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Ethical considerations for semaglutide use in children
Nanette Ryan1, Dominic Wilkinson2,3, Julian Savulescu4,2
1Centre for Biomedical Ethics, National University of Singapore, Singapore.
Archives of Disease in Childhood
|January 6, 2026
Summary
Semaglutide medications like Ozempic are approved for pediatric obesity but raise ethical concerns. This paper explores these challenges and offers recommendations for responsible clinical use in children.
Area of Science:
- Pharmacology
- Pediatrics
- Bioethics
Background:
- Semaglutide (Ozempic, Wegovy, Rybelsus) is a prominent medication initially for type 2 diabetes.
- It is now approved for pediatric obesity management in several countries, sparking debate.
- Concerns exist regarding long-term safety, efficacy, and developmental impacts in children.
Purpose of the Study:
- To examine ethical challenges of prescribing semaglutide to children.
- To focus on access barriers, stigma, and structural determinants of childhood obesity.
- To provide ethical recommendations for clinicians regarding pediatric semaglutide use.
Main Methods:
- Ethical analysis of current semaglutide prescribing practices in pediatric populations.
- Review of regulatory approvals and clinical guidelines for pediatric obesity management.
- Exploration of socioeconomic and psychological factors influencing access and stigma.
Main Results:
- Prescribing semaglutide to children presents ethical dilemmas concerning informed consent and potential harms.
- Access barriers and societal stigma exacerbate inequities in obesity treatment.
- Neglect of broader social determinants of health undermines effective pediatric obesity interventions.
Conclusions:
- Ethical frameworks are needed to guide the use of semaglutide in pediatric obesity.
- Recommendations focus on mitigating harm, ensuring equitable access, and promoting child autonomy.
- A holistic approach addressing social determinants is crucial for children's health.
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