ESPE2024 Poster Category 3 Fat, Metabolism and Obesity (35 abstracts)
Real-life Experience of Liraglutide Treatment and Weight Control in Obese Adolescents: A Preliminary Study Supported by Psychoanalysis
Hasan Karakaş 1 , Hande Turan 1 , Didem Güneş Kaya 2 , Yeşim Sağlam Öz 3 , Gökçe Velioğlu Haşlak 1 , Mert Uçar 1 , İlayda Altun 1 , Gürkan Tarçın 1 , Elvan Bayramoğlu 1 & Olcay Evliyaoğlu 1
1Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric Endocrinology, Istanbul, Turkey. 2Istanbul University-Cerrahpaşa, Cerrahpaşa Faculty of Medicine, Department of Pediatric, Istanbul, Turkey. 3University of Health Sciences, Bakirkoy Prof. Dr. Mazhar Osman Research and Training Hospital for Psychiatry, Department of Child and Adolescent Psychiatry, Istanbul, Turkey
Objective: The use of glucagon-like peptide-1 (GLP-1) agonists for the medical treatment of childhood obesity was approved by the FDA four years ago; however, clinical experiences are limited. In this context, our study aims to present the clinical data of obese adolescents receiving liraglutide treatment in our clinic, providing preliminary insights into its efficacy and potential benefits.
Method: We retrospectively evaluated data from patients treated for obesity in our clinic who failed to achieve weight loss through diet and exercise and subsequently received liraglutide treatment. Patients who discontinued the treatment for more than a month due to drug side effects were excluded. Monthly evaluations of Body Mass Index (BMI), body measurements, and body composition were conducted. All cases underwent semi-structured interviews using the 'Schedule for Affective Disorders and Schizophrenia for School-Age Children-present and lifetime version, DSM-5' and were assessed with the 'Beck Depression Inventory and Suicidal Ideation Scale' by a child psychiatrist
Results: Nineteen patients (M:F= 8:11) were included in the study. The mean age was 15.9±2.6 years, and the mean treatment duration was 5.0±3.1 months. Hepatosteatosis was detected in all patients, and impaired glucose tolerance was observed in one. An average weight loss of 4.92±4.7% (4.5±4.1 kg) was achieved within the first three months of treatment. Treatment was discontinued early in 5 patients due to financial constraints and in two due to severe vomiting. Moreover, over 64% of the patients had a moderate to high depression score. A positive correlation was found between body fat mass and trunk fat ratio with depression scores, emphasizing the psychological burden of obesity (P = 0.009, r =0.792 and P = 0.024, r =0.717).
| baseline | Follow-up | p | |
| Body Weight (kg) | 101,5±20,2 | 95,2±23 | <0,001 |
| BMI-SDS | 3,32±0,45 | 2,91±0,71 | 0,002 |
| HOMA-IR | 6,3±3,4 | 3,3 ±1,6 | 0,010 |
| Body Fat Mass (kg/%) | 43,3±9,7 / 45,5±3,6 | 37,8±12,6 / 42,3±4,7 | 0,012 / 0,022 |
Conclusion: This preliminary study demonstrates the efficacy and side effects of liraglutide in obese adolescents. Significant improvements were observed in body weight, BMI, insulin resistance, and body fat percentage. Aside from nausea and vomiting, no severe side effects were observed. The depression rate among study participants was higher compared to the obese patients in literature. Although a definitive cause-effect relationship could not be established due to the study's limited size and cross-sectional design. While our research highlights the potential benefits of liraglutide, there is a need for larger-scale studies on the subject.
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