GLP-1 Medications
You've probably heard a lot about GLP-1 medications lately — things like Ozempic, Wegovy, or Saxenda. So, let's talk about where they fit into this picture, because there's a lot of confusion out there.
First, what they actually do:
These medications don't directly "loosen the locks" of insulin resistance in muscle and fat the way lifestyle changes do. Instead, they work through a few different pathways. They quiet down a hormone called glucagon, which lowers how much sugar the liver releases into the blood. They also help the pancreas respond better to meals, releasing insulin more effectively when a child eats. But their biggest effect on weight comes from something else entirely: they slow down how quickly food leaves the stomach and act on appetite centres in the brain, which is what helps a child feel full sooner and stay satisfied longer.
Are they approved for kids?
Yes, for specific ages and situations. Liraglutide and semaglutide are approved for adolescents 12 and up with obesity, and a few others (liraglutide, dulaglutide, exenatide) are approved for youth with type 2 diabetes. They are not a first option — paediatric guidelines place them as an add-on to lifestyle care, used when diet and activity changes alone haven't been enough, and before more intensive options like surgery are considered.
What does the research show?
Studies show these medications can meaningfully reduce BMI and body weight in kids and teens. When it comes to insulin resistance itself, the picture is more nuanced: HbA1c — a marker of average blood sugar — tends to stay much the same in kids who don't have diabetes, simply because it was already in a normal range to begin with. But insulin resistance markers themselves, like HOMA-IR and fasting insulin, often improve meaningfully — and the amount of improvement tracks closely with how much weight a child loses, rather than with how insulin-resistant they were to start. The most common side effects are stomach-related — nausea and vomiting.
Earlier on, there was concern about a possible link between these medications and mood-related effects like anxiety or depression, and warning labels reflected that. Since then, larger studies — including research specifically in children and teens — have been reassuring: kids and teens on GLP-1 medications for obesity or type 2 diabetes actually showed a lower risk of depression and suicidal thoughts or behaviours compared to those on metformin, with no meaningful difference in anxiety. Regulators have since moved to walk back the earlier warning based on this evidence. That said, ongoing monitoring for mood changes is still a sensible part of care, as it would be with any new medication.
These medications can be a helpful tool for the right child in the right situation — but they work alongside the food, movement, and sleep habits.
Children prescribed a GLP-1 medication should be monitored by a registered dietitian throughout treatment to protect adequate nutrition, growth, and development.
Written by: Carina de Fries (Dietitian)
