Tirzepatide for Severe Obesity in Adolescents Without Diabetes
- 1Children's Hospital Los Angeles and Keck School of Medicine of USC, Department of Pediatrics, Center for Endocrinology, Diabetes and Metabolism, Los Angeles, California
Abstract
Background/Objective: Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has demonstrated substantial weight reduction in adults but remains unapproved for obesity treatment in adolescents without diabetes. The objective of this report is to describe adolescents with severe obesity without diabetes treated with tirzepatide, highlighting body mass index reduction (BMI), metabolic outcomes, and tolerability in a safety-net setting.
Case Presentation: Five adolescents (ages 11-16 years; 3 males, 2 females) presented with severe obesity (BMI 37-52 kg/m2; ≥120% of the 95th percentile). Baseline percent of the 95th percentile BMI (%BMIp95) ranged from 125% to 200%. Tirzepatide was initiated at 2.5 mg weekly and titrated to 10 to 15 mg. Over 6 to 18 months, %BMIp95 decreased across all patients, with reductions from baseline to 18 months of 190% to 158%, 200% to 145%, 150% to 85%, and 135% to 85%; one patient decreased from 125% to 85% by 12 months. These changes corresponded to absolute weight reductions of 17.6 to 40 kg (13%-36%). Hemoglobin A1c decreased or remained within the normal range (4.3%-5.6%), triglycerides declined, and alanine aminotransferase normalized. No hypoglycemia or pancreatitis occurred. No treatment discontinuations were documented during available follow-up.
Discussion: Marked weight reduction and metabolic improvement observed in these youth with obesity, without type 2 diabetes are consistent with outcomes reported in adult populations receiving tirzepatide, with greater weight loss associated with improved cardiometabolic parameters.
Conclusion: This series highlights substantial weight reduction among adolescents with severe obesity treated with tirzepatide. Participants tolerated therapy during observed follow-up without reported gastrointestinal adverse effects, supporting further investigation in pediatric populations.
Related
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- Neuropsychiatric association of tirzepatide and semaglutide in obesity with and without type 2 diabetes
- Biliary and Pancreatic Safety of Incretin-Based Therapies in Obesity and Type 2 Diabetes: A Propensity-Matched Real-World Comparison of Tirzepatide, Semaglutide, and DPP-4 Inhibitors
- Neuropsychiatric Safety of GLP-1 Receptor Agonists and Tirzepatide in Adults with Type 2 Diabetes Mellitus or Obesity.
- Efficacy and safety of semaglutide versus placebo in adults with overweight or obesity without diabetes: updated meta-analysis of randomized trials
BibTeX
@article{yehia2026tirzepatide,
title = {{Tirzepatide for Severe Obesity in Adolescents Without Diabetes}},
author = {Reham Yehia and Priya Patel and Emily Sousa and Alaina P. Vidmar},
journal = {AACE Endocrinology and Diabetes},
year = {2026},
month = jul,
doi = {10.1016/j.aed.2026.07.013},
url = {https://doi.org/10.1016/j.aed.2026.07.013},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Tirzepatide for Severe Obesity in Adolescents Without Diabetes
AU - Reham Yehia
AU - Priya Patel
AU - Emily Sousa
AU - Alaina P. Vidmar
PY - 2026
DA - 2026/07/31
JO - AACE Endocrinology and Diabetes
DO - 10.1016/j.aed.2026.07.013
UR - https://doi.org/10.1016/j.aed.2026.07.013
AB - Background/Objective: Tirzepatide, a dual glucose-dependent insulinotropic polypeptide and glucagon-like peptide-1 receptor agonist, has demonstrated substantial weight reduction in adults but remains unapproved for obesity treatment in adolescents without diabetes. The objective of this report is to describe adolescents with severe obesity without diabetes treated with tirzepatide, highlighting body mass index reduction (BMI), metabolic outcomes, and tolerability in a safety-net setting. Case Presentation: Five adolescents (ages 11-16 years; 3 males, 2 females) presented with severe obesity (BMI 37-52 kg/m2; ≥120% of the 95th percentile). Baseline percent of the 95th percentile BMI (%BMIp95) ranged from 125% to 200%. Tirzepatide was initiated at 2.5 mg weekly and titrated to 10 to 15 mg. Over 6 to 18 months, %BMIp95 decreased across all patients, with reductions from baseline to 18 months of 190% to 158%, 200% to 145%, 150% to 85%, and 135% to 85%; one patient decreased from 125% to 85% by 12 months. These changes corresponded to absolute weight reductions of 17.6 to 40 kg (13%-36%). Hemoglobin A1c decreased or remained within the normal range (4.3%-5.6%), triglycerides declined, and alanine aminotransferase normalized. No hypoglycemia or pancreatitis occurred. No treatment discontinuations were documented during available follow-up. Discussion: Marked weight reduction and metabolic improvement observed in these youth with obesity, without type 2 diabetes are consistent with outcomes reported in adult populations receiving tirzepatide, with greater weight loss associated with improved cardiometabolic parameters. Conclusion: This series highlights substantial weight reduction among adolescents with severe obesity treated with tirzepatide. Participants tolerated therapy during observed follow-up without reported gastrointestinal adverse effects, supporting further investigation in pediatric populations.
SN - 3050-9157
ER -