The Rise of GLP-1 Medications in Pediatric Obesity: Breakthrough or Barrier?

Childhood obesity remains one of the most urgent public health challenges in the United States, affecting roughly one in five children and adolescents. According to the Centers for Disease Control and Prevention, the prevalence of obesity among U.S. youth is about 19.7%, with higher rates among certain racial, ethnic, and low-income populations.

While lifestyle interventions, such as improved nutrition, increased physical activity, and behavioral counseling, have long been the foundation of treatment, a new class of medications is rapidly transforming the field: GLP-1 receptor agonists. These drugs are generating both excitement and debate, especially as their use expands into pediatric care.

So, are GLP-1 medications a true breakthrough, or do they risk widening existing gaps in care?

What are GLP-1 medications?

GLP-1 (glucagon-like peptide-1) receptor agonists are medications that mimic a naturally-occurring hormone involved in regulating appetite, insulin secretion, and digestion. By slowing gastric emptying and increasing satiety, they help reduce food intake and promote weight loss.

Two of the most widely discussed GLP-1 medications are semaglutide and liraglutide. Originally approved for type 2 diabetes, both medications are now FDA-approved for chronic weight management in certain adolescent populations aged 12 and older. Their growing popularity reflects a broader shift toward recognizing obesity as a chronic, biologically complex disease, not simply a result of lifestyle choices.

Clinical trials have demonstrated significant results in adolescents using GLP-1 medications. A landmark study published in The New England Journal of Medicine found that teens treated with semaglutide experienced an average 16.1% reduction in BMI, compared to just 0.6% in the placebo group. Similarly, trials involving liraglutide showed meaningful reductions in BMI and improvements in metabolic health markers.

Beyond weight loss, GLP-1 medications may improve insulin resistance, blood pressure, and lipid profiles (cholesterol levels). These benefits are particularly important given that childhood obesity is strongly linked to long-term risks such as type 2 diabetes, cardiovascular disease, and even certain cancers.

Despite their clinical promise, GLP-1 medications remain out of reach for many families. Without insurance, these drugs can cost $900 to $1,300 per month, a significant financial burden. Even for insured patients, access is often delayed by prior authorization requirements, step therapy protocols, and inconsistent coverage policies.

According to the American Academy of Pediatrics, disparities in access to obesity treatment, including medications, mirror broader inequities in healthcare. Children from underserved communities, who are already at higher risk for obesity, are often the least likely to receive advanced treatments.

Additional barriers include limited availability of pediatric obesity specialists, geographic disparities in care access, and stigma surrounding obesity treatment. This raises a critical concern: Could a breakthrough therapy unintentionally widen health disparities?

While short-term outcomes are encouraging, long-term safety data in pediatric populations is still evolving.

Common side effects include nausea, vomiting, diarrhea, or constipation. In most cases, these symptoms are mild to moderate and improve over time. However, there are still unanswered questions about long-term use in developing bodies, potential impacts on growth and development, weight regain after discontinuation, and more.

Early evidence suggests that stopping GLP-1 therapy often leads to partial or full weight regain, highlighting the chronic nature of obesity and the potential need for ongoing treatment. Experts emphasize that medication should not replace foundational lifestyle interventions but instead serve as part of a comprehensive, multidisciplinary care plan.

The emergence of GLP-1 medications marks a turning point in pediatric obesity treatment. For adolescents who have struggled with traditional approaches, these therapies offer meaningful, evidence-based results, and in many cases, renewed hope. However, their full potential will only be realized if systemic barriers are addressed.

Expanding insurance coverage, improving provider access, and reducing stigma will be essential to ensuring equitable care. As research continues and policies evolve, the challenge is clear: How do we ensure that this medical breakthrough benefits all children, not just a select few?

Your responses and feedback are welcome!

