Some doctors and obesity experts have praised the effort to tackle the growing crisis, but others say the task force should also consider drug interventions, including the use of semaglutide, an increasingly popular weight-loss drug. Food and Drug Administration Approved Use of the drug Wegovy in children aged 12 years and older in 2022.
“Having the option of pharmacotherapy in the right clinical circumstances is really important,” says Susma Vaidya, associate medical director of the IDEAL Clinic, a weight-loss program at Children’s National Hospital in Washington, D.C. “I’m a big believer in pharmacotherapy, and we’ve been advocating lifestyle changes for a long time, but I don’t think we’ve made much progress.”
in 2023 Randomized controlled trial of semaglutide In a study of 13- to 17-year-olds with a BMI above the 95th percentile, 44% of teenagers who took the drug saw a significant drop in BMI and were reclassified as normal weight or overweight rather than obese.
But as demand for anti-obesity drugs soars, some parents worry they could have long-term health consequences, with reports of side effects including nausea, vomiting and diarrhea. Doctors counter that the physical and mental effects of obesity can be lifelong and seriously disabling.
Obese children are at higher risk of developing chronic diseases such as type 2 diabetes, high blood pressure and heart disease. Childhood obesity can have significant mental and social impacts, including depression and anxiety.
“We don’t have long-term data on weight-loss drugs, so it’s understandable that that’s a concern, but we do have long-term data on outcomes related to obesity, and we know that people who are obese are at risk for certain complications,” Vaidya said.
The Centers for Disease Control and Prevention classifies 20 percent of children and adolescents between the ages of 2 and 19 as obese. As part of its guidelines, the Preventive Services Task Force states that providing 26 or more hours of counseling and supervised exercise for up to a year can result in weight loss in both children and adolescents.
Pediatricians say adding anti-obesity drugs to a weight-loss program can significantly improve a patient’s BMI and should be taken when the benefits outweigh the harms.
“This is a case-by-case decision for each child, but we’re not talking about teenagers who want to lose a few pounds for the summer,” says Mona Sharifi, a pediatrician and researcher at the Yale School of Medicine and a member of the American Academy of Pediatrics. “We’re talking about kids who are being seriously affected, and they need to be offered all their options.”
The task force said weight-loss drugs were not included in its recommendations because they have not been adequately studied in adolescents. John M. Lewis, a member of the U.S. Preventive Services Task Force, said the recommendation emphasizes the importance of conducting additional research before recommending that drugs be included in treatment plans. Recommendations and changes are typically made every five years, but the guidelines could be revised if more evidence emerges about drugs, Lewis said.
“The task force may reconsider its recommendations if there is a fundamental change in our understanding of a health issue,” Lewis said.
Unlike the task force, the American Academy of Pediatrics in 2023 recommended discussing weight-loss drugs with families for eligible patients. The biggest hurdle is getting insurers, including government programs, to cover the cost of the drugs. The Medicare Modernization Act of 2003 limits coverage for weight-loss drugs such as Wegobee, which can cost more than $1,000 a month without insurance.
The CDC says childhood obesity costs the U.S. $1 billion a year in health care costs. Sharifi added that while early intervention could reduce those costs, more people will end up needing expensive drugs and surgeries later on if those programs aren’t funded.
“It’s sad that intensive behavioral therapy programs aren’t available nationwide, despite years of strong evidence-based recommendations,” Sharifi said. “Some pediatricians try to incorporate these interventions into 20-minute consultations with families, but it doesn’t work.”
