Reuters World News - Wegovy and the future of childhood obesity

Episode Date: July 19, 2025

Teenagers in the United States are using Wegovy and other weight-loss drugs at quickly rising rates. On this special episode of Reuters World News, we look at the decisions facing parents and children in the battle against childhood obesity. Sign up for the Reuters Econ World newsletter here. Listen to the Reuters Econ World podcast here. Visit the Thomson Reuters Privacy Statement for information on our privacy and data protection practices.You may also visit megaphone.fm/adchoices to opt out of targeted advertising. Learn more about your ad choices. Visit megaphone.fm/adchoices

So I'm just going to start by having you tell me what your name is. My name is Austin James Smith. Austin Smith is about to start his senior year in a high school just outside of Kansas City, Missouri. And while he's preparing for his final year of school and considering his options for life after graduation, he's doing so with a renewed self-image. My starting weight was about 289 pounds. Austin is one of nearly 100,000 young people who've started taking Wagovi and other powerful weight loss drugs to manage chronic obesity. Eight million teens in the U.S. are living with obesity and with it the increased risk

of developing chronic diseases like type 2 diabetes, liver disease, and heart conditions, and faced with the more immediate threat of bullying and social isolation that can cause serious mental health risks. There's this one kid who called me pregnant because of my weight, which is a main one. And that's the main one that I can remember that stuck through me. So young people like Austin find themselves at a difficult crossroads. Do they continue down a path of conventional treatments like diet and exercise?

that often yield minimal, if any, weight loss results? Or begin what could be a lifelong treatment using these powerful GLP-1 injections despite concerns from doctors about nutritional deficiencies, eating disorders, and unknown long-term health effects? For Austin, his final year of high school is shaping up to look much different than how it began. Whenever I started walking onto the bus,

I noticed that my sides weren't constantly, hitting the seats of the bus since they're pretty narrowed together, which made me feel really happy and I was really ecstatic to tell my parents when I got home. But Austin's journey, like so many others, hasn't come without setbacks and struggles. On this special episode of Reuters World News, we'll talk to a parent taking the leap on a new medication that could bring her son much-needed relief from his struggles with weight. from health care providers considering how to use this powerful medication facing an epidemic of youth obesity.

And what the future looks like for those young people hoping this medicine will be the answer. I'm your host, Christopher Waljasper, in Chicago. When these powerful weight loss drugs became available to adults back in 2021, they came with a lot of questions. But when the Food and Drug Administration approved the use of Wagovi for people as young as 12, almost three years ago, the questions shifted. No longer was it a conversation between a patient and a doctor. Now parents are having these discussions with their teens about the potential benefits as well as possible repercussions that these medications could have on a young person going through a lot

of changes. Things like hormones, growth spurts, body image, social media, being a kid is hard. So two of our healthcare reporters, Chad Turhune and Robin Raspow, decided to follow a handful of young people and their families to better understand how they're approaching the decision to try these powerful weight loss drugs. Chad, Robin, thanks for joining me today. Thank you for having us. It's great to be here. So in all these conversations you had with young people and their loved ones, what were the considerations, things that were going through their minds? as they decided whether or not to take this medication. So when we started reaching out to families, a lot of the families were considering, one, whether

they could access these medicines because health insurance was still very limited and still for many people as today. And almost all families we spoke to did not want their children on the drug for the long term or a lifetime. And for the kids, they had different. priorities. We spoke with doctors and parents who wanted their kids to be healthy. And in some cases, that was the case for the kids as well. But for other kids, they wanted bullying or negative attention that they had received. They felt in part because of their weight to stop. And they felt like the drugs would help stop the bullying. Chad, of the medical experts you all spoke to, how are they approaching this medication as a possible tool in combating obesity among young people?

