CHILDHOOD OBESITY AND GLP-1 RECEPTOR AGONISTS: CURRENT EVIDENCE, CHALLENGES AND FUTURE PERSPECTIVES – A NARRATIVE REVIEW

Authors

DOI:

https://doi.org/10.31435/ijitss.3(51).2026.6241

Keywords:

Childhood Obesity, Pediatric Obesity, GLP-1 Receptor Agonists, Liraglutide, Semaglutide, Adolescent Obesity, Pharmacological Treatment

Abstract

Introduction: Childhood obesity has become one of the most significant global public health challenges of the twenty-first century. The prevalence of obesity among children and adolescents continues to increase worldwide, contributing to the growing burden of metabolic, cardiovascular, endocrine and psychological disorders. Traditional interventions based on lifestyle modification often demonstrate limited long-term effectiveness, highlighting the need for additional therapeutic strategies. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a promising pharmacological option for pediatric obesity management.

Purpose of the Study: The aim of this review is to provide a comprehensive overview of the current evidence regarding the use of GLP-1 receptor agonists in children and adolescents with obesity, with particular emphasis on their mechanisms of action, clinical efficacy, safety profile, psychological impact and future therapeutic perspectives.

Materials and Methods: The literature review was based on publications published between 2007 and 2025. PubMed, Scopus and Google Scholar databases were searched using keywords including childhood obesity, pediatric obesity, adolescent obesity, GLP-1 receptor agonists, liraglutide, semaglutide, tirzepatide, pharmacological treatment and weight management. Priority was given to randomized controlled trials, systematic reviews, meta-analyses and international clinical guidelines published in English.

Description of the State of Knowledge: Recent clinical trials have demonstrated significant efficacy of GLP-1 receptor agonists in reducing body weight and body mass index in pediatric patients with obesity. Liraglutide and semaglutide have shown clinically meaningful improvements in weight reduction, metabolic parameters and quality of life. Among currently available GLP-1 receptor agonists, semaglutide demonstrated the greatest efficacy for BMI and weight reduction in a recent network meta-analysis of pediatric obesity treatments. Although gastrointestinal adverse effects remain the most commonly reported complications, overall treatment tolerability appears favorable. Ongoing studies are evaluating long-term safety, treatment durability and the role of next-generation incretin-based therapies.

Conclusion: GLP-1 receptor agonists represent a promising advancement in the management of childhood obesity. Their ability to achieve significant weight reduction and improve obesity-related comorbidities may substantially decrease the lifetime risk of cardiovascular disease, chronic kidney disease,and premature mortality.

References

NCD Risk Factor Collaboration (NCD-RisC). (2017). Worldwide trends in body-mass index, underweight, overweight, and obesity from 1975 to 2016: A pooled analysis of 2416 population-based measurement studies in 128.9 million children, adolescents, and adults. The Lancet, 390(10113), 2627–2642. https://doi.org/10.1016/S0140-6736(17)32129-3

Kumar, S., & Kelly, A. S. (2017). Review of childhood obesity: From epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clinic Proceedings, 92(2), 251–265. https://doi.org/10.1016/j.mayocp.2016.09.017

Hampl, S. E., Hassink, S. G., Skinner, A. C., Armstrong, S. C., Barlow, S. E., Bolling, C. F., Avila Edwards, K. C., Eneli, I., Hamre, R., Joseph, M. M., Kraftson, A. T., Levy, S. J., Pate, R. R., Ryder, J. R., & Walsh, S. M. (2023). Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics, 151(2), e2022060640. https://doi.org/10.1542/peds.2022-060640

Rankin, J., Matthews, L., Cobley, S., Han, A., Sanders, R., Wiltshire, H. D., & Baker, J. S. (2016). Psychological consequences of childhood obesity: Psychiatric comorbidity and prevention. Adolescent Health, Medicine and Therapeutics, 7, 125–146. https://doi.org/10.2147/AHMT.S101631

Pont, S. J., Puhl, R., Cook, S. R., & Slusser, W. (2017). Stigma experienced by children and adolescents with obesity. Pediatrics, 140(6), e20173034. https://doi.org/10.1542/peds.2017-3034

Mead, E., Brown, T., Rees, K., Azevedo, L. B., Whittaker, V., Jones, D., Olajide, J., Mainardi, G. M., Corpeleijn, E., O'Malley, C., Beardsmore, E., Al-Khudairy, L., Baur, L., Metzendorf, M. I., & Demaio, A. (2017). Diet, physical activity and behavioural interventions for the treatment of overweight or obese children from the age of 6 to 11 years. Cochrane Database of Systematic Reviews, 2017(6), CD012651. https://doi.org/10.1002/14651858.CD012651

