Off-label prescriptions of GLP-1 weight-loss drugs for American children as young as 8 have surged 310-fold since 2019, according to a new study that is renewing debate over how young is too young for medications originally developed for adults with diabetes. The children getting these prescriptions are overwhelmingly dealing with severe obesity and related health problems, but researchers say the sharp rise raises fresh questions about long-term safety in growing bodies.
The study, led by researchers at NYU Langone Health and published Friday in the journal Pediatrics, analyzed electronic health record data from more than 3.5 million U.S. children ages 8 to 11 who did not have diabetes. According to NYU Langone Health, the researchers drew on Epic Cosmos electronic health records from more than 47,000 health clinics nationwide to track the trend through June 2026. CBS News New York, which first reported on the dramatic increase in U.S. kids taking GLP-1s for weight loss, notes that correspondent Doug Williams spoke with the obesity medicine specialist who authored the study about what the findings mean for families and doctors.
Among the young children who were prescribed GLP-1s, 93.7% had severe obesity and 65.2% had at least one obesity-related illness, such as high blood pressure, high cholesterol, or sleep apnea, per the same NYU account. Severe obesity in children is generally defined as a body mass index exceeding 120% of the 95th percentile for their age. The pattern suggests physicians are largely reserving these medications for the highest-risk pediatric patients rather than prescribing them broadly, as MedPage Today reports.
An Access Gap That Cuts Against Need
One of the study's more striking findings involves who actually gets these prescriptions. Children living in higher-income communities were 55% more likely to be prescribed GLP-1 medications than those in lower-income areas, even though childhood obesity is more prevalent in lower-income communities, according to a report from CBS News. High out-of-pocket costs and inconsistent insurance coverage appear to be driving that gap, leaving many of the children who could benefit most without access to treatment.
The drugs most commonly prescribed to these young patients were Novo Nordisk's Wegovy, along with Novo's Saxenda and Eli Lilly's Zepbound, according to Reuters. None of those medications carry FDA approval for children under 12 — Wegovy and Saxenda are approved starting at age 12, while Zepbound is approved only for adults. Prescribing a drug outside its approved age range is legal under a physician's clinical discretion, but it means these young patients are being treated in territory the FDA has not formally evaluated.
How Guidelines and Approvals Set the Stage
The regulatory backdrop helps explain why prescriptions climbed so fast. The FDA approved semaglutide, sold as Wegovy, for chronic weight management in adolescents 12 and older in December 2022, but no GLP-1 drug currently holds approval for children younger than that, according to Contemporary Pediatrics. Weeks later, in January 2023, the American Academy of Pediatrics issued its first comprehensive obesity guideline update in 15 years, recommending anti-obesity medications as an adjunct to lifestyle therapy for adolescents 12 and up while leaving room for clinicians to consider the drugs in younger children on a case-by-case basis.
The scale of pediatric obesity nationally helps explain the pressure on doctors to intervene. CDC data show that roughly 20% of U.S. children and adolescents — about 14.4 million young people — live with obesity, defined as a body mass index at or above the 95th percentile for their age and sex. Severe childhood obesity carries elevated long-term risks for type 2 diabetes and cardiovascular disease, risks that have pushed some physicians toward earlier medical intervention rather than lifestyle changes alone.
Trial Data Behind the Push, and Open Questions Ahead
Clinical trial evidence has bolstered physician confidence in these drugs for older adolescents. In the Phase 3 STEP TEENS trial, adolescents ages 12 to 17 taking weekly semaglutide alongside lifestyle interventions saw a 16.1% mean reduction in BMI after 68 weeks, compared with a 0.6% mean increase in the placebo group, according to trial data published on novoMEDLINK. Those results have fueled interest in pushing the drugs into younger age groups, and active clinical trials are now evaluating GLP-1 medications in children as young as 6, building on a 2024 University of Minnesota study that found liraglutide safe and effective in young children, as reported by The Independent. Researchers stress that formal pediatric trials are still needed to nail down age-specific dosing and safety profiles before any broader approval could follow.
Not everyone in pediatric medicine is convinced the benefits outweigh the unknowns for younger kids. Pediatric endocrinologists have warned that significant weight loss from GLP-1s during a child's developing years carries risks of lean muscle loss and potential effects on bone density, since adolescence is a critical window for building peak muscle mass and bone strength. That concern has prompted new research, including UCSF's NIH-funded ABCD T2D trial, aimed at tracking body composition changes in young patients over time, according to UCSF's Department of Pediatrics.
The findings arrive as the pediatric GLP-1 landscape continues to shift rapidly across the country, from parents weighing hard choices about their children's medication to state-level debates over pricing and coverage, as Hoodline has previously reported. For now, the absolute number of children under 12 taking these drugs remains small, but the 310-fold jump since 2019 signals a trend that pediatricians, insurers, and regulators are only beginning to reckon with.
