Nearly 17 Million Young Americans Could Benefit From Ozempic-like Drugs

Newsweek

2 days ago

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Nearly 17 million young Americans could be eligible for GLP-1RAs—a class of medications used to treat type 2 diabetes and obesity—including Ozempic and Wegovy.
This is based on estimations from Yale School of Medicine researchers who have assessed how many adolescents and young adults in the US are eligible for the drugs and how many can realistically access them.
Despite millions being eligible, one in five young adults who meet the criteria are uninsured and one-third denied having a routine place for healthcare.
The researchers describe this as "a barrier to identifying, treating, and preventing cardio-kidney-metabolic diseases".
The prevalence of type 2 diabetes and obesity continues to increase in youth across the country, hence the need for improved intervention.
"Assuming that all individuals who were appropriate candidates for these medications could receive them after shared-decision making with their clinician, we could see substantial progress made in treating and preventing obesity-related diseases in US youth, such as dyslipidemia and hypertension," paper author Ashwin K. Chetty told Newsweek.
This, he explained, "could lead to the prevention of severe complications of obesity into adulthood, such as strokes and heart attacks."
Hand holding Ozempic-like injection pens on dark background.
Hand holding Ozempic-like injection pens on dark background.Chetty said the GLP-1RA eligibility criteria they used covered indications for semaglutide (Ozempic, Rybelsus and Wegovy), liraglutide (Saxenda and Victoza), Bydureon BCise (exenatide), Trulicity (dulaglutide) and tirzepatide (Zepbound and Mounjaro).
While some medications contain the same ingredient under a different brand name, the drugs are licensed in different ways. In the U.S., Ozempic, for example, is approved for use in people with type 2 diabetes, while Wegovy is approved for those with obesity or who are overweight and have related health problems.
Wegovy and Ozempic mimic a hormone called glucagon-like peptide-1—hence 'GLP-1'—which targets areas of the brain that regulate appetite.
"Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are approved to treat pediatric obesity and T2D, and a small but growing number of adolescents and young adults receive GLP-1RAs, which are largely covered through private insurance or Medicaid," the researchers wrote.
"Insurance status, access to care and clinical profile of the broader population of youth eligible for GLP-1RAs are unclear but important for policy development. We characterized demographic, clinical, and socioeconomic characteristics of US adolescents and young adults eligible for any GLP-1RA."
To inform the estimations, the cross-sectional study pooled publicly available data from the National Health and Nutrition Examination Survey (NHANES) January 2017–March 2020 and August 2021–August 2023. They included US adolescents aged 12–17 and young adults aged 18–25 who met U.S. Food and Drug Administration criteria for GLP-1RA treatment.
Over-the-shoulder view of a person in bed checking a smartphone.
Over-the-shoulder view of a person in bed checking a smartphone.For adolescents, GLP-1RA indications included type 2 diabetes or obesity defined either as BMI in the 95th percentile or higher for age and sex or body weight greater than 60kg and BMI corresponding to 30 for adults by international cutoffs.
For young adults, GLP-1RA indications included type 2 diabetes, obesity (a BMI greater than 30) or a BMI of 27 or higher with a weight-related condition (dyslipidemia, hypertension, cardiovascular disease, or type 2 diabetes).
The sample included 572 adolescents and 590 young adults eligible for GLP-1RA treatment, representing an estimated 5.8 million adolescents and 11.1 million young adults.
Adolescents eligible for the drugs included 40.3 percent insured by Medicaid, 40.5 percent privately insured and 7.2 percent uninsured. Eligible young adults included 20.8 percent insured by Medicaid, 49 percent privately insured and 19.4 percent uninsured.
While 92.2 percent of adolescents reported having a routine place for healthcare, 68.1 percent of young adults reported the same, according to the study. Among both groups, cardio-kidney-metabolic risk factors (dyslipidemia, impaired kidney function, hypertension and prediabetes) were prevalent.
"Of note, some indications for young adults were fully encompassed by other indications and were not analyzed separately," said Chetty. For example, the indication of type 2 diabetes may include having also a cardiovascular disease.
The analysis also did not include people aged 10–11 years with type 2 diabetes as there were too few participants in their sample in that age group with the condition.
"While Medicare is not allowed to cover anti-obesity medications that are indicated only for obesity, Medicaid can cover anti-obesity medications, though only a fraction of state Medicaid programs do," said Chetty.
The researchers say their findings indicate broad Medicaid coverage could increase access to GLP-1RAs for a large portion of U.S. youth who may benefit from them. "This could look like state-level formulary changes that include anti-obesity medications or federal policy changes that foster coverage for these therapies," said Chetty.
"Beyond expanding insurance coverage, improving access also involves ensuring these individuals have access to general healthcare and clinician appointments, which we show in this study is a particularly significant concern for young adults."
Why are we seeing rising rates of metabolic diseases in America's youth? Paper author and pediatric nephrologist Dr. James Nugent told Newsweek: "Changes in lifestyle behaviors and structural factors like increased screen time, decreased physical activity, poor sleep, and consumption of ultra-processed foods and sugar-sweetened beverages are important contributors to obesity in youth.
"The COVID-19 pandemic has further accelerated the rise in obesity due to its effect on these lifestyle behaviors. Chronic stress, food insecurity, poverty, and adverse childhood experiences are also strongly associated with obesity in youth. Additionally, in utero exposure to maternal obesity and diabetes are risk factors for obesity and type 2 diabetes in childhood."
The authors said study limitations include self-reported data subject to recall bias and potential misclassification of the type of diabetes. They also flagged GLP-1RAs should be considered alongside intensive health behavior and lifestyle treatment (and surgery where applicable). And while expanded insurance coverage may substantially increase access, uninsurance and lack of routine care are barriers to this therapy.
How can we ensure young people receive holistic care too? "Improving access to comprehensive obesity treatment will involve ensuring that individuals receive access to healthcare with regular follow-ups and support to engage in health behavior and lifestyle treatment, such as specific programs tailored to providing intensive health behavior and lifestyle treatment," said Chetty.
"As Dr. Mona Sharifi, a co-author of this paper, has shown, intensive health behavior and lifestyle treatment programs can be cost-effective but inadequate funding is the main barrier to implementing and sustaining these programs."
What's next? "Given the size and clinical characteristics of the U.S. youth population eligible for GLP-1RAs, there should be greater discussion of how to improve access to GLP-1RAs and other anti-obesity interventions among this population."
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Reference
Chetty, A. K., Sharifi, M., & Nugent, J. T. (2025). Glucagon-like peptide-1 receptor agonist eligibility among US adolescents and young adults. JAMA Pediatrics. https://doi.org/10.1001/jamapediatrics.2025.2308