SUN-218 - Early Experience of Once Weekly Semaglutide in Children Younger than 12 Years: A Case Series

Background: Childhood obesity is a significant public health concern, affecting nearly 20% of children aged 6–11 years in the US. Despite this growing burden, pharmacologic treatment options for children younger than 12 years remain limited. Once-weekly subcutaneous semaglutide, a glucagon-like peptide-1 receptor agonist, is used to treat obesity in adolescents and adults; however, data in younger children, particularly regarding growth and metabolic outcomes, are scarce.

Objective: To describe changes in anthropometric and metabolic measures following once-weekly semaglutide therapy in children younger than 12 years.

Methods: We conducted a retrospective case series of children younger than 12 years treated with semaglutide (0.125–2 mg weekly) for severe obesity at a tertiary care center in South Florida between May 2025 and January 2026. Anthropometric measures (weight, BMI, height) and metabolic parameters (HbA1c, lipid profile, liver enzymes) were assessed at treatment initiation and follow-up. Diagnoses of metabolic-associated steatotic liver disease (MASLD) and obstructive sleep apnea (OSA) were recorded. Data were summarized descriptively.

Results: Twelve patients (8 female) were included, with a mean age of 10.6 ± 1.0 years at treatment initiation. Baseline BMI ranged from 22.6 to 50.0 kg/m², with BMI z-scores from 1.71 to 2.6. All received semaglutide 0.25–2 mg weekly. Follow-up duration was 3–6 months. Mean BMI z-score decreased by 0.17 and weight z-score by 0.36. Mean height z-score was 1.7 at baseline and 1.6 at follow-up. Baseline labs were available for 10 patients: four had mildly elevated ALT/AST and four had hypertriglyceridemia. Total and LDL cholesterol were within reference ranges in all patients. Two had elevated baseline HbA1c (>5.6%). Follow-up labs were available for six patients. ALT and AST remained stable. HbA1c was stable or decreased (up to –0.7%), and triglycerides decreased in two patients. Three patients had MASLD and two had OSA.

Conclusion: In this early clinical experience, once-weekly semaglutide therapy in children younger than 12 years with severe obesity was associated with short-term reductions in BMI z-score and favorable metabolic trends without impaired linear growth. These findings suggest semaglutide may be a promising adjunctive treatment for young children with severe obesity and related comorbidities. Larger prospective studies are needed to evaluate long-term efficacy and safety.

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