Emerging Therapeutic Strategies for Infantile Obesity: A Narrative Review
Pharmacotherapy, including liraglutide, can support weight management in children but should not replace comprehensive behavioral and family-based interventions.
Where it sits
this study against the rest of the liraglutide corpusSummary and findings
This narrative review examined various strategies for addressing childhood obesity, including pharmacological approaches like liraglutide. It analyzed data from 35 pharmacotherapy trials involving 4,331 participants. The review found that medication combined with behavioral treatment reduced BMI by 1.71 kg/m² more than behavioral treatment alone.
Abstract
<h4>Background: </h4> /Objectives: Childhood obesity is a chronic, multifactorial disease requiring attention to biological, behavioral, psychological, family, and socioeconomic factors. This narrative review examined the integration of lifestyle, family-based, psychological, and pharmacological approaches, focusing on treatment engagement, disordered eating, attention-deficit/hyperactivity disorder (ADHD), and treatment durability. <h4>Methods:</h4> PubMed/MEDLINE, Scopus, and Web of Science were searched for studies published primarily from 2010 to August 2026. Pediatric trials, observational studies, systematic reviews, meta-analyses, guidelines, and public-health reports were prioritized. <h4>Results:</h4> Intensive family-based, multicomponent behavioral treatment remains the best-supported foundation of care, although psychological outcomes are infrequently assessed. Psychiatric comorbidity is heterogeneous; loss-of-control eating, emotional symptoms, ADHD, and executive-function difficulties may impair engagement in selected patients. Professionally supervised obesity treatment containing a dietary component did not, on average, worsen eating psychopathology and reduced several related symptoms. Family participation improved outcomes, whereas logistical, socioeconomic, and psychological barriers reduced attendance. Across 35 pharmacotherapy trials involving 4,331 participants, medication plus behavioral treatment reduced BMI by 1.71 kg/m² more than behavioral treatment with or without placebo. Semaglutide, liraglutide, and phentermine/topiramate produced larger numerical reductions than older agents in separate trials, but heterogeneity and the absence of head-to-head comparisons preclude formal ranking. Gastrointestinal adverse events were frequent with GLP-1 receptor agonists. Pediatric trial and real-world evidence indicate partial weight regain after discontinuation, while prescribing remains limited and unequal. <h4>Conclusions:</h4> Pediatric obesity care should be phenotype-informed, multidisciplinary, and longitudinal. Pharmacotherapy can enhance BMI reduction but should complement rather than replace behavioral, psychological, and family care. Outcomes should extend beyond BMI to metabolic, psychological, functional, and long-term measures.
Background
This paper addresses the complex issue of childhood obesity, which is influenced by various biological, behavioral, and socioeconomic factors. Previous research has established the importance of a multifaceted approach to treatment, including lifestyle changes and pharmacotherapy. This review is significant as it synthesizes recent findings on the effectiveness of different treatment strategies, particularly in pediatric populations.
Methods
The review utilized a literature search from PubMed/MEDLINE, Scopus, and Web of Science for studies published from 2010 to August 2026. It prioritized pediatric trials, observational studies, systematic reviews, and meta-analyses. The focus was on pharmacological and behavioral interventions for childhood obesity.
Results
The primary finding reported is that medication plus behavioral treatment reduced BMI by 1.71 kg/m² more than behavioral treatment with or without placebo. The review included data from 35 pharmacotherapy trials involving 4,331 participants. It noted that semaglutide, liraglutide, and phentermine/topiramate produced larger numerical reductions in BMI compared to older agents.
Interpretation
The findings suggest that while pharmacotherapy can enhance BMI reduction, it should not replace behavioral and psychological interventions. The effect size of 1.71 kg/m² is statistically significant but may not be clinically meaningful in all contexts. Limitations include the heterogeneity of the trials and the lack of direct comparisons between pharmacological agents, which may affect the reliability of the conclusions drawn.
Key findings
- Medication plus behavioral treatment reduced BMI by 1.71 kg/m² more than behavioral treatment with or without placebo.
- Across 35 pharmacotherapy trials involving 4,331 participants.
- Semaglutide, liraglutide, and phentermine/topiramate produced larger numerical reductions than older agents.
- Gastrointestinal adverse events were frequent with GLP-1 receptor agonists.
- Partial weight regain after discontinuation was indicated by pediatric trial and real-world evidence.
Limitations
- Narrative review, not a systematic analysis.
- Heterogeneity in included studies.
- Absence of head-to-head comparisons.
- Psychological outcomes infrequently assessed.
- Limited and unequal prescribing practices.