Current and forthcoming pharmacotherapies for adolescent obesity: Evidence-based review

Table 2 Determinants of access, prescribing trends, and psychosocial challenges in the use of drugs for the treatment of obesity in the adolescent population: An analysis of the outlook for 2025¹

Parameters	Current trend (2025)	Main barriers	Impact on equity/psychosocial	Ref.
Prescription	Shift from liraglutide to semaglutide and tirzepatide due to greater potency (BMI reduction > 15%)	Global supply shortages and clinical inertia in primary care	Preferential access in private sectors; gap in public health due to lack of stock	[6,67,68]
Economic access	Increased demand for health insurance coverage for new-generation drugs (arGLP-1)	High out-of-pocket costs and strict “prior authorization” requirements by insurers	Exclusion of adolescents from low socioeconomic status and ethnic minorities	[68,69]
Real use	Transition to digital care and telemedicine models for chronic disease management	Lack of specialists in pediatric obesity in rural or remote areas	Geographical inequality: “Medical deserts” in many communities and locations limit multidisciplinary follow-up	[68-70]
Psychosocial considerations	Reduction of weight stigma by validating the biological basis of treatment	Risk of off-label use driven by social media aesthetic standards	Possible exacerbation of eating disorders due to rapid weight loss	[70,71]

¹This table summarizes the transition from treatment models based solely on lifestyle to the integration of molecules that serve as glucagon-like peptide-1 receptor agonists and dual agonists (glucose-dependent insulinotropic polypeptide/glucagon-like peptide-1). It highlights the gap between the clinical efficacy of drugs such as semaglutide and tirzepatide and systemic barriers to coverage.

BMI: Body mass index; arGLP-1: Glucagon-like peptide-1 receptor agonists.