The February Pediatrics in Review article, Glucagon-Like Peptide-1 Agonists and Pediatric Obesity, by Drs Vaidya and Taylor, on the use of glucagon-like peptide-1 (GLP-1) agonist therapy in the treatment of pediatric obesity is certainly timely. Both the short- and long-term effects of pediatric obesity are felt across both primary care and specialty care pediatrics. Until recently, management of this chronic health condition remained limited to poorly-adhered-to lifestyle guidance and irreversible and difficult-to-attain surgical options for the highest risk adolescents. The advent of GLP-1s as a groundbreaking treatment modality could potentially revolutionize the management of this chronic disease and could even change the trajectory of physiological co-morbidities for affected patients.
This revolution also comes with an advocacy opportunity for pediatricians who are on the front lines of combatting this disease. Access to these pharmaceuticals remains a significant barrier. High costs, restrictive insurance policies, and lack of coverage are preventing the adolescents who may benefit from these treatments from receiving them. Out of pocket cost to patients is often prohibitive. Adolescents insured through Medicaid—which provides coverage for 40% of US children—have even poorer access to these drugs for weight loss indications.
It is therefore incumbent upon us as pediatricians and child health experts to advocate for expanded insurance coverage by helping insurers to recognize obesity as a chronic disease. We need to particularly advocate for coverage for children from underserved and lower-income communities who are already disproportionately affected by obesity. Finally, coverage for medications should also be integrated with coverage for comprehensive obesity care, including nutritional counseling and behavioral support that is family centered to achieve the best future health outcomes. Pediatric obesity is a serious medical condition, not a personal failing.
