- Adolescent obesity rates are climbing, leading to severe health risks.
- The FDA approved GLP-1s for children over 12 and dispensing has increased.
- Questions about long-term effects of GLP-1s on children remain largely unanswered.
Obesity is a growing concern across the U.S., and the Centers for Disease Control and Prevention said it’s reached an all-time high in children and adolescents.
About 1 in 5 U.S. adolescents has obesity, according to the CDC. Experiencing obesity in childhood can lead to greater risks of adult obesity and other concerns like type 2 diabetes, heart disease and social and emotional struggles.
The National Library of Medicine said weight loss is the best way to improve the consequences of chronic obesity. Calorie restriction with or without physical exercise is the traditional treatment, whereas bariatric surgery has proven to be the most effective treatment.
GLP-1s were developed in the early 2010s and are now a third option for weight loss, but it seems people are increasingly reaching for them first, and users are getting younger and younger. In 2020, the U.S. Food and Drug Administration approved the use of liraglutide for obese children between ages 12 and 17, and it approved the use of semaglutide in 2022. To be prescribed the drug, patients must meet a specific body mass index and weight.
Of the 1 in 5 obese adolescents in the U.S., fewer than 1% of them use a GLP-1, according to the CDC. But as prices of these drugs drop, that number is expected to increase. Deseret News reported that Novo Nordisk, a global healthcare company, has plans to reduce the U.S. list price of semaglutide injections and tablets to $675 a month for patients with insurance compared to current prices of $1,000 to $1,349 a month.
According to the Journal of the American Medical Association, dispensing of GLP-1s to children and adolescents increased by almost 600% between 2020 and 2023.
Because GLP-1s are such a new drug, the long-term effects, especially on developing children, are largely unknown. The drug is one that must be taken consistently to continue working. “We still don’t know what a lifetime on GLP-1s looks like,” The New York Times said.
But, doctors seem willing to gamble with the unknown long-term risks on the promise of positive short-term results. The Times reported that some physicians think “the health effects of diseases like obesity and diabetes are so severe when they start early in life that medical intervention is not just warranted; it’s the ethical approach.”
In 2023, the American Academy of Pediatrics published new guidelines regarding how to treat children and adolescents with obesity, which they defined as children older than 2. According to the Times, the guidelines recommended “doctors treat childhood obesity more aggressively, including with GLP-1s.”
Dr. Aaron Kelly, co-director of the University of Minnesota’s Center for Pediatric Obesity Medicine, is one of the doctors heading that charge. Per the Times, “Dr. Kelly is now part of a team running a study on GLP-1s in children as young as 6.” The results for children have been similar to those seen in adults; children on the drugs lose weight and improve their blood pressure, sugar control and cholesterol levels. Children also seem to experience short-term side effects similar to those of adults like nausea and vomiting.
The Times asked good questions regarding children and GLP-1s: “How do the medications affect a child’s growth and development? How do they shape growing bones, brains and muscles? What’s their impact on puberty and mental health? What of body image and nutrient intake?” While the answers are unclear, the American Association of Medical Colleges reported the experience of Frankie McGinn, a 16-year-old from Chicago who lost 42 pounds with the help of GLP-1s: “I’m happier, and I have more confidence. I feel better in my body. [Medication] has helped me in so many ways,” she said.