Joyce Lee, MPH’06, MDFEL’06, is a pediatrician, diabetes specialist, clinical and health services researcher, and a professor of pediatrics and communicable diseases and nutritional sciences at U-M. Her research focuses on real-world health outcomes for children with obesity and diabetes and health informatics. She recently published research about the increasing use of weight loss drugs such as Wegovy and Ozempic.
How did these drugs used initially to treat diabetes become known as weight loss drugs?
These drugs were initially developed for treating patients with type 2 diabetes, but there were effects on weight as well, which led to further studies to evaluate the efficacy of these drugs for weight loss. Clinical trials demonstrated that these drugs were extremely effective for weight loss. For example, a 2022 study of semaglutide under the brand name Wegovy demonstrated a 16 percent reduction in the Body Mass Index for the pediatric population, a level of efficacy that we have not seen previously for pharmacologic or lifestyle interventions in children.
How would you summarize the findings and importance of your study?
Little is known about the use of GLP-1 RA medications like Wegovy or Ozempic in younger patients. We found that there was a 594 percent increase in GLP-1 RA medication dispensing between 2020-23 among adolescents and young adults, highlighting the importance of studying the long-term safety and effectiveness of these medications.
Why are these findings significant?
The rapid increase in dispensing suggests that there is a significant demand for this medication in younger populations. But there are questions about long-term side effects with indefinite use, who should get access to these medications, whether insurance covers the medication, and the overall costs to the patient and the healthcare system.
Were the GLP-1 prescriptions mostly for weight loss or diabetes?
We don’t know. That is one of the limitations of the study. With this data source, we don’t have the indication for which the medication was prescribed, so it could be for type 2 diabetes or weight loss.
Why are we seeing increased use of these drugs among adolescents and young adults?
The dramatic weight loss achieved with these drugs, the FDA approval of Wegovy for weight management for adolescents in 2022, and the inclusion of these medications in the American Academy of Pediatrics 2023 clinical practice guidelines for childhood obesity likely drove interest and uptake in these drugs.
Is the rising use of Ozempic amongst celebrities and social media influencers contributing to the increased demand by/for young people?
I would speculate that social media could be contributing to increased demand among younger individuals, but our study did not address that question.
Are there potential side effects for adolescents that aren’t seen in adults?
We are unaware of side effects that are unique to adolescents. Adolescents, just like adults, experience nausea, vomiting, constipation, and headaches. Then there are additional risks for younger individuals, given that they are of reproductive age. For example, in females, the GLP-1 RAs should not be taken during pregnancy or while breastfeeding, and females should be counseled that the medications may make birth control pills less effective. We still don’t know about the long-term side effects if individuals remain on these medications indefinitely, which seems to be important for maintaining weight loss.
Is there anything else you’d like the U-M community to know about this topic?
We were surprised that the increases in GLP-1 dispensing were more pronounced among females than among males. We found that in 2023, 60 percent of adolescents dispensed medications were female, and 76.4 percent of young adults dispensed medications were female. This disproportionate dispensing may reflect a societal bias towards weight in females. Continued use of this medication will, therefore, have particular consequences for women’s health.
The rapid increase in dispensing suggests significant demand among younger populations. We need more data on long-term safety and effectiveness. Given a shortage of endocrinologists and obesity medicine specialists, it’s likely that primary care physicians need more education and training focused on using this class of medications.
