GLP-1 drugs in teens: what youth say

A qualitative study published in the Journal of Adolescent Health on 2 June 2026 interviewed 29 adolescents and young adults (ages 12 to 22) who were using or considering weight-loss medications, including semaglutide, tirzepatide, liraglutide, and phentermine with or without topiramate^[1]. The study also interviewed 23 of their caregivers. The central finding: families are broadly positive about these medications, but nobody is sure when or whether to stop.

How families decide to start

The research team at the University of Pittsburgh and UPMC Children's Hospital, led by Hilla Nehushtan and Mary Ellen Vajravelu, used semistructured interviews to map the decision landscape. Six factors shaped whether a young person started a GLP-1 or other anti-obesity medication: family influence, peer perspectives, physician guidance, media exposure, financial considerations, and a personal risk-benefit assessment^[1]. Caregivers played a particularly large role, providing both the practical logistics (scheduling injections, managing insurance) and the emotional support that kept adolescents on treatment.

That caregiver role echoes what the 2023 American Academy of Pediatrics (AAP) clinical practice guidelines recommend: shared decision-making that incorporates the family, not a prescription handed to a teenager in isolation. A 2024 clinician's guide in Pediatric Clinics of North America reinforced the point, noting that adolescents aged 12 and older with obesity should be offered pharmacotherapy "as an adjunct to health behavior and lifestyle treatment" with family involvement throughout^[3]. The Nehushtan data suggests families are already doing this informally. The question is whether clinical workflows are keeping up.

What changes once treatment begins

Participants described high baseline appetite and, in some cases, binge-eating episodes before starting medication. Once on treatment, appetite dropped substantially. Several participants used the phrase "food noise" to describe the intrusive thoughts about eating that the medication quieted^[1]. That language mirrors what adult GLP-1 users report, and it aligns with the mechanistic observations in recent neuroscience research on how incretin-class drugs affect reward circuits in the brain.

The STEP TEENS trial, published in the New England Journal of Medicine in 2022, provides the quantitative backdrop. In 201 adolescents aged 12 to 17, once-weekly semaglutide 2.4 mg reduced BMI by 16.1% over 68 weeks compared with a 0.6% increase on placebo^[2]. 73% of the semaglutide group achieved at least 5% body-weight reduction versus 18% on placebo. The Nehushtan study adds the subjective layer that trials like STEP TEENS do not capture: what the experience of taking these drugs actually feels like for a teenager.

The endpoint question nobody can answer yet

The most striking finding in the Nehushtan interviews is the uncertainty around discontinuation. Both youth and caregivers expressed broadly positive experiences with treatment but did not know when, or whether, to stop. The study notes that this uncertainty is not irrational: adult discontinuation data (notably the SURMOUNT-4 trial for tirzepatide and STEP 1 extension data for semaglutide) show substantial weight regain after stopping medication, and no paediatric discontinuation trial has reported yet^[1].

The researchers recommended that future clinical guidance incorporate structured shared decision-making around continuation and discontinuation, and flagged disordered eating assessment as a gap: if a young person started medication partly because of binge-eating patterns, clinicians need tools to separate the medication's appetite suppression from unresolved eating-disorder pathology.

What this does not tell us

This is a qualitative study with 29 youth participants at a single centre. It does not report weight-loss outcomes, adverse-event rates, or treatment durations. It cannot tell us which medication the participants would have done best on, or whether their positive experiences persist at 12 or 24 months. The sample skewed female (55%) and was recruited from a tertiary weight-management clinic, which limits generalisability to primary-care settings.

What it does offer is the patient and family voice, which is largely absent from the randomised controlled trial literature on adolescent obesity pharmacotherapy. For a field where the AAP now recommends shared decision-making as a core part of prescribing, knowing what families actually think and worry about has practical clinical value. Clinicians making shared decisions with families can use these findings to anticipate the questions their patients will ask.

Where this fits on PeptideMethods

This study sits in the broader adolescent GLP-1 cluster. For the pharmacological detail on the two most commonly prescribed drugs in this population, see our pages on semaglutide (the only GLP-1 currently FDA-approved for adolescent obesity) and tirzepatide (approved for paediatric type-2 diabetes via SURPASS-PEDS, with obesity trials in younger populations still running). If you or your child are considering one of these medications, talk to a clinician who knows the individual case.