For many parents looking for help for a child suffering from obesity, appropriate treatment is not available, and they are torn between nutritional counseling and using the weight drug Wegovy.
Wejovi is the first weight loss treatment approved by the US Food and Drug Administration since 2014. It comes in the form of an injection and is given under the skin. 2.4 milligrams of the active ingredient semaglutide is injected once a week.
Leading medical groups in the United States recommend intensive behavioral counseling — 26 hours a year — to teach children and their families practical ways to eat healthier and move more.
But these programs are not widely available, and waiting lists can last for months. They are often not covered by health insurance and require a time commitment that is difficult for many families to make, according to Reuters interviews with more than a dozen doctors and parents.
As a result, less than 1 percent of the nearly 15 million American children with obesity receive this type of structured care, according to the US Centers for Disease Control and Prevention.
Doctors involved in this process told Reuters that efforts by the Centers for Disease Control and Prevention and others to expand insurance coverage have stalled.
Novo Nordisk
Wijovi was approved for adults in 2021 and for teens in late 2022, providing a highly effective way to lose weight for the first time.
Novo Nordisk is still unable to meet demand for the drug among adults, with at least 25,000 first-time prescriptions dispensed each week.
Many families are searching for the drug for their teenagers, Reuters found last February.
Many doctors and parents are concerned about using the drug without data on whether Wijovi could affect a child’s development, or pose other long-term risks.
Change habits
Ruth Medina of Holyoke, Massachusetts, wanted to know if a change in family habits, rather than medication, could help her 15-year-old daughter, Jelene, when she reached 200 pounds (about 91 kilograms) this year.
Medina said the family had a history of type 2 diabetes, a condition exacerbated by excess weight.
Medina added, “I don’t want to go down this path. And here I felt afraid.” Gilini’s pediatrician recommended the Healthy Weight Program at Holyoke Health Center, where children and their parents come for visits with a dietitian and community health worker to set individual goals, as well as group sessions on cooking, decoding food labels and other lifestyle changes.
Vinnie Biggs, who supervises the program, said families face a four-month wait to register. Biggs added that Medina and her daughter’s participation is covered in part by the state health insurance program Medicaid. At the family’s first session this month, Jelene chopped up cauliflower, carrots and other vegetables for a plate of food. The mother and daughter said they loved the meal and took the leftovers and recipe home.
Jelene has lost some weight. I started walking more, playing tennis, and snacking on fruits and vegetables. Her mother remains concerned about the appeal of the many fast food restaurants near her home.
“We are walking amidst a lot of temptations,” Medina said. “I want to do everything I can to get to a healthy weight.”
The U.S. Preventive Services Task Force, an influential federal panel of experts, says it’s best to stick with lifestyle changes for teens with obesity until more data is available. Regarding the long-term safety and effectiveness of available medications, according to a draft recommendation published last December.
Behavior and lifestyle therapy
The task force examined clinical trials involving intensive behavioral programs for children and found that children lost, on average, 5.7 pounds (about 2.6 kilograms). But Wijovi and similar drugs helped people lose significant weight, 15% or more of their body weight. In clinical trials.
The lack of insurance coverage for counseling will likely convince more families to try medications in the future. Some doctors say Wijovi’s wider use by young people will make it even more necessary for children to learn healthy eating habits for themselves.
In the long term, doctors worry that reliance on medications alone could contribute to nutritional deficiencies or eating disorders.
“These medications are very effective at reducing weight and health risks, but you don’t suddenly adopt a healthier diet or become more physically active,” said Dr. Thomas Robinson, professor of pediatrics and director of the Healthy Weight Center Institute at Stanford University Children’s Health in Palo Alto, California.
At Stanford University’s lifestyle counseling program, teachers give parents and their children solid lessons about eating wisely: High-calorie foods, like ice cream or even almonds, are “light” foods that should be eaten in moderation.
Vegetables are considered a “green light” and can be eaten in unlimited quantities. Most foods are yellow and fall somewhere in between, Robinson said.
Health insurance does not cover the Stanford program, so families pay out of pocket or receive financial assistance from the hospital, Robinson said. The full cost is $3,500. Since 2022, the CDC, the American Academy of Pediatrics, and other key experts have advocated for better coverage of obesity counseling.
In a statement reached by Reuters, the CDC said that ensuring equitable access to both obesity medications and lifestyle treatments “is pivotal so that families have access to multiple options for treating childhood obesity and supporting optimal health.”
Is it safe for children and teenagers who are diabetic or overweight to use weight loss drugs, including Javi?
Professor Mohamed Atta Handous, a lecturer at the College of Medicine at Qatar University and a senior consultant in pediatrics, said – in an exclusive interview with Al Jazeera Seha within comprehensive coverage about the drug Ozambik and GLP-1 agonists – that “the answer is Yes and no, and it is more of a no. The way the medicine works is that the medicine tells the body not to eat too much and it slows down the stomach and thus the person feels full and then young men and women can lose weight, but the problem is that young men must take in sufficient calories, such as proteins and the like. Good natural fats, so that their body grows well, and if they take medication, they will eat smaller quantities, at the same time they will not get the necessary proteins and we are afraid that they will not grow and develop like all boys and girls.”
He said that in the West, they started using medicines at the age of 12 years or more, and now there are calls for their use from the age of 6 years.
Professor Handous added that there are now claims, and studies have begun to try this medicine on boys and girls at the age of 6 years, whether in the form of needles or orally, but “I personally advise – if a child definitely needs such a medicine – to take it after the age of over.” 16 years, but if the age is less than that, the body will still be growing and the muscles will still be growing, so we do not want to prevent our children from this healthy development.”
Causes of obesity in children
Dr. Handous said that the causes of obesity in children are multiple and include the environment: how children see their parents, relatives, and friends eating, genes, and hormones, as all of these lead to weight gain. “It is our role as doctors to be kind parents so that they do not wait until children need medications, needles, or surgeries.”
The doctor advised the child to start practicing sports and a good health regimen at an early age, “The correct exercise that I mean is not to push the child to play outside, but rather within a system in a sports club, for example, that is appropriate for the age, a football club, or a taekwondo club, or a basketball club, or a swimming club.” What children like is important for it to be regulated and to have specific times during the week, for example, twice a week during which the child exercises appropriately, in addition to controlling the environment, and not submitting to the desires of the child if he asks for fast food or the like. Parents fulfill these desires for their sons and daughters because they love them But this is not true. We love our children more if we control the food they eat.”