Even as millions of older adults clamor for expensive new weight-loss drugs such as Ozempic and Wegovy, monthly use of the medications soared in people aged 12 to 25, according to a new analysis of records from U.S. retail pharmacies. About 20% of U.S. children and 42% of adults struggle with obesity.

The American Academy of Pediatrics added the drugs last year as part of its recommendations for treating obesity in kids ages 12 and up. The group still prioritizes lifestyle changes like diet and exercise. “There was this realization that, while obesity is not something that is a person’s fault or a value judgment about their willpower or anything else, obesity has significant health risks associated with it, and we should treat it like we do other chronic illnesses,” said Dr. Christopher Bolling, who helped write the new guidelines.

These drugs were originally developed to treat Type 2 diabetes by causing the pancreas to release insulin, which helps control blood sugar. However, the medications also slow a person’s gastrointestinal tract down, making them feel full longer and reducing hunger. The drugs’ dramatic weight-loss effectiveness sparked a huge demand for the medications that led to some shortages.

The medications are very expensive, and insurance companies don’t always agree to cover them. Many patients who stopped taking the drugs reported they quickly regained the weight they had lost.

Patient says: “I have a lot of self-confidence now, a lot more than I used to. It has changed everything.” – Israel McKenzie, a Tennessee teen who lost 110 pounds.

Doctor says: “It’s not like we just throw medicine at them … This is after you’ve tried exercise, nutrition, then you can use this in addition.” — Dr. Sheela Magge, Johns Hopkins.

Parent says: “I don’t want her to have a liver transplant when she’s 25, 26. She wants to be a doctor. I want her to be healthy.” — Candice Mott, Washington, D.C.