- Kids as young as 12 can now take Wegovy, an injectable weight-loss medication.
- Two parents shared why they decided to put their children on Wegovy.
Natalie is 12, with dark hair and perfectly arched eyebrows that hint at her flair for the dramatic. The seventh grader loves acting class and dance and has comedic timing beyond her years.
But there's something strained and fragile under her humor, especially when she talks about certain subjects, such as mealtimes or gym class.
Like her mother, Kailey, Natalie has polycystic ovarian syndrome, a condition in which the ovaries overproduce testosterone, causing an array of unpleasant symptoms and, in many cases, insulin resistance and a propensity to gain weight. Insider is using Natalie and Kailey's first names to protect their privacy.
Kailey, 36, started taking the type 2 diabetes drug Mounjaro off-label in August 2022 to help with some of these symptoms, including weight gain. About nine months later, she started her preteen daughter on a similar medication, Wegovy.
For Kailey, the decision to put her 12-year-old on an injectable weight-loss medication was complicated. She mulled over the decision for a year, researching Wegovy and taking note of her own experience on Mounjaro. Her worst fear, she told Insider, was that her daughter might develop an eating disorder.
But she also agonized over Natalie's future health, including her insulin resistance and the symptoms of depression that Natalie had started to develop in middle school as she became more concerned about fitting in with her peers. Kailey decided she had to try something.
"She's a kid, so I'm wary about the things we put in her body, but she came home one day crying," Kailey told Insider. "She's perfect, and we tell her that all the time, but I don't want to minimize how she's feeling, and we're coming at this from the standpoint of treating a disease."
Kailey is just one of many parents walking a fine line: trying to instill body confidence and positivity in a child while putting them on weight-loss medication — potentially for life.
Wegovy is the most effective medication for adolescent obesity
In December 2022, the Food and Drug Administration approved Wegovy to treat obesity in children between the ages of 12 and 17 who have a body mass index higher than 95% of kids of their age and sex. Like its sister drug, Ozempic, it belongs to a class of drugs known as GLP-1 receptor agonists.
These drugs help to regulate blood sugar by prompting the pancreas to make more insulin. They also slow down digestion and stop the brain from feeling hunger signals.
Less than two weeks after the approval, the American Academy of Pediatrics released controversial guidelines recommending weight-loss medication as a treatment option for children aged 12 and up with obesity.
When the news came out, Dr. Claudia Fox, the codirector of the Center for Pediatric Obesity Medicine at the University of Minnesota, was excited. "My first thoughts were, 'I'm super happy, thrilled, and relieved to finally have effective therapies for our patients,'" Fox told Insider.
Fox said there had historically been few options for children who have health issues related to weight. "I've been doing this work for a long time, and for 10 or 15 years, we've mostly been using medications in an off-label manner — medications that are not FDA-approved for the specific indication of childhood obesity," Fox said.
There are only three other medications that are FDA-approved to treat obesity long-term in children as young as 12 years old: Qsymia, Alli, and Saxenda. But studies have shown that adolescents lose the most weight on Wegovy.
Although more than one in five American kids between the ages of 12 and 17 qualify to take Wegovy based on their BMI, far fewer are actually on the drug. The relatively recent approval, national shortages, and a $1,300-a-month price tag mean the number of kids on the drug is much lower than it could be. Fox told Insider that only about 1% of her patients were on Wegovy.
Parents have to balance treating obesity with fighting weight bias
Rasheeda, 47, was skeptical when her doctor first told her about Ozempic three years ago. She'd heard the gruesome tales of gastrointestinal side effects such as uncontrollable vomiting and diarrhea and turned down the medication at first. But no other strategy to lose weight had worked."I had tried for years to lose weight, I had been eating healthier and eating normal portions — even my friends are like, 'You really don't eat a whole lot. I eat more than you' — but my body just would not release the weight," she told Insider.
But after a year and a half of taking the weight-loss medication, she's lost 100 pounds.
