Five GLP-1 medicines carry an approval for people under 18 in the US — two for obesity from age 12, three for type 2 diabetes from age 10. Zepbound, Ozempic and the newer pills are not among them. Each approval rests on one adolescent trial of a year or less, which is the main thing to know about the evidence.
This page is the label record: what each medicine is approved for in young people, the trial behind it, what that trial measured, and what is still being studied. The labels and registry entries were read on 15 October 2026. Nothing here is advice for any young person; it is what the documents say.
The approvals, in one table
| Medicine | Approved in under-18s for | From age | Trial behind it | Size and length |
|---|---|---|---|---|
| Wegovy (semaglutide) | Obesity | 12 | STEP TEENS (NCT04102189) | 201, 68 weeks |
| Saxenda (liraglutide) | Obesity, body weight over 60 kg | 12 | SCALE Teens (NCT02918279) | 251, 56 weeks |
| Victoza (liraglutide) | Type 2 diabetes | 10 | 26-week trial + 26-week extension | 134 |
| Trulicity (dulaglutide) | Type 2 diabetes | 10 | 26-week trial | 154 |
| Mounjaro (tirzepatide) | Type 2 diabetes | 10 | SURPASS-PEDS (NCT05260021) | 99, 30 weeks + 22-week extension |
| Zepbound (tirzepatide) | — | — | "not established in pediatric patients" | — |
| Ozempic, Rybelsus, Foundayo | — | — | adult indications only | — |
Source: section 1 (Indications) and section 8.4 (Pediatric Use) of each manufacturer's current label: Wegovy June 2026, Saxenda February 2026, Victoza October 2025, Trulicity June 2026, Mounjaro August 2026, Zepbound August 2026.
Two features of the table matter. Saxenda's teenage approval has a weight floor — more than 60 kg — that Wegovy's does not. And Mounjaro and Zepbound are the same molecule with opposite answers: tirzepatide is approved from age 10 for diabetes under one name and not at all under 18 for weight under the other, because only the diabetes use has been tested in young people. The older exenatide products were also approved from age 10 for diabetes; every US exenatide product is now listed as discontinued (see exenatide).
Wegovy: the obesity trial with the largest effect
STEP TEENS enrolled adolescents aged 12 and over with a BMI at or above the 95th percentile for their age and sex. After a 12-week lifestyle run-in, they were randomised two to one to weekly semaglutide or placebo, stepped up over 16 weeks and then held for 52. Average age was 15; 38% were boys. 86.7% of those who completed were on the 2.4 mg maintenance dose at the end. The FDA added the adolescent indication in December 2022.
| At week 68 | Placebo (67) | Wegovy 2.4 mg (134) |
|---|---|---|
| BMI change | +0.6% | -16.1% |
| Body weight change | +2.7% | -14.7% |
| Reached ≥5% BMI reduction | 19.7% | 77.1% |
| Reached ≥10% | 7.7% | 65.1% |
| Reached ≥15% | 4% | 57.8% |
Adolescent trials measure BMI rather than weight as the main outcome because a growing teenager's weight is expected to rise. The placebo group's weight went up 2.7% while its BMI barely moved, which is that effect in the numbers.
Side effects in the teenage trial
The label's adolescent table lists events reported by at least 3% on Wegovy and more often than on placebo:
| Event | Placebo | Wegovy |
|---|---|---|
| Nausea | 18% | 42% |
| Vomiting | 10% | 36% |
| Diarrhoea | 19% | 22% |
| Abdominal pain | 6% | 15% |
| Dizziness | 3% | 8% |
| Gallstones (cholelithiasis) | 0% | 4% |
| Hair loss | 0% | 4% |
| Anxiety | 2% | 4% |
| Rash · hives | 0% · 0% | 3% · 3% |
The label adds that adolescents on Wegovy had more gallstones, gallbladder inflammation, low blood pressure, rash and hives than adults on Wegovy. Vomiting at 36% is about three and a half times the placebo rate and is the largest absolute gap in the table. Ten per cent in each group stopped the study drug.
Saxenda: an older, smaller effect
SCALE Teens randomised 251 adolescents aged 12 to 17 to daily liraglutide or placebo for 56 weeks after a 12-week lifestyle run-in. 82.4% reached the 3 mg dose.
| At week 56 | Placebo (126) | Saxenda (125) |
|---|---|---|
| BMI change | +0.35% | -4.29% |
| Body weight change | +2.37% | -2.65% |
| Reached ≥5% BMI reduction | 18.7% | 43.3% |
| Reached ≥10% | 8.1% | 26.1% |
The primary measure was BMI standard deviation score, which fell by 0.23 on Saxenda against no change on placebo. 10.4% of adolescents on Saxenda stopped because of an adverse reaction, against none on placebo. The label also records one case of pancreatitis, more episodes of low blood sugar than on placebo, and resting heart rate rising by 3 to 7 beats per minute. Set side by side, the two obesity trials differ by roughly fourfold on BMI — but they were separate trials of different lengths, and there is no head-to-head comparison in adolescents.
