The Effectiveness of Semaglutide Treatment in Youths with Autism Spectrum Disorder and Obesity: A Real-World Experience

Youth with autism spectrum disorder (ASD) are at increased risk for obesity, yet data on anti-obesity medications in this population are limited. To evaluate anthropometric and cardiometabolic outcomes associated with semaglutide treatment in youth with ASD and obesity. We performed a retrospective cohort subanalysis of youth aged ≥12 years with ASD and obesity receiving multidisciplinary obesity care. Semaglutide exposure was defined as documentation of weekly dosing of at least 0.5 mg. Outcomes included changes in percentage of the 95th percentile for BMI (%BMIp95), weight, BMI z -score, percent body fat, and cardiometabolic laboratory values. Multivariable linear regression adjusted for baseline outcome value, age, sex, race, insurance, stimulant use, atypical antipsychotic use, other anti-obesity medications, and follow-up duration. Among 120 youth, 20 (16.7%) received semaglutide, and 100 did not. Semaglutide was associated with greater reductions in %BMIp95 ( B = −8.11, p = 0.006) and body weight ( B = −7.61 kg, p = 0.003). Semaglutide was also associated with a trend toward lower ALT ( p = 0.053). Semaglutide was associated with clinically meaningful weight reduction in youth with ASD and obesity.