Guidelines Backlash, the Biggies — Drugs, Part 3

The weight-loss drugs that have been approved and are about to be approved all have one thing in common: Nobody knows the results of starting at a young age and staying on them for years. This will be learned by trial and error, from observing the reactions of actual human subjects. It would, however, be fair to say that all the known potential problems look even more dire with the prospect of long-term use.

Regarding the new meds, studies show that “many children see results in six months to a year,” but that does not exactly constitute a cure. Apparently, the improvement only lasts as long as the drugs do. Ariana Eunjung Cha of The Washington Post interviewed Mary Savoye, associate director for pediatric obesity at Yale New Haven Children’s Hospital, and reported,

She said treatment should continue to include nutrition and behavioral modification as well…[W]hile there’s no consensus on how long patients should remain on the drugs, “we are thinking it’s for their lifetime. We are very honest with our patients. We say that we want you to know you may have to take it for a very long time and maybe forever.”

Psychiatrist Kimberly Dennis, who specializes in treating addictions, eating disorders, and co-occurring disorders, says this about that:

We also have little long-term impact data on health for kids or adolescents who have started on these medications. And what happens longer-term when a child stops taking their medication? Or are they supposed to take them forever? Will young people develop a tolerance, requiring higher doses? What must a kid think about their body if a doctor gives them medication every week to shrink it?

When it comes to semaglutide injections, whether directly prescribed or used off-label, some medical professionals are very doubtful, for reasons summarized by journalist Christine Byrne:

[I]t’s well documented that both weight-loss drugs and weight-loss surgery come with side effects. Among the known side effects mentioned for the drugs named in the guidelines are elevated blood pressure, dizziness, tremor, headache, nausea, vomiting, fecal urgency, and gassiness. (These are just the potential short-term side effects; for many of the drugs, there’s a lack of research on long-term issues.)

Deeper into the downsides

Wegovy, a brand name for the generic semaglutide, was approved almost two years ago to treat…

[…] chronic weight management in adults with obesity or overweight with at least one weight-related condition (such as high blood pressure, type 2 diabetes, or high cholesterol), for use in addition to a reduced calorie diet and increased physical activity.

It is administered via weekly injection that needs to be carefully increased “over 16 to 20 weeks… to reduce gastrointestinal side effects.” These include nausea, diarrhea, vomiting, constipation, stomach pain, abdominal distension, indigestion, belching, gastroenteritis, flatulence, and gastroesophageal reflux disease.

In addition, patients may experience headaches, fatigue, dizziness, and low blood sugar. Their futures might include pancreatitis, gallstones, acute kidney injury, diabetic retinopathy, increased heart rate, and suicidal ideation or behavior.

It gets worse

When prescribed for diabetes control the brand of choice is Ozempic. Now, thanks to the ever-alert media, we know that there is such a condition as “Ozempic face” which just might be irreversible. As of yet, nobody knows. Journalist Taylor Penley relates the words of Dr. Marc Siegel:

“I spoke with some dermatologists about this yesterday,” Dr. Siegel said of “Ozempic face,” a bizarre side effect reported in Ozempic patients who claim the drug is making them look older. “It’s an overuse of the drug to where you lose weight too quickly. The buccal mucosa — the fat — leaves your face, and you become gaunt looking.”

Periodic Ozempic shortages have even been reported. After it’s endorsed by social media “influencers,” and headlines warning us that there might not be enough of it to go around… a shortage? No kidding, really? The whole debacle sounds ridiculous, except for one tiny fact, which is that diabetes patients rely on the stuff to keep them alive and functioning.

Then along comes a tidal wave of faddists who are not motivated to go out and burn calories the old-fashioned way, but prefer instead to buy up all the semaglutide. And if this substance is approved for pediatric weight control, expect to see a lot of wizened, elderly-looking kids.

Your responses and feedback are welcome!

Source: “What you need to know about the new childhood obesity guidelines,”, 01/20/23
Source: “A Critical Look at New Guidelines for Kids With Higher BMIs,”, 02/11/23
Source: “The New Obesity Guidelines for Kids Are Appalling,”, 02/02/23
Source: “FDA Approves New Drug Treatment for Chronic Weight Management, First Since 2014,”, 06/04/21
Source: “’Ozempic face?’ Dr. Siegel warns of popular diabetes drug’s bizarre side effect,”, 01/29/23
Image by Markus Grossalber/CC BY 2.0

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OVERWEIGHT: What Kids Say explores the obesity problem from the often-overlooked perspective of children struggling with being overweight.

About Dr. Robert A. Pretlow

Dr. Robert A. Pretlow is a pediatrician and childhood obesity specialist. He has been researching and spreading awareness on the childhood obesity epidemic in the US for more than a decade.
You can contact Dr. Pretlow at:


Dr. Pretlow’s invited presentation at the American Society of Animal Science 2020 Conference
What’s Causing Obesity in Companion Animals and What Can We Do About It

Dr. Pretlow’s invited presentation at the World Obesity Federation 2019 Conference:
Food/Eating Addiction and the Displacement Mechanism

Dr. Pretlow’s Multi-Center Clinical Trial Kick-off Speech 2018:
Obesity: Tackling the Root Cause

Dr. Pretlow’s 2017 Workshop on
Treatment of Obesity Using the Addiction Model

Dr. Pretlow’s invited presentation for
TEC and UNC 2016

Dr. Pretlow’s invited presentation at the 2015 Obesity Summit in London, UK.

Dr. Pretlow’s invited keynote at the 2014 European Childhood Obesity Group Congress in Salzburg, Austria.

Dr. Pretlow’s presentation at the 2013 European Congress on Obesity in Liverpool, UK.

Dr. Pretlow’s presentation at the 2011 International Conference on Childhood Obesity in Lisbon, Portugal.

Dr. Pretlow’s presentation at the 2010 Uniting Against Childhood Obesity Conference in Houston, TX.

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