JOHN YANG: You physicians are increasingly using weight loss drugs to treat obesity, diabetes and other chronic conditions in young people, including children.

In the last three years, the number of people aged between 12 and 25 using drugs like Wegovy and Ozempic has surged nearly 600 percent.

Ali Rogin looks at the high demand for these drugs and the concerns surrounding them.

ALI ROGIN: Approximately one in five children and adolescents in the U.S. is obese, but experts say early intensive treatment can prevent health issues down the line.

Early last year, the American Academy of Pediatrics recommended the use of medication to treat obesity in children's ages 12 and up.

We spoke to two young women who have been using these medications.

SOPHIE SIMMONS: I had been struggling with my weight, and I had never gotten my period before, and we weren't sure what was up with it, and I had taken some labs, and we found out that I had PCOS.

I think a lot of people think, especially PCOS, that they're stuck and there isn't options, and they're finding out that this is an option, because it has helped me lose almost 90 pounds, and I got my period, and it's helped with my confidence in so many other things.

And continuing it, I think, has just shown the effectiveness of it as well.

AUTUMN EKSTROM: I had tried, like, working out and stuff like that, but like, nothing was showing, like, helpful or like, there was no change at all in anything.

And so it was just kind of, like, hard and disappointing.

And the only thing that, like, actually helped with all that was the medication.

My appetite is, like -- has like, changed completely.

And like, it's been, like, suppressed like so much.

I think the end goal is, like, ultimately, to, like, get me off of it.

Because, like, I don't want to be, like, taking it forever.

And like, if we can, like, we've been lowering the dosages.

So, like, if we can slowly get me off of it and like, everything, like, kind of like stays, like, normal or like, or if anything, like, things get better and not worse, then, like, that's good.

ALI ROGIN: Despite the effectiveness of these drugs, some doctors are concerned about the lack of data available for children using them long term.

Dr. Melanie Cree is a pediatric endocrinologist at Children's Hospital Colorado, and she treated both Sophie and autumn.

Dr. Cree, thank you so much for joining us.

First of all, why are we seeing this increase of children using these medications?

DR. MELANIE CREE, Pediatric Endocrinologist, Children's Hospital Colorado: The reason we're seeing such an increase is that these medications work, and our children are really suffering from outcomes from excess weight, ranging from mental health and bullying to the development of serious metabolic disease such as type 2 diabetes.

ALI ROGIN: When you're treating patients, what sort of options do you consider before looking at medication?

MELANIE CREE: So we always look at lifestyle in terms of trying to help a child who's struggling with weight achieve better health, and we can look at different aspects of food.

Are they getting enough fruits and vegetables, cutting down on simple carbohydrates, really cutting liquid calories?

What can they do to increase their activity?

Is there neighborhood safe to exercise in?

Do they have access to facilities or sports?

Sleep is very important.

Do they have somewhere quiet to sleep?

Do they get enough sleep and then, obviously, mental health is very important, and are they stressed, or are they living in a difficult social environment, and helping align all of these to optimize children's health is something that we do prior to trying any medication.

ALI ROGIN: What are some of the misconceptions that you've encountered about prescribing these medications and the children who are on them?

MELANIE CREE: I think the number one misconception is that the individual is failing somehow, that somebody has to do these medications if they don't have a strong enough willpower, and that they're weak and can't do this on their own.

And that's just absolutely not true.

These are chemicals, and when you take chemicals and they help you lose weight, that means that you've got a problem with the chemicals in your brain that are helping you to regulate how you sense appetite and how you sense fullness, and so you take these medications, and they actually change the way that your brain senses food.

ALI ROGIN: Like we talked about earlier.

There are concerns about the lack of long term information on the use of these in children.

What are your concerns?

MELANIE CREE: Many.

There's a very, very low risk of increased thyroid cancer for the duration of time that we've studied these medications, and for animals entire lives, but humans live much longer.

So, I think that's one of the biggest things that we're automatically watching for.

Something that one of my research partners is interested in, is how do these medications affect the brain differently when we're an adolescent within a developing brain, compared to an adult who doesn't have a developing brain, and brain that's changing so much.

If you use this medication all through your teens, does that permanently change how your brain senses food?

ALI ROGIN: In the patients that you've been seeing as they get older, do you recommend for them to stay on these medications over the long term, well into adulthood.

What does that tend to look like?

MELANIE CREE: You know, we've got patients that have come down 80, 90 pounds.

We're now at ideal goal weight.

And what do we do?

We've done a really good job of figuring out how to start it, how to keep people healthy, on it increase protein and really increase activity.

And then we get to go wait.

The data in adults show that if you don't lose at least 15 percent of your weight on semaglutide, when you stop, a year later, you're back up to your starting weight.

I've been trying with a couple patients to switch them from the injectables when they get to target weight to pills that we have a little bit more safety data on, but right now, this is exactly what we're doing, trial and error with my patients and all of us in the woods together.

ALI ROGIN: And what about the insurance question?

There are concerns that companies won't want to support the long term usage of these drugs in children as they get older.

I know that this is uncharted territory in many ways, but what are the possible issues there?

MELANIE CREE: Well, what we're having a problem with is when they get to their goal weight, then the insurance companies are renewing their approvals and saying, well, this individual isn't obese.

We're not going to pay for the medication anymore, and they're that way because we were using the medication.

So that is exactly the hurdle that we're facing right now.

You know, if we can prevent Type 2 Diabetes in kids, the economic effect is going to be dramatic within the next 15 years.

It's very hard, and our health care system is not set up around prevention, but we really need to come up with pediatric models to model and say, okay, well, what is the cost if a patient develops type 2 diabetes as a teenager.

What are you looking at in the next 20 years?

Pregnancy complications for youth who have excess weight and then have babies in their 20s are much higher.

So there are a lot of costs that are much higher.

But putting all of that together to make the drug company right now pay for it is a little bit challenging.

ALI ROGIN: Dr. Melanie Cree with Children's Hospital Colorado.

Thank you so much.

MELANIE CREE: Thank you.