Severe obesity is already a major problem for many children – even more so because obese children very often become obese adults.
Could weight loss injections also be a solution for people under 18? A study indicates that the active ingredient liraglutide is effective and safe in childrenThe effect was investigated in six to twelve year olds.
No really successful method so far
“So far, there is no medication available to treat obesity in this age group,” says Daniel Weghuber from the University Hospital of Salzburg, who was not involved in the study. Most adolescents with obesity already had it when they started school. It is therefore important to intervene in children as early as possible.
11
percent of the children participating in the study discontinued treatment due to side effects.
Up to now, the only method available has been lifestyle changes as part of family education, explains Weghuber, head of the University Clinic for Pediatrics and Adolescent Medicine. “That’s easy to say, but very difficult to implement.” In this respect, the use of liraglutide could be an important additional step, especially in children with an extreme form of obesity.
Long-term consequences also unclear
As with adolescents and adults, the question arises as to whether the substance is suitable and safe for long-term therapy. “This question applies not only to children between the ages of six and twelve, but to all people with this therapy,” says Weghuber.
All that is known so far is that when the drug is discontinued, the majority of those affected regain weight.
According to current knowledge, liraglutide must be taken over a long period of time, over decades. What long-term effects this could have is still unclear, because this and similar drugs have not been in use long enough.
Nerys Astbury of the University of Oxford – also not involved in the study – also points out: “Although there was no evidence that liraglutide had any adverse effects on changes in height, bone age or pubertal status, further longer-term follow-up of participants and their growth patterns is needed.”
Martin Wabitsch from Ulm University Hospital explains that there is hope that early use of the drug will lead to such a significant effect that the dose can later be reduced or the drug can even be discontinued altogether.
56 children were treated
The new study published in the New England Journal of Medicine ran for 56 weeks. It involved 82 severely obese children in the USA. 56 of them received a daily injection of liraglutide (brand name “Saxenda”), 26 placebo injections.
All participants also received individual advice on healthy nutrition and physical activity, write the researchers led by Claudia Fox from the University of Minnesota in Minneapolis.
The average body mass index (BMI) decreased by 5.8 percent for the children in the liraglutide group, while it increased by 1.6 percent in the test group. In general, all children gained weight as they grew, but the children in the liraglutide group gained only 1.6 percent of their initial weight, while those in the placebo group gained 10 percent. The observed weight change in the treated children is ten times greater than that expected from a lifestyle change, says Weghuber.
Side effects as in older subjects
The side effects observed corresponded to those previously observed in analyses with adolescents and adults, the study continues. These were common nausea, vomiting and diarrhea. Almost 11 percent of the children who received liraglutide stopped taking it due to the side effects.
Wabitsch believes that the drug will be of interest in the future primarily to children with extreme obesity – “and certainly not to all children with obesity.” This small group of patients is characterized by a strong biological predisposition to obesity. A defect in the central regulation of hunger and satiety is characteristic. “This is exactly where liraglutide comes in.”
Data on similar active ingredients are still pending
Liraglutide is a so-called glucagon-like peptide-1 (GLP-1) receptor agonist. It binds to the GLP-1 receptor. This inhibits appetite, among other things. The active ingredient is also approved in Europe for the treatment of diabetes and obesity in adolescents and adults.
Studies have shown that successor drugs from the same substance group such as semaglutide (brand name “Wegovy”) and tirzepatide (“Mounjaro”) are more effective and do not need to be injected daily. There are currently no studies on the tolerability and effectiveness of these two active ingredients in children.
Semaglutide and liraglutide are approved in the EU and USA for use from the age of twelve, explains Wabitsch, who was not involved in the analysis presented. The current publication will lead to liraglutide also being approved for use from the age of six, the doctor is convinced. A similar study for semaglutide is currently underway in his center in Ulm with children, the results of which are expected next year. (dpa)
