Liraglutide combined with intense lifestyle modification in the management of obesity in adolescents

Apperley, Louise; Gait, Lucy; Erlandson-Parry, Karen; Laing, Peter; Senniappan, Senthil

doi:10.1515/jpem-2020-0714

Cited by 10 publications

(12 citation statements)

References 21 publications

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“…Patients exhibited a lack of adherence to lifestyle modifications, a crucial factor identified for achieving significant weight loss in previous research [ 20 ]. Despite conducting an initial consultation on lifestyle modifications, patients lost motivation to adhere to lifestyle interventions when weight loss was not observed.…”

Section: Discussionmentioning

confidence: 99%

“…Many participants displayed a significant psychological connection to food, highlighting the potential benefit of including a psychologist in the team. Apperley et al [ 20 ] conducted a study with an intense weight management program with liraglutide. The participants were reviewed by a multidisciplinary team (MDT) every two weeks for advice and support and treated with daily subcutaneous injections of liraglutide (dose range 1.2-3.0 mg).…”

Section: Discussionmentioning

confidence: 99%

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Single-Center Experience of Using Liraglutide in Adolescents With Obesity +/- Type 2 Diabetes

Dauleh,

Pasha,

Gad

et al. 2024

Cureus

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Background Childhood obesity is recognized as a chronic illness with limited therapeutic options. Tackling obesity (BMI; the weight in kilograms divided by the square of the height in meters, at the 95th percentile or higher) with lifestyle interventions, especially in adolescents, has proven to be a daunting task, yielding only modest results. Research on the use of liraglutide for weight reduction in pediatric patients has yielded conflicting results. Notably, there is a lack of studies in the Middle East reporting on the outcomes of glucagon-like peptide 1 (GLP-1) receptor agonists in treating obesity in children and adolescents, with or without diabetes. This study, conducted in the Middle East, represents the first investigation into the utilization of liraglutide for weight reduction in this pediatric population. Methods This retrospective study collected data on 22 consecutive participants, aged 12 to 19 years, who were diagnosed with obesity (defined as having a BMI greater than the 95th percentile for their age and sex) and had either type 2 diabetes mellitus (T2DM) or were non-diabetic who attended endocrine clinics in Sidra Medicine, Doha, Qatar, between 2020 and 2022. The study protocol involved a liraglutide treatment period spanning 18 months (72 weeks), with scheduled follow-up appointments at six-month intervals. The primary endpoints were changes in weight and BMI from baseline to the 72-week mark. Secondary endpoints were safety measures and changes in HbA1c. Results Out of the initial cohort of 22 patients, 12 completed the full 72-week duration of the study, while 10 patients either discontinued treatment or did not adhere to the prescribed medication regimen due to side effects. Among the 12 patients who completed the study, six had a diagnosis of T2DM. At baseline, the weight, standard deviation score (SDS), BMI, and BMI standard deviation (SD) were 113.9 kg, 2.9, 40.9 kg/m 2 , and 2.6 respectively. At the 18-month follow-up, the weight, SDS, BMI, and BMI SD were 117.8kg, 2.6, 39kg/m 2 , and 2.5, respectively. Thus, no statistically significant change in the weight parameters was evident at 18 months compared to baseline. Dropout from the study and poor compliance were high (10 out of 22 patients) due to side effects, mainly gastrointestinal (nausea, abdominal pain, diarrhea, and vomiting). No statistically significant differences were observed between obese vs. obese with T2DM. No significant change in HbA1c was found between baseline and treatment follow-up in the diabetes patients. No adverse effects in terms of impairment of liver and kidney function or pancreatitis were observed. Conclusions The administration of liraglutide to adolescents with obesity, regardless of whether they had T2DM or not, in a real-life setting, did not yield statistically significant reductions in BMI/weight parameters, and HbA1c levels at the 72-week mark. Nevertheless, the study fin...

