| name | wegovy-pediatric-eligibility |
| description | Check whether an adolescent aged 12 to under 18 years qualifies for Wegovy (semaglutide 2.4 mg) using BMI age-sex 95th-percentile cutoff, weight above 60 kg threshold, and secondary-obesity exclusion. Use when a clinician asks "is my teenager eligible for Wegovy", "Wegovy in adolescents", "pediatric semaglutide 2.4 mg indication", or needs to screen a 12 to 17 year-old with obesity before initiation. Grounded in the Wegovy Canadian Product Monograph (Novo Nordisk, March 2024). |
Wegovy — Pediatric Eligibility Screener
Purpose
Binary yes/no decision for Wegovy initiation in a 12-to-17-year-old. Three hard criteria + one exclusion — fail any, and the patient is not a Wegovy candidate per the Canadian label.
Activation
Trigger when:
- A patient aged 12–17 y with obesity is being considered for Wegovy.
- Clinician asks about Wegovy in adolescents / pediatric semaglutide 2.4 mg.
- Screening before initiation.
Required Inputs
- Age (years, to 0.5 y precision)
- Sex (male/female)
- Height + weight → calculate BMI
- Cause of obesity (exogenous vs secondary)
- History of diet/activity trial
Step 1 — Check BMI Cutoff (≥ 95th percentile)
| Age (y) | Male BMI | Female BMI |
|---|
| 12.0 | 24.2 | 25.2 |
| 12.5 | 24.7 | 25.7 |
| 13.0 | 25.1 | 26.3 |
| 13.5 | 25.6 | 26.8 |
| 14.0 | 26.0 | 27.2 |
| 14.5 | 26.4 | 27.7 |
| 15.0 | 26.8 | 28.1 |
| 15.5 | 27.2 | 28.5 |
| 16.0 | 27.5 | 28.9 |
| 16.5 | 27.9 | 29.3 |
| 17.0 | 28.2 | 29.6 |
| 17.5 | 28.6 | 30.0 |
Patient's BMI must be ≥ the cutoff for their age and sex. (Source: US CDC growth references.)
Step 2 — Weight Threshold
Body weight > 60 kg (132 lb). Absolute.
Step 3 — Inadequate Response to Lifestyle
Must have documented inadequate response to a reduced-calorie diet + increased physical activity trial alone.
Step 4 — Exclusion: Secondary Obesity
NOT studied / not recommended in:
- Hypothalamic obesity
- Monogenic obesity (e.g., MC4R, leptin pathway, POMC, PCSK1)
- Endocrine causes (e.g., Cushing, hypothyroidism — treat the cause)
If secondary obesity is suspected → refer for genetic/endocrine workup first (see monogenic-obesity-diagnosis, pediatric-obesity-etiology-screener).
Decision
- ALL 3 criteria met + exclusion ruled out → ELIGIBLE
- ANY criterion failed → NOT ELIGIBLE per Canadian label