Objectives Childhood obesity is a public health concern worldwide, with rates continuing to rise, despite preventive measures. Lifestyle modification remains the mainstay in the treatment of patients with excessive weight, but unfortunately, this is not always successful. Options for medical management of obesity in the paediatric population are limited. Methods Seven adolescents (all girls, mean age 14.9 years) with a body mass index (BMI) above 98th percentile and serious complications secondary to obesity were offered an intense weight management programme. The participants were reviewed by a multidisciplinary team every two weeks for advice and support, and treated with daily subcutaneous injections of liraglutide (dose range 1.2–3.0 mg). Scores for anxiety and depression were evaluated using the Revised Child Anxiety and Depression Scale. Results The results showed a significant weight loss over the three months with an average reduction of 5.4 kg (4.2%; 95% CI 1.93–8.78; p=0.0087). The mean drop in BMI was 2.1 kg/m 2 , which is statistically significant (95% CI 0.973–3.199; p=0.0037). Resolution of complications (raised intracranial pressure and steatohepatitis) was noted following weight loss. Anxiety and depressive symptoms improved over the three-month intervention course, especially features of separation anxiety disorder. Liraglutide was well tolerated by all patients. Conclusions Liraglutide medication, alongside a dedicated multidisciplinary team guided lifestyle therapy, is effective and safe in the treatment for excessive weight in adolescents, leading to the reversal of the complications related to obesity and improvement in the psychological symptoms.

中文翻译：

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利拉鲁肽联合强烈的生活方式改变在青少年肥胖管理中的作用

目标 儿童肥胖是世界范围内的一个公共卫生问题，尽管采取了预防措施，但其发病率仍在继续上升。生活方式的改变仍然是治疗体重过重患者的主要方法，但不幸的是，这并不总是成功的。儿科肥胖的医学管理选择有限。方法 七名青少年（所有女孩，平均年龄 14.9 岁）的体重指数 (BMI) 高于 98%，并有肥胖继发的严重并发症，他们接受了严格的体重管理计划。参与者每两周接受一个多学科团队的审查，以获得建议和支持，并每天接受皮下注射利拉鲁肽（剂量范围 1.2-3.0 mg）。使用修订后的儿童焦虑和抑郁量表评估焦虑和抑郁的分数。结果 结果显示，三个月内体重明显减轻，平均减轻 5.4 公斤（4.2%；95% CI 1.93–8.78；p=0.0087）。BMI 的平均下降为 2.1 kg/m 2 ，具有统计学意义（95% CI 0.973–3.199；p=0.0037）。在体重减轻后注意到并发症（颅内压升高和脂肪性肝炎）的解决。在三个月的干预过程中，焦虑和抑郁症状有所改善，尤其是分离焦虑症的特征。所有患者对利拉鲁肽的耐受性良好。结论 利拉鲁肽药物与专门的多学科团队指导的生活方式治疗一起，可有效且安全地治疗青少年体重过重，从而逆转肥胖相关并发症并改善心理症状。