GLP-1 Medications for Teens: What Parents Need to Know

What's Actually FDA-Approved for Adolescents?

As of December 2025, the following GLP-1 medications have FDA approval for adolescent obesity:

Important: Ozempic and Mounjaro are NOT approved for pediatric use in obesity. These are diabetes medications. Off-label prescribing does occur but is not FDA-sanctioned for weight management in adolescents.

The Clinical Trial Evidence: STEP TEENS

The pivotal trial that led to Wegovy's adolescent approval was STEP TEENS, published in the New England Journal of Medicine in 2022.

These results were actually stronger than the adult trials—adolescents responded robustly to treatment.

What the American Academy of Pediatrics Says

In January 2023, the AAP released its first comprehensive clinical practice guidelines for childhood obesity in 15 years. The recommendations were significant:

This represented a major shift. The AAP explicitly moved away from the "wait and see" approach that had dominated pediatric obesity care for decades.

Side Effects in Adolescents: What the Trial Showed

Side effects in STEP TEENS were similar to adult trials, though some occurred more frequently in adolescents:

The discontinuation rate due to adverse events was 5.2% in the semaglutide group versus 4.4% with placebo—relatively low.

The Questions Parents Should Ask

1. "Has my child tried lifestyle changes first?"

GLP-1 medications are positioned as adjuncts to—not replacements for—lifestyle intervention. Both groups in STEP TEENS received counseling on nutrition, physical activity, and behavior change. Medication amplifies these efforts rather than substituting for them.

That said, the AAP explicitly states that medication shouldn't be delayed indefinitely. If 3-6 months of structured lifestyle intervention hasn't produced meaningful results, medication is appropriate to discuss.

2. "What's the goal here?"

Goals should be individualized. For some adolescents, preventing weight gain during growth may be sufficient. For others, meaningful weight loss is needed to address comorbidities (type 2 diabetes, sleep apnea, fatty liver disease).

BMI alone doesn't capture health. A comprehensive assessment should include metabolic markers (blood glucose, lipids, blood pressure), physical function, and quality of life—not just the number on the scale.

3. "How long will my child need to take this?"

This is the uncomfortable question. Obesity is a chronic disease. Just as we wouldn't stop blood pressure medication when blood pressure normalizes, stopping GLP-1s typically results in weight regain.

4. "Are there effects on growth or development?"

STEP TEENS found no signal of impaired linear growth over 68 weeks. Adolescents continued growing in height as expected. However, longer-term data (beyond 68 weeks) on pubertal development, bone health, and final adult height is not yet available.

5. "What about mental health?"

Adolescence is a vulnerable period for mental health. Obesity itself is associated with depression and anxiety. Weight loss can improve psychological well-being, but rapid body changes can also be destabilizing.

In STEP TEENS, mental health outcomes were actually favorable—patients reported improved quality of life and no increased risk of depression or suicidal ideation compared to placebo. However, individual monitoring remains important.

Eligibility Criteria: Who Qualifies?

Per FDA labeling and AAP guidelines, candidates for GLP-1 therapy typically meet these criteria:

Practical Considerations for Families

Insurance Coverage

Pediatric obesity medication coverage is inconsistent. Many commercial insurers cover Wegovy for adolescents, but prior authorization is typically required. Medicaid coverage varies by state. Some families face significant out-of-pocket costs.

Injection Training

Wegovy is a once-weekly subcutaneous injection. Adolescents can learn to self-inject, but initial parental supervision is recommended. The auto-injector pen makes administration relatively straightforward.

Managing Side Effects

GI side effects are common initially. Strategies include:

• Eating smaller, more frequent meals
• Avoiding high-fat or greasy foods
• Staying hydrated
• Taking medication at bedtime (sleeping through initial nausea)
• Slow titration if side effects are significant

School Considerations

Since Wegovy is once weekly (typically at home), it doesn't usually interfere with school. However, teens may need accommodations for smaller portion sizes at lunch or more frequent bathroom access during initial GI adjustment.

What We Don't Know Yet

Parents should understand the evidence gaps:

• Long-term effects: No pediatric data beyond 68 weeks
• Effects on final adult height: Unknown
• Pubertal development impacts: Limited data
• Bone health long-term: Unknown
• Optimal duration of therapy: Unknown
• When/if to stop: No clear guidance

This isn't a reason to avoid treatment when indicated, but it's a reason for ongoing monitoring and shared decision-making.

Common Parent Questions

Finding the Right Provider

Pediatric obesity medicine requires expertise. Look for:

• Pediatric endocrinologists with obesity expertise
• Pediatricians with obesity medicine board certification (ABOM)
• Pediatric weight management programs at academic medical centers
• Multidisciplinary teams (physician, dietitian, psychologist)

General pediatricians can prescribe GLP-1s but may prefer to refer to specialists for initiation and monitoring.