Prescribing of GLP-1 Receptor Agonists for Adolescents with Obesity and Associated Disparities

This retrospective cohort study examined national prescribing patterns of glucagon like peptide 1 receptor agonists (GLP1RAs) for U.S. adolescents with obesity using electronic health record data from over 2 million patients aged 12 to 17 years between 2021 and 2025. Among eligible adolescents, only 0.9% received a GLP1RA prescription, though use increased after semaglutide approval in December 2022, with semaglutide rapidly surpassing liraglutide and off-label tirzepatide use rising by 2025. Prescribing was strongly associated with clinical and sociodemographic factors: adolescents with severe obesity were more likely to be prescribed, while males, Hispanic/Latino and non Hispanic Black youth, non English/Spanish speakers, those living in rural or socioeconomically disadvantaged areas, and those with Medicaid or self pay coverage were significantly less likely to receive prescriptions. These findings highlight growing uptake of GLP1RAs but reveal substantial disparities in access, suggesting insurance barriers and structural inequities may limit availability for groups disproportionately affected by obesity.