How to Approach Weight-Loss Drugs for Children

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The United States childhood obesity epidemic has been old news for some time. That is until the new weight loss drugs hit the market. The American Academy of Pediatrics is telling parents it is safe for children over 12 years old to take weight loss drugs like Wegovy after the Food and Drug Administration approved it for people age 12 and older.

Twenty-two percent of adolescents age 12 to 19 have obesity. Many of these children will be told to diet and exercise instead of being told it is a chronic disease that is caused by genetics, poor living environments, food deserts, mental health conditions, pharmaceuticals, pollution, exposure to endocrine disruptors, and myriad other contributors that affect how our bodies store energy. Much of the current research shows that most children with obesity will not overcome the condition through diet and exercise because obesity is not caused by a lack of willpower.

The 6 percent of children and adolescents with severe obesity, which is defined as having a body mass index at or above 120 percent of the 95th percentile for height and weight, will most likely be deprived of these lifesaving drugs due to resistance to prescribed new drugs to children, the exponential costs of the drugs, and a parent's lack awareness. Sadly, many children with severe obesity develop diabetes, heart disease, high blood pressure, kidney failure, and eye damage.

When is it in the best interest of the child?
The ethical concern becomes, when is it in the best interest of the child to prescribe a new drug with no long-term safety research documented? I can only imagine the struggle parents and physicians will have to determine whether the drug's unknown harm outweighs the benefit of helping reduce a child's weight to alleviate comorbidities such as hypertension and diabetes.

A recent clinical trial being conducted by Eli Lilly is testing the drug in children aged 6 to 11. That study is in its earliest phase. Among children ages 2 to 5, more than 1 in 8 (13.4 percent) have obesity. Among children and youth ages 6 to 11, more than 1 in 5 (20.3 percent) have obesity. And it is not just a US problem. There is a global rise in severe obesity in children and adolescents. Data recorded from 1967 to 2017 showed that 9 million children and adolescents demonstrated a 1.7 increase in the prevalence of severe obesity.

Wegovy works by helping children feel less hungry and stopping food cravings. So far, the side effects reported include nausea and vomiting, which is similar to the experience of adults taking the drug. But what researchers don't fully understand is how the drug works. And what the long-term effects will be on children's developing bodies. Parents and physicians are reporting one significant barrier to getting the drug for children most in need, health insurance companies.

For parents with private insurance, pediatricians must submit pre-approval forms. And for parents who use Medicaid, weight loss drugs are not even an option.

Medicaid will not pay for weight-loss drugs, no matter how severe the obesity. And because adults have had access to the drugs before the FDA approval for children, there are shortages. It has been reported that parents looking for the drug for their children are unable to find it in pharmacies.

Remember, these weight loss drugs are for children with severe obesity with life-threatening comorbidities such as diabetes, hypertension, kidney failure, and heart disease. They are not for children who want to lose weight for the sake of losing weight.

We must continue to help children who have gained too much weight too fast. They should feel cared for, loved, and safe. Let's continue to ask important questions: How do we prevent children from experiencing fat-shaming, weight bias, and bullying in our culture? How do we compassionately and kindly care for children who are going through changes in their weight?