Weight Loss Effect of Lisdexamfetamine in Children with Severe Obesity: A Case Series

<b><i>Background:</i></b> Pharmacological options for severe obesity in early childhood are limited. While lisdexamfetamine is approved for attention-deficit/hyperactivity disorder (ADHD) and binge eating disorder, its role in managing obesity in children without these conditions has not been well studied. This case series assessed the effect of lisdexamfetamine on weight in young children with severe obesity but without ADHD or binge eating disorder. <b><i>Methods:</i></b> We conducted a retrospective chart review of six children with severe obesity treated with lisdexamfetamine for weight management. Demographic, anthropometric, and metabolic data were collected. One patient had Prader-Willi syndrome (PWS); the others had no known syndromic obesity. <b><i>Results:</i></b> Median age at treatment initiation was 6.5 years (range: 4.5-14), with equal male and female distribution. Median treatment duration was 12 months (range: 12-24), and mean maximum tolerated lisdexamfetamine dose was 35 mg (range: 10-60). In patients without syndromic obesity (n = 5) including one child with hypothalamic obesity, lisdexamfetamine significantly reduced body mass index (BMI) percent of the 95th percentile at 12 months (median change -24%, range: -18 to -28, <i>p</i> = 0.031), equating to a 13.8% reduction in BMI. Height percentile remained unchanged (<i>p</i> = 0.59). The patient with PWS did not achieve lasting weight loss. Three children reported decreased appetite. <b><i>Conclusions:</i></b> Lisdexamfetamine was associated with weight loss in young children with severe obesity without genetic syndromes. Further studies are warranted to assess the long-term efficacy and safety of lisdexamfetamine in the management of pediatric obesity.