TOP 35 - Patient Perspectives on the use of GLP-1RAs in Pediatric Obesity Management

Publication Number: 2786.TOP 35

Leora Allen, MassGeneral Hospital for Children, Cambridge, MA, United States; Rachel Whooten, MassGeneral Hospital for Children, Boston, MA, United States

Background: In the context of rising pediatric obesity rates, the landscape of treatment options has changed with the FDA approval of glucagon-like peptide-1 receptor agonists (GLP-1RA) for youth over 12 years old, as well as the inclusion of obesity pharmacotherapy in the American Academy of Pediatrics’ (AAP) 2023 clinical practice guidelines. While patient perspectives on GLP-1RAs have been examined in adult populations, the adolescent population remains unstudied.

Objective: In this explanatory sequential mixed methods study, we examined perspectives on GLP-1RA usage, medication access and barriers to use, and lifestyle and behavioral supports among parent-adolescent dyads with adolescent GLP-1RA use.

Design/Methods: We recruited parent-adolescent dyads using electronic health records of GLP-1RA prescriptions within an academic medical center in Eastern Massachusetts (n=23 dyads; response rate 38%). Eligibility criteria included (1) adolescent between 12-18 years old and (2) ability to complete surveys in English. Parents of eligible participants received an introductory letter and phone call; interested parents received an emailed link to a survey, provided contact information for child to receive the survey, and were invited to participate in a semi-structured qualitative interview. Audio recordings were sent to a third party for secure transcription.

Our study population included 23 adolescents (57% male), with parent-proxy surveys and clinical data available for all participants (100%) and a subset completing adolescent surveys (n=12; 52%) and opting in to the qualitative interview (n=11; 6 dyads, 5 parent-only). Overall, 60% of participants self-identified as Non-Hispanic White, 30% Hispanic/Latino, and 17% Black/African American. In initial quantitative analyses, average age and BMI at GLP-1RA initiation were 14.2 years (SD 1.5 years) and 41.1 kg/m2 (SD 8.3 kg/m2), respectively. Initial GLP-1RA prescriptions were 61% semaglutide, 22% dulaglutide, and 17% liraglutide. Using a validated measure of shared decision making, parents and adolescents endorsed high levels in relation to the decision to start pharmacotherapy (mean score 38.5 (SD 5.5) and 36.9 (SD 10.3), respectively, out of 45).

Future data analysis will include defining trends based on BMI change and laboratory data (estimated completion 11/30/2025), as well as completing thematic analysis of qualitative interview transcripts (estimated completion 12/31/2025). Together, this mixed-methods approach will provide additional context to the unique needs and experiences of adolescents receiving GLP-1RA therapy.