Evaluating Eating Behaviour, Energy Homeostasis, and Obesity in Childhood-Onset Craniopharyngioma: A Feasibility Study

Elanor C Hinton; Fiona E Lithander; Rebecca L Elsworth; Katherine Hawton; Kruthika Narayan; Sophie Szymkowiak; Holly L Bedford; Nimra Naeem; Ruth Elson; Tashunka Taylor-Miller; Julian P Hamilton-Shield; Elizabeth C Crowne

doi:10.1159/000530863

Evaluating Eating Behaviour, Energy Homeostasis, and Obesity in Childhood-Onset Craniopharyngioma: A Feasibility Study

Horm Res Paediatr. 2024;97(1):80-93. doi: 10.1159/000530863. Epub 2023 May 17.

Authors

Affiliations

¹ NIHR Bristol Biomedical Research Centre, University of Bristol, Bristol, UK.
² Bristol Medical School, University of Bristol, Bristol, UK.
³ Liggins Institute, University of Auckland, Auckland, New Zealand.
⁴ Department of Nutrition and Dietetics, University of Auckland, Auckland, New Zealand.
⁵ Department of Paediatric Endocrinology and Diabetes, Bristol Royal Hospital for Children, University Hospitals Bristol NHS Foundation Trust, Bristol, UK.

Abstract

Introduction: Craniopharyngiomas are rare brain tumours (incidence 1.1-1.7 cases/million/year). Although non-malignant, craniopharyngioma causes major endocrine and visual morbidities including hypothalamic obesity, yet mechanisms leading to obesity are poorly understood. This study investigated the feasibility and acceptability of eating behaviour measures in patients with craniopharyngioma to inform the design of future trials.

Methods: Patients with childhood-onset craniopharyngioma and controls matched for sex, pubertal stage, and age were recruited. After an overnight fast, participants received the following measures: body composition, resting metabolic rate, oral glucose tolerance test including magnetic resonance imaging (patients only), appetite ratings, eating behaviour, and quality of life questionnaires, ad libitum lunch, and an acceptability questionnaire. Data are reported as median ± IQR, with effect size measure (Cliff's delta) and Kendall's tau for correlations, due to the small sample size.

Results: Eleven patients (median age = 14 years; 5 F/6 M) and matched controls (median age = 12 years; 5 F/6 M) were recruited. All patients had received surgery, and 9/11 also received radiotherapy. Hypothalamic damage post-surgery was graded (Paris grading): grade 2 n = 6; grade 1 n = 1; grade 0 n = 2. The included measures were deemed highly tolerable by participants and their parent/carers. Preliminary data suggest a difference in hyperphagia between patients and controls (d = 0.5), and a relationship between hyperphagia with body mass index standard deviation score (BMISDS) in patients (τ = 0.46).

Discussion: These findings demonstrate that eating behaviour research is feasible and acceptable to craniopharyngioma patients and there is an association between BMISDS and hyperphagia in patients. Thus, food approach and avoidance behaviours may be useful targets for interventions to manage obesity in this patient group.

Keywords: Craniopharyngioma; Eating behaviour; Energy; Hyperphagia; Obesity.

MeSH terms

Adolescent
Child
Craniopharyngioma* / complications
Feasibility Studies
Feeding Behavior
Homeostasis
Humans
Hyperphagia / complications
Pediatric Obesity* / complications
Pediatric Obesity* / epidemiology
Pituitary Neoplasms* / complications
Pituitary Neoplasms* / epidemiology
Quality of Life

Grants and funding

This study was funded through the University Hospitals Bristol and Weston NHS Trust Research Capability Funding scheme and supported by the NIHR Biomedical Research Centre, Nutrition theme. The views expressed in this publication are those of the authors and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health and Social Care.