"GLP-1 receptor agonists are probably still underused in children, adolescents and young people," Auzanneau said. "This is to be expected because these treatments are relatively new for these age groups. There may be concerns about side effects and there may be issues regarding health insurance coverage. We expect use to continue to increase as these issues are addressed."

Measurable benefits outside the clinical trial

The researchers then asked a harder question: do the drugs work as well in everyday clinical practice as they do in tightly controlled clinical trials?

"While these drugs have performed very well when given to young people under the tightly controlled conditions of clinical trials, data on concrete benefits in real-world conditions is lacking," Auzanneau explained.

To find out, the team focused on a subset of 240 children and young people (median age 16.4 years, 59% female, 47% with a migration background) whose drug use was documented across at least two visits to a treatment center. The median duration of treatment was 11 months. Liraglutide dominated, accounting for 70% of prescriptions at the first visit, followed by dulaglutide, semaglutide and tirzepatide. The drugs were typically combined with other treatments, most commonly metformin.

When treatment began, 19% of participants had overweight, 44% had obesity and 32% had extreme obesity. Because children and teenagers are still growing, researchers express their weight relative to peers of the same age using a measure called BMI SDS, where a higher score indicates a higher weight. The average starting score was 2.23, in the obese range.

The results were encouraging. More than a third of participants (37%) reduced their BMI SDS by at least 5%, and 25% achieved a reduction of 10% or more. The average reduction across the whole group was 2.3%.

"A reduction of 2.3% is meaningful when we consider that many of these children and young people had gained weight for years, despite making lifestyle changes," Auzanneau said.

Blood sugar control, measured with an HbA1c test that reflects average glucose over roughly three months, also improved. The proportion of participants with hypertension fell from 60% to 52%. The improvements held up after the researchers adjusted for sex, age group, migration background and starting BMI.

Beyond weight loss

Auzanneau emphasized that the benefits extend beyond the scale. "This isn't just about weight loss. By helping children, adolescents and young adults reach a healthier weight, these drugs should reduce their likelihood of developing depression, sleep apnea and other severe conditions that are linked to obesity," she said.

Better blood sugar control carries its own long-term payoff. "The GLP-1 receptor agonists will help lower the risk of heart disease and damage to the eyes, kidneys and nerves," Auzanneau added. "This is very important because these complications of type 2 diabetes reduce the quality and, often, also the length of life."

Caveats to keep in mind

The findings deserve careful interpretation. The study analyzed registry data rather than a randomized trial, so the researchers cannot fully rule out other factors influencing the results. The subgroup used for the outcomes analysis was relatively small—240 participants—and the median follow-up of 11 months offers limited insight into long-term safety and effectiveness in growing children. The findings were also presented at a conference rather than published in a peer-reviewed journal at this stage.

Still, the data offer one of the clearest pictures yet of how a new generation of obesity and diabetes medicines is being used, and with what effect, in young Europeans. As regulators, insurers and physicians work through remaining concerns, Auzanneau and her colleagues expect prescriptions—and the evidence base—to keep growing.