Obésités hypothalamiques et chirurgie bariatrique

Hypothalamic obesity has various origins (tumor, traumatism, radiotherapy, vascular, genetic, psychotropic drugs use...), is a rare and serious disease, and is associated with severe comorbidities and eating disorders which are inaccessible to psychotherapy or anti-obesity drugs. The impact of caloric restriction seems limited, even when associated with physical activity programs. There are fewpublished drug trials, usually with small number of patients, and with modest weight reduction. Bariatric surgery is a potential therapeutic option. Only few observations are published in the literature. In secondary obesity following craniopharyngioma, bariatric surgery allows a noticeable weight loss but less than that seen in common obesity. The malabsorptive surgery seems to be more effective. In Prader-Willi syndrome patients, postoperative weight loss is small and complications are frequent. Finally, in patients with monogenic obesity, the small number of cases reports does not allow to draw any conclusion.