Yeah, I think a lot of pediatricians we talk to who are really alarmed at the rate of disease and young people. Many pediatricians never would have seen a child with type 2 diabetes for much of their career, and now it was becoming increasingly common to have 14-year-olds, 15-year-olds diagnosed with type 2 diabetes. And then what they told us was the disease accelerated so much faster in these young people. The complications were coming so much faster. And so you have people in their early 20s really facing some dire health circumstances. And then you also had liver disease and possibly heart disease. And so you start to have this effect where you could have people in their 30s and 40s possibly dying from preventable diseases. The rest of the rest of the heart disease. The rest of the

recommendation up until now has been this intensive lifestyle counseling program. And oftentimes, it was a huge time commitment. And the results, frankly, were often lackluster. So I think when these medications came on, there was a huge relief of like, wow, we have something we can offer these families that would be much easier to access and maybe would be even more effective. And so I think pediatricians and a lot of obesity specialists were very open to this. But then you certainly had a lot of other experts saying, oh my gosh, what are we doing? Because adults are one thing, adolescence, that is a critical phase of development. If you think of your cognitive development, your brain, your bone health, as a teen, you need to be consuming a lot of calories because that is

just feeding all of this development in your body. And so I think there was just a concern of like, sure, there's some immediate payoff. These kids could lose some weight. Maybe we, you know, prevent type 2 diabetes, heart disease, sleep apnea, a bunch of really troubling things. But what are we doing to them long term? And there was really no science or clinical trials that told us long term, what's going to happen with these kids, five, 10 years down the road? Do we have a clear understanding of why we've seen arise in obesity and some of these more troubling health concerns in younger people? I think obesity is a very complicated disease, and it is a chronic disease, and a mix of factors, I think, drive it, and everybody's

different. Certainly your genetics can play a role, certainly the environment we live in. But, like, yeah, if you look at the statistics, I mean, back in 1980, it was only about 5% of children or teens had obesity, and now it's more than 20%. So something certainly changed, and I think it was a whole range of factors, but I think for a lot of these families and these teens, to finally go into a doctor's office and not be blamed, not to face that stigma. And so many of them live that time and time again, a doctor basically talking down to them and really casting blame on them. And certainly I think the parents felt a lot of guilt like this is my fault. And that is just not the case. There are a whole factors that lead to this. And it's not because you're a bad parent. It's not because you didn't have

enough willpower to say no. This is a disease just like type 2 diabetes and a whole range of things. And I think finally they reach some doctors who are like, you know what, we're going to work on this together. You don't need to be carrying all this shame and stigma. So I think that's the other part of this story. And I think the medical establishment has had to come to grips with. We didn't always talk about this in the right way. Yeah, that's right. And with some of the families we spoke to there was a strong family history of obesity, which is indicative of a potential genetic cause. Another teen had a brain tumor when she was younger that had damaged part of her brain that influenced her metabolism. And another girl had PCOS or polycystic ovary syndrome, which increases the risk of weight

gain. So it was a wide variety of potential reasons. And again, as Chad said, obesity. is a complex disease, and we still don't really know what causes it, but there seems to be risk factors, and many of these children had one or more of those risk factors. Next, we'll talk to a parent who's faced this decision about how to best help a child struggling with their weight and considered these new powerful weight loss drugs. Stay with us. To better understand how these families are approaching these diseases, decisions. We wanted to talk to a parent who's been there. So Chad and Robin connected me with

Elizabeth Smith. She's the mother of Austin, who we heard from earlier. So I called her up. Elizabeth, thanks for joining me today. No problem. Thank you. We also reached out to Dr. Elena Vidmar, an associate professor of pediatric endocrinology, and the medical director of the obesity, medicine, and bariatric surgery program at Children's Hospital in Los Angeles. Thanks, Dr. Vidmar, for me in here. My pleasure. Okay.

