Endocrine Abstracts

JOINT606

Background: About 30% of children in Europe are living with overweight or obesity. As a chronic and relapsing disease obesity should be treated as early and effective as possible. Health behaviour and lifestyle therapy (HBLT) is the first-line treatment and while effective at changing behavior, produces fairly modest weight loss for most youth with obesity. In addition to established pharmacotherapy, more effective obesity medication (OM) has recently been approved for the treatment of obesity in adolescents as adjunct to HBLT. Pairing HBLT and ongoing OM is a new challenge when striving for a comprehensive and chronic care model in pediatric obesity. This study evaluates the adherence to recommended treatment with HBLT in adolescents receiving OM.

Methods: In this explorative study, adolescents (aged ≥11 years) living with obesity and receiving OM were retrospectively analyzed. HBLT before and during OM (specifically liraglutide) was evaluated descriptively. HBLT was defined as intensive multidisciplinary HBLT according to national guidelines, dietary counseling, psychologic counseling, or any kind of HBLT. Moreover, change in anthropometric and cardiometabolic outcomes during OM treatment was evaluated.

Results: In this study, 37 patients with a mean age of 14.7 years were included in the study. Mean treatment duration was 10.3 months. 92% received HBLT before start of liraglutide treatment, while 62% had HBLT during liraglutide treatment. In 43% dose escalation was delayed and 41% discontinued treatment. Gastrointestinal adverse events were reported in 54% and ultimately led to discontinuation of treatment in 38%. Percentage change in BMI from baseline to end of treatment or last follow-up for patients who continued treatment was -2.7% (-0.9 kg/m²). BMI reduction was greatest in patients who continued OM (-6.24%), whereas patients who discontinued gained 0.13% BMI on average. 28% reduced their BMI by 5%. OM was further associated with improvements in cardiometabolic risk factors.

Conclusion: Liraglutide is highly effective in real world pediatric obesity management. Adherence and coping with side effects are the main barriers to effective treatment. Concomitant HBLT to OM seems essential to strengthen patients’ engagement and sustainability. Pairment of OM and HBLT should be a priority in national disease management plans.