Adipose Tissue_Appetite_and Obesity

SAT-675 - Clinical Variability in Response to Semaglutide in Adolescents with Severe Obesity.

Saturday, June 13, 2026

9:30 AM - 4:30 PM CT

Late-Breaking Poster Presenter(s)

RD

Robert Daly

UMDNJ-RWJ MEDICAL SCHOOL
Mendham, NJ, United States

Co-Author(s)

RD

Robert Daly

UMDNJ-RWJ MEDICAL SCHOOL
Mendham, NJ, United States
AM

Andrew Makar, Student, Class of 2025

Student
Boston University
Boston, Massachusetts, United States
EL

Erica Lupiano, BS

Short Hills, NJ, United States
JM

Joshua Matthew, Medical student MS3

Medical student MS3
Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, US
New Brunswick, New Jersey, United States
DM

Deepa Mathew, DO

Pediatric Endocrinologist
Unterberg Children's Hospital Monmouth Medical Center
Long Branch, New Jersey, United States
IM

Irene Mamkin, MD

Pediatric Endocrinologist
Cooperman Barnabas and Newark Beth Israel Medical Center, RWJBarnabas Health
Livingston, New Jersey, United States
MG

Mariam Gangat, MD

Pediatric Endocrinologist
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
IM

Ian Marshall, MD

Pediatric Endocrinologist
Rutgers Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
AK

Ahmed Khattab, MD

Pediatric Endocrinologist
Rutgers-Robert Wood Johnson Medical School
New Brunswick, New Jersey, United States
Svetlana Ten, MD (she/her/hers)

Pediatric Endocrinologist
Rutgers University- Robert Wood Johnson University Hospital
Staten Island, NY, United States

Disclosure(s):

Svetlana Ten, MD: BioMarin: speaker ()

Background:
Semaglutide, a GLP-1 receptor agonist, produces substantial weight loss in individuals with obesity; however, clinical response is heterogeneous. While many patients achieve significant reductions in body weight, a subset demonstrates suboptimal or minimal response. The mechanisms underlying this variability are not fully understood and may involve differences in central appetite regulation, pharmacogenomics, insulin resistance, and behavioral factors.
Methods
We conducted a retrospective review of 96 patients' charts with severe obesity treated with Semaglutide over a period of 6 months to 2 years.
Results
A total of 96 patient charts were reviewed. The mean age was 16.5 ± 2.6 years, the mean BMI was 40 ± 7.5 kg/m², and 66 (68.8%) were female. Patients were stratified into four groups based on the percentage change in BMI.
Group 1: ≥10% BMI reduction, 33 patients (34.4%), including 4 males, BMI decreased from 38.9 ± 7.1 to 31.4 ± 6.5 kg/m², Mean reduction: 19 ± 8.3%, 1 patient (3%) had diabetes.
Metabolic outcomes: Triglycerides decreased from 152 ± 102 to 105.7 ± 62.2 mg/dL, TG/HDL ratio improved from 3.4 ± 2.2 to 2.2 ± 2.0, HbA1c decreased from 6.0 ± 1.7% to 5.3 ± 0.4% (p < 0.05). No significant changes in ALT, AST, or LDL.
Group 2: 5–9% BMI reduction, 26 patients (27.1%), including 9 males, BMI decreased from 40.5 ± 7.4 to 37.8 ± 6.5 kg/m², Mean reduction: 6.7 ± 1.3%, 7 patients (27%) had diabetes.
Metabolic outcomes: Triglycerides decreased from 141.2 ± 91.2 to 123.4 ± 65.7 mg/dL, TG/HDL ratio improved from 3.4 ± 3.0 to 3.0 ± 2.8, ALT decreased from 37.7 ± 29 to 28.9 ± 21.3 U/L, and AST decreased from 29.8 ± 15.2 to 24.0 ± 12.7 U/L (p < 0.05). No significant changes in LDL or HbA1c
Group 3: Weight gain, 18 patients (18.8%), including 6 males, BMI increased from 40.1 ± 8.5 to 42.3 ± 9.4 kg/m², Mean increase: 5.3 ± 4.5%, 5 patients (28%) had diabetes.
Metabolic outcomes: Triglycerides decreased from 121.2 ± 41.3 to 91.9 ± 29 mg/dL, TG/HDL ratio improved from 2.9 ± 0.9 to 2.1 ± 1.0 (p < 0.05). No significant changes in LDL, ALT, AST, or HbA1c.
Group 4: No significant BMI change, 19 patients (19.7%), including 8 males, BMI changed from 41.3 ± 7.9 to 40.4 ± 7.8 kg/m², Mean change: −0.9 ± 0.5%, 6 patients (31.5%) had diabetes.
Metabolic outcomes: No significant changes in triglycerides, TG/HDL ratio, LDL, ALT, AST, or HbA1c.
Conclusion
A total of 56 patients (61.5%) achieved meaningful weight loss. Greater BMI reduction was associated with significant improvements in triglycerides, TG/HDL ratio, and HbA1c.
Some patients who gained weight still showed improvements in Triglycerides and Insulin Resistance, suggesting additional factors beyond weight change may influence outcomes
However, 38.5% of patients did not lose weight, highlighting variability in response and the need for individualized treatment strategies.

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