GLP-1 for Adolescent Obesity (Ages 12–17)

Overview

Obesity in adolescents is a growing public health concern, affecting nearly 1 in 5 youth in the United States. When lifestyle interventions such as diet and exercise are not enough, pharmacological therapies like GLP-1 receptor agonists are increasingly being considered as part of a comprehensive treatment strategy.

FDA-Approved Medications for Adolescent Obesity

  • Liraglutide (Saxenda): Approved for chronic weight management in adolescents aged 12–17 with a body weight ≥60 kg and BMI ≥95th percentile for age and sex.
  • Semaglutide (Wegovy): Approved in 2022 for adolescents aged 12+ with obesity or overweight plus a weight-related condition. Demonstrated an average weight reduction of ~16% in clinical trials.

Indications for Treatment

GLP-1 medications may be considered for adolescents who:

  • Have a BMI ≥95th percentile (obesity) or ≥120% of the 95th percentile (severe obesity)
  • Fail to achieve significant weight loss with behavioral interventions alone
  • Have weight-related comorbidities such as prediabetes, hypertension, or dyslipidemia

Dosing & Monitoring

  • Dosing for adolescents typically mirrors adult protocols but is adjusted based on tolerance and side effects.
  • Initiation often starts with a low dose, gradually titrated upward.
  • Regular monitoring of growth, pubertal development, and lab values (e.g., glucose, lipids) is essential.

Safety & Tolerability

  • Common side effects: nausea, vomiting, constipation, fatigue, and headache.
  • Serious but rare risks: pancreatitis, gallbladder disease, thyroid tumors (in rodent studies).
  • Adolescents should be counseled on how to manage gastrointestinal effects and the importance of adherence.

Support & Behavioral Counseling

  • Family involvement enhances adherence and lifestyle change.
  • Behavioral therapy is a cornerstone of pediatric obesity care and should accompany pharmacologic treatment.
  • Focus on sustainable habits—sleep, screen time, self-esteem, and nutrition education.

References

  1. Kelly AS, et al. “Semaglutide in Adolescents with Obesity.” NEJM. 2022.
  2. FDA. “Saxenda and Wegovy Approval for Pediatric Use.” 2022–2023.
  3. Daniels SR, Hassink SG. “The Role of Medication in the Treatment of Pediatric Obesity.” Pediatrics. 2023.
  4. CDC. “BMI for Children and Teens: Percentile Data.” Updated 2024.