Weight-loss medicines for teenagers: where UK practice stands

Children and teenagers are still growing, and weight is interpreted against growth charts, not adult BMI cut-offs. Treatment must protect growth, development and mental health. A young person may also be sensitive to how weight is discussed. Services therefore emphasise a supportive, non-blaming approach involving the whole family, not a young person alone.

• Regular, balanced meals and reduced sugary drinks and snacks.

• Daily physical activity that the young person enjoys.

• Better sleep and reduced screen time before bed.

• Family changes in how food is bought, cooked and eaten.

• Support for bullying, low mood or anxiety, which often accompany weight difficulties.

• Checks for medical causes, such as thyroid disease, and for effects of other medicines.

Medication is considered only for some young people with significant obesity and health complications, usually after structured support has been tried and assessed by a specialist team. Regulators have extended the licence of certain weight-management medicines to adolescents from a stated age. NHS availability depends on NICE guidance, local commissioning and specialist service capacity, so do not assume that a licence means access.

A multidisciplinary team, which may include paediatricians, dietitians and psychologists. Consent and assent conversations involving both parent and young person. Assessment for eating disorders. Monitoring of growth, puberty, mood and nutrition. A plan for how long treatment will continue and how it will end. Clear safety advice about pregnancy for young people of child-bearing potential.

Medicines that suppress appetite can reinforce restrictive eating in young people vulnerable to eating disorders. Rapid weight loss may affect growth and bone health. Self-image and peer pressure can drive requests that are not clinically indicated. A clinician should be willing to say no, and to explain why.

Be alert to rapid unexplained weight loss, avoidance of meals, obsessive calorie counting, secretive eating or exercising, fainting, mood changes and purchasing of products online. If you are worried, see your GP promptly. Services for eating disorders exist on the NHS, and early help improves outcomes.

Young people are acutely aware of how adults talk about bodies. Focus on health behaviours that the whole household shares, such as cooking together, walking and regular sleep, rather than on appearance or targets. Avoid labelling foods as good or bad, and avoid weighing a young person at home unless the clinical team has asked you to. Praise effort and wellbeing rather than numbers.