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This study aimed to recapitulate the change trajectory of postoperative weight and investigate the association between postoperative hypothalamic damage and weight gain and hypothalamic obesity (HO) in patients with adult‐onset craniopharyngioma. Forty‐seven (49.0%) patients and 18 (18.8%) patients experienced clinically meaningful weight gain (≥5%) and HO at the last follow‐up, respectively. Significant postoperative weight gain is common in patients with adult‐onset craniopharyngioma. In addition, postoperative hypothalamic damage can predict clinically meaningful weight gain and HO.
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