The weight loss drug craze has taken off, especially on social media, and discussions about it may find its way into your home if you’re a parent of tweens and teens. For example, Wegovy has been approved by the Food and Drug Administration for the treatment of obesity in adolescents as young as 12 years old. Ozempic has not been FDA-approved as a weight loss drug (it is prescribed in those 18 and up as a medication to treat Type 2 diabetes) but people have been taking it off-label for drastic weight loss, NBC has reported.
Known medically as semaglutide, Wegovy was approved for weight loss management in adults in June of 2022, and its lower-dose-sister-drug, Ozempic, was initially approved in 2017 for medical use in patients with type 2 diabetes. But both drugs have recently gone mainstream, and that’s in large part because it’s been rumored that the injections are popular among celebrities looking to lose weight. On TikTok, the hashtag #Wegovy has been viewed over 705 million times so far, and the drug has increased so much in popularity that the FDA says it’s currently in short supply. It almost catches up to #Ozempic, with over a billion views on TikTok, and either way it’s likely that that weight loss drug content is ending up in your teen’s “For You” page.
While doctors who prescribe Wegovy are optimistic that the drug will help those it is intended for, there are concerns that the drug could be used to simply promote thinness, unattainable beauty standards, and even disordered eating to adolescents who have just become eligible. There’s also concerns that the latest guidelines from the American Academy of Pediatrics, advocating for more “aggressive” treatment can lead to more mental and physical struggles for young people trying to cultivate healthy relationships with their bodies and with food.
So, we asked the experts how drugs like Wegovy and Ozempic work, what the physical and mental risks may be, and what other weight loss alternatives for children are out there. Here’s what they had to say.
What are these weight loss drugs and who is a candidate?
Wegovy is a glucagon-like peptide-1 (GLP-1) agonist, which in simpler terms means it imitates a hormone in your body that tells your brain to regulate your food intake, which ultimately lowers your appetite and how much food you want to consume. Ozempic works in a very similar way, but at slightly lower dose.
Endocrinologist Arti Thangudu, MD and CEO and founder of Complete Medicine, says that weight loss drugs also promote satiety. “So they make people feel full faster, and they do that by slowing how fast food moves through the GI tract. So in that way, they suppress appetite, and they also work on brain receptors,” she said. “So a lot of times we eat because we’re bored, happy, sad, not necessarily because we’re hungry. And these drugs decrease that food fixation.”
Wegovy and Ozempic are injections designed to be administered at home once a week in the arm, thigh or stomach, and depending on the individual’s weight loss and health goals, can be used for a varying length of time.
Like all prescriptions, there are several factors that determine who is eligible. Pediatrician Elena Shea, MD said Wegovy is indicated in teens aged 12 and older with BMI greater than 95 percent for age and gender. “Research shows that an elevated BMI significantly increases the risk of type 2 diabetes, hypertension, early heart attack and overall poor health for young people,” she said. “A minor could also be prescribed Wegovy for treatment of their type 2 diabetes.” Dr. Shea adds that a patient’s Wegovy dosage and timeline of usage is unique to each individual and should be carefully monitored by their doctor.
What are the physical risks and side effects of these medications?
Dr. Thangudu says the most common side effect people experience is nausea, which typically resolves in about three to four weeks after starting the medication. “It’s tolerable for most patients, but there have been a handful of patients that have had to stop the medication due to intolerable nausea,” she said. “And some people do have GI side effects from it, like an upset stomach.”
Other risks include worsening reflux, headache, dizziness and abdominal pain. More severe side effects in pediatric patients include gallbladder disease, increased heart rate and low blood pressure. Doctors also recommend that patients who are currently prescribed medications in the same class of the GLP-1 agonist or diabetes medication not take Wegovy, and seek other weight loss alternatives.
“We need to counsel our patients on the potential side effects and make sure that benefits outweigh the risks,” Dr. Thangudu said.
Are there other alternatives to Wegovy for children?
Dr. Shea says that Wegovy is not the only option, it is just the only once-a-week option that is approved for minors. Currently there are other daily GLP-1 agonists available for teens with obesity and type 2 diabetes. Saxenda, a daily injection, and Qsymia, a daily oral, are also available for treatment of obesity in teens.
“It is important for families to discuss these options, along with lifestyle modifications, to establish the best plan of care for their child,” Dr. Shea said. And she adds that for parents and families seeking weight loss solutions for their children, they should discuss all available options with their pediatrician first.
Here’s what else you may not know about Wegovy.