Holst, J. J. (2007). The physiology of glucagon-like peptide 1. Physiological Reviews, 87(4), 1409–1439. https://doi.org/10.1152/physrev.00034.2006

Drucker, D. J. (2018). Mechanisms of action and therapeutic application of glucagon-like peptide-1. Cell Metabolism, 27(4), 740–756. https://doi.org/10.1016/j.cmet.2018.03.001

Kelly, A. S., Auerbach, P., Barrientos-Pérez, M., Gies, I., Hale, P. M., Marcus, C., Mastrandrea, L. D., Prabhu, N., Arslanian, S., & NN8022-4180 Trial Investigators. (2020). A randomized, controlled trial of liraglutide for adolescents with obesity. New England Journal of Medicine, 382(22), 2117–2128. https://doi.org/10.1056/NEJMoa1916038

Weghuber, D., Barrett, T., Barrientos-Pérez, M., Gies, I., Hesse, D., Jeppesen, O. K., Kelly, A. S., Mastrandrea, L. D., Sørrig, R., Arslanian, S., & STEP TEENS Investigators. (2022). Once-weekly semaglutide in adolescents with obesity. New England Journal of Medicine, 387(24), 2245–2257. https://doi.org/10.1056/NEJMoa2208601

Jastreboff, A. M., Aronne, L. J., Ahmad, N. N., Wharton, S., Connery, L., Alves, B., Kiyosue, A., Zhang, S., Liu, B., Bunck, M. C., & Stefanski, A. (2022). Tirzepatide once weekly for the treatment of obesity. New England Journal of Medicine, 387(3), 205–216. https://doi.org/10.1056/NEJMoa2206038

Jastreboff, A. M., Kaplan, L. M., Frías, J. P., Wu, Q., Du, Y., Gurbuz, S., Coskun, T., Haupt, A., Milicevic, Z., & Hartman, M. L. (2023). Triple-hormone-receptor agonist retatrutide for obesity. New England Journal of Medicine, 389(6), 514–526. https://doi.org/10.1056/NEJMoa2301972

Kerr, J. A., et al. (2025). Global, regional, and national prevalence of child and adolescent overweight and obesity, 1990–2021, with forecasts to 2050: A forecasting study for the Global Burden of Disease Study 2021. The Lancet, 405(10478), 785–812. https://doi.org/10.1016/S0140-6736(25)00397-6

World Obesity Federation. (2025). World Obesity Atlas 2025. https://www.worldobesity.org/resources/resource-library/world-obesity-atlas-2025.

Skinner, A. C., Ravanbakht, S. N., Skelton, J. A., Perrin, E. M., & Armstrong, S. C. (2018). Prevalence of obesity and severe obesity in US children, 1999–2016. Pediatrics, 141(3), e20173459. https://doi.org/10.1542/peds.2017-3459

Sanyaolu, A., Okorie, C., Qi, X., Locke, J., & Rehman, S. (2019). Childhood and adolescent obesity in the United States: A public health concern. Global Pediatric Health, 6, 2333794X19891305. https://doi.org/10.1177/2333794X19891305

Müller, T. D., Finan, B., Bloom, S. R., D'Alessio, D., Drucker, D. J., Flatt, P. R., Fritsche, A., Gribble, F., Grill, H. J., Habener, J. F., Holst, J. J., Langhans, W., Meier, J. J., Nauck, M. A., Perez-Tilve, D., Pocai, A., Reimann, F., Sandoval, D. A., Schwartz, T. W., ... Tschöp, M. H. (2019). Glucagon-like peptide 1 (GLP-1). Molecular Metabolism, 30, 72–130. https://doi.org/10.1016/j.molmet.2019.09.010

Secher, A., Jelsing, J., Baquero, A. F., Hecksher-Sørensen, J., Cowley, M. A., Dalbøge, L. S., Hansen, G., Grove, K. L., Pyke, C., Raun, K., Schaffer, L., Tang-Christensen, M., & Verma, S. (2014). The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss. Journal of Clinical Investigation, 124(10), 4473–4488. https://doi.org/10.1172/JCI75276

van Can, J., Sloth, B., Jensen, C. B., Flint, A., Blaak, E. E., & Saris, W. H. M. (2014). Effects of the once-daily GLP-1 analog liraglutide on gastric emptying, glycemic parameters, appetite and energy metabolism in obese, non-diabetic adults. International Journal of Obesity, 38(6), 784–793. https://doi.org/10.1038/ijo.2013.162

