Weighing in on teens and weight loss drugs

Close to a quarter of a million U.S. children ages 12 to 19 live with a common chronic disease that has been stigmatized for years. According to the American Academy of Pediatrics, this disease is associated with serious short and long-term health concerns when left untreated, including cardiovascular diseases, type 2 diabetes, obstructive sleep apnea and nonalcoholic fatty liver disease as well as reduced quality of life. This disease is obesity. 

We’ve talked about it before. And we’ve acknowledged that there are complex genetic, physiologic, socioeconomic and environmental factors at play when striving to develop a strategy for treatment.  

In January of 2023, the U.S. Food and Drug Administration approved the weight loss drug, that is popular among adults, for children over twelve. This drug is called semaglutide and is the main ingredient in the injected medication called Wegovy. 

“Weight is a sensitive topic for most of us, and children and teens are especially aware of the harsh and unfair stigma that comes with being affected by it,” Sarah Hampl, MD, a lead author of the AAP’s “Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents with Obesity.” 

“Research tells us that we need to take a close look at families – where they live, their access to nutritious food, health care and opportunities for physical activity – as well as other factors that are associated with health, quality-of-life outcomes and risks. Our kids need the medical support, understanding and resources we can provide within a treatment plan that involves the whole family,” she said on AAP’s website. 

Nishant H. Patel, MD specializes in pediatric gastroenterology at Orlando Health in Florida. When asked online to talk about how to decide if a child is a candidate for weight loss meds, he explained that the “FDA has approved semaglutide for teens who have a body mass index (BMI) of 30 or greater; or a BMI of 27 or greater who also have other health problems, such as high blood pressure, diabetes or high cholesterol, that make weight loss important.” 

Dr. Patel said that your child’s healthcare provider should ascertain whether your child has already tried a healthy diet and exercise routine without losing weight. This, Dr. Patel said, would be a prerequisite to taking the medication. 

“The doctor also may look at whether your child is motivated to stick with a healthy lifestyle while taking the medication, has access to proper nutrition, and has support from family or community,” Dr. Patel said. 

“A study of semaglutide published in July shows that 45% of teens who took the medication lost enough weight to drop below the clinical cutoff for obesity, meaning they moved to a normal weight or were in the overweight category. These teens greatly lowered their risk of many obesity complications. That’s significant to their health,” he said. 

But there are drawbacks. Gastrointestinal problems are the most common issues because the drug can slow down the child’s digestive system. Besides nausea, vomiting, diarrhea, constipation indigestion, etc., some teens also experienced fatigue, headache, gastroparesis and pancreatitis. 

Another thing to think about before putting your child on this medication is that it’s possible they will always have to stay on the drug or risk gaining the weight back. Unfortunately, it’s too early for the research to prove one way or another on that. 

And it’s expensive if your health insurance doesn’t cover it. However, Dr. Patel pointed out, “your care team may be able to help you apply for assistance from the manufacturer.” 

This is a prescribed medication. You will want to discuss any weight loss treatment with your trusted healthcare provider. There are websites that claim that they can provide you with compounded semaglutide with an online interview. Please be skeptical. 

The FDA says they have received negative reports about compounded semaglutide. “Patients should not use a compounded drug if an approved drug is available to treat a patient. Patients and healthcare professionals should understand that the agency does not review compounded versions of these drugs for safety, effectiveness, or quality.” 

They also had reports that in some cases compounders were using an unapproved form of semaglutide, so please beware. 

If you are seeking a primary care provider for you or a family member, Bonner General Family Practice is accepting new patients. Call for an appointment 208-265-2221. 

Kathy Hubbard is a member of the Bonner General Health Foundation Advisory Council. She can be reached at kathyleehubbard@yahoo.com.