Emmalea Zummo was excited about the possibility of taking part in a study that could assist her in losing weight. The confident, active youngster from Jeanette, Pennsylvania, weighed 250 pounds at age 15, which qualified him as obese. Her endocrinologist informed her about a medication called semaglutide that was being tested in the trial.
Before beginning the study, Emmalea had used all of her available options.
She participated in a wide range of fitness regimens and other sports and activities to stay active because some of her early doctors recommended it, according to Emmalea Zummo’s mother, Davina Zummo. She controlled what and how much she ate, watched calories, and followed a gluten-free diet.
Zummo claims that Emmalea eliminated all snacks, junk food, and sweets but that nothing changed and “she felt defeated.”
Semaglutide, which was initially created as a therapy for type 2 diabetes, was licenced by the FDA last year for weight loss in adults. The medicine, which targets brain regions that control hunger, was being studied by researchers to see if it could also aid with adolescent weight loss. Emmalea shared this interest.
Although it’s common for teenagers to judge one another, Emmalea adds that her peers “were delighted for me, continuously pushing and helpful.”
Today, Emmalea, who is almost 18 years old, claims the medicine assisted her in losing 75 pounds, supporting the lifestyle and dietary counselling she received during the 68-week trial.
The same message is repeated to parents of obese teenagers like Emmalea: If their children cut back on sugar, choose healthy snacks over junk food, and exercise frequently, benefits will follow.
But like with adults, many overweight young people find it difficult to lose weight. Gains fluctuate despite best efforts.
Can medicine help?
According to a recent study published in the New England Journal of Medicine, semaglutide can cause modest but significant weight loss. Uncertain of whether that will be sufficient to tip the scales in favour of improved health overall, the results have child health experts upbeat.
According to Silva Arslanian, MD, a paediatric endocrinologist at the University of Pittsburgh School of Medicine and a co-author of the new study, “There is a real need for safe and effective drugs to treat obesity.”
According to Arslanian, “typically, we provide lifestyle recommendations: Eat more veggies; avoid fried food; and don’t drink soda. She laments that “it can be quite hard to achieve those adjustments” in our society.
The topic of medication should be discussed, according to several specialists.
The availability of this medication is exciting. The medicine proved safe and tolerated, according to Amanda Staiano, PhD, a researcher at Louisiana State University in Baton Rouge’s Pennington Biomedical Research Center, and the trial results suggest little side effects. “Semaglitude and other novel drugs are revolutionising teenage obesity treatment, even though they have not yet received FDA approval. It’s going to be a fascinating period for obesity treatment.
However, Staiano emphasises that the effectiveness of any obesity treatment, including medications like semaglutide, depends on lifestyle and behavioural counselling.
Although obesity is “not an issue of lack of willpower,” according to paediatrician Daniel Weghuber, MD, of Salzburg’s Paracelsus Medical University, “this drug seems to enable people who are living with obesity to adhere to the recommendations that they have been following for years and years but were unable to achieve the goal.” This, in my opinion, is significant. It helps people accomplish their objectives.
In the current study, 201 overweight or obese boys and girls between the ages of 12 and 18 were randomly assigned to receive semaglutide injections once weekly or placebo injections. Throughout the roughly 16-month trial, they were all given lifestyle treatments, including guidance on a healthy diet and exercise routine.
In comparison to 17% of the adolescents who received the sham injections, 75% of the adolescents who received semaglutide had lost and maintained at least 5% of their excess body weight by the end of the trial. The medication group lost 33.7 pounds on average, whereas the control group lost only 5.3 pounds on average.
According to Weghuber, the research indicates that treating obese teens with a mix of lifestyle modifications and anti-obesity drugs “will open up a new chapter.”
In 2016, there were more than 340 million overweight or obese children and teenagers globally, ages 5 to 19. In the US, the CDC estimates that from 2017 to 2020, obesity will afflict 22.2% of 12- to 19-year-olds.
Obesity is associated with a shorter life expectancy and an increased chance of significant medical conditions such type 2 diabetes, heart disease, nonalcoholic fatty liver disease, sleep apnea, and several malignancies. Additionally, sadness, anxiety, low self-esteem, and other psychological problems are more prevalent among obese teenagers.
Children’s obesity has long been a problem for public health, but the COVID-19 pandemic has made it worse, according to Melissa Ruiz, MD, of the Pediatric Diagnostic Center in Ventura, California. She estimates that some of her “chubby” pre-pandemic patients gained 20–30 pounds during their post-pandemic clinic visits.
According to Ruiz and other professionals, parents should reject the idea that obesity is something kids or adults do to themselves or that they are failing their kids by not controlling their weight.
We must admit that genetic factors play a role in obesity, according to Ruiz.
Parents should ask their child’s paediatrician for assistance. “Ask where you can go if the paediatrician is unable to assist you. Ask for a recommendation for someone who can help and say, “I understand that you might not be trained in this yet,” advises Ruiz.
However, a medical professional believes that medication shouldn’t be used as a stand-alone treatment.
According to Lydia Bazzano, MD, PhD, a nutrition researcher at the Tulane University School of Public Health and Tropical Medicine in New Orleans, “Medication is a last resort, only after behavioural interventions fail and after exploring the range of behavioural strategies to weight loss, including changing dietary patterns such as timing and meal plan.”
Surgery and even medication have a place, but only after patients have tried every food and lifestyle choice, according to Bazzano. “You don’t want the adolescent to take medication for the rest of their lives. Medication should only be used to get the child to where he needs to be and then to keep him there, according to the expert.
The topic of adolescent obesity is really challenging, says Bazzano. Not just the child, but the entire family must be involved. It must be on the same level as the entire family, which can be quite difficult. There may be a small weight decrease if the whole family participates.
And Bazzano claims that the weight loss observed in the most recent trial does not impress her. “That’s not enough of a decline to declare the youngster is out of the hazardous area,” she adds of a 5% drop in body weight.
Before experts begin recommending semaglutide to children, according to Staiano, they need more knowledge on the drug.
When it comes to the long-term effects of chronic pharmaceutical use and whether or whether adolescent weight recovers after stopping the medication, she says, more research is needed.
How long should the prescription for the drug be written? the remainder of their lives? How can we help patients who are successful in losing such a large quantity of weight? How can we make sure that families can afford and have access to these treatments—behavioral counseling, medications, and weight loss surgery?
Emmalea, who stopped taking semaglutide approximately a year ago, has kept her weight in check by putting a lot of effort into eating a balanced diet and exercising regularly. She acknowledges that she has made progress and that she “feels comfortable in my own skin,” but she does not see her current weight of 171 pounds as the finish line. The 5’4″ high school senior says, “I’d like to be between 145 and 150.”
Even so, she admits, “I don’t strictly monitor myself because thinking negatively about food is not healthy and can actually exacerbate a food disorder.”
She wasn’t convinced the research would work for her when she started it. She claims that she wanted to be engaged because she was interested in medical and research: “I believed that if it didn’t assist me, at least it may others.”
