By Dr. Asnat Raziel, bariatric surgeon specializing in obesity treatment, metabolic health and healthy longevity; Director of the Multidisciplinary Center for Obesity Treatment, Assia Medical, Assuta Ramat HaChayal, Tel Aviv
Wegovy for children: what the new study showed
Wegovy for children is a topic that, until recently, almost no one had studied. Now the first results from a large trial are arriving. Children received weekly semaglutide, the active ingredient in Wegovy, alongside a tailored diet and physical activity. According to the announcement, it helped 40.4% of children aged six to 11 drop below the definition of obesity.
This is important news for families coping with severe childhood obesity. However, the full data still await scientific presentation and review by drug regulators.
Childhood obesity is not a parenting failure
For years, people saw childhood obesity mainly as the result of habits: poor eating, too little movement or parents who struggle to set limits. Today, medicine understands that it is a chronic disease. Genetics, hormones and the mechanisms of hunger and fullness all affect it. In addition, environment, sleep, emotional well-being and social factors play a role. I covered this in more depth in my article on childhood obesity treatment in Israel.
The scale of the problem is enormous. According to the World Obesity Atlas 2026, about 177 million children and adolescents aged 5 to 19 were living with obesity in 2025. By 2040, the atlas projects that the number will climb to about 228 million. Moreover, a classic 2003 study in JAMA found that the quality of life of children with severe obesity was similar to that of children undergoing cancer treatment. In short, this is not a cosmetic issue.
Wegovy for children: two in five dropped below the obesity threshold
The study’s name is STEP Young. It is a phase 3, randomized, double-blind, placebo-controlled trial. It ran in several countries and included 165 children with obesity, aged six to under 12. One group received a weekly semaglutide injection, while the other received a placebo injection. Treatment lasted 68 weeks. At the same time, all the families received guidance on a reduced-calorie diet and physical activity.
Most of the children started with significant disease: more than 85% had class 2 or class 3 obesity. According to Novo Nordisk’s announcement of September 7, 2026, after 68 weeks, 40.4% of the children on semaglutide dropped below the obesity threshold. In the placebo group, by contrast, not a single child did. In other words, nearly two in five children moved into the overweight or healthy weight category.
How to read this number
The figure is based on the trial product estimand. This means the calculation assumes all the children stayed on treatment the whole time. That is why we also need to wait for the complementary analysis, which includes children who stopped treatment or missed doses. That analysis reflects what happens in the clinic much more closely.
In addition, the trial met its primary goal: a large drop in BMI in the semaglutide group compared with placebo. However, the company has not yet released the average reduction. So for now, we cannot precisely compare the size of the effect with that seen in adolescents and adults.
Why do doctors measure children differently?
Children’s weight and height change naturally as they grow. For this reason, a single BMI (body mass index) value is not enough. Instead, doctors compare it with growth charts by age and sex. This study used the charts of the U.S. Centers for Disease Control and Prevention (CDC).
Doctors usually define obesity in children as a BMI at or above the 95th percentile. Class 2 means a BMI of at least 120% of the 95th percentile value, and class 3 means at least 140%. The goal of treatment is not a low number on the scale. Rather, the goal is to improve the growth trajectory, metabolic health, fitness and quality of life, while protecting normal development.
How does semaglutide work?
Semaglutide mimics a natural hormone called GLP-1 (glucagon-like peptide-1). The hormone acts in the brain and the digestive system. It increases fullness, reduces hunger and slows stomach emptying. I explained this mechanism in my article on the hormones and brain circuits of satiety.
Children take the drug as a weekly injection, and the dose rises gradually. In the trial, children reached a maximum dose of 1.7 or 2.4 mg a week, depending on their weight at the start. Keep in mind that the drug does not replace nutritious meals, movement, sleep and family support. Even so, it may reduce biological hunger, which helps the family make changes that last.
There is already substantial experience in adolescents
Regulators in the United States and Europe have already approved Wegovy for adolescents aged 12 and older with obesity. The STEP TEENS trial, which included 201 adolescents, formed the basis for that approval. After 68 weeks, BMI fell by an average of 16.1%, compared with a 0.6% rise in the placebo group. Also, 73% of adolescents on semaglutide lost at least 5% of their weight, compared with 18% on placebo. You can read more about the STEP program in my article on the STEP trials of Wegovy.
