GLP-1 medications important for kids with obesity and Type 2 diabetes

MADISON, Wis. – As childhood obesity and Type 2 diabetes rates continue to rise, GLP-1 receptor agonist (GLP-1 RA) medications are transforming care for some children and teens with these chronic diseases. However, as the drugs gain widespread attention for adult weight loss, a UW Health Kids expert says stigma, misinformation and insurance barriers are making it harder for eligible young patients to access treatment.

GLP-1 RA medications mimic a naturally occurring hormone released after eating that helps regulate blood sugar and signals fullness. These medications have been used in adults for decades and have been approved for pediatric use since 2019. They have become an important treatment option for children with Type 2 diabetes or obesity, helping fill a long-standing gap in care, according to Dr. Elizabeth Mann, director of the UW Health Kids Type 2 diabetes program.

The need for effective treatment options is growing rapidly. Nearly one in five children in the United States has obesity, a chronic disease that increases the risk of Type 2 diabetes, heart disease, kidney disease and other serious health complications. As those rates rise, so does the demand for specialized care. The UW Health Kids Type 2 diabetes program cared for about 25 patients annually in 2020. By 2025, that number had grown to nearly 150, she said.

“GLP-1 medications are among the first truly effective medications we’ve had for children with Type 2 diabetes, so they fill a critical treatment gap,” said Mann, who is also an associate professor of medicine, University of Wisconsin School of Medicine and Public Health. “Before these therapies became available, our primary treatment options were insulin and metformin. While those medications remain important, many children were not meeting their treatment goals. The addition of GLP-1 medications has changed the course of this disease for many young patients.”

For children with obesity, GLP-1 RA medications are used alongside lifestyle changes such as nutrition counseling, healthier eating patterns, and increased physical activity. For children with Type 2 diabetes, the medications can improve blood sugar control while supporting overall metabolic health.

“These medications are not intended for children who simply want to lose a few pounds,” Mann said. “They are prescribed for specific pediatric patients with chronic medical conditions, and they work best when combined with comprehensive medical care and healthy lifestyle interventions.”

Despite their effectiveness, misconceptions about GLP-1 RA medications remain widespread, fueled in part by their growing visibility in the media and celebrity culture, according to Mann.

“As these medications have become more visible, particularly among adults, we’ve seen growing stigma around their use,” she said. “There is a perception that GLP-1 medications are a shortcut for weight loss, and unfortunately that stigma is affecting children who could benefit from treatment. These patients are already facing significant weight bias, and this adds another layer.”

It is important to think about obesity and Type 2 diabetes the same way as other chronic medical conditions like high blood pressure, Mann said.

“If a medication is successfully treating high blood pressure, we don’t tell patients to stop taking it once their blood pressure improves,” she said. “We recognize that high blood pressure is a chronic disease. Obesity and Type 2 diabetes should be viewed through that same lens. GLP-1 medications are not a shortcut. They are a treatment tool that helps manage chronic disease and prevent serious long-term complications.”

Even when families and physicians determine that a GLP-1 RA medication is appropriate, access can be a challenge. The medications are expensive, and only a limited number of insurance companies will cover them, Mann said.

“If a family can get it covered, some insurance plans only approve the medication for a few months at a time or require patients to meet specific benchmarks before coverage is renewed,” Mann said. “That can disrupt treatment for a chronic disease.”

Coverage can be especially restrictive for children with obesity, with some insurers requiring patients to demonstrate weight loss before continuing coverage, she said.

“We wouldn’t expect a child with another chronic condition to repeatedly lose access to an effective medication,” Mann said.

For many children, obesity and Type 2 diabetes are not simply the result of individual choices. These are complex chronic diseases shaped by genetics, the environment, socioeconomic factors and other influences, she said.

“Our goal is to help kids be healthy and happy, both physically and emotionally, and give them the best chance at a long, healthy life,” Mann said. “GLP-1 medications are one of the tools that can help us do that.”