Can teenagers use Wegovy, and if so, what adjustments are needed for dosing?

Wegovy may be considered for adolescents in specialist services when strict criteria are met, but this is not the same as routine adult access. Dosing follows a careful step-up plan with slower changes if side effects appear, and growth, nutrition and mental-health support are monitored closely. Decisions are made by paediatric teams with family involvement; adult commissioning pathways do not automatically apply to teens.

How current guidance approaches adolescents

In the UK, Wegovy is licensed primarily for adults, and NICE TA875 makes its recommendations with adult use in mind. For younger people, the situation is more restricted. NICE notes that weight management in children and adolescents should first rely on behavioural and family-based interventions. Only in very limited circumstances, within specialist paediatric services, might medicines like semaglutide be considered. This means it is not available for teenagers in the same way it is for adults through NHS commissioning pathways.

Why specialist services are essential

Adolescents are still growing physically and emotionally, so any medicine that alters appetite and weight needs to be handled with care. Specialist teams bring together doctors, dietitians, psychologists, and nurses who can monitor not just weight change, but also growth patterns, nutrition, and mental wellbeing. The NHS stresses that medicines for young people should be offered only as part of a holistic plan, never as a stand-alone solution. This differs from adult services, where Wegovy may be prescribed more widely under NICE and NHS commissioning rules.

How dosing is adjusted

When semaglutide is considered for adolescents, dosing follows the same principle as in adults: a step-up plan that begins at a low dose and increases gradually. However, clinicians often adjust the pace more cautiously in young people. If side effects such as nausea or vomiting appear, the team may hold the dose for longer or slow down escalation. The STEP TEENS trial, published in the New England Journal of Medicine, showed that semaglutide 2.4 mg was effective in adolescents with obesity, but safety monitoring was intensive, and careful attention was given to tolerability. This reinforces why specialist supervision is non-negotiable.

Evidence from clinical studies

The STEP TEENS trial provided the strongest evidence so far, demonstrating significant reductions in body mass index (BMI) and improvements in health markers compared with lifestyle changes alone. However, researchers also stressed the importance of ongoing support for nutrition and psychological health. Unlike adult studies, the adolescent trial placed greater weight on family involvement, highlighting how parents and carers play a role in helping young people manage side effects and adjust routines. Regulators and NICE take these findings into account, but so far routine NHS commissioning for teenagers has not been recommended.

Safeguards around mental health

One of the key differences for younger people is the close attention to mental health. Adolescence is already a time of change, and restrictive diets or sudden weight changes can affect mood and self-esteem. NHS services therefore ensure psychological support is built into any care pathway involving semaglutide. NICE also notes the need to monitor for disordered eating behaviours, ensuring that treatment supports long-term wellbeing rather than creating new challenges. These safeguards are part of why medicines like Wegovy are limited to specialist centres in this age group.

The role of families in care

In paediatric services, decisions are rarely made by the young person alone. Families are involved in discussions about whether semaglutide is suitable, how dosing should progress, and what lifestyle adjustments are realistic at home. This shared approach helps reinforce consistency and reduces the pressure on the teenager to manage everything themselves. It also allows healthcare professionals to provide education to parents, ensuring the household environment supports healthy eating, activity, and safe medicine use.

Why adult pathways do not apply

NHS commissioning for adults, based on NICE TA875, sets clear BMI thresholds and service pathways. These rules do not extend automatically to under-18s. Instead, prescribing for teenagers remains exceptional and is decided case by case by paediatric endocrinologists or specialist obesity services. This protects young people from unnecessary exposure to medicines that have not yet been widely studied in their age group. It also ensures that when treatment is offered, it comes with the right level of oversight and multi-disciplinary support.

Putting it all together

Teenagers are not offered Wegovy in the same way as adults. Access is tightly controlled, limited to specialist services, and built on strong safeguards around growth, nutrition, and mental health. Dosing adjustments are made more cautiously, often with longer pauses if side effects appear, and families are closely involved throughout the process. Evidence from trials like STEP TEENS shows that semaglutide can be effective in this group, but it is not a stand-alone answer. Looking at the whole story, what matters is that care for adolescents remains holistic, protective, and guided by experts, ensuring any use of Wegovy is safe and appropriate for the years of growth still ahead.