Semaglutide treatment for children with obesity: an observational study

Arch Dis Child. 2024 Mar 12:archdischild-2023-326687. doi: 10.1136/archdischild-2023-326687. Online ahead of print.

Abstract

Objective: To assess efficacy and tolerability of semaglutide as a weight loss treatment for children living with comorbid obesity.

Design: Retrospective observational study of the first 50 children from a weight management service treated with semaglutide for at least 6 months.

Setting: A tertiary paediatric multidisciplinary weight management clinic in a UK hospital.

Patients: Aged 10-18 years old with a body mass index (BMI) SD score (SDS) >2 with a weight-related comorbidity (including insulin resistance (defined as homeostatic model assessment for insulin resistance >4), type 2 diabetes, metabolic-associated fatty liver disease, obstructive sleep apnoea or hypertension).

Interventions: Once-weekly injectable semaglutide titrated over 8 weeks to a final dose of 1 mg in addition to dietary and lifestyle advice.

Main outcome measures: Primary outcome measures were change in weight, BMI SDS and percentage body weight. Secondary outcomes were side effects and cessation of treatment.

Results: After 6 months of treatment, statistically significant decreases in BMI SDS (0.32±0.27, p<0.001) and body weight (7.03±7.50 kg, p<0.001) were seen. Mean percentage total weight loss was 6.4±6.3% (p<0.001). For the 14 patients for whom 12-month data were available, statistically significant decreases were seen in mean BMI SDS (0.54±0.52, p<0.001). Mean body weight decreased by 9.7±10.8 kg (p<0.001). Percentage total weight loss at 12 months was 8.9±10.0% (p<0.001). Mild gastrointestinal side effects were common. One patient developed gallstones. Five patients discontinued treatment due to side effects.

Conclusion: Semaglutide appears to be a safe and effective weight loss adjunct when used in a multidisciplinary weight management clinic.

Keywords: Child Health; Endocrinology; Obesity.