So, Elizabeth, give us a sense of who your son, Austin, is. So Austin is 17. He will be 18 at the end of July. He does have very high functioning autism. He is very kind and outgoing. He's very much an extrovert. He has never met a stranger. He loves everybody.

he has a lot of trust in people. Like he thinks everybody is good. He's just a really awesome kid. He loves plants. He loves fishing. He's going into his senior year. And he actually takes AP classes at school and honors classes. So he's very intelligent.

So now tell me about how Austin's weight has played a role in his life leading up to the decision to take this medication? He had been bullied relentlessly over the years from as young as like fourth grade because he carries his weight in his stomach. And so a lot of kids would say, well, you look pregnant. You're so fat. When are you going to have your baby? And that just made him very like closed down and did not want to be.

around people just very, like, depressed and sad and just not a happy child. Oh, that's so hard. So, Dr. Vidmar, how are medical professionals thinking about our prior understanding of addressing weight with nutrition, with exercise versus these new medications that seem like, almost like a miracle drug in some ways by how effective they are. I think we're understanding that the science really shows that this is a complex disease process, right? And unfortunately, the weight stigma has held us in this place that really suggests that this is about behavior and willpower. And that sort of left us stuck in this space of we're going to try interventions and tools that we kind of know are set up to fail.

So we know that when you do diet and exercise alone, you may. maybe can lose five to 10 pounds in a year. And that's excellent if that's what's required to meet your health goals, where a lot of our newer weight loss medications, maybe you're looking at somewhere from 20 to 40 pounds in a year. And when you think about maybe weight loss surgery, you're looking at 100 pounds in a year. So each tool has an anticipated amount of weight loss that you're going to achieve. And we really need to think about pediatric obesity based on the severity of the condition. But to do that, you really have to embrace and understand the science behind it as a complex chronic disease. And I think, unfortunately, the weight stigma around young kids living

in larger bodies has prevented us from doing that. So we've kind of been stuck in the staged approach, which is kind of do one thing and then move on to the next thing and the next thing. And that's kind of left us stuck behind. But the new 2023 American Academy of Pediatric Guidelines really encourages us as pediatric clinicians to move into a complex chronic disease bottle, which is you see the young person in front of you and you really meet them where they're at. So Elizabeth, what was it like when Austin first started taking this medication? I mean, you had already started taking Wagovi before him, right? When I had taken my first dose of Wagovi, I had a little bit of reaction. So I was really trying to encourage Austin, let's wait until like school is out and then we'll do

year injection. But he was very persistent. He was like, I want to start it now. And so on May the 20th of 2023, we got home that day from his sister's graduation party. And he was like, we're doing my injection today. Like, I don't care what you say. And so I actually did the injection for him for about two or three weeks. And then he was like, I don't need your help anymore. I can just do this myself. And so now two years later, he remembers to take his injection himself every single Saturday. And he likes to do it very dramatically. Like he takes the pen and he's like, watch. He's like, Mom, watch. You're missing it. Oh my goodness. You make me so anxious when you do that. So how long after Austin started taking Wagovi did you like notice? Oh,

something's different. I think it was a few months. And what I learned from myself is when you see yourself every day or you see a loved one every day, to me, it's really hard to see that weight loss. So I learned very early on to take a lot of photos. And so that way you can really look back and you can compare. And so it was a few months. And I was like, let's do some photos. And then we compared a a photo that was taken on May 20th to a few months later, you could really see the decrease in his stomach size. And so it actually happened pretty rapidly. What was the perception among his peers when he went back to school in the fall? I made sure to check in with him frequently and ask, have you had any bullying?

Have you had any comments? And he said, no, it's fine. So why there wasn't like, oh, my goodness, you look amazing. there wasn't the bullying, and that is really what we were concerned about. But he was a marching band at the time, and even when he was at his largest at 300 pounds, his marching band uniform was too big. And so when he went back that fall, it was really, really big. And his band directors said, we offered him a smaller uniform, and he refuses. But he could put his arms and just stretch And so I said, give him a new uniform.

