Once-weekly subcutaneous semaglutide plus lifestyle modification reduced body mass index (BMI) more than placebo plus lifestyle modification among children aged 6 to younger than 12 years with obesity in the phase 3 STEP Young trial.1
At 68 weeks, 40.4% of semaglutide-treated participants had a BMI below the age- and sex-specific obesity threshold, compared with 0% receiving placebo, according to an announcement from Novo Nordisk.¹
Key Facts
- Drug: Semaglutide, GLP-1 agonist
- Indication studied: Pediatric obesity
- Trial: STEP Young, phase 3
- Population: Ages 6 to younger than 12
- Outcome: 40.4% below obesity cutoff
- Comparator outcome: 0% with placebo
- Safety: No new signals reported
- Status: Top-line multinational data
- Approval: No new indication announced
“Childhood obesity is particularly concerning due to both immediate and enduring impacts on health, including a strong predilection to adult obesity and increased risk for the early emergence of obesity-related complications,” Ania M. Jastreboff, MD, PhD, director of the Yale Obesity Research Center, said in the company announcement.¹ “Most of the children in the STEP Young trial were classified as having severe (class II or III) obesity at baseline, yet treatment with semaglutide resulted in a BMI percentile category below the obesity threshold in approximately 40% of the children within about a year of treatment.”
The findings are top-line results and have not yet been reported in a peer-reviewed publication. Novo Nordisk said detailed data will be presented at ObesityWeek 2026 in November.
STEP Young was a randomized, double-blind, placebo-controlled, multinational trial involving 165 children with obesity. Participants received semaglutide at a maximum weekly dose of 1.7 mg or 2.4 mg, determined by baseline weight, or placebo. Both groups also received a reduced-calorie diet and increased physical activity.¹
The primary end point was percentage change in BMI from baseline through week 68. Although the company stated that the trial met this end point, it did not disclose the magnitude of BMI change, between-group treatment difference, confidence interval, or statistical significance in the announcement.
Improvement in BMI classification was a confirmatory secondary end point. Obesity was defined as BMI at or above the 95th percentile for age and sex using CDC growth charts. Class II and class III obesity were defined as BMI at least 120% and 140% of the 95th percentile, respectively. More than 85% of participants had class II or III obesity at baseline.¹
Supportive end points include anthropometric measures, cardiovascular risk factors, glucose metabolism, and body composition in a dual-energy x-ray absorptiometry subgroup. Assessments are planned at weeks 68 and 104.
Childhood obesity is associated with cardiometabolic abnormalities, psychosocial morbidity, and persistence of obesity into adulthood.²,³ Current pediatric guidance recommends intensive, family-centered health behavior and lifestyle treatment and supports pharmacotherapy for selected patients when clinically appropriate.² Treatment choices remain particularly limited for children younger than 12 years.
Semaglutide is a glucagon-like peptide-1 receptor agonist that mimics endogenous GLP-1 activity involved in glucose regulation, appetite, and body weight. It has been studied across type 2 diabetes, obesity, cardiovascular disease, heart failure, chronic kidney disease, and other cardiometabolic conditions. STEP Young was conducted as part of postmarketing requirements for the semaglutide clinical development program, according to Novo Nordisk.¹
The company characterized overall safety and tolerability as consistent with earlier adult and pediatric studies of semaglutide and liraglutide and reported no new safety concerns, including signals involving growth or pubertal development. However, adverse-event frequencies, discontinuation rates, gastrointestinal events, and serious adverse events were not provided.
Interpretation therefore remains limited by the top-line nature of the disclosure, the modest sample size, and the absence of detailed efficacy and safety results. Longer follow-up will be important to determine durability, effects on cardiometabolic outcomes, consequences of treatment discontinuation, and safety during growth and puberty. The findings do not by themselves establish a new regulatory indication for children aged 6 to younger than 12 years.
References
- Novo Nordisk. STEP Young phase 3 data: 40.4% of children living with obesity achieved a BMI below the obesity threshold with semaglutide and lifestyle modification. News release. Published September 7, 2026. Accessed September 8, 2026. https://www.novonordisk.com/content/nncorp/global/en/news-and-media/news-and-ir-materials/news-details.html?id=916600
- Hampl SE, Hassink SG, Skinner AC, et al. Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics. 2023;151. doi:10.1542/peds.2022-060640
- Kumar S, Kelly AS. Review of childhood obesity: from epidemiology, etiology, and comorbidities to clinical assessment and treatment. Mayo Clin Proc. 2017;92:251-265.
- Schwimmer JB, Burwinkle TM, Varni JW. Health-related quality of life of severely obese children and adolescents. JAMA. 2003;289:1813-1819.