Then Rasheeda watched as her 16-year-old son, Brian, repeated her struggle. Rasheeda asked for herself and Brian to be identified by their first names to protect their privacy.
Rasheeda stopped frying food and cut out processed ingredients. Brian went to the gym five days a week, but he continued to gain weight. Metrics such as Brian's cholesterol and liver enzymes improved with cleaner eating, but his blood-pressure readings teetered on the verge of worrisome.
It was clear to Rasheeda that lifestyle changes alone hadn't been enough for her to lose weight, and they weren't for her son. After a year of research, Rasheeda sought out a pediatrician who would prescribe Wegovy to Brian; he started taking it this past February.
Brian's father is diabetic, and Rasheeda hopes to help her son avoid the same fate.
Brian has a different motivation. He wants to be able to do more physical activities. Plus, he's sick of being teased at school, and he sees weight loss as a way to "do something about it," Rasheeda said.
"The thing that hurt my heart the most was that one day, I was telling him how handsome he was, how beautiful he was, how he had a good heart, and he started crying and saying, 'I'm not handsome,'" Rasheeda said. She said she reminded him: "'You have this weight, that doesn't define who you are.' I want to get him really loving who he is in his body right now, and that the weight is just going to be a side effect."
Since starting on Wegovy, Brian's portion control has improved markedly, and he's lost about 20 pounds. Moving around is easier for him.
"My energy is better now. I'm outside doing more things like walking my dog and playing sports, and I feel more confident playing basketball now because I can move more," he told Insider.
He now sees a doctor who prescribes the weight-loss medication, as well as a nutritionist and a psychologist, as part of his treatment plan.
Natalie is also happy about the changes she's seen in her body.
"I feel like I can do more, like in my acting classes," Natalie said. "I didn't want to do anything physical before, and now I can dance."
Not everyone thinks that kids should be on weight-loss medications
While Natalie and Brian have both told their parents that they're glad to be on weight-loss medications, the journey hasn't been easy.
Brian said that at first, he had "a lot of side effects," such as cramps and diarrhea, though he said those had gotten better.
Natalie's main side effect has been nausea. She feels lightheaded if she eats foods that are low in nutritional value. Instead, she needs protein and is bemused by her newfound cravings for Panera salads and fruit. Processed foods, such as pizza or tater tots, now make her feel sick or even vomit. Sweets have lost their draw because they make Natalie's head and jaw feel tight.
Many medical experts remain divided over whether larger body sizes are inherently unhealthy, and the BMI system has been called into question as a metric of health for years."You can be metabolically healthy at any weight, and weight does not necessarily equal health," said Dr. Karla Lester, a Nebraska-based pediatrician and obesity-medicine specialist who recently founded her own telehealth platform to offer metabolic treatment and coaching to adolescents.
She's in favor of the use of medications such as Wegovy for certain kids but is against "diet culture" and purely BMI-based assessments of pediatric health.
"If it's not a problem for them, then it's not a problem for me," Lester said of a child's weight or BMI.
Dr. Elizabeth Wassenaar, a regional medical director at the Eating Recovery Center, worries that the AAP's recommendation that children be medicated or undergo surgery for weight loss — and the recent hype around weight-loss medications — could increase harmful biases.
"It reinforces the message that you need to look a certain way to be successful, happy, and healthy," she told Insider.
For parents, there can be an extra layer of pressure. "We live in a society where there is tremendous pressure to not screw up your kids, and the idea gets reinforced that if you let your kid be in a larger body, you've somehow failed as a parent," Wassenaar said.
Intentionally or not, parents sometimes pass those pressures on to their children, who face additional pressures from peers and social media, she says.
Kailey still wrestles with how to talk to her daughter about being on Wegovy. "It's a fine line, and weight doesn't equal health," Kailey said. "But hers is caused by a metabolic disease, and I told her, 'Your weight is going to fluctuate throughout your life, and no matter what, you're perfect, and it's not your fault.'"
She's still glad her 12-year-old is on the drug. She said ultimately, it was "a no-brainer."