Endocrine Abstracts

Childhood obesity is a highly prevalent, chronic, and progressive disease. While lifestyle therapy is the cornerstone of obesity treatment, this intervention is usually ineffective for achieving clinically significant and durable BMI reduction. The limitations of lifestyle therapy stem from the fact that this intervention does not address the underlying pathophysiology of obesity. Anti-obesity pharmacotherapy, in contrast, directly addresses the pathophysiology, thereby enhancing the outcomes achieved with lifestyle therapy alone. Indications for using adjunct anti-obesity medications in the pediatric population include: a) having class 2 or 3 (severe) obesity or b) having class 1 obesity with obesity-related comorbidities. Very few medications are approved for the indication of obesity in children and adolescents. However, recently two medications have been approved: liraglutide, a GLP-1 receptor agonist for obesity in youth ages ≥12 years and setmelanotide, a melanocortin-4 receptor agonist, for monogenic obesity due to POMC, PCSK1, and LEPR receptor deficiencies in children ages ≥6 years. Furthermore, there are several medications in the pipeline of phase 3 clinical trials. Understanding the role of anti-obesity medications in the management of pediatric obesity is critical for improving the outcomes of this serious disease.