These days, it can feel impossible to avoid hearing chatter about Ozempic, which has become a colloquial catch-all term for a handful of medications aimed at diabetes and/or weight loss. From celebrities and social media influencers to people you know IRL (and a seemingly endless supply of ads with annoyingly catchy slogan songs), losing weight has re-entered the cultural zeitgeist in full force… although plenty would argue it never really went anywhere to begin with.
Just as you likely pored over magazines and watched famous women’s bodies be picked apart on every public platform, your child is almost certainly taking note of the Ozempic obsession, even if you’re doing your best to model body acceptance at home. So what happens when your kid asks you to try one of these weight loss meds? And what do you do if their doctor is the one recommending them?
The 411 on GLP-1s
First, a quick breakdown of the glucagon-like peptide-1 receptor agonists, aka GLP-1 agonists, with buzzy brand names like Wegovy, Mounjaro, Zepbound, and, of course, Ozempic. This class of medications — available in both oral and injectable form — helps manage blood sugar (glucose) levels and slow the movement of food through the digestive system. This can help you feel fuller longer, so you eat less. And yes, many patients lose weight in the process.
The first GLP-1 agonist was approved in 2005 by the Food and Drug Administration (FDA) to treat Type 2 diabetes, but only in recent years have select GLP-1s been approved for weight loss. These drugs are big business, and that business is rapidly growing, with experts predicting $150 billion in annual revenue by the start of the next decade. You’ve probably heard about manufacturing shortages and high costs to consumers, making these meds inaccessible to so many.
Still, it’s impossible to ignore the marriage between these alleged “miracle drugs” and the pervasive fatphobia and policing of bodies, especially marginalized ones, and the ways in which fatness is demonized, both culturally and in medicine. It’s merely one piece of the disparity pie between resources and health — it’s no secret that the American families who have the time, space, money, and energy to cook fresh foods and spend time with their kids outdoors are the same families with easier access to healthcare, including said pricey weight loss meds.
The Semaglutide Stronghold
Most GLP-1 meds are currently only approved for adults 18 and up, but manufacturers and health experts alike have their eyes on tweens and teens. In late 2022, the FDA approved Wegovy as a weight loss treatment for children 12 and over. Days later, in early 2023, the American Academy of Pediatrics (AAP) issued new childhood obesity guidelines recommending weight loss measures (including pharmacotherapy and metabolic and bariatric surgery) in teens 13 and up. So, there’s a chance your child’s doctor will push for weight-related medical intervention.
Of course, eating disorders among children and teens have skyrocketed in recent years, fueled in no small part by social media and screen time. It’s almost impossible for kids to escape filtered, altered images online, contributing to poor body image, dieting, and/or extreme exercise.
The diet pills and “meal replacement shakes” of past decades are now merely a doctor’s visit away, and some experts are warning about their safety among kids whose bodies are still growing and developing. An increased risk of disordered behaviors adds another layer of concern, as Dr. Brian Erly, medical director of EDCare, tells Scary Mommy.
“Because these drugs are new, we don’t have a lot of information about long-term developmental effects of these medications in children and teens,” he says.
Side effects — both physical and emotional — are another major concern, with Erly noting that hypoglycemia (low blood sugar) is a common side effect of diabetes medications, including GLP-1 agonists.
“There are also several potentially serious side effects of GLP-1 drugs, which are currently being investigated,” he adds. “We don’t yet have a clear picture of how GLP-1 drugs might affect the risks of these conditions. Side effects under investigation include medullary thyroid cancer, gallbladder disease, pancreatitis, and suicidal thoughts.”
In short, a weekly shot or daily pill should not be treated as a harmless quick fix for anyone, let alone a child.
Another key thing for parents to consider, per Erly: the-long term necessity of these treatments. “Unfortunately, most adults who stop taking GLP-1 drugs for obesity regain some or all of the weight they had previously lost,” he says. “Similarly, individuals who stop taking these drugs for diabetes have worsening blood sugar control. While there is less data available for adolescents, we would expect a similar phenomenon to occur.”
“Since the long-term effects of these medications on adolescents are not yet well understood, providers should carefully assess individual risk factors before prescribing them,” he adds.
Mind and Body
Erly also warns that emphasis on weight and body size increases the risk of eating disorders during an already vulnerable time in a child’s life. “Body dissatisfaction is the single greatest risk factor for developing an eating disorder in adolescents,” he says. “A care pathway that pathologizes larger body sizes may worsen the physical and mental health of children.”
So, if your child comes to you asking about weight loss meds — or worse, feels pressure to use them from their doctor — you’ll want to keep an open dialogue that is free of shame, stigma, or judgment, as Los Angeles-based eating disorder therapist Rachel Goldberg, LMFT, PMH-C, tells Scary Mommy.
“I think it’s very important for the parent to first and foremost express an open mind and then be curious,” she says. “It may have taken a lot of courage for a teen to bring this up, depending on their relationship with their parent, so it’s important to reassure them that they can talk about it openly and that their request won’t be immediately dismissed or met with a firm ‘no.'”
Understanding your child’s perspective can help you assess the seriousness of the situation, as well as how you can best help them navigate their feelings and their experiences. “This open approach will also allow parents to do research and discuss the pros and cons together,” she adds.
Goldberg notes that because these meds have only recently been approved for children and adolescents, there’s simply not enough data about the risks (or benefits) to their overall emotional well-being. She does note the strong correlation between weight loss and restrictive eating to disordered eating and distorted thoughts about food and body image, especially among tweens and teens.
“These drugs could also exacerbate body image issues, as they may reinforce a negative self-image,” she says. “Teens might begin to put more concentration on their bodies, potentially fueling greater dissatisfaction, especially if a parent’s acceptance of the drug suggests their body is not where it should be.” If a child loses weight on the drug and then is taken off it (due to side effects or access), “they might spiral into a deep depression, an eating disorder, extreme anxiety, or cope in destructive ways — especially if this was believed to be their last hope.”
Accordingly, she cautions, “It’s a very slippery slope to put someone so young on a drug with unknown long-term consequences and should be carefully considered after exploring other options.”
Next Steps
Goldberg recommends that parents look at all perspectives, which could mean getting a second opinion if your child’s doctor suggests these meds and you’re not comfortable.
It’s also essential to “consider the future consequences,” she says. “If the medication works, their child might be happier, physically healthier, and have improved mental well-being. However, it could also lead to a lifetime of relying on the medication, risk an eating disorder, or struggles if they stop taking it. On the other hand, choosing not to permit their child to use the medication might result in depression, poor physical health, and again the possibility of disordered eating or an eating disorder.”
As with so many parenting scenarios, there’s simply no one-size-fits-all solution.
Building Healthy Habits
Both pros suggest using the conversations as a way to build lifelong healthy habits, including finding movement that your child actually enjoys and incorporating nutrient-dense foods they want to eat as often as possible. Encouraging screen-free time to simply be a kid and have fun with their friends — as well as regularly getting enough quality sleep — is crucial, too.
Helping them honor their bodies via intuitive eating and mindful movement will allow them to feel better in their skin, adds Erly. “The American Academy of Pediatrics recommends that all children and adolescents follow the 5-2-1-0 plan, which stands for five fruits and vegetables a day, two hours or less of screen time, one hour of physical activity, and zero sugar-sweetened drinks.”
Goldberg recommends chatting with a therapist who specializes in disordered eating or considering family therapy, “where a therapist can help guide discussions, explore options, and understand both the teen’s and the parent’s perspectives.” Ultimately, providing your child with a safe zone to share their thoughts is more important than anything else, including and most especially the tag inside their clothes or the number on a scale.