Here's this old one. I don't care if he argues with you. And so he got a new band uniform that was probably two or three sizes smaller. Because keep in mind, it was too big before. And it was actually like fitting to his size. And I think that's when a lot of people really started to notice. Because wearing big baggy clothes, it's hard to see. But when you put on something that's more like form fitting, his teachers definitely notice.

And they were like, wow, Austin, you look great. Have the physical changes allowed him to do anything he wouldn't have done otherwise? Like tremendously. He is not the same kid he was before Wagovi. So he had this amazing opportunity where last June in 2024, he got to go to Belize. it was like through school so he went with a group of teachers with the North Kansas City School District

and so he got to go to Belize and what we learned right before the trip is that there was zip lining in Belize So had he not lost the weight he wouldn't have been able to go zip lining he went on six different zip lines in Belize. And he took videos and

um sorry it makes me emotional. In the videos you can just hear his laughter. Nice to be done man. How was it? Adrenaline pumping

and yes. And he would not have had that amusing. experience had he not been able to lose the weight. My family's going to love this footage like always. We've talked a lot about the positive changes in Austin, but I want to make sure we are kind of taking a step back

and seeing the whole experience. Have there been any drawbacks? I would say really the only negative is made him more picky. He used to eat pretty much anything. And with Wagobe, he's kind of, he eats a lot of chicken fingers. We'll go to a Mexican restaurant and he gets chicken fingers. Go to a Cuban restaurant. Can I have some chicken fingers?

So Dr. Vidmar, adolescents are already going through so much change. How do medical providers help young people prepare for the psychological things that they're going to have to deal with for the chemical changes that are happening with hormones? Talk to me about the balance of weight loss and adolescents. These kids are developing. They are going through developmental stages. And so I think that that's where so many of us do this within some sort of multidisciplinary team, where there are physicians and dietitians and psychologists.

And we're considering that, right? How do we come alongside and partner? Like, I'm a sub-specialist as an endocrinologist, but I partner with primary care providers. And then really parents, right? Parents are the holders of everything that these kids are going through. So understanding really what they need to thrive. And even, for example, right, a lot of young kids living in larger bodies will talk about sort of the food noise that they experience and how just that light switch in their brain that controls when they're hungry and when they're full is not working well. So when they're not on these medications, they're thinking about food a lot and it's distracting from their day.

It's distracting from school. it's distracting from their relationships. And so that's a great example of for some kids, going on these medications really turns down the food noise and provides opportunity and space for other things to be either addressed and taken care of, maybe like another mental health condition or just space for other things to be enjoyed. How do you approach nutritional needs, right? So how do health care providers think about ensuring that balance when, these medications might impact the food choices of a young person?

I think that's really important. And I think there's a lot of really creative ways to do it. I think that working with registered dietitians who are the experts in this space, and again, really working with patients and families. I think where we are in 2025 is that we have all this beautiful science about food. What is the best most hopeful, healthful food that we can put in our bodies? But the key is, what does that look like in the family setting? right? So if a physician says, make all these changes in your home, change everything about your home

environment, but the family can't do it, then that's not helpful. Or if a young person says, I'm only going to eat chicken fingers. But the physician says, I want you to change everything else and eat no chicken finger. That's not going to be successful. So I think the key for us is how to focus on something that's going to be effective. So maybe it's just eat more protein and eating chicken fingers gets us there. And maybe a multivitamin or focusing on the fruits and vegetables that that young person likes. Right. So I think there's a lot of strategies that can really meet the patient where they are. So, Elizabeth, what does Austin's doctor say about the long-term plan for Austin, you know, as he moves into the final year of high school and beyond?

