Scientific publications
Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration
J C Galofré 1 2 3 , J J Díez 4 5 6 7 , R Attanasio 8 , E V Nagy 9 , R Negro 10 , E Papini 11 , P Perros 12 , M Žarković 13 , E Akarsu 14 , M Alevizaki 15 , G Ayvaz 16 , T Bednarczuk 17 , B N Beleslin 13 18 , E Berta 9 , M Bodor 9 , A M Borissova 19 , M Boyanov 20 21 , C Buffet 22 , M C Burlacu 23 , H Dobnig 24 25 , V Fadeyev 26 , B C T Field 27 , E Fliers 28 , D Führer 29 , T Hakala 30 , J Jiskra 31 , P Kopp 32 , M Krebs 33 , M Kršek 31 , M Kužma 34 , M Lantz 35 , I Lazúrová 36 , L Leenhardt 22 , V Luchytskiy 37 , F M Puga 38 , A McGowan 39 , S Metso 40 , C Moran 41 42 , T Morgunova 26 , D A Niculescu 43 , B Perić 44 , T Planck 35 , C Poiana 43 , E Robenshtok 45 , P O Rosselet 46 , M Ruchala 47 , K R Riis 48 , A Shepelkevich 49 , M Tronko 50 , D Unuane 51 , I Vardarli 52 53 , W E Visser 54 , M Vryonidou 55 , Y R Younes 56 , L Hegedüs 48
Purpose: The use of thyroid hormones (TH) to treat obesity is unsupported by evidence as reflected in international guidelines. We explored views about this practice, and associations with respondent characteristics among European thyroid specialists.
Methods: Specialists from 28 countries were invited to a survey via professional organisations. The relevant question was whether "Thyroid hormones may be indicated in biochemically euthyroid patients with obesity resistant to lifestyle interventions".
Results: Of 17,232 invitations 5695 responses were received (33% valid response rate; 65% women; 90% endocrinologists). Of these, 290 (5.1%) stated that TH may be indicated as treatment for obesity in euthyroid patients. This view was commoner among non-endocrinologists (8.7% vs. 4.7%, p < 0.01), private practice (6.5% vs. 4.5%, p < 0.01), and varied geographically (Eastern Europe, 7.3%; Southern Europe, 4.8%; Western Europe, 2.7%; and Northern Europe, 2.5%). Respondents from Northern and Western Europe were less likely to use TH than those from Eastern Europe (p < 0.01). Gross national income (GNI) correlated inversely with this view (OR 0.97, CI: 0.96-0.97; p < 0.001). Having national guidelines on hypothyroidism correlated negatively with treating obesity with TH (OR 0.71, CI: 0.55-0.91).
Conclusions: Despite the lack of evidence, and contrary to guidelines' recommendations, about 5% of respondents stated that TH may be indicated as a treatment for obesity in euthyroid patients resistant to life-style interventions. This opinion was associated with (i) respondent characteristics: being non-endocrinologist, working in private practice, treating a small number of hypothyroid patients annually and (ii) national characteristics: prevalence of obesity, Eastern Europe, low GNI and lack of national hypothyroidism guidelines.
CITATION J Endocrinol Invest. 2024 Jun 15. doi: 10.1007/s40618-024-02409-z
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