Primary outcome
What QUEST measured first
| Intensive Behavioral Program Armn=50 | Medication Armn=58 |
|---|---|
| -1.8(34) | -22.3(34) |
From the results posted on ClinicalTrials.gov (NCT04873245), updated at source Nov 6, 2026.
Phase 2 · Semaglutide
QUEST trial results
Lifestyle Counseling and Medication for Adolescent Weight Management
Percent Change in Body Mass Index (% change in body mass index (BMI)), Randomization to Week 56. Intensive Behavioral Program Arm: -1.8; Medication Arm: -22.3.
- Participants
- 121
- Status
- completed
- Completed
- 2026-06-30
- Sponsor
- University of Minnesota
As posted on ClinicalTrials.gov (NCT04873245), updated at source Nov 6, 2026. Read again whenever the registry updates it. Registry figures can differ from a published paper, which may use another analysis.
Side effects by arm
Side effects in QUEST
Percent of participants affected, All cause mortality, serious adverse event and adverse event information was collected from the time of consent until Week 56.. The most common events the registry lists.
| Event | Intensive Behavioral Program Arm | Medication Arm |
|---|---|---|
| Any serious event | 3.3% | 1.7% |
| Nausea | 24.6% | 66.7% |
| Abdominal pain | 26.2% | 55% |
| Vomiting | 18% | 53.3% |
| Diarrhea | 16.4% | 50% |
| Abdominal Distension | 6.6% | 30% |
| Constipation | 9.8% | 25% |
| COVID Infection | 4.9% | 13.3% |
| Dizziness | 0% | 13.3% |
| Heartburn | 9.8% | 11.7% |
| Nasopharyngitis | 8.2% | 10% |
| Influenza | 3.3% | 10% |
| Respiratory Infection | 9.8% | 1.7% |
| Increased depression symptoms | 8.2% | 6.7% |
| Alopecia | 0% | 6.7% |
| Blood pressure increased | 6.6% | 0% |
| Headache | 3.3% | 5% |
From the results posted on ClinicalTrials.gov (NCT04873245), updated at source Nov 6, 2026.
The trial
How QUEST was run
The prevalence of adolescent severe obesity is at an all-time high in the United States and the refractory nature of this disease has led to a serious and challenging conundrum in terms of how to provide effective, safe, scalable, and durable treatments without placing undue strain on the healthcare system. Clinical practice guidelines recommend behavioral interventions as the primary strategy for all ages and classes of obesity - moderate to severe. In 2017, the U.S. Preventive Services Task Force (USPSTF) released updated screening recommendations concluding that comprehensive, intensive behavioral interventions with a total of ≥26 contact hours over a period of 2-12 months resulted in weight loss in youth with obesity, with ≥52 contact hours leading to even greater weight loss and improvements in some cardiometabolic risk factors. However, the practicality of delivering these types of intensive behavioral services to the millions of youth with severe obesity in the U.S. is debatable not only because of the treatment-resistant nature of severe obesity, but also due to the time-commitment, acceptability, and sustainability of this approach for adolescent patients and their families along with the extensive resources required to provide these interventions. Indeed, fewer than 50% of pediatric patients referred for weight management services enroll in treatment, and high attrition rates of up to 50% have been reported in behavioral-based clinical trials and in the clinical setting. Moreover, adherence to behavioral counseling significantly diminishes over time, which too often erodes early weight loss success and ultimately derails durability. The reality of what most patients/families are able to do and the unique physiological and psychosocial features of severe...
- Intensive Behavioral Program Arm: Participants randomized to this arm of the study will receive intensive behavioral therapy. Participants will receive 52 weekly sessions (50% in person and 50% virtual).
- Medication Arm: Participants randomized to this arm of the study will receive semaglutide and will receive behavioral therapy. Behavioral therapy will consist of 12 monthly sessions (50% in person and 50% virtual).
Who could join the trial
Inclusion Criteria: * Obesity (Body Mass Index (BMI) \>/= 95th percentile or BMI \>/= 30 kg/m2) * Age 12 to \< 18 years old and Tanner stage \>1 Exclusion Criteria: * Diabetes (type 1 or 2) * Current or recent (\< 6 months prior to enrollment) use of anti-obesity medication(s) defined as orlistat, phentermine, topiramate, combination phentermine/topiramate, liraglutide (or other GLP-1RA) and/or combination naltrexone/bupropion (monotherapy use of naltrexone or bupropion is not an exclusion) * Previous bariatric surgery * Any history of treatment with growth hormone * Medically-documented history of bulimia nervosa * Any history of schizophrenia, psychosis, mania, chemical dependency * Unstable depression requiring hospitalization within the previous 6 month * Any history of suicide attempt * History of suicidal ideation or self-harm within the previous 30 days as determined at screening by a PHQ-9 score \>/= 15 or Suicidal ideation of type 4 or 5 on the C-SSRS * Current pregnancy or plans to become pregnant * ALT or AST \>/= 5 times the upper limit of normal * Creatinine \> 1.2 mg/dL * Uncontrolled hypertension as determined by the local medical monitor * Diagnosed and medically-documented monogenic obesity * Medically-documented history of cholelithiasis * Untreated thyroid disorder * Medically documented history of pancreatitis * Personal or family history of medullary thyroid carcinoma or multiple endocrine neoplasia syndrome type 2 * Clinically significant heart disease as determined by the local medical monitor * Personal history of malignant neoplasms within the past five years * Hypersensitivity to any component of semaglutide
Trial averages do not predict what one person will experience. Results are shown as the registry posts them, without interpretation.
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