Role of GLP-1 Receptor Agonists in Pediatric Obesity: Benefits, Risks, and Approaches to Patient Selection

Curr Obes Rep. 2020 Dec;9(4):391-401. doi: 10.1007/s13679-020-00409-7. Epub 2020 Oct 21.

Abstract

Purpose of review: Effective treatments for pediatric obesity are limited. Glucagon-like peptide-1 receptor (GLP-1R) agonists have emerged as therapeutic agents for obesity in adults and have shown benefits outside of weight loss. Here we explore the evidence for GLP-1R agonist use in pediatric obesity.

Recent findings: Emerging evidence suggests that GLP-1R agonists have a role in pediatric obesity treatment. A recently published, randomized, placebo-controlled trial found a greater reduction in BMI z-score (- 0.22 SDs) in adolescents receiving liraglutide compared with placebo. As in adults, gastrointestinal adverse effects were commonly seen. GLP-1R agonists appear to perform favorably compared with other approved pharmacological agents for pediatric obesity. However, heterogeneity in weight loss response, cost, side effects, and need for injections may limit their use in many pediatric patients. Rather than broadly applying this therapy if it is approved, we suggest careful patient selection and monitoring by clinicians pending further studies.

Keywords: GLP-1R agonist; Liraglutide; Metformin; Orlistat; Pediatric obesity; Phentermine.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Anti-Obesity Agents / therapeutic use*
  • Body Mass Index
  • Child
  • Female
  • Glucagon-Like Peptide-1 Receptor Agonists*
  • Humans
  • Liraglutide / therapeutic use
  • Male
  • Patient Selection*
  • Pediatric Obesity / drug therapy*
  • Randomized Controlled Trials as Topic
  • Weight Loss / drug effects

Substances

  • Anti-Obesity Agents
  • Liraglutide
  • Glucagon-Like Peptide-1 Receptor Agonists