He was able to do genetic testing for both Austin and myself. He just wanted to see if there was any thing that could like map out or say like why we were obese. And for Austin, it came back with something called a POMC deficiency. And the way that I've understood it is like the switch in your brain that says you are full, you can stop eating now. But Austin does not have that. So he would just eat and eat and eat. So because of that pawn. see deficiency, they are thinking Austin is going to have to be on this medication for life, which is a little bit devastating for me as a mother. That's not something you want for your child, but he lacks that switch that says,

okay, you're full. You can stop. So he will just for now continue to be on the 1.7 milligram. he's right around 200 pounds. He is 5 foot 10. And I asked him, you know, what weight do you want to be at? And he's like, well, what weight do you think I should be at? I said, well, my goal is a mother. I just want you to be happy and I want you to be healthy.

So we really try to not focus that number on the scale. He doesn't weigh very often. maybe once every three or four months is how often he weighs. And that's just so we can keep track. Tell me more about feeling devastated at the idea that Austin might have to be on this medication the rest of his life. Health insurance is very expensive. Like, we pay about $500 a month, which is a lot of money. But we are very fortunate compared to other people who,

might pay $500 per pay period for one person. And then recently, at the beginning of the year, my company had to drop GLP ones. But I do work for a nonprofit hospital. And so we do have access to some programs that other places who are non-profits don't have access to. And so we are able to get it through our pharmacy. It's $100 a month or $250. for 90-day supply. Wow. Which before we were not paying anything out of pocket. It was completely free.

So while it is way under what the market value is for it, it's still more of an expense for us. Of course. Yeah. And of course, I can only carry him on my insurance until he turns 26. And then beyond that, it's just really up to him. Yeah. It's a big unknown.

Yes. Thank you. You took the words out of my mouth. It's very unknown. I can't control it. And that is scary. When you just want to, even if your child is 26 or 45, you just want the best for your child and you want to keep them safe and healthy. And I don't know what that's kind of look like in the next 10 years. And that's a little terrifying. So, Dr. Vidmar, is there a consensus in the medical community about young people taking these medications long term? They're certainly not a consensus yet, but I think there's a lot of understanding that these medications are not a cure for living in a larger body. They don't change the biology long term. So they work as long as you take them.

And then when you stop, they stop working. So I think we have to acknowledge what are the goals that we're talking. trying to achieve. And maybe you achieve those in the short term or in a shorter term, maybe two, five years. But I think there are definitely a group of young people that are going to need them their whole life, kind of like we're talking about with Austin. And that's okay. And again, I think it comes back to this complex chronic disease idea. There are plenty of young people with type one diabetes, with asthma, where they get diagnosed as a kid, and we know they're going to need their treatment their whole life. So I think it's really a redefining what is the condition and what do we

think the treatment's going to be like over time. We all want more data. We want to understand long term. But I also think it's okay to understand the condition and that it might very well be something with the treat long term because we know what it looks like to not treat and what those risks are. Now, Austin's experience on Wagovi these last few years has been life. changing, even with the ups and downs he's faced along the way. But as our health care reporters, Chad and Robin, have reported, for a lot of the young people they've spoken to, those experiences haven't been as clear cut. So Chad, Robin, tell me about Stephanie Serrano and the struggles she's faced on her weight loss journey. Yeah, Stephanie was a young woman that we met in Maryland,

and she had zero interest in taking a weight loss medication. She was over 300 pounds, really struggling. She knew something needed to change. Every time I went to the doctor, it would always be like, oh, you're unhealthy, you're overweight, you're too big for your, you know, for your age, for your grade, for everything. Stephanie already had type 2 diabetes. She already had liver disease. She was really struggling health-wise, and her doctor was very concerned. She was depressed. She would really become a shut-in. This was during COVID. She had stopped going to school in person. Because I was like, I'm going to see people from school. They gave her an option to return, and she said, no, I'm going to stay home.

