Real-World Use of GLP-1 Receptor Agonist Liraglutide in Adolescents with Obesity: A First Longitudinal Single-Center Analysis from Switzerland †

Abstract

Highlights: What are the main findings? Liraglutide reduced clinically relevant BMI-SDS in adolescents with obesity under real-world clinical conditions, with a safety profile consistent with clinical trials. Despite efficacy, treatment discontinuation was common, mainly due to limited weight loss or mild nausea. What are the implications of the main findings? Thorough pre-treatment counseling is essential to set realistic expectations and address manageable side effects. Further studies are needed to identify factors that may predict a favorable response to therapy, and to clarify the broader role of GLP-1 receptor agonists in adolescent obesity. Background: Adolescent obesity remains a challenge with limited treatment options. GLP-1 receptor agonists such as liraglutide (Saxenda®) have shown efficacy in trials, but real-world data in youth are scarce. Methods: This retrospective longitudinal, non-interventional study analyzed 22 adolescents treated with liraglutide in a Swiss pediatric endocrinology center. All received non-structured nutritional/lifestyle counseling with three-monthly follow-up. BMI standard deviation scores (BMI-SDS) and adverse effects were recorded. Results: The mean age at initiation was 14.9 years (range 12.5–17.5); 15 patients had Southern European immigrant background. Mean treatment duration was 8.2 months (range 1–18). BMI-SDS decreased significantly from +2.63 (IQR +2.4/+2.8) to +2.40 (IQR +2.2/+2.6). Median intra-individual reduction was −0.20 (IQR −0.28/−0.10), p = 0.0003 with large effect size (rb = −0.77). Thirteen patients discontinued treatment, mainly due to insufficient weight loss or mild nausea. In the patients continuing therapy BMI-SDS decreased from +2.59 (IQR +2.4/+2.8) to +2.08 (IQR +1.9/+2.4). No serious adverse events occurred. Conclusions: Liraglutide showed a comparable efficacy to the pivotal clinical trial in reducing BMI-SDS in adolescents, while the side-effect profile was similarly mild and consistent with previously reported data. Discontinuation rates remained high, highlighting the need for thorough pre-treatment counseling on expected mild, transient symptoms and strategies to mitigate nausea. Future prospective studies are needed to assess long-term outcomes and identify patient characteristics associated with greater treatment success, to better individualize GLP-1–based therapy in adolescent obesity.