‘I’ve treated children with weight-loss drugs. The youngest is 12’

About six months ago, a series of patients came to me begging for weight-loss injections to manage obesity. As doctor who has run a private weight-loss clinic for four decades and been prescribing this medicine for five years, this doesn’t sound too unusual. More surprising was that they didn’t want the drugs for themselves – they wanted them for their children.

I initially declined to treat them. I have only ever helped adults. Overweight and obese children are usually supported in schools or by their GP. However, when parents came back to me desperate and in tears, I was moved to reconsider. I thought about why they were begging me, and realised it was because they weren’t getting help anywhere else.

These were former patients who had experienced tremendous results on weight-loss drugs themselves and wanted their children – who were suffering from poor physical and mental health because of their weight – to have the same results.

Weight-loss drug Wegovy has been available for some patients on the NHS since 2023 but only for obese people who meet certain criteria. Availability is patchy so lots of people have had to to seek out the treatment privately. The health service does not offer this medication to children. However, the UK’s medicines watchdog has approved the drug for 12 to 17-year-olds (a signal that it’s safe and effective in this age group), which means it can be administered privately.

Following talks with Novo Nordisk, the drug manufacturer, I launched a pilot in my clinic in January, offering Wegovy to five patients in that age group.

Not only did they tolerate the medicine very well, but the combination of the medication, diet and lifestyle changes alongside support from my in-house psychologist, meant they lost significant amounts of weight (up to five stone) and were delighted to have the help. Within a few months, my clinic was treating 50 children – the youngest being 12.

Tiredness, trauma and junk food: Why Britain’s children are obese

Shockingly, 26.8 per cent of children aged two to 15 in England are overweight or obese. It’s a figure that’s only getting worse. The reasons are complex.

A common finding is that they all have uncontrollable appetites. It’s normal for teenagers to notice that they are feeling hungrier than usual as they’re growing but this is notches above – they’re hungry to the point that they can’t stop eating. Sometimes this is because they have suffered a trauma that triggers comfort eating, such as their parents splitting up.

Another pattern among my patients is that a child goes into high school being overweight and then rapidly gains more weight, pushing them into the obese category. Most of the time, it’s not that the child is eating unhealthy meals, as their parents earn enough money to serve nutritious food. The big problem is the snacking and junk food that they are eating around their meals.

The parents of many of my adolescent patients are also on weight-loss drugs so being obese is often a family issue. It’s hard to generalise why this is the case. It may be that the family is overeating at mealtimes.

One finding that I see among a lot of the children, which is different from adults, is the lack of sleep because they are staying up late to play video games. This has knock-on effects for their diet and exercise levels the next day. Children seem to be less active than they used to be, with some engaging in virtually no physical activity at all. They only play sport when they have to during PE at school.

As I’m treating patients privately, I’m only seeing the children of parents who have resources to afford help. They’re prepared to pay money for medication because they’ve exhausted other options. The prevalence of obesity is highest in underprivileged children, who we know are also more likely to be eating cheap junk food. But I’m not seeing them.

The bottom line is that these children are at risk of premature death – they will die earlier than their peers if no one intervenes. The health risks they face are far-reaching but can be divided into physical and psychological. The physical is Type 2 diabetes, heart disease, renal failure and, quite frighteningly, a predisposition to more cancers and developing cancer at a younger age.

Psychologically, there is bullying and difficulties socially integrating – the children become very insular. They don’t meet people and that often leads to self-harming and depression.

How I work with children and weight loss drugs

For a child to be offered Wegovy or Mounjaro at my clinic they have to meet strict criteria. After a parent makes an enquiry and fills out a questionnaire, I measure their child’s height and weight to calculate their BMI. I also take waist circumference into account.

I then look at a percentile chart and the young person has to be the 95th percentile or higher to be treated with weight-loss drugs. The greatest BMI that we’ve had was just under 50, which is off the scale – we couldn’t plot it on the percentile chart. For comparison, 18.5 to 24.9 is considered a healthy weight and 30 is classed as obese.