Source: “Once-Weekly Semaglutide in Adolescents with Obesity,” The New England Journal of Medicine, 11/2/22
Source: “Prescriptions for Obesity Medications Among Adolescents Aged 12–17 Years with Obesity — United States, 2018–2023,” CDC, 6/5/25
Source: “Executive Summary: Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity,” Pediatrics, February 2023
Source: “New Institute for Clinical and Economic Review Report Shows Significant Jump in Launch Prices, Exceeding Inflation and GDP Growth,” ICER, 10/23/25
Image by Leeloo The First/Pexels

Is There an Ultra-Processed Foods Coverup?

Today’s post carries on from “The Nutrition That Never Arrived,” which discusses the work of Dr. Dhruv Khullar, as well as his referencing of Dr. Kevin Hall’s highly-regarded study of ultra-processed foods.

The alarming aspect of this topic is that, almost exactly one year ago, CBS News published a piece titled “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist.” That scientist of course was Dr. Hall, described therein as “The National Institutes of Health’s top researcher on ultra-processed foods.”

Hall had announced that, after 21 years at his dream job, he was retiring early because, apparently, the NIH is no longer a place where unbiased science can be conducted. The details are rather shocking, according to journalist Alexander Tin:

Hall told CBS News that he was blocked by the department from being directly interviewed by a reporter from The New York Times, asking about recent research on how ultra-processed foods can be addictive.

Apparently, the NIH leadership did not want any comparison made between being hooked on ultra-processed foods and, for instance, your average meth habit — unless the disease manifests in exactly the same way and causes exactly the same effects as hard-drug addiction.

Hall was allowed to reply to The Times with written answers which “were then edited and sent to the reporter without his consent.” This behavior, needless to say, is normally considered highly unacceptable among professionals in the fields of both medicine and journalism.

Then the situation deteriorated even further when the government denied tampering with Hall’s words, and accused him of untruthfulness about the interference, and acted like the material wasn’t very good or worth being concerned about. Hall, however, maintained that his work on the effects of ultra-processed food on carefully observed subjects…

[…] was the largest study of its kind and no previous study had the same level of dietary control, much less admitted them to a hospital to ensure diet adherence…

Meanwhile, the NIH officials maintained that no censorship was in effect, and that any attempt to portray the government’s position as false would be deliberate distortion. In order to avoid being contradicted, the government agency also prevented Hall from participating in a conference on the subject.

At the same time, Susan Mayne, who had formerly been in charge of the food safety and nutrition center run by the Food and Drug Administration, spoke up for Hall’s research.

This whole controversy surprised many observers because just a few months earlier, reporters were writing passages like this one, published in January of 2025 in The New Yorker:

The dirty little secret is that no one really knows what caused the obesity epidemic. It’s the biggest change to human biology in modern history. But we still don’t have a good handle on why.

That was Dhruv Khullar, quoting what had been said to him by Dariush Mozaffarian, a dean at the Tufts School of Nutrition Science and Policy. The implication is that ultra-processed foods have “probably contributed to rising obesity rates,” although other factors also are involved — like changes in the human microbiome and general metabolism, as well as (probably) epigenetics.

Of course, as always, the possibility exists that the situation is influenced by factors that have not even been suspected yet.

(To be continued… )

Your responses and feedback are welcome!

Source: “RFK Jr. aides accused of censoring NIH’s top ultra-processed food scientist,” CBS News, 04/17/25
Source: “Why Is the American Diet So Deadly?,” The New Yorker, 01/06/25
Image by geralt/Pixabay

Spectacular Obesity Costs Spotlighted

This is a continuation of “Unacceptable Obesity Costs Suspected.” About a decade ago, medical specialists and public health authorities were noticing more and more suspicious correlations between a substance known as bisphenol A (BPA) and various undesirable effects on humans. Chiefly, BPA seemed to be causing childhood obesity, and in some quarters, great interest was generated in the notion of discontinuing its use in products that might ever introduce the stuff into the bodies of children, orally or via any other route.

