Systematic Review and Meta-Analysis of Liraglutide Treatment in Children Who Are Overweight or Obese: A Therapeutic Paradigm Shift?

Pediatric obesity is a public health problem with long-term repercussions, in which there is limited effectiveness of interventions such as lifestyle changes. This study evaluated the efficacy and safety of liraglutide in overweight/obese children and adolescents (six to 18 years) using a systematic review and meta-analysis of randomized clinical trials (RCTs). Databases such as PubMed, Web of Science, and ClinicalTrials.gov were searched up to February 2025, and the analysis included four RCTs (n=378). Liraglutide significantly reduced BMI Z-score (standardized mean difference or SMD: -1.03; 95% CI: -1.24 to -0.81; I²=0%) and showed modest improvements in HbA1c (SMD: -1.14; 95% CI: -2.10 to -0.17; I²=92%), though with high metabolic heterogeneity. There was a tendency toward increased hypoglycemia (relative risk or RR: 1.55; 95% CI: 1.00-2.40), but there was no significant difference in the overall adverse effects (RR: 1.06; 95% CI: 0.97-1.15). The results support the use of liraglutide to reduce BMI in this population, but the current evidence is limited by the small number of studies, methodological biases, and variability in metabolic outcomes. More robust RCTs and studies with prolonged follow-up are needed to consolidate liraglutide's role in the management of pediatric obesity.