Adolescent Girls’ Obesity and Women’s Health: Nutrition and Pharmacotherapy in the GLP-1 Era: A Narrative Review with Metaanalysis

Background/Objectives: Obesity in adolescent girls is associated with metabolic and reproductive changes that can persist into adult life. Methods: This review examines nutrition therapy and glucagon-like peptide-1 (GLP-1) receptor agonist pharmacotherapy in girls aged 8–18 years. PubMed/MEDLINE, Scopus and OpenAlex were searched; one author selected the studies and extracted the data. Each outcome is classified as demonstrated in adolescent trials, extrapolated from adults, mechanistic, unknown or an expert proposal. Results: In adolescents aged 12 to <18 years, semaglutide and liraglutide increased the proportion achieving a 5% reduction in body weight or body mass index compared with placebo, and semaglutide improved insulin resistance; a Cochrane review rates the anthropometric benefit of paediatric pharmacotherapy as low-certainty. Effects on androgen excess and menstrual function have been shown only in adults and cannot be separated from weight loss; pubertal timing, lean mass and bone accrual have not been studied as outcomes in randomised trials. Conclusions: Small trials in adolescents and young women with polycystic ovary syndrome suggest that dietary or lifestyle treatment with weight loss can improve menstrual regularity, whereas effects on androgens are inconsistent. Nutritional protection of lean mass, bone and micronutrient status during drug-induced weight loss is untested; we present it, with a stepped-care framework, as an expert proposal.