Children and teens in Connecticut are driving up demand for a category of injectable weight loss drugs. But the surge in use has some doctors across the state concerned.
The drugs Ozempic and Wegovy contain a class of medication called semaglutide. It mimics the hormone GLP-1 that gets naturally released by the gut in response to eating.
GLP-1 can stamp out hunger. And these drugs do the same thing, sending signals to the brain that can help control appetite.
Because of that, Ozempic, which was originally developed to treat diabetes, has started to get prescribed as an off-label medicine for weight loss. Wegovy is also being used to treat obesity in kids 12 and older who meet a certain body mass criteria.
Lately, more parents are requesting these drugs for kids struggling with their weight, said Dr. Sue Decotiis, an obesity medicine specialist who has a practice in Westport.
“Parents see their teens gaining weight. And perhaps they've even sent their child to a nutritionist, dietician, and they don't see the results,” Decotiis said. “Then they are saying, 'Well, I think we have to take the second step.'”
Emerging evidence shows the drugs could be effective at encouraging weight loss. A 2022 study in the New England Journal of Medicine showed participants taking these medications saw an average reduction in their body mass index of 16.1% versus 0.6% with the placebo.
Meanwhile, a growing popularity for drugs like Ozempic has contributed to shortages.
Pediatric obesity expert Dr. Jessica Williams, at Connecticut Children’s, said she’s seen a a 50% surge in children and teens using GLP-1 for weight loss.
“We understand that obesity is a severe medical condition, and there are risks to that patient's health and well being,” Williams said. “And we now have treatments available that are safe and appropriate that can be a game changer.”
Over the last year, Williams said, data has begun to emerge showing that these medications are appropriate and are now FDA approved to treat obesity in children 12 and up.
Doctors say demand is also increasing for Eli Lilly’s Zepbound, which is approved for weight loss in the 18-and-older demographic.
As weight loss stigmas persist, concerns about using medication remain
While some kids may need the drugs to lose weight, doctors worry that some children and teens are turning to medication too quickly without first trying diet and exercise.
“The concern is that it's not a first step, you don't want to start a teen who was overweight or obese on one of these drugs, without really being sure that the child has tried diet and healthy eating,” Decotiis said. “Many times … that does not happen.”
Doctors need to ensure children are first having well-balanced meals, not eating a lot of junk food and are physically active, she said.
“All of these things have to be corrected before somebody could even consider putting a teen on these medications,” Decotiis said.
But doctors emphasize that weight loss is complex.
The brain plays a very important role in what doctors call a “weight setpoint.” That’s what the body thinks its weight should be and where the body is driving its weight to be.
“So it affects your hunger level, it affects your metabolism, and it affects your [food] cravings,” Williams said. “Even in-utero exposure, if the baby is exposed to gestational diabetes, there are factors that are pushing the biology. Thank goodness we understand this is not a willpower problem.”
Some doctors also express concern that kids on the drugs may not be getting enough nutrition because they are taking a hunger suppressant.
“So we have to say, 'Well make sure that you have maybe some yogurt, some protein shake, some bone broth' and, of course, hydration,” Decotiis said.
The other concern is body image.
“We want to have a healthy relationship with food and a healthy relationship with physical activity,” Williams said. “And we want to promote that and celebrate that.”
Because, she said, weight does not equal worth.
“Your weight is not you,” she said. “There's so much negative shame, bias, guilt, stigma.”
