August 01, 2025
2 min learn
Key takeaways:
- AAP started recommending weight-loss drugs for adolescents with weight problems in 2023.
- Suppliers prescribed drugs extra usually after the rules got here out, however way of life drugs stays way more frequent.
Though prescriptions for weight-loss remedy have elevated for adolescents with weight problems within the years for the reason that AAP began recommending them, way of life remedy stays rather more frequent, a research discovered.
The AAP issued a coverage assertion originally of 2023 recommending that physicians supply weight-loss remedy to adolescents aged 12 years or older and consider teenagers for bariatric and metabolic surgical procedure. The authors famous that the rise in prescriptions might be tied to the explosion in curiosity in GLP-1 drugs for weight reduction, in addition to larger acceptance for utilizing anti-obesity medicine.
Davene R. Wright, PhD
“The AAP tips led to criticism and broad public unease about indiscriminate use of those drugs, notably in younger youngsters,” Davene R. Wright, PhD, affiliate professor of inhabitants administration at Harvard Medical Faculty, informed Healio. “The info present this isn’t the case.”
Wright and colleagues in contrast how usually physicians prescribed completely different weight-loss remedies to their pediatric sufferers earlier than and after the AAP revealed its steerage. They analyzed digital well being information from a subset of 30 U.S well being techniques, for 310,503 youngsters and adolescents (45.9% ladies; imply age, 13.2 years) aged 8 to 17 years who have been eligible for weight problems remedy and visited a doctor between Jan. 1, 2021, and Dec. 31, 2024. Roughly half of the visits occurred earlier than the AAP revealed its steerage in January 2023, and simply over half occurred after.
The sufferers’ imply BMI percentile was 97.4 (normal deviation, 1.6), and one-third had class 2 or class 3 weight problems (23.2% and 12.5%, respectively). Most (96.2%) visits the place the clinician was identified have been with major care suppliers, the researchers famous.
Out of 281,807 sufferers who didn’t have proof of diet counseling earlier than their documented go to, 9.7% had proof of way of life remedy through the research interval. Life-style remedy charges elevated over the 4-year research interval, however Wright and colleagues didn’t discover a important distinction in how usually suppliers referred sufferers for diet counseling earlier than or after the rules have been revealed.
In distinction, prescriptions for drugs elevated considerably after the rules have been revealed, based on the authors. An estimated 0.4% of sufferers acquired new prescriptions for weight reduction drugs through the research interval, and clinicians have been 65% extra more likely to prescribe them after Jan. 1, 2023 (OR = 1.65; 95% CI, 1.23-2.21). Prescription charges elevated 5% per thirty days after the AAP revealed its tips.
Metformin was essentially the most generally prescribed remedy earlier than and after the brand new steerage, however the proportion of sufferers receiving metformin decreased afterward (80.2% earlier than vs. 63% after), based on the researchers. In contrast with earlier than the rules have been revealed, the proportion of sufferers receiving semaglutide elevated 10-fold (2.5% vs. 26.8%; P <0.01).
Wright mentioned children who acquired drugs tended to be older and have extra extreme weight problems.
“Life-style intervention stays way more frequent than drugs for weight administration,” she mentioned. Nevertheless, just one in 10 eligible youngsters have been referred to dietary counseling, Wright mentioned, displaying there may be room for enchancment.
Tricia Rodriguez, PhD, MPH
“Continued analysis is required to higher perceive long-term security, effectiveness and entry to care — particularly as medical follow and public discourse evolve associated to using anti-obesity drugs in adolescent populations,” Tricia Rodriguez, PhD, MPH, director of utilized analysis at Truveta, informed Healio.
References:
For extra data:
Davene R. Wright, PhD, and Tricia Rodriguez, PhD, MPH, could be reached at ellief@truveta.com.
