Few Teens With Obesity Are Prescribed Obesity Medicines, 2018–2023

About one in five U.S. adolescents has obesity, a complex chronic disease that affects physical, social and emotional health and raises the risk of adult obesity, type 2 diabetes and heart disease. In 2022, the FDA extended approval of two adult obesity medicines — phentermine-topiramate extended-release and semaglutide — to ages 12–17. In January 2023, the American Academy of Pediatrics advised clinicians to offer obesity medicines, including GLP-1 receptor agonists, to teens 12 and older with obesity, alongside health behavior and lifestyle treatment. CDC used electronic medical records to see how prescribing changed.

The study

• 526,973 adolescents aged 12–17 with obesity (BMI at or above the 95th percentile) during 2018–2023, from IQVIA ambulatory records.
• It counted FDA-approved obesity medicines: orlistat, phentermine, phentermine-topiramate, setmelanotide, and the high-dose GLP-1RAs liraglutide (Saxenda) and semaglutide (Wegovy). Diabetes versions of these drugs (Ozempic, Victoza) were excluded.

Findings

Share of adolescents with obesity prescribed obesity medications, 2018–2023. CDC.

• The share prescribed an obesity medicine rose from 0.1% in 2020 to 0.2% in 2022, then jumped to 0.5% in 2023 — about 300% higher than 2020, after adjustment.
• In 2023, prescriptions were for semaglutide (Wegovy) (57.1%), phentermine or phentermine-topiramate (37.7%), liraglutide (Saxenda) (11.9%) and others (3.3%).
• Counting Ozempic and Victoza too raised the share only slightly, to 0.7%.

Who got prescriptions (2023)

• Of 427 teens prescribed a medicine, 82.9% had severe obesity — 51.8% class 3 — though only 40.9% of all teens with obesity had severe obesity.

Black teens were 39% less likely to be prescribed obesity medicines than White teens, even though they were 27% more likely to have severe obesity (50.0% vs. 39.0%).

What it means

• Despite the steep rise, fewer than 1% of teens with obesity were prescribed an obesity medicine in 2023.
• Providers mostly prescribed to teens with severe obesity, which carries higher cardiometabolic risk, poorer quality of life and declining physical function.
• Phentermine options may have grown because they're taken by mouth, cost less out of pocket and were more consistently available than weekly semaglutide injections.
• With prescriptions rising, postmarketing safety monitoring is essential. GLP-1RA shortages also raise concerns about counterfeit and compounded products, which the FDA doesn't review before they reach patients.
• Every teen with obesity — including those on medicine — should get evidence-based health behavior and lifestyle programs that build healthier nutrition and activity habits and improve quality of life and self-esteem. Health systems may need to expand their capacity to provide them to the millions of children and families who need them.

Sources

Based on "Prescriptions for Obesity Medications Among Adolescents Aged 12–17 Years with Obesity — United States, 2018–2023," Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.