Gen Alpha (children 14 and younger) led the rise of GLP-1 utilization from 2023 to 2024, with an 85% growth rate in that period. But what is behind the sharp increase?
3 factors at play
There are several factors behind increased GLP-1 utilization in children.
1. The first is the obesity epidemic. About one-third of pediatric patients have some form of obesity or are overweight, Alvaro Flores, MD, medical director for the Weight and Wellness Clinic at Omaha-based Children’s Nebraska, told Becker’s.
“This epidemic brings with it a host of other issues: diabetes, prediabetes, liver disease, joint problems and reflux, to name a few,” he said. “These comorbidities significantly increase risk as these children become adults.”
2. Social media has played a significant role in individuals’ awareness of their weight and treatments for weight loss. Social media influencers and celebrities are known to push a “thin” body, which has had a powerful impact on the younger generation. This can be especially true for children carrying extra weight.
“They may have tried lifestyle interventions without expert guidance,” Sarah Hampl, MD, professor of pediatrics at the University of Missouri-Kansas City School of Medicine and the Endowed Professor for Healthy Lifestyles at the Children’s Mercy Kansas City Center for Children’s Healthy Lifestyles and Nutrition, told Becker’s. “Social media is flooded with unrealistic advice like ‘lose 50 pounds in 50 days,’ and kids may not have the discernment to know what’s credible. So they — and their families — may try things that are ineffective, without support from pediatricians or trusted healthcare providers.”
Many families are unable to access structured, supervised weight management programs. These programs help families make sustainable changes at home, but medical and insurance communities do not recognize these programs as treatment, Dr. Hampl said.
“Many pediatricians simply don’t have the time to deliver this kind of intensive treatment, and when options are limited, it can be tempting to jump straight to medication,” she said. “But that risks sending the message that weight management is quick or easy — it’s not. It’s complex, and outcomes vary. Some kids may respond well to lifestyle changes alone, while others may need medication or surgery.”
3. Physicians have started turning to GLP-1 drugs to treat childhood obesity and weight management needs partially because of the long-term results and benefits they have seen, Amy Shah, MD, division director of endocrinology at Cincinnati Children’s, told Becker’s.
In 2023, children 12 and older with obesity and children 10 and older with Type 2 diabetes were approved by the FDA to take GLP-1 medications. Most children taking GLP-1s are 12 and older, but a study is testing the effectiveness of GLP-1s on children ages 6-12, Dr. Flores said.
Pros, cons of GLP-1 treatment
GLP-1 drugs show many of the same benefits in children as adults: reduced appetite, better blood sugar control, and weight loss. But it also has some of the same side effects, such as nausea, vomiting, constipation, diarrhea and, in rare cases, hypoglycemia, muscle loss, pancreatitis and impacts to mood, especially in children with a history of mental health disorders. However the long-term reduction of health complications makes these drugs worth it for many families.
“That said, we really stress that treatment for childhood obesity must be comprehensive,” Dr. Hampl said. “It’s not ‘medication or lifestyle changes,’ it has to be both. A big concern is when kids don’t receive that foundational support. As pediatricians, we have this amazing opportunity to help shape lifelong health, and we shouldn’t waste it by treating obesity in isolation with only medication.”
There are also concerns for when patients stop taking the medication, because like adults, many children can quickly regain the weight they had lost after ending treatment.
The long-term outlook
So is GLP-1 utilization in children a trend that will build? Leaders told Becker’s it is likely.
“Diet and exercise are essential, but they don’t work for every child,” Dr. Flores said. “Surgery is another option, but it’s not suitable for everyone. GLP-1s offer a middle ground. Families are more aware of them now, and as insurance coverage improves, use will likely continue to rise.”
Dr. Hampl and Dr. Shah said they are hopeful that the medical community will also increase access to alternative treatment options, including other medications and behavioral services that could have more sustainable changes on patient weight loss and health.
What’s missing
Although GLP-1 drugs have been top of mind for many physicians, there are a few things experts say are missing from the discussion.
1. The most prominent missing element is long-term data. Most of the current studies have lasted a year or less.
“We need to understand the benefits of these medications when initiated early in childhood and whether these medications change the trajectory of chronic conditions like heart disease, fatty liver disease and Type 2 diabetes,” Dr. Shah said.
2. The healthcare system needs to focus on improving access to health food, physical activity and community resources, Dr. Flores said. Physicians also need to help families understand the importance of not turning to compounded GLP-1s or unverified sources.
3. More parent and teen voices should be included in the discussion.
“We need more end-user feedback,” Dr. Hampl said. “Children’s hospitals in particular can play a leadership role here. Some already have, partnering with groups like the [American Academy of Pediatrics] and the Children’s Hospital Association to improve health environments in hospitals and advocate for insurance coverage of comprehensive treatment programs.”
4. Hospitals should lead by example by providing their employees with access to the full suite of obesity treatments, including medications, surgery and lifestyle programs.
“If we expect the community to embrace comprehensive treatment, we should be modeling that internally,” Dr. Hampl said.