Agosta, M., Sofia, M., Pezzino, S., D'Amato, S., Litrico, G., Mazzone, C., La Greca, G., & Latteri, S. (2024). Efficacy of liraglutide in pediatric obesity: A review of clinical trial data. Obesity Medicine, 48, 100545. https://doi.org/10.1016/j.obmed.2024.100545

Pi-Sunyer, X., Astrup, A., Fujioka, K., Greenway, F., Halpern, A., Krempf, M., Lau, D. C. W., le Roux, C. W., Violante Ortiz, R., Jensen, C. B., & Wilding, J. P. H. (2015). A randomized, controlled trial of 3.0 mg of liraglutide in weight management. New England Journal of Medicine, 373(1), 11–22. https://doi.org/10.1056/NEJMoa1411892

Liu, L., Shi, H., Shi, Y., Wang, A., Guo, N., Tao, H., & Nahata, M. C. (2024). Comparative efficacy and safety of glucagon-like peptide-1 receptor agonists in children and adolescents with obesity or overweight: A systematic review and network meta-analysis. Pharmaceuticals, 17(7), 828. https://doi.org/10.3390/ph17070828

Wilding, J. P. H., Batterham, R. L., Calanna, S., Davies, M., Van Gaal, L. F., Lingvay, I., McGowan, B. M., Rosenstock, J., Tran, M. T. D., Wadden, T. A., Wharton, S., Yokote, K., Zeuthen, N., & Kushner, R. F. (2021). Once-weekly semaglutide in adults with overweight or obesity. New England Journal of Medicine, 384(11), 989–1002. https://doi.org/10.1056/NEJMoa2032183

Kushner, R. F., Calanna, S., Davies, M., Dicker, D., Garvey, W. T., Goldman, B., Lingvay, I., Thomsen, M., Wadden, T. A., & Rubino, D. M. (2020). Semaglutide 2.4 mg for the treatment of obesity: Key elements of the STEP trials. Obesity, 28(6), 1050–1061. https://doi.org/10.1002/oby.22794

Rubino, D., Abrahamsson, N., Davies, M., Hesse, D., Greenway, F. L., Jensen, C., Lingvay, I., Mosenzon, O., Rosenstock, J., Rubio, M. A., Rudofsky, G., Tadayon, S., Wadden, T. A., Wizert, A., & STEP 4 Investigators. (2021). Effect of continued weekly subcutaneous semaglutide vs placebo on weight loss maintenance in adults with overweight or obesity: The STEP 4 randomized clinical trial. JAMA, 325(14), 1414–1425. https://doi.org/10.1001/jama.2021.3224 Bergmann, N. C., Davies, M. J., Lingvay, I., & Knop, F. K. (2023). Semaglutide for the treatment of overweight and obesity: A review. Diabetes, Obesity and Metabolism, 25(1), 18–35. https://doi.org/10.1111/dom.14863

Styne, D. M., Arslanian, S. A., Connor, E. L., Farooqi, I. S., Murad, M. H., Silverstein, J. H., & Yanovski, J. A. (2017). Pediatric obesity—Assessment, treatment, and prevention: An Endocrine Society clinical practice guideline. Journal of Clinical Endocrinology & Metabolism, 102(3), 709–757. https://doi.org/10.1210/jc.2016-2573

Armstrong, S. C., Bolling, C. F., Michalsky, M. P., & Reichard, K. W. (2019). Pediatric metabolic and bariatric surgery: Evidence, barriers, and best practices. Pediatrics, 144(6), e20193223. https://doi.org/10.1542/peds.2019-3223

Inge, T. H., Courcoulas, A. P., Jenkins, T. M., Michalsky, M. P., Helmrath, M. A., Brandt, M. L., Harmon, C. M., Chen, M. K., Xanthakos, S. A., Horlick, M., Buncher, C. R., & Teen-LABS Consortium. (2016). Weight loss and health status 3 years after bariatric surgery in adolescents. New England Journal of Medicine, 374(2), 113–123. https://doi.org/10.1056/NEJMoa1506699

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2026-09-25

How to Cite

Skowron, W., Skowron, M., Łapot, M., Hober, K., Krupnik, D., Bzdak, W., Szwemińska, P., Górak, J., & Neumann, W. (2026). CHILDHOOD OBESITY AND GLP-1 RECEPTOR AGONISTS: CURRENT EVIDENCE, CHALLENGES AND FUTURE PERSPECTIVES – A NARRATIVE REVIEW. International Journal of Innovative Technologies in Social Science, 5(3(51). https://doi.org/10.31435/ijitss.3(51).2026.6241

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