Navigating GLP-1 Medications for Adolescents: A Pediatrician’s Evidence-Based Guide

Introduction

As a pediatrician and plant-based health coach, I’m often asked about the role of medications like Wegovy (a GLP-1 agonist) in managing adolescent obesity. Recently, I shared my insights in a SingleCare article on age restrictions for GLP-1s. In this blog post, I’ll expand on that discussion, exploring the benefits, risks, and critical considerations for families and providers.

Who Is a Candidate for Wegovy?

GLP-1 medications like Wegovy are not a first-line treatment but may be appropriate for adolescents aged 12+ with:

• BMI ≥95th percentile for age/sex

• Obesity-related comorbidities (e.g., hypertension, prediabetes, NAFLD)

• Documented, sustained efforts to improve metabolic health through lifestyle changes without meaningful progress

Contraindications to Screen For:

• Personal/family history of medullary thyroid carcinoma or MEN2 syndrome

• Active disordered eating or body image concerns

• Limited family support or inability to commit to long-term follow-up

The Benefits: What the Research Shows

Clinical trials in adolescents demonstrate:

• 16.1% reduction in BMI over 68 weeks (vs. 0.6% increase in placebo groups)

• Improved waist circumference, blood pressure, HbA1c, lipid profiles, and liver function

• Potential to lower long-term risks of diabetes, cardiovascular disease, and fatty liver

Unique Risks in Adolescents

While effective, Wegovy requires careful monitoring in growing teens due to:

1.     Developmental Impacts

• Caloric restriction may affect bone mineralization, growth hormones, and puberty.

• Nutritional adequacy must be prioritized to support growth.

2.     Side Effects

• GI issues (nausea, vomiting, diarrhea) are common but often improve over time.

• Higher rates of gallstones, rash, and hypotension compared to adults.

3.     Weight Regain

• Discontinuation often leads to rebound weight gain, necessitating long-term planning.

4.     Misuse Potential

• Vulnerable populations (e.g., athletes, teens with body image concerns) require extra caution.

Monitoring: A Non-Negotiable Protocol

Monthly follow-ups (tapering to quarterly) should include:

• Growth metrics: Height, weight, BMI, pubertal development

• Metabolic markers: HbA1c, lipids, liver enzymes, renal function

• Mental health screenings: Anxiety, depression, disordered eating patterns

• Nutritional evaluation: Ensure adequate protein, vitamins, and hydration

Practical Challenges

1.     Insurance Barriers

• Medicaid often excludes weight management medications, creating access disparities.

2.     Cost

• Out-of-pocket expenses can exceed $1,300/month without coverage.

3.     Stigma

• Open conversations are needed to reduce shame around medication use.

My Perspective: A Holistic Approach

As I emphasized in the SingleCare article, Wegovy should never replace lifestyle interventions. My experience as a plant-based health coach has shown me that lasting metabolic health depends on:

• Whole-food, fiber-rich diets

• Regular physical activity

• Behavioral support for lasting habit change

Medications are one tool in a broader strategy—not a standalone solution.

Conclusion
Prescribing Wegovy to adolescents demands individualized care, shared decision-making, and vigilant monitoring. While the metabolic benefits are compelling, we must balance them against developmental risks and systemic barriers like cost and access.

For more on this topic, read my full interview in SingleCare’s “Are There Age Restrictions on GLP-1s?” and explore my blog and social media for more tips and resources.

Have questions? Schedule a free consultation or send me an email!

Dr. Heather Gosnell
Pediatrician | Plant-Based Health Coach | Advocate for Holistic Family Wellness

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