The Impact of Weight Loss Drugs on Teenagers: What Parents Need to Know

“Nothing tastes as good as skinny feels. “ -Kate Moss

I remember hearing this when I was a teenager, and I couldn’t help but hang on to every word. Kate Moss was the cool girl we all wanted to be. I was too young to realize that being that thin probably involved cigarettes and illegal substances. All I saw was a young woman who never had to “squeeze” into her skinny jeans… or anything for that matter. Clothing looked like it was made for her- Prada not only came in her size, she was the measuring stick! 

Obviously, this wasn’t healthy…and even though I cried in countless dressing rooms and bought trendy diet books, I somehow never developed an eating disorder. Others were not so lucky. 

Society seemed to try and correct itself in the 2010s. The desire to be thin would never leave us, but all of a sudden... girls wanted to be “toned” and “strong”.  The narrative became interesting too. At about the time I was getting my master’s in social work (2017-2020) Lizzo was at the top of the charts and plus-size models were being featured in Sports Illustrated.

The conversation was now about being, “beautiful at any size” and curvy women were being celebrated for standing-up against the Anna Wintour’s of the world. The passion behind this movement spread like wildfire and women who likely had fallen prey to the lemon-juice/cayenne pepper/honey diet wanted revenge! However, along the way, facts were being set aside and the science was getting jumbled to fit whatever opinion you wanted to support. 

For example, in one of my “healthcare in social work” classes I was nearly “canceled” for challenging the notion that obesity does not mean someone is unhealthy. I pointed to heart disease, diabetes and osteoarthritis- but my classmates (mostly women) glared at me. They said BMI is an outdated concept of health and that I was perpetuating the stigma against overweight individuals. No one talked to me after that class, and I continually sat alone for  the rest of the quarter. That day, I secretly cried in the bathroom, mostly out of confusion and a concern that I picked the wrong profession. 

Here we are now in 2024, and the narrative has changed again. The celebrities who celebrated larger sizes were the first in line to get semaglutides (Ozempic, Wegovy etc.). Following their lead, the masses followed and now there is a shortage in supply for these injectable drugs--- putting those who actually need it for diabetes in a bit of a pickle.

I have changed in the past 5 years as well. I am now a therapist who is passionate about helping adolescents. Given this population choice, I am surrounded by girls (and boys) who are continuing the decades-long tradition of judging their self worth by their image- specifically their weight. The conversation in the media is confusing for teens. You are supposed to be happy at any size and push back at your doctor when they ask to weigh you before your physical…But wait! Maybe we actually want you to be skinny at any cost. 

Putting aside the health-concerns these drugs are inflicting on individuals (stomach paralysis, increases in likelihood of thyroid cancer etc.) and the fact that they are life-long drugs (you have to be on them forever or you will gain back all the weight), I am concerned about the cultural implications this will have on adolescents. Here is where I see the biggest cultural impacts (the direct health impacts is worth a whole other blog post)…

Goodbye Dinner Table

I am one of those therapists that encourages the family dinner table discussions every night. Yes, even if your teen glares at you the entire time, having the consistency of sharing a meal at dinner time is important. This dinner routine lets your teen know that they have a consistent time to talk where they have your full attention. They might not want to contribute to the conversation but at least they know they can. What happens when parents who take Wegovy and Ozempic no longer want to eat? The tradition is no longer communal- and the shared experience of tasting food is gone. Meals are no longer the focus and cooking is just for the kids who now have a strange concept of the role of food in our culture. Food is an excuse for us to come together, celebrate cultures. What happens when we take away everyone's appetite?

What is the picture of health?

There are some people who look healthy, and we can see it more than ever when they go through their own transformation to get there. However, these drugs not only make individuals become thin, they transform their faces into ghost-like reflections of their normal selves. They also lose muscle mass right along with fat. The previously shouted positive narrative of celebrating strength now has less cheerleaders. The message is starting to circle back to a new type of celebrated thinness. It reminds me of the 90s heroin chic only now its Ozempic. Shouldn’t we still celebrate all shapes and sizes under the umbrella of positive health? The media took it too far when obesity was praised, but shouldn’t we still appreciate the vast spectrum of human diversity and size? Our teens are back to wanting thin- at any cost. 

Hard work?

This is a controversial thought, but it's worth asking. For those who are taking Ozempic for mostly vanity purposes (meaning they are not in danger of becoming diabetic or getting heart disease any time soon), is this an easy button that we are teaching today’s youth? The people we used to want our kids to admire usually were examples of discipline, hard-work and conviction. The narrative I always believed in was: Get stronger, faster and feel better. When this happens, your jeans will likely fit better too. Now, the message is to just fit into your jeans. 

Sports?

Sports are an excuse  for some parents to ensure their teens would stay healthy and active. I worry that with a drug like Ozempic, less kids will start sports and therefore miss out on its other benefits  (especially team sports). Specifically, the important lessons associated with winning, losing, teamwork and dedication. With 4,000 kids now being prescribed Ozempic or other semaglutide drugs in 2023 (and that number is rising), they might no longer want the excuse to get started or might even lack the energy to even compete. 

Semaglutide drugs for weight loss are a bandaid to the obesity epidemic. We are responding to societal damage caused by processed foods and excess screens with a weight-loss drug. I am worried that our kids will once again pay the price- as they have with social media, covid lockdowns and fast-food provided in excess. There are no shortcuts, we need to put down phones, enroll kids in sports and reassess our food choices.