When I first saw the CDC’s MMWR latest report on obesity medication prescribing for adolescents, my initial reaction was probably the same as yours: less than 1 percent of teens with obesity got these medications in 2023? That seems pretty dismal.
But then I took a step back and looked at what this data is telling us. And honestly? We’re missing the real story here.
We’re witnessing something historic.
Think about where we were just five years ago. We had essentially no FDA-approved obesity medications for adolescents. The conversation around childhood obesity has long been dominated by a simplistic “eat less, exercise more” approach, which we now know doesn’t work for everyone. Now we’ve got semaglutide, phentermine-topiramate, and clear AAP guidelines telling us exactly when and how to use them.
That 300 percent increase in prescribing in 2023? That’s not a small bump—that’s a seismic shift. We went from virtually zero to helping over 400 adolescents in this database alone. Scale that nationally, and we’re talking about thousands of kids who now have access to treatments that could genuinely change their lives.
I’ve practiced pediatrics long enough to recall when childhood obesity was rarely discussed as a medical condition. Now, we’re prescribing evidence-based medications for obesity as a disease – remarkable progress.
Beyond the headlines, the data tells a more compelling story
Here’s what really caught my attention: 83 percent of these prescriptions went to adolescents with severe obesity. This isn’t random prescribing or jumping straight to medications for every overweight kid. Providers are making thoughtful clinical decisions about who needs these interventions the most.
The medications being prescribed also make sense. Semaglutide dominated, followed by phentermine combinations—exactly what you’d expect based on the evidence. The evidence shows that providers are aligning their practice with the guidelines.
The challenge is real, but so is the solution.
The most significant barriers I see aren’t medical—they’re systemic. And that’s encouraging because these are problems we know how to solve.
The racial disparities in the data are stark and unacceptable. Black adolescents were 39 percent less likely to get these medications despite being 27 percent more likely to have severe obesity. But every factor driving this disparity is something we can address: Insurance coverage barriers, cost issues, prior authorization hurdles, and provider knowledge gaps.
I’ve seen how quickly things can change when the medical community decides to tackle a problem. Look at how we transformed adolescent depression screening and treatment over the past decade. We can do the same thing here.
We need health care systems to streamline their treatment pathways for obesity. We need medical schools to recognize obesity medicine as a legitimate specialty. We need policymakers to realize that covering obesity medications isn’t optional—it’s essential health care. We also need continuing education programs that help every pediatrician feel confident in addressing obesity comprehensively.
What excites me about where we’re headed
For the first time in my career, I feel like we have all the pieces in place to really tackle childhood obesity:
- We’ve got medications that work.
- We’ve got clear clinical guidelines.
- We’ve got changing attitudes.
A personal perspective
I’ve seen too many of my patients struggle with obesity through their teenage years, knowing that their excess weight was increasing their risk for diabetes, cardiovascular disease, and mental health comorbidities. I’ve had countless conversations with families where we’d go through the motions of discussing diet and exercise, while the unspoken reality hung in the air—that we were essentially offering band-aids for a condition that required real medical intervention.
But that’s changing. Last year, I treated a 16-year-old African American girl whose BMI was 44 Kg/m2. She was withdrawn, struggling with depression, and had essentially given up on physical activity. Using the new AAP guidelines, I started her on evidence-based obesity medication alongside counseling and lifestyle interventions.
Over eight months, she lost 30 percent of her body weight, bringing her BMI down to 34 Kg/m². More importantly, I watched her transform from a depressed teenager into someone who now loves cooking healthy meals and actually asks to go on family hikes. Her mother told me, “You gave me my daughter back.”
Not every success story requires medication, though. I also treated a 9-year-old with a BMI of 30 Kg/m2 using personalized ultra-processed food counseling and a holistic family approach. We worked together to eliminate his daily habit of soda and chips, replacing them with healthier options that the whole family could embrace. With daily exercise becoming a family activity, he has now achieved a BMI of 25 Kg/m2 and is a happy, confident fourth-grader who looks forward to recess again.
Both cases show what’s possible when we treat obesity as the complex medical condition it is—sometimes requiring medication, and/or intensive lifestyle intervention, but always requiring a comprehensive, family-centered approach.
That’s the real satisfaction of treating obesity as the medical condition it is. Now I can offer something more. I can prescribe medications with real evidence behind them and treat obesity as part of comprehensive primary care. I can help other pediatricians understand the counseling approaches and treatment options that work, supporting them as they incorporate obesity medicine into their own practices.
That feels like hope to me.
Looking forward
That 0.5 percent prescription rate? I don’t see it as a failure. I see it as our starting point. Every year, that number should increase as more providers become comfortable with these medications, more insurance plans cover them, and more families become aware of their options.
In the next decade, I envision treating severe adolescent obesity becoming as routine as managing adolescent depression or diabetes, with every pediatrician confidently discussing obesity medications with suitable patients and no cost or access barriers hindering care.
The momentum is already building. The tools are in our hands. The evidence is clear. Now we just need to use them. This isn’t about being satisfied with where we are—it’s about recognizing how far we’ve come and feeling energized about where we’re going. Because for the first time in a long time, I genuinely believe we can turn the tide on childhood obesity.
And that’s worth getting excited about.
V. Sushma Chamarthi is a pediatrician and obesity medicine physician.
