Ethical considerations for semaglutide use in children

Semaglutide, marketed as Ozempic, Wegovy and Rybelsus, has rapidly become one of the most prominent medications of recent years. Initially approved in 2021 for type 2 diabetes in adults, semaglutide is now authorised for obesity management in adults and children in several countries, including Germany, the UK, Denmark and the United Arab Emirates. Despite this broad regulatory approval, its paediatric use remains a subject of debate. Advocates highlight its potential to reduce cardiovascular risk and prevent obesity-related illness, while critics emphasise uncertainties about long-term safety, efficacy and impacts on child development.This paper examines the ethical challenges raised by prescribing semaglutide to children, focusing on access barriers, stigma and the neglect of structural determinants of obesity, and provides ethical recommendations for clinicians aimed at mitigating harm, supporting autonomy and promoting children's health.