Childhood obesity is a rapidly escalating global health issue that affects millions of children across both developed and developing countries. Defined by an excessive accumulation of body fat that may impair health, obesity in children is typically measured using the Body Mass Index (BMI) adjusted for age and sex. The World Health Organization (WHO) reports that the number of overweight and obese children under the age of five was over 39 million in 2020, and this figure continues to rise due to a combination of poor dietary habits, sedentary lifestyles, and environmental influences ^[1]. Childhood obesity is not just a temporary concern; it has severe long-term implications for physical, mental, and social well-being.

The long-term effects of obesity that begins in childhood are profound and wide-ranging. Obese children are significantly more likely to become obese adults, thereby increasing their risk for a multitude of chronic conditions such as type 2 diabetes, hypertension, cardiovascular diseases, musculoskeletal disorders, and certain types of cancer ^[2,3]. Moreover, childhood obesity is associated with psychological effects including low self-esteem, depression, social isolation, and even academic underachievement due to stigma and bullying ^[4]. These adverse outcomes not only diminish quality of life but also contribute to increased healthcare utilization and economic burden on families and health systems globally ^[5].

Given the complexity and scale of the problem, effective prevention and management strategies are vital and must begin early in life. Interventions that promote balanced nutrition, regular physical activity, reduced screen time, and adequate sleep have shown promise in both preventing and managing childhood obesity ^[6]. Schools, families, healthcare providers, and policymakers all play crucial roles in creating supportive environments that enable children to make healthier choices. Multicomponent programs—especially those that involve parental engagement and are implemented in school or community settings—have proven to be among the most effective approaches to long-term prevention ^[7].

In cases where lifestyle interventions alone do not lead to significant weight reduction or when obesity is associated with serious health risks, pharmacological treatment may be considered under strict medical supervision. Medications such as liraglutide, a GLP-1 receptor agonist, and orlistat, a lipase inhibitor, have been approved for use in adolescents with obesity and have shown moderate success in promoting weight loss when combined with lifestyle changes ^[8,9]. However, the use of pharmacotherapy in pediatric populations remains limited and is typically reserved for older adolescents with severe obesity due to concerns regarding long-term safety, side effects, and the need for continued behavioural support ^[10]. Therefore, while drug treatment can serve as a supportive measure, it should not replace the foundational role of healthy lifestyle promotion in the prevention and management of childhood obesity.

Study Place: The present study was a prospective, randomized study conducted after taking permission from institutional ethical committee in department of Paediatrics at Rama medical college and hospital & research centre,

 Study Period: The study was conducted over a period of 6 Months.

 Sample size calculation: 

Total sample Size: 80 obesity aldoscents attending hospital.

 Inclusion Criteria:

1. Patients of both the sexes.
2. Patients under the age group between 10 – 18 years.
3. Patients with obesity.
4. Patient not taken any medications
5. Patients ready to give inform consent form.

Exclusion Criteria:

1. Patient below 10 years or above 18 years.
2. Patient not ready to give inform consent form.
3. Patients not willing to participate in the study.
4. Patients not willing to take medications that is prescribed.

Study design

The obesity aldoscents patients was divided into two groups.

• Group – 1 40 patients treated with Liraglutide subcutaneous 0.6 mg/day
• Group – 2 40 patients treated with Orlistat 120 mg three times daily with each main meal containing fat

Study procedure –

The patients was brought to the hospital due to over weight there biochemical investigation like blood glucose levels, lipid profile and sociodemographical status like BMI, Wrist circumference, Waist-to-Height Ratio (WHtR) and Skinfold Thickness was noted as baseline and after 15 days, 2 months all the investigation was done in the both the groups.   

 Statical analysis –

The data analysis will be done by using SPSS Software. All the data will be noted under Microsoft office excel sheet. Paired t test will be conducted to compare the within the groups. P value < 0.05 consider as statical significant and p <0.005 consider as highly significant.

The study was conducted after taking permission form the institution ethical committee. Before the initiation of treatment, baseline anthropometric and biochemical parameters were recorded for all participants, including body mass index (BMI), wrist circumference, waist-to-height ratio (WHtR), skinfold thickness, fasting blood glucose, and lipid profile. These measurements were subsequently reassessed at 15 days and 2 months of therapy in both study groups. Group 1 received liraglutide (0.6 mg/day, subcutaneous), while Group 2 received orlistat (120 mg, three times daily with meals). The collected data were compiled, tabulated, and subjected to statistical analysis in order to evaluate within-group and between-group changes over time.

Table 1 shows the gender distribution among obese adolescents.

