GLP-1 Medications for Teenagers

Most of what we know about GLP-1 medications comes from adults. But obesity often starts in childhood, and families have asked whether these medications can be used in teenagers too. Regulators have approved at least one for ages 12 and up, so it is worth understanding what the main trial in adolescents did and did not show. This is general education, not medical advice, and decisions about a young person’s care belong with the family and their pediatric clinician.

The adolescent trial

In 2022, Weghuber and colleagues published a randomized trial in the New England Journal of Medicine. It enrolled 201 adolescents aged 12 to under 18 who had obesity, or overweight with at least one weight-related condition. Two thirds received once-weekly semaglutide and one third received a placebo. Everyone also received lifestyle counseling, and the study ran for 68 weeks.

• BMI fell by an average of about 16 percent in the semaglutide group and rose by about 0.6 percent with placebo.
• About 73 percent of teens on the medication lost at least 5 percent of their body weight, compared with about 18 percent on placebo.
• About 90 percent of the teens completed treatment.

Doctors often track BMI rather than weight in growing young people, because height is still increasing.

What happened afterward

The trial also followed participants for a short period after the 68 weeks. By week 75, the average BMI in the medication group was about 13 percent below where it started. That is a smaller change than at week 68, which suggests that some of the effect faded once treatment ended. This echoes what adult studies describe in our guide to what happens when you stop a GLP-1 medication.

Safety and side effects

The researchers described the side effects as similar to those seen in adults, with stomach-related problems the most common. Five teens in the medication group developed gallbladder disease, compared with none on placebo. For a closer look at what adult participants reported, see our article on side effects in the big GLP-1 trials. Eating enough protein and drinking enough fluid matter for anyone on these medications, and especially for growing bodies, as we describe in eating well while taking a GLP-1 medication.

Questions this trial cannot answer

• Long-term safety. The trial lasted a little over a year, and adolescents who start a medication may take it for many years.
• Growth and development. Teens are still growing, and longer follow-up is needed to understand effects over time.
• Emotional wellbeing. Weight is a sensitive subject for young people, and the way families talk about it matters. Our article on weight stigma explains why.

Where this leaves families

A medication is one option within a broader plan that includes food, movement, sleep and support. Eligibility rules differ by product and by country, so a pediatrician or an obesity specialist is the right person to ask. Our guide to who qualifies for a GLP-1 medication covers the adult criteria.

Sources

• Weghuber D, Barrett T, Barrientos-Perez M, et al. Once-weekly semaglutide in adolescents with obesity. New England Journal of Medicine, 2022;387:2245-2257 (figures from the abstract and trade coverage of the results; details of the post-treatment period come from secondary summaries).
• U.S. Food and Drug Administration. Prescribing information for the adolescent indication (a secondary source reports approval for ages 12 and older in January 2023; check the current label).