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

Author:

Bensignor Megan O.12ORCID,Kelly Aaron S.12,Kunin‐Batson Alicia12ORCID,Fox Claudia K.12ORCID,Freese Rebecca3,Clark Justin4,Rudser Kyle D.234,Bomberg Eric M.12ORCID,Ryder Justin56,Gross Amy C.12ORCID

Affiliation:

1. Department of Pediatrics Medical School, University of Minnesota Minneapolis Minnesota USA

2. Center for Pediatric Obesity Medicine University of Minnesota Medical School Minneapolis Minnesota USA

3. Clinical and Translational Science Institute Biostatistical Design and Analysis Center, University of Minnesota Minneapolis Minnesota USA

4. Division of Biostatistics and Health Data Science University of Minnesota School of Public Health Minneapolis Minnesota USA

5. Department of Pediatrics and Surgery Ann & Robert H. Lurie Children's Hospital of Chicago Chicago Illinois USA

6. Department of Pediatrics and Surgery Northwestern Feinberg School of Medicine Chicago Illinois USA

Abstract

SummaryIntroductionWhilst 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.MethodsAdolescents 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.ResultsThe 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.ConclusionsPrior 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.

Funder

National Institutes of Health

National Institute of Diabetes and Digestive and Kidney Diseases

Publisher

Wiley

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