US clinicians increasingly prescribe GLP-1 drugs to young children with obesity, although overall use remains limited and access disparities persist.
A national electronic health record analysis suggests prescribing of
“While the absolute numbers of children under the age of 12 receiving GLP-1 treatment is still low, GLP-1 use is accelerating rapidly,” lead investigator Babak J. Orandi, MD, PhD, of NYU Grossman School of Medicine, said in the study announcement.¹
Researchers used Epic Cosmos, an electronic health record database encompassing more than 300 million patients across 2067 hospitals and 47 100 clinics. The analysis focused on children with obesity but without diabetes and compared prescribing among those aged 8 to 11 years with prescribing among adolescents aged 12 to 17 years.¹
From 2019 through June 2026, 20 282 children aged 8 to 11 years received a GLP-1–based medication, according to the report. Prescribing was less frequent among younger children than adolescents, at 0.6% and 0.9%, respectively. However, the investigators also reported that the proportion of younger children receiving treatment increased from 0.03% in 2019 to 9.3% in 2026, described as a 310-fold increase.¹,²
The reported 9.3% estimate is difficult to reconcile with the separate 0.6% figure because the announcement does not specify whether the percentages used different populations, denominators, or observation periods. That discrepancy will require clarification in the complete Pediatrics report before the magnitude of uptake can be interpreted confidently.
Prescribing was concentrated among children with greater clinical severity. Approximately 93.7% of treated children had severe obesity, and 65.2% had at least 1 obesity-associated condition, including hypertension, dyslipidemia, or sleep apnea. One-quarter had prediabetes. Girls were more likely than boys to receive treatment, although sex-specific prescribing estimates were not provided.¹
Socioeconomic differences also emerged. Children living in higher-income communities were reportedly 55% more likely to receive these medications than children in other communities. Co-senior author Allan B. Massie, PhD, said the pattern may represent an early divergence in access to therapies that can be costly and may depend on insurance coverage and access to pediatric specialty care.¹
“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 Massie in the press release.1
The products evaluated included Saxenda, Wegovy, and Zepbound. The study announcement grouped these agents as GLP-1 RAs and attributed their clinical effects to appetite suppression, weight reduction, and improved glucose regulation. However, it did not provide results by individual drug, dose, treatment duration, or regulatory status for each pediatric age group.¹
The findings should therefore be interpreted as a description of real-world prescribing rather than evidence of efficacy or safety in children younger than 12 years. Electronic health record analyses may miss prescriptions written outside participating systems, treatment discontinuation, insurance denials, and medication adherence. The report also did not present changes in body mass index, cardiometabolic outcomes, gastrointestinal adverse events, growth, pubertal development, or treatment persistence.
Long-term follow-up will be particularly important because the source described ongoing trials enrolling children as young as 6 years. Until those results are available, clinicians will need clearer age-specific evidence on benefits, harms, treatment duration, and outcomes after discontinuation. The announcement also stated that clinical guidelines permit obesity pharmacotherapy beginning at age 8 years but did not identify the guideline or distinguish general obesity treatment from use for specific indications.¹
