* Nearly 14.7 million American children live with obesity, leaving parents unsure of how to help them.
* One mom shares her child’s lifelong journey with obesity and how she turned to anti-obesity medication for help.
* In January 2023, the American Academy of Pediatrics recommended anti-obesity drugs like Wegovy for adolescents with obesity.
[Both names were changed in this story to protect their privacy]
Jillian's eldest child, Lucy, struggled with maintaining a healthy weight her entire life.
"My spouse and I engage in regular physical activity; we're quite athletic, and we comprehend how dietary choices and physical exertion can enhance one's life. It was extremely challenging to witness this persist for years without being able to intervene," Jillian shared with Healthline.
They observed their daughter facing ridicule for her weight from peers, mentors, and other adults.
"For a teenager grappling with significant obesity, the social and emotional toll is evident. We reached a juncture where we questioned what could awaken her to the possibilities of a different life," Jillian reflected.
Over time, they emphasized the importance of consuming nutritious foods and engaging in physical activity to help Lucy improve her health. During the pandemic, their concerns about her obesity were amplified as it was identified as a risk factor for severe COVID-19 illness.
"She was 16 at the time. We believed that presently, she might be fine, but if she continues down this path and falls ill in her 40s, 50s, or 60s while being overweight, it could be disastrous. We consistently approached the issue from a health standpoint," Jillian explained.
Throughout Lucy's adolescence and teenage years, Jillian and her spouse connected her with a dietitian and offered to cover the expenses for a customized meal plan, personal training sessions, and a gym membership.
"We proposed this for years, but it always faced considerable resistance," Jillian mentioned. "I believe the magnitude of weight loss she needed was so daunting to her that she refrained from attempting anything."
Turning to medication when no other options seem possible
In 2022, during a stroll with her friend, Dr. Angela Fitch, a specialist in obesity, Jillian confided her struggles in aiding Lucy to shed weight. Fitch enlightened her about Wegovy, an anti-obesity GLP-1 medication approved for individuals over 12 years old.
"I had absolutely no intention of seeking a medication to revolutionize her life. I was hopeful that it would occur organically, either through physical activity or dietary adjustments, or both," Jillian disclosed.
While she anticipated Lucy's resistance to the medication, akin to her reaction to lifestyle modifications, Lucy surprisingly expressed interest.
In November 2022, at the age of 18, Lucy commenced Wegovy under the supervision of Fitch, who serves as the chief medical officer at knownwell. The medication is covered by Lucy's parents' insurance.
"The data indicates that individuals fare better with medication than without. This holds true for many illnesses—asthma, depression," Fitch informed Healthline. "For centuries, we've attributed individuals' inability to control their obesity solely to willpower. What we've come to realize is that you can't always overcome biology with sheer willpower. Altering biology is challenging."
In fact, research suggests that the majority of adolescents aged 12 to 19 with obesity, comprising 22% of the demographic, struggle to manage the condition.
In January 2023, the American Academy of Pediatrics (AAP) advocated for anti-obesity medications like Wegovy for adolescents in its Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity.
Fitch contends that the question shouldn't revolve around why doctors are prescribing anti-obesity medication to children, but rather why they aren't.
"If we refrain from medicating them, they could potentially face premature death, suffer from diabetes, sleep apnea, hypertension, heart disease, kidney disease, high blood pressure at an earlier age. Why wouldn't we want to assist them in avoiding that?" she questioned.
After 14 months on Wegovy, Lucy has shed nearly 70 pounds. Jillian attested that the weight loss has profoundly transformed her daughter's life.
"She graduated from high school last year and is currently thriving in college, thoroughly enjoying herself," Jillian remarked. "Previously, she was withdrawn. She wouldn't consider trying new things or engaging with people. Now, she embraces every opportunity and exudes a newfound happiness. She's a completely different individual."
What parents should consider before putting kids on anti-obesity medication
While studies indicate that GLP-1 medication is safe for adolescents aged 12 and above, and that the benefits outweigh the risks for those with obesity, Dina Peralta-Reich, MD, a fellow of the AAP and the Obesity Medicine Association, emphasized the importance of utilizing these medications under appropriate supervision.
"The supervision must be provided by an experienced individual who comprehends the unique physiology of children, as it differs significantly from that of adults," she conveyed to Healthline.
Before initiating medication, children and teenagers should consult their pediatrician or pediatric endocrinologist, who can evaluate whether a GLP-1 medication is suitable for them.
Peralta-Reich underscored that medication should not be prescribed before attempting to incorporate healthier dietary and lifestyle habits, addressing triggers, and including physical activity.
Fitch concurred, dispelling the misconception that people resort to anti-obesity medications as an effortless solution.
"As parents, we make decisions cautiously. Parents arrive seeking assistance for their children after attempting various strategies to manage their condition without resorting to medication," Fitch remarked.
She urges patients to prioritize lifestyle interventions. Nonetheless, when these interventions prove ineffective, medication may be considered.
"At times, the interplay between the environment and the human body, coupled with genetic factors, cannot be rectified solely through lifestyle modifications," Fitch pointed out.
She emphasized the importance of seeking assistance from physicians well-versed in treating obesity as a medical condition.
"Many children lack access to obesity care and are repeatedly advised to consume five servings of fruits and vegetables daily, limit screen time to two hours, and engage in one hour of exercise. However, we must strive to adapt to our environment in the most beneficial manner possible," Fitch stressed.
Because Wegovy and other anti-obesity medications are administered via injections, Peralta-Reich recommended parents educate their children on proper usage.
For older adolescents capable of self-administration, she emphasized ensuring they comprehend the correct dosage and frequency of medication intake. For younger children, parents should administer the medication.
"It's essential for patients to have regular follow-up appointments with their physician. This isn't like visiting the doctor once every two months; patients should see their physician at least once a month, or even more frequently," she emphasized.
Consider side effects and long-term use for kids using anti-obesity medication
Parents should seek information regarding the potential adverse effects of GLP-1 medications and how to mitigate them based on their child's lifestyle and dietary habits, according to Peralta-Reich.
For Lucy, the repercussions of consuming alcohol at college gatherings are a stark reality. If she exceeds one drink, she experiences illness, causing distress.
"She desires to embody the typical college experience, to the extent that she contemplated discontinuing the medication due to alcohol consumption. However, she hasn't altered her eating habits or maintained regular exercise, so reverting to her previous state is inevitable," Jillian disclosed.
Peralta-Reich emphasized the importance of considering the potential long-term complications of medication.
"For instance, if the child has yet to undergo puberty, parents should discuss how the medication may impact their growth," she noted.
While Lucy has surpassed this developmental stage and transitioned into early adulthood, Jillian expressed her reluctance for her daughter to remain on medication indefinitely.
"Despite the transformative impact on my daughter's life...I recognize that this is an ongoing issue, and this prescription could become a lifelong commitment. I don't wish that for her," Jillian confessed.
She remains optimistic that the weight loss Lucy has achieved with Wegovy will initiate a shift towards healthier lifestyle choices, eventually rendering medication unnecessary.
"It must stem from her. It cannot be imposed by me," Jillian emphasized. "I am not thrilled that she relies on a drug to maintain this state, but the benefits far outweigh any concerns. She's immensely content."
