Medicines that have transformed obesity treatment in adults may also help teenagers with obesity lose weight, according to a new review of clinical trials.
Researchers found that GLP-1 drugs reduced body weight and improved several other health measures in children and adolescents without diabetes.
The research was presented at the International Congress on Obesity 2026 in Mexico City, hosted by the World Obesity Federation. The study was led by Dr. Manpreet Kaur Oberoi of the University of Western Ontario in Canada and colleagues.
GLP-1 receptor agonists are a group of medicines that copy some of the actions of a natural hormone released after eating. They can reduce appetite, slow the movement of food through the stomach and help people feel full for longer.
These drugs were first widely known for treating type 2 diabetes, but several are now used for obesity. Some GLP-1 medicines have also been approved for weight management in adolescents aged 12 and older in a number of countries.
Childhood obesity is a growing health concern because excess weight can affect health both immediately and later in life. Children with obesity have a higher risk of developing problems such as high blood pressure, abnormal cholesterol, fatty liver disease, sleep apnea and type 2 diabetes.
Treating obesity in children can be difficult because children are still growing and their nutritional needs differ from those of adults. Lifestyle support involving healthy eating, physical activity, sleep and family involvement remains an important part of care.
The researchers wanted to understand how much additional benefit GLP-1 medicines might provide and whether the drugs appear safe in young people without diabetes. They carried out a systematic review and meta-analysis, which combines evidence from several previous clinical trials.
The team searched three major medical research databases for randomized controlled trials available through May 2025. Randomized trials are particularly useful because participants are assigned to different treatment groups, making it easier to compare a medicine with placebo or standard care.
From 1,095 records initially identified, only nine studies met all of the researchers’ requirements. Together, these trials included 756 children and adolescents between the ages of 6 and 18, although the average age across the studies was around 14 to 15 years.
Three trials studied exenatide, five investigated liraglutide and one examined semaglutide. Some studies were small and lasted only five to 24 weeks, while the larger trials followed participants for roughly one year or longer.
Across the studies, children receiving a GLP-1 medicine had greater improvements in a measure called BMI-SDS than children receiving placebo or standard care. This measure compares a child’s body mass index with expected values for other children of the same age and sex.
Using this measure is important because a child’s body naturally changes while growing. A lower BMI-SDS generally means the child’s weight is moving closer to the expected range for their age, sex and height.
Across the different drugs and age groups, the average difference in body weight between treatment and comparison groups was about 5.08 kilograms, or 11.2 pounds. This is an average treatment effect and does not mean every child taking the medicine will lose exactly that amount.
The size of the effect also differed substantially between medicines. Semaglutide produced the largest average difference in weight at about 17.75 kilograms, while exenatide and liraglutide were associated with smaller average differences of about 3.53 and 3.12 kilograms.
Those numbers should be compared cautiously because they come from different trials rather than a single study directly testing all three medicines against one another. Differences in treatment length, participants, doses and study design can influence the results.
The review found possible benefits beyond weight. Systolic blood pressure, the top number in a blood pressure reading, fell by an average of about 2.24 mmHg in children receiving GLP-1 treatment.
Three studies also measured heart rate, with the combined results showing an average reduction of about 2.83 beats per minute. Quality-of-life scores improved as well, suggesting some participants may have experienced benefits in how they felt or functioned in everyday life.
Nausea was the clearest side effect. Children receiving GLP-1 medicines were about three times as likely to experience nausea as those receiving placebo.
Vomiting and diarrhea were reported more often numerically in treatment groups, but the combined analysis did not find a statistically clear increase compared with placebo. Serious problems such as pancreatitis, gallstones and appendicitis were uncommon and occurred at similar rates in treatment and comparison groups.
The researchers concluded that GLP-1 medicines appear effective for adolescents aged 12 and older with obesity who do not have diabetes, with a generally manageable safety profile. They emphasized that more research is necessary to understand long-term safety and whether benefits are maintained.
Although some participants in the collected trials were younger than 12, this does not mean these medicines are routinely approved for obesity in younger children.
Children below the approved age may receive an experimental treatment in carefully controlled clinical trials designed to determine whether it is safe and what dose might be appropriate.
The study offers encouraging evidence, but several limitations matter. Only nine trials with 756 participants met the criteria, some studies were small or short, and there was only one included semaglutide trial despite that drug producing the largest reported weight effect.
Long-term questions are especially important when treating children because medication might potentially be used for years. Researchers need more information about growth, development, nutrition, weight regain after treatment ends and uncommon side effects that small trials may not detect.
Overall, the findings support GLP-1 medicines as a potentially useful option for selected adolescents with obesity when used as part of professional medical care. They do not suggest that medication should replace healthy nutrition, physical activity or family-based support, nor do they establish long-term safety in younger children.
The strongest evidence currently applies to adolescents, particularly those aged 12 and older. Larger and longer trials will be needed before doctors can fully understand how these powerful medicines should fit into obesity treatment throughout childhood.
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