FDA Clears Diabetes Medication for Obesity in Adolescents

The U.S. Food and Drug Administration (FDA) recently approved liraglutide (Saxenda, Victoza) as a treatment for adolescents who are obese. The medicine adds a third option for adolescents who want to try medication to treat obesity.

The injectable medication was originally approved for type 2 diabetes, and was approved to treat adult obesity in 2014.

Other than liraglutide, orlistat and phentermine are the only FDA-approved medications for the treatment of obesity in adolescents. Orlistat is approved for children over the age of 12; phentermine can be used over the age of 16. Orlistat blocks the absorption of dietary fat, and phentermine is a stimulant that decreases appetite, explains Joseph Skelton, MD, a professor of pediatrics at Wake Forest School of Medicine, who was not affiliated with the research.

Liraglutide is a glucagon-like peptide-1 receptor agonist, which is different than most existing weight loss medications, Skelton says. It decreases appetite, but also has an effect on insulin and blood sugars.

“There are thoughts that these mechanisms work together to help control weight, different from how most other [medications] work,” he tells Verywell.

Evaluating Weight Loss Medication

The FDA approved the medication for adolescents ages 12 and 17 with a bodyweight above 132 pounds and an initial body mass index (BMI) corresponding to 30 kg/m2 or greater in adults. The treatment should be used in addition to reduced-calorie meals and exercise. 

Aaron S. Kelly, PhD, a professor at the University of Minnesota Medical School Center for Pediatric Obesity Medicine, published research on the drug this year in the New England Journal of Medicine. His trial was able to demonstrate that liraglutide worked to lower BMI and body weight in adolescents with obesity.

Is Weight Loss Medication Right For Children?

Skelton says the medicine is targeted for adolescents in the “obese” category.

“At this time, there is no qualifier on having a medical condition as a result of the extra weight,” he says.

He notes that medications are generally reserved for those who are pursuing a behavior-based weight management program.

“This should not be used in people who aren't making changes in their habits and behaviors—medications, particularly in children, should be seen as an adjunct to lifestyle programs,” he says. “They are unlikely to have even short-term improvements in weight if used alone.”

Because liraglutide is newly-indicated for teens, use should be limited to adolescents participating in a medical weight management program and supervised by obesity medicine professionals, Skelton says.

Stephen R. Daniels, MD, pediatrician-in-chief at Children’s Hospital Colorado, thinks most pediatricians and pediatric obesity specialists would only prescribe medicine to adolescents with more severe forms of obesity. But because taking liraglutide involves using a needle, he thinks not all eligible adolescents would consider this option. In some cases, surgery may be a better option.

“While the weight loss with liraglutide is in the range that would have a clinical benefit with respect to the medical complications of obesity, it is not as great as is achieved with bariatric surgery,” Daniels tells Verywell.”We will need to see how both of those modalities are used and what physicians, patients and families will find most helpful.”

While the medication does seem to work by diminishing appetite, there are side effects, including gastrointestinal issues, dizziness, anxiety, and injection side reaction.

The Future of Childhood Obesity Treatment

Skelton expects more medications to come on the market in the next few years for adolescents.

“We are increasingly recognizing that obesity in children is much more than too many calories in, and not enough calories out,” he says. “As with adults, children's bodies are complex systems, and are responding as to be expected in today's environment.”

He says our bodies tend to fight weight loss, particularly if done in unsafe ways, such as overly restrictive diets. Additionally, genetics play a huge role in what our weight and build will be.

“As more medication is made available, adolescents and parents are inquiring more and more, particularly if they are wary of pursuing surgery,” Skelton says. “They are also interested if they would like to hold off on having surgery until they are older. [Medication] will not be the answer for most adolescents and families struggling with weight, but it can be helpful.”