GLP-1 medications for kids; when are they appropriate?

Meantime, want to bring you some health news that we felt like was important to bring up during this time right now. Talking about GLP-1 medications. We know we see them in the headlines a lot as they relate to adults and also with weight loss. But also what's kind of being discussed. Disregarded, what doctors are saying is being disregarded is their use with children and how it can actually be beneficial. I want to bring in Dr. Elizabeth Mann with UW Health. Dr. Mann, thank you so much for joining me today on Fox 6 Now. Thanks for having me. So talking about GLP-1, I mean, I know for me even like I associate it with adults and with weight loss, and then also you hear about all of those negative side effects and things of that nature. But today, you want to talk about the effects that it actually has on children with dealing with obesity and also with type 2 diabetes. I mean, I was reading here that it's been approved since 2019 for pediatric use. So what are the benefits of these medications for younger patients that people may not realize? Yeah, I think you're not alone, Maddie. I think most people hear about these medications and we hear about it mostly for adults who are looking to lose a little bit of weight. And we know that they've gained increasing popularity. I think what we're missing... Is the context that these are medications that have been around for a really long time and they are in a class of medication called incretin therapies that are really effective at treating chronic health problems like type 2 diabetes and obesity. And in pediatrics where these medications are really helpful is actually achieving our goal outcomes and helping kids manage their chronic diseases in a way that we have never been able to prior to the use of these medications. We were talking about the stigma and the misinformation in the headlines that we see. So how is this affecting children being able to reach these treatments? Yeah, unfortunately, we know that weight-based stigma is really common in our society and our pediatric patients feel that. Our pediatric patients who live in larger bodies have to face the stigma that comes with that in every aspect of their life. And unfortunately, I think that's leading into and that stigma is kind of shaping insurance policies. GLP-1 medications have kind of Fallen into this realm of kind of ethical considerations about whether patients are morally able or worthy of getting them. But I think we need to separate that from the stigma or recognize that's where that is sort of coming from. And frame it more as a discussion about chronic health conditions and any other chronic health conditions when we have medications that work to keep people healthy and prevent long-term health complications and improve outcomes. Those medications should be available. These are FDA-approved therapies that are known to be safe and effective at treating obesity and type 2 diabetes in kids. But unfortunately, there are insurance barriers, which I think stem from the stigma around using these medications. So with the insurance barriers, is there a solution to this? Is there a way that we can break that stigma and have kids get this access to the medication if that is recommended by their doctor Yeah, I think on an individual patient level. Patients work with their providers and we, you know, submit prior authorizations and we appeal insurance denials as much as we can. But unfortunately, what I think we need is a larger scale approach that just demonstrates their efficacy. And like most things with our health care system, we have to be able to tie that to financial outcomes, which is that keeping people healthy is ultimately better financially for insurance companies. So we just continue to fight and advocate and share with our insurance partners and our payers that these are medications that are costly in the short term, but can help people keep people healthy and improve costs in the long run. Some critics might say when it relates to childhood obesity, saying, well, Why don't they just go on a diet or why don't they just start exercise instead of putting them on these medications? What would you say to them? I think in decades past, we believed that obesity was someone's choice or rather a fault of someone doing or not doing the right thing. What we understand now is even under the same circumstances, some people, some children are going to develop obesity and maybe metabolic complications associated with that, where some kids would never develop that. And so what we're recognizing is It's more complicated than diet and exercise alone. These are really genetic conditions. Children have experienced a lot of their metabolic programming in utero in addition to their genetics. And so these are really non-modifiable risk factors. And we have really targeted lifestyle interventions for a long time because that was our only therapy and we've not been able to change the trend of pediatric obesity. Now that we have medications that are effective we can finally kind of change the curve and change the trajectory of what we've been seeing in pediatric obesity rates but we need access to the medications to be able to do that. And I'm sure there's some parents who are listening right now who are resonating with a lot of what you're saying, whether they have children who are struggling with obesity or struggling with type 2 diabetes. What would the step for them be? When do you think it's necessary for them to talk to their doctors about these options of medications? Yeah. I mean, as a pediatrician first, I'm always going to say, have that relationship with your primary care provider. That's the person who knows your child, who knows your family, who understands what needs to be screened and when. And if you're worried or you have a family history of type two diabetes, have that conversation with your provider and they'll be able to direct you towards the screening that you might need. And also recognize that And I think one of the important things with our family is when they do get referred to us is for us to say, look, I believe you. I know this is not your fault. And I think that ultimately is one of the most important things that you will be able to hear from your healthcare provider is I see you, I hear you, and we're here to help and be a partner. Yeah, I think that's so important too, just knowing that your primary care doctor is an advocate for you and is there for your health. I think those are a really great points there, Dr. Mann. Anything else you feel like is important for people to know who are watching right now? No, I really appreciate the opportunity to talk about it. I recognize GLPs are out there and in the news. And so I think the more we can just kind of educate and help people understand the importance of using them in this population, the better. I, yeah, I absolutely agree. It was a very enlightening conversation. I mean, I was one of the people who just saw those headlines about adults in weight loss. So hearing this whole new perspective about children and the benefits has been super interesting. Dr. Mann, thank you so much for taking the time to join us today on Fox 6 Now. Yeah, thanks for having me.