Weekly Weight Loss Medication Reduces BMI in Teens

Weekly Weight Loss Medication Reduces BMI in Teens

Semaglutide is a glucagon-like peptide-1 analog that may reduce hunger and thus support weight loss. In a recent New England Journal of Medicine Study researchers report that a weekly dose of semaglutide resulted in a significant reduction in body mass index (BMI) in adolescents.

Learn: Once-weekly semaglutide in adolescents with obesity. Photo credit: SKT Studio / Shutterstock.com

Obesity in young children

Researchers predict that by 2030, over 250 million children and adolescents will be considered obese. Obese children and adolescents are at higher risk for numerous health problems, including dysglycemia, hypertension, nonalcoholic fatty liver disease, obstructive sleep apnea, dyslipidemia, altered mental health, and impaired quality of life.

Although certain lifestyle changes can improve the quality of life of young obese individuals, their effects are often limited in their ability to significantly reduce BMI values. As a result, several pharmacologic agents have been approved to support long-term weight maintenance, some of which include liraglutide, orlistat, and phentermine-topiramate.

About the clinical trial of semaglutide

The Semaglutide Treatment Effect in People with Obesity (STEP) TEENS study is a double-blind, randomized, parallel-group, placebo-controlled study that enrolled a total of 201 obese or overweight participants aged 12 to 18 years.

While obesity was defined as a BMI in the 95th percentile or higher, a person with a BMI in the 85th percentile or higher was considered overweight. All participants were also diagnosed with at least one weight-related comorbidity.

Each study participant was randomly assigned to receive either a 2.4 milligram (mg) dose of semaglutide once weekly or a placebo administered subcutaneously for a total of 68 weeks. In addition to placebo or medication, all study participants participated in a 12-week lifestyle intervention that included counseling about healthy eating options and physical activities that could support weight loss.

Any person who lost more than five kilograms (kg) or took an obesity-related medication within 90 days before screening was excluded from the study. Additional exclusion criteria included prior bariatric surgery, uncontrolled thyroid disease, prior diagnosis of major depressive disorder within two years prior to screening for the study, diagnosis of major psychiatric disorder or bulimia nervosa, and history of suicide attempt.

Effectiveness of semaglutide

eBook on laboratory diagnostics and automation

Compilation of the top interviews, articles and news from the last year. Download a copy today

Of the 201 people enrolled in the study, 134 received semaglutide and 67 received placebo, of which 132 and 64, respectively, completed the full 68 weeks of treatment. In general, baseline characteristics were similar between both groups, except for body weight, BMI and waist circumference, which were all higher in the semaglutide group.

The average age of the study participants was 15.4 years, 62% of whom were female and 79% white. The mean body weight was 107.5 kg and the mean BMI was 37.0.

At the end of the 68-week period, the semaglutide group showed a 16.1 percent reduction in their BMI values ​​compared to a 0.6 percent change in the placebo group. In addition, 73% of those who received semaglutide lost at least 5% of their body weight, which is comparable to only 18% of the placebo group.

In addition to BMI, treatment with semaglutide was also associated with reductions in total cholesterol, low-density lipoprotein cholesterol (LDL), very low-density lipoprotein cholesterol, triglycerides, alanine aminotransferase (ALT), and glycated hemoglobin levels compared to placebo tied together. There was no difference between semaglutide and placebo treatments in their effects on blood pressure or high-density lipoprotein (HDL) cholesterol levels.

After discontinuing medication, study participants in both groups received lifestyle interventions for an additional seven weeks. At the end of this period, or Week 75, semaglutide recipients' BMI remained below their baseline, while those who received the placebo had a BMI that exceeded their baseline.

Safety of semaglutide

Importantly, 79% and 82% of semaglutide and placebo recipients, respectively, experienced an adverse treatment effect, with the overall number of adverse events being higher in the semaglutide group.

The most commonly reported adverse events were gastrointestinal (GI) related, with the most common symptoms being nausea, vomiting and diarrhea. Adverse gastrointestinal events were reported in 62% and 42% of semaglutide and placebo recipients, respectively. Importantly, most of these symptoms were mild or moderate, with a maximum duration of two to three days in the semaglutide group.

Serious adverse events were reported in 11% and 9% of semaglutide and placebo recipients, respectively. For example, five semaglutide recipients experienced acute gallbladder disease. Nevertheless, the safety profile of semaglutide appears to be consistent with that of other glucagon-like peptide-1 receptor agonists.

Conclusions

Taken together, clinical trial results indicate that a weekly dose of 2.4 mg of semaglutide along with lifestyle changes significantly and to a greater extent lowers BMI and other weight-related measures than lifestyle changes alone.

Reference:

• Weghuber, D., Barett, T., Barrientos-Perez, M., et al. (2022). Einmal wöchentlich Semaglutid bei Jugendlichen mit Adipositas. Das New England Journal of Medicine. doi:10.1056/NEJMoa2208601.

.