Objective:

To report the effects of setmelanotide treatment in a 22-month-old child with acquired hypothalamic obesity following Escherichia coli sepsis and meningoencephalitis, highlighting its significance in expanding treatment options.

Key Findings:

• The patient experienced stabilization and reduction in body weight over 13 months, indicating a positive response to treatment.
• Improvements were noted in liver enzymes, lipid profile, motor activity, and quality of life, suggesting comprehensive health benefits.
• The most significant clinical response occurred at doses ≥1.25 mg daily, underscoring the importance of dosage in treatment efficacy.

Interpretation:

This case represents the youngest patient treated with setmelanotide for acquired hypothalamic obesity and suggests potential therapeutic benefits beyond currently approved genetic indications, warranting further investigation.

Limitations:

• The study is based on a single case report, limiting generalizability.
• Long-term effects and safety in very young children remain uncertain, highlighting the need for additional research.

Conclusion:

Setmelanotide may be a promising treatment option for selected patients with acquired hypothalamic obesity, but further studies are needed to confirm its efficacy and safety.