Weight Maintenance Following Discontinuation of Semaglutide in an Adolescent with Antipsychotic-Associated Weight Gain: A Case Report.

Abstract

Introduction: Antipsychotic-induced weight gain (AIWG) presents a significant clinical challenge in pediatric psychiatry, often leading to Class II or III obesity and metabolic comorbidities. While treatment with metformin is the current standard of care, its efficacy is often modest. Preclinical and translational data suggest that, by targeting the underlying cause of AIWG, GLP-1Ras may help restore satiety signaling that is disrupted in patients taking antipsychotics.

Case presentation: We describe an adolescent who experienced profound weight gain following aripiprazole treatment which was successfully managed with semaglutide. Notably, after achieving therapeutic goals of normalization of body mass index (BMI) and hemoglobin A1c, the patient was able to discontinue semaglutide while maintaining her weight loss and normalization of hemoglobin A1c over six months of follow-up.

Conclusion: This single case raises the hypothesis that GLP-1RAs could serve as a temporary "bridge therapy" to counteract iatrogenic metabolic insults; given the confounding factors discussed below, this observation is hypothesis-generating and requires confirmation in larger, prospective studies before broader clinical application.