GLP-1 Prescribing in Under-12s Has Risen 310-Fold Since 2019
Key Takeaways:
- GLP-1 prescribing for US children aged 8 to 11 living with obesity rose 310-fold between 2019 and 2026, though overall numbers remain low.
- Most of those prescribed the medicines had severe obesity (93.7 per cent) and 65.2 per cent already had an obesity-related condition.
- Children in higher-income communities were 55 per cent more likely to receive a prescription, pointing to a widening access gap.
A first national picture of GLP-1 use in younger children
New research from NYU Langone Health has produced what its authors describe as the first national overview of how glucagon-like peptide-1 (GLP-1) receptor agonists are being prescribed to children under the age of 12 who are living with obesity in the United States.
The headline finding is one of rapid acceleration from a very low base. The number of US children under 12 living with obesity who were prescribed the weight loss medicines Saxenda, Wegovy and Zepbound remained low in June 2026 – but it was 310 times higher than in 2019, the year the medicines first began to be prescribed in this group.
The study was published online in the journal Pediatrics on 4 September.
What the researchers found
Among children aged 8 to 11 who were living with obesity and did not have diabetes, the proportion prescribed a GLP-1 receptor agonist increased from 0.03 per cent in 2019 to 9.3 per cent in 2026 – a 310-fold rise across a period of seven and a half years. Over that timeframe, 20,282 children aged 8 to 11 were prescribed a GLP-1 medicine.
The researchers also compared prescribing across age groups. GLP-1 medicines were less commonly prescribed to younger children living with obesity, aged 8 to 11, than to adolescents living with obesity, aged 12 to 17, at 0.6 per cent and 0.9 per cent respectively.
That age gradient persists even though clinical guidelines permit the use of these medicines for obesity in children from the age of 8. Girls were more likely than boys to receive a prescription.
An estimated 20 per cent of children in the US are living with obesity, defined as a body mass index (BMI) above the 95th percentile for children of the same age and sex, in the absence of diabetes – a well-recognised complication of the condition.
Who is being prescribed these medicines
The clinical profile of the children receiving GLP-1 medicines suggests that prescribers are, for the most part, reserving them for those with the greatest clinical need.
Most children prescribed a GLP-1 medicine had severe obesity (93.7 per cent), meaning their BMI was substantially higher than that of almost all other children of the same age and gender. Most (65.2 per cent) were also living with at least one illness linked to obesity, such as raised cholesterol, high blood pressure or sleep apnoea.
A further quarter of the younger children living with obesity who were prescribed GLP-1s had prediabetes, placing them at high risk of developing the condition most commonly associated with obesity.
Why the researchers see this as a valuable tool
Lead investigator and obesity medicine specialist Babak J. Orandi, MD, PhD, an associate professor in the Departments of Surgery and Medicine at NYU Grossman School of Medicine, framed the findings as both a snapshot and a signal.
“Our study offers the first national overview in young children of the use of GLP-1 drugs to fight the obesity epidemic in the United States and shows that while the absolute numbers of children under the age of 12 receiving GLP-1 treatment is still low, GLP-1 use is accelerating rapidly,” said Dr Orandi. “The careful use of GLP-1s remains a valuable tool in confronting the obesity epidemic among young Americans.”
Dr Orandi noted that GLP-1 medicines can be highly effective in treating obesity and improving its metabolic complications, supporting weight loss, better blood sugar regulation and appetite suppression.
Weighing the risks of treating and of not treating
The study team was explicit that the decision facing families is not a simple choice between risk and safety.
While parents may hesitate at the prospect of their child being prescribed one of these medicines, there are also long-term risks attached to withholding treatment from young children living with obesity. Those risks include the development of chronic conditions such as diabetes, high blood pressure and liver disease in early adulthood and middle age.
For clinicians supporting families through exactly this kind of conversation, the College of Contemporary Health’s CPD short course GLP-1RAs in Practice (Prescribing and Supporting) addresses the practical side of initiating and monitoring GLP-1 therapy, including how to discuss benefits, risks and expectations with patients and their families.
An emerging gap in access
Alongside the prescribing trend itself, the study surfaced a socioeconomic pattern that the authors treat as a warning sign.
Many young children living with obesity in upper-income communities were 55 per cent more likely to be prescribed GLP-1 medicines than those who were not.
Study co-senior author Allan B. Massie, PhD, an associate professor in the Departments of Surgery and Population Health at NYU Grossman School of Medicine, said that current prescribing patterns already show the beginnings of a growing divergence between those who do and those who do not have access to the medicines.
“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 Dr Massie.
The case for long-term monitoring
Dr Orandi said that long-term monitoring of children prescribed GLP-1 medicines is needed to confirm that the drugs remain both safe and effective in this age group.
Clinical trials are already under way in children living with obesity from as young as 6 years of age. Dr Orandi said these will inform and offer guidance to physicians, policymakers and parents as the use of anti-obesity medicines continues to grow.
How the study was carried out
The team drew on Epic Cosmos, a national dataset built from the electronic health records of more than 300 million American patients. The dataset covers 2,067 hospitals and 47,100 health clinics that use Epic, the largest electronic health record vendor in the US. Epic had no role in conducting the study.
Funding, authorship and disclosures
Funding support for the study was provided by NYU Langone.
Alongside Dr Orandi and Dr Massie, the NYU Langone researchers involved as co-investigators were Suhani S. Patel, MPH; Mary Jo Messito, MD; Michal A. Mankowski, PhD; and Dorry L. Segev, MD, PhD.
Dr Orandi has served on an advisory board for the pharmaceutical company Boehringer Ingelheim. Dr Segev has received consulting and speaking honoraria from Sanofi, CareDx, Moderna, AstraZeneca, Roche, Optum, OrganOx, Hansa Biopharma and Biosidus, and is a journal editor for Springer. None of these activities relate to the current Pediatrics study. NYU Langone is managing the terms and conditions of these relationships in line with its policies and procedures.
What this means for practice
The picture emerging from this study is of a treatment moving quickly from the margins towards the mainstream in a younger age group than many clinicians and families may expect – and doing so unevenly. Prescribing appears to be concentrated among children with the highest clinical need, but also among those with the greatest access to care.
For healthcare professionals, that combination raises practical questions about assessment, shared decision-making with families, monitoring over long periods, and equity of access within their own services.
CCH insight
Supporting children and families through GLP-1 therapy calls for confidence in both the pharmacology and the conversation. The College of Contemporary Health’s CPD short course GLP-1RA Therapy: The Complete Programme is designed for healthcare professionals who want a structured, evidence-based grounding in initiating, monitoring and supporting GLP-1 receptor agonist treatment – including how to set realistic expectations and manage long-term follow-up.
Explore GLP-1RA Therapy: The Complete Programme →
Source: NYU Langone Health
