The GLP-1 Agonist Exenatide Is Associated with Improved Adherence to Health Behavior and Lifestyle Treatment in Adolescents with Obesity: A Randomized Controlled Trial.

INTRODUCTION: We aimed to study the effects of the glucagon-like peptide-1 receptor agonist exenatide on behavioral outcomes in children and adolescents with obesity. METHODS: This study reports pre-specified secondary outcomes of a randomized, double-blind, placebo-controlled trial in adolescents with obesity, aged 10-18 years. Participants (n = 44) were randomized to 6 months treatment with exenatide or placebo, along with a lifestyle intervention consisting of nutritional advice from a dietitian and sessions with a psychologist to optimize physical activity. Change in choices of food and drink, portion sizes, meal frequency, sleep, screen time, and physical activity were assessed by 6-min walking test, accelerometry, and questionnaires. RESULTS: Exenatide treatment was associated with improved adherence to choices of recommended food and drinks (score change 4.34, 95% CI: 1.05-7.63, p = 0.01, Hedges' g 0.82, 95% CI: 0.17-1.49), decreased portion size (score change -4.05, 95% CI: -6.51 to -1.58, p = 0.002, Hedges' g -1.29, 95% CI: -2.13 to -0.45), and increased self-reported physical activity (1.82 h, 95% CI: 0.68-2.96, p = 0.002 Hedges' g 0.97, 95% CI: 0.33-1.62), while no differences in meal frequency, snacking, sleep, screen time, objectively measured physical fitness or activity were found. CONCLUSION: Exenatide treatment was associated with modest improvements in selected self-reported dietary behaviors, including improved adherence to recommended food and drink choices and reduced portion sizes, as well as increased self-reported physical activity, although no changes were observed in objective measures of physical activity or other lifestyle factors.