GLP-1 receptor agonists show early promise in reducing BMI among children with severe obesity, study finds

Key Takeaways:

• GLP-1 receptor agonists appear to enhance treatment outcomes for children with severe obesity when added to existing intensive behavioural and lifestyle interventions.
• Clinically meaningful BMI reductions were observed in a higher proportion of children following the integration of GLP-1 medications into their care plans.
• Families reported additional benefits beyond weight loss, including reduced conflict around food and improved ability to follow lifestyle recommendations.

Background: Addressing Severe Obesity in Children

Children living with severe obesity face considerable health challenges and are at increased risk of metabolic and psychological complications. While glucagon-like peptide-1 (GLP-1) receptor agonists are now widely used to treat obesity in adults, their use in paediatric care remains a developing area.

These medications mimic the hormone GLP-1, which helps reduce appetite, prolong satiety, and slow gastric emptying. When prescribed as part of a holistic care plan, they may support young people in achieving clinically significant improvements in weight and health outcomes.

At the 2025 European Congress on Obesity (ECO), new data were presented suggesting that incorporating GLP-1 receptor agonists into childhood obesity treatment regimens could enhance the likelihood of meaningful BMI reduction.

The Study: Real-World Outcomes from Sweden’s National Childhood Obesity Centre

Dr Annika Janson and her research team at the National Childhood Obesity Centre, Karolinska University Hospital, Stockholm, investigated the real-world effects of GLP-1 receptor agonists when used in conjunction with intensive health behaviour and lifestyle treatment (IHBLT).

The retrospective study included 1,126 children aged 0–16 years (51.6% boys), all living with severe obesity as defined by the International Obesity Task Force criteria. Each participant was enrolled in the IHBLT programme, which involves a multidisciplinary approach to support children and their families in modifying lifestyle behaviours, such as:

• Healthy eating and nutrition education
• Managing meal portions and timing
• Reducing screen time
• Promoting physical activity
• Supporting psychological wellbeing
  

This intensive intervention is tailored in collaboration with families, schools, and other community stakeholders.

Introduction of GLP-1 Agonists into the Programme

From 2023 onwards, GLP-1 receptor agonists – initially liraglutide, later including semaglutide – were prescribed to approximately one in four children within the programme. The study aimed to determine whether adding these medications led to improved BMI outcomes, acknowledging the complexities and inconsistencies of medication use in real-world settings.

“GLP-1 drugs are increasingly used to treat obesity in adults. They can also be used in children from the age of 12 and clinical trials have shown children lose 5–16% of their body weight after a year of treatment,” said Dr Janson.

She also highlighted that real-life application presents challenges absent in clinical trials:

“Children have varying degrees of obesity, co-morbidities and complications and may have faced problems in supply of the drug, financing it or taking it. As a consequence, it is difficult to isolate the effect of adding GLP-1 drugs to the plethora of treatments that are already available.”

Findings: BMI Improvements and Emerging Trends

The study compared outcomes from children treated prior to 2023 with those treated during and after 2023, when GLP-1 drugs were introduced. Prior to 2023, the average BMI reduction across patients was relatively stable. However, among those treated in 2023, 30% of children achieved a clinically significant BMI reduction – defined as at least a 0.25 standard deviation drop – compared with 27% in previous years.

While the difference is modest, researchers believe it reflects a positive early trend.

“Only a fraction of the children had GLP-1 drugs and most of those who did started on them 6–12 months into the treatment programme,” explained Dr Janson. “Longer-term treatment may lead to greater improvements in BMI.”

Moreover, a point prevalence estimate from January 2025 found that approximately one quarter of the 2023 cohort were actively taking GLP-1 medications at that time.

“These are just early indications but it does look as if the average effect of being a patient at our clinic has improved after adding GLP-1 drugs to the toolbox,” she added.

Beyond BMI: Family Experiences and Behavioural Shifts

Notably, Dr Janson reported that families described benefits that extended beyond measurable weight outcomes.

“Many children with severe obesity describe hunger and a strong appetite – both of which GLP-1 receptor agonists are known to help with,” she said.

“Results beyond obesity are also important. The families reported reduced conflicts around food and improved capacity for other lifestyle adaptations. It was easier to stick to meals and limit snacks. Portions could be down-sized. For some children, not being hungry all the time is a new feeling.”

Conclusion: A Valuable Tool with Cautious Optimism

While not a universal solution, GLP-1 receptor agonists appear to be a promising adjunct in the care of children living with severe obesity. The study’s findings support their wider use, particularly when integrated within a comprehensive treatment plan.

“GLP-1 receptor agonists are clearly beneficial to many children with severe obesity and while they won’t help in all cases, more children should have access to these important medications,” Dr Janson concluded.

CCH Insight:

This study is a great example of how GLP-1RAs are meant to work. They are not, as some people think, a ‘lazy way’ or an ‘easy way’ to lose weight. They are a tool which, when used as part of a holistic care plan and supported by a multidisciplinary team, enables people (in this case children with severe obesity) to follow a healthier diet and lifestyle. The children were able to achieve this because GLP-1 medications modified their appetites, so they were no longer constantly hungry or thinking about food.