At the same time, concern grew about the costs that the use of this industrial chemical exacted from society in terms of both human suffering and financial impact. A ton of money was being spent to repair the ravages of BPA on kids, and on young people and adults who had encountered it in early life. Of course, it didn’t do adults any good either, even if, as children, they had managed to escape it.

Neither the first warning nor the last

Late in 2016, amid a climate of escalating suspicion, The Lancet published a report that brought up in no uncertain terms the price tag, in actual money, for tolerating BPA. By then, research had determined that the cost of disease and dysfunction caused by endocrine-disrupting chemicals, familiarly known as EDCs, amounted to more than 1% of the European Union’s annual gross domestic product, familiarly known as its GDP. (In American dollars, this amounted to the equivalent of around $217 billion.)

According to the report,

Exposure to EDCs varies widely between the USA and Europe because of differences in regulations and, therefore, we aimed to quantify disease burdens and related economic costs to allow comparison… Estimates were made based on population and costs in the USA in 2010. Costs for the European Union were converted to US$ (€1=$1·33).

In the United States, the costs accruing to EDCs were calculated to be around 2.33% of the gross domestic product, or around $340 billion. Experts utilized studies from the fields of epidemiology and toxicology to reckon the “probabilities of causation for 15 exposure–response relations between substances and disorders.” The scientists also had much to say about American societal expenses. They determined that…

The difference was driven mainly by intelligence quotient (IQ) points loss and intellectual disability due to polybrominated diphenyl ethers (11 million IQ points lost and 43,000 cases costing $266 billion in the USA vs 873,000 IQ points lost and 3290 cases costing $12.6 billion in the European Union).

The pesticides containing the dangerous chemicals were much more responsible in Europe, implying a need for improved screening there, for “chemical disruption to endocrine systems and proactive prevention.” The known effects of these chemicals on various body systems were already quite concerning, but the discoveries about their ability to wipe out IQ points definitely suggested a need for more awareness in that department. In 2018, PubMed had this to say about a small study:

This is the first study reporting the presence of bisphenols in two distinct regions of the human brain. Bisphenols accumulation in the white matter-enriched brain tissue could signify that they are able to cross the blood-brain barrier.

More recent publications

Another report (among many) supported the idea that exposure to BPA analogues is strongly connected with not only obesity, but also other undesirable health effects, especially in children. Then another one caused a stir by confirming that…

[…] endocrine-disrupting chemicals negatively affect a wide range of systems throughout the human body and have consequences at every life stage.

By now, professionals interested in this question were accustomed to hearing BPA and its relatives described as “forever chemicals,” meaning that once present in the body, they refuse to leave. The chemicals were deemed responsible not only for obesity but also for diabetes and reproductive disorders in both sexes.

On the policy front, the good news was that some substances had been banned; the bad news was that equally harmful chemicals were recruited to take their places. In no sane vocabulary could this be defined as progress.

Two years ago, a Spanish study of 106 children between ages 5 and 10, about half each of girls and boys, indicated that BPA “impacts the gut microbiome of children differently, with normal-weight children showing greater bacterial diversity compared to those who are overweight or obese.” In other words, this endocrine disruptor affects the gut microbiome adversely, leading to a variety of undesirable results.

Yet, the situation is very complicated, with many unclear connections and relationships among various factors. Still, enough is known to create certainty that this chemical and others like it should ideally be kept out of the body altogether — especially in the case of children and even more particularly where babies are concerned.

Your responses and feedback are welcome!

