Experts Weigh in on Teens Using Weight Loss Drugs

Increasing numbers of young people are using Wegovy and other popular prescription weight loss drugs to shed pounds. While the rate of obesity among teens is growing, experts say parents and teens should use caution when deciding whether to use these medications.

According to the Centers for Disease Control and Prevention (CDC), obesity impacts one in five children and teens in the United States. Though it's unclear why obesity is affecting so many young people, factors like genetics, too much screen time, less physical activity, and access to high calorie "junk" foods likely play a role.

In January 2023, the American Academy of Pediatrics took a bold step towards obesity treatment among young people by updating its Clinical Practice Guidelines. The new Guidelines recommend that physicians should consider offering weight loss drugs to adolescents ages 12 and older with obesity — along with diet and lifestyle changes.

Currently, Wegovy (semaglutide), Saxenda (liraglutide), orlistat, and Qsymia (phentermine and topiramate) are FDA-approved weight loss medications for children and teens over 12.

And research shows that these medications can help young people lose weight. For example, one study found that nearly half of obese adolescents using semaglutide lost enough weight to no longer meet obesity criteria.

Because these weight loss drugs are effective, more healthcare providers are prescribing them to teenagers. According to an NBC report, a PurpleLab analysis found that healthcare professionals wrote around 4,000 prescriptions for semaglutide to children ages 12 to 17 in 2023.

Still, weight loss medications may carry risks, and the experts Healthnews spoke with warn that the use of these drugs may not be the best strategy for adolescent obesity.

Should teens use weight loss drugs like Wegovy?

Sue Decotiis, M.D., a triple board-certified medical weight-loss doctor with offices in New York City and Connecticut, tells Healthnews that if a teen has a medical issue like diabetes or is struggling with obesity, weight loss drugs like Wegovy may be the solution. However, these medications should never be the first line of treatment for teens with obesity.

Decotiis, board-certified by the American Board of Internal Medicine, American Academy of Antiaging Medicine, and the American Board of Obesity Medicine, says, "The first thing I'd do is put the teen under a screening to see their baseline metabolic rate and their insulin levels. Kids usually have a fast metabolism, so by seeing their metabolism and insulin levels it would give me an idea whether they actually need the drug or not."

Danielle Kelvas, M.D., a primary care physician at the HCG Institute and CEO and founder of DKMD Consulting, agrees.

Kelvas tells Healthnews, "While the FDA may have approved Ozempic and Wegovy for kids above 12 years, I would take GREAT pause before putting my kid on a weight loss drug. It just hasn't been studied in kids, so we really won't know the long-term effects for another few years."

While the American Academy of Pediatrics Clinical Practice Guidelines say it's appropriate for teens to use Wegovy and other weight loss drugs due to the rising rate of childhood obesity, Kelvas has reservations due to potential risks.

"The risk vs benefit ratio partly drove that recommendation," Kelvas says. "But I personally feel we are jumping the gun by allowing FDA approval before the studies have been completed. I hope no children are hurt in this process."

Kelvas is also concerned about who really benefits from weight loss drug use among teens.

Follow the money — who stands to benefit the most from letting kids as young as 6 take these drugs? Instead of teaching them healthy lifestyle habits, we show them at a very young age how to rely on pills. I just can't support that, especially because they are a vulnerable population, and cannot consent to this.

Danielle Kelvas, M.D.

Avantika Waring, M.D., Chief Medical Officer at 9amHealth, tells Healthnews that while treating children and teenagers with these medications may seem aggressive, they can be life-altering. So, it boils down to weighing the risks versus the benefits.

Waring explains that if a teenager is struggling to lose weight through natural approaches, like diet and exercise, and their weight significantly impacts their quality of life or puts them at high risk for serious, potentially life-threatening complications in the future, such as heart disease, then a pediatrician may determine that medication for weight loss is the right decision.

Still, Waring cautions, "We don't have long-term data with these medications in this population, and we are seeing some serious side effects in the adult population the longer we use them, so we need to be careful in the way these medications are prescribed in younger generations."

Some of the known side effects, like reduced bone density, bring up specific concerns for adolescents, Waring says. That's because it's the age when they typically experience a significant growth period and need essential nutrients for strong bones.

"Starting a medication that could potentially impact this growth may have lasting effects on a teenager's physical development," Waring adds.

Risks of giving weight loss medications to teens

Besides the unknowns surrounding potentially harmful long-term health effects of semaglutide use in teens, Decotiis says these medications might not be the best choice for adolescents with an eating disorder (ED) or a mental health condition.

"Teens who have an ED should not be prescribed a GLP-1. If this is the case, they should seek a mental health professional," Decotiis says.

Kelvas also questions whether semaglutide and similar weight loss drugs are suitable for teens with disordered eating or an ED.

Teens are struggling with disordered eating (eating disorders) at an increasing rate. So, if we provide them with weight loss drugs, are we going to see an uptick in eating disorders and adverse events, considering their abuse potential? I don't have a good feeling about giving these drugs to kids at all.

Danielle Kelvas, M.D.

Waring tells Healthnews that aside from the potential adverse health implications, some of the risks surrounding the use of these medications in young people may include body confidence issues.

"As a community, it's crucial to avoid stigmatizing certain body types or body-shaming kids and teens," Waring explains. "The purpose of using these medications or undergoing metabolic surgery is intended to improve health, and we have to focus on treating disease instead of perpetuating harmful body standards."

Waring says that children and adolescents with a higher BMI who are still healthy and active should be able to have the confidence to embrace their bodies regardless of size.

Non-drug weight loss strategies for teenagers

Despite the uptick in the use of semaglutide and other prescription weight loss drugs among teens, nearly 10% of young people without access to these medications have used potentially harmful non-prescription weight loss products to shed pounds. So, the drive to find a weight loss solution may be high among teens with a high body mass index (BMI) or obesity.

Still, the experts Healthnews spoke with say there are healthier approaches to losing weight. And those strategies essentially boil down to lifestyle and dietary changes.

"Healthy eating and exercise," Decotiis suggests. "Teens need to be supervised by parents. They need their guidance in making the right meal choices and creating healthy habits. There are pediatric nutrition doctors who would be a better fit than a teen going on a GLP-1 who doesn't truly need it."

Kelvas cautions parents to evaluate their children's eating habits and implement lifestyle changes before seeking prescription weight loss medications.

"Are they exercising and participating in sports? Are we being mindful of their screen time and sleep hygiene? I know that there are significant disparities in food quality and quantity among socioeconomic classes. Somehow, it has become cheaper to feed a child a Pop-Tart instead of a salad," Kelvas says.

Waring agrees that teenagers should prioritize natural and more proven approaches, such as adopting healthy eating habits and boosting physical activity, before turning to medications.

"Especially as they grow up, it is important to focus on overall health and well-being and celebrate progress rather than resorting to quick fixes that change the number on a scale," Waring explains. "Weight fluctuates constantly in teenagers as hormones change, making natural solutions the best alternative to weight loss medication."