What do young kids with severe obesity do? The case of liraglutide, an anti-obesity drug that can help reduce body mass, says Sarah Ro

Most kids with obesity become teens with obesity and then adults with obesity. Sarah Ro, who directs the University of North Carolina Physicians Network Weight Management Program, said many young kids with severe Obesity have Already developed significant Health Issues. Her clinic in Hillsborough treats children with severe obesity who have health issues such as high blood pressure, type 2 diabetes or an advanced form of liver disease linked to excess weight.

“We know that a lot of the decisions doctors make are based on trials in adults,” he says. Evidence from children is what we need to make clinical decisions.

The findings from the latest trial have been the same as those from older children. A 2020 study1 investigating liraglutide in 12–17-year-olds found that 43% of those who took the drug showed a reduction of at least 5% in their BMI, compared with 19% of those who were on a placebo. In a trial conducted in 1992, semaglutide was found to be more effective in losing body weight than placebo.

Only 6 people were Black in that study and so the results might not generalize to children of colour. More diverse studies are needed, Ball says.

Scientists don’t like the latest trial’s strategy of usingBMI to measure progress. A person with a body mass index of 34 isn’t perfect. For kids, because they’re growing, it’s not an ideal metric,” says Ball. The authors of an editorial wrote that they know that a body mass index is not a good indicator of fat mass.

Sarah Nutter, a weight stigma researcher at the University of Victoria in Canada, says that obesity should be defined by weight-related health problems. She believes that the authors should have used a more reliable indicator of health than the body mass index.

Source: Should young kids take the new anti-obesity drugs? What the research says

What is the definition of obesity? How to define it? How weight loss drugs affect growth, puberty and childhood obesity, and what the exit strategy is for kids

Not much. There is no long-term data regarding the effects of GLP-1 on growth and puberty in young children. That’s partly because the drugs are relatively untested in the youngest people. For example, none of the GLP-1 mimics has been approved in the United States for treating obesity in kids younger than 12 years.

The children who took part in the latest study received liraglutide for just over one year and were followed for another six months. The study’s authors plan to continue to collect data on the drug’s safety until January 2027.

GLP-1 mimics are currently considered lifelong drugs. It’s a chronic relapsing disease that requires ongoing treatment for obese people. But, in practice, some children will need to stop taking the drugs — when their families lose insurance coverage, for example, or if the negative side effects, such as nausea, become intolerable. What the exit strategy for kids would be is a question for further research.

Ro treats children who experience incessant bully by peers and knows about it. “No one seems to be talking about the risks of doing nothing,” says Ro. Carrying 250 pounds (113 kilograms) on a 10-year-old body can affect growth and puberty, not to mention the heart, lungs and kidneys, as well as mental health and lifespan, she says. “As in all things,” she adds, “we need to weigh the risks and benefits of treatment versus no treatment.”

“Obesity is a disease,” Oprah Winfrey declared after disclosing her weight loss with an Ozempic-like drug. “It’s a brain disease,” a prominent obesity doctor explained on a “60 Minutes” episode about the drugs. “Obesity is disease” even has its own discover page on TikTok.

Diagnosis by B.M.I. was always imprecise; in an era of remarkably effective weight loss drugs, it’s untenable. Consider that 40 percent of American adults are classified as having obesity with a B.M.I. of 30 or above. With new treatments that cost upward of $1,000 per person per month, along with supply shortages, how to define obesity is more than just a fight over nomenclature. It is about figuring who is sick and how to get the best health care, and allocating resources in the most efficient way. It’s about ending the murkiness that has surrounded obesity diagnosis for decades.