She really did not want to be around other people. I haven't seen a lot of people in years, and if they see me, it's just like, oh, you look the same. And she really had just cut herself off from the rest of her life and was really struggling with, what do I do? Is this how the rest of my life is going to be like? And at the time, it was like social media was just everywhere, and everyone was just having glowups and I was just like, where's mine at? I mean, for all these teens, social media is a

huge part of their life. And so at one point, she was seeing all of her friends in high school on social media and all these wonderful videos. And she just felt, you know, as an outsider. It's like, I can't share anything like that. She felt very isolated. And she shared with me that she felt, you know, It was silly to even flirt with a boy because, you know, who would like me, who could ever love me. I finally gave up and I was just like, you know what, nothing's going to change, you know. And Stephanie agreed to try OZMPIC and actually did lose weight on it, but she did not like taking an injection and she certainly did not want to take a medication long term. She really wanted weight loss surgery. That's what she was seeking, a real permanent change in her life.

So Stephanie loses some weight on OZemps. and more still when she undergoes gastric sleeve surgery. How does that change her physical and mental health? She had a lot of success losing weight. Her type 2 diabetes went into remission. Her liver function improved. So on the health front, a lot of improvement. She did find it a little easier to make friends and be more active at her local church

in activities. But even then she would say kind of inside her head, like, well, why are you offering to be my friend now? Why weren't you my friend a year ago when I was a lot heavier? So it was just complicated in these people's lives of just navigating all this. You know, it didn't magically solve everything. Physically, I'm doing great, but my person, I didn't change what I am. I'm not a different person.

I'm the same me, but I'm the same me, but I still see the same. body that I had before surgery. And then a new problem emerged. She became afraid of gaining all the weight back. And I was in denial of that for a while. I was doubting myself, like, that's not how I look. That's insane. And so her relationship with food was very fraught.

She had a psychologist. They were all urging her, look, you need to continue to eat, you need to eat protein, you need to continue to exercise. I became obsessed with counting calories. I became obsessed with working out. I was over counting my calories. And that's where it really messed me up to be scared of food. But she would just eat a little bit of food,

and then she'd feel like she'd have to go exercise, you know, feverishly for an hour to work it all off. Or she would skip meals, which was a very common thing that a lot of these teens told us. Either they weren't hungry, or in her case, she was just afraid of really eating everything. So she was guzzling energy drinks and doing a lot of things that, frankly, that were unhealthy because you still needed to have adequate nutrition

after taking these drugs or having surgery in her case. And so at one point, her doctor diagnosed her with an eating disorder, which is one of the main concerns for young people taking these drugs, is that their relationship with food becomes very, very complicated. And she was obsessing over the nutritional labels on food. She would scan them and say, oh, you know, I've already had. had X number of calories a day, I can't have any more. And finally, her psychologist had to tell her, like, look, that's well-intentioned, but you've got to stop looking at those nutritional labels. You've got to stop doing that. There's a lot of kids that do look up to me.

And so that is something she has continued to work on. She says she's made progress, but it's still really difficult that relationship with food going forward. Like, I want to be like you. And I was like, I want you to be better. I think one of the reasons we wanted to do this story is that these kids are the first wave of teenagers who have been able to access these drugs. And like Chad said, we just don't know what happens in the long term after kids have been on the drugs for a while, both physically and mentally. And that's one of the reasons where you pursued this story is to understand when this small, sampling of families that we followed and spoke to, how are they doing? And, you know, another thing to think about is, in order to approve these drugs, the manufacturer Novodordis, studied children

or teens for a little over a year. And most of the kids that we've talked to have now been on these drugs for longer than that. So it's really in some ways uncharted new territory. And that's why it was so interesting for us to follow these families for the length of time that we did and, you know, hopefully others will as well to understand how it works in the long term for these kids. A huge thanks to Robin Rispow and Chad Turhune for their reporting, as well as Callahan O'Hare, who conducted the interviews with Austin and Stephanie. Thank you to Elizabeth Smith and Dr. Vidmar for sharing their stories and expertise. The Reuters podcast team includes Bilkasu Labaron, David Spencer, Gail Issa, Kim Vennel, Sharon Reichgarson, Jonah Green, and myself, Christopher Walgessler.

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