Role of glucagon-like peptide-1 receptor agonists in pediatric obesity and metabolic dysfunction associated steatotic liver disease

Table 1 Key effects of available generic glucagon-like peptide-1 analogs

GLP-1 analog	Approval and indications	Key effects
Liraglutide	Approved for weight management in adolescents ≥ 12 years with BMI ≥ 30 kg/m2	Significant reduction in BMI and improvements in liver enzymes in adolescents with obesity and MASLD
Semaglutide	Approved for adolescents ≥ 12 years with BMI ≥ 95th percentile	Significant reductions in BMI and waist circumference. Promising anti-fibrotic effects on liver injury
Exenatide	Approved for type 2 diabetes in children ≥ 10 years	Improved BMI, liver function, and metabolic measures in children and adolescents
Dulaglutide	Approved for managing type 2 diabetes in children ≥ 10 years and adults	Superior to placebo in improving glycemic control. Inferior to semaglutide in reducing body weight
Tirzepatide	Approved for weight management in adults with obesity and obstructive sleep apnea (Zepbound) and type 2 diabetes (Mounjaro)	Superior weight loss and BMI reduction compared to other available treatments, with potential future applications in pediatric obesity
Retatrutide	Under investigation for obesity and diabetes	Promising results expected due to the combined effects on GLP-1, GIP, and glucagon receptors

BMI: Body mass index; MASLD: Metabolic dysfunction-associated steatotic liver disease; GLP-1: Glucagon-like peptide-1; GIP: Glucose-dependent insulinotropic polypeptide.