ECHO trial results

Inclusion Criteria: * Age 10-25 years at time of enrollment * Diagnosis of hypothalamic obesity with age- and sex adjusted BMI ≥ 95% or BMI ≥30 kg/m² if over 18 y * History of craniopharyngioma or another tumor located in the hypothalamic area * Hypothalamic lesion documented by neuroradiology * ≥ 6 months post-surgical or radiation treatment * Weight stable or increasing over 3 months prior to screening visit * Stable hormone replacement for at least 3 months prior to screening visit Exclusion Criteria: * Renal impairment (GFR\<60 ml/min/1.73m² using the Schwarz formula) * History of gastroparesis; pancreatitis or gallstones (unless status post cholecystectomy) * Family history of multiple endocrine neoplasia type 2 or familial medullary thyroid carcinoma metabolic disorders * Any insulin-treated diabetes mellitus, poorly controlled type 2 diabetes (HbA1c ≥ 10%), or any other chronic serious medical conditions such as cardiovascular disease, malignancy or hematologic disorder, complicated syndromic disorder, or psychiatric disorders (schizophrenia, major depression, history of suicide attempts) * Calcitonin \>50 mg/L at screening * Initiation of weight loss medications within 3 months of screening visit * Previous donation of blood \>10% of estimated blood volume within 3 months prior study * Current warfarin use * Current use of any other GLP1 receptor agonist * Untreated thyroid disorder or adrenal insufficiency * History of bariatric surgery or planned bariatric surgery until end of study * Pregnancy, lactation or expectation to conceive during study period * Subject unlikely to adhere to study procedures in opinion of investigator * Subject with contraindication to neuroimaging by MRI