GLP-1 prescribing to US children aged 8 to 11 rose 310-fold since 2019, study finds

Prescriptions for GLP-1 weight-loss drugs to US children aged 8 to 11 with obesity rose from 0.03% in 2019 to 9.3% by June 2026, a 310-fold increase, according to a study published September 4 in the journal Pediatrics ^[1][2][4]. None of the medications is FDA-approved for children under 12, though clinical guidelines allow them to be considered for obesity in children as young as 8 in certain cases ^[1][2].

The study, a research brief from NYU Langone Health, looked at 3,520,531 children aged 8 to 11 who had obesity and did not have diabetes ^[2][4]. Researchers used Epic Cosmos, a national electronic health records database covering more than 300 million US patients and drawing on 2,067 hospitals and 47,100 clinics ^[2][4]. They tracked prescriptions for Saxenda (liraglutide), Wegovy (semaglutide) and Zepbound (tirzepatide) from January 1, 2019 through June 17, 2026 ^[2][4]. Over that period, 20,282 children received one of the drugs, equal to 0.6% of the group ^[2][4]. The 9.3% figure describes prescribing in 2026, while the 0.6% figure covers the full study period ^[2][4]. The increase was statistically significant, with a P value below .001 ^[2].

Most children who received a prescription had severe obesity, 93.7%, which Reuters rounds to 94% ^[1][4]. About 65% had at least one condition tied to obesity, such as high cholesterol, high blood pressure or sleep apnea, and roughly a quarter were prediabetic ^[1][4]. Prescribing was more common among 11-year-olds than 8-year-olds (79.5 versus 41.5 per 10,000), among girls than boys (75.9 versus 42.8) and among children with less social vulnerability than more (76.1 versus 49.2) ^[2]. Children with an obesity-related condition were far more likely to receive one of the drugs, at 188.9 per 10,000 ^[2]. The authors concluded that clinicians "appear to be reserving GLP-1RAs for those at greatest cardiometabolic risk" ^[2].

Children living in higher-income communities were 55% more likely to be prescribed the drugs ^[1][4]. "Physicians and health policymakers alike have a responsibility to ensure, as use of GLP-1 medications continues to rise, that all young children with obesity who need these drugs have access to them and that these valuable and sometimes costly treatments become available to more than those who have access to health insurance and can afford to visit pediatric clinics," said co-senior author Allan Massie, an associate professor in the departments of surgery and population health at NYU Grossman School of Medicine ^[4]. The study reports that prescribing is less common for children aged 8 to 11 than for adolescents aged 12 to 17, at 0.6% versus 0.9% ^[4].

The study was funded by NYU Langone. Lead investigator Babak Orandi has served on an advisory board for Boehringer Ingelheim, and co-author Dorry Segev has received consulting and speaking honoraria from Sanofi, CareDx, Moderna, AstraZeneca, Roche, Optum, OrganOx, Hansa Biopharma and Biosidus, according to NYU Langone ^[4]. Epic had no role in the study ^[1][4].

Why it matters for patients

Every prescription described in this study is off-label: Saxenda, Wegovy and Zepbound are approved for adults and some older children, not for children under 12 ^[1][2]. That means the decision rests on a clinician's judgment and on guideline language that permits consideration from age 8 in certain cases, rather than on an FDA approval specific to this age group ^[1][2].

The study tracked prescriptions, not outcomes. It did not report side effects, how much weight children lost, or how they fared over time, and no long-term safety data for this age group is presented ^[2][4]. Orandi said long-term monitoring is needed to confirm the drugs remain safe and effective in these patients ^[1][4].

The findings also point to an access divide. Children in higher-income communities were 55% more likely to receive a prescription, which the authors describe as emerging disparities in access ^[1][4]. For families, the practical questions — whether a pediatric obesity specialist is available nearby, whether insurance covers the drug, and what follow-up looks like — are shaped by those same factors.

What happens next

Orandi said clinical trials are already under way in children with obesity as young as 6, which he said will inform physicians, policymakers and parents ^[4]. No results dates for those trials have been disclosed. No change to FDA labeling for children under 12 has been announced, and no timeline for such a decision has been reported.