GLP-1 prescribing to children aged 8 to 11 rose 310-fold since 2019, but stayed under 1 percent

Prescriptions for GLP-1 drugs to children aged 8 to 11 with obesity rose 310-fold between 2019 and the middle of 2026, according to a study published September 4 in the journal Pediatrics. Even after that rise, the drugs remain rare in this age group. Across the whole seven and a half years, 20,282 children out of roughly 3.5 million with obesity received a prescription, which is 0.6 percent.

No GLP-1 drug is approved by the US Food and Drug Administration for weight management in anyone under 12, so every one of these prescriptions was written off-label. Off-label means a doctor prescribes an approved drug for an age group, condition or dose the FDA has not formally reviewed. It is legal and common in pediatrics. It also means the agency has not evaluated how well the drug works, or how safe it is, in the group being treated.

A 310-fold rise that starts from close to zero

A 310-fold increase sounds enormous, and in relative terms it is. It also describes a jump from a very small number to a number that is still small. The research team, led by Babak J. Orandi at NYU Grossman School of Medicine, tracked yearly prescribing from January 2019 through June 2026 using Epic Cosmos, a database assembled from the electronic health records of more than 300 million patients across about 2,067 hospitals and 47,100 clinics.

For comparison, the researchers found that 0.9 percent of adolescents aged 12 to 17 with obesity had received a GLP-1, against 0.6 percent of the younger group. Roughly 20 percent of US children have obesity, so the large majority of children who might be considered candidates are not taking these medicines.

Almost every child prescribed one already had severe obesity

Among the children who did receive a prescription, 93.7 percent had severe obesity. That term has a specific meaning here: a body mass index above 120 percent of the 95th percentile for a child of the same age and sex on US growth charts. It is a considerably higher bar than the 95th percentile that defines obesity itself.

Separately, 65.2 percent had at least one obesity-related health problem, and about a quarter had prediabetes. The authors read this pattern as evidence that clinicians are holding these drugs back for the children at the greatest immediate risk to their hearts and metabolism, rather than reaching for them as a general treatment for childhood obesity.

Children in higher-income communities were 55 percent more likely to get one

Prescribing was not evenly distributed. Children in upper-income communities were 55 percent more likely to receive a GLP-1 than children without that access. Allan B. Massie, a co-senior author at NYU Grossman, said in a statement that clinicians and policymakers have a responsibility to make sure these treatments reach more than the children whose families carry insurance and can get to a pediatric clinic.

What is actually approved below age 18

Two medicines are approved for long-term weight management in adolescents aged 12 and older. Wegovy, the brand of semaglutide, carries that indication on its current label, revised in February 2026. Saxenda, the brand of liraglutide, was approved for the same age group in December 2020. Zepbound, the brand of tirzepatide, is approved only for adults; its January 2026 label states plainly that its safety and effectiveness have not been established in children. Nothing in this class is approved for weight management under age 12.

The study covered all three of those products. It excluded children who had a diabetes diagnosis before starting the drug, so these are prescriptions written for weight, not for type 2 diabetes.