• An estimated 17 million U.S. adolescents and young adults were eligible for GLP-1 receptor agonists, but many lacked insurance or a routine place for healthcare.
  • Adolescents and young adults were eligible for GLP-1 receptor agonists due to type 2 diabetes, obesity, or BMI of 27 or higher with a weight-related condition (the latter indication was included only for young adults).
  • One in five young adults eligible for GLP-1 receptor agonists were uninsured, and one-third denied having a routine place for care.

Though an estimated 17 million U.S. adolescents and young adults were eligible for GLP-1 receptor agonists for conditions like obesity and type 2 diabetes, many lacked insurance or a routine place for healthcare, a cross-sectional study suggested.

In a sample of adolescents eligible for GLP-1 receptor agonists, 40.3% were insured by Medicaid, 40.5% were privately insured, and 7.2% were uninsured. Among eligible young adults, 20.8% were insured by Medicaid, 49% were privately insured, and 19.4% were uninsured, reported James T. Nugent, MD, MPH, Yale School of Medicine in New Haven, Connecticut, and colleagues.

While 92.2% of eligible adolescents reported having a routine place for healthcare, only 68.1% of eligible young adults reported the same, they noted in a research letter in JAMA Pediatrics opens in a new tab or window .

"One in five young adults eligible for GLP-1 receptor agonists were uninsured and one-third denied having a routine place for healthcare -- a barrier to identifying, treating, and preventing cardio-kidney-metabolic diseases," Nugent and colleagues wrote.

Among U.S. youth, the prevalence of obesity and type 2 diabetes continues to increase, and a small but growing number of adolescents and young adults are prescribed GLP-1 receptor agonists for treatment, largely covered through private insurance or Medicaid. MedPage Today has previously reported on an increase in prescribingopens in a new tab or window of these medications for children, and earlier this year, the CDC noted that nearly one in three U.S. kids has prediabetesopens in a new tab or window , though experts questioned the data.

"Whether and how to cover GLP-1 receptor agonists has been a highly active area of research and policy, and our study contributes to this ongoing conversation by describing the socioeconomic characteristics of U.S. youth who are eligible for GLP-1 receptor agonists," co-author Ashwin Chetty, an MD candidate at Yale School of Medicine, told MedPage Today in an email.

"A key takeaway from this study is that Medicaid insures a substantial portion of U.S. youth who are eligible for GLP-1 receptor agonists, specifically two in five adolescents and one in five young adults who are eligible for these medications," Chetty said. "Only a fraction of state Medicaid programs currently cover GLP-1 receptor agonists for obesity, but our findings indicate that broad Medicaid coverage can increase access to these medications for a large portion of U.S. youth who may benefit from them," he added.

In an accompanying opens in a new tab or window editorialopens in a new tab or window , Stacie Dusetzina, PhD, of Vanderbilt University Medical Center in Nashville, Tennessee, and colleagues wrote, "While GLP-1 treatment for youth with obesity is increasingly common in the U.S., it is important for clinicians, patients, and caregivers to understand potential barriers to accessing these drugs in the short and long term. Proactively initiating lower-cost obesity treatment among those indicated to receive medication therapy could be one way to ensure that longer term use is not disrupted by changes in insurance status as youth age into adulthood."

For their study, the researchers pooled data from the National Health and Nutrition Examination Survey from January 2017 to March 2020 and August 2021 to August 2023. The study sample included 572 adolescents (ages 12 to 17) and 590 young adults (ages 18 to 25), representing an estimated 5.8 million adolescents and 11.1 million young adults eligible for GLP-1 agonists. The mean age of eligible adolescents was 14.5 years, and the mean age of eligible young adults was 21.9 years. Slightly more than half of both adolescents and young adults were male.

Adolescents and young adults were eligible for GLP-1 receptor agonists if they had type 2 diabetes or obesity. In young adults, a body mass index (BMI) of 27 or higher with a weight-related condition (dyslipidemia, hypertension, cardiovascular disease, or type 2 diabetes) also made them eligible.

Among eligible adolescents, the indication was obesity with or without diabetes for 99.2%, and type 2 diabetes alone for 0.8%. For young adults, the indication was obesity with or without diabetes for 88.2%, and BMI of 27 or higher with a weight-related condition with or without diabetes for 11.8%. All young adults with type 2 diabetes (1.4%) had either obesity or BMI of 27 or higher with a weight-related condition.

Researchers noted that cardio-kidney-metabolic risk factors -- like dyslipidemia, impaired kidney function, hypertension, and prediabetes -- were prevalent among both groups.

Limitations included self-reported data subject to recall bias and potential misclassification of diabetes subtype, Nugent and colleagues noted.

Disclosures

Nugent reported receiving awards from the American Heart Association and Yale University, and a grant from the National Center for Advancing Translational Science. Chetty reported receiving personal fees from Close Concerns outside the submitted work. A co-author reported receiving grants from the NIH during the conduct of the study, and personal fees from the American Academy of Pediatrics outside the submitted work.

Dusetzina had no disclosures. A co-author of the editorial reported being a co-investigator in a Novo Nordisk-sponsored clinical trial, but reported not receiving any personal remuneration, effort support, or direct funding from the company.

Primary Source

JAMA Pediatrics

Source Reference: opens in a new tab or window Chetty A, et al "Glucagon-like peptide-1 receptor agonist eligibility among US adolescents and young adults" JAMA Pediatr 2025; DOI: 10.1001/jamapediatrics.2025.2308.

Secondary Source

JAMA Pediatrics

Source Reference: opens in a new tab or window Luo J, et al "Exploring challenges with widespread use of GLP-1based therapies for adolescents and young adults" JAMA Pediatr 2025; DOI: 10.1001/jamapediatrics.2025.2469.