Teens Are Being Prescribed Wegovy and GLP-1s at Record Rates. Should Parents Be Worried?

It’s hard to remember a time before Ozempic, Wegovy, and other injectable drugs referred to as GLP-1 receptor agonists (that imitate the role of a hormone, GLP-1, that works to balance blood sugar and curb hunger, ultimately supporting weight loss) were absolutely everywhere. The jingles on the commercials get stuck in your head, ads about them are all over social media, and your kids are taking in all this information right along with you. In fact, more and more teens that meet certain weight and health criteria are going on GLP-1s after the FDA’s approval of Wegovy for children 12 and up in late 2022. The numbers of prescriptions of GLP-1s have continued to spike from there: Research published by JAMA this year confirms an increase of 503% in male adolescents ages 12 through 17, and a jump of 587.5% in female adolescents between 2020 and 2023.

For Suzie Jimenez, a Texas resident who has been open on her TikTok account about her own and her 15-year-old son’s Jeremiah’s experiences using GLP-1s, supporting her son in taking Wegovy felt like a necessity. After Jeremiah ended up in the ER for severe stomach pain, his pediatrician was alarmed by the amount of weight he had gained during the pandemic, which contributed to pre-diabetes, and suggested some lifestyle and behavioral changes. But according to Suzie, more than changing diet and incorporating more exercise was necessary to make a difference in her son’s metabolism. “We considered doing a gastric bypass surgery, but we thought the GLP-1 would be a safer route, that I could adjust with a doctor,” she tells SheKnows.

How do you know GLP-1s are going to be the right decision for your teen, and what side effects should you be concerned about? Pediatricians and metabolic health experts weigh in.

Why has Ozempic and Wegovy use increased in children and teens?

With the FDA approval, availability of Wegovy and coverage under many major health insurance plans has skyrocketed. Britta Reierson, MD, FAAFP, a board-certified family physician and obesity medicine specialist at knownwell, a metabolic health company, cites a national Michigan Medicine survey that shows that up to 60,000 young adults are using GLP-1s on a regular basis, compared to 8,700 a month in 2020. The most common prescribers to teens, according to the survey, are endocrinologists, family physicians, and nurse practitioners, in order to preemptively treat health complications that can come about with obesity in teens, such as type 2 diabetes, high blood pressure and cholesterol, asthma, and even some mental health implications. “This is a positive trend reflecting a growing acceptance for addressing and treating obesity in younger populations,” Dr. Reierson tells SheKnows.

Another family medicine physician, Marie Ramas, MD, FAAFP, has started seeing an upward trend in the last six to eight months of teens in her office wanting to go on GLP-1 medications for both aesthetic and preventative health reasons. “Social media has to play a role with so many celebrities and influencers using GLP-1s, and this has an effect on teens’ perceptions,” Dr. Ramas tells SheKnows. She reports getting direct messages on social media from teens with curiosity about how Wegovy or other GLP-1s may help them if they’re overweight. In her office, parents are often leading the conversation about their teens taking GLP-1s. So what do parents need to know?

Are there potential health benefits of semaglutide for teens?

First, Wegovy and other GLP-1s work pretty consistently with treating insulin resistance, and help with the feeling of being full, explains Dr. Ramas — this can contribute to changing someone’s relationship with food. A New England Journal of Medicine study states that weekly doses of semaglutide, the name of the drug in Wegovy and Ozempic injections, can not only help adolescents ages 12 to 18 with weight reduction but with improving cardiometabolic risk factors that accompany obesity. These benefits include lower blood pressure, healthier glucose and cholesterol levels, and improved liver health, says Dr. Reierson.

Some parents, including Jimenez, emphasize that GLP-1s were the metabolic booster that helped their teenager get in the right mindset to improve their health on a daily basis. And medical professionals agree with that, to some degree. “Many teens report improved self-esteem, decrease in depression and anxiety, improved sleep, better mobility, and a greater motivation to maintain healthy lifestyle habits,” according to Dr. Reierson. Another mother also based in Texas, Julissa Alcantar Martinez, shared her son Diego’s journey with Ozempic, starting at age 16, on her TikTok account in 2023. She’s seen a remarkable change in his self-esteem: He’s more willing to try new activities and adventures without fear that he weighs too much or won’t have enough energy to finish.

As for chemical changes to the brain from taking GLP-1s, there is conflicting research, but not enough to suggest that these drugs alone definitively can harm teens’ mental health. In fact, one recent study found that teenagers age 12 to 18 who had been on a GLP-1 prescription for a while had 33% lower risk for severe depression and suicidal ideation. There’s not sufficient proof that the drugs can single-handedly lower these serious mental health implications, Newsweek reported. More likely, the weight loss associated with GLP-1s may help teens better cope with the social stigma associated with obesity and may reduce suicidality; more research needs to be done about the effect of the drugs on chemical processes in the brain.

What are possible side effects or unknowns of GLP-1’s?

