Nov. 10, 2022 — The prospect of being concerned in a analysis program that may assist her drop extra pounds intrigued Emmalea Zummo. At 15, the confident, energetic teenager from Jeanette, PA, weighed 250 kilos – sufficient to be thought-about overweight. The trial she realized about by way of her endocrinologist was for a drug known as semaglutide.
Earlier than becoming a member of the examine, Emmalea had exhausted a reservoir of methods.
“She had been doing a wide range of train applications, was concerned in numerous sports activities and actions to remain lively, as a few of her early docs stated that will work,” Davina Zummo, Emmalea’s mom, says. “She counted energy, did a gluten-free food plan, restricted what she ate, when she ate, and the way a lot.”
Emmalea lower out all snacks, junk meals, and sweets, however nothing made a distinction, Zummo says: “She felt defeated.”
The FDA final yr authorized semaglutide, which was developed initially as a therapy for sort 2 diabetes, for weight reduction in adults. However researchers needed to know if the drug, which targets areas of the mind that regulate urge for food, additionally might assist adolescents drop extra pounds. Emmalea was curious, too.
Though usually youngsters might be judgmental of one another, Emmalea’s associates “had been comfortable for me, consistently motivating and supportive,” she says.
In the present day, Emmalea, now practically 18, says the remedy helped her lose 75 kilos, giving a lift to the life-style and food plan teaching she obtained all through the 68-week examine.
Dad and mom of teenagers like Emmalea who battle with weight problems hear the identical chorus: If their children slash the sugar, eat wholesome snacks as an alternative of junk meals, and train usually, the outcomes will comply with.
However for a lot of obese youths — as with adults — shedding kilos usually proves irritating. Positive factors come and go, regardless of good intentions.
May remedy assist?
A new examine within the New England Journal of Drugs reveals that semaglutide can certainly result in small however significant losses of extra body weight. Whether or not that’s sufficient to tip the scales, because it had been, towards total higher well being is unclear, however the findings have specialists in little one well being optimistic.
“There’s a actual want for protected and efficient drugs to deal with weight problems,” says Silva Arslanian, MD, a pediatric endocrinologist on the College of Pittsburgh College of Drugs and a co-author of the brand new examine.
“Usually, we make life-style suggestions: Eat extra greens; don’t eat fried meals; don’t drink soda,” Arslanian says. Sadly, she says, we reside in a world the place “it may be very laborious to make these modifications.”
Many consultants agree that remedy must be a part of the dialog.
“It’s thrilling to see this therapy turning into accessible. And the examine outcomes counsel few unwanted effects, so the drug was protected and tolerable,” says Amanda Staiano, PhD, a researcher on the Pennington Biomedical Analysis Heart at Louisiana State College in Baton Rouge. “Though not authorized but by the FDA, semaglitude and different new drugs are remodeling weight problems therapy for adolescents. It may be an thrilling time for treating weight problems.”
Staiano stresses, nevertheless, that life-style and behavioral counseling are key for the success of any weight problems therapy, together with medicine like semaglutide.
Daniel Weghuber, MD, a pediatrician at Paracelsus Medical College in Salzburg, Austria, says that though weight problems is “not a difficulty of lack of willpower, this drug appears to allow people who find themselves dwelling with weight problems to stick to the suggestions that they’ve been following for years and years however weren’t capable of obtain the purpose. I believe that that is necessary. It allows folks to attain their targets.”
Within the new examine, 201 overweight or obese girls and boys between the ages of 12 and 18 obtained both once-weekly injections of semaglutide or sham photographs. In addition they all obtained life-style interventions — counseling on wholesome diet and bodily exercise — all through the practically 16-month examine.
By the top of the examine, 75% of the adolescents who obtained semaglutide had misplaced and stored off at the very least 5% of their extra physique weight, in comparison with 17% of those that bought the sham injections. On common, these handled with the drug misplaced 33.7 kilos, in comparison with a median of simply 5.3 kilos within the different group.
