Endocrine Abstracts

Introduction: Childhood obesity remains a major health concern and there are a number of serious complications associated with it. These include type 2 diabetes mellitus (T2DM), obstructive sleep apnoea (OSA), idiopathic intracranial hypertension (IIH) and non-alcoholic fatty liver disease (NAFLD). Glucagon-like peptide 1 (GLP-1) therapy has shown promising results for weight loss in adults and has recently been approved for the use in the treatment of childhood obesity for adolescents aged 12 years and over.

Method: Adolescents with severe obesity attended a dedicated multidisciplinary team (MDT) weight management clinic. Each patient had significant complications secondary to obesity, which included T2DM, insulin resistance, IIH, OSA, dyslipidaemia, hepatic fibrosis, delayed puberty and depression. Liraglutide, a once daily subcutaneous injection, was commenced at a dose of 0.6 mg and increased, if required, to a maximum dose of 3 mg. The patients were reviewed by the MDT every two weeks.

Results: Seven patients completed a three-month course of Liraglutide and three of these continued to complete six months in total. The mean age at the start of the treatment course was 14.9 years (range:13-16 years) and all patients were female. Mean percentage weight loss was 4.2% (1.2-9.7%) and 5.8% (4-8.2%) at 3 and 6 months, respectively. Significant weight loss (5.3 kg, 95%CI 1.93-8.78, P = 0.009) and significant reduction in body mass index [BMI] (2.09 kg/m², 95% CI 0.97-3.20, P = 0.004) was noted at 3 months of treatment. This further continued with weight loss (6.9 kg, 95% CI 1.33-12.53, P = 0.033) and BMI reduction (2 kg/m², 95% CI 0.06-3.94, P = 0.047) being significant at 6 months of treatment. There were no side effects reported during the treatment courses. Resolution of IIH and steatohepatitis were noted following weight loss in two patients.

Conclusion: These are promising results showing significant weight loss and BMI reduction in adolescents over three and six months of liraglutide treatment, alongside regular support from a dedicated MDT. This intervention has potential to help and improve significant complications secondary to childhood obesity.