Glucagon-like peptide 1 receptor agonists (GLP-1RA), such as Ozempic and Wegovy, have been rapidly adopted for the treatment of obesity in both youth and adults. However, despite this rapid adoption and the known GLP-1RA mechanism of action for weight loss, which targets brain circuits responsible for appetite and eating behaviors, almost nothing is known about how these drugs affect the brain in youth who are treated for obesity, or how these drugs affect the brain of youth differently from adults. The goal of the current study is to compare youth and adults with obesity who are treated a GLP-1RA and measure potential difference in GLP-1RA associated change in brain function, appetite, and eating behaviors.

Inclusion Criteria:

• English-speaking
• male or female (sex assigned at birth)
• 12-18 y/o with obesity (BMI>120% of the 95th %ile)
• 30-45 y/o with obesity (BMI>35 kg/m2)

Exclusion Criteria:

• treated with glucagon-like peptide-1 (GLP-1) agonists (e.g., exenatide, liraglutide, semaglutide, tirzepatide) for weight management in the prior 3 months
• currently taking anti-psychotic medications (anti-depressants accepted)
• diagnosis of type 2 diabetes
• current or lifetime anorexia nervosa or current bulimia nervosa
• head injury resulting in loss of consciousness >30min
• neurological disorder (e.g., Parkinson's disease) or history of stroke
• any contraindication to receiving a MRI (e.g., orthodontal braces)
• psychological/behavioral dysfunction (e.g., autism spectrum disorder) or physical impairment that would interfere with study procedures, as determined by study physician
• if female, desiring to become pregnant, or currently pregnant or breastfeeding

Pending consent authorization by participants

study statistician