Project: Effects of GLP-1 medication in adolescents with obesity

The introduction of treatment with GLP-1 receptor agonists can help many adolescents lose weight, but we still know relatively little about how these medications affect the body beyond weight loss.

Background

Pediatric obesity is a chronic and complex disease and one of the most pressing public health challenges of our time. Obesity can affect both physical and mental health in children and adolescents. Many experience impaired physical function, reduced quality of life, and weight-related stigma.

GLP-1 medications are approved for the treatment of obesity in children and adolescents. Although studies have shown that these medications, when combined with health behaviour and lifestyle treatment, can lead to substantial weight loss, there is still limited knowledge about how they work in real-world clinical practice and what effects they have beyond weight loss. This includes their impact on nutritional status, physical function and cardiorespiratory fitness, as well as how adolescents themselves experience the treatment.

Aim

The aim of this project is to investigate the effectiveness of GLP-1 medications in children and adolescents with obesity when used in routine clinical care. In addition to weight loss, we study how treatment affects body composition, physical function, nutritional status, and cardiometabolic health. By generating evidence that is relevant to clinical practice, the project aims to strengthen the scientific basis for the use of GLP-1 medications in pediatric obesity care.

Methods

We follow adolescents over time after they initiate treatment with GLP-1 medications at the National Childhood Obesity Centre at Karolinska University Hospital.

In addition to routine measurements of height and weight, the adolescents undergo several assessments to provide a broader picture of their health. Body composition is measured to estimate body fat and muscle mass. Physical function and strength are assessed using tests of both upper- and lower-body function. Cardiorespiratory fitness is assessed using a cycle ergometer test.

We analyse blood samples to assess nutritional status, including levels of vitamins and minerals that are important for growth and health. We also monitor several markers of cardiometabolic health, including blood pressure, blood glucose, blood lipids, and liver function. In a subgroup, we also conduct structured in-depth interviews to better understand how adolescents and their parents experience GLP-1 treatment. Together, these assessments provide a more comprehensive picture of how treatment affects health beyond weight loss alone.

Significance

Most previous studies of GLP-1 medications in adolescents have been clinical drug trials. Our research investigate how treatment works in routine clinical care, where patients often differ from those who participate in clinical trials.

The findings from this study will contribute to improved monitoring and safer use of GLP-1 medications in children and adolescents with obesity.