Doctor Finds GLP-1 Drugs Used Carefully for At-Risk Kids

Dr. Babak Orandi sees patients in their 30s and 40s waiting for organ transplants because of damage that started when they were children. As both a transplant surgeon and obesity medicine specialist at NYU Langone, he wanted to know if doctors were being careful about prescribing newer GLP-1 medications to younger kids.

The results brought him relief. Among more than 3.5 million children ages 8 to 11 with obesity, only 0.6% received these prescriptions. Even more telling, 94% of those who did receive them had severe obesity with complications like sleep apnea, prediabetes, high blood pressure, or fatty liver disease.

These aren't healthy kids being medicated unnecessarily. They're children already facing adult diseases that put them on a path toward organ failure.

The data revealed something concerning too. The majority of children with severe obesity and complications never received treatment at all. This suggests doctors may be too hesitant rather than too quick to prescribe.

Dr. Orandi knows the discomfort many feel about children taking weight-loss medications. But he points to a harder truth: 20% of American children have obesity, and adolescents with severe obesity face up to nine times higher risk of chronic kidney disease in young adulthood. Childhood fatty liver disease increases mortality risk 40-fold.

His research showed a 310-fold increase in GLP-1 prescriptions for this age group since 2019, but the numbers remain small and targeted. Several drugs in this class are already approved for adolescents 12 and older.

The Bright Side

Pediatricians are getting it right. They're carefully identifying the children at greatest risk and offering evidence-based treatment while the medical community pushes for systemic changes to food environments, marketing practices, and neighborhood design.

Dr. Orandi advocates for both approaches working together. Three policies alone (taxing sugary drinks, ending tax deductions for junk food advertising to children, and improving school nutrition) could save more in healthcare costs than they cost to implement.

He chose obesity medicine because he wanted to meet patients at the beginning of their health stories, not at the end when they need transplants. For some young adults on transplant waiting lists today, early intervention might have changed everything.

The goal isn't to medicalize childhood but to respond to children whose health has already been compromised by an environment that produces obesity with remarkable efficiency. Thoughtful medical care and systemic change aren't competing priorities. They're both essential to keeping the next generation off transplant waiting lists.