I was 11 years old when my mother took me to Weight Watchers.
It was the early 1990s, in a world before we had language like ‘diet culture,’ and when going to dieting programs in shopping-center storefronts was a kind of rite of passage; a common pastime for prepubescent girls and their midlife moms.
For chubby girls growing up in the 1990s – perhaps even more so now – losing weight felt less like a choice and more like a social requirement.
But today I find myself wondering, if the pharmaceutical interventions available now had existed back then, would I have been prescribed one? And might that have changed the entire trajectory of my life?
A recent study, published in Pediatrics, gives us insight into how quickly the landscape is changing. Researchers looked at how many GLP-1 prescriptions there were among 3.5 million children ages eight to 11 in higher weight bodies, whose BMI was at or above the 95th percentile, and without diabetes between January 2019 and June 2026.
Just 0.6% of the study, approximately 20,000 children, received a prescription for GLP-1 meds. Although prescribing remained uncommon overall, it rose significantly over the study period.
I was likely at or above the BMI cutoff during parts of my adolescence.
My mom was on the doorstep of an impending divorce. I was grappling with a changing body and a possibly changing household. We needed food to cope.
Garland as a child: ‘For chubby girls growing up in the 1990s – perhaps even more so now – losing weight felt less like a choice and more like a social requirement’
A recent study found the number of GLP-1 prescriptions among children is increasing
Her intention wasn’t to damage my sense of self-esteem or destroy my relationship with food. My mom loved me very much. So, when I asked her to take me, she agreed.
And now that I’m a parent myself – and a clinical social worker specializing in eating disorders – I can imagine how hard it would have been for her not to oblige. When your child asks you for help with something, especially something you know carries tremendous stigma, what parent wouldn’t want to act? What parent wouldn’t want to stifle the pain and judgment before their child had to endure it?
In the end, neither my mom nor I proved particularly good at following societal rules, especially the ones intended to make us smaller.
After our meetings at the mall, we would sometimes go to Jack in the Box for dinner. And whatever attempts we made to introduce ‘healthy choices’ into our diets were short-lived. I got bored after a few meetings and eventually we both stopped going.
But if I was that same chubby, prepubescent girl growing up today then instead of subtle hints about my weight at annual pediatrician visits, perhaps there would have been an offer of medication.
My body wouldn’t simply have been socially unacceptable; I might have understood it as something that required pharmaceutical intervention.
Viewing weight loss as a preference or a ticket to better health would have been replaced by the perception that my body was not only genetically unlucky but that it was medically unwell.
Unlike the now antiquated dieting programs I grew up with, a medication might have changed my appetite and weight more quickly and substantially.
Instead of contending with my feelings about my changing body alone, I might also have had a social media audience to react to my newly changed form. That same public would likely let me know what those changes meant about the larger body I’d inhabited before.
Puberty is already an enormous period of physical and psychological change. Body composition, weight and fat distribution naturally change as children develop.
Garland age 11 or 12: ‘Puberty is already an enormous period of physical and psychological change. Body composition, weight and fat distribution naturally change as children develop’
As young people are trying to understand how their bodies are perceived and to what degree their bodies truly belong to them, adults have enormous power and influence to shape the answers.
That doesn’t mean medication is never appropriate to consider. Some children have serious medical conditions that their clinicians and families are trying to navigate to reduce substantial health risks.
But it does mean we should be extraordinarily thoughtful about what we are treating, why we are treating it, and the messaging that a child hears when we do.
If the trends in prescriptions among children are anything like we’ve seen in the adult population, these medications will likely become more available over time. With the increase in access, families deserve clear information, not just about their potential benefits but also about what we still don’t know.
The long-term relationship between GLP-1 medications, childhood development and eating disorder risk remain largely under-researched. We need better answers about what happens when medications are discontinued, how weight loss or regain impacts growing bodies, how appetite suppression affects a developing child’s relationship with hunger and fullness and how clinicians should identify children who may already be vulnerable to disordered eating.
For me, these unanswered questions are incredibly significant. We owe the next generation our willingness to think beyond weight alone.
Health is nuanced and we want children to be able to play, concentrate at school, have energy, connect and participate in the parts of childhood that bring pleasure and meaning.
We also want solid evidence around these medications, with benefits and possible unintended consequences carefully considered, especially when it comes to interventions offered during a period when children have limited bodily autonomy and are reliant on their trusted adults.
That said, we need to be able to talk about weight stigma itself. Most parents seeking weight-loss treatment for their children believe they’re helping them. Our culture applauds weight loss and thinness is treated as evidence of health, discipline and even virtue.
Wanting to protect a child from the pain of teasing, discrimination and exclusion is understandable but changing a child’s body is not the same as caring for their health.
‘Wanting to protect a child from the pain of teasing, discrimination and exclusion is understandable but changing a child’s body is not the same as caring for their health’ (photographed: Garland as a teen)
Kathryn Garland (left) is a clinical social worker specializing in eating disorders. She has co-written the book Hungry for Connection with Vanessa Scaringi, a licensed psychologist
The danger is that in trying to protect children from weight stigma, we can inadvertently collude with the very messages that are hurting them.
They can learn that their body is the problem. If a child comes to believe that belonging, safety and approval depend on making their body smaller, the intervention can carry a psychological consequence no prescription warning can capture.
Just as mothers of the 1990s signed on to the pitfalls of diet culture with good intentions, today’s parents need good information rather than shame.
If Weight Watchers and the diet industry infiltrated my childhood, their influence seems almost quaint compared with the reach of today’s social media technology and targeted marketing.
After a few months of weigh-ins and disappointing results, my mom and I simply bowed out. If I had been taking a medication, I wonder how much more complicated it might have been to change course. Would I still be taking it today, decades later?
Whatever decision a family makes, treatment should protect a child’s relationship with hunger and fullness, bodily autonomy, emotions and sense of self.
Unfortunately, we can’t protect children from every negative message about their bodies, but we can refuse to make their belonging contingent on being thin. And we can make sure that whatever treatment we choose, love is at the center of that decision.
When I asked my mother about what could now be viewed as a parenting misstep, she didn’t get defensive. The greatest gift she gave me wasn’t that she always got it right. It’s that she has been willing to acknowledge when she didn’t, to listen, and to connect again afterward.
I hope to offer my own children that same gift. While raising kids in the era of GLP-1s, we need that kind of openness. There will be uncertainty. There may be choices that families come to understand differently with time, and as the science evolves, some of what we believe now may change.
What shouldn’t change is our willingness to listen to our children, to their lived experience and to what their bodies are telling them. Whatever choices we make about treatment, the goal should be their health and well-being, not their ability to conform to society’s expectations of what their bodies should be.
Kathryn Garland, LCSW, CEDS-C, is a clinical social worker and certified eating disorder specialist. She is co-author of the new book Hungry for Connection: Heal Your Relationships with Food & People in an Insecurely Attached World, along with Vanessa Scaringi, published by New Harbinger Publications.
