ORIGINAL RESEARCH article
Front. Endocrinol.
Sec. Pediatric Endocrinology
Volume 16 - 2025 | doi: 10.3389/fendo.2025.1663499
12-Month Outcomes of GLP-1 in Severe Pediatric Obesity: Real-World Data
Provisionally accepted
L Cominato1,2*
M L Resende2N Bernardes2L Rachid2
C G.B.S Passone2
L B.F Mattar2G Neme2S G Souza2R S Pinto1R R Franco2D Damiani1,2- 1Clinical Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- 2Universidade de Sao Paulo Instituto da Crianca, São Paulo, Brazil
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Background: Real-world data on liraglutide for pediatric obesity is limited, especially in public healthcare systems of low-and middle-income countries. Objective: To evaluate the real-world effectiveness and safety of liraglutide in managing severe obesity among children and adolescents with severe obesity treated at a public quaternary hospital in Brazil. Methods: This cohort study included patients aged 6–17.9 years with BMI Z-score (Z-BMI) ≥+3, treated with liraglutide (up to 3.0 mg/day) and lifestyle intervention. Outcomes included changes in BMI, Z-BMI, weight, WHtR, metabolic markers, and adverse events over 3 months, 6 months and 12 months. Results: Of 74 patients, 55 completed 6 months and 22 completed 12 months. In patients aged 6-12 years (n=23), median Z-BMI decreased from +3.90 (3.4-5.1) to +3.06 (2.7-3.7) (p < 0.0001), and WHtR from 0.70 (0.66-0.73) to 0.64 (0.60-0.68) (p < 0.0001); 82.6% achieved ≥5% BMI reduction and 47.8% ≥10% BMI reduction. In adolescents aged ≥12 years (n=32), Z-BMI declined from +3.77 (3.02-4.66) to +3.48 (2.64-4.34) (p < 0.0001), and WHtR from 0.74 (0.62-0.80) to 0.67 (0.58-0.76) (p < 0.0001); 73.9% achieved ≥5% and 43.5% ≥10% BMI reduction. Improvements were also observed in LDL cholesterol, HbA1c, and HOMA-IR. Adverse events were mild and transient. Conclusion: Liraglutide was effective and safe in reducing adiposity and improving metabolic health in children and adolescents with severe obesity in a real-world setting.
Keywords: GLP-1 analog, Obesity, Treatment, Children, adolescents
Received: 10 Jul 2025; Accepted: 22 Aug 2025.
Copyright: © 2025 Cominato, Resende, Bernardes, Rachid, Passone, Mattar, Neme, Souza, Pinto, Franco and Damiani. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: L Cominato, Clinical Hospital, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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