Revolutionary new drug Wegovy is changing the game for childhood obesity – find out how!

To understand whether Wegovy should be used as part of the solution to childhood obesity, you must first understand the problem.

That's not always easy, even for a doctor, says Megan Kelsey, MD, medical director of lifestyle medicine and adolescent bariatric surgery at Children's Hospital Colorado.

Kelsey admits that early in her career she didn't fully understand the complexities of childhood obesity, blaming it on personal choices that could be reversed with willpower and exercise.

It took time to understand how genetic, physiological, socioeconomic, and environmental factors contribute to childhood obesity and how misconceptions stigmatize the disease and form barriers to treatment.

“If it takes me a little time to recover, imagine the people who don't work with these patients every day and have no training in physiology. It’s harder for them,” she says.

It is an urgent problem in a country where 15 million children and adolescents suffer from obesity.

“Many people think that children will outgrow it and… we now have many years of research to show that that is not the case,” he says.

Semaglutide works by mimicking the hormone glucagon-like peptide 1 produced in the intestines, which controls appetite and cravings. While our natural GLP-1 leaves the body quickly, semaglutide has long-lasting effects.

In the form of Ozempic and Rybelsus, semaglutide has been used to treat diabetes for years, but its approval in 2021 for weight management grabbed headlines. Demand has skyrocketed.

Testimonials from social media influencers and entertainers like Tracy Morgan, Sharon Osbourne and Oprah Winfrey did little to cool demand, and financial analysts predict that weight-loss drugs like Wegovy could make up a $100 billion market. dollars by 2030.

There appears to be a good reason for the semaglutide rush. Studies show that it is not unusual for people who take it to maintain a 15% reduction in body weight, which is encouraging when you consider that losing just 5% to 10% can significantly improve health and quality of life.

As with so many diseases, obesity treatment outcomes improve with early intervention, which is why many scientists and doctors were eager to test semaglutide in younger people with obesity.

An article from December 2022 in the New England Journal of Medicine Children who injected semaglutide weekly for 68 weeks, while receiving lifestyle counseling, were found to reduce body mass index by an average of 16%.

They also showed improvements in waist size, cholesterol, triglycerides and other areas. Semaglutide appears to work even better in children than in adults, according to the study, noting that why requires more research.

The only more effective treatment is bariatric surgery, a much more invasive and risky procedure, says Aaron Kelly, PhD, co-director of the Center for Pediatric Obesity Medicine at the University of Minnesota School of Medicine. He and his colleagues analyzed the NEJM findings from last year and found that almost 45% of children saw their weight drop below the baseline level of obesity.

The results are so impressive that one month after the NEJM study the American Academy of Pediatrics Doctors recommended considering semaglutide, along with exercise and nutrition counseling, among options for treating children 12 years and older with obesity.

Side effects include nausea, vomiting and diarrhea, but that's fairly common for many widely used medications, experts say.

Doctors and parents may be more cautious about reports of decreased muscle mass and bone density. In rare cases (less than 1%) patients can have serious side effects such as gallstones or pancreatitis, and some doctors say more research is needed to help determine long-term effects on a still-developing brain.

It's up to doctors to clarify the side effects, Kelly says, but ultimately the risks must be balanced against the serious effects of untreated obesity.

Make no mistake: Semaglutide is no magic bullet, Kelly says, noting that the AAP guidelines recommend exercise and improved diets along with the medication. Rather, she says, semaglutide is more of a set level, “making the playing field a little more level” for patients to make healthy changes.

Studies show that adults taking Wegovy regained 2/3 of their lost weight within a year of stopping the drug, so it's possible, even likely, that a child could be taking semaglutide for life, says Amanda. Velázquez, MD, director of obesity medicine at Cedars-Sinai Center for Weight Management and Metabolic Health.

People with type 2 diabetes will need insulin indefinitely. Patients with asthma may use enhanced steroids for years or longer. People with high cholesterol often use statins (one of the most common prescription drugs on the market) long-term as well.

“If you're trying to change the biology with a drug and you take it away,” Velázquez says, “the body goes back to what it wants to do.”

Parents may balk at the side effects, but Velázquez says they are “unremarkable” for this type of medication, and the side effects of semaglutide for patients with obesity are no different than the side effects for patients with diabetes who They have been using the drug for years.

Velázquez is more concerned about the $1,400-a-month price tag, which puts it out of reach for many families, and insurance companies are reluctant to cover semaglutide solely for weight loss. But there will eventually be generic versions, and pharmaceutical companies are scrambling to develop other weight-loss drugs.

Prejudice and ignorance regarding semaglutide and childhood obesity (among patients, parents, and even doctors) can be a serious impediment, Velázquez says. There is often a notion that children must “prove themselves” to receive medications like semaglutide, he says.

“We don't meet these prerequisites with type 2 diabetes, high blood pressure or heart attacks,” he says. “Ignoring and not treating would be bad practice.”

Even the AAP guidelines recognize that stigma is a harmful side effect of obesity. It can keep patients out of the doctor's office for fear of being judged. To combat stigma, it is up to doctors to understand and “raise awareness about the relevance of the social and environmental determinants of childhood obesity,” the guidelines say.

In consultations, Kelsey at Children's Colorado downplays weight and encourages young patients and their parents to understand that obesity is a chronic, complex disease — “not a moral failing,” she says — and that medications like Wegovy are one of the many potential paths to good health. Determining the right course is very personalized, she and Velázquez say.

“People beat themselves up and say, 'I can do it.' You can, but your body doesn't want to,” Kelsey tells them. “You may find it helpful to have a little help to change your health in a more permanent way.”