The trial included 201 participants ages 12 to 17 years, 200 of which were living with obesity.
Researchers gave 131 participants a 2.4 mg dose of semaglutide once per week. The rest got a placebo.
By the end of the trial, nearly 45% (44.9%) of teens who started the study with obesity had fallen below the obesity threshold, and a quarter had returned to a healthy weight.
“The study demonstrates that the drug Wegovy (semaglutide) was effective in treating teens with obesity,” says Dr. Natasha Agbai, MD, a board-certified pediatrician in San Fransisco specializing in childhood weight management.
Wegovy is effective for weight loss in teens with obesity for the same reason it helps adults.
“It decreases the appetite so a person gets full faster and doesn’t feel hungry between meals,” Ganjian says.
Ganjian is encouraged by the study but cautions against putting Wegovy on a pedestal alone.
“It doesn’t tell us that this is the panacea or magic bullet for obesity,” Ganjian says.
Indeed, even the FDA approval indicated that adolescents eligible for a Wegovy prescription should also receive dietary and physical activity guidance.
“Typically, dietary changes include eating more fruits, vegetables, and whole grains,” says Dr. Michelle W. Katzow, MD, MS, FAAP, the medical director of POWER Kids Weight Management Program with Northwell Health’s Cohen Children’s Medical Center. “[Also], eating less processed, high sugar, high-fat foods. Physical activity changes include aiming to be active for 60 minutes per day.”
Ganjian adds that the trial results do not indicate whether the adolescent will need to be on the medication long-term.
But adolescents may still be growing. However, Breidbart says teens who start Wegovy will likely need it long-term because obesity is similar to any chronic illness like asthma or diabetes.
“It is unlikely we can sustain weight loss effects to the same extent off medication,” Breidbart says. “If we are starting that medication in a teenager, they have chronic obesity. We wouldn’t expect their BMI to normalize as they grow. I wouldn’t expect that a pubertal growth spurt would normalize their BMI.”
Breidbart says there may be exceptions, which is why working with a trained medical provider is critical for teens.
Experts say that Wegovy is generally safe.
“Rare side effects include kidney, pancreas, gallbladder, and thyroid problems,” says Ganjian.
Katzow agrees that Wegovy is generally safe but may have some side effects that affect people differently. These side effects may include:
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“Obesity in adolescents poses significant risks to their overall health and well-being,” says Agbai. “These conditions can have long-term consequences, potentially leading to chronic health problems and reduced quality of life.”
Agbai says the risks of childhood obesity can include:
Katzow says it’s important to raise awareness of the mental health of young people with obesity.
“It may be that a lot of the long-term adverse health outcomes associated with obesity are due to stigma and discrimination, not altered physiology,” says Katzow. “That is not the responsibility of people living with obesity to fix. That is the responsibility of everyone else.”
In an attempt to avoid feeding into the stigma, parents may be hesitant to discuss obesity and the potential for Wegovy use with their teens who are living with obesity.
Katzow says that may not be bad because customization and patient-driven care are critical.
“For parents and doctors, we have to start with the teen, their interests, their motivations, their goals,” says Katzow. ”If they don’t want to talk about weight, then it may not be in the best interest of their overall well-being to talk about weight. We can do real damage, and most certainly have, by pushing the issue in the interest of health with a teen who has different goals for their health than their parents or their doctors do.”
But Breidbart often sees teens who do have weight-loss goals, and she seeks to help them do so safely and effectively.
Lifestyle tweaks are still the first-line treatment, but sometimes those alone are not enough. In those instances, Wegovy may help. Holistic care is critical, including the mental health component.
“It’s a conversation that needs to be had with parents, the kids, and sometimes a psychologist to deliver into issues around eating or anxiety that could be contributing to binge eating or overeating or emotional eating,” Breidbart says. “Typically, it’s a decision that takes some time.”