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Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration

Authors: J. C. Galofré; J. J. Díez; R. Attanasio; E. V. Nagy; R. Negro; E. Papini; P. Perros; +48 Authors

Treatment of Obesity with Thyroid hormones in Europe. Data from the THESIS* Collaboration

Abstract

Abstract 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.

Keywords

Humans; Obesity/epidemiology; Obesity/therapy; Europe/epidemiology; Thyroid Hormones/blood; Female; Male; Middle Aged; Adult; Surveys and Questionnaires; Hypothyroidism/epidemiology; Hypothyroidism/therapy; Hypothyroidism/drug therapy; Practice Patterns, Physicians'/statistics & numerical data; Practice Patterns, Physicians'/standards; Hypothyroidism; Levothyroxine; Obesity; Survey, Male, Adult, Thyroid Hormones, 3126, Medizin, Levothyroxine, 610, Middle Aged, 3111, 3121, Europe, Hypothyroidism, Surveys and Questionnaires, Obesity ; Surveys and Questionnaires [MeSH] ; Female [MeSH] ; Adult [MeSH] ; Humans [MeSH] ; Levothyroxine ; Hypothyroidism/epidemiology [MeSH] ; Middle Aged [MeSH] ; Hypothyroidism/therapy [MeSH] ; Europe/epidemiology [MeSH] ; Hypothyroidism/drug therapy [MeSH] ; Obesity/therapy [MeSH] ; Original Article ; Male [MeSH] ; Obesity/epidemiology [MeSH] ; Practice Patterns, Physicians'/standards [MeSH] ; Practice Patterns, Physicians'/statistics ; Thyroid Hormones/blood [MeSH] ; Hypothyroidism ; Survey, Humans, Female, Original Article, Obesity, Practice Patterns, Physicians', Survey

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    influence
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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
3
Top 10%
Average
Average
Green
hybrid