One challenge to the whole GLP-1 landscape is access to them in the first place, between shortages, high costs, and lack of insurance coverage. This is an issue especially for people who are most likely to be eligible for semaglutide prescriptions, Black and Latinx communities. Eleven percent of eligible people do not have insurance, according to 2022 research. Black and brown patients also have limited access to medical information, and may face incorrect assumptions and biases when they enter a medical office (particularly if the provider does not share their lived experience), Dr. Ramas points out.  

As for the medications themselves, the physical side effects are pretty well known: nausea and other G.I. issues like vomiting and diarrhea. “These medications also have potential serious side effects, like pancreatitis, gallbladder issues, and thyroid tumors, so any history of these conditions is a direct contraindication for prescribing, says Dr. Reierson.

Psychiatrists and other mental health professionals sound the alarm that taking GLP-1s may provoke not only distress associated with uncomfortable side effects, but unhealthy eating habits. “Kids describe to me that they often experience a loss of interest in food and a lack of enjoyment in social activities involving shared meals,” says Anne Marie O’Melia, MS, MD, FAAP, CEDS-S, Chief Clinical and Quality Officer at Eating Recovery Center. “They describe feeling ashamed of their bodies and frustrated that they require daily or weekly medications to control their body size and improve their social acceptance.” The other issue Dr. O’Melia emphasizes is that studies about GLP-1s don’t address eating disorder risk, and there are not regular eating disorder screening guidelines for GLP-1 patients. The result? Patients are commonly falling into disordered eating behavior because of the restrictive nature of the medications when it comes to food.  Parents become the ones who need to closely monitor their teen’s nutrition and stay vigilant of any atypical eating behaviors, adds Dr. Reierson.

The biggest unknowns about medications in this category are long-term implications of teenagers (and adults) using GLP-1s; there isn’t enough data yet, experts point out. “Currently, GLP-1s seem to require a long-term or even lifelong commitment, as studies indicate that weight is often regained when the medication is discontinued,” says Natasha Agbai, MD, a San Francisco-based pediatrician and obesity medicine specialist at Discover Health. While she’s hopeful for promising research around GLP-1s and mental health for teens, Dr. Agbai is concerned with alcohol’s exacerbated effect on people taking GLP-1s, especially for teens who might be experimenting with alcohol and don’t understand their own tolerance. This is one more area that parents are essentially responsible for keeping close tabs on their teens.

Doctors have specific rules they adhere to when prescribing it.

GLP-1s for children are not unregulated, especially if you want your health insurance to cover them. Dr. Agbai states that she follows FDA guidelines when prescribing Wegovy, which means only prescribing it to children 12 and above. Her evaluation involves a thorough medical history and physical exam, and even some genetic or lab testing to understand any metabolic or health conditions. Specific criteria that pediatricians and family medicine physicians tend to look for include a BMI at or above the 95^th percentile for the teen’s age and sex; there must also be a health-related concern such as high blood pressure, type 2 diabetes, fatty liver disease, or sleep apnea to send the prescription, explains Dr. Reierson.

Teens should also be closely monitored by pediatricians when they first start. Dr. Agbai schedules a one-week follow-up appointment with families to screen for side effects. “There isn’t one universally ‘right’ way to monitor these prescriptions, but this approach has worked well with my patients,” she says. Parents should also be looped into any conversations with a pediatrician about risks, side effects, and healthy lifestyle changes that are associated with the medications.

What else should parents know?

For some teen GLP-1 patients and their families, it’s about weighing the costs and benefits of taking medication for weight loss. While Alcantar Martinez’s son Diego ended up with nausea and the dreaded gastrointestinal symptom of “sulfur burps” on Ozempic, particularly when he ate more carbs, he was able to use a small dose of Ozempic as a jumping off point to sticking with healthier habits. Now 18, Diego cooks his own meals and focuses on moderate portion sizes and trying new foods; he monitors his steps and uses an app to track his progress at the gym and with eating. “We have seen gains in all parts of his life,” Alcantar Martinez says. Jimenez adds that her son Jeremiah began training with a personal trainer focused on weightlifting and building strength while taking Wegovy, and has added more cardio and walks in between those sessions.

Both parents highlight that families need to be an integral part of any eating and exercise changes. “This is by no means an easy way out — you have to accompany the medication with a healthy lifestyle and can’t just give them the shot,” says Jimenez. She notes that she tried out GLP-1s herself and had success before her son tried them, so she felt more comfortable with the process, especially knowing that these are not brand-new drugs and have been prescribed to adults and children with diabetes for years. Still, parents should ask their pediatrician or family physician as many questions as necessary, and accompany that with their own research.

Most importantly, parents need to create a safe space so that their teens can have an honest, vulnerable conversations with them about their body without judgment, Jimenez says. Teens don’t always listen to their parents a hundred percent of the time about nutrition and exercise, but it’s imperative to listen to them.

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This article was originally published on sheknows.com.