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. 2025 Jan;48(1):201-212.
doi: 10.1007/s40618-024-02409-z. Epub 2024 Jun 15.

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
Affiliations

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

J C Galofré et al. J Endocrinol Invest. 2025 Jan.

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: Hypothyroidism; Levothyroxine; Obesity; Survey.

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Conflict of interest statement

Declarations. Conflict of interest: LH, PP, EP, EVN and JCG received consultancy fees from Institut Biochimique SA. Ethical approval: This article does not contain any studies with human participants or animals performed by any of the authors. Informed concent: For this type of study, formal consent is not required.

Figures

Fig. 1
Fig. 1
Physicians’ use of thyroid hormone (TH) for obesity and prevalence of obesity in countries included in the study. The line represents predicted probabilities obtained by univariable logistic regression (OR 1.09, 95%, CI 1.05–1.13 per 1 kg/m2, p < 0.001). Please note that the line is slightly curved. Using a linear regression plot is not suitable as we analysed the binomial (Yes–No) variable and the probability of obtaining “Yes” for different levels of obesity
Fig. 2
Fig. 2
Geographical inequalities in the A Prevalence of obesity in Europe by country. Source WHO [Ref 41]. B Percentage of specialists who manage obesity with thyroid hormones in Europe according to the THESIS survey (data in Table 2). C Gross national income per capita in the countries included in the THESIS survey. Source the World Bank [Ref 40]
Fig. 3
Fig. 3
Physicians’ use of thyroid hormone (TH) for obesity and Gross national income (GNI) in countries included in the study. The line represents predicted probabilities obtained by univariable logistic regression (OR 0.97, 95% CI 0.96–0.98 per 1000 US $, p < 0.001). Please note that the line is curved. Using a linear regression plot is not suitable as we analysed the binomial (Yes–No) variable and the probability of obtaining “Yes” for different levels of GNI
Fig. 4
Fig. 4
Obesity prevalence and Gross national income (GNI) in countries included in the study. It’s worth noting that in this case, a linear regression is appropriate as we correlated Obesity and GNI per country. The choice of regression method was based on the nature of the variables and the research question we were trying to answer
See this image and copyright information in PMC

References

    1. Negro R, Attanasio R, Nagy EV, Papini E, Perros P, Hegedüs L (2020) Use of thyroid hormones in hypothyroid and euthyroid patients; the 2019 Italian survey. Eur Thyroid J. 9:25–31. 10.1159/000502057 - PMC - PubMed
    1. Borissova A-MI, Boyanov MA, Attanasio R, et al (2020) Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* questionnaire survey of Bulgarian physicians (Бългapcкo дpyжecтвo пo eндoкpинoлoгия). Endokrinologia (Sofia) 24: 229–309. https://endo-bg.com/en/prilozhenie-na-hormonite-na-shtitovidnata-zhleza-...
    1. Niculescu DA, Attanasio R, Hegedüs L, Nagy EV, Negro R, Papini E, Perros P, Poiana C (2020) Use of thyroid hormones in hypothyroid and euthyroid patients: a Thesis* questionnaire survey of Romanian physicians *Thesis: treatment of hypothyroidism in europe by specialists: an international survey. Acta Endocrinol (Buchar). 16:462–469. 10.4183/aeb.2020.462 - PMC - PubMed
    1. Bednarczuk T, Attanasio R, Hegedüs L, Nagy EV, Negro R, Papini E, Perros P, Ruchała M (2021) Use of thyroid hormones in hypothyroid and euthyroid patients: a THESIS* questionnaire survey of polish physicians. *THESIS: treatment of hypothyroidism in Europe by specialists: an international survey. Endokrynol Pol 72:357–365. 10.5603/EP.a2021.0048 - PubMed
    1. Riis KR, Frølich JS, Hegedüs L, Negro R, Attanasio R, Nagy EV, Papini E, Perros P, Bonnema SJ (2021) (2021) Use of thyroid hormones in hypothyroid and euthyroid patients: a 2020 THESIS questionnaire survey of members of the Danish endocrine society. J Endocrinol Invest 44:2435–2444. 10.1007/s40618-021-01555-y - PMC - PubMed

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