Who Should Decide if Weight-Loss Injections Should be Prescribed for Kids?

The latest statistics from the National Health Institute find about 43 percent of US adults are considered obese. Ten percent of US adults are categorized as severely obese—with BMIs over 40 percent. As alarming as these figures are, childhood and young adult obesity rates aren’t far behind. 

Nearly 20 percent of children and adolescents are obese, with about six percent of children considered severely obese. Both rates have more than doubled since 2000. Type 2 diabetes rates in young adults and children have also more than doubled in the last 20 years. 

Skyrocketing obesity rates for children are especially concerning for two reasons. First, obese children are likely to become obese adults, who are also more likely to raise obese children—snowballing obesity rates for future generations. Second, many dietary and lifestyle choices needed to lose weight are outside a child’s control. 

While many medical professionals agree that “prevention is better than the cure,” it’s unclear whether preventing or curing obesity is more important. Many pervasive and costly obesity-reduction and prevention programs for children fail miserably. Consequently, some medical professionals advise drastic surgical procedures—including gastric sleeves and gastric bypasses—to help children address their obesity. 

Another increasingly popular—and controversial—option may soon be at their disposal. 

A recent Bloomberg article confirms Novo Nordisk has begun testing the widespread weight loss Ozempic on children under six. Eli Lilly also began testing its weight loss shot Mounjaro on children. 

These trials will likely take several years. However, some believe they will become a “game changer” in addressing childhood obesity. 

Weight loss shots have become very popular. The Food and Drug Administration approved Ozempic, Mounjaro, Wyngobic, and other injection treatments. Many of these drugs also help patients with type 2 diabetes lose weight—which can be challenging due to complications from the disease. These treatments are also prescribed for aesthetic purposes and to address obesity-related health concerns. Ozempic is already prescribed to adolescents as young as twelve. 

But any treatment that can dramatically improve health can also lead to harmful side effects. Weight loss injections can result in stomach and gallbladder issues, acute pancreatitis, and other potentially serious side effects. They can also be deadly if abused. And, as with any new treatment, long-term effects are unknown. 

How effective or risky weight loss injections will be for children remains a mystery. Many currently known side effects can be especially harmful for younger users. Further, many treatments that are safe for adults can have wide-ranging and previously unknown side effects when used by kids.

What should be done? The answer is complicated. But as Thomas Sowell wisely remarks, “The most basic question is not what is best, but who shall decide what is best.” 

When deciding whether weight loss injections should be used to treat children, it is either parents with medical professionals making the decision or regulators. And the groups often do not see eye-to-eye. 

A host of regulatory issues make children much less likely to be included in the formal drug approval process. Only about 20 percent of all drugs approved by the FDA are for use in children. 

Consequently, pediatricians often prescribe medication off-label- using drugs approved by the FDA to treat conditions or groups they are not approved for. As physician Cindy Jackson remarks in an article published by the Association of American Medical Colleges, “In pediatrics, off-label prescribing is the rule, not the exception.”

Fortunately, peer-reviewed research finds physicians and drug producers find practical uses of treatments regularly. My research published in the Journal of Institutional Economics finds that physicians and drug developers can more effectively manage the risk-reward tradeoff for risky medication than regulators.

We aren’t sure how effective weight loss injections will be for children. The most likely result will be a mixed bag—providing clear medical benefits and some risk of harm. In these scenarios, the best we can do is to place the decision in the hands of those with the best record of helping patients and managing risk. 

Thankfully, that choice is clear.