Are Teens Eligible for Weight-Loss Drugs or Surgery?

If your teen has a body mass index (BMI) in the overweight or obese categories, they’re not alone. Obesity has become one of the most common chronic conditions in childhood. In the U.S., 1 in 3 children and adolescents fall into the overweight or obese BMI categories. And this puts them at risk for serious short- and long-term health risks later in life. So many caregivers are looking for safe and effective treatments to help their teens manage their weight. 

With so much attention around weight-loss medications, like Wegovy (semaglutide), you may be wondering if this is an option for your teen. Let’s take a closer look at all of the healthy weight-loss options available and how you can help your teen.  

What is a healthy weight for teens?

There’s no one-size-fits-all weight for teens. What’s considered a healthy weight will differ from person to person. Right now, BMI is the most used tool to determine someone’s weight category. While it’s a convenient tool, it’s not perfect.

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BMI doesn't measure body fat directly. It predicts the amount of body fat based on height and weight. Some studies have shown that a higher-than-average BMI for a child may predict future health risks. But keep in mind that it’s just a screening tool and not a perfect measurement. 

For children, the BMI category of a “healthy weight” is assigned using percentile curves based on age and sex. Overweight is defined as a BMI between the 85th and 94th percentile for children and teens of the same age and sex. Obesity is defined as a BMI of the 95th percentile for children and teens of the same age and sex.

How can teens lose weight safely?

There are safe and effective ways to help teens lose weight, but they’re not quick and easy. That’s because obesity is a complex condition. And the most successful treatment approaches consider all of the factors that may be at play.

This usually starts with parents and family addressing lifestyle factors within the family. From there, obesity treatment may consist of:

• Management of underlying conditions (like depression or polycystic ovarian syndrome)

• Nutrition support

• A physical activity plan

• Behavioral therapy

• Medications

• Surgery (in rare cases)

Do weight management programs work for teenagers?

With the supervision of a healthcare professional, weight management programs for teens are very effective. But long-lasting diet, lifestyle, and behavioral changes are not easy to make without additional support. 

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These programs offer intensive treatment with a team approach that involves a:

• Physician

• Nutritionist

• Mental health provider

Unfortunately, these designated programs are not available in all areas. When there’s limited access, you may still be able to find individual providers and services. 

Should teens take weight-loss pills?

A healthcare provider may prescribe children and adolescents medication to lose weight as a part of their treatment plan. But options are generally limited for teens. That’s because there isn’t much research available on teens and weight-loss medications. 

In general, experts only recommend weight-loss medications as an option for teens after they try a weight management program. Even then, these medications are reserved for children who: 

• Have more immediate risk of health problems related to obesity

• Are at least 12 years old (16 and up for some medications)

• Have a BMI of at least the 95th percentile or more

Oral medications that are commonly used in teens who meet the above criteria include:

• Orlistat blocks the absorption of fat by blocking certain digestive enzymes. It can have side effects like gas and diarrhea that make it hard to tolerate. Average weight loss is 5-10 lbs in 6 months.

• Phentermine is a stimulant that works by reducing appetite. It’s only used short term for teens 16 years old and older because of the risk of serious side effects affecting the heart. Average weight loss is 8 lbs in 2 weeks.

• Phentermine / topiramate (Qsymia) is a combination medication that works to reduce appetite. Average weight loss is 15 lbs in 3 months.

Making the decision to take weight-loss medication is a personal one. You should always discuss the risks and benefits with your provider. They will help determine the best weight management plan for your teen based on their specific health and lifestyle history. 

Is Wegovy safe for teens?

Wegovy (semaglutide) is a safe and FDA-approved once-weekly injection to treat obesity in children and teens over 12 years old. It works in the brain to decrease appetite, and it slows the rate at which the stomach empties. This lets your teen feel fuller for longer and decreases the amount of calories they take in.

The most common side effects are gastrointestinal symptoms like nausea, vomiting, and diarrhea. Most of these symptoms are mild and resolve within a few days. 

A recent study found that teens who took Wegovy and made lifestyle changes had a greater reduction in BMI compared to similar medications. And Wegovy can also lessen heart-health risks. Treatment also led to improvements in metabolic risk factors like cholesterol and HbA1c levels. 

Saxenda (liraglutide) is another medication in the same class as Wegovy. This daily injection is approved for teens 12 years old and older. Like any medication, you should have a full discussion with your healthcare provider on whether Wegovy is appropriate for your teen. 

Is weight-loss surgery an option for teens?

For some teens, lifestyle changes and medication alone are not enough to treat the complications of obesity. In these severe cases, weight-loss surgery may be an option. The more commonly used weight-loss surgeries are the gastric sleeve or gastric bypass. 

Providers may recommend weight-loss surgery for a teen who:

• Is 13 years old or older

• Has a BMI of 35 or greater (above the 120th percentile) with weight-related health complications

• Has a BMI of 40 or more (above the 140th percentile) with no weight-related health complications

There are many things to take into account when considering weight-loss surgery for your teen — including costs. Insurance coverage varies for teens under the age of 18.

The benefits of weight-loss surgery can be great. Research shows that 95% of teens reversed Type 2 diabetes, and 80% of teens no longer had high blood pressure after surgery. 

When to ask your teen’s doctor about weight-loss treatment

Growth and weight measurements are an important part of development and should be discussed regularly at primary care visits. If you’re concerned about your child's weight, let your healthcare provider know. They can offer tips and suggestions on how to manage their weight and develop a treatment plan. 

In some cases, they can also refer you and your teen to a weight management specialist for more specialized treatment. 

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Written by:

Louisa Salisbury, MD

Louisa Salisbury, MD, is a licensed, board-certified general pediatrician. She received a bachelor’s degree in human development from the University of California, San Diego, and obtained her medical degree from the University of Vermont Robert Larner College of Medicine.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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