Prescriptions for GLP-1 weight-loss medicines among U.S. children aged eight to 11 have increased more than 300-fold since 2019, highlighting both the growing burden of childhood obesity and the debate over how early these drugs should be used.
A study published in the publication Pediatrics found that the proportion of children with obesity receiving GLP-1 drugs rose from just 0.03 per cent in 2019 to 9.3 per cent by June this year.
More than 20,000 children received the medicines during the study period, with Wegovy, made by Novo Nordisk, the most commonly prescribed. Doctors also prescribed Novo Nordisk's Saxenda and Eli Lilly's Zepbound.
The researchers examined health records covering more than 3.5 million children aged eight to 11 to see who had obesity but no diabetes, which is what the drug was originally designed for.
The vast majority of those given GLP-1 drugs – around 94 per cent – had severe obesity, while about two-thirds had another condition linked to obesity, including high cholesterol, high blood pressure or sleep apnoea.
Dr. Babak Orandi, an obesity specialist at NYU Langone Health and the study's lead investigator, said the scale of the increase had caught him off guard.
“I just wasn't expecting the increase to be quite this dramatic,” he said.
GLP-1 medicines are not currently approved by U.S. regulators specifically for weight management in children under 12. However, clinical guidelines can support their use in children as young as eight in certain circumstances.
The rapid increase does not mean large numbers of young children are taking the drugs, researchers stressed. But the trend is accelerating quickly, raising questions about what is known – and what is still uncertain – about their long-term use in children.
Clinical trials are under way, but Orandi urged caution while evidence continues to develop.
“I think it's important to have a healthy degree of skepticism.”
He compared the situation with a lesson he was taught in medical school: doctors and patients should be wary of being the first to use a new medicine before its risks and benefits are fully understood.
At the same time, Orandi said the health risks associated with severe childhood obesity are already well established.
“The long-term ramifications of childhood obesity are pretty severe.”
The study found a significant difference in access based on where children lived. Those in higher-income communities were 55 per cent more likely to receive GLP-1 treatment, even though obesity rates are often higher in lower-income communities.
Allan Massie, a co-author of the study and associate professor at NYU Grossman School of Medicine, said access to the medicines should not be limited to families with better insurance or greater financial means.
“Physicians and health policymakers alike have a responsibility to ensure ... these valuable and sometimes costly treatments become available to more than those who have access to health insurance and can afford to visit paediatric clinics.”
GLP-1 medicines, which can reduce appetite and help regulate blood sugar, have transformed the treatment of obesity in adults and older children. Their growing use in younger children, however, remains an emerging area of medicine.
The researchers stressed that medication alone is not enough. Treatment for childhood obesity should also involve changes to diet, physical activity and other aspects of a child's lifestyle.
As more clinical trial data emerges, doctors will have a clearer picture of whether the benefits of GLP-1 treatment for younger children outweigh the potential long-term risks.
For now, the sharp rise in prescriptions reflects a difficult balancing act: finding effective treatment for children facing serious health consequences from obesity while ensuring that medicines used at such a young age are proven safe over the long term.
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