Slimming injections – Tested on children:

The use of so-called slimming injections has skyrocketed in the last couple of years. Norwegians shelled out NOK 3 billion for the syringes last year, according to figures from the Pharmacy Association.

The Danish company Novo Nordisk, which is behind several slimming injections, is now testing them on children between the ages of six and twelve.

Pétur B. Júlíusson is a pediatrician and senior physician at the Outpatient Clinic for Obesity at Haukeland University Hospital. He has a very positive view of the introduction of medicine.

– It is an important, new tool for us to help mostly older young people with severe obesity, where lifestyle treatment has not been of much help, he says to Dagbladet.

– Hard to help

It is the active substance liraglutide that is now being tested on children in the clinical study. It is the same active substance used in the medicine Saxenda for adults.

78 children in nine different countries have received an injection daily for 56 weeks. Tor Frostelid, Market Access and Public Affairs Director at Novo Nordisk Norway, has confirmed to P4 news that Norway is not included in the study.

But if the drug is approved in the USA and Europe, it can quickly be used by children with severe obesity as young as 6 years of age in Norway.

At Haukeland University Hospital, treatment with slimming injections is currently only relevant for young people with severe obesity.

Júlíusson believes that there will be very few children between the ages of six and twelve who are relevant, as the situation is today.

– We always start with lifestyle treatment, where the whole family is involved. Such treatment often goes a long way in this age group.

Then there is a big “but”: An important and under-communicated thing is that children with severe obesity represent a very heterogeneous group, he says.

– There are probably small groups of children here who can be very difficult to help in any other way than with such drugs, says Júlíusson, and emphasizes that we need more data and research in the area.

Possible side effects

American and European drug authorities are currently investigating the drugs Ozempic and Wegovy for new, previously unknown side effects.

Novo Nordisk medicines are suspected of causing side effects such as hair loss, suicidal thoughts and aspiration, according to a report from the American FDA (Food and Drug Administration).

In Norway, there have been 17 reports of suicidal thoughts as a suspected side effect after using Saxenda, Ozempic and Wegovy, according to figures DMP (Directorate for Medical Products, formerly the Norwegian Medicines Agency) previously obtained for Dagbladet.

Novo Nordisk has stated to Dagbladet that they are still confident in the medicine’s benefit/risk profile.

Senior doctor and pediatrician Júlíusson says that we have to wait for the results of some important studies before we can say so much about the side effects.

– In older children and adults, the side effects have been nausea in the initial phase of treatment, a side effect that usually passes within a relatively short time.

– Do we know enough about any long-term damage?

– The studies to date, which have mainly been conducted on adults, have been encouraging, but we do not have any long-term treatment data regarding children.

Slimming injections for the rest of your life?

The requirement for the young people who will receive treatment is an isoBMI above 40, i.e. a BMI that corresponds to a BMI of 40 or more in adults, and at the same time have a serious co-morbidity.

According to Júlíusson, this is a small group, and believes that the current indication is strict.

– This could probably be extended to everyone with a BMI over isoBMI 35, where lifestyle treatment has not worked and where there are health challenges linked to the weight situation. I think it will come in time.

The head doctor is clear that this type of treatment should only take place under the auspices of the specialist health service, with up-to-date and interdisciplinary lifestyle treatment.

– Is it a healthy way to lose weight?

– In my world, this is about helping young people with severe obesity, where other treatment has not led to sufficient normalization of weight. In the long run, the alternative is surgery for these individuals. I think these new drugs will reduce the future need for bariatric surgery.

– Do you have to take diet pills for the rest of your life? What happens to the body when you quit?

– This is a big question. I think that the young people we are treating now will hopefully not have to deal with this for the rest of their lives, says Júlíusson, and adds:

– Good quality lifestyle treatment must be at the bottom. These medicines can possibly be perceived as helping to get a better effect from the lifestyle treatment. That’s how important it is, and with such good treatment, I think that these medicines can rather be used periodically.

– On detours

The preparations Wegovy, Saxenda and Ozempic are all manufactured by the pharmaceutical company Novo Nordisk. The latter is a diabetes medicine and has also been shown to suppress appetite, while the other two are approved medicines for obesity or overweight.

The huge demand for the diabetes medicine has led to a global shortage of Ozempic, and people with type 2 diabetes not being able to get their medicine.

According to Aftenposten, around a quarter of the patients who have had Ozempic covered by the state have not been entitled to it.

In February, the Directorate for Medical Products (Dmp) issued a recommendation to Norwegian doctors to only give the medicine to patients with diabetes. They also encourage pharmacies to only dispense the medicine for four weeks at a time.

Senior doctor Júlíusson says he has understood it to mean that Ozempic is a medicine that is not difficult to produce.

– But on the whole it seems very wrong to treat a large proportion of the population with such medicines. I think that this is only a solution for those who have developed obesity as a disease.

– As regards population changes in BMI, we must ensure that we as a population avoid becoming increasingly heavier. It requires changes on a completely different level.