Understanding the Action and Use of GLP-1 Agonists in Children – A Pediatrician’s Viewpoint
The United States, like much of the developed world, is facing increasing rates of childhood obesity and related health concerns. Despite years of research and various efforts, addressing this public health issue remains a complex challenge.
This article reviews the potential mechanisms, benefits, and considerations for using GLP-1 agonists in children based on the current scientific understanding. While early research is promising, the application of these treatments in children requires careful consideration and should always be done in consultation with a healthcare provider.
As a pediatrician, I recognize that while the science behind these treatments is evolving, it's important to remember that individual responses to treatments can vary. For children, every approach needs to be carefully weighed, considering their unique developmental needs.
Why Has the Fight Against Obesity Been So Challenging?
Several factors contribute to the struggle against obesity, including:
Widespread availability of inexpensive, high-calorie, ultra-processed foods
Reduced physical activity due to modern lifestyles, increased screen use, and limited access to safe exercise spaces
Chronic exposure to obesogenic chemicals in air, water, and food
Pervasive mental stress in society
Shifts in the intestinal microbiome influenced by these factors, along with antibiotic and medication use
Inadequate allocation of medical and nutritional resources
While governments and healthcare providers have focused on education to address these challenges, it has not been effective for many. Structural issues, such as high-calorie school meals and food deserts, highlight the limitations of current strategies.
Recently, GLP-1 agonists have gained attention in treating type 2 diabetes and obesity in adults, due to their ability to help regulate blood sugar and support weight management. As their use among adults has grown, there is increasing interest in exploring their potential for managing obesity and type 2 diabetes in children.
Why is Childhood Obesity Such a Concern?
Childhood obesity is a pressing public health issue with significant long-term health implications. It is linked to various health risks, including type 2 diabetes, cardiovascular conditions, certain cancers, and psychosocial challenges. These concerns make addressing obesity in children critical for supporting their future well-being.
Traditional interventions, such as lifestyle changes and behavioral therapies, often yield limited success, underscoring the need for more effective strategies. While addressing the root causes of obesity, such as diet and activity, is important, broader systemic changes have not gained widespread momentum. Therefore, it’s essential for parents and healthcare providers to explore the available options for supporting healthy growth and weight management in children.
What is GLP-1?
GLP-1 is an incretin peptide hormone produced in the gut by the enteroendocrine L cells in the distal small intestine and colon, primarily in response to macronutrient ingestion. (1)
When it’s released into the bloodstream and the gut, it triggers several actions: it increases insulin secretion from the pancreas in response to glucose, reduces the release of glucagon (a hormone that raises blood sugar), shifts the immune system towards an anti-inflammatory state, slows down how quickly the stomach empties, and signals the brain to promote feelings of fullness through the vagus nerve.
These effects are mediated through the GLP-1 receptor, a G-protein coupled receptor expressed in various tissues, including the pancreas, brain, and gastrointestinal tract. (7)
What the Research Shows About GLP-1 Agonists for Adults
GLP-1 agonists, such as exenatide, liraglutide, semaglutide, and others, mimic the action of the endogenous GLP-1 peptide by binding to the GLP-1 receptor, thereby potentiating the physiological effects.
The data to date have shown that these medicines lead to improved glycemic control, reduced inflammation, reduced cardiovascular disease, weight loss, and appetite suppression in studies and clinical experience in adult populations. (11)
The use of GLP-1 agonists in adults has shown substantial benefits, prompting investigations into their efficacy and safety in children.
What the Research Shows About GLP-1 Agonists for Pediatric Obesity
.........the article continues at the RUPA article link
This data matters a lot
Dr. M