GLP-1 and GIP/GLP-1 Agonists Effectively Reduce BMI in Obese Children, But Lifestyle Co-Intervention Impact Unclear

The global rise in pediatric obesity necessitates effective interventions beyond traditional lifestyle modifications. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) and dual GIP/GLP-1 receptor agonists have revolutionized adult obesity management, offering substantial weight loss. However, their efficacy and optimal integration with nutritional and behavioral co-interventions in children and adolescents remain a critical knowledge gap. Understanding this synergy is crucial for developing comprehensive treatment strategies, as current standard-of-care often combines pharmacotherapy with lifestyle changes, yet the independent contribution of each component is poorly defined in this vulnerable population.

Researchers conducted a systematic review of 15 studies (including 12 interventional [RCT/non-RCT] and 3 observational studies) involving 1448 participants aged 6-19 years with overweight or obesity, with or without type 2 diabetes (T2D). The search spanned PubMed, Scopus, and ClinicalTrials.gov. Studies evaluated treatment with various GLP-1 RAs or dual GIP/GLP-1 agonists, including liraglutide, exenatide, semaglutide, dulaglutide, tirzepatide, and lixisenatide. Primary endpoints included anthropometric outcomes (e.g., BMI reduction), metabolic parameters, and the scope and structure of concomitant nutritional and behavioral interventions.

The systematic review analyzed 15 studies with a total of 1448 participants, revealing varied intervention durations from 6 to 68 weeks. Specific agents included liraglutide (n=6 studies), exenatide (n=5), semaglutide (n=1), dulaglutide (n=1), tirzepatide (n=1), and lixisenatide (n=1). Reported BMI reductions varied across studies and pharmacological agents. Notably, semaglutide trials demonstrated the most significant reductions, with some reporting decreases of up to -16.1%. Metabolic parameters were also assessed, though specific numerical improvements were not detailed in the abstract. Lifestyle interventions, ranging from general dietary advice to structured, multidisciplinary programs, were heterogeneously reported across the included studies. Due to this significant heterogeneity in study design and reporting, the independent contribution of these lifestyle interventions to the observed outcomes could not be definitively determined.

Available evidence suggests that GLP-1 RAs and dual GIP/GLP-1 agonists represent an effective therapeutic option for children and adolescents with obesity and metabolic disorders.