Children could be given weight loss jabs to help 'reduce mealtime battles'
Administering weight-loss injections to obese children has been found effective and may provide a respite from mealtime conflicts, according to experts.
Researchers convened at the European Congress on Obesity in Málaga, Spain to reveal study results indicating that medications aid significantly overweight young individuals in losing extra pounds alongside their existing diet and lifestyle regimen.
Such jabs, known as GLP-1 receptor agonists, are designed to curb appetite and can be obtained through the NHS for adults with elevated BMI, or privately.
Nice halted its review of semaglutide (Wegovy) for childhood obesity management in the 12 to 17 age group after Novo Nordisk, the producer, failed to deliver requisite proof.
Yet, paediatric clinics with specialist expertise have the discretion to prescribe these injections when there is a genuine clinical necessity.
Side effects reported from these pharmaceuticals encompass nausea, diarrhoea, abdominal pain, and disturbances in vision.
Karolinska University Hospital's Dr Annika Janson, who showcased the fresh findings, commented: "GLP-1 drugs are increasingly used to treat obesity in adults."
She further explained: "They can also be used in children from the age of 12 and clinical trials have shown children lose 5%-16% of their body weight after a year of treatment."
Nevertheless, she highlighted: "However, treating children in real-life situations has challenges that don't come up in research studies.
"Children have varying degrees of obesity, co-morbidities and complications and may have faced problems in supply of the drug, financing it or taking it.
"As a consequence, it is difficult to isolate the effect of adding GLP-1 drugs to the plethora of treatments that are already available."
Dr Janson and her team have introduced the use of GLP-1 receptor agonists to their existing treatment regime for child obesity as part of a pioneering study.
The research included 1,126 children, with severe obesity, up to the age of 16, undergoing intensive health behaviour and lifestyle therapy (IHBLT) at Stockholm's respected National Childhood Obesity Centre.
This form of treatment, IHBLT, spans involvement with not just the affected youngsters but also families and educational institutions, promoting healthy diets, appropriate meal sizes and timings, reduced screen exposure, exercise, and emotional health.
Commencing in 2023, approximately one-quarter of the patients started receiving the GLP-1 medication liraglutide. Subsequently, the similar drug semaglutide (Wegovy) was employed in treatment plans.
Although BMI reductions remained fairly consistent across the groups until 2022, the addition of the weight loss injection yielded an incremental benefit.
Statistics indicate that around 30 per cent of participants on liraglutide shed a meaningful amount of weight beneficial to their health, a slight increase compared to approximately 27 per cent in earlier cohorts without the jab.
Despite the modest change, which is influenced by the fact that not all children were consistently medicated, Dr Janson posits this represents a significant trend, especially when noting more pronounced outcomes with semaglutide later in the study.
"Only a fraction of the children had GLP-1 drugs and most of those who did started on them six to 12 months into the treatment programme. Longer-term treatment may lead to greater improvements in BMI," she said.
"These are just early indications but it does look as if the average effect of being a patient at our clinic has improved after adding GLP-1 drugs to the toolbox."
She added: "Many children with severe obesity describe hunger and a strong appetite – both of which GLP-1 receptor agonists are known to help with.
"Results beyond obesity are also important. The families reported reduced conflicts around food and improved capacity for other lifestyle adaptations.
"It was easier to stick to meals and limit snacks. Portions could be down-sized. For some children, not being hungry all the time is a new feeling.
"GLP-1 receptor agonists are clearly beneficial to many children with severe obesity and, while they won't help in all cases, more children should have access to these important medications."
A spokesman for Novo Nordisk said: "Novo Nordisk did not submit evidence for a Nice appraisal for semaglutide and liraglutide for managing overweight and obesity in young people aged 12 to 17 years due to a lack of utility data and risk equations in linking weight loss in adolescents to long-term outcomes.
"As such, there are significant limitations in estimating the cost-effectiveness in this patient population, utility estimates that adequately capture the full impact on their quality of life, and not enough data to support an economic model that meets the Nice reference case.
"At this time, Novo Nordisk does not intend to make an evidence submission for the appraisal of semaglutide and liraglutide for managing overweight and obesity in young people aged 12 to 17 for the use in the NHS.
"We will continue to evaluate our evidence package in consideration of supporting any potential future submission for this patient group."
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