Children who took the weight loss drug liraglutide late in the study lost significantly more weight than children who received a placebo, according to a new study.
Doctors say it can be extremely difficult for anyone with obesity to lose weight, regardless of age. Most adults and children aged 12 and older have access to highly effective new drugs called GLP-1 receptor agonists, but younger children must rely solely on lifestyle changes such as diet, exercise and counseling to lose weight. Even with more aggressive procedures, children generally have modest results, doctors say.
The first study of the effects of the GLP-1 drug liraglutide, sold under the brand names Saxenda and Victoza, in younger children found that the drug could have a significant impact on their body mass index (BMI), a measure that practitioners use to determine , whether the person suffers from obesity.
Liraglutide was approved by the US Food and Drug Administration in 2014 to help adults lose weight. In 2020, this consent was extended to children between the ages of 12 and 17.
The study was published Tuesday in the New England Journal of Medicine and presented at the annual conference of the European Association for the Study of Diabetes by its lead co-author Dr. Claudia Fox, a pediatrician who works with the Center for Pediatric Obesity Medicine. University of Minnesota School of Medicine in Minneapolis.
The researchers examined the effects of the drug on children between the ages of 6 and 12 who had what is considered a high BMI. The average 10-year-old in the study, Fox said, weighed about 155 pounds.
The study included 82 children, 56 of whom received a once-daily injection of liraglutide. The rest received a placebo. All children were also counseled to encourage a healthier diet and moderate-to-vigorous exercise for at least an hour a day.
The groups had significantly different results. In just over a year, the BMI of children given the drug dropped 7.4 percentage points more than children in the placebo group. Children in the liraglutide group had a 5.8% decrease in BMI. Patients in the placebo group had an increase of 1.6%.
The study was funded by drug manufacturer Novo Nordisk.
The results were consistent with other studies done on teenagers, Fox said, but younger children had better results.
“That was the most surprising to me, and it makes me think that maybe we should be intervening at a younger age,” Fox said.
The study did not directly compare weight loss between age groups, so more research would be needed to see if her theory could be correct.
Liraglutide was considered safe for young children in the study, but participants in both the placebo and medication groups had some side effects.
Stomach problems such as nausea, diarrhea and vomiting were more common in the group given the drug, but Fox said very few people dropped out of the study because of side effects. Stomach problems tended to occur early in the study and decrease over time, she said.
The research was also not designed to look at how long children would have to stay on the drugs. When the trial period ended and the children stopped taking medication or received counseling, their BMIs crept up again. However, the increase was not as significant in this younger age group as in adolescents in earlier studies, and this could mean that the drugs have a more robust long-term outcome if used earlier.
“We know obesity is a chronic disease,” Fox said. “Once the procedure is over, the disease can come back, and that’s true of any other chronic disease, whether it’s diabetes, asthma, hypertension — any chronic disease that requires chronic treatment.”
Any drug that could help children with obesity could have a big impact on public health. Obesity is considered the most common chronic health problem for children in the United States, with nearly 20% of all children having what is considered a high BMI. And that number is growing, with prevalence more than tripling since the 1970s, according to the US Centers for Disease Control and Prevention.
Obesity is not just a short-term problem, as obese children usually become obese adults and may face lifelong health problems related to it, said Dr. Simon Cork, Associate Professor of Physiology at Anglia Ruskin University. Science Media Center.
“The evidence that liraglutide is safe and effective in children is positive,” said Cork, who was not involved in the research.
Developing anti-obesity drugs for children is complicated because children are still growing, he said. More studies that follow children over a longer period of time will be needed to ensure that appetite suppression does not have consequences later in development. There was no indication in the new study that liraglutide was harmful to a child’s height changes or puberty, but researchers will need to make sure the drugs don’t slow growth.
Precocious puberty can be a problem for children with obesity, as can type 2 diabetes, and they can develop heart problems, liver and kidney disease, and cancer later. But a weight loss drug that proves to be effective in the long term could do much more for health than just help you lose weight. Children with obesity may also face significant bias and stigma, studies show.
“Because treating children and adolescents living with obesity has the potential to have longer-term health benefits, although these drugs are currently expensive, their value in reducing the risk of obesity-related conditions and improving long-term health needs to be considered,” says Dr. Nerys Astbury, associate professor of diet and obesity at the University of Oxford’s Nuffield Department of Primary Health Care Sciences, told Science Media Centre. Astbury was not involved in the new study.
In December, draft guidelines from the U.S. Preventive Services Task Force — which affect whether insurance will cover medical care — recommended that doctors provide intensive behavioral interventions to help children lose excess weight, but did not recommend weight-loss drugs or surgery.
The American Academy of Pediatrics, which updated its own guidelines for treating obesity in 2023, recommended both options for some people.
Although doctors — and even parents — don’t always agree, Fox believes weight-loss drugs and surgeries like gastric bypass or sleeve gastrectomy should be options for kids.
“There is a feeling among patients’ families that they need to work harder to lose weight, but going to the park more and eating better food is not always enough,” she said. “We cannot rely solely on behavioral interventions for a biological disease and achieve significant improvement.”
