Breaking New Ground: Liraglutide Offers Hope for Childhood Obesity in Kids Under 12

September 2024?NEJM

The SCALE Kids study looked into how well the drug liraglutide (branded as Victoza or Saxenda) works for treating obesity in children aged 6 to under 12. Currently, no medications are approved for treating obesity in children this young, except in certain specific genetic conditions. While liraglutide has been used successfully in adults and teenagers to help with weight loss, it hadn’t been tested in younger children before this study.

Study Setup and Approach

The trial included 82 children who were all dealing with obesity. These children were split into two groups: one group of 56 kids received a daily injection of liraglutide (up to 3 mg), while the other group of 26 kids received a placebo. Both groups also got lifestyle guidance, like advice on healthy eating and exercise. The study lasted 56 weeks (just over a year), and the researchers tracked the results for another 26 weeks afterward.

The main goal of the study was to see how much the children’s BMI (body mass index) changed over time. BMI is a measure of body fat based on height and weight. The researchers also looked at how much each child’s body weight changed and how many kids had a 5% reduction in BMI—a marker of meaningful weight loss.

Main Results

By the end of the 56-week treatment period, the results were clear: children taking liraglutide had an average BMI reduction of 5.8%, while children on the placebo actually saw their BMI go up by 1.6%. This meant there was a difference of 7.4 percentage points between the two groups. When looking at overall body weight, kids on liraglutide saw a slight weight gain of 1.6%, but the placebo group gained much more—10.0% on average.

Another important finding was how many kids saw a 5% drop in BMI. In the liraglutide group, 46% of kids reached this goal, compared to just 9% of kids in the placebo group. This means liraglutide was much more effective at helping children achieve significant weight loss.

Safety and Side Effects

As with any medication, the researchers paid close attention to side effects. 89% of the kids on liraglutide and 88% of the kids on the placebo reported some kind of side effect. While the overall number of side effects was similar, gastrointestinal issues (like nausea, vomiting, or diarrhea) were more common in the children taking liraglutide—80% of them experienced these issues, compared to 54% in the placebo group.

There were also serious side effects in a small number of kids: 12% in the liraglutide group and 8% in the placebo group. Even though these numbers were relatively low, the higher rate of stomach-related problems in the liraglutide group is something to consider when using this drug in younger children.

Main Takeaway

This study showed that liraglutide helped children aged 6 to under 12 with obesity reduce their BMI when combined with lifestyle changes like better eating and more exercise. Children taking liraglutide had better results than those who took a placebo, with many achieving meaningful weight loss.

However, liraglutide did cause more gastrointestinal side effects, so that’s an important factor to consider. Overall, the results are promising and suggest that liraglutide could be a helpful option for treating obesity in younger children. Obviously, more research is needed to see how safe and effective it is over the long term, but this study offers hope for families struggling with childhood obesity.

Dr. Tashko