17歲時,伊斯雷爾?麥肯齊飽受肥胖之苦,他高中就輟學(xué)了。后來他去餐館打工,但他不好意思和別人說話。
“我當(dāng)時的心情很糟糕,”麥肯齊說。他身高6英尺1英寸(約182.84厘米),盡管一再努力節(jié)食和鍛煉,但體重已攀升至335磅(約151.95公斤)?!拔乙呀?jīng)絕望了?!?/p>
新的研究顯示,Wegovy是一種用于治療糖尿病和肥胖癥的藥物(GLP-1受體激動劑),服用這種藥物的青少年和青壯年人數(shù)激增,麥肯齊也是其中的一員。去年,這位田納西州農(nóng)村少年開始服用這種減肥藥,九個月就減掉了110磅(約49.89公斤)。
對2020年至2023年期間近94%美國零售藥店的配藥記錄的最新分析顯示,盡管大量老年人爭相購買Ozempic和Wegovy等藥物,但這類藥物在12至25歲人群中的月使用量也在飆升。
本周三發(fā)表在《美國醫(yī)學(xué)會雜志》上的這份報告,利用IQVIA處方數(shù)據(jù)庫首次對GLP-1藥物在美國該年齡段人群中的使用情況進(jìn)行了分析。主導(dǎo)這項研究的密歇根大學(xué)兒科醫(yī)生、糖尿病專家喬伊斯?李博士說,僅在2023年,就有近3.1萬名12至17歲的青少年和超過16.2萬名18至25歲的青年使用了這種藥物。
她說:“這說明,這種藥物已經(jīng)被當(dāng)作一種減肥藥,越來越多的醫(yī)生會給人們開這種藥物?!?/p>
報告顯示,使用任何GLP-1藥物(包括2005年首次獲批用于治療糖尿病和2014年獲批用于減肥的老藥)的12至25歲年齡段人數(shù),從2020年的每月約8,700人,攀升至2023年的每月6萬多人,增幅近600%。盡管這些患者的其他藥物處方量下降了約3%,但GLP-1藥物的處方量仍出現(xiàn)了上升。
李指出,服用減肥藥的人僅占肥胖癥年輕人的一小部分。根據(jù)美國疾病控制與預(yù)防中心的數(shù)據(jù),約20%的美國兒童和青少年以及約42%的成人患有這種慢性疾病。
2023年初,美國兒科學(xué)會建議對患有肥胖癥的兒童和青少年進(jìn)行早期評估和積極治療,包括在必要時進(jìn)行手術(shù)和藥物治療。
田納西州青少年麥肯齊說,他從五年前開始發(fā)胖,當(dāng)時正值青春期。
他說:“我開始通過控制飲食來解決所有問題?!?/p>
他的醫(yī)生說,肥胖使他的哮喘加重,而且他有可能患上糖尿病。他開始遵照醫(yī)囑減少含糖汽水和零食的攝入量,并加強(qiáng)鍛煉,但這些努力都無濟(jì)于事。
“我以前的醫(yī)生告訴我,他無能為力,”他說?!八嬖V我,這是我的錯?!?/p>
2023年初,麥肯齊聯(lián)系上了田納西州查塔努加厄蘭格兒童醫(yī)院的兒科肥胖癥專家喬尼·杰克醫(yī)生,他經(jīng)常給孩子們開GLP-1藥物。
杰克說:“我告訴他,我今天已經(jīng)見過10個和你一樣的人,我們有很多治療方法。”這些方法通常包括密集行為干預(yù)和營養(yǎng)干預(yù),必要時結(jié)合藥物治療。
針對麥肯齊的情況,杰克給他開了減肥藥Wegovy。2022年底,該藥獲準(zhǔn)供美國12歲以上兒童使用。新數(shù)據(jù)顯示,2023年,超過6,000名12歲以上兒童服用Wegovy。超過7,600名12歲以上兒童服用Ozempic,該藥最初獲準(zhǔn)用于治療成人糖尿病,但可在標(biāo)簽外用于青少年。還有一些人服用一些GLP-1老藥,如Saxenda和Trulicity。
麥肯齊說,他并沒有出現(xiàn)明顯的藥物副作用。但李指出,有些年輕人會出現(xiàn)惡心、嘔吐或便秘、甚至是嚴(yán)重到需要停藥的癥狀。
李說,了解這類藥物在年輕人中的激增使用情況很重要。她說:這類藥物需要持續(xù)使用,因此“我們確實(shí)需要考慮這類藥物對年輕人群的長期安全性和有效性。”
此外,這類藥物價格昂貴,而且由于供應(yīng)問題或不在保險范圍內(nèi),這類藥物往往很難獲得。
值得注意的是,研究發(fā)現(xiàn),政府管理的醫(yī)療補(bǔ)助計劃支付了12至17歲青少年近一半以及18至25歲青年約四分之一的GLP-1藥物治療費(fèi)用。商業(yè)保險支付了年齡較小兒童近44%以及年齡較大兒童約三分之二的GLP-1藥物治療費(fèi)用。
如今,麥肯齊說他的哮喘好多了,他也愿意與同事們和朋友們互動了。
“我現(xiàn)在很自信,比以前自信多了,”他說。“一切都和以前不一樣了?!保ㄘ敻恢形木W(wǎng))
美聯(lián)社健康與科學(xué)部得到了霍華德?休斯醫(yī)學(xué)研究所科學(xué)與教育媒體集團(tuán)的支持。美聯(lián)社對所有內(nèi)容負(fù)全部責(zé)任。
翻譯:郝秀
審校:汪皓
17歲時,伊斯雷爾?麥肯齊飽受肥胖之苦,他高中就輟學(xué)了。后來他去餐館打工,但他不好意思和別人說話。
