A medical expert has raised concerns about GLP-1 weight-loss drugs being prescribed to children as young as six, warning they should not be seen as a straightforward way to prevent obesity later in life.
Figures from the Centers for Disease Control and Prevention (CDC) indicate that nearly one in five U.S. children and teens have obesity, with prevalence rising to more than 20 percent among school-age children and adolescents. Despite that, GLP-1 medications are not formally approved for routine weight management in children under 12.
According to The Wall Street Journal, some physicians are using the medications off-label in younger children in an effort to reduce the chances of obesity-related conditions developing, including high blood pressure and Type 2 diabetes.
At present, GLP-1 drugs are approved for obesity treatment in children aged 12 and over, while in the US they are also approved for children aged 10 and older with Type 2 diabetes. Researchers are also studying their use in younger children, including trials of liraglutide in children aged 6 to under 12.
One doctor has cautioned that these medications have a place in treatment, but should never be approached as a cosmetic solution.
Dr Suzanne Wylie, GP and medical adviser for IQdoctor, said:
“As a GP, I think it is important to begin by saying that GLP-1 medications should not be viewed as cosmetic weight loss treatments for children, because they are powerful prescription medicines that have a legitimate role in managing obesity in carefully selected young people, but only under specialist medical supervision and as part of a much broader treatment plan rather than as a quick fix.
“There has understandably been growing public interest in these drugs because of their success in adults, but children are still growing physically, hormonally and emotionally, which means the decision to prescribe them requires much more careful consideration than it does in an adult.
She said one of the biggest issues is the lack of long-term evidence on how the drugs could affect children over time, particularly while they are still developing.
“One of the biggest concerns is that we simply do not yet have the same depth of long-term safety data in children that we have in adults, particularly when it comes to how these medications might affect growth, nutrition and development over many years,” Dr Wylie continued.
“While studies have shown that GLP-1 medications can be effective in reducing weight in adolescents with obesity, there are still unanswered questions about what prolonged treatment during childhood might mean, which is why these medicines should never be used casually or without specialist oversight.”
CDC data shows that roughly 19.7 percent of children in the US between the ages of two and 19 are living with obesity, while obesity is more common as children get older.
Dr Wylie also warned that because children are still growing, appetite suppression caused by GLP-1 drugs could make it harder for them to get enough nutrients needed for healthy development.
She says: “Another issue is that children have much higher nutritional requirements than adults because they are building bone, muscle and other tissues throughout adolescence, and these medications work by reducing appetite and slowing stomach emptying.
“If a young person is eating significantly less without careful dietary support, there is a genuine risk that they may not consume enough protein, vitamins and minerals to support healthy growth, which is why dieticians form such an important part of any specialist obesity service looking after these patients.”
She added that the side effects commonly seen in adults can be especially difficult for younger children, and said there are also psychological risks if medication is presented as the answer to weight concerns.
“There are also the more familiar side effects that we see in adults, including nausea, vomiting, abdominal pain, constipation and diarrhoea, all of which can be particularly difficult for younger patients to tolerate,” the doctor explains.
“In some cases these side effects can become severe enough to affect hydration, school attendance and overall quality of life, while rarer complications, such as gallbladder disease or pancreatitis, although uncommon, remain important risks that need to be discussed before treatment begins.
“From a psychological perspective, it is equally important that we do not send the message that medication is the answer to every weight concern during childhood, because many young people are already vulnerable to low self-esteem, bullying and poor body image. If medicines are introduced without addressing emotional wellbeing, eating behaviors, physical activity, family habits and the wider social factors contributing to obesity, then we risk treating only one part of a much more complex condition. Children need support that helps them develop healthy lifelong habits rather than relying solely on medication.”
Dr Wylie said that in the UK, these treatments are typically considered only in the most serious cases and after broader factors have been reviewed.
She adds: “It is also worth remembering that not every child who is overweight requires drug treatment.
“In UK practice, medication is generally reserved for young people with significant obesity who are at risk of developing serious health complications and who have been assessed by specialist multidisciplinary teams. That assessment looks beyond a child’s weight alone and considers their overall health, medical history, psychological wellbeing and family circumstances before deciding whether the potential benefits outweigh the risks.
“Ultimately, these medications do have an important place in modern obesity treatment for carefully selected young people, and for some families they can genuinely be life-changing by reducing the risk of conditions such as type 2 diabetes, high blood pressure and fatty liver disease. However, they should never be seen as an easy solution or something that parents should seek independently through unregulated sources, because the safest and most effective use of GLP-1 medicines in children comes through specialist medical care, ongoing monitoring and comprehensive lifestyle support, with the aim of improving a child’s long-term health rather than simply reducing the number on the scales.”
Experts in pediatric obesity say treatment decisions should usually be made by specialist multidisciplinary teams and paired with nutrition, physical activity and mental health support. In the US, the Food and Drug Administration has approved several medications for adolescents aged 12 and older with obesity, while GLP-1 drugs have also been approved for certain children aged 10 and older with Type 2 diabetes, but not as a simple or universal fix for younger children.