Childhood obesity and GLP-1 receptor agonists: Current evidence, challenges and future perspectives – a narrative review

Introduction

Childhood obesity has become one of the most significant global public health challenges of the twenty-first century. The prevalence of obesity among children and adolescents continues to increase worldwide, contributing to the growing burden of metabolic, cardiovascular, endocrine and psychological disorders. Traditional interventions based on lifestyle modification often demonstrate limited long-term effectiveness, highlighting the need for additional therapeutic strategies. In recent years, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have emerged as a promising pharmacological option for pediatric obesity management. Purpose of the Study: The aim of this review is to provide a comprehensive overview of the current evidence regarding the use of GLP-1 receptor agonists in children and adolescents with obesity, with particular emphasis on their mechanisms of action, clinical efficacy, safety profile, psychological impact and future therapeutic perspectives. Materials and Methods: The literature review was based on publications published between 2007 and 2025. PubMed, Scopus and Google Scholar databases were searched using keywords including childhood obesity, pediatric obesity, adolescent obesity, GLP-1 receptor agonists, liraglutide, semaglutide, tirzepatide, pharmacological treatment and weight management. Priority was given to randomized controlled trials, systematic reviews, meta-analyses and international clinical guidelines published in English. Description of the State of Knowledge: Recent clinical trials have demonstrated significant efficacy of GLP-1 receptor agonists in reducing body weight and body mass index in pediatric patients with obesity. Liraglutide and semaglutide have shown clinically meaningful improvements in weight reduction, metabolic parameters and quality of life. Among currently available GLP-1 receptor agonists, semaglutide demonstrated the greatest efficacy for BMI and weight reduction in a recent network meta-analysis of pediatric obesity treatments. Although gastrointestinal adverse effects remain the most commonly reported complications, overall treatment tolerability appears favorable. Ongoing studies are evaluating long-term safety, treatment durability and the role of next-generation incretin-based therapies.