The most interesting number for comparison comes from a secondary analysis in the journal Obesity. According to it, 44.9% of adolescents on semaglutide moved to the overweight or healthy weight range, compared with 12.1% on placebo. The share of adolescents with class 3 obesity fell from 37.3% to 13.6%. In younger children, the result of 40.4% is therefore close to that in adolescents. The striking difference is in the placebo group: among the younger children, no one dropped below the threshold without the drug.
Liraglutide: earlier research in children
Researchers have also tested another drug from the same family in young children: daily liraglutide. The SCALE Kids trial in NEJM included 82 children aged 6 to 11. After 56 weeks at a dose of 3.0 mg a day, BMI fell by 5.8%, compared with a 1.6% rise on placebo. Thus, the weekly semaglutide results extend a research trend that has already begun.
In Israel, the 2026 national health basket (the list of treatments Israel’s health funds must cover) includes Wegovy injections for ages 12 to 18 only. I wrote about this in a separate article on weight loss injections for teens in the health basket.
Wegovy for children: what do we know about safety?
According to the company, the safety profile was similar to earlier studies in children, adolescents and adults. The researchers found no new safety signals, and no harm to growth or sexual development. The known side effects of semaglutide are mainly digestive: nausea, vomiting, abdominal pain, diarrhea or constipation. They are especially common while the dose is going up.
In the adolescent trial, digestive side effects occurred in 62% of patients, compared with 42% on placebo. Gallstones appeared in 4% of the semaglutide group and in none of the placebo group. In addition, the FDA label for Wegovy notes that gallstones and gallbladder inflammation were more common in adolescents than in adults. Therefore, young children need monitoring of nutrition, protein intake, growth, development and emotional well-being, with the support of a multidisciplinary team.
What we still want to know
This is a company announcement, not a full scientific paper. The trial also looks at body measurements, cardiovascular risk factors and blood sugar control. Beyond that, it examines body composition in a subgroup using DXA scans, at week 68 and again at week 104. The week 104 point matters most, because it shows what happens over time. It is just as important to know the dropout rate and how muscle and fat changed. The company plans to present the full data at ObesityWeek 2026, which takes place in Washington from November 14 to 17.
Wegovy for children: still not approved under age 12
Encouraging results are not regulatory approval. The FDA label currently covers Wegovy from age 12. Likewise, the European Medicines Agency (EMA) approves it only for adolescents aged 12 and older with obesity who weigh more than 60 kg. It also instructs doctors to stop treatment if BMI has not dropped by at least 5% after 12 weeks at the maximum dose. As a result, treating children under 12 is, for now, off-label.
Early treatment is not cosmetic treatment
Severe obesity at a young age sometimes comes with prediabetes, fatty liver, high blood pressure and abnormal blood fats, even in childhood. Sleep apnea, orthopedic problems and a lower quality of life can come on top of these. The American Academy of Pediatrics guidelines emphasize early, family-based, stigma-free treatment. Furthermore, childhood obesity tends to continue into adulthood, and with it, cardiovascular risk. Studies in adults have already shown that semaglutide reduces heart events, as I wrote in my article on semaglutide and heart protection.
What to ask before starting treatment
The decision to treat a child with medication depends on the severity of obesity, the pattern of weight gain and related conditions. Previous attempts, eating patterns, emotional health and the family’s readiness also matter. Here are practical questions for the appointment:
- What is the defined treatment goal for my child?
- How will you track growth, muscle mass and development?
- Who will guide nutrition?
- What is the follow-up plan if side effects appear?
- What happens when treatment stops?
The bottom line on Wegovy for children
The new study shows an impressive result. Among young children who stayed on treatment, 40.4% dropped below the obesity threshold within about a year and a quarter, compared with no children on placebo. For families who have already worked hard, this is real hope. At the same time, these are preliminary results from the company, and a full review will be possible only after scientific publication. If approval for younger ages does come, its place will be within a supervised, family-based program that tracks growth, nutrition, muscle and emotional well-being.
The information in this article is general and does not replace personal medical advice. Any decision about treating a child needs tailored medical guidance.
References
Once-Weekly Semaglutide in Adolescents with Obesity
Liraglutide for Children 6 to <12 Years of Age with Obesity – A Randomized Trial
Health-related quality of life of severely obese children and adolescents
WEGOVY (semaglutide) injection – Prescribing Information
Wegovy – European Medicines Agency
Novo Nordisk funded the STEP Young, STEP TEENS and SCALE Kids trials.
