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By alleviating pain, mechanical load, and psychosocial burden, these agents can also create a window to initiate sustainable health behaviors in adolescents. However, use during critical developmental periods raises concerns regarding long-term effects on musculoskeletal maturation. Adolescence is marked by rapid accrual of muscle and bone mass, and GLP-1-associated weight loss may attenuate this process, potentially reducing peak musculoskeletal capacity and increasing future frailty risk. This perspective piece advocates for integration of tailored exercise prescription with GLP-1 medication therapy. Given limited longitudinal pediatric data, a balanced approach is necessary. GLP-1s should be integrated within a multimodal framework emphasizing resistance training, weight-bearing activity, and optimized nutrition particularly adequate protein intake to preserve lean mass. Exercise may also synergize with GLP-1-mediated metabolic improvements to enhance functional outcomes. Clinicians should provide individualized, developmentally appropriate guidance that addresses access barriers and patient preferences while reinforcing that pharmacotherapy is not a substitute for lifestyle intervention. Integrated care models that prioritize musculoskeletal integrity and functional health are essential to maximizing long-term outcomes, underscoring the need for longitudinal research in pediatric populations.<\/jats:p>","DOI":"10.1177\/21532176261475103","type":"journal-article","created":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T09:44:07Z","timestamp":1785750247000},"page":"504-509","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Protecting Musculoskeletal Development and Physical Function in Adolescents on GLP-1 Therapy"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2108-3899","authenticated-orcid":false,"given":"Webb A.","family":"Smith","sequence":"first","affiliation":[{"name":"Children\u2019s Foundation Research Institute, Le Bonheur Children\u2019s Hospital, Memphis, Tennessee, USA."},{"name":"Department of Pediatrics, University of Tennessee Health Science Center, Memphis, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahlee","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Endocrinology, Diabetes, and Metabolism, Children\u2019s Hospital Los Angeles, Los Angeles, California, USA."},{"name":"Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy J.","family":"Khalil","sequence":"additional","affiliation":[{"name":"Health &amp; Wellbeing Program, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Giovinazzo","sequence":"additional","affiliation":[{"name":"Health &amp; Wellbeing Program, Children\u2019s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7772-6235","authenticated-orcid":false,"given":"E. 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