At age 17, Israel McKenzie was so burdened by obesity that he stopped attending high school in person and was embarrassed to talk to people at his restaurant job.
“I was in a really dark place,” says McKenzie, whose weight ballooned to 335 pounds on his 6-foot-5 frame despite repeated diet and exercise efforts. “I had lost hope.”
But last year, the weight-loss drug Wegovy helped him lose 50 pounds in nine months, making the rural Tennessee teenager part of a wave of teens and young adults using diabetes and obesity medications known as receptor agonists. GLP-1, new research shows.
Even as millions of older adults clamor for medications like Ozempic and Wegovy, monthly use of the medications has soared among people ages 12 to 25. This is according to new analysis of the distribution records of nearly 94% of US retail pharmacies from 2020 to 2023.
The report, published in the journal JAMA on Wednesday, used the IQVIA prescription database to compile the first analysis of national GLP-1 drug uptake among this age group. Nearly 31,000 children ages 12 to 17 and more than 162,000 people ages 18 to 25 used the drugs in 2023 alone, said Dr. Joyce Lee, a pediatrician and diabetes specialist at the University of Michigan who led the research.
“What it suggests is that it is one of the tools available and that there are more providers prescribing this medication to the population,” she said.
The report shows that the number of young people ages 12 to 25 using any GLP-1 medication — including older medications first approved to treat diabetes in 2005 and for weight loss in 2014 — has risen from about 8,700 per month in 2020 to over 60,000 per month in 2023, an increase of almost 600%. The increase occurred even as prescriptions for other medications among these patients fell by about 3%.
Those who received the drugs were just a fraction of the young people struggling with obesity, Lee noted. About 20% of U.S. children and teens and about 42% of adults have the chronic disease, according to the Centers for Health and US Disease Prevention.
In early 2023, the American Academy of Pediatrics recommended that children and adolescents with obesity be evaluated early and treated aggressively, including with surgery and medication if necessary.
McKenzie, the Tennessee teenager, said he started gaining weight five years ago, during puberty.
“I started turning to food for all my problems,” he said.
The extra weight worsened his asthma and put him at risk of developing diabetes, his doctor said. He tried to follow medical advice, cutting out soda and sugary snacks and exercising more, but his efforts failed to make a difference.
“My old doctor told me there was nothing he could do,” he said. “He told me it was my fault.”
In early 2023, McKenzie connected with Dr. Joani Jack, a pediatric obesity specialist at Erlanger Children’s Hospital in Chattanooga, Tennessee, who regularly prescribes GLP-1 medications for children.
“I told him I saw 10 other people like you today and that we have lots of tools and treatment options,” Jack said. They usually include intensive behavioral and nutritional interventions combined with medication if necessary.
In McKenzie’s case, Jack prescribed the weight-loss drug Wegovy, which in late 2021 was approved for use in US children over the age of 12. More than 6,000 children in this age group will have received Wegovy in 2023, the new data shows. More than 7,600 received Ozempic, which is approved to treat diabetes in adults but can be used off-label in teenagers. Others received older GLP-1 drugs such as Saxenda and Trulicity.
McKenzie said he has had no notable side effects from the medication, but Lee noted that some young people report nausea, vomiting or constipation, including symptoms so severe that they stop taking the medications.
It’s important to understand the increasing use of these medications among young people, Lee said. The medications are intended for continuous use, so “we really need to think about the long-term safety and effectiveness of these medications for this population,” she said.
Furthermore, medicines are expensive and often difficult to obtain, either due to supply problems or because they are not covered by insurance.
Notably, government Medicaid plans paid for nearly half of the GLP-1 drugs prescribed to 12- to 17-year-olds and about a quarter of those used by 18- to 25-year-olds, the investigation found. Commercial insurance covered care for nearly 44% of younger children and about two-thirds of older children.
Today, McKenzie says her asthma is better and she looks forward to interacting with co-workers and friends.
“I have a lot of self-confidence now, much more than before,” he said. “That changed everything.”
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