Study Group

Obesity Treatment for Teens: Liraglutide Coming Soon?

While the world has been busy with COVID-19, quite a lot has been happening in obesity. Last week, JAMA Pediatrics published an important review of all the evidence-based options for treating obesity in adolescents. The bottom line? Those options are too few, but more are coming. Today, we got a good look at one of those options. Aaron Kelly et al published the results of an impressive RCT in teens for liraglutide in the New England Journal of Medicine. Also known as Saxenda, it appears to have safety and effectiveness for teens similar to what it has for adults.

Clinically Significant Benefits

Obesity is a chronic disease that’s hard to treat. For any given treatment, not everyone responds. Not even close. In this new study, 43 percent of the teens receiving liraglutide reduced their BMI by a five percent. In obesity treatment, that’s a meaningful response. Both the liraglutide group and the placebo group received lifestyle therapy. But the group that got only lifestyle therapy were much less likely to reduce their BMI by ten percent. In fact, only 19 percent of them did. More than three times as many in the liraglutide group achieved a ten percent reduction in BMI.

Kelly explained to us:

Based on the literature and on guidance from the US Preventive Services Task Force, we believe that the mean reduction in BMI with liraglutide was clinically significant. The mean reduction in body weight was approximately 10 pounds. However, it should be noted that we observed a high degree of variability in response such that many participants experienced greater weight loss. In future studies, it will be important to identify predictors of response so we can better tailor treatments. We need to improve our ability to get the right treatments to the right patients at the right time.

FDA required this study as a condition for approving Saxenda. So hopefully, in time, this new indication for its use will be reflected in its labeling.

Welcome News

Gitanjali Srivastava is a pediatrician and the Medical Director for Vanderbilt Obesity Medicine. She told us:

This is fantastic news. It provides important confirmatory evidence for the extensive experience that we already have with liraglutide in teens.

Joseph Skelton, director of the obesity care program at Brenner Children’s Hospital, was similarly enthusiastic about this publication:

This study was extremely well done, from the outcome measures to the analysis. Because of that, the benefit of Liraglutide vs placebo is clear. And the degree of weight status improvement is in a range that health benefits should arise. This study did not show that, but the population under study was in the Class II obesity range and on-average did not have significant cardio-metabolic complications.

A Long Road Ahead

In JAMA Pediatrics, Michelle Cardel et al made it clear that this is just one milestone on a long road ahead to better childhood obesity care:

This considerable need for increased attention to obesity care calls for dedicated resources in both education and research for treatment of obesity in youths.

More options are coming to fill this critical need. This is certainly good news.

Click here for today’s publication in NEJM, here for the review by Cardel et al, and here for a commentary by Leonard Epstein and Teresa Quattrin.

Study Group, photograph © Rudd Center for Food Policy and Obesity / Rudd Center Image Library

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March 31, 2020