GLUCAGON-LIKE peptide-1 receptor agonists (GLP-1 RAs) are increasingly being investigated as treatment options for children and adolescents with obesity or type 2 diabetes, conditions that have become urgent global health concerns. Obesity now affects one in five young people, raising the risk of developing diabetes and long-term cardiometabolic complications. A new systematic review and meta-analysis of 18 randomised clinical trials involving 1,402 participants aged between 6 and 17 years has provided the most comprehensive evidence to date on the efficacy and safety of GLP-1 RAs in this population.
The findings demonstrated that GLP-1 RAs were effective in significantly improving several clinical outcomes. Participants receiving these drugs showed reductions in haemoglobin A1c levels, fasting glucose, body weight, body mass index (BMI), BMI standard deviation score, BMI percentile, and systolic blood pressure when compared with placebo. These changes represent meaningful improvements in both glycaemic control and cardiometabolic health, underscoring the potential role of GLP-1 RAs in addressing paediatric obesity and diabetes.
In terms of safety, gastrointestinal side effects such as nausea, vomiting, and diarrhoea were significantly more common among those taking GLP-1 RAs. However, other adverse outcomes including depression, suicidal thoughts or behaviours, hepatobiliary disorders, hypoglycaemia, and treatment discontinuation did not differ significantly between the treatment and placebo groups. This is particularly important given concerns about the long-term psychiatric safety profile of GLP-1 RAs, which were not supported by the evidence in this analysis.
Overall, the results indicate that GLP-1 RAs can provide important benefits for young people struggling with obesity or type 2 diabetes. While the trials analysed were relatively short in duration, the findings suggest that these treatments may play a valuable role in improving health outcomes in high-risk paediatric populations. Nonetheless, gastrointestinal side effects remain an important consideration, particularly if long-term use is required. Continued research is needed to assess durability of benefits and to ensure safe, equitable use of these therapies in children and adolescents.
Reference
Kotecha P et al. Efficacy and safety of GLP-1 RAs in children and adolescents with obesity or Type 2 diabetes: a systematic review and meta-analysis. JAMA Pediatr. 2025;DOI:10.1001/jamapediatrics.2025.3243.
