November 10, 2022 – The prospect of her participation in a research program that could help her lose weight has intrigued Emalia Zumo. At the age of 15, the confident and energetic teenager from Janet, Pennsylvania, weighed 250 pounds—enough to be considered chubby. The experience she learned about through her endocrinologist was with a drug called semaglutide.
Before joining the study, Emmalea had exhausted a stock of strategies.
“She was doing a variety of exercise programs, and was involved in countless sports and activities to stay active, and some of her early doctors said that would work,” says Davina Zumo, Emalia’s mother. Free diet, decide what you ate, when you ate, and how much you ate.
Emmalea stopped all snacks, fast food, and sweets, but nothing made a difference, says Zumo: “I felt defeated.”
The U.S. Food and Drug Administration last year approved semaglutide, which was initially developed as a treatment for type 2 diabetes, for weight loss in adults. But the researchers wanted to see if the drug, which targets the areas of the brain that regulate appetite, could also help teens lose weight. Emmalea was also curious.
Although teens can often be judgmental of each other, Emmalea’s friends “were happy for me, were constantly motivating and supporting me,” she said.
Today, 18-year-old Emalia says the drug helped her lose 75 pounds, giving the lifestyle and diet training boost she received throughout the 68-week study.
Parents of obese teens like Emmalea hear the same phrase: If their kids cut back on sugar, eat healthy snacks instead of junk foods, and exercise regularly, results will follow.
But for many young adults who are overweight — as with adults — shedding pounds is often frustrating. Gains come and go, despite good intentions.
Can medication help?
a New study In the New England Journal of Medicine It shows that semaglutide can indeed lead to small but meaningful losses in excess body weight. Whether this is enough to tip the scales, as it were, toward better health in general is unclear, but the findings suggest that child health professionals are optimistic.
“There is a real need for safe and effective medications to treat obesity,” says Silva Arslanian, a pediatric endocrinologist at the University of Pittsburgh School of Medicine and a co-author on the new study.
“Usually, we make lifestyle recommendations: eat more vegetables; don’t eat fried food; don’t drink soda,” Arslanian says. Unfortunately, she says, we live in a world in which “it can be very difficult to make these changes.”
Many experts agree that medication should be part of the conversation.
“It’s exciting to see this treatment become available. Study results do suggest some side effects, so the drug was safe and well tolerated,” says Amanda Staiano, a researcher at the Pennington Center for Biomedical Research at Louisiana State University in Baton Rouge. “Although not yet approved by the US Food and Drug Administration, semaglitude and other new drugs are changing the treatment of obesity in adolescents. It will be an exciting time for obesity treatment.”
However, Steano stresses that lifestyle and behavior counseling is key to the success of any obesity treatment, including drugs such as semaglutide.
Daniel Wegober, MD, A pediatrician at Paracelsus Medical University in Salzburg, Austria, says that although obesity “Not an issue of lack of willpower, this drug appears to enable obese people to stick to the recommendations they’ve been following for years and years but haven’t been able to hit the target. I think this is important. It enables people to achieve their goals.”
In the new study, 201 obese or overweight boys and girls, ages 12 to 18, received either a once-a-week injection of semaglutide or a dummy injection. They all also received lifestyle interventions – advice on healthy nutrition and physical activity – throughout the study period, which lasted about 16 months.
By the end of the study, 75% of the teens who received semaglutide lost at least 5% of their excess weight, compared to 17% of those who received the placebo. On average, those treated with the drug lost 33.7 pounds, compared to an average of just 5.3 pounds in the other group.
The research suggests that the combination of lifestyle changes and obesity medication will “open a new chapter” for treating obese teens, Wijober said.
More than 340 million Children and teenagers all over the world 5-19 year olds overweight or obese in 2016. In the United State, Affected by obesity 22.2% of those ages 12 to 19 from 2017 to 2020, according to the CDC.
Obesity is associated with lower life expectancy and a higher risk of serious health problems such as type 2 diabetes, heart disease, nonalcoholic fatty liver disease, sleep apnea, and certain types of cancer. Obese teens are also more likely to experience depression, anxiety, low self-esteem, and more psychological issues.
While childhood obesity has long been a public health concern, the problem has only worsened during the COVID-19 pandemic, says Melissa Ruiz, MD, with the Children’s Diagnostic Center in Ventura, California,. She estimates that some of her patients who were “obese” before the pandemic achieved a weight gain of 20 to 30 pounds in clinic visits after the pandemic.
Ruiz and other experts say parents should ignore the idea that obesity is something that children – or adults – do to themselves, or that they are failing their children by not keeping their weight in check.
“There are genetic components that play the role of obesity, and we have to admit that,” Ruiz says.
Parents should seek help from their child’s pediatrician. “If your pediatrician can’t help you, ask, ‘Where can I go?'” Say, ‘I understand you may not have practiced this yet’ and ask for a reference for someone who can help,” Ruiz says.
But the drug shouldn’t be considered a panacea, according to one expert.
“Medication is a last resort, only after behavioral interventions have failed and after you have explored a range of behavioral strategies for weight loss, including changing dietary patterns such as timing and meal plan,” says Lydia Bazano, MD, PhD, a nutrition researcher at Tulane University School of Health. General and Tropical Medicine in New Orleans.
medicine and until surgery You have a place, Bazano says, but only if patients exhaust all diet and lifestyle choices. “You don’t want your teen to have lifelong treatment. Medications should only be used to push the child to the point where they should be — and then maintain that weight,” she says.
Bazzano adds that adolescent obesity is a very difficult topic to deal with. “You have to involve the whole family, not just the child. It has to be at the level of the whole family, and that can be very difficult. If the whole family gets involved together, there can be a modest weight loss.”
Bazano says it was not affected by the weight loss seen in the latest study. She says a 5% reduction in body weight is beneficial, but “that is not enough to say that the child is outside the risky range.”
Steano believes that experts need more information about semaglutide before they begin prescribing it to children.
“We need to see the long-term results from chronic medication use and whether the weight rebounds when teens stop using the medication,” she says.
“How long should medication be prescribed? For the rest of their lives? How do we support patients who are able to lose such a significant amount of weight? How do we ensure that these treatments – behavioral counseling, medication, weight-loss surgery – are financially affordable for families?”
Emalia, who stopped taking semaglutide about a year ago, has maintained her weight thanks to a focus on a balanced diet and exercise. While she says she’s pleased with her progress and “feels comfortable with my skin,” she doesn’t consider her current weight of 171 pounds to be the end zone. “I’d like to be somewhere between 145-150,” says the 5’4″ high school student.
However, she says, “I don’t strictly monitor myself because thinking about food in a negative way is unhealthy and can actually worsen an eating disorder.”
When she set out to study, she wasn’t sure it would be effective for her. But because of her interest in medicine and research, she says, she wanted to share: “I thought if it didn’t help me, at least others could.”