Hyperphagia: Full Overview For Healthcare Providers

Hyperphagia is a symptom that can accompany several metabolic diseases, such as diabetes, hyperthyroidism, and Leptin disorders. Certain genetic diseases, such as Prader-Willi Syndrome, also have hyperphagia as a symptom. Sometimes polyphagia and hyperphagia are used interchangeably, but there are subtle differences. Polyphagia has a pathological cause (secondary to a disease) and leads to eating even when feeling full. Polyphagia patients can lose or gain weight. Hyperphagia is extreme, insatiable hunger with a physiological cause, which can be from medical, genetic, and physiological disorders (Science Direct, 25 July 2012)

Hyperphagia can also have non-medical, lifestyle-based underpinnings. It tends to cause overeating and/or binge eating, which in turn can lead to weight gain, blood sugar dysregulation, eating disorders, and many other challenges.

Here, we will look at the diseases of which hyperphagia may be a symptom, how to treat it, and ongoing research into this interesting facet of obesity physiology.

Hyperphagia vs. Normal Hunger

To fully understand hyperphagia, one must know how it differs from normal hunger. For example, someone who undertakes a new, intense exercise regimen may suddenly experience a new level of hunger. However, this is not hyperphagia.

With hyperphagia, hunger is not only extreme but insatiable. The person continues to feel hungry even after eating. Hyperphagia also tends to engender abnormal food-seeking behavior. This behavior may include stealing or hoarding food, thinking about it incessantly, or going to great lengths to acquire it.

In October 2023, a group of expert researchers and clinicians met to develop a unified definition of hyperphagia: “a pathologic, insatiable hunger accompanied by abnormal food-seeking behaviors.” They proposed abnormal melanocortin 4 receptor (MC4R) signaling as the central cause across associated diseases. Therefore, they recommended genetic testing for people with hyperphagia, along with comprehensive weight-management strategies.

Diseases Commonly Associated with Hyperphagia

Disorders that can lead to hyperphagia range from something as common as diabetes to extremely rare, genetic diseases.

Diabetes or Prediabetes

Sometimes, a patient reports intense hunger, which ultimately leads to a diagnosis of diabetes or prediabetes. Hyperphagia shows up in Type 1, Type 2, and gestational diabetes. It can affect the person, whether they are hypoglycemic or hyperglycemic.

Diabetic hyperphagia is sometimes called polyphagia because it fits into the “three Ps”: polyphagia, polydipsia (extreme thirst), and polyuria (frequent urination). It can be an early warning sign of diabetic ketoacidosis.

As we know, diabetes and obesity share a complicated relationship. Hyperphagia further complicates it since it can be a warning sign of diabetes and/or a cause of obesity. Obesity itself can lead to insulin resistance and, eventually, type 2 diabetes. While we understand that cutting calories is key to treating obesity, doing so can be difficult or impossible with hyperphagia.

Because GLP-1 receptor agonists influence food reward and fullness, they may have potential applications for extreme hunger. However, these medications are still new, and much remains to be learned.

Thyroid Disorders

Hyperphagia can appear as a symptom of hyperthyroidism or Grave’s disease. When elevated hormones increase metabolism, a person can burn calories faster and thus feel hungrier. An overactive thyroid tends to cause weight loss rather than weight gain, so in this case, hyperphagia may not lead to overweight or obesity.

Mental Health Conditions

Atypical depression and anxiety disorders can lead to intense hunger. In atypical depression, patients also tend to exhibit hypersomnia and lethargy. Again, these are complicated multi-disease relationships, as the incidence of depression and anxiety is amplified by obesity, which can stem from hyperphagia in a vicious circle. Mental health also plays a role in other chronic diseases such as diabetes and obesity. Patients struggling with mental health disorders require additional support to ensure they are successful with implementing the treatment plan.

Rare Diseases

There are several rare genetic forms of obesity, classified as MC4R pathway diseases, some of them associated with hyperphagia. They include PWS, Bardet-Biedl syndrome, POMC deficiency, and LEPR deficiency.

Rare, highly impactful variants in the MC4R pathway result in the loss of function of key energy balance-regulating systems. This pathway regulates body weight. Genetic testing has quickly become one of the most important tools in determining if a rare genetic disorder may be affecting normal energy balance. As a result, we are gaining a better understanding of MC4R pathway-related rare genetic disorders of obesity.

