Endocrine Abstracts

The Glucagon like one peptides (GLP-1’s) Wegovy (semagluatide) and Saxenda (Liragluatide) are licensed for the treatment of severe obesity in young people aged 12-17 years. We report our “real-world experience” of treating a large cohort of 98 young people with GLP-1’s under the umbrella of our complications of excess weight clinic (CEW clinic). All young people and their families were offered a minimum of three months dietetic and lifestyle support from a multidisciplinary team comprising nurse specialists, dietician, family support workers and psychologist. Those who struggled to manage their weight with diet and lifestyle changes were offered support with a GLP-1. Families continued to receive lifestyle support and were reviewed 4 weekly in clinic. Ninety-eight young people (48 male & 50 female) received treatment - 21 individuals initially received Saxenda and subsequently Wegovy, whilst 77 received Wegovy alone. The mean age was 14.1 years (range 11-17 years). Mean weight before treatment was 118.8 kg, BMI 41.6 kg/m2 and mean BMI standard deviation score (SDS) +3.7. The change in weight, BMI and BMI SDS at 3, 6, 9 & 12 months are shown in the table. Nine patients stopped medication within 6 months as a result of noncompliance or failure to attend appointments. Two stopped because of nausea and one because of a deterioration in mental health. Nausea that subsequently resolved was commonly reported. There were no serious adverse events such as pancreatitis. A reduction in BMI SDS of -0.25 is widely recognised as the threshold to improve physical health. The reduction in weight of 22.0 kg and in BMI SDS of -0.74 noted at 12 months is likely to result in clinically meaningful improvements in complications such as hypertension, MASLD and diabetes risk. These data and data on quality of life are currently being analysed.

Conclusion: Support with GLP-1 s alongside lifestyle intervention results is significant and clinically relevant weight loss.