What GLP-1 (Glucagon-like peptide-1) receptor agonist medications are approved for pediatric use for weight loss?

From the Guidelines

Currently, the only GLP-1 medication approved for pediatric use is liraglutide, but it is authorized for children 10 years and older with type 2 diabetes, not specifically for weight management in this population. When considering weight loss medications for pediatric patients, it is essential to prioritize their safety and efficacy. According to the most recent study 1, GLP-1 receptor agonists have been shown to be safe and effective for decreasing A1C and promoting weight loss in youth with type 2 diabetes. However, their use in pediatric patients for weight loss is still off-label and lacks formal approval. Some key points to consider when evaluating weight loss medications for pediatric patients include:

• The FDA has approved orlistat (Xenical) for ages 12 and older, and phentermine (Lomaira) for ages 16 and older, for weight loss in adolescents with obesity 1.
• Liraglutide 3.0 mg is approved for use in adolescents (>12 years) in several Asian countries for weight management 1.
• GLP-1 receptor agonists, such as semaglutide (Wegovy, Ozempic) or tirzepatide (Mounjaro), may be prescribed off-label for adolescents with severe obesity, but this practice lacks formal approval and long-term safety data in pediatric populations 1.
• Treatment of pediatric obesity typically begins with lifestyle modifications, including dietary changes, increased physical activity, and behavioral therapy, before considering pharmacological interventions 1. The most appropriate approach is to prioritize lifestyle modifications and consider pharmacological interventions only when necessary, under close monitoring by a pediatrician. It is crucial to weigh the potential benefits and risks of each medication and consider the individual needs and circumstances of each pediatric patient. In the absence of approved GLP-1 medications for pediatric weight loss, comprehensive clinical trials are necessary to establish appropriate dosing, safety profiles, and long-term effects on growth and development in children and adolescents 1.

From the Research

GLP-1 Receptor Agonists for Pediatric Obesity

• GLP-1 receptor agonists have emerged as a potential treatment for pediatric obesity, with studies showing their efficacy in promoting weight loss and improving metabolic parameters in children and adolescents 2, 3.
• The use of GLP-1 receptor agonists in pediatric patients has been increasing, with liraglutide being the most commonly used medication 4.
• Recent studies have highlighted the benefits of GLP-1 receptor agonists in pediatric obesity treatment, including improved weight loss and metabolic outcomes, as well as delayed gastric emptying and appetite suppression 3, 5.

Approved GLP-1 Meds for Peds

• Liraglutide has been approved by the Food and Drug Administration for the treatment of pediatric obesity, and its use is expected to increase 4, 6.
• Other GLP-1 receptor agonists, such as exenatide and semaglutide, have also shown promise in pediatric obesity treatment, but more research is needed to establish their safety and efficacy in this population 3, 5.

Considerations for Use

• Patient tolerance and gastrointestinal side effects are important considerations when prescribing GLP-1 receptor agonists to pediatric patients 4.
• Providers should be vigilant about side effects and adjust the doses of GLP-1 receptor agonists accordingly 4.
• Mental health care and nutritional concerns are also important considerations when using GLP-1 receptor agonists in pediatric obesity treatment 6.