Pharmacotherapy in pediatric obesity: current evidence and landscape

Purpose of review Childhood obesity is escalating globally. Lifestyle and behavioral changes, which are the frequently used interventions in clinical practice, lead to only modest improvements in children with established obesity. Bariatric surgery is currently the most effective obesity treatment but has very limited utilization in pediatric obesity and is preferentially used for children with worsening comorbidities. There exists a massive treatment gap for children suffering with obesity especially after the failure of lifestyle modifications. Pharmacotherapy that is an established management tool in adults is very infrequently used in children. Only two medications, Phentermine and Orlistat are approved by the Food and Drug Administration (FDA) for use in adolescent obesity. Herein, we discuss the current landscape and available literature on the use of antiobesity pharmacotherapy in children. Recent findings There are emerging pediatric data about the efficacy of the many weight loss medications that are FDA approved in adults. Moreover, more clinical trials are underway on the rarer, intractable forms of obesity such as monogenic, syndromic, and hypothalamic obesity. Weight loss medications in children, like adults, have variable efficacy and similar side effect profiles. Rigorous research and improved education of providers about weight loss medications may address the huge treatment gap in severe pediatric obesity.

Automated summary

There is a growing body of pediatric data on the efficacy of weight loss medications approved by the FDA for adults. Clinical trials are also underway for rarer forms of obesity in children, such as monogenic, syndromic, and hypothalamic obesity. Weight loss medications in children have varying efficacy and similar side effect profiles to those seen in adults, highlighting the need for rigorous research and improved education for providers on these medications to address the treatment gap in severe pediatric obesity.