Children with high BMIs should not use obesity medications like WeGovy, US doctors warn

In January 2023, the American Academy of Pediatrics (AAP) recommended that healthcare providers offer weight-loss medications, in addition to lifestyle adjustments, to treat obesity in children 12 and older. However, not all health professionals agree with the AAP’s recommendation.

The US Preventive Services Task Force — a panel of more than a dozen doctors and public health experts from various academic institutions — issued a statement pushing for drug-free weight-loss interventions for children who are 6 and older on Tuesday.

“We believe we need more evidence to be able to make a recommendation for or against medications in children and adolescents,” Wanda Nicholson, the task force’s chair and senior associate dean of diversity and inclusion at the George Washington University School of Public Health, told STAT.

“While there were trials evaluating the effectiveness of FDA-approved medications, there was a limited number of trials per medication from our review. And in addition, there was limited evidence on weight loss maintenance after medications were discontinued in children,” Nicholson said.

Lifestyle interventions are still preferred by doctors over drugs

GLP-1 drugs like WeGovy and Ozempic contain semaglutide, a substance that increases a person’s insulin, the natural hormone that regulates blood sugar and tells the body when it’s full.

These injectable drugs have proven successful as weight-loss interventions for adults with obesity, early research shows.

However, this class of drugs has its limitations. Many GLP-1 users have reported weight gain after ceasing GLP-1 use, while others have mentioned side effects like diarrhea, “paralyzed” stomachs, hair loss, and nausea.

The US Preventive Services Task Force voiced concern for these potential side effects in children, as well as an excessive focus on weight instead of health.

Nicholson said clinicians have used lifestyle interventions, like nutrition and exercise plans, to help children with obesity lose weight and reduce risk factors like hypertension, diabetes, and liver disease.

However, the AAP’s and the US Preventive Services Task Force’s recommendations overlap, according to Amanda Staiano, an associate professor of pediatric obesity and health behavior at the Pennington Biomedical Research Center of Louisiana State University.

“The AAP explicitly states that drugs should not be a monotherapy. They are an adjunct to be used in combination with intensive health behavior and lifestyle treatment,” Staino, who was on the AAP’s clinical practice guideline authorship committee, told STAT.