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Licensed Unlicensed Requires Authentication Published by De Gruyter April 7, 2021

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

  • Louise J. Apperley , Lucy Gait , Karen Erlandson-Parry , Peter Laing and Senthil Senniappan EMAIL logo

Abstract

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/m2, 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.


Corresponding author: Dr. Senthil Senniappan, MD FRCPCH MSc (Diab) PhD, Consultant Paediatric Endocrinologist & Honorary Senior Lecturer, Department of Paediatric Endocrinology, Alder Hey Children’s NHS Foundation Trust, Liverpool L14 5AB, UK, Phone: +441512525281, Fax: +441512824606, E-mail:

Acknowledgements

None.

  1. Research funding: None declared.

  2. Author contributions: LA – collected and analysed data, wrote and revised the draft. LG, KE-P, PL – contributed to the revision of the draft. SS – supervised the study and revised the final draft.

  3. Competing interests: None to declare.

  4. Ethical approval: R&D Number 6252.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2020-0714).


Received: 2020-12-16
Accepted: 2021-03-01
Published Online: 2021-04-07
Published in Print: 2021-05-26

© 2021 Walter de Gruyter GmbH, Berlin/Boston

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