A Surge in Pediatric Obesity Treatment? Or a Small Uptick?

Reporting for Reuters, Robin Respaut and Chad Terhune tell us that prescription data in the U.S. reveals increasing use of semaglutide for obesity in adolescents. Does this signal a huge surge in pediatric obesity treatment? Or merely a small uptick from almost negligible access to care?

That all depends on the story you want to tell about this important but emotive subject.

1,238 Adolescents

What we are talking about is 1,238 adolescents receiving a prescription for semaglutide in the first ten months of 2023. It was first approved by FDA for this indication at the end of December of 2022. Results from a landmark study of the drug for this purpose came out the month before at ObesityWeek and in the New England Journal of Medicine.

Before that, in December, 2021, FDA approved the first GLP-1 medicine for obesity in teens – liraglutide. Compared to semaglutide, it is only modestly effective, but some individuals get excellent results.

For perspective on those 1,238 teens getting a prescription for semaglutide in 2023, this is more than double the number who received either semaglutide or liraglutide in 2022. And in 2021, only 236 youth received a prescription for liraglutide. So percentage-wise, we are seeing a big increase.

But measured against the total population of kids with obesity, it’s tiny. Five million kids have severe obesity – 1,238 teens getting a prescription is 0.002% of that population. Compared to the total population of kids with obesity – about 15 million – it is negligible.

The Human Impact

For a young person living with severe obesity, the impact of this disease can be overwhelming. One of the youths speaking on his lived experience with obesity at the NIH in November summed it up simply: “This is a constant weight on my whole life.”

Bystanders feel free to comment about whether treatment should be available to these kids, expressing worries about body positivity and mental health – valid concerns. But the reality of life for a teen with severe obesity is a double whammy. You’re facing the prospect of severe impairment to health that nobody really understands, but your peers do see your size and treat you cruelly because of it.

A mom trying to instill body positivity in her daughter before she found effective treatment for severe obesity describes the impossible situation she faced:

“I’ve always tried instilling, ‘No matter what size you are, you’re still beautiful. Size is not the indicator of who you are as a person. Your character is.’

“That’s hard to make your child believe that when you have the cool kids at school saying mean things and making them feel otherwise.”

Unmet Need

So yes, utilization of medical advances for treating obesity in young persons has grown – from a base that was vanishingly small. And still, the unmet medical and human need for care is still great.

Click here for the report from Reuters, here, here, and here for further reporting.

Enclosed Field with Rising Sun, painting by Vincent van Gogh / WikiArt

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February 17, 2024