Brain Activation and Satiety in Children 2

NCT ID: NCT04520490

Last Updated: 2025-12-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

ACTIVE_NOT_RECRUITING

Clinical Phase

PHASE3

Total Enrollment

63 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-01-28

Study Completion Date

2026-02-12

Brief Summary

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Childhood obesity and related long-term effects are serious public health problems, but not all children with obesity do well in treatment. This study will test a new combination of family-based behavioral treatment (FBT) with a drug intervention using a glucagon-like peptide-1 receptor agonist (GLP-1RA) exenatide once weekly extended-release (ExQW, Bydureon®) in order to improve obesity intervention outcomes in 10-12-year-old children.

Detailed Description

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Using functional and structural magnetic resonance neuroimaging, this study will evaluate brain factors which could undermine treatment responses and long-term obesity intervention outcomes. Specific Aim 1 will test the effect of adding ExQW to FBT on change in BMI z-score over a total GLP-1RA treatment duration of 24 weeks and a subsequent 1-year observational follow-up period after treatment cessation. To provide mechanistic insight, Specific Aim 2 will test whether adding GLP-1RA intervention to FBT impacts neural activation by food cues. Finally, the proposed research will investigate the role of a cellular inflammatory process in the mediobasal hypothalamus-called gliosis-which might contribute to impaired hypothalamic function, attenuated satiety responsiveness, and potentially to worse weight management outcomes. Specific Aim 3 will test if hypothalamic gliosis is modified by FBT and/or FBT plus GLP-1RA in children and if its extent is related to immediate and/or long-term intervention outcomes.

Study Design: This double-blinded, randomized, placebo-controlled research study uses fMRI to characterize neural responses to a test meal before and at the end of FBT intervention, with vs. without additional GLP-1RA intervention. In addition, it uses structural MRI (sMRI) to test if MBH gliosis is reversible and/or associated with intervention outcomes.

Conditions

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Childhood Obesity

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Primary Study Purpose

TREATMENT

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors

Study Groups

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Exenatide once weekly extended-release

Weekly subcutaneous injections of glucagon-like peptide (GLP)-1 agonist exenatide once weekly extended-release (2mg) for 24 weeks in randomized intervention.

Group Type ACTIVE_COMPARATOR

Family Based Behavioral Treatment

Intervention Type BEHAVIORAL

Children with obesity accompanied by at least one parent or caregiver will attend 24 weekly sessions. Most sessions will be held via video-conference and include 25-30 min. meetings between an interventionist and each child/parent pair to individualize treatment, followed by separate child and parent group meetings lasting 40 - 45 min. A select few sessions will be held in-person between an interventionist and each child/parent pair with no group session. Parents will serve as primary agents of change for their child and for themselves. Training will focus on food and physical activity education, parenting around food and physical activity, and use of behavioral skills (e.g., self-monitoring, environmental control, contingency management). Intervention groups of 8-12 children/families will be initiated every 3-6 mos. in study yrs. 2-3.

Exenatide 2 mg [Bydureon]

Intervention Type DRUG

Weekly injections of active drug.

Matching placebo

Weekly subcutaneous injections of placebo for 24 weeks.

Group Type PLACEBO_COMPARATOR

Family Based Behavioral Treatment

Intervention Type BEHAVIORAL

Children with obesity accompanied by at least one parent or caregiver will attend 24 weekly sessions. Most sessions will be held via video-conference and include 25-30 min. meetings between an interventionist and each child/parent pair to individualize treatment, followed by separate child and parent group meetings lasting 40 - 45 min. A select few sessions will be held in-person between an interventionist and each child/parent pair with no group session. Parents will serve as primary agents of change for their child and for themselves. Training will focus on food and physical activity education, parenting around food and physical activity, and use of behavioral skills (e.g., self-monitoring, environmental control, contingency management). Intervention groups of 8-12 children/families will be initiated every 3-6 mos. in study yrs. 2-3.

Placebo

Intervention Type DRUG

Weekly placebo injections

Interventions

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Family Based Behavioral Treatment

Children with obesity accompanied by at least one parent or caregiver will attend 24 weekly sessions. Most sessions will be held via video-conference and include 25-30 min. meetings between an interventionist and each child/parent pair to individualize treatment, followed by separate child and parent group meetings lasting 40 - 45 min. A select few sessions will be held in-person between an interventionist and each child/parent pair with no group session. Parents will serve as primary agents of change for their child and for themselves. Training will focus on food and physical activity education, parenting around food and physical activity, and use of behavioral skills (e.g., self-monitoring, environmental control, contingency management). Intervention groups of 8-12 children/families will be initiated every 3-6 mos. in study yrs. 2-3.

Intervention Type BEHAVIORAL

Exenatide 2 mg [Bydureon]

Weekly injections of active drug.

Intervention Type DRUG

Placebo

Weekly placebo injections

Intervention Type DRUG

Other Intervention Names

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Bydureon®

Eligibility Criteria

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Inclusion Criteria

* 10-12 years of age
* Male or female
* Ability and willingness to participate in study visits including fMRI scans, blood draws, and weekly injections;
* Parent willing to provide informed written consent and child willing to provide written assent;
* Child has BMI z-score \>95th percentile. for age and sex;
* One parent that is obese or overweight (BMI \>27 kg/m2); willingness of 1 parent (does not have to be the parent with obesity) to engage in weekly family-based weight control treatment delivered in English.

Exclusion Criteria

* History of acute or chronic serious medical conditions;
* known diabetes mellitus or recent (6 mo.) history of anemia;
* Presence of any implanted metal or metal devices, including ferro-metallic surgical clips or orthodontic braces;
* Claustrophobia;
* Documented cognitive disorder, disruptive behavior, inability to participate in group sessions;
* Current use of medications known to alter appetite, body weight, or brain response
* Food intolerance to test meal (macaroni and cheese) or vegetarianism/veganism or severe food allergies.
* Known renal impairment (GFR\<60 ml/min/1.73m2)
* History of gastroparesis, pancreatitis or gallstones (unless status post cholecystectomy);
* Family history of multiple endocrine neoplasia type 2 or familial medullary thyroid carcinoma;
* Known elevated calcitonin level at phone screening or increased measured calcitonin level at study visits;
* Untreated thyroid disorder or adrenal insufficiency;
* Use of weight loss medications (child participant) within 3 months of screening visit.
* Participating parent is pregnant
Minimum Eligible Age

10 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Washington

OTHER

Sponsor Role collaborator

Seattle Children's Hospital

OTHER

Sponsor Role lead

Responsible Party

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Christian L Roth, MD

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Locations

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Seattle Children's Hospital

Seattle, Washington, United States

Site Status

Countries

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United States

Other Identifiers

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STUDY00001984

Identifier Type: -

Identifier Source: org_study_id