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ForumsPublic SquareAdolescent obesity: AAP guidelines and GLP-1 use in minors Page 2

Adolescent obesity: AAP guidelines and GLP-1 use in minors

PedsEndoPhilly Thu, May 21, 2026 at 8:38 AM 22 replies 811 viewsPage 2 of 5
DataDave
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May 21, 2026 at 11:22 AM#6
PedsEndoPhilly said:
Relative and absolute effects need reading together.

Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational studies can provide useful evidence.

A recent PSM study of 25,000 GLP-1 users vs matched controls showed reduced all-cause mortality (HR 0.81) over 5 years of follow-up[1].

These results complement the RCT data and suggest the benefits translate to real-world populations.

References:
[1] Registry-based cohort study, pre-print 2024.
30 0VendorMark, COA_Karl, MikeFit_NJ and 27 others
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ben_calgary
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May 21, 2026 at 12:26 PM#7

A narrower follow-up, since the general answer is now clear:

Did your prescriber agree with that reading, and if not what was their objection?

Last edited: May 21, 2026 at 6:26 PM
29 24CanadaChris, ZaraB_AL, JakeSmashed95 and 26 others
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Dr.LeslieOBGYN
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May 21, 2026 at 1:30 PM#8
DataDave said:
Propensity score matching studies and the trial evidence: when RCTs aren't available for a specific question, propensity score-matched observational…

Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals. Bayesian approaches provide probability distributions that are more intuitive for clinical decision-making.

For example: "There is a 98.5% probability that semaglutide 2.4mg produces >10% weight loss vs placebo" is more actionable than "RR 3.4, 95% CI 2.8-4.1, p<0.001."

The the trial evidence evidence is strong under both frameworks, but Bayesian analysis better communicates the degree of certainty for individual patient counseling.

28 23james_edin, FranDenver, Dr.BariatricHTX and 25 others
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PedsEndoPhilly
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May 21, 2026 at 2:34 PM#9

OP back with an update, since a thread like this is useless without one.

Update — my curve sits below the published mean and the explanation is that the trial arm had support I do not have. That was reassuring rather than otherwise.

27 22Dr.LeslieOBGYN, MikeNYC_runner and 24 others
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mark_tokyo
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May 21, 2026 at 7:40 PM#10
Dr.LeslieOBGYN said:
Bayesian meta-analysis perspective on the trial evidence: traditional frequentist meta-analyses report point estimates and confidence intervals.
Dr.LeslieOBGYN said:
...regarding the trial evidence...

I think this is an underappreciated point. To expand on it with some data:

A recent meta-analysis of 18 RCTs (n=15,600) found that the trial evidence was associated with a robust effect size across diverse patient populations[1].

The NNT was 15, which is comparable to antihypertensives for stroke reduction. That's a strong clinical argument for this approach.

Last edited: May 21, 2026 at 10:40 PM
41 14TrialNerd_Beth, HPLC_Greg, LibrarianMeg and 38 others
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