The Ethics of Wegovy in Pediatric Mental Health

Semaglutide (Wegovy), a glucagon-like peptide-1 receptor agonist (GLP-1 RA), has attracted global attention for its appetite-suppressing and weight-loss effects. Approved by the U.S. FDA in 2022 for adolescents aged 12 and older, it has since been authorized in several other countries. Despite this, its use among youth remains limited, with ongoing concerns about its long-term safety, efficacy, and suitability during periods of growth and development. Advocates see Wegovy as an important tool for addressing pediatric obesity and its psychological burdens, while critics caution against widespread use in such a vulnerable population. This paper examines an underexplored ethical dimension of Wegovy's use in children: its impact on mental health. We argue that Wegovy may offer mental health benefits for children-such as reducing weight stigma, improving self-esteem, and avoiding invasive interventions such as bariatric surgery. However, these potential benefits are constrained by barriers to access, supply shortages, risks of misuse, and the possibility of reinforcing stigma and class-based discrimination. In light of these considerations, we argue that while Wegovy offers promising health benefits for children, its long-term effects on growth, development, and mental health remain uncertain, warranting further study before definitive policy decisions are made. If future evidence confirms its value, it is our view that access should be equitable and accompanied by reforms to reduce stigma, regulate prescribing, and prevent misuse. Until then, clinicians should prescribe cautiously, ensuring clear medical need and implementing safeguards against risks such as weight regain, treatment interruption, and bias in care.