Joyce Lee, MD, MPH and Team Publish Study in JAMA Showing an Increase Use in Weight Loss Drugs among Youths

Public interest in weight loss drugs like Wegovy and Ozempic is surging, but national data on dispensing patterns in the United States are surprisingly scarce.

Now, a national study from Michigan Medicine shows that the use of these weight loss drugs is increasing rapidly in adolescents and young adults 12-25 years, especially females.

Using 2020 - 2023 data from a national database representing 92% of pharmacies, the study team found a 594% increase in the monthly number of adolescents and young adults using Wegovy, Ozempic, and other glucagon-like peptide-1 receptor agonists (GLP-1RAs).

For females, this increase was even more pronounced.

The number of female adolescents 12-17 years using GLP-1RAs increased 588%, compared with 504% for male adolescents.

The number of female young adults 18-25 years using GLP-1 RAs increased 659%, compared with 481% for male young adults.

“This is the first study to document national trends in GLP-1RA dispensing in any population, including youth, said Joyce Lee, MD, MPH, the lead author of the paper. Lee is a pediatric endocrinologist and Professor of Pediatrics in the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan Medical School, the C.S. Mott Children's Hospital, and the Caswell Diabetes Institute.

GLP-1RAs were approved for type 2 diabetes in 2005 and for weight management in 2014.

Interest in these drugs surged in 2021 when semaglutide was approved for weight management in adults under the brand name Wegovy, and increased even further when Wegovy was approved for weight management in adolescents at the end of 2022.

The report finds that endocrinologists, family medicine physicians and nurse practitioners were among the top prescribers of GLP-1 RAs to youth, suggesting that these clinicians should be the focus of efforts to ensure safe and appropriate prescribing.

For example, because the biggest usage increase occurred in females, clinicians need to educate female patients about the potential safety risks of these GLP-1 RAs during pregnancy.

The report also found that dispensing of Ozempic increased in youth, even though Ozempic is not approved in children for type 2 diabetes or weight management.

“This finding suggests increasing off-label use of Ozempic for weight management in adolescents and young adults,” said Kao-Ping Chua, MD, the senior author of the paper and a member of the CHEAR Center.

Lee adds that some concerns have been raised about both the cost of GLP-1 RAs, which are expensive and meant to be taken over the longterm, as well as the unknown effects of these drugs on growth and development in youth.

“The increasing use of GLP-1 RAs highlights the importance of understanding the long-term safety, efficacy, and cost-effectiveness of GLP-1RAs in adolescents and young adults,” she said.

Additional authors include Lauren Oshman, M.D., M.P.H., Dina H. Griauzde, M.D., MS.c.

The purchase of the IQVIA data was supported by the Susan B. Meister Child Health Evaluation and Research Center at the University of Michigan Medical School. This work was supported by grants P30DK089503 (MNORC), P30DK020572 (MDRC), and P30DK092926 (MCDTR) from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the Elizabeth Weiser Caswell Diabetes Institute at the University of Michigan. Dr. Chua is supported by grants R01DA057284-01 and K08DA048110-04 from the National Institute on Drug Abuse (NIDA). Dr. Sharifi’s research is supported by the National Heart, Lung, and Blood Institute (NHLBI) (R01HL151603) and the National Institute on Minority Health and Health Disparities (NIMHD) (R01MD014853) of the National Institutes of Health (NIH).

The Susan B. Meister Child Health Evaluation and Research Center, ElizabethWeiser Caswell Diabetes Institute, and the NIDDK NIDA, NHLBI, and NIMHD of the NIH had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Lee reported receiving personal fees from GoodRx, Tandem Diabetes Care, and Sanofi outside the submitted work. Oshman reported stock investment from Eli Lilly (divested 2022) and Abbott (divested 2022) outside the submitted work. Griauzde reported receiving grants from NIH/NIDDK outside the submitted work. Chua reported receiving personal fees from the Benter Foundation and US Department of Justice outside the submitted work.

Paper cited: “Dispensing of Glucagon-Like Peptide-1 Receptor Agonists to Adolescents and Young Adults, 2020-2023,” JAMA. DOI: 10.1001/jama.2024.7112