News release

From: World Obesity Federation (WOF)

Meta-analysis shows that use of GLP-1 drugs to treat weight loss in children with obesity but without diabetes is safe and effective

New research being presented at this year’s International Congress on Obesity (ICO2026) hosted by the World Obesity Federation (WOF) in Mexico City, Mexico (15-17 July) shows that use of glucagon-like peptide receptor agonists (GLP-1 RAs) for weight loss in children of various ages without diabetes is safe and effective. The study is by Dr Manpreet Kaur Oberoi, University of Western Ontario, London, ON, Canada and colleagues.

Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have been recently approved in multiple jurisdictions for weight management in the non-diabetic children aged 12 years and older. However, their safety and efficacy remain unclear. This systematic review and meta-analysis aimed to examine the impact of GLP-1 RAs on both safety and efficacy, in the non-children with obesity but without diabetes.

The author searched the databases PubMed/MEDLINE, CENTRAL, and Embase up May 2025 for randomised controlled trials on GLP-1 RAs in non-diabetic children with obesity, assessing efficacy on weight, body mass index standard deviation score (BMI-SDS) (also known as BMI z-score), cardiometabolic outcomes (blood pressure, heart rate), and health-related quality of life (HRQoL) and safety outcomes (adverse events). Two reviewers screened studies, extracted data, and assessed bias. Statistical analysis combined the results from all included studies to estimate the average effect of GLP-1 medications compared with placebo or standard care. Primary outcomes were focused on efficacy (e.g., weight and cardiometabolic effects) and secondary outcomes were focused on safety.

A total of 1095 studies were screened, and nine studies (756 participants) were included in the study.  Four of the studies were considered small, with 12-44 particpants and lasting 5-24 weeks; the other five were considered large with 55- to 251 participants and lasting 52-68 weeks.  Three trials were in the US, one in Germany, one across Sweden and Austria, and four involved international consortia. Three trials were exanatide, five on liraglutide, and one on semaglutide. Various GLP-1 RAs are approved for use in children aged 12 years and over. The mean age of particpants across this meta-analysis was 14-15 years, with the age range across all studies six to 18 years.*

Although the initial search identified 1,095 records using broad search terms, only nine studies met the eligibility criteria. This reflects the limited number of GLP-1 RA trials conducted specifically for paediatric obesity, as many studies identified during screening focused on pediatric diabetes, which was not the population of interest for this review.

BMI-SDS is a tool doctors use to understand how a child's weight compares with other children of the same age and sex while allowing for normal growth. A lower BMI-SDS means a child’s weight is moving closer to the expected range for their age and height. In this study, children who received GLP-1 receptor agonists showed a greater improvement in BMI-SDS than those who did not receive treatment, suggesting these medicines helped improve weight status beyond what would be expected from growth alone.

Across all ages and weights, the mean weight lost per child was just over 5kg (5.08kg) representing the average difference between children who received a GLP-1 medication and those who did not, rather than the exact change for an individual child. For example, if two children both started at 95 kg, the child receiving a GLP-1 medication would weigh about 90 kg at follow-up, while the child in the comparison group would remain around 95 kg; an average difference of about 5 kg between the groups). Between the type of GLP-1 RAs agents, semaglutide showed the most pronounced mean weight loss (-17.75 kg) versus exenatide (-3.53 kg) and liraglutide (-3.12 kg).

Chidlren treated with GLP-1 RAs also saw an average systolic blood pressure fall of 2.24 mm Hg, and, in the three studies assessing heart reat, saw an average drop of 2.83 beats per minute. Children on GLP-1 RAs also saw quality of life scores increase.

The only significant safety concern was increased nausea risk (three times higher than children given placebo),  Other reported adverse events, including vomiting and diarrhooea, were not significantly increased compared with placebo, although a numerical trend toward higher incidence was observed. Serious adverse events (such as pancreatitis, gallstones, and appendicitis) were rare and occurred at similar rates in children receiving GLP-1 medications and those receiving placebo or standard care.

Dr Oberoi concludes: “This study showed that the use of GLP-1 RAs in children aged over 12 years with obesity but not diabetes were significantly efficient in lowering the BMI, weight, heart rate, and systolic BP and in improving quality of life, while maintaining a manageable safety profile. To our knowledge, this is the first study to report on changes in heart rate and quality of life scores for children treated with GLP-1 RAs. Larger, longer-term trials are needed to confirm sustained efficacy, optimise dosing strategies, evaluate long-term safety, and more thoroughly assess patient-reported outcomes quality of life outcomes.”

*Although GLP-1 receptor agonists are currently approved for obesity only in individuals aged 12 years and older, younger children may receive these medications as part of carefully regulated clinical trials. Participants continue to receive the standard of care, with the investigational treatment evaluated under strict ethical and regulatory oversight. These trials are conducted to assess the safety, efficacy, and appropriate dosing of the medication before it can be considered for regulatory approval in younger paediatric populations.

This press release is based on a poster abstract at the International Congress on Obesity (ICO) in Mexico City, Mexico, 15-17 July. The material has been peer reviewed by the congress selection committee. There is no full paper at this stage and the work has not yet been submitted to a medical journal for publication