HMN 2025: How An estimated 17 million US youth meet criteria for GLP-1RA treatment

A cross-sectional analysis from Yale School of Medicine estimates that approximately 5.8 million adolescents and 11.1 million young adults in the United States meet eligibility criteria for glucagon-like peptide-1 receptor agonists (GLP-1RAs), drugs approved to treat obesity and type 2 diabetes (T2D) in some pediatric populations.

Prevalence of obesity and T2D has continued to rise among U.S. youth, presenting an opportunity to treat with GLP-1RAs. Previous studies have examined prescribing trends, though clinical and insurance profiles of those eligible for GLP-1RAs remain poorly described.

In the study, “Glucagon-Like Peptide-1 Receptor Agonist Eligibility Among US Adolescents and Young Adults,” published in JAMA Pediatrics, researchers pooled data from the National Health and Nutrition Examination Survey (NHANES) to identify U.S. youth meeting FDA criteria for GLP-1RA therapy.

Sample data included 572 adolescents aged 12–17 and 590 young adults aged 18–25, representing a weighted estimate of 5.8 million adolescents and 11.1 million young adults.

Eligibility criteria for adolescents included T2D or obesity based on body mass index (BMI) thresholds adjusted for age and sex or corresponding adult BMI thresholds. For young adults, eligibility included T2D, obesity (BMI ?30), or a BMI ?27 with a weight-related condition such as dyslipidemia, hypertension, cardiovascular disease, or T2D.

Researchers applied a treatment-based algorithm to extrapolate diabetes type, as NHANES data does not include direct diabetes subtype identifiers. Exclusions included pregnancy, type 1 diabetes, missing BMI or diabetes-related information.

Population-weighted estimates revealed that 99.2% of eligible adolescents and 88.2% of eligible young adults qualified due to obesity, with or without T2D. Only 0.8% of adolescents and 11.8% of young adults qualified due to BMI ?27 with weight-related conditions. While T2D alone did not count as eligibility, young adults with T2D (1.4%) all had either obesity or a qualifying BMI with comorbidities.

Of those eligible for treatment, insurance status varied sharply. Among adolescents, 40.3% had Medicaid and 7.2% were uninsured. 20.8% of young adults were covered by Medicaid, 19.4% were uninsured, and 49.0% had private insurance. While 92.2% of adolescents reported a routine place for health care, only 68.1% of young adults did.

GLP-1RA-eligible adolescents and young adults shared cardio-kidney-metabolic risk factors. Among adolescents, 35.1% had dyslipidemia, 10.1% had hypertension, and 74.7% had reduced kidney function based on estimated glomerular filtration rate (eGFR 2).

In young adults, 44.5% had dyslipidemia, 26.7% had hypertension, 71.9% had reduced kidney function, and 42.0% were classified with probable obstructive sleep apnea.

Researchers conclude that GLP-1RA eligibility extends to nearly 17 million youth nationwide. Lack of insurance and inconsistent access to routine care among young adults may hinder efforts to diagnose and manage cardio-kidney-metabolic conditions.

© 2025 Science X Network