Work

Dynamics of Body Composition and Metabolic Risk in Adolescents With Obesity Under GLP ‐1 Receptor Agonist Therapy

Year: 2026

Type: article

Abstract: ABSTRACT Aim To explore changes in body composition in adolescents with obesity treated with glucagon‐like peptide‐1 receptor agonist (GLP‐1 RA) and their association with metabolic syndrome (MetS) components. Methods This real‐world retrospective study included adolescents (12–18 years) with obesity who received multidisciplinary lifestyle‐based obesity care between 2020 and 2024. GLP‐1 RA therapy (liraglutide or semaglutide) was prescribed and dosed on an individualised basis. BMI and muscle‐to‐fat ratio (MFR) z ‐scores (by bioimpedance), and MetS components (glucose intolerance, hypertension, and dyslipidemia) were evaluated and compared with patients not receiving GLP‐1 RA at corresponding time points. Multivariable regression analyses adjusted for sex, age, physical activity, and length of follow‐up evaluated contributors for improvement in body composition. Results Of 67 eligible adolescents, 41 (61.2%) received GLP‐1 RA therapy. The GLP‐1 RA‐treated group experienced greater improvements in BMI z ‐scores (−0.34 [−0.57, −0.07] vs. −0.07 [−0.17, 0.05], p < 0.001), and MFR z ‐scores (0.41 [0.12, 0.56] vs. 0.13 [0.01, 0.25], p = 0.007) compared to those without GLP‐1 RA therapy. GLP‐1 RA treatment duration was identified as the sole contributor to BMI and MFR z ‐score improvements ( R 2 = 0.515, p < 0.001 and R 2 = 0.231, p = 0.012, respectively). A 0.25‐unit decrease in BMI z ‐score and a 0.25‐unit increase in MFR z ‐score were associated with 2.8‐fold and 1.8‐fold higher odds of MetS component improvement, respectively. Conclusion Adolescents with obesity under GLP‐1 RA therapy combined with lifestyle intervention demonstrated improvements in body composition and MetS components.

Source: Acta Paediatrica

DOI: 10.1111/apa.70554