Effectiveness, safety, and treatment patterns of GLP-1 receptor agonists in adolescents with obesity: a multicenter retrospective study from Saudi Arabia.

Background: Real-world evidence on the use of glucagon-like peptide-1 (GLP-1) receptor agonists in pediatric obesity remains limited, particularly regarding treatment outcomes, safety, and clinical practice patterns. Objective: To evaluate changes in body weight and BMI z-score, assess safety outcomes, and describe treatment patterns among adolescents receiving GLP-1 receptor agonists in routine clinical practice in Saudi Arabia. Methods: A multicenter retrospective observational study was conducted using medical records of adolescents aged 12-18 years who received GLP-1 receptor agonists between January 2021 and December 2024. Data on demographic and clinical characteristics, treatment patterns, and outcomes were collected. Within-group changes were assessed using the Wilcoxon signed-rank test, and between-group comparisons were performed using the Kruskal-Wallis test. Results: A total of 81 patients were included. GLP-1 therapy was associated with modest reductions in weight and BMI z-score across treatment groups, depending on the GLP-1 receptor agonist used, with no statistically significant differences between groups. Median percentage weight reduction ranged from -2 to -7%. Adverse events were infrequently documented and, when reported, predominantly gastrointestinal. Endocrinologists issued most prescriptions; the median treatment duration was 4 months, dose titration was documented in 37% of patients, and referral for bariatric surgery occurred in 9% of cases. Conclusion: In routine clinical practice, GLP-1 receptor agonists were associated with modest weight reduction and were generally well tolerated among adolescents with obesity. Variability in treatment patterns highlights the need for more standardized approaches to optimize the use of GLP-1 therapies in pediatric obesity management.