Table 2 shows the age-wise distribution among obese adolescents

Table 3: Dietary Food Intake among Obese Adolescents

Table 4 shows the sociodemographic status at baseline, 15 days, and 2 months among Group A and Group B.

Table 5 shows the biochemical changes at baseline, 15 days, and 2 months among Group A and Group B.

Table 6 shows the mean difference after comparison of baseline with 15 days among Group A and Group B.

Table 7 shows the mean difference after comparison of baseline with 2 months among Group A and Group B.

In the present study, gender distribution among obese adolescents was almost equal in both groups. In the liraglutide group, there were 22 males (55%) and 18 females (45%), while in the orlistat group there were 21 males (52.5%) and 19 females (47.5%). This nearly balanced distribution indicates that obesity in adolescence affects both genders similarly. Similar findings were reported by Weiss et al. (2004), who observed that the prevalence of obesity-related complications did not differ significantly between boys and girls in adolescent populations ^[11].

The age-wise distribution revealed that the largest proportion of obese adolescents were in the 13–15-year age group (40%), followed by the 16–18-year group (37.5%), while only 22.5% were in the 10–12-year category. This trend suggests that mid-adolescence is a critical period for the onset or worsening of obesity, likely due to hormonal changes, lifestyle transitions, and increasing independence in dietary habits. A similar pattern was reported by Narayan et al. (2016), who found that obesity prevalence peaked in mid-adolescence and was strongly linked to behavioral and dietary modifications during this stage ^[12].

Dietary intake patterns in this study further highlighted the role of lifestyle in adolescent obesity. Half of the adolescents (50%) reported frequent junk food consumption, while 31.2% were non-vegetarian and only 18.8% were vegetarian. The predominance of junk food consumption reflects the contribution of high-calorie, nutrient-poor diets to excessive weight gain. These findings are consistent with those of Hebebrand et al. (2019), who noted that fast food and processed snack consumption were strongly correlated with increased BMI and metabolic risks in obese adolescents ^[13].

Anthropometric outcomes showed significant reductions in BMI, skinfold thickness, and waist-to-height ratio, with greater improvements in the orlistat group compared to liraglutide. At 15 days, BMI reduction was 2.8 ± 0.2 kg/m² in the liraglutide group and 4.0 ± 0.1 kg/m² in the orlistat group, while after two months, reductions were 8.5 ± 0.4 kg/m² and 12.4 ± 0.1 kg/m² respectively. These results suggest that orlistat produced earlier and more pronounced improvements in obesity indices. Chanoine et al. (2005) similarly demonstrated that orlistat therapy combined with lifestyle modifications resulted in significant reductions in BMI and body fat percentage in obese adolescents compared to placebo ^[14].

Biochemical parameters also improved significantly during the study period. Fasting glucose levels decreased by 5 ± 4 mg/dL in the liraglutide group and 8 ± 4 mg/dL in the orlistat group over two months. Total cholesterol decreased by 10 ± 5 mg/dL with liraglutide and 18 ± 6 mg/dL with orlistat, while triglycerides dropped by 10 ± 6 mg/dL and 18 ± 7 mg/dL respectively. These improvements highlight the beneficial role of pharmacological therapy in metabolic regulation among obese adolescents. Similar findings were reported by Kelly et al. (2020), who demonstrated that liraglutide significantly reduced BMI standard deviation scores and improved glycemic parameters in adolescents with obesity ^[15]. Furthermore, Yanovski et al. (2011) reported that orlistat therapy resulted in significant reductions in serum lipids and fasting glucose among obese pediatric patients, supporting the metabolic improvements observed in the present study ^[16].

The present study demonstrates that both liraglutide and orlistat are effective pharmacological agents in improving anthropometric and biochemical parameters among obese adolescents when combined with lifestyle interventions. Although liraglutide showed gradual and steady improvements in BMI, waist-to-height ratio, and metabolic markers, orlistat was associated with more rapid and significant reductions, particularly evident at 15 days and more pronounced after two months of treatment. Dietary assessment further highlighted that a high proportion of adolescents consumed junk food, reinforcing the role of unhealthy eating behaviors in the development and persistence of obesity.

Overall, the findings suggest that orlistat provides a more robust short-term response, while liraglutide offers consistent long-term benefits. This emphasizes the importance of tailoring anti-obesity therapy according to the clinical needs of adolescents, with pharmacological treatment serving as a useful adjunct to lifestyle modification. These results support earlier reports that weight loss interventions in adolescence not only improve anthropometric indices but also reduce metabolic risk factors, thereby preventing long-term complication

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