Weghuber stated the analysis suggests the mixture of life-style modifications and weight problems drugs “will open up a brand new chapter” for treating adolescents with weight problems.
Greater than 340 million kids and adolescents worldwide aged 5-19 had been obese or overweight in 2016. Within the United States, weight problems affected 22.2% of 12- to 19-year-olds from 2017 to 2020, in accordance with the CDC.
Weight problems is linked with decreased life expectancy and better danger of growing critical well being issues comparable to sort 2 diabetes, coronary heart illness, nonalcoholic fatty liver illness, sleep apnea, and sure cancers. Youngsters with weight problems are additionally extra prone to have melancholy, nervousness, poor vanity, and different psychological points.
Whereas weight problems in kids has lengthy been a public well being concern, the issue has worsened in the course of the COVID-19 pandemic, Melissa Ruiz, MD, with the Pediatric Diagnostic Heart in Ventura, CA, says. A few of her sufferers who had been “chubby” pre-pandemic had weight beneficial properties of 20-30 kilos at post-pandemic clinic visits, she estimates.
Ruiz and different consultants say dad and mom ought to discard the notion that weight problems is one thing kids – or adults — are doing to themselves, or that they’re failing their kids by not protecting their weight in verify.
“There are genetic parts that determine into weight problems, and we now have to acknowledge that,” Ruiz says.
Dad and mom ought to search assist from their little one’s pediatrician. “If the pediatrician can not aid you, ask, ‘The place can I am going?’ Say, ‘I perceive that you simply won’t be educated on this but’ and ask for a reference for somebody who might help,” Ruiz says.
However remedy shouldn’t be thought-about an all-in treatment, in accordance with one skilled.
“Medicine is a final resort, solely after behavioral interventions fail and after exploring the vary of behavioral methods to weight reduction, together with altering dietary patterns comparable to timing and meal plan,” says Lydia Bazzano, MD, PhD, a diet researcher at the Tulane College College of Public Well being and Tropical Drugs in New Orleans.
Medicine and even surgical procedure have a spot, however provided that sufferers have exhausted all of the dietary and life-style choices, Bazzano says. “You don’t need the adolescent to have a lifetime of remedy. Medicine ought to solely be used to kickstart the kid to the purpose he must be — after which keep that weight,” she says.
Adolescent weight problems is a really tough topic to navigate, Bazzano provides. “You must have interaction all the household, and never simply the kid. It needs to be on the degree of the entire household, and that may be very difficult. If all the household engages collectively, there generally is a modest weight reduction.”
And Bazzano says she’s not impressed with the load loss seen within the newest examine. A 5% drop in physique weight is useful, she says, however “that’s not sufficient of a lower to say the kid is out of the dangerous vary.”
Staiano thinks consultants want extra details about semaglutide earlier than they need to begin prescribing it to children.
“We have to see long-term outcomes from persistent remedy use and whether or not weight rebounds when adolescents cease utilizing the remedy,” she says.
“How lengthy ought to the remedy be prescribed? For the remainder of their lives? How can we help sufferers who’re capable of lose such a major quantity of weight? How can we guarantee these therapies — behavioral counseling, drugs, and weight reduction surgical procedure — are accessible and financially inside attain of households?”
Emmalea, who stopped taking semaglutide a few yr in the past, has maintained her weight because of concentrating on a well-balanced food plan and train. Whereas she says she’s happy along with her progress and “feels snug in my very own pores and skin,” she doesn’t think about her present weight of 171 kilos to be the top zone. “I’d prefer to be someplace between 145-150,” says the 5’4” highschool senior.
Nonetheless, she says, “I don’t strictly monitor myself as a result of considering of meals in a damaging approach is just not wholesome and might really result in worsening a meals dysfunction.”
When she launched into the examine, she wasn’t certain it might be efficient for her. However due to her curiosity in medication and analysis, she says, she needed to be concerned: “I believed that if it didn’t assist me, at the very least it would others.”