Hyperfagie

Hyperfagie, or hyperphagia, is an abnormally increased appetite for food, often accompanied by persistent hunger and a reduced sense of fullness. It is typically a symptom rather than a standalone disorder and can occur on its own or as part of other medical, genetic, endocrine, or psychiatric conditions. The condition commonly leads to excessive caloric intake and, over time, obesity and associated metabolic complications.

Causes are diverse and may include genetic or developmental syndromes such as Prader-Willi syndrome, Bardet-Biedl syndrome, and related disorders. Hypothalamic dysfunction due to brain injury, tumors, inflammation, or infiltrative diseases can disrupt appetite-regulating centers. Endocrine and metabolic disorders such as hypothyroidism or Cushing’s syndrome, as well as diabetes, can contribute. Medications—including certain antipsychotics (for example, olanzapine and clozapine), antidepressants, corticosteroids, and some anticonvulsants—may increase appetite. Psychiatric conditions such as binge eating disorder also feature episodes of excessive food intake, though with distinct behavioral patterns.

Diagnosis involves a thorough medical history and physical examination, targeted laboratory tests (thyroid function, glucose or HbA1c, cortisol, metabolic panels), and imaging or genetic testing when a structural or genetic cause is suspected. Differential diagnosis includes primary obesity without a specific underlying cause and other eating disorders.

Treatment aims to address the underlying cause and reduce caloric intake. Approaches include dietary management, behavioral therapy, and environmental controls, particularly in children with Prader-Willi syndrome. Growth hormone therapy may improve body composition in some conditions. Pharmacologic options for appetite control exist but require specialist oversight; bariatric surgery may be considered in selected cases. Management is typically multidisciplinary, and prognosis depends on the underlying etiology and adherence to treatment.