Preserved Linear Growth in Overweight or Obese Children Treated with Soagambi-Tang: A Real-World Clinical Study with...

Background/Objectives: Pediatric obesity is linked to adverse metabolic outcomes and altered growth trajectories. Conventional weight-reduction strategies often raise concerns regarding potential impairment of linear growth, highlighting the need for approaches that reduce adiposity while preserving physiological development. Methods: This real-world clinical study investigated children aged 7-16 years who were administered the herbal medicine Soagambi-tang for 2 weeks, followed by a follow-up evaluation 6 months post-treatment. Anthropometric measures, body composition, and growth velocity were evaluated. Network pharmacology and molecular docking analyses were employed to investigate potential molecular mechanisms. Results: Twenty-five participants were included. After treatment, the proportion of children classified as obese decreased from 60.0% to 36.0%, and 32.0% showed improvement in weight-status category without any worsening. Body fat percentage decreased consistently among participants with available body composition data, from 30.24 ± 4.52% to 25.95 ± 5.44% (p < 0.0001), and fat mass significantly decreased from 15.22 ± 5.60 kg to 14.28 ± 5.77 kg (p = 0.0496), whereas lean body mass increased from 36.12 ± 12.08 kg to 38.89 ± 12.70 kg (p < 0.001). BMI percentile significantly decreased from 93.7 ± 3.9 to 91.2 ± 6.1 (p = 0.008), while height z-score and height percentile significantly increased from 0.57 ± 0.99 to 0.77 ± 1.07 and from 64.5 ± 25.5 to 68.6 ± 25.0, respectively (both p < 0.001). Mean annual height velocity was 7.45 ± 2.43 cm/year, and height change was positively correlated with lean body mass change (r = 0.543, p = 0.005), reflecting a meaningful upward shift in growth trajectory. In silico network pharmacology and molecular docking analyses identified key bioactive compounds in Soagambi-tang that were predicted to be associated with pathways related to pediatric obesity and puberty-associated endocrine regulation. Conclusions: These findings suggest that Soagambi-tang treatment was associated with reduced adiposity and preserved linear growth in children with overweight or obesity. Given the study design and limited sample size, controlled prospective studies are required to confirm efficacy and safety.