Prescriptions for Obesity Medications Among Adolescents Aged 12-17 Years with Obesity - United States, 2018-2023.

Obesity affects approximately one in five U.S. adolescents. Although an increasing number of medications are approved for adolescent obesity as an adjunct to health behavior and lifestyle treatment, national data on the prevalence and correlates of obesity medication prescribing for adolescents are sparse. Ambulatory electronic medical record data were analyzed to assess trends in the proportion of U.S. adolescents aged 12-17 years with obesity (body mass index ≥95th percentile) who were prescribed Food and Drug Administration (FDA) -approved obesity medications during 2018-2023. Log-binomial models were used to estimate characteristics of adolescents associated with receiving an obesity medication prescription in 2023. The proportion of U.S. adolescents who were prescribed obesity medications increased substantially in 2023 (by approximately 300% compared with 2020), the year after FDA expanded its approval of two obesity medications to include adolescents and after publication of the 2023 American Academy of Pediatrics clinical practice guideline. Despite this substantial relative increase, 0.5% of adolescents with obesity were prescribed an obesity medication in 2023, with a majority (83%) of prescriptions received by adolescents with severe obesity. Semaglutide (Wegovy, indicated for persons aged ≥12 years with obesity), and phentermine or phentermine-topiramate were most commonly prescribed. Prescribing prevalence was higher among girls than among boys (adjusted prevalence ratio [aPR] = 2.05), among adolescents aged 15-17 years than among those aged 12-14 years (aPR = 2.24), and among those with severe (class 2 or class 3) obesity than among those with class 1 obesity (aPR = 4.03 and 12.78, respectively). Prescribing prevalence was lower among Black or African American adolescents than among White adolescents (aPR = 0.61). Continued monitoring of the use of these medications could help guide strategies to ensure that all adolescents with obesity have access to evidence-based obesity treatment, including medications and health behavior and lifestyle interventions.