Anti-obesity medication in the management of children and adolescents with obesity: recent developments and research gaps

Pediatric obesity is a global public health concern. While in most countries the incidence keeps rising, the need for effective and long-term management for children and adolescents living with this chronic, relapsing disease is pressing. Health behavior and lifestyle treatment (HBLT) is recommended as first-line treatment. A new generation of recently approved anti-obesity medications (AOM) now has the potential to fill the gap between limited effects on body mass index (BMI) by HBLT alone and large effects by metabolic and bariatric surgery in adolescents with obesity aged 12 years and older. While, for semaglutide and phentermine/topiramate, effectiveness is substantial with relevant, but mostly mild to moderate adverse events, there is a gap in evidence regarding long-term effects and safety, effects on outcomes beyond BMI reduction and data for certain groups of patients, such as children <12 years and minority groups. When integrating AOM treatment into national health care systems it should be offered as part of a comprehensive patient-centered approach. This article summarizes recent AOM developments, integration into pediatric obesity management, and identifies research gaps.