What Parents Need to Know About GLP-1 Medications for Young Athletes

GLP-1 drugs like Ozempic and Wegovy have become increasingly common for adults for both diabetes management and weight loss.

Even well-known celebrities and tennis star Serena Williams have endorsed GLP-1 drugs, increasing their visibility and normalizing their use. These GLP-1 drugs are becoming more common, both through prescriptions from doctors and via off-label use. They are also now more readily available online, which means that it's become all too easy for your young athlete to access these drugs, with or without a medical professional prescribing them.

Here, U.S. Anti-Doping Agency (USADA) Special Advisor Dr. Amy Eichner is explaining what you need to know about GLP-1s and how these drugs may impact your young athlete.

What are GLP-1s?

Glucagon-like peptide-1 receptor agonists, commonly referred to as GLP-1s (like semaglutide), are drugs intended to treat and manage Type 2 diabetes. Some GLP-1 agonists like Wegovy have been approved by the Food and Drug Administration (FDA) for weight loss, while others like Ozempic and Mounjaro are only prescribed for diabetes patients.

GLP-1s come in injectable form and work by suppressing feelings of hunger, reducing food noise (the constant thinking about food), stimulating the pancreas to release insulin, and slowing the stomach's emptying process so that a person will feel full for longer. All of these effects allow people to eat less, because they simply aren't feeling hunger cues.

Why are athletes interested in GLP-1s?

Unfortunately, the pressure to be thin, especially for young women, is still a problem, and athletes in particular may be susceptible to pressure to lose weight for both aesthetic and sport performance reasons. Social media has also made 'quick fix' solutions like GLP-1s more popular and normal, even for young athletes, Eichner says.

Benefits and Risks of GLP-1 Use for Young Athletes

The primary benefit of a GLP-1 drug for a young athlete is the treatment and management of Type 2 diabetes. Eichner adds that it's rare that a young athlete should be prescribed a GLP-1 drug solely for weight loss reasons, especially if the athlete is primarily considering a GLP-1 in order to improve sport performance.

"Right now, they're not prohibited because no one has documented a convincing performance edge," says Eichner. "Of course, there is a theoretical performance advantage in sports that have weight classes or sports like cycling and long distance running where weight is a factor, but because the GLP-1s suppress appetite and cause muscle loss as well as fat loss, they aren't necessarily going to improve performance."  However, Eichner also points out that not much is known about potential performance-enhancing effects of GLP-1s, and more research needs to be done. The World Anti-Doping Agency is monitoring these substances.

There are approved GLP-1 drugs for managing Type 2 diabetes in kids older than 10. For young athletes on a GLP-1, parents could face unique challenges in fueling them for sport. Because these drugs reduce appetite, it can be difficult for a young athlete to continue to fuel enough for their training and athletic performance goals. And a young athlete may not be aware of their under-fueling, since the GLP-1s suppress feelings of hunger.

"Athletes who are doing endurance sports are already on such a fine line of energy balance between training and fueling, and the slightest disruption can really be detrimental," Eichner says. Because of this, if an athlete is prescribed a GLP-1, it's important to be aware of the potential for Relative Energy Deficiency in Sport (REDs) due to under-fueling. Your athlete should be working with their doctor and other qualified experts, such as a registered dietitian and their coach, to determine appropriate fueling and training protocols while using the medication.