Kompaniyets Lyudmyla, Pierce Samantha L, Porter Renee, Autrey Kali, Chua Kao-Ping, Belay Brook, Blanck Heidi M, Goodman Alyson B
MMWR Morb Mortal Wkly Rep. 2025 Jun 5;74(20):337-344. doi: 10.15585/mmwr.mm7420a1.
Obesity affects approximately one in five U.S. adolescents. Although an increasing number of medications are approved for adolescent obesity as an adjunct to health behavior and lifestyle treatment, national data on the prevalence and correlates of obesity medication prescribing for adolescents are sparse. Ambulatory electronic medical record data were analyzed to assess trends in the proportion of U.S. adolescents aged 12-17 years with obesity (body mass index ≥95th percentile) who were prescribed Food and Drug Administration (FDA) -approved obesity medications during 2018-2023. Log-binomial models were used to estimate characteristics of adolescents associated with receiving an obesity medication prescription in 2023. The proportion of U.S. adolescents who were prescribed obesity medications increased substantially in 2023 (by approximately 300% compared with 2020), the year after FDA expanded its approval of two obesity medications to include adolescents and after publication of the 2023 American Academy of Pediatrics clinical practice guideline. Despite this substantial relative increase, 0.5% of adolescents with obesity were prescribed an obesity medication in 2023, with a majority (83%) of prescriptions received by adolescents with severe obesity. Semaglutide (Wegovy, indicated for persons aged ≥12 years with obesity), and phentermine or phentermine-topiramate were most commonly prescribed. Prescribing prevalence was higher among girls than among boys (adjusted prevalence ratio [aPR] = 2.05), among adolescents aged 15-17 years than among those aged 12-14 years (aPR = 2.24), and among those with severe (class 2 or class 3) obesity than among those with class 1 obesity (aPR = 4.03 and 12.78, respectively). Prescribing prevalence was lower among Black or African American adolescents than among White adolescents (aPR = 0.61). Continued monitoring of the use of these medications could help guide strategies to ensure that all adolescents with obesity have access to evidence-based obesity treatment, including medications and health behavior and lifestyle interventions.
肥胖影响着约五分之一的美国青少年。尽管越来越多的药物被批准用于青少年肥胖症，作为健康行为和生活方式治疗的辅助手段，但关于青少年肥胖症药物处方的患病率及相关因素的全国性数据却很稀少。对门诊电子病历数据进行分析，以评估2018 - 2023年期间12至17岁肥胖（体重指数≥第95百分位数）的美国青少年中，开具美国食品药品监督管理局（FDA）批准的肥胖症药物的比例趋势。使用对数二项模型来估计2023年与接受肥胖症药物处方相关的青少年特征。2023年，开具肥胖症药物的美国青少年比例大幅上升（与2020年相比增加了约300%），这一年FDA扩大了对两种肥胖症药物的批准范围，将青少年纳入其中，并且在2023年美国儿科学会临床实践指南发布之后。尽管有如此显著的相对增长，但2023年仍有0.5%的肥胖青少年开具了肥胖症药物处方，其中大多数（83%）的处方由重度肥胖青少年获得。司美格鲁肽（Wegovy，适用于≥12岁的肥胖者）、苯丁胺或苯丁胺 - 托吡酯是最常开具的药物。女孩的处方患病率高于男孩（调整患病率比[aPR]=2.05），15 - 17岁青少年的处方患病率高于12 - 14岁青少年（aPR = 2.24），重度（2级或3级）肥胖青少年的处方患病率高于1级肥胖青少年（分别为aPR = 4.03和12.78）。黑人或非裔美国青少年的处方患病率低于白人青少年（aPR = 0.61）。持续监测这些药物的使用情况有助于指导相关策略，以确保所有肥胖青少年都能获得基于证据的肥胖症治疗，包括药物治疗以及健康行为和生活方式干预。