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Single-Center Experience of Using Liraglutide in Adolescents With Obesity +/- Type 2 Diabetes

Dauleh,

Pasha,

Gad

et al. 2024

Cureus

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“…Concerning liraglutide, it is an agonist of the human GLP-1 receptor, which plays an essential role in the resistance to obesity [ 48 , 49 ]. Numerous clinical trials have observed that the administration of liraglutide at 3.0 mg per day to obese patients and most importantly, accompanied by a change in lifestyle, significantly reduces visceral adipose tissue over 40 weeks of treatment [ 50 , 51 , 52 ].This study was conducted following the Delphi methodology, which inherently presents limitations in validity and reliability. It is a very laborious process that requires at least two rounds to obtain an adequate consensus, subjective criteria are developed that are subject to external influences from the participants, and there may be confusion in the interpretation of the content of some questions.…”

Section: Discussionmentioning

confidence: 99%

Approach to Patients with Obesity and Other Cardiovascular Risk Factors in Primary Care Using the Delphi Methodology

Blasco

Moreno

Palenzuela

et al. 2022

JCM

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Background: Implementing preventive strategies for patients with obesity would improve the future burden of cardiovascular diseases. The objective was to present the opinions of experts on the approach to treating patients with obesity and other cardiovascular risk factors from a primary care perspective in Spain; Methods: Using the Delphi technique, a 42-question questionnaire was developed based on results from the scientific literature, and sent to 42 experts in primary care. Two rounds of participation were held; Results: There is a close relationship between obesity and cardiovascular risk factors among primary care physicians. It is necessary to use a checklist in primary care that includes metabolic parameters such as body mass index, waist circumference, and levels of C-reactive protein and ferritin. It is also useful to combine pharmacological treatment, such as liraglutide, with a change in lifestyle to achieve therapeutic goals in this population; Conclusions: There is a high level of awareness among experts in Spain regarding obesity and other cardiovascular risk factors, and the need to address this pathology comprehensively. The need to incorporate specific tools in primary care consultations that allow for better assessment and follow-up of these patients, such as cuffs adapted to arm size or imaging techniques to assess body fat, is evident. Teleconsultation is imposed as a helpful tool for follow-up. Experts recommend that patients with obesity and associated comorbidities modify their lifestyle, incorporate a Mediterranean diet, and administer liraglutide.

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“…A recent UK‐based study has shown that when combined with an intense weight management programme, patients treated with liraglutide dropped BMI by 2.1 kg/m 2 over a period of 3 months. Liraglutide was shown to be well tolerated by all patients receiving the treatment 78 . Liraglutide has also shown promise as a potential therapeutic option in treatment‐resistant obesity by Kochar et al 74 Adolescents with obesity which was initially managed by lifestyle changes and then oral medications but had failed to achieve weight loss, were trialled on liraglutide for 12 weeks 74 .…”

Section: Definitionmentioning

confidence: 99%

Childhood obesity: A review of current and future management options

Apperley

Blackburn

Erlandson-Parry

et al. 2021

Clinical Endocrinology

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Obesity is becoming increasingly prevalent in paediatric populations worldwide. In addition to increasing prevalence, the severity of obesity is also continuing to rise. Taken together, these findings demonstrate a worrying trend and highlight one of the most significant challenges to public health. Childhood obesity affects multiple organs in the body and is associated with both significant morbidity and ultimately premature mortality. The prevalence of complications associated with obesity, including dyslipidaemia, hypertension, fatty liver disease and psychosocial complications are becoming increasingly prevalent within the paediatric populations. Treatment guidelines currently focus on intervention with lifestyle and behavioural modifications, with pharmacotherapy and surgery reserved for patients who are refractory to such treatment. Research into adult obesity has established pharmacological novel therapies, which have been approved and established in clinical practice; however, the research and implementation of such therapies in paediatric populations have been lagging behind. Despite the relative lack of widespread research in comparison to the adult population, newer therapies are being trialled, which should allow a greater availability of treatment options for childhood obesity in the future. This review summarizes the current evidence for the management of obesity in terms of medical and surgical options. Both future therapeutic agents and those which cause weight loss but have an alternative indication are also included and discussed as part of the review. The review summarizes the most recent research for each intervention and demonstrates the potential efficacy and limitations of each treatment option.

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Liraglutide combined with intense lifestyle modification in the management of obesity in adolescents

Cited by 10 publications

References 21 publications

Single-Center Experience of Using Liraglutide in Adolescents With Obesity +/- Type 2 Diabetes

Single-Center Experience of Using Liraglutide in Adolescents With Obesity +/- Type 2 Diabetes

Approach to Patients with Obesity and Other Cardiovascular Risk Factors in Primary Care Using the Delphi Methodology

Childhood obesity: A review of current and future management options

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