If they pass this eligibility test, I have a 45-minute video call with the child and a parent. I explain what the treatment involves and the potential side effects. Then, if they are happy to go ahead, the child and their parents sign a consent form.

The first consultation with me is £100 and then they pay for the cost of the injection, which is administered at home by their parent. It costs £165 for a four-week supply and the dose given to children is the same as adults, typically at 0.25mg and building up to 2.4mg.

Improving children’s lifestyle habits is half the battle

While the medicine will curb their appetite, they still have to reduce their food intake to lose weight. I provide a meal plan, tailored to each patient, but it is essentially a meal of protein, such as meat, fish, eggs or chickpeas, with vegetables or salad three times a day. For children who don’t want breakfast, I recommend a protein shake mid-morning – though it would be better if they had Weetabix or scrambled eggs. Some won’t eat green vegetables, so they have carrots instead.

I always urge patients to be more active but this is often met with resistance. When I suggest meeting up with friends to play football or tennis, the mothers tell me that nobody goes out like that any more – they’re all in their rooms playing video games. For those who don’t really move at all, my aim is to get them to do a walk two or three times a week.

Results are visible on the scales after the first week – it’s very rapid. This encourages them to keep up their habits because when you know something is working, you want to do more of it.

Achieving a healthy weight is a physical and mental challenge

My adolescent patients have lost a lot of weight while on weight-loss drugs. One young man has dropped from 18st to 13st and is heading towards a normal BMI. The change in the quality of life is outstanding.

None of them, however, have yet come off the drugs. Most patients started off being severely obese – as opposed to being just a bit overweight – and the weight loss they experience is gradual. You can’t put a time limit on achieving a healthy weight. It’s a process.

However, while many see their mental health improve as they lose weight, it isn’t always that simple. One mother told me that she had received a phone call from the mother of her son’s best friend to say that he’s suicidal. That’s despite him losing nearly five stone. His body image hasn’t improved and he’s not seeing himself as a slim person. My clinic has a psychotherapist who was able to support him.

There’s lots going on in the minds of children, even after they lose weight. They are still scared of being bullied and they’re losing weight at a time when their body is changing anyway – they’re getting taller, they’re going through puberty.

What’s next for childhood obesity

The incidence of obesity among children is going to increase. We’re the first clinic in the UK to treat children with the new class of weight-loss injections but, obviously, my desire is that treatment will become more widely available because it’s heartbreaking watching them struggle. The ultimate aim is for them to become healthy young adults who have their weight under control.

Additionally, Novo Nordisk are doing trials in younger children so the treatment may become available to under-12s in the future.

However, we can’t rely on weight-loss jabs alone. When you’re talking about the obesity crisis in the UK, you’re talking about ultra-processed junk food.

In the nearly four decades that I’ve been running my clinic, absolutely everything about food has changed for the worse – from how it’s made to how it’s sold, and where and how we eat. When I hear about children’s diet and exercise habits now, I can’t help but think “my childhood wasn’t like that”.

There’s a lot of people who say “if they just stopped eating, if they weren’t such pigs, they’d be fine”. I think that’s a tragedy. It’s much more complex than that.

There’s an awful lot that needs to be done to bring down obesity. If you look at the decline in smoking, that was down to a push in educating people, banning advertising and warnings on packets. Until that happens for junk food, we’re not going to see changes.

What really spurred me to offer weight-loss jabs to children was the poor state of their mental health. It broke my heart to listen to parents tearfully tell me that their child was being so badly bullied that they had become depressed, attempted suicide and were on antidepressants. It was so desperately sad and devastating for the families.

The data shows that, at this point in time, the thing that is going to make the biggest difference is pharmacotherapy – weight-loss drugs. They will drive immediate results. For the first time, we’ve got light at the end of this tunnel.

Dr Sindy Newman is a private GP who has specialised in bariatric medicine for 30 years. She is the founder and head of Diet UK, a weight loss clinic that has helped thousands lose weight.

As told to Emily Craig