Pharmacotherapy for Obesity in Children and Adolescents: State of the Science, Research Gaps and Opportunities
View the Executive Summary (PDF, 197.09 KB)
The overarching goal of the workshop will be to identify gaps and opportunities to guide research and speed progress in the safe, effective, and equitable use of pharmacotherapy for obesity in children and adolescents. This workshop will convene leading scientific and clinical experts with expertise in obesity pathophysiology, clinical trials of pharmacotherapy, clinical use of medication to treat obesity, precision medicine, implementation science, health equity and disparities, and health economics to discuss the use of pharmacotherapy in children, systemic and individual barriers to treatment, effects on physical and mental health, quality of life and eating behaviors, and cost-effectiveness of therapy. At the end of the workshop, participants will identify gaps and opportunities for future research to guide
- best practices for the use of pharmacotherapy for pediatric obesity, including prescriber training, timing of initiation, duration of therapy, combination therapies, and lifestyle supports;
- understanding of contextual factors that influence equitable access and reduce barriers to care; and
- important and unique aspects of the use of pharmacotherapy for obesity in vulnerable populations, including bias and stigma, communication, development of autonomy, and growth and development.
Such research will inform optimal and equitable medical management of children and adolescents with obesity.
Pediatric obesity is highly prevalent and increasing, with approximately 20% of children and adolescents living with this chronic, progressive, and relapsing disease. Non-Hispanic Black and Hispanic youth and children from families experiencing poverty and/or food insecurity are disproportionately affected. Pediatric obesity has been associated with serious complications and co-morbidities, including type 2 diabetes, non-alcoholic fatty liver disease, dyslipidemia, elevated blood pressure, and mental health problems. The many adverse health consequences of obesity threaten the health of tens of millions of Americans and place great strain on the health care system. More importantly, obesity and sequelae can impair a child’s well-being and quality of life during a critical time for growth and development. Moreover, most children and adolescents with obesity retain their excess adiposity into adulthood. The dose and duration of lifestyle modification therapy needed to meaningfully reduce adiposity in children and adolescents is high, often limiting its feasibility in practice. In addition, most behavioral/lifestyle obesity treatment interventions show only modest favorable changes in average body mass index (BMI), which are not sustained. And although response is mixed, a substantial number of children do not experience meaningful improvement. Since 2020, three anti-obesity medications (AOMs)—Liraglutide, Semaglutide, and Phentermine/Topiramate—have been approved by the U.S. Food and Drug Administration for chronic weight management in children ages 12 years and older with non-syndromic obesity, and trials of new medications in the pediatric population are ongoing, including in young children and preadolescents. The availability of AOMs offers an important adjunct to lifestyle intervention for a substantial number of children and adolescents. Research is needed to address important knowledge gaps to ensure appropriate, effective, safe, equitable, and successful adoption of obesity pharmacotherapy in clinical practice, as well as evaluate the long-term use of pharmacotherapy and its potential adverse effects.
- Sarah C. Armstrong, M.D.
Professor of Pediatrics
Chief, Division of General Pediatrics and Adolescent Health
Duke University School of Medicine
- Ihuoma Eneli, M.D, M.S.
Visiting Professor of Pediatrics
University of Colorado
Children’s Hospital Colorado
- Aaron S. Kelly, Ph.D.
Professor of Pediatrics
Minnesota American Legion and Auxiliary Chair in Children’s Health
Co-Director, Center for Pediatric Obesity Medicine
University of Minnesota Medical School
Obesity Action Coalition
- Liz Paul, Patient Advocate
- Miranda Broadney, M.D.
- Mary Evans, Ph.D.
- Barbara Linder, M.D.
- Katrina Loh, M.D.
- Voula Osganian, M.D., Sc.D., M.P.H.
- Ken Wilkins, Ph.D.
- Theresa Woo, Ph.D.
- Sue Yanovski, M.D.
- Andrew Bremer, M.D.
- Laurie Donze, Ph.D.
- Charlotte Pratt, Ph.D.
- Deborah Young-Hyman, Ph.D.
November 27, 2023
The Bethesdan Hotel
8120 Wisconsin Ave
Bethesda, MD 20814
WebinarThe link to join the webinar will be distributed via email prior to the date of the event.
Voula Osganian, M.D., Sc.D., M.P.H.
The Scientific Consulting Group, Inc.