Understanding Pediatric Weight Loss Medications: A Guide for Parents
As pediatric obesity rates continue to rise, more families are looking for solutions beyond lifestyle changes alone. Achieving and maintaining a healthy weight can be challenging because of the underlying biological influences. While nutrition, physical activity, and behavioral changes are crucial, some children may benefit from weight-loss medications. As I tell my patients, “medication can help us make the changes that we are trying to make.” This guide will help parents get a better understanding of when medications are appropriate, how they work, their costs, and what to expect.
Please refer to our previous discussions for more information about
How to Determine Your Child’s BMI
Body Mass Index (BMI) is a common tool used to assess a child's weight status. Although BMI is not a perfect measure, it helps healthcare providers understand weight in relation to height.
Steps to Calculate BMI for Your Child
Use the CDC BMI Calculator
Enter your child's age, weight, height, and gender.
Click "Calculate" to get their BMI and percentile ranking.
Understand the BMI Percentiles
Underweight: Below the 5th percentile
Healthy weight: 5th to 84th percentile
Overweight: 85th to 94th percentile
Obesity: 95th percentile or higher
Severe obesity: 120% of the 95th percentile
What if My Child is in the Obese Category?
Discuss with a healthcare provider.
Look at growth trends. A child’s BMI over time is more important than a single number.
Consider medical support. If lifestyle changes alone are not effective, medication may be an option.
When Are Weight Loss Medications Considered for Kids?
The American Academy of Pediatrics (AAP) and the Obesity Medicine Association suggest that weight-loss medications can be considered for children with obesity when:
BMI is above the 95th percentile, especially if rapidly increasing.
Other health conditions are present, such as prediabetes, high cholesterol, fatty liver disease, or sleep apnea.
The child struggles with strong food cravings or loss-of-control eating.
There is a family history of severe obesity or bariatric surgery.
Remember that your doctor will discuss these options with you and monitor closely for side effects. Some children have no side effects at all. Others may need to change doses or medication types. As you can see there are several options available.
FDA-Approved Medications for Pediatric Weight Loss
1. Qsymia (Phentermine-Topiramate)
FDA-approved for ages 12+
How it works: Increases fullness, decreases appetite, and food cravings
Cost: $99/month (cash price)
Common side effects: Tingling sensations, taste changes, mood changes, dizziness
2. Phentermine (Adipex)
FDA-approved for ages 16+ (used off-label for younger kids)
How it works: Suppresses appetite
Cost: $15-$30/month
Common side effects: Increased heart rate, sleep issues, possible anxiety
3. Topiramate
Typically used for seizure disorders and migraine headaches in children as young as 2 years of age
Used off-label for weight management
How it works: Reduces food cravings and promotes fullness
Cost: $15-$30/month (usually covered by insurance)
Common side effects: Numbness/tingling, taste changes, fatigue
4. Vyvanse (Lisdexamfetamine)
FDA-approved for ADHD in children and binge eating disorder in adults
Used off-label for weight management
How it works: Controls impulsive eating and food cravings
Cost: $100/month (without insurance), frequently covered by insurance
Common side effects: Jitteriness, anxiety, increased heart rate
GLP-1 Medications
These medications mimic natural hormones that regulate hunger and help control appetite. GLP-1 medications have actually been in use for 20 years. GLP-1 medications have become more effective and convenient with the newer formulations.
5. Wegovy (Semaglutide)
FDA-approved for ages 12+
How it works: Reduces hunger and slows stomach emptying
How it is given: Once WEEKLY injection
Weight loss: Average ~17% BMI reduction
Cost: $499/month (recent price drop)
Common Side effects: Nausea, vomiting, constipation
6. Saxenda (Liraglutide)
FDA-approved for ages 12+
Recent studies have shown safety and efficacy in children ages 6 - 11
How it works: Reduces appetite and food cravings
How it is given: Once DAILY injection
Weight loss: ~5% BMI reduction
Cost: $340/month (now available in generic form)
Common Side effects: Nausea, vomiting, constipation
7. Zepbound (Tirzepatide)
Currently FDA-approved for adults for obesity and sleep-apnea (being studied for children)
How it works: Targets multiple hunger-regulating hormones
Weight loss: ~20% weight reduction in adults
Cost: $499-$699/month
Common side effects: gastrointestinal side effects are less frequent
What Should Parents Expect with Medication?
Lifestyle changes are still needed: Medications work best alongside nutrition and behavior changes.
Weight loss may be gradual: Some children may see rapid changes, while others plateau before additional loss. Everyone responds differently.
Adjustments may be necessary: Some kids respond well to one medication but not another. Monthly visits allow us to tailor medications to your child’s needs.
Insurance coverage varies: Many of these medications are not covered by insurance, requiring out-of-pocket payment.
What About Long-Term Use?
Obesity is a chronic condition, meaning some kids may need medication long-term.
If children lose enough weight and develop healthier habits, they may be able to discontinue medication slowly with medical supervision.
Research is ongoing to determine what the risks and benefits of long-term use are.
We already know the long-term effects of having obesity. Obesity increases risk for over 200 weight-related conditions including diabetes, heart disease and cancer.
Your doctor will carefully weigh the risks and benefits with you at your pediatric weight management appointment.
Take Home Message
Weight loss medications can be life-changing for children with obesity, especially when combined with healthy lifestyle habits and medical supervision. While cost and side effects are factors to consider, these medications offer hope to children struggling with weight-related health issues. Working closely with a pediatric weight management doctor will allow shared, personalized decisions, monitoring and adjustments as needed.
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