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Randomized Controlled Trial
. 2024 May;19(5):e13105.
doi: 10.1111/ijpo.13105. Epub 2024 Feb 9.

Evaluating appetite/satiety hormones and eating behaviours as predictors of weight loss maintenance with GLP-1RA therapy in adolescents with severe obesity

Megan O Bensignor  1   2 , Aaron S Kelly  1   2 , Alicia Kunin-Batson  1   2 , Claudia K Fox  1   2 , Rebecca Freese  3 , Justin Clark  4 , Kyle D Rudser  2   3   4 , Eric M Bomberg  1   2 , Justin Ryder  5   6 , Amy C Gross  1   2
Affiliations
Randomized Controlled Trial

Evaluating appetite/satiety hormones and eating behaviours as predictors of weight loss maintenance with GLP-1RA therapy in adolescents with severe obesity

Megan O Bensignor et al. Pediatr Obes. 2024 May.

Abstract

Introduction: Whilst glucagon-like peptide-1 receptor agonists (GLP1-RAs) are effective for treating adolescent obesity, weight loss maintenance (WLM; preventing weight regain) remains a challenge. Our goal was to investigate appetite/satiety hormones and eating behaviours that may predict WLM with exenatide (a GLP1-RA) versus placebo in adolescents with severe obesity.

Methods: Adolescents who had ≥5% body mass index (BMI) reduction with meal replacement therapy were randomized to 52 weeks of once-weekly exenatide extended release or placebo. In this secondary analysis, eating behaviours and appetite/satiety regulation hormones post-meal replacement therapy (pre-randomization to exenatide or placebo) were evaluated as possible predictors of WLM. Percent change in BMI from randomization to 52 weeks served as the primary measure of WLM.

Results: The analysis included 66 adolescents (mean age 16.0 years; 47% female). Lower leptin response to meal testing was associated with greater WLM in terms of BMI percent change in those receiving exenatide compared to placebo (p = 0.007) after adjusting for sex, age and BMI. There were no other significant predictors of WLM.

Conclusions: Prior to exenatide, lower leptin response to meals was associated with improved WLM with exenatide compared to placebo. The mostly null findings of this study suggest that GLP1-RA treatment may produce similar WLM for adolescents with obesity regardless of age, BMI, sex and eating behaviours.

Keywords: appetite; glucagon‐like peptide‐1 receptor agonist; pediatric obesity; pharmacotherapy; weight regain.

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Conflict of interest statement

MOB revives research support from Vivus Inc. (donated study drug) and Abbot Inc. EMB is site co-investigator for Novo Nordisk. CKF serves as a site PI for a Novo Nordisk and an Eli Lilly clinical trial. JRR receives research support in the form of donation of drug and placebo from Boehringer Ingelheim. ASK engages in unpaid consulting and educational activities for Boehringer Ingelheim, Eli Lilly, Novo Nordisk, and Vivus; receives donated drug/placebo from Novo Nordisk and Vivus for National Institute of Diabetes and Digestive and Kidney Diseases-funded clinical trials.

This research was supported by R01DK105953, K23DK125668, and K23DK129721 from the National Institute of Diabetes and Digestive and Kidney Diseases. This research was also supported by the National Institutes of Health’s National Center for Advancing Translational Sciences, grant UL1TR002494. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health’s National Center for Advancing Translational Sciences.

Figures

Figure 1.
Figure 1.. Percent Change in BMI from Randomization to 52 Weeks (WLM) by Randomization Leptin Response.
Participants whose leptin meal-response at randomization was in the lower 25th percentile of the intra-study population had more WLM on exenatide XR than those on placebo. MRT: meal-replacement therapy
See this image and copyright information in PMC

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