“我當(dāng)時的心情很糟糕,”麥肯齊說。他身高6英尺1英寸(約182.84厘米),盡管一再努力節(jié)食和鍛煉,但體重已攀升至335磅(約151.95公斤)?!拔乙呀?jīng)絕望了?!?/p>
新的研究顯示,Wegovy是一種用于治療糖尿病和肥胖癥的藥物(GLP-1受體激動劑),服用這種藥物的青少年和青壯年人數(shù)激增,麥肯齊也是其中的一員。去年,這位田納西州農(nóng)村少年開始服用這種減肥藥,九個月就減掉了110磅(約49.89公斤)。
對2020年至2023年期間近94%美國零售藥店的配藥記錄的最新分析顯示,盡管大量老年人爭相購買Ozempic和Wegovy等藥物,但這類藥物在12至25歲人群中的月使用量也在飆升。
本周三發(fā)表在《美國醫(yī)學(xué)會雜志》上的這份報告,利用IQVIA處方數(shù)據(jù)庫首次對GLP-1藥物在美國該年齡段人群中的使用情況進(jìn)行了分析。主導(dǎo)這項研究的密歇根大學(xué)兒科醫(yī)生、糖尿病專家喬伊斯?李博士說,僅在2023年,就有近3.1萬名12至17歲的青少年和超過16.2萬名18至25歲的青年使用了這種藥物。
她說:“這說明,這種藥物已經(jīng)被當(dāng)作一種減肥藥,越來越多的醫(yī)生會給人們開這種藥物?!?/p>
報告顯示,使用任何GLP-1藥物(包括2005年首次獲批用于治療糖尿病和2014年獲批用于減肥的老藥)的12至25歲年齡段人數(shù),從2020年的每月約8,700人,攀升至2023年的每月6萬多人,增幅近600%。盡管這些患者的其他藥物處方量下降了約3%,但GLP-1藥物的處方量仍出現(xiàn)了上升。
李指出,服用減肥藥的人僅占肥胖癥年輕人的一小部分。根據(jù)美國疾病控制與預(yù)防中心的數(shù)據(jù),約20%的美國兒童和青少年以及約42%的成人患有這種慢性疾病。
2023年初,美國兒科學(xué)會建議對患有肥胖癥的兒童和青少年進(jìn)行早期評估和積極治療,包括在必要時進(jìn)行手術(shù)和藥物治療。
田納西州青少年麥肯齊說,他從五年前開始發(fā)胖,當(dāng)時正值青春期。
他說:“我開始通過控制飲食來解決所有問題?!?/p>
他的醫(yī)生說,肥胖使他的哮喘加重,而且他有可能患上糖尿病。他開始遵照醫(yī)囑減少含糖汽水和零食的攝入量,并加強(qiáng)鍛煉,但這些努力都無濟(jì)于事。
“我以前的醫(yī)生告訴我,他無能為力,”他說?!八嬖V我,這是我的錯?!?/p>
2023年初,麥肯齊聯(lián)系上了田納西州查塔努加厄蘭格兒童醫(yī)院的兒科肥胖癥專家喬尼·杰克醫(yī)生,他經(jīng)常給孩子們開GLP-1藥物。
杰克說:“我告訴他,我今天已經(jīng)見過10個和你一樣的人,我們有很多治療方法?!边@些方法通常包括密集行為干預(yù)和營養(yǎng)干預(yù),必要時結(jié)合藥物治療。
針對麥肯齊的情況,杰克給他開了減肥藥Wegovy。2022年底,該藥獲準(zhǔn)供美國12歲以上兒童使用。新數(shù)據(jù)顯示,2023年,超過6,000名12歲以上兒童服用Wegovy。超過7,600名12歲以上兒童服用Ozempic,該藥最初獲準(zhǔn)用于治療成人糖尿病,但可在標(biāo)簽外用于青少年。還有一些人服用一些GLP-1老藥,如Saxenda和Trulicity。
麥肯齊說,他并沒有出現(xiàn)明顯的藥物副作用。但李指出,有些年輕人會出現(xiàn)惡心、嘔吐或便秘、甚至是嚴(yán)重到需要停藥的癥狀。
李說,了解這類藥物在年輕人中的激增使用情況很重要。她說:這類藥物需要持續(xù)使用,因此“我們確實(shí)需要考慮這類藥物對年輕人群的長期安全性和有效性。”
此外,這類藥物價格昂貴,而且由于供應(yīng)問題或不在保險范圍內(nèi),這類藥物往往很難獲得。
值得注意的是,研究發(fā)現(xiàn),政府管理的醫(yī)療補(bǔ)助計劃支付了12至17歲青少年近一半以及18至25歲青年約四分之一的GLP-1藥物治療費(fèi)用。商業(yè)保險支付了年齡較小兒童近44%以及年齡較大兒童約三分之二的GLP-1藥物治療費(fèi)用。
如今,麥肯齊說他的哮喘好多了,他也愿意與同事們和朋友們互動了。
“我現(xiàn)在很自信,比以前自信多了,”他說?!耙磺卸己鸵郧安灰粯恿?。”(財富中文網(wǎng))
美聯(lián)社健康與科學(xué)部得到了霍華德?休斯醫(yī)學(xué)研究所科學(xué)與教育媒體集團(tuán)的支持。美聯(lián)社對所有內(nèi)容負(fù)全部責(zé)任。
翻譯:郝秀
審校:汪皓
At 17, Israel McKenzie was so burdened by obesity that he stopped going to high school in person and was embarrassed to speak to people at his restaurant job.