Other Factors

Other disease states with which hyperphagia is associated include pancreatic tumors, the sleep disorder Kleine-Levin syndrome, and Pick’s disease, a type of frontotemporal dementia.

It can also stem from premenstrual syndrome (PMS) or certain medications such as corticosteroids and cannabinoids.

How Do You Treat Hyperphagia?

Generally, treating hyperphagia means treating the underlying condition of which it is a symptom. However, some non-medical interventions can help address it directly. These include mindful eating, meal planning, adequate hydration, and opting for nutrient-dense, filling foods. Mental health support also plays an important role in treating certain patients

These interventions can help give the patient a greater sense of control. They may prove inadequate, though, in children or those with cognitive disabilities (such as PWS).

Pharmaceutical Interventions

In recent years, new drugs have been approved to directly treat hyperphagia in certain rare diseases.

In March 2025, the FDA approved its first treatment for hyperphagia in Prader-Willi syndrome. (Previously, human growth hormone therapy was the only FDA-approved treatment for the disease. It has not been shown to significantly improve hyperphagia.)

Vykat XR, an extended-release oral tablet, is approved for adults and children four and older. It has been through four double-blind and/or open-label studies over the course of four years. The manufacturer, Soleno Therapeutics, also launched a patient support program.

Imcivree (setmelanotide) is an injectable drug approved by the FDA in 2020 to target impairment in the hypothalamic MC4R pathway. It is indicated for weight loss and maintenance for adults and children six and older with obesity due to Bardet-Biedl syndrome. It is the first FDA-approved treatment for that condition.

Emerging Knowledge of Hyperphagia

As we continue to gain insights about hyperphagia, a few key areas show promise.

Key Research Areas

Research into MC4R pathway diseases is ongoing and will likely further the pursuit of new therapeutics. Efforts are underway to improve the diagnosis of hyperphagia in these cases, which could better enable understanding and treatment.

University of Texas researchers have also identified another gene, Gpr45, that appears to play a role in appetite. In their research, two different mutations of Gpr45 led affected mice to become obese on a standard diet. The same happened when they deleted the gene in healthy mouse embryos.

Also related to hunger, the Max Planck Institute recently reported findings on a small, specialized group of neurons in the hypothalamus. In mice, these PNOC/NPY nerve cells directly influence hunger and weight gain. These same cells exist in the human brain and are controlled by leptin. They will likely become a target for further research aimed at controlling appetite.

In April 2025, Rhythm Pharmaceuticals announced the outcome of a Phase 3 clinical trial of setmelanotide, an MC4R agonist. In a study of 120 patients with hypothalamic obesity, it reduced BMI by 16.5%, compared with an increase of 3.3% on placebo.

Digital technology offers more and more opportunities in obesity treatment, such as HAPPYthalamus, a mobile app in development for children with hypothalamic obesity. A small study published in May 2025 reported that it still needs work to realize its potential.

FAQs About Hyperphagia

What is the difference between hyperphagia and polyphagia?

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not list hyperphagia as an eating disorder. It does, however, list binge eating. Binge eating differs in that it occurs as discrete eating episodes and is not necessarily driven by physical hunger. Someone experiencing binge eating needs different interventions.

Is hyperphagia an eating disorder?

There is no cure for PWS. Interventions focus on managing symptoms, one of which is hyperphagia. In 2025, the first pharmaceutical was approved by the FDA to treat hyperphagia in PWS.

How is hyperphagia linked to autism?

There is no clear, direct link between hyperphagia and autism spectrum disorder (ASD). However, some medications used to treat ASD can increase appetite. In addition, some of the genomic factors commonly associated with ASD may also play a role in early-onset childhood obesity. Likewise, adults with ASD are at risk for overweight or obesity, though not necessarily due to hyperphagia.

What causes hyperphagia in children?

In children, hyperphagia may be caused by any of the known underlying conditions, including diabetes, rare inherited diseases, side effects from medications, or thyroid imbalances. Since children may have a harder time communicating their symptoms, a diagnosis can require keen observation, possibly paired with genetic testing.

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