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GLP-1 Receptor Agonists in Adolescents: Emerging Endocrine, Reproductive, and Psychosocial Concerns
Muhammad Ali Haider1, Haseeba Javed2
1HBS Medical and Dental College, Islamabad, Pakistan.
Journal of Pediatric and Adolescent Gynecology
|June 27, 2026
Summary
Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) show promise for adolescents with obesity, T2DM, and PMOS. Long-term effects on bone health, reproduction, and eating disorders require careful monitoring and patient selection.
Area of Science:
- Endocrinology
- Pediatrics
- Metabolic Disorders
Background:
- Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) are increasingly used in adolescents for obesity and type 2 diabetes mellitus (T2DM).
- There is growing interest in using GLP-1 RAs for polyendocrine metabolic ovarian syndrome (PMOS) in adolescents.
- Adolescence is a critical period for peak bone mass acquisition, with limited data on the effects of pharmacologic weight loss during this stage.
Purpose of the Study:
- To examine emerging concerns regarding bone health, reproductive safety, eating disorder risk, and endocrine development associated with GLP-1 RA use in adolescent populations.
- To review current evidence and identify areas of uncertainty regarding the long-term implications of GLP-1 RA therapy in this demographic.
Main Methods:
- This commentary synthesizes existing literature and clinical trial data on GLP-1 RA use in adolescents.
- It specifically reviews findings related to weight loss, growth, pubertal development, bone mineral density, reproductive outcomes, and eating disorder risk.
- The analysis also considers evidence from adult studies where applicable.
Main Results:
- GLP-1 RAs (liraglutide, semaglutide) demonstrate significant weight reduction in adolescents with obesity, without short-term impacts on growth or puberty.
- Potential risks include impaired bone mineral accrual due to rapid weight loss and increased eating disorder risk due to appetite suppression.
- No data exist on reproductive outcomes post-adolescent exposure, and GLP-1 RAs are contraindicated in pregnancy.
Conclusions:
- GLP-1 RAs offer potential benefits for adolescents with obesity, T2DM, and PMOS.
- Long-term skeletal, reproductive, psychological, and endocrine outcomes remain uncertain.
- Careful patient selection, bone health monitoring, resistance exercise, contraceptive counseling, and eating disorder screening are recommended.
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