Source: “Exposure to endocrine-disrupting chemicals in the USA: a population-based disease burden and cost analysis,” TheLancet.com, December 2016
Source: “Possible Obesogenic Effects of Bisphenols Accumulation in the Human Brain,” Ncbi.nlm.nih.gov, 05/29/18
Source: “Bisphenol A Analogues in Food and Their Hormonal and Obesogenic Effects: A Review,” Ncbi.nlm.nih.gov, 09/06/19
Source: “Common Plastic Chemical Linked to Increased Childhood Obesity Risks,” SciTechDaily.com, 03/09/24
Images by Kalle_89 and OpenClipart-Vectors/Pixabay

How Childhood Obesity May Be Reshaping the American Dream

For generations, the idea of the American Dream has rested on a simple promise: Every child has the opportunity to build a better life than their parents. But emerging research from Rutgers suggests that a growing health crisis of childhood obesity may be quietly undermining that promise in ways that extend far beyond physical well-being.

Childhood obesity has long been associated with increased risks of chronic conditions like diabetes, heart disease, and mental health challenges. Now, a new study published in the Journal of Population Economics reveals that its impact may also stretch into lifetime earnings and financial mobility.

According to the research, children who experience obesity are significantly less likely to climb the economic ladder as adults. In fact, their income ranking can fall about 20 percentile points below that of their parents, compared to peers who maintained a healthy weight in childhood.

As study co-author Dr. Yanhong Jin explains,

Childhood obesity isn’t just a health crisis — it is an economic mobility crisis.

The study draws on data from the National Longitudinal Study of Adolescent to Adult Health, a large-scale, long-running dataset that has tracked more than 20,000 Americans from adolescence into adulthood over several decades. This rich dataset allowed researchers to examine not only health outcomes, but also education, income, and even genetic factors tied to body weight.

By incorporating genetic data, the researchers were able to isolate the effects of obesity itself, separate from influences such as family income or neighborhood environment. The findings were striking: Even when controlling for these factors, childhood obesity remained strongly linked to lower economic mobility.

The study highlights several key reasons why children with obesity may face economic disadvantages later in life. One is lower educational attainment. Children with obesity may encounter barriers in school, from absenteeism to social stigma, which can impact academic success.

Then there are ongoing health challenges. Chronic health conditions can limit productivity, career choices, and long-term earning potential. Also, think about the workplace disadvantages. Adults who were obese as children reported higher levels of job discrimination and were more likely to end up in lower-paying occupations.

Together, these factors create a compounding effect that can make it harder to achieve upward mobility.

Where you grow up also matters. The research also found that individuals who experienced childhood obesity were less likely to live in economically thriving neighborhoods as adults. They were more likely to reside in areas with lower average incomes and higher poverty rates, further limiting access to opportunity.

Interestingly, the economic impact of childhood obesity was not evenly distributed. Girls experienced a larger economic penalty than boys. Not surprisingly, children from low-income families were more affected. And those raised in the South and Midwest faced stronger long-term impacts. These disparities suggest that childhood obesity may amplify existing inequalities, making it even harder for vulnerable populations to break cycles of poverty.

Traditionally, efforts to address obesity have focused on treatment, helping people lose weight after the condition develops. But this research points to the importance of early prevention.

Intervening during childhood — before obesity takes hold — could yield benefits that go far beyond improved health. It may also enhance educational outcomes, expand career opportunities, and increase the likelihood of upward mobility.

As co-author Man Zhang notes, tackling childhood obesity isn’t just about reducing healthcare costs. It’s about investing in the future economic potential of the next generation.

This study challenges us to think differently about childhood obesity. It is not only a medical issue or a lifestyle concern — it is also a social and economic one.

As science writer and researcher Sanjana Gajbhiye writes for Earth.com,

Preventing obesity early can improve both health and future opportunities. It can support better education, stronger careers, and higher income levels.

Protecting the promise of the American Dream may require expanding how we view public health challenges and recognizing that the well-being of children today is deeply connected to the economic vitality of tomorrow.

Your responses and feedback are welcome!

Source: “Childhood Obesity Makes It Harder to Climb the Economic Ladder, Study Finds,” Rutgers.edu, 3/18/26
Source: “Childhood obesity may lower a child’s chances of moving up in life,” Earth.com, 3/19/26
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