Unlocking the Truth: Anti-Obesity Meds for Kids in Israel
Hey there! So, I was just digging into this really interesting study about something super important: how we’re helping kids and teens in Israel tackle overweight and obesity, specifically when it comes to using medications. You know, childhood obesity is a massive deal globally, and Israel is no exception. It’s not just about how someone looks; it’s linked to all sorts of health issues popping up way too early, things we used to only see in adults. And honestly, if it’s not addressed, it often sticks around into adulthood, bringing more health risks with it.
Now, we all know that lifestyle changes – eating better and moving more – are the absolute foundation. They’re crucial! But sometimes, for kids with more severe obesity or those already dealing with health problems because of their weight, lifestyle changes alone might not be enough. That’s where anti-obesity medications (AOMs) can potentially come into play, acting as a helping hand alongside those lifestyle efforts.
But here’s the thing: while we have studies showing these medications *can* work, what happens in the real world? Not in a controlled trial, but in everyday clinics, with regular kids and families? That’s what this study, looking at data from Clalit Health Services (CHS), Israel’s biggest health organization, wanted to figure out. They peeked into the records of hundreds of thousands of kids aged 10 to 18 to see who was getting these meds, what kind they were, and what happened to their weight and other health markers like blood sugar and cholesterol.
Who’s Getting These Meds Anyway?
Okay, first off, the study looked at over 300,000 kids in the CHS system who were classified as overweight or obese. And guess what? Only a tiny fraction, just 0.7%, were prescribed AOMs. That struck me as pretty low, especially when compared to some numbers I’ve seen from places like the United States, where it might be higher.
So, who were these kids in Israel getting the prescriptions? It turns out they were more often:
- Girls
- A bit younger
- Had higher BMI z-scores (meaning their weight was further above what’s typical for their age and height)
- From families with medium to high socioeconomic status
What makes total sense is that the kids prescribed AOMs were also way more likely to already have health problems linked to their weight. We’re talking things like:
- Dyslipidemia (unhealthy cholesterol/fat levels)
- Type 2 Diabetes (T2D)
- Impaired Glucose Tolerance (IGT)
- High blood pressure (Hypertension)
- Obstructive Sleep Apnea (OSA)
- Non-alcoholic Fatty Liver Disease (NAFLD)
- And for the girls, Polycystic Ovary Syndrome (PCOS)
They were also more likely to have been referred to dietitians and endocrine specialists. This suggests that doctors were generally prioritizing these medications for kids who were struggling the most or already had complications.
Which Meds Were They Using?
The study looked at three main medications available during the study period (2017-2024):
- Metformin: This one was the most common by far, making up almost 74% of prescriptions. It’s typically used for diabetes, but it can help with weight too.
- GLP-1 receptor agonists (like Liraglutide): These were the second most common, around 24.5%. They work on appetite and digestion signals.
- Orlistat: This one blocks some fat absorption and was prescribed the least, only about 1.7%.
Why was Metformin so popular? The study authors think it could be because it’s been around longer, might have fewer side effects for some, is covered by national health insurance (making it cheaper), or maybe doctors and patients are just more familiar with it. Plus, some kids using Metformin also had Type 2 Diabetes, so it was helping two things at once.
Interestingly, the study found that girls tended to stick with their medication longer than boys. And the kids who actually *purchased* at least two prescriptions (which the study used as a sign of sticking with treatment) were more likely to be girls, have higher BMI z-scores to start with, and have more of those weight-related health issues like T2D, hypertension, and NAFLD. This kind of makes sense – if you’re dealing with more serious problems, you might be more motivated to keep taking the medicine.
So, Did They Work in the Real World?
Now for the big question: did these medications actually make a difference for the kids who took them (at least two prescriptions)? The study looked at changes in BMI z-scores and those cardiometabolic health markers. And yes, they did see positive changes!
While kids were on the medication, their BMI z-scores went down significantly. And it wasn’t just weight! They also saw improvements in:
- Lower blood glucose levels
- Lower HbA1c (a measure of long-term blood sugar)
- Lower triglycerides
- Lower total cholesterol
- Higher HDL cholesterol (the “good” kind!)
These improvements were seen with both Metformin and the GLP-1 receptor agonist. The Orlistat group was too small to really say much about its effects in this study.
What happened when kids stopped taking the medication? Their BMI z-scores and those health markers did tend to creep back up a bit. But – and this is important – they generally didn’t go all the way back to where they started. They remained better than they were before treatment began. This suggests the medication helped, even if the benefits weren’t fully maintained after stopping.
Real World vs. Research Trials: Why the Difference?
The study authors pointed out that the weight loss seen in this real-world setting was maybe a bit more modest than what you might see in highly controlled research trials. Why the difference? Well, real life is messy! In trials, patients are often very carefully selected, get lots of support from a whole team (dietitians, counselors, etc.), and are closely monitored, which helps them stick to the plan.
In the real world, kids and families are juggling school, work, other appointments, and maybe don’t have as much access to intensive lifestyle support. Plus, sticking to taking a medication every day or week can be tough. The study noted that the “persistence” (how long kids kept buying the medication) was relatively low, which definitely impacts how much benefit they get.
Despite these real-world challenges and the lower persistence, the study still showed that AOMs *can* be effective in helping kids lose weight and improve their health markers, especially for those with more severe obesity and related health problems. It highlights that these medications have potential, even outside of a perfect research setting.
The Big Picture
So, what’s the takeaway from this dive into the data from Israel? For me, it reinforces a few things:
- Childhood obesity is a complex issue, and lifestyle changes are key, but sometimes we need more tools.
- Anti-obesity medications *do* seem to help kids with obesity, especially those with health complications, leading to lower BMI z-scores and better cardiometabolic health.
- The fact that only a tiny percentage of eligible kids are getting these prescriptions in Israel is something to think about. Is it access? Cost (for some meds)? Lack of awareness? Doctor comfort levels? Sociocultural factors? Probably a mix of everything.
- Sticking with the treatment seems important for getting the best results, which is a challenge in the real world.
The study itself had limitations, as all real-world studies do. They couldn’t be sure every purchased pill was taken, didn’t have data on *how well* kids were doing with lifestyle changes alongside the meds, and didn’t look at newer medications like Semaglutide (which wasn’t available in this way during the study period). But its strength is that it looked at a really large group of kids in a real healthcare system.
Ultimately, this study from Israel adds to the growing picture that AOMs can be a valuable part of the plan for managing childhood obesity, particularly for those who need it most. But we need to figure out how to make them more accessible and how to help kids and families stick with treatment to get the most benefit. It’s definitely not a magic bullet, but it looks like a tool that could help some kids on their journey to better health.
Source: Springer
