MON-242 Effects of Liraglutide on Body Composition Distribution in Adolescents with Refractory Obesity Post-Vertical Sleeve Gastrectomy

Abstract Disclosure: B. Tran: None. A. Zenno: None. N.M. Mirza: None. E. Nadler: None. S.M. Brady: None. K. Chen: None. S.T. Chung: None. J.A. Yanovski: None. Background:Metabolic and bariatric surgery (MBS) is an effective surgical treatment for severe obesity in adolescents, but nearly 50% of those who undergo MBS have continued obesity or weight regain after MBS. We conducted a pilot trial of liraglutide, a GLP-1 analogue, in adolescents with persistent obesity at least 1y after vertical sleeve gastrectomy (VSG). Liraglutide was associated with a BMI change of -1.7 kg/m2, -4.3%, after 16 weeks (DOI: 10.1111/ijpo.13154). In this secondary analysis, we hypothesized that liraglutide would: (1) reduce trunk and appendicular fat mass, lean mass, and visceral adipose tissue (VAT) and (2) reductions in subcomponent fat mass would be associated with improvements in fasting serum glucose, cholesterol, and triglycerides. Methods:This phase II pilot trial enrolled adolescents aged 12-20.9 years with obesity ≥1 yr post-VSG. Liraglutide was initiated at 0.6 mg daily by subcutaneous injection and increased by 0.6 mg weekly, with a maximum dose of 3.0 mg/d. To assess participants’ body composition, dual-energy x-ray absorptiometry (DXA) scans were performed at baseline and after 16 weeks of liraglutide. Blood samples were also collected for metabolic assessment at 0 and 16 weeks. Results: Among 43 youths screened, 34 initiated liraglutide and 31 participants (age 18.1 ± 1.9y, 61% female, BMI 40.9 ± 7.4 kg/) completed the 16-week treatment period. In the pilot study, mean change in total fat mass was found to be -3.2 ± 3.4 kg (-1.1 ± 2.0%, <0.001). In this subsequent secondary analysis, mean changes in trunk, total arm, and total leg fat mass were found to be -1.95 ± 2.3 kg (-0.3 ± 2.5%, p<0.00001), -0.55 ± 0.6 kg (-0.2 ± 1.0%, p<0.00001), and -0.94 ± 1.7 kg (+0.4 ± 2.2%, p=0.005), respectively. 12 participants (age 19.6 ± 0.9y) had VAT mass estimated pre- and post-treatment, which changed by -0.15 ± 0.2 kg (-0.6 ± 1.0%, p=0.03). Mean change in total lean mass was -1.76 ± 1.81 kg (1.1 ± 1.9%, p<0.00001). Mean changes in trunk, total arm, and total leg lean mass were -0.87 ± 1.4 kg (-0.02 ± 2.2%, p=0.002), -0.32 ± 0.8 kg (-0.2 ± 1.2%, p= 0.03), and -0.49 ± 1.4 kg (+0.2 ± 2.2%, p =0.06), respectively. Changes in fasting glucose concentration (mean change -2.9 ± 6.7 mg/dL, p<0.001) correlated with change in trunk fat, r=0.42 (p=0.02), while changes in the other body composition subcomponents were not significantly associated with changes in fasting glucose, cholesterol, or triglycerides. Conclusions: Liraglutide 3.0 mg/d for 16 weeks reduced total and subcomponent fat and lean mass in adolescents with obesity post-VSG. 35% of all weight lost was lean mass. Change in trunk fat mass was positively correlated with liraglutide-associated change in fasting glucose. Future studies should focus on potential causes for variability in body composition changes to better characterize liraglutide responders compared to non-responders. Presentation: Monday, July 14, 2025