Once-weekly semaglutide in adolescents with obesity (STEP TEENS)

Phase 3 RCT (n=201 adolescents 12-17 with obesity). Semaglutide 2.4 mg weekly + lifestyle vs. placebo + lifestyle for 68 weeks. Mean BMI change -16.1% vs. +0.6%; 73% of treated achieved ≥5% weight loss vs. 18% placebo. GI adverse events more common but acceptable. The pivotal trial cited by AAP 2023 to recommend pharmacotherapy from age 12. Open question: durability, cost, and effects of long-term GLP-1 exposure on adolescent metabolism and growth not yet known.