Use of weight-loss drug Wegovy up 50% among US teens

American teens are increasingly turning to the weight-loss drug Wegovy as more families and their doctors gain confidence in its use for young people with obesity, new data shared with Reuters shows.

The average rate of teens beginning treatment with the highly effective Novo Nordisk drug grew 50% last year to 14.8 prescriptions per 100,000 adolescents, according to an analysis by health data firm Truveta.

That’s up from a rate of 9.9 prescriptions per 100,000 in 2023, the first full-year Wegovy was available to children aged 12 and older. The average rate climbed further during the first three months of this year, reaching 17.3 new prescriptions per 100,000.

That still represents a minute fraction of the estimated 23,000 of every 100,000 teens in the country living with obesity and is far slower than the uptake among US adults.

“It's promising that more young people are using these medications, but it’s still a small percentage of patients with severe obesity who are getting access to them,” said Dr Cate Varney, director of obesity medicine at the University of Virginia health system.

“When lifestyle changes only are insufficient, we need these additional tools.”

For its analysis, Truveta reviewed the electronic health records of 1.3-million patients aged 12 to 17. The data covers 30 US health systems with more than 900 hospitals and 20,000 clinics across the country.

The analysis did not include other GLP-1 drugs, including Novo’s Ozempic and Eli Lilly’s Zepbound, which are not approved to treat obesity in adolescents, or compounded versions of these therapies.

Wegovy became an option to treat adolescents in late 2022 after decades in which the conventional approaches of diet, exercise and counselling largely failed.

About eight-million American teens, or 23% of people aged 12 to 19, have obesity, up from 5% in 1980, according to US government data. Young people with obesity run a much higher risk of developing chronic, costly, life-shortening conditions such as type-2 diabetes and cardiovascular and liver diseases.

In January 2023, the American Academy of Paediatrics recommended that doctors provide weight-loss drugs to children with obesity starting at 12. Yet the medical community has not uniformly embraced GLP-1s for adolescents.

Some doctors are hesitant because the drugs’ long-term safety for children during a critical phase of development is unknown and the treatments may need to be used indefinitely. Overall, there are limited options for many teens and their parents because insurance plans often do not cover any treatment for obesity, including intensive behavioural counselling, visits to a dietitian or the new GLP-1 medications.

At Nemours Children’s Hospital in Wilmington, Delaware, the Healthy Weight and Wellness Clinic treated about 2,000 adolescent patients last year.

About 25% were prescribed Wegovy or another GLP-1 medication, said Dr Thao-Ly Phan, the clinic’s medical director. The number of adolescents with a GLP-1 prescription nearly doubled from 2023. On average, their patients taking a GLP-1 drug lost 6.8kg within six to 12 months and nearly 13.6kg after more than a year.

For many of the other patients, the medications were not an option, either because of insurance hurdles or concern within families about potential risks. Other teens opted for lifestyle changes or older, cheaper weight-loss drugs, with some success.

“It is important for us to continue to monitor and better understand outcomes from the medications — positive and negative — before widespread use,” Phan said.

US health secretary Robert F Kennedy Jnr has criticised the idea of prescribing Ozempic or Wegovy widely to children to treat obesity. In a federal health report he released last month, GLP-1 drugs were cited as an example of the “overmedicalisation of our kids”. It noted a lack of “long-term safety data, raising the spectre of unforeseen problems that interrupt, damage or impair metabolism and growth development”.

Novo said semaglutide, the active ingredient in Wegovy and Ozempic, “did not appear to affect growth or pubertal development” during its clinical trials involving teens.

For many adults obesity starts in childhood or adolescence and “we are confident in the proven safety and efficacy of our GLP-1 medicines”, Novo said.

Eli Lilly’s weight-loss drug Zepbound is in late-stage clinical trials for use by adolescents. Lilly told Reuters “there has been no evidence to date suggesting impairment in growth or metabolism” from GLP-1 medications.

Dr Robert Siegel, a paediatrician and director of the Centre for Better Health and Nutrition at Cincinnati Children’s Hospital, said about 15% of adolescents being treated there were prescribed Wegovy or a similar GLP-1 medication from July 2021 to July 2023. They include patients being treated for type 2 diabetes for which the GLP-1 drugs were originally developed.

Siegel said he prefers to start teens on three to six months of intensive lifestyle management before considering medication.

While obesity specialists can help navigate potential risks from the drugs, many primary-care providers need more training, he said. They may not have the equipment to monitor for the loss of muscle mass — a side effect of these medicines — or lack the resources to work with families over an extended period on healthier eating and exercise.

“These medications are likely to be needed for a long time to maintain weight,” Siegel said, “and we only have a relatively short-term experience with them.”

Reuters