A Growing Global Health Challenge
The battle against adolescent obesity has become a major public health priority. Globally, the prevalence of obesity among those aged 5-19 has quadrupled since 1990, with an estimated 170 million children and adolescents living with obesity in 2024. This
trend is mirrored in India, which is witnessing a rapid surge in overweight and obesity across all age groups. Projections suggest India could be home to over 27 million children and adolescents with obesity by 2030. This is not just a matter of numbers; obesity in youth increases the risk of serious health problems like type 2 diabetes and cardiovascular disease, and can lead to significant mental health challenges, including stigma and bullying.
The New Wave of Obesity Medications
In recent years, a class of drugs known as GLP-1 receptor agonists has emerged as a powerful tool in weight management. Medications like semaglutide (Wegovy) and liraglutide (Saxenda), originally developed for diabetes, mimic a gut hormone that signals fullness to the brain and slows stomach emptying. Clinical trials have shown significant results; in one major study, adolescents using semaglutide lost an average of 16.1% of their body weight over 68 weeks. These drugs, administered via injection, are approved for use in adolescents aged 12 and older in many countries. Their effectiveness has led to a rapid increase in prescriptions.
WHO's Call for a Measured Approach
In its first-ever global guidelines on the issue, the WHO has clearly stated that medication should not be the first or only solution. The organization recommends against the use of pharmacological treatments for children under 10. For adolescents aged 10 to 19, the WHO advises that approved medicines should only be considered after a comprehensive, supervised program of lifestyle changes—including diet, physical activity, and behavioural support—has failed to produce desired results. Dr. Luz María De Regil, a director at the WHO, emphasized that the foundation of care is not medicine or surgery, but access to comprehensive support for healthy living.
Weighing the Unknowns and Potential Risks
The WHO's caution is rooted in the lack of long-term data on how these potent drugs affect growing bodies. Adolescence is a critical period of development, and experts have raised concerns about the potential impact on growth, bone health, puberty, and brain development. Common side effects include nausea, vomiting, and diarrhea, while more serious but rare risks like pancreatitis and gallbladder issues have been noted. There is also the question of what happens when the medication is stopped, with studies suggesting that weight is often regained. Furthermore, experts warn about the potential for triggering or worsening eating disorders in a population already vulnerable to body image pressures.
Beyond the Prescription: A Holistic Strategy
The clear message from the WHO and other health experts is that medication cannot be a standalone 'cure' for obesity. The guidelines stress a person-centred approach where the goal is improving overall health and well-being, not just weight loss. This requires a multi-pronged strategy that includes structured dietary and physical activity interventions, along with behavioural and psychological support for the entire family. In the Indian context, where generic versions of some of these drugs are becoming available, ensuring they are prescribed responsibly within a comprehensive care plan is crucial. The focus must remain on creating supportive environments that make healthy choices accessible and affordable for all children.
