5 Things Parents Considering Weight Loss Drugs for Their Kids Need To Know

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In January of 2023, the American Academy of Pediatrics released guidelines recommending the use of weight loss drugs as a way to combat obesity in children 12 and older. Childhood obesity is a problem that isn’t going away, and this is the first new set of guidelines released in nearly a decade.

Currently, there are four weight-loss medications on the approved list: Wegovy, Saxenda, orlistat and Qsymia. Wegovy and Saxenda are part of a newer class of drugs called GLP-1 agonists, which have soared in popularity in the last few years. Along with Ozempic, they are gaining popularity with adults looking to lose weight.

Because these medications have only been recently approved for children 12 and older, parents naturally have had questions and concerns, especially when it comes to side effects and the possibility for adolescents to develop eating disorders. Here is what you need to know about these types of weight-loss drugs.

How long would kids need to take weight loss medication?

“We don’t really have data about this in adolescents yet,” Dr. Emily Breidbart, a pediatric endocrinologist at NYU Langone Health, told NBC News. “But we generally counsel families that this is a long-term treatment.”

This falls in line with what doctors say about adults who take medications such as Wegovy — they must take the medications long term to maintain their weight. Once they stop taking the medication, many adults will gain that weight back. This is common with any kind of preventative medication, but it’s different for an adult than it is for children. Adults often have tried many treatments before being put on weight loss medication, while teenagers likely haven’t had the same amount of time to try out other options.

Pediatric endocrinologist Dr. Alaina Vidmar, who is also medical director of the healthy weight clinic at Children’s Hospital Los Angeles, told the news outlet that although more research still needs to be done on the long-term effects of weight loss medication on teens, there needs to be a weighing of the risks of the medication versus the risks of obesity.

Currently, there is no specific age when kids should start taking the medication.

The guidelines from the American Academy of Pediatrics notes that doctors should prescribe weight loss medication to children 12 and over, but that’s really the only specific guidelines that have been given. Experts say there’s no magic age or weight for kids to start these medications.

Body mass index, or BMI, doesn’t work for children the same way it works for adults, and there has been criticism of the ways BMI is used in general in recent years. What is considered obese for a 12-year-old may not be considered obese when the same kid is 16. The Centers for Disease Control and Prevention has three classifications of obesity in children for pediatricians to use, which they are applying to how they prescribe weight-loss drugs.

“We know that the risk of developing things like Type 2 diabetes, high blood pressure, high cholesterol, heart disease goes up as the class of obesity goes up,” Vidmar explained. “I think a lot of clinicians will look at a child who has Class I obesity with no comorbidities differently than they might approach a child who has Class III obesity with pre-diabetes, high blood pressure and high cholesterol.”

Yes, diet and exercise are still important.

Just because a child is taking weight loss medication doesn’t mean that diet and exercise aren’t still incredibly important lifestyle changes.

Dr. David Ludwig, a pediatric endocrinologist at Boston Children’s Hospital, explained that the medications aren’t going to cause someone to lose all of the excess weight the person needs to lose. The medications are “not going to completely cure obesity, as they produce about 15% weight loss,” Ludwig said. “That’s great, but many patients that show up at our obesity clinic have much more than 15% excess weight. They may have 50% or in some cases 100% or more excess weight.”

In an editorial published in the Journal of the American Medical Association, Ludwig criticized the American Academy of Pediatrics' guidelines for failing to put enough emphasis on the importance diet has on the effectiveness of the medication.

What about side effects?

There has been a lot of talk about the side effects from these new weight loss medications, which often includes upset stomach, nausea, vomiting, and diarrhea. None of these side effects are pleasant and sometimes have led people to stop taking the medications.

Ludwig explained, however, that these particular side effects are actually proof the medications are working — they slow down how quickly the body digests food. “The food stays in the stomach too long, so people develop nausea and vomiting,” he told NBC News.

He added that the effects of these drugs are of course being monitored, especially for younger users.

There are legitimate concerns that children using weight loss drugs can lead to them developing eating disorders.

When the American Academy of Pediatrics made the decision to add weight loss medication to its guidelines, that prompted criticism. It has been no secret there are adults who are taking these medications with the express intent to lose weight and not for medical reasons. With 20% of kids being affected by eating disorders, it’s an understandable concern that teens will also begin to use these medications inappropriately.

The Collaborative of Eating Disorder Organizations wrote an open letter to the academy, saying that allowing children to take weight loss drugs “will contribute to an increase in eating disorders,” citing an increase in eating disorders among young people who take over-the-counter weight loss pills.

In an article for Business Insider, Dr. Elizabeth Wassenaar, a regional medical director at Eating Recovery Center, expressed concerns these new guidelines would increase harmful biases. “It reinforces the message that you need to look a certain way to be successful, happy, and healthy,” she said.

“I do think that this is a really understudied issue,” Breidbart said, citing why she only uses weight loss drugs in extreme cases. “That’s why, in general, in my practice we’ve been using these drugs for severe obesity, especially with comorbidities.”

There is still a lot to learn, which is why parents should work alongside pediatric specialists who are up to date with their knowledge of these weight loss medications.