Obesity treatment in younger kids shows potential with liraglutide, according to a new research study.
It's a tough go for individuals dealing with obesity to shed pounds, regardless of their age, according to medical experts. Majority of adults and teens 12 years and above have access to advanced medications known as GLP-1 receptor agonists, but younger kids are limited to lifestyle modifications like diet, physical activity, and counseling to combat weight gain. Even with intensive intervention methods, youngsters generally register modest improvements, doctors assert.
The initial research on the effects of the GLP-1 drug liraglutide, which is marketed as Saxenda and Victoza, on young children discovered that the medication could significantly influence their Body Mass Index (BMI), a metric employed by healthcare specialists to evaluate obesity.
Liraglutide obtained approval from the US Food and Drug Administration in 2014 to aid adults in weight loss. In 2020, the approval was expanded to include youngsters aged between 12 and 17.
The study was published in the New England Journal of Medicine on Tuesday and presented at the annual European Association for the Study of Diabetes conference by Dr. Claudia Fox, a pediatrician associated with the Center for Pediatric Obesity Medicine at the University of Minnesota Medical School in Minneapolis.
The study focused on the effects of the drug on children within the age group of 6 to 12, who were considered to be overweight. The typical 10-year-old in the study weighed approximately 155 pounds.
The research included 82 children, 56 of whom received a daily liraglutide injection, while the remaining 26 children were administered a placebo. All the children received dietary counseling and were encouraged to engage in moderate to high-intensity exercises for an hour every day.
The two groups exhibited contrasting results. Over a period of 12 months, the BMI of the children in the medication group dropped by 7.4 percentage points more than the children in the placebo group. The BMI of the children in the liraglutide group decreased by 5.8%, while it increased by 1.6% among the children in the placebo group.
The study was financed by pharmaceutical company Novo Nordisk.
The results aligned with earlier studies conducted on teenagers, Fox stated, but the younger children showed more impressive improvements.
“That was the most surprising aspect for me, and it makes me think we should be intervening at younger age groups," Fox mentioned.
The study didn’t directly compare weight loss across different age groups, necessitating further research to determine if Fox's theory held water.
Liraglutide was found to be safe for the young children involved in the study, but participants across both groups experienced some side effects. Stomach problems, such as nausea, diarrhea, and vomiting, were more common in the medication group, though very few children dropped out due to the side effects. The stomach issues typically manifested early on in the study but subsided over time, Fox indicated.
The research did not address the duration children would have to stay on the drugs. Once the trial period ended and the children ceased using the medication or receiving counseling, their BMI increased, though not as drastically for this age group as it did for older children in previous studies. This could imply that the medications might have a more lasting effect if administered earlier.
“We do know that obesity is a chronic disease,” Fox said. “As soon as the intervention is over, the disease can reappear, and that is true of any other chronic disease, whether it’s diabetes, asthma, hypertension – any chronic disease that requires chronic treatment.”
Obesity is the most prevalent chronic health issue among children in the United States, with close to 20% of children having an above-average BMI. The incidence of obesity has been on the rise, having surged more than threefold since the 1970s, according to the US Centers for Disease Control and Prevention.
Obesity poses not just short-term challenges, as children with obesity often continue to struggle with weight problems into adulthood and face a lifetime of health complications, Dr. Simon Cork, a senior lecturer in physiology at Anglia Ruskin University, told the Science Media Centre.
“The evidence that liraglutide is both safe and effective in children is encouraging,” Cork, who was not associated with the research, commented.
Developing obesity medication for children is complex because children are still developing physically. More extended studies will be needed to ensure that appetite suppressants do not impact growth later in development. There were no signs in the new study that liraglutide had detrimental effects on children's growth or puberty, but researchers will keep a close eye on this aspect.
Early puberty and type 2 diabetes can exacerbate issues for children with obesity, and they may eventually develop cardiovascular issues, liver and kidney diseases, and certain types of cancer. However, a weight loss drug that demonstrates long-term efficacy could offer significant health benefits beyond weight loss for children with obesity.
“Because treating children and adolescents living with obesity can result in longer-lasting health advantages, although these medications are at present costly, their worth in reducing obesity-related risks and enhancing longer-term health must be considered,” Dr. Nerys Astbury, an associate professor of diet and obesity at the Nuffield Department of Primary Health Care Sciences at the University of Oxford, told the Science Media Centre. Astbury was not involved in the new study.
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In the last month, preliminary guidelines from the US Preventive Services Task Force, instrumental in deciding insurance coverage for healthcare services, suggested that medical practitioners should provide intensive behavioral therapies to assist children in shedding extra pounds. However, it did not advocate for weight loss medications or surgeries.
The American Pediatric Association, with its revised guidelines for handling obesity management set for 2023, supported both approaches for certain individuals.
Despite inconsistencies in opinion amongst healthcare providers and parents, Fox advocates for considering weight loss medications and surgeries such as gastric bypass or sleeve gastrectomy as options for children.
"Patients' families often believe they merely need to exert more effort to shed weight, but frequent park visits and healthier food choices may not always suffice," she stated. "We can't solely rely on behavioral interventions to tackle a biological disorder, expecting substantial improvement."
The use of GLP-1 receptor agonists, such as liraglutide, has proven effective in combating obesity in older individuals, but more research is needed to determine their impact on younger children. obesity is a serious health issue, with close to 20% of children in the United States having an above-average Body Mass Index (BMI), and it can lead to a lifetime of health complications.
