Experts: Weight loss meds offer options for some teens with obesity

When healthy eating and exercise interventions don't work, weight loss meds may help teens with obesity. But there is an "urgent need" for guidelines.
two yellow pills on white

Weight loss medications could offer an effective option for teens with obesity that has not improved with other measures, health experts say.

Almost one of five youth struggle with obesity. In a new opinion piece, researchers outline an urgent need for evidence-based guidance on the use of obesity pharmacotherapy for adolescents.

“There is an emerging population of adolescents ‘stuck’ in between lifestyle modification therapy and bariatric surgery for which obesity pharmacotherapy may be helpful,” writes corresponding author Gitanjali Srivastava, assistant professor of medicine in endocrinology, diabetes, and nutrition at the Boston University School of Medicine.

For the paper, which appears in Obesity, researchers reviewed published data about pediatric obesity pharmacotherapy and discuss the risks of prescribing obesity medications approved for adults to youth.

They also recommend that only well-trained experts prescribe any obesity medications for adolescents and advocate for more research resources for pharmacological intervention trials in youth.

Pediatric obesity links to many poor health outcomes both in youth and adulthood, including diabetes, sleep apnea, liver disease, high blood pressure, muscle and bone problems, heart disease, and mental health problems.

Obesity during adolescence can even predict how likely an individual is to die from diabetes in his or her 60s. Common treatments for obesity in adolescents include lifestyle interventions and weight reduction surgeries, but medications for weight loss remain relatively underutilized, according to the authors.

Pediatric obesity is an emerging field, and there are no official guidelines to help clinicians manage patients with medications that were originally introduced in the adult population.

In the paper, the authors offer guidance on current best practices in using obesity medications in pediatric populations and review 10 medications for this purpose.

Clinicians should still try interventions for healthy eating and exercise first and they should continue concurrently with medication therapy later on, the researchers say.

Adolescents with severe obesity or those who have obesity-related medical conditions are appropriate candidates for weight loss medications, and patients and family members should actively participate in decisions to start medications and know the potential risks and benefits.

The FDA has not approved some weight loss medications for pediatric use, necessitating careful discussion of potential side effects. Special considerations of side effects, such as potential impacts on growth and puberty, apply to the pediatric population.

“We hope this opinion piece on pediatric obesity pharmacotherapy will be followed by more clinical trial data, specialized pediatric obesity medicine training programs, the development of protocols and screening tools, and ultimately formal recommendations on the clinical use of medications to treat pediatric obesity,” Srivastava says.

Source: Boston University

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