As childhood obesity rates soar, Michigan doctors are increasingly prescribing weight loss medications to young patients as part of a broader treatment strategy.
Rising Concern and Medical Response
Pediatricians like Dr. Lynn Smitherman of Wayne Pediatrics in Detroit are witnessing a surge in children with serious health issues linked to obesity. “I’m seeing more children now — maybe 12 and up — with hypertension, prediabetes, or even full-blown diabetes and requiring surgery to fix knees and hips,” Dr. Smitherman noted.
Smitherman, whose practice includes many overweight children, prescribes weight loss drugs to about two or three out of every hundred patients.
Medical Opinions and Guidelines
Injectable GLP-1 agonist drugs, such as Wegovy, which suppress appetite and mimic the hormone glucagon-like peptide 1, are among the treatments used. However, the medical community is divided on their use in young patients.
The American Academy of Pediatrics supports the use of these medications for children as young as 12 in severe cases, viewing childhood obesity as a chronic disease with biological, social, and structural drivers. The academy’s guidelines also advocate for at least 26 hours of intensive behavioral and lifestyle treatment. Conversely, the U.S. Preventive Services Task Force recently omitted weight loss drugs and surgery from their childhood obesity recommendations, citing insufficient evidence for pediatric use.
A Growing Need
In Michigan, nearly 20% of children aged 10 to 17 are classified as obese, according to the Robert Wood Johnson Foundation. This excess weight predisposes them to chronic health issues, including cardiovascular disease, diabetes, and liver disease, and contributes to psychological and emotional problems.
The FDA has approved several weight loss drugs for pediatric patients, including Saxenda, Wegovy, and Qsymia. Some physicians also use drugs like Ozempic off-label to aid weight loss.
Dr. Justine Bunka of Bronson Rambling Road Pediatrics in Battle Creek prescribes weight loss medications about twice a week, emphasizing the potential long-term benefits. “Having a 12-year-old who’s obese and not being able to get any weight loss medication until they’re 18 is just really six years of letting them get in their way and accumulate more health problems,” she said.
Economic and Health Impacts
Obesity in children is a significant financial burden on the healthcare system, costing more than $300 extra annually per child compared to those of healthy weight. In 2019, these costs totaled approximately $1.3 billion.
The number of adolescents prescribed weight loss drugs has increased more than sixfold since 2020, with 30,947 prescriptions in 2023, according to a study from Michigan Medicine published in the Journal of the American Medical Association.
Concerns and Equity
Despite the promising aspects of weight loss drugs, there are concerns about their side effects and potential misuse among adolescents. Gastrointestinal issues like vomiting and nausea are common side effects. Additionally, young people may see these medications as a quick fix, without understanding the importance of federal approval and clinical trials.
Obesity disproportionately affects children of color and those from low-income families, exacerbating health inequities. Hispanic and Black children have the highest obesity rates, while white and Asian children have significantly lower rates.
Access to weight loss drugs can help address these disparities, but insurance coverage remains a hurdle. Dr. Bunka advocates for broader acceptance and coverage of these medications to improve long-term health outcomes for children.
Looking Forward
The ongoing challenge of childhood obesity requires a multifaceted approach, combining medication, behavioral interventions, and broader societal changes. As understanding of obesity’s complex causes deepens, so does the need for varied treatment options to support affected children and their families.
