44. Hyperostosis-hyperphosphatemia syndrome (HHS): report of two cases with a recurrent mutation and review of the literature
  45. Needle detachment from the Sure-T® infusion set in two young children with diabetes mellitus (DM) treated with continuous subcutaneous insulin infusion (CSII) and unexplained hyperglycaemia
  46. Familial dysalbuminemic hyperthyroxinemia in a 4-year-old girl with hyperactivity, palpitations and advanced dental age: how gold standard assays may be misleading
Downloaded on 29.4.2026 from https://www.degruyterbrill.com/document/doi/10.1515/jpem-2014-0415/html?lang=en
Scroll to top button