Several months ago a patient named Jonathan who was 10 years old was referred to us. 

Jonathan had a brain tumor resected two years ago at another institution out-of-state, resulting in the loss of his pituitary gland followed by radiation therapy.

Since that time he developed an excessive eating disorder which caused him to eat from the moment he awoke in the morning until the time he fell asleep at night. He was found stealing food from other children's lockers at school, and hiding food in his own home in order to be able to go back for more after the rest of the family was asleep.

Jonathan also developed narcolepsy following surgery. He was found sleeping in the bathrooms at school, falling out of his school chair sound asleep, and actually fell asleep while swimming in a pool. He had difficulty sleeping through the night, and he had wide mood swings demonstrating significant anger and agitation. 

Since the surgery, Jonathan gained over 100 pounds within two years. Jonathan's parents sought medical help at several university institution's throughout the country at which time the normal hormones which he was lacking from the loss of his pituitary gland were replaced. 

The family was told that there was nothing more that could be done. The parents were repeatedly told that it was their responsibility to teach their child how to control his appetite. They were told to set strict limits and were ultimately lead to believe that they had poor parenting skills since they were unable to control their son's appetite.

After a thorough review of the patient's history, imaging studies, laboratory studies, and tests that we ordered for him to obtain in Nebraska, the patient and his parents flew into Chicago to consult with us. 

After about 6 1/2 hours of consulting with Jonathan and his parents, they began to understand that his problem was treatable as long as we could find medication to stimulate the parts of his brain that were unable to function because the normal stimulus (neuropeptides) had been destroyed by the tumor and/or the radiation therapy. These areas of the brain involved mainly the hypothalamus.

After three months of medical therapy, Jonathan and his family have regained a new life. Jonathan is now able to stay awake throughout the entire day and sleep throughout the night. 

His appetite has been fascinating to watch. At the beginning he did not understand what the sensation of fullness was since this area of his brain had not been stimulated for over two years. 

He continued to steal food even in his own home, but according to his mom, his food was left untouched when found in the morning. 

Jonathan now eats only when he is hungry, has a normal sleep/wake cycle, and has stabilized his mood swings allowing him to develop a normal social life. His BMI started at 44 and is now down to 30 in only a few months.

Case Two:

A patient named Wally was well over 300 pounds and for years I had begged him to lose weight because we both knew he was eventually going to need an operation to replace his heart valve!

At his current weight it was unlikely he would have survived the operation. All I could do for years was to recommend that he go to a weight loss program, but just like everyone else, all he did was yo-yo up and down. 

All the current literature which you can find documented in the NIH Guidelines of Treatment of Obesity, have shown that all individuals who join a weight loss program to lose at least 10 percent of their body mass, will regain at least as much if not more of the weight they have lost within the next four years. 

We finally persuaded him to begin medical consultation and treatment in April of 1999. By October of 1999 he had lost 100 pounds. One week later he was sent for heart surgery. He did unbelievably well and within four days was sent home. 

Two days later he was in my office laughing and kidding around with all of us! Wally is currently doing well and is maintaining his low Body Mass Index with minimal medication. 

Since his weight loss he no longer has hypertension, diabetes, pain from his osteoarthritis, or reflux disease. His risk of heart attack and cancer has dramatically been reduced and the life span of his new heart valve and his previous joint replacement has been significantly prolonged!

He started with a list of approximately twelve medications and now takes only one-half of ONE tablet to maintain his weight.