At 17, Israel McKenzie was so burdened by obesity that he stopped going to high school in person and was embarrassed to speak to people at his restaurant job.
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Israel McKenzie lost 110 pounds in nine months while on the weight loss drug Wegovy.
“I was in a really dark place,” says McKenzie, whose weight had climbed to 335 pounds on his 6-foot-1 frame, despite repeated efforts to diet and exercise. “I had given up hope.”
But last year, the weight-loss drug Wegovy helped him shed 110 pounds in nine months, making the rural Tennessee teen part of a surge of adolescents and young adults using diabetes and obesity medications known as GLP-1 receptor agonists, new research shows.
Even as millions of older adults clamor for drugs such as Ozempic and Wegovy, monthly use of the medications soared in people ages 12 to 25. That’s according to the new analysis of dispensing records from nearly 94% of U.S. retail pharmacies from 2020 to 2023.
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The report, published in the journal JAMA, used the IQVIA prescription database to compile the first look at the national uptake of GLP-1 drugs among that age group. Nearly 31,000 children ages 12 to 17 and more than 162,000 people ages 18 to 25 used the medications in 2023 alone, said Dr. Joyce Lee, a University of Michigan pediatrician and diabetes expert who led the research.
“What it’s suggesting is that it’s one of the tools in the toolbox and there are more providers prescribing this medication for the population,” she said.
The report shows that the number of 12- to 25-year-olds using any GLP-1 drug — including older medications first approved to treat diabetes in 2005 and for weight loss in 2014 — climbed from about 8,700 a month in 2020 to more than 60,000 a month in 2023, a nearly 600% increase. The rise occurred even as prescriptions of other drugs among those patients fell by about 3%.
Those who received the drugs were just a fraction of young people who struggle with obesity, Lee noted. About 20% of U.S. children and adolescents and about 42% of adults have the chronic disease, according to the U.S. Centers for Disease Control and Prevention.
In early 2023, the American Academy of Pediatrics recommended that children and teens with obesity be evaluated early and treated aggressively, including with surgery and medication if warranted.
McKenzie, the Tennessee teen, said he began gaining weight five years ago, during puberty.
“I started turning to food for all of my problems,” he said.
The extra weight made his asthma worse and put him in danger of developing diabetes, his doctor said. He tried to follow medical advice by cutting out sugary soda and snack foods and exercising more, but the efforts failed to make a difference.
“My old doctor told me there was nothing he could do,” he said. “He told me it was my fault.”
In early 2023, McKenzie connected with Dr. Joani Jack, a pediatric obesity specialist at Children’s Hospital at Erlanger in Chattanooga, Tennessee, who regularly prescribes GLP-1 drugs for kids.
“I told him I’ve seen 10 other people just like you today and we have lots of tools and treatment options,” Jack said. Those typically include intensive behavioral and nutrition interventions combined with medication, if necessary.
In McKenzie’s case, Jack prescribed the weight-loss drug Wegovy, which in late 2022 was approved for use in U.S. children over age 12. More than 6,000 kids in that age group received Wegovy in 2023, the new data show. More than 7,600 received Ozempic, which is approved to treat diabetes in adults, but can be used off-label in adolescents. Others received older GLP-1 drugs such as Saxenda and Trulicity.
McKenzie said he had no notable side effects from the medication, but Lee noted that some young people report nausea, vomiting or constipation, including symptoms so serious that they stop the drugs.
It's important to understand the surging use of these medications in young people, Lee said. The drugs are meant for continuing use, so “we really need to think about the long-term safety and effectiveness of these medications for this population,” she said.
In addition, the drugs are expensive and often difficult to obtain, either because of supply problems or because they’re not covered by insurance.
Notably, government-run Medicaid plans paid for nearly half of the GLP-1 drugs prescribed to 12- to 17-year-olds and about a quarter of those used by people aged 18 to 25, the research found. Commercial insurance covered care for nearly 44% of the younger kids and about two-thirds of those who were older.
Today, McKenzie says his asthma is better and he looks forward to interacting with co-workers and friends.
“I have a lot of self-confidence now, a lot more than I used to,” he said. “It has changed everything.”
New study shows that self-compassion can successfully benefit weight loss plans
New study shows that self-compassion can successfully benefit weight loss plans
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For the millions of American adults trying to lose weight, the journey can be long and arduous. Weight loss requires a person to make a host of lifestyle changes, think differently about nutrition and exercise (among other things), and demonstrate dedication, patience and perseverance.
In fact, weight loss is such a behavioral, mental, and physical undertaking that relatively few stick with it. Studies show that, on average, 40% of people enrolled in weight loss programs drop out of them within the first 12 months.
Hers reports that researchers from Drexel University's Weight, Eating and Lifestyle Science (WELL) Center may have found the key to helping people stay on their weight loss journeys: self-compassion.
In the study on the role of self-compassion in weight loss, the WELL Center researchers had overweight and obese adults enrolled in a behavioral weight loss treatment program complete a seven-day ecological momentary assessment, or EMA—a method used to understand people's behaviors and experiences in real time in their natural environments.
The EMA in this study collected information on whether participants experienced any dietary lapses, whether they responded to those lapses with self-compassion, their mood and their body dissatisfaction.
The researchers found that self-compassion, specifically being kind to oneself, following a dietary lapse was associated with less negative affect and greater perceived control over weight loss behaviors in the hours after a lapse. They concluded that self-compassion could be an adaptive trait for those working to lose weight, helping them get back on track after experiencing a setback.
The study confirms what psychologists have long known: that your attitude and mindset can have a major impact on your physical health. When it comes to weight loss, cultivating a flexible and encouraging attitude can help a person stick with set goals.
It's common for people to experience some kind of lapse—a day or two of poor eating habits, a couple of missed workouts—during their weight loss journey. Those who are overly rigid or harsh on themselves are likely to see such lapses as failures and give up on their efforts to lose weight. On the other hand, those who are more forgiving and compassionate to themselves are likely to see such lapses as minor blips, and as the study finds, they're more likely to get back on track.
Dr. Amy Lukowski, a counseling psychologist and expert in health behavior change, says that she always encourages people to acknowledge that lapses will happen, but that they shouldn't detract from people's weight loss goals. She tells people, "When you fall off, because you will, get back on your plan as soon as you can."
Experts encourage people looking to lose weight to set achievable and realistic goals, take a holistic approach to weight loss, and reward themselves for their achievements. If you set a goal for yourself to get a certain number of steps each day and you do it, celebrate it—and if you miss a day, don't let that discourage you from getting back to it the next day.
Three things tend to influence weight loss: diet, movement and sleep. Medications can help turn off hunger signals and turn on satiety signals, especially for those who have tried and struggled to lose weight in the past.
In short, the weight loss journey isn't an easy one. But setting realistic goals, being consistent with lifestyle changes, celebrating successes and being kind to oneself for the inevitable and occasional bad days can go a long way toward helping people lose weight.
Jessica Yu has a Ph.D. in Clinical Psychology from Rutgers University