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Obesity in Patients with Craniopharyngioma: Assessment of Food Intake and Movement Counts Indicating Physical Activity

Department of Pediatrics, University Hospital of Bonn (K.J.H., C.R.), 53113 Bonn, Germany; Department of Pediatrics, Hospital of Oldenburg (H.L.M.), 26133 Oldenburg, Germany; Department of Pediatrics, Hospital of Murnau (E.W.), 82418 Murnau, Germany; and Department of Nutritional Psychology, University of Göttingen (V.P.), 37075 Göttingen, Germany

Address all correspondence and requests for reprints to: Christian Roth, M.D., Children’s University Hospital, Adenauerallee 119, 53113 Bonn, Germany. E-mail: croth{at}uni-bonn.de.

Patients with childhood-onset craniopharyngioma (CP) often suffer from obesity. We evaluated two important etiological factors of obesity development, energy intake and physical activity. Energy intake was supposed to be high due to a disturbed hypothalamic regulation of appetite. We used a validated nutritional diary to determine the 1-wk food intake in 27 CP patients (12 with intrasellar tumors and 15 with hypothalamic tumors) and 1027 controls who were a representative sample of the 7- to 16-yr-old German population. In 2 accelerometry settings, we determined movement counts indicating physical activity. Nineteen CP patients were comparable to 26 controls for age and body mass index. One setting was a clinical one during weight reduction; the other was an out-patient setting. Daily energy intake was 1916 ± 677 kcal (mean ± SD) in intrasellar CP patients, 2075 ± 877 kcal in hypothalamic CP patients, and 2476 ± 815 kcal in non-CP controls. Patients suffering from CP showed fewer movement registrations [clinical setting, 228 vs. 298 cpm for obese controls (P = 0.01); out-patient setting, 228 vs. 282 cpm for controls (P = 0.08)]. Differences were most pronounced during leisure time (382 cpm in CP patients vs. 546 cpm in obese controls; P = 0.002; clinical setting). Our findings suggest that reduced physical activity, rather than increased energy intake, in CP patients is responsible for the obesity development noted in these subjects.

Abbreviations: ADH, Antidiuretic hormone; BMI, body mass index; CP, craniopharyngioma; SDS, SD score.

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