As the popularity of weight-loss drugs like Ozempic and Wegovy continues to rise, their use is no longer limited to adults but has extended to adolescents, including those who have undergone bariatric surgery. Dr. Michael Kochis, a resident in the Department of Surgery at Massachusetts General Hospital, recognized the lack of research on the use of these drugs in adolescent bariatric surgery patients. He and his team conducted a study to examine national practice patterns and address safety concerns for younger users. Dr. Kochis recently spoke with the Harvard Gazette about their findings and the broader implications for pediatric care.
Safety of Weight-Loss Drugs in Adolescents
The safety of GLP-1 receptor agonists, such as Ozempic and Wegovy, has been increasingly validated, particularly in adults. However, the data on their use in children and adolescents remain sparse. “While these drugs have passed the necessary safety checks to receive FDA approval, and ongoing monitoring continues post-approval, the side effects—such as nausea and a constant feeling of fullness—are not universally well-tolerated,” Dr. Kochis explained.
For pediatric patients, the available data are significantly less robust. “The challenge is that these drugs are less frequently prescribed to younger patients, making it harder to gather large datasets,” he added. The study underscores the importance of collecting comprehensive data to ensure the safety and efficacy of these drugs in the pediatric population, given that their effects might differ from those observed in adults.
Focus on Bariatric Surgery Patients
Dr. Kochis and his team chose to focus their research on adolescent bariatric surgery patients rather than the general adolescent population. “Our group specializes in bariatric surgery, and we’ve noticed a growing interest in the use of these medications among our patients,” he said. The unique physiological changes that occur due to bariatric surgery, including alterations in metabolism and hormone balances, present additional considerations when using these weight-loss drugs.
“The surgeries themselves cause significant changes in the body’s metabolism and hormone levels, and it’s unclear how these alterations might interact with the effects of GLP-1 receptor agonists,” Dr. Kochis noted. The research aimed to explore these interactions before, during, and after surgery, providing critical insights into the appropriate use of these medications in this specific patient group.
Study Findings: Usage and Variation
The study revealed two key findings. First, the use of these medications among adolescents undergoing bariatric surgery is already widespread. “Essentially, the cat’s out of the bag—it’s happening,” Dr. Kochis stated. Second, there is considerable variation in how these drugs are used across different institutions, leading to uncertainty about the best practices.
“We’re in uncharted territory,” Dr. Kochis emphasized. “There’s a recognition that each institution is approaching the use of these drugs differently, and no one really knows what the right or best answer is.” This variation presents an opportunity for institutions to come together, share their experiences, and work towards establishing consensus-based or evidence-based best practices.
The Need for Collaboration and Data Sharing
The discovery of such variation in practice patterns highlights the need for collaboration among pediatric bariatric centers. “This study should spark discussions and encourage providers to start sharing their experiences with their peers,” Dr. Kochis suggested. By doing so, institutions can collectively determine the most effective strategies for using these medications in the context of pediatric bariatric surgery.
The variation in practices also suggests that some approaches may be more effective than others, raising concerns about the quality of care. “Once we have a better understanding of the optimal use of these medications, there will be opportunities to standardize care,” Dr. Kochis said.
Future Research and Implications for Parents
Looking ahead, Dr. Kochis emphasized the need for more data and collaboration. “Pediatric surgery is relatively rare compared to adult surgery, making it an ideal area for collaboration and knowledge-sharing,” he explained. Mass General is currently working to establish a collaborative focused on pediatric metabolic and bariatric surgery, which will involve pooling data from various institutions to enhance the quality of research and care.
Dr. Kochis also advised parents to approach these medications with caution. “It’s great that parents are informed about these options, but it’s crucial to have a multidisciplinary discussion with their child’s healthcare providers before making any decisions,” he warned. The use of these drugs should be tailored to each patient’s unique circumstances and should not be influenced solely by media portrayals or celebrity endorsements.
In summary, while weight-loss drugs like Ozempic and Wegovy hold promise, their use in pediatric bariatric patients requires careful consideration, further research, and collaborative efforts to ensure their safe and effective application.
