Weight-loss drugs and children: What doctors say about the safety, effectiveness of the medications

There is a divide among some physicians about if and when children should use weight-loss drugs, which have surged in popularity among adults. 

In a recent study published in the New England Journal of Medicine, researchers found that Novo Nordisk’s drug liraglutide, sold under the brand names Saxenda and Victoza, led to a reduction in body mass index (BMI) in children between 6 and 12 years old who have obesity. 

Currently, the drug is only approved by the Food and Drug Administration (FDA) for the long-term treatment of obesity (with or without Type 2 diabetes) in children who are at least 12 years old.

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“No medications are currently approved for the treatment of nonmonogenic, nonsyndromic obesity in children younger than 12 years of age,” the study said. “Though the use of liraglutide has been shown to induce weight loss in adults and adolescents with obesity, its safety and efficacy have not been established in children.” 

Novo Nordisk, which also manufactures semaglutide and sells it under the brand names Wegovy and Ozempic, told FOX Business that it remains “committed to long-term leadership, advancing scientific understanding and improving the lives of people in all populations with obesity, including adolescents and children.” 

Some physicians told FOX Business that these types of studies highlight the significant potential for these drugs to help children who are at risk of developing conditions like diabetes. 

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Dr. Pat Basu, managing partner at Varsity Healthcare Partners, told FOX Business that it is probable that several children are going to benefit from this. 

“It’s important to remember, really, that the childhood obesity problem is an epidemic,” Basu said. 

From 2017 to March 2020, obesity prevalence was 20.7% among those between the ages of 6 and 11, and 22.2% among adolescents between the ages of 12 and 19, according to the Centers for Disease Control and Prevention (CDC).

“That absolutely leads… to things like diabetes, heart disease – they could even begin to get problems in their joints, so there is a real need for better options,” Basu said. 

Basu argued that it can be very easy for people to say “just eat less sugar.” 

While he agrees that these lifestyle changes are vital for both adolescents and adults on these drugs, sometimes it’s not enough. 

“Diet and exercise are always the No. 1 thing,” he said. But, for a lot of kids, it doesn’t work because of certain factors like their metabolism or other socioeconomic factors, he added. 

Before making any decisions, Basu encourages parents to evaluate the research and to talk to their pediatrician. 

“A pediatrician and a medical doctor and their parents should be making this decision together, because I think it is the ethical responsibility to be able to tell parents, ‘yes, there might be some benefit here. But just to be clear, we don’t necessarily know what the consequences are in 30 years or 40 years,'” he said. 

What is known is that “if this obesity continues for the next 30 years, your child will almost certainly have very bad cardiovascular problems, very bad blood vessel problems and kidney problems as a result of their diabetes,” Basu said.

New York City-based weight loss doctor Sue Decotiis argued that it’s essential to keep in mind that a very young child is not feeding themselves, and that families need to evaluate what their kids are eating first and foremost.

“There’s a procedure doctors should be following first before they resort to weight-loss drugs” when a child is overweight or obese, Decotiis said. For one, you need to find out if and how much junk food the child is consuming, she said.

“I would first recommend getting rid of the junk food and having a huge lifestyle intervention with the family. You can’t just put a kid on one of these drugs,” Decotiis said. “It’s really not a good idea. It goes against the training we receive as doctors.” 

Decotiis said she would never approve of putting a child under the age of 12 on one of these medications, adding that “sometimes you see kids outgrow their fat when they start growing into their bodies.”

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Meanwhile, Dr. Tro Kalayjian, an internal medicine and obesity medicine physician, agreed that these drugs “should be used as a last resort when wholehearted lifestyle measures fail.” 

“These drugs are amazing drugs and have good initial data, but doctors need to use them responsibly, not hand them out in seven minutes after merely telling patients to eat less or eat the food pyramid,” he said. 

Kalayjian said there needs to be “holistic, multi-disciplinary teams to actually help children and families who struggle to make healthy food choices in a truly toxic modern-processed food environment.”