Hypothalamic sarcoidosis: a new cause of morbid obesity.

I have described a 21-year-old man who had biopsy-proven hypothalamic sarcoidosis and polyphagia with a weight increase to 393 lb (178.6 kg) on a 5 ft 4 inch frame during a seven-year follow-up. This morbid obesity appears to be due to sarcoid invasion of the satiety center in the ventral medial nucleus of the hypothalamus. In addition, sarcoid invasion of the supraoptic nucleus produced partial diabetes insipidus. Anterior pituitary deficiency, with complete gonadotropin and growth hormone deficiency, as well as partial ACTH and TSH deficiency, were also present.