Retrospective review of GLP-1RA outcomes in adults with Prader-Willi syndrome attending a dedicated multi-disciplinary clinic — ASN Events
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Retrospective review of GLP-1RA outcomes in adults with Prader-Willi syndrome attending a dedicated multi-disciplinary clinic (#312)

Fiona Combe 1 , Timothy Pitcher 1 , Jane Sorbello 1 , Raquel Maggacis 1 2 , Moe Thuzar 1 , Brendan Nolan 1 2 , Jack Lockett 1 2
  1. Department of Diabetes and Endocrinology,, Princess Alexandra Hospital,, Brisbane, QLD, Australia
  2. PA-Southside Clinical Unit, Medical School, The University of Queensland,, Brisbane, QLD, Australia

Prader-Willi syndrome (PWS) is a genetic disorder with the cardinal feature of hyperphagia, imposing risk of life-threatening obesity (1). GLP-1 receptor agonists (GLP-1RA) achieve substantial weight loss in general obesity. Evidence in adults with PWS is limited to case reports, with clinical trials underway (2).  

This audit aims to analyse weight outcomes with GLP-1RA in adults with PWS.  

A single-institution retrospective review was conducted on 54 adults attending a dedicated PWS multidisciplinary clinic, prescribed GLP-1RA between December 2015 and June 2026.  

Seventeen of 54 patients in the clinic were prescribed GLP-1RA and included for analysis (mean age 27 years, range 18–46; 53% female; 59% with T2DM), supported by exercise physiology (41%), dietitian (35%), psychiatry (29%) and psychology (12%). NDIS support was available to 94%; 83% lived in the family home. In the 12 months preceding treatment, median weight gain was 3.3kg (IQR 0.6-7.4kg). Median baseline weight (treatment initiation) was 99 kg (92-120.5kg), BMI 44.4kg/m2 (35.5-56.8kg/m2), and median treatment duration 987 days (595-1483 days). Semaglutide (70.5%) was most commonly initiated GLP-1 RA with median maximum dose 1mg weekly (1-1.5mg). Two suffered nausea/vomiting (one ceased), one ceased due to altered carbamazepine levels. Nadir weight occurred at median 413 days withmedian weight loss of 4.3kg (2.2-8.4kg). Maximum body weight loss ≥5%, ≥10% and ≥15% was achieved in 41%, 24% and 12%, respectively. At last follow-up, 35% of people maintained ≥5% loss. Seven patients gained weight at last follow-up (median 11kg, 1.7-21kg). Two patients with unrestricted food access died of obesity-related complications (gaining 37kg and 29kg).   

Overall, 41% achieved clinically meaningful weight loss at nadir, falling to 35% at last follow-up. GLP-1RA are a useful adjunct in adults with PWS for weight control. Two deaths from obesity-related complications despite GLP-1RA highlight the need for a secure food environment in people with PWS. 

  1. Dempsey D, Hall M, Lanning B, Barron-Millar B, Huang M, Cowen N, et al. The burden of illness in Prader-Willi syndrome: a systematic literature review. Orphanet journal of rare diseases. 2025;20(1):374-25.
  2. Ng NBH, Low YW, Rajgor DD, Low JM, Lim YY, Loke KY, et al. The effects of glucagon‐like peptide (GLP)‐1 receptor agonists on weight and glycaemic control in Prader–Willi syndrome: A systematic review. Clinical endocrinology (Oxford). 2022;96(2):144-54.