The diabetes approvals: Victoza, Trulicity, Mounjaro
These three trials were run in young people who already had type 2 diabetes. Their main outcome is blood sugar (HbA1c), not weight.
- Victoza: 134 patients aged 10 to 17 over 26 weeks plus an open-label extension. The label notes a higher risk of low blood sugar in children than in adults, whether or not they also took insulin or metformin.
- Trulicity: 154 patients aged 10 and over over 26 weeks. Children reported more injection-site reactions than adults on Trulicity.
- Mounjaro: SURPASS-PEDS randomised 99 patients aged 10 and over, already on metformin, basal insulin or both, to 5 mg, 10 mg or placebo for 30 weeks. Average age was 15; 61% were girls; 66% identified as Hispanic or Latino. HbA1c, starting near 8.0%, fell 1.9 points on 5 mg and 2.2 on 10 mg against 0.2 on placebo, and 68% and 81% reached 6.5% or below, against 28%. Vomiting was reported by 16% and 12% against 3%, and abdominal pain by 22% and 15% against 9% — rates the label calls higher than in adults.
What is being studied now
| Registry number | What it tests | Size | Status (15 October 2026) |
|---|---|---|---|
| NCT06075667 — SURMOUNT-ADOLESCENTS | Tirzepatide in adolescents with obesity | 160 | Primary completion 2 June 2026; no results posted |
| NCT06439277 — SURMOUNT-ADOLESCENTS-2 | Tirzepatide in adolescents with obesity and weight-related conditions | 300 | Recruiting; primary completion October 2027 (estimated) |
| NCT06571383 — STEP TEENS weight maintenance | Long-term semaglutide 2.4 mg in adolescents | 500 | Active; primary completion November 2028 (estimated) |
The maintenance study is the one that addresses the question parents most often raise — what happens over years, and after stopping — and it is not due to report until late 2028.
What has not been established
- Long-term use. No adolescent trial behind an approval ran past 68 weeks of treatment.
- Stopping. The adolescent trials do not show the course of weight after treatment ends; the adult evidence is on stopping GLP-1 drugs.
- Tirzepatide for weight in teenagers. The first trial has finished but not reported.
- Children under 10 or 12. No GLP-1 medicine is approved below these ages for either use.
Every one of these decisions involves a young person who is still growing, and the labels' own wording on gallbladder events, low blood sugar and low blood pressure is written for prescribers. Questions about a teenager's weight or diabetes treatment belong with their paediatrician or a paediatric specialist, who can weigh the trial record against that young person's health. The adult picture for each medicine is on which drugs are GLP-1s and GLP-1 side effects.
Sources
- Novo Nordisk, WEGOVY (semaglutide) injection prescribing information, effective 2026-06-18 (set id ee06186f-2aa3-4990-a760-757579d8f77b): sections 1, 6.1 (Table 5), 8.4 and 14.3 (Table 18), via openFDA, read 2026-10-15.
- Novo Nordisk, SAXENDA (liraglutide) prescribing information, effective 2026-02-25: sections 1, 8.4 and 14.2 (Table 8), read 2026-10-15.
- Novo Nordisk, VICTOZA (liraglutide) prescribing information, effective 2025-10-14: sections 1 and 8.4, read 2026-10-15.
- Eli Lilly, TRULICITY (dulaglutide) prescribing information, effective 2026-06-16: sections 1 and 8.4, read 2026-10-15.
- Eli Lilly, MOUNJARO (tirzepatide) prescribing information, effective 2026-08-27: sections 1, 6.1, 8.4 and 14.5 (Table 9), read 2026-10-15.
- Eli Lilly, ZEPBOUND (tirzepatide) prescribing information, effective 2026-08-28: section 8.4, read 2026-10-15.
- Drugs@FDA, NDA 215256 (Wegovy) submission history: efficacy supplement approved 2022-12-23, read 2026-10-15.
- ClinicalTrials.gov: NCT04102189, NCT02918279, NCT05260021, NCT06075667, NCT06439277, NCT06571383, read 2026-10-15.