MON-232 - Real-World Treatment Patterns and Goals of Adolescents Living with Obesity in the US Population: Results from a Multinational Cross-sectional Survey (UNICORN)

Background
Obesity is a complex progressive disease affecting approximately 22% of adolescents in the United States (US). This study described the real-world treatment journey of adolescents with obesity (AwO), including treatment history and experience with obesity management medications in the US.
Method
We analyzed US data from the Adelphi Pediatric Obesity I Disease Specific Programme™, a multinational, cross-sectional survey conducted from May to December 2025. Physicians provided data for patients aged 12-17 years with a current or previous diagnosis of obesity (body mass index [BMI] ≥95th percentile for age and gender) enrolled in an obesity management program at data collection. Results were summarized descriptively.
Results
A total of 115 physicians reported data for 684 AwO (mean age, 15 years; female, 50.7%; mean BMI percentile, 98.7): class I obesity (38.0%), class II obesity (33.3%), class III obesity (15.6%), overweight (10.8%) and underweight/normal weight (2.2%) at data capture. Family history of obesity or related conditions was reported in 83.9% of AwO (n=574), including parental obesity (both parents: 43.6%; one parent: 29.5%), and type 2 diabetes (21.3%). Most AwO (n=667) initially consulted a pediatrician (54.0%), a general practitioner (26.1%), or a pediatric endocrinologist (10.6%). Mean [SD] prior weight loss attempts (in the last 3 years) were 2.3 [1.8], and 38.2% had a physician-defined target weight (mean desired weight loss, 20.3%). Current obesity management plans included dietary (76.3%) and exercise programs (73.2%), pharmacotherapy (62.9%), alternative therapies such as counseling (28.4%), and weight loss support groups (15.1%). Among AwO on pharmacotherapy (n=405), the most frequently prescribed included semaglutide (55.1%), metformin (21.5%), phentermine/topiramate (9.6%), and tirzepatide (6.9%). Reasons for initiating the current obesity management plans (n=684) included multiple failed diet/exercise attempts (40.6%), concern about future health risks despite no comorbidities (31.6%), desire for rapid weight loss (21.3%), and comorbidities requiring weight loss (19.7%). Physicians were moderately (34.8%), very (25.4%), or extremely concerned (16.1%) about AwO not reaching weight loss targets. In addition to weight reduction, physicians reported that improved quality of life (61.5%), mental health (38.7%), mobility (35.5%), comorbidity prevention/ management (30.8%), lower lipid levels (20.0%), and blood pressure reduction (15.6%) were key factors in measuring treatment success.
Conclusion
This analysis highlights the treatment journey for AwO and key considerations physicians make when determining which obesity management strategies to initiate for AwO. Physicians’ concerns about the success of current treatment options underscore the need for better approaches to achieve weight loss and treatment goals in AwO.

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