Injected Semaglutide for obesity in adolescents

A new type of drug, technically known as Glucagon-like peptide-1 (GLP-1) receptor agonists lower weight in obese adults, and one such drug (liraglutide) also is U.S. FDA approved for adolescents. Now, in an industry-sponsored trial, 201 adolescents (age range, 12–17) with body-mass index (BMI) ≥95th percentile (mean BMI, 37 kg/m2) were randomised to receive weekly injections of the GLP-1 agonist semaglutide or placebo for 68 weeks, along with behavioral lifestyle therapy.

Mean changes in BMI at 68 weeks were −16.1% in the semaglutide group and +0.6% in the placebo group. The semaglutide group also had reductions in cardiometabolic risk factors, including weight, waist circumference, glycosylated hemoglobin level, and lipid levels.

Gastrointestinal adverse effects classified as "nonserious" (e.g., nausea, vomiting, abdominal pain) were more common with semaglutide than with placebo (62% vs. 42%). Additionally, 5 semaglutide recipients and no placebo recipients developed acute gallbladder disease. In the 7 weeks after cessation of treatment, BMI increased significantly in the semaglutide group.

Injected semaglutide lowered weight in teenagers with obesity. Although semaglutide is not yet FDA approved for adolescents, some paediatricians and adolescent medicine experts likely believe sufficient evidence already exists to use GLP-1 agonists liberally in these patients.

Ideally, a short-term course of semaglutide would be accompanied by healthy lifestyle changes that maintain weight reduction after the drug is stopped, but that goal often is elusive.