How do European citizens prioritize environment and climate issues? The role of the value "Respect for the planet" in combination with education and cultural background.

Pediatric obesity represents a significant and growing global public health concern, with prevalence increasing worldwide. In addition to predisposing children to early-onset type 2 diabetes, obesity increases the risk of cardiovascular disease, fatty liver disease, and psychosocial complications.[] Lifestyle interventions, such as dietary modification and increased physical activity, remain first-line therapy; however, their long-term effectiveness in achieving sustained weight reduction is limited.[] Bariatric surgery has demonstrated greater efficacy in severe cases, but it is invasive, associated with perioperative and long-term risks, and restricted to a select subset of the population.[] These limitations have prompted growing interest in pharmacologic strategies. Glucagon-like peptide-1 receptor agonists (GLP-1 RAs), including semaglutide, liraglutide and exenatide, have emerged as pharmacologic therapies for obesity.[] These agents promote weight reduction through mechanisms that include stimulation of insulin secretion, suppression of glucagon release, delayed gastric emptying, and induction of satiety, resulting in improvements in glycemic control, and other metabolic parameters.[] A meta-analysis by Ryan .[] reported that GLP-1 RAs were associated with reductions in body weight and body mass index (BMI), as well as improvements in glycemic control, among children and adolescents. More recent evidence suggests that certain agents, particularly semaglutide, may achieve greater weight reduction compared with lifestyle modification or other pharmacologic treatments such as orlistat.[] Nevertheless, concerns remain regarding gastrointestinal adverse effects and the long-term safety profile of GLP-1 RAs in pediatric populations.[] Given their increasing use, a rigorous synthesis of evidence is warranted. Therefore, this systematic review aims to evaluate the efficacy and safety of GLP-1 RAs in pediatric obesity using data derived exclusively from randomized controlled trials, with outcomes focused on BMI, weight reduction, metabolic parameters, and safety profiles. Accordingly, the objective of this systematic review and meta-analysis is to synthesize evidence from randomized controlled trials to determine the efficacy and safety profile of GLP-1 RAs in pediatric obesity. This systematic review and meta-analysis of randomized controlled trials (RCTs) was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The study was prospectively registered in the International Prospective Register of Systematic Reviews (PROSPERO) under the registration number (CRD420251164159). No ethical approval or informed consent were required in this study as this is a systematic review and meta-analysis of previously published studies. Studies were considered eligible for inclusion in this systematic review and meta-analysis if they met the following criteria: (1) study design of RCTs; (2) included pediatric and adolescent participants aged 2–18 years with obesity (BMI ≥95 percentile for age and sex) or overweight (BMI between the 85 and 94 percentiles); (3) evaluated GLP-1 RAs as a pharmacological treatment for pediatric obesity; (4) reported relevant outcomes of interest, including changes in BMI, weight reduction, waist circumference, and safety outcomes; and (5) were published in the English language [].