One in five adolescents in the United States are affected by obesity, according to the CDC, and rates are continually increasing. In January, The American Academy of Pediatrics released its first comprehensive guidelines on treating obesity in children in response to these growing numbers. They cited weight loss treatments like prescriptions and surgeries as options, once practices like nutrition coaching, physical activity and changes in behavior were implemented.
But now that millions of Americans are eligible to take the drug, getting your hands on it could be difficult. Currently, the Affordable Care Act doesn’t require health plans to cover obesity-related medications or surgeries, so if you are hoping to be prescribed Wegovy for weight loss purposes, you need to check with your insurance provider to see if it is covered. If you’re looking to pay out of pocket, the cost of four doses, or one month’s worth, is around $1,300.
It’s important to note that many people experience rebound weight gain after pausing use. According to an April 2022 study published in Diabetes, Obesity, and Metabolism, most people gain back a majority of their weight within one year of stopping Wegovy. And for this reason, doctors recommend taking the lowest dose that is effective to maintain healthy and sustainable weight loss.
There are potential mental health side effects of Ozempic and Wegovy too.
Before you decide to pick up a prescription for weight loss drugs for your tween or teen, consider that there are mental health implications of weight changes too. “Medication has been suggested to overweight clients that do not even have elevated A1C levels [what a medication for diabetes would treat], which sends a problematic message to our client and signals problems with the system as a whole, explains Alyssa Goldenberg, LMSW, clinician and Assistant Director of Admissions at The Dorm, an intensive outpatient treatment program for young adults. “There is a total lack of compassion for eating disorders and how the client got to a place where they might be having medical complications,” Goldenberg adds.
Though these weight loss drugs like Wegovy have only been prescribed to teens for less than a year, they can still have impact on teens’ mental and emotional health, especially because they’re another device of peer pressure. “It reiterates that there is something wrong with the way they are and covers up the need to use food as a coping mechanism or anxieties around fitting in via weight loss,” Goldenberg says.
Weight fluctuations might not be related to a medical issue, but may have more to do with a young person’s relationship to food and quantity of food, and the emotional impact it has on them. Taking medication for weight loss doesn’t get to the root of the issue, which could be an underlying mental health condition, explains Goldenberg. If your child is dealing with anxiety or depression that could be influencing disordered eating, you should watch out for those signs (more on what to look out for below) involve a mental health professional to get to the cause of the mental health condition and treatment options.
Remember that health and wellness is not a one-size-fits-all.
Doctors agree that medications like Wegovy and Ozempic are not for everyone. Children who have a history or are silently suffering from disordered eating are likely not candidates, as medical experts agree these mental health concerns need to be addressed first. And along with routine mental health screenings, good nutrition, diet and exercise are necessary in ensuring success with the drug.
Jenna Werner, a registered dietitian and owner of Happy Strong Healthy Nutrition Practice says that parents are the biggest influence before the media gets to them, so taking charge by working on your own relationship with food first is a great place to start.
“As a dietitian I know my clients can only go as far as me when it comes to their relationship with food and wellness and the same with our kids,” Werner said. “They pick up on the words we use to describe food, the small habits or rituals you may participate in around or about your food intake or what you are eating versus what they are. Focus on how you are talking about food and how you can encourage all foods in their diet.”
If you’re concerned your child might be suffering from disordered eating or are not sure what signs to look for Werner recommends looking for their language around food and how they act at family meals. “If they potentially are hiding food in their rooms, closets, bathrooms, eating alone versus with you, these could all indicate binge eating or bulimia,” she said.
And even if you are trying to stay informed and up to date on the latest health news, it can be incredibly challenging to wade through the sea of information and determine what is factual and what is just diet talk. And adolescents are struggling with this too.
According to a new study from the University of Vermont, food, nutrition, and weight loss content on TikTok encourage a toxic diet culture among teens and young adults. Researchers also note that expert opinions are often not included.
Aubrey Gordon, author of “What We Don’t Talk About When We Talk About Fat” andCo-host of the podcast Maintenance Phase, said that when it comes to navigating the bevy of health and wellness news out there, she checks multiple sources and fact-checks any new research before making any personal decisions.
“Health and wellness media isn’t always fact-checked as rigorously as other media, which means it can often contain misinformation and disinformation,” she said. “And that goes double for TikTok, YouTube, and other social media about health, wellness and weight loss.”
So, when it comes to determining what might be best for you or your child’s health, it’s important to remember that health advice is not a one-size-fits-all. Seeking out information from licensed professionals and learning about what options are available are key factors in determining what is right for you or your child.
Before you go, check out our favorite quotes to inspire healthy attitudes about food and bodies:
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