“I was in a really dark place,” says McKenzie, whose weight had climbed to 335 pounds on his 6-foot-1 frame, despite repeated efforts to diet and exercise. “I had given up hope.”
But last year, the weight-loss drug Wegovy helped him shed 110 pounds in nine months, making the rural Tennessee teen part of a surge of adolescents and young adults using diabetes and obesity medications known as GLP-1 receptor agonists, new research shows.
Even as millions of older adults clamor for drugs such as Ozempic and Wegovy, monthly use of the medications soared in people aged 12 to 25. That’s according to the new analysis of dispensing records from nearly 94% of U.S. retail pharmacies from 2020 to 2023.
The report, published in the journal JAMA on Wednesday, used the IQVIA prescription database to compile the first look at the national uptake of GLP-1 drugs among that age group. Nearly 31,000 children aged 12 to 17 and more than 162,000 people aged 18 to 25 used the medications in 2023 alone, said Dr. Joyce Lee, a University of Michigan pediatrician and diabetes expert who led the research.
“What it’s suggesting is that it’s one of the tools in the toolbox and there are more providers prescribing this medication for the population,” she said.
The report shows that the number of 12- to 25-year-olds using any GLP-1 drug — including older medications first approved to treat diabetes in 2005 and for weight loss in 2014 — climbed from about 8,700 a month in 2020 to more than 60,000 a month in 2023, a nearly 600% increase. The rise occurred even as prescriptions of other drugs among those patients fell by about 3%.
Those who received the drugs were just a fraction of young people who struggle with obesity, Lee noted. About 20% of U.S. children and adolescents and about 42% of adults have the chronic disease, according to the U.S. Centers for Disease Control and Prevention.
In early 2023, the American Academy of Pediatrics recommended that children and teens with obesity be evaluated early and treated aggressively, including with surgery and medication if warranted.
McKenzie, the Tennessee teen, said he began gaining weight five years ago, during puberty.
“I started turning to food for all of my problems,” he said.
The extra weight made his asthma worse and put him in danger of developing diabetes, his doctor said. He tried to follow medical advice by cutting out sugary soda and snack foods and exercising more, but the efforts failed to make a difference.
“My old doctor told me there was nothing he could do,” he said. “He told me it was my fault.”
In early 2023, McKenzie connected with Dr. Joani Jack, a pediatric obesity specialist at Children’s Hospital at Erlanger in Chattanooga, Tennessee, who regularly prescribes GLP-1 drugs for kids.
“I told him I’ve seen 10 other people just like you today and we have lots of tools and treatment options,” Jack said. Those typically include intensive behavioral and nutrition interventions combined with medication, if necessary.
In McKenzie’s case, Jack prescribed the weight-loss drug Wegovy, which in late 2022 was approved for use in U.S. children over age 12. More than 6,000 kids in that age group received Wegovy in 2023, the new data show. More than 7,600 received Ozempic, which is approved to treat diabetes in adults, but can be used off-label in adolescents. Others received older GLP-1 drugs such as Saxenda and Trulicity.
McKenzie said he had no notable side effects from the medication, but Lee noted that some young people report nausea, vomiting or constipation, including symptoms so serious that they stop the drugs.
It’s important to understand the surging use of these medications in young people, Lee said. The drugs are meant for continuing use, so “we really need to think about the long-term safety and effectiveness of these medications for this population,” she said.
In addition, the drugs are expensive and often difficult to obtain, either because of supply problems or because they’re not covered by insurance.
Notably, government-run Medicaid plans paid for nearly half of the GLP-1 drugs prescribed to 12- to 17-year-olds and about a quarter of those used by people aged 18 to 25, the research found. Commercial insurance covered care for nearly 44% of the younger kids and about two-thirds of those who were older.
Today, McKenzie says his asthma is better and he looks forward to interacting with co-workers and friends.
“I have a lot of self-confidence now, a lot more than I used to,” he said. “It has changed everything.”
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