GLP-1 and related medications are now prescribed to a growing number of adolescents, but FDA approval for pediatric use varies significantly by drug, and several of the most widely discussed GLP-1 medications are not approved for anyone under 18 at all. Understanding exactly which drugs are approved for younger patients, and for what, is a useful starting point before any conversation about whether a child or teenager is a candidate.
Which GLP-1 Medications Are Approved for Adolescents
Wegovy (semaglutide) and Saxenda (liraglutide) are both FDA-approved for chronic weight management in adolescents aged 12 and older with obesity. Two other GLP-1 medications, Trulicity (dulaglutide) and Bydureon BCise (exenatide extended-release), are approved for managing type 2 diabetes in children as young as 10. These approvals came after dedicated pediatric clinical trials, generally smaller and shorter than the adult trials for the same drugs, that were required specifically to support use in younger age groups.
Which Ones Are Adults-Only
Several other GLP-1-class medications that are extremely widely prescribed in adults have no pediatric approval at all. Ozempic (semaglutide, for type 2 diabetes) is approved only for adults 18 and older; the manufacturer's own labeling states that safety and effectiveness in children have not been established. Mounjaro and Zepbound (tirzepatide) are likewise approved only for adults, with pediatric trials still ongoing and no FDA pediatric approval as of this writing. A prescription for any of these drugs in a patient under 18 would be off-label use, meaning it falls outside what the FDA has specifically reviewed and approved for that age group.
How Common Is Pediatric Prescribing, and Is It Growing?
According to CDC data published in its Morbidity and Mortality Weekly Report, the share of U.S. adolescents aged 12 to 17 with obesity who were prescribed an FDA-approved obesity medication rose roughly threefold between 2020 and 2023, from about 0.1% to about 0.5%. Even with that rapid relative increase, the absolute number remains small: fewer than 1% of adolescents with obesity were prescribed one of these medications in 2023. Among adolescents who were prescribed a medication that year, semaglutide (Wegovy) accounted for the largest share, at just over half, followed by phentermine-based medications and liraglutide (Saxenda). The same CDC analysis found prescribing rates were more than twice as high among girls as boys, and higher among older adolescents (15 to 17) than younger ones (12 to 14).
Why the Evidence Base Looks Different in Children
Pediatric drug trials are, by regulatory design and practical necessity, smaller and shorter than adult trials for the same medication. That means less is currently known about the long-term effects of GLP-1 medications specifically in children and adolescents, including questions researchers are still actively studying, such as effects on linear growth, bone development, and puberty timing during a period of life when the body is still developing. This isn't unique to GLP-1 drugs; it reflects a broader, well-recognized pattern in pediatric pharmacology, where the evidence base for any given drug in children typically lags behind the adult evidence base, sometimes by years.
What Pediatricians Weigh
For the drugs that are FDA-approved in adolescents, prescribing guidelines generally call for considering a patient's BMI percentile for age and sex, whether structured lifestyle and behavioral interventions have already been tried, and relevant lab work, rather than treating the medication as a first-line or standalone intervention. Because the approved age thresholds, indications, and evidence base differ meaningfully from drug to drug, this is an area where parents and caregivers should talk to a pediatrician or pediatric endocrinologist directly, rather than assuming that because a medication is approved and well-studied in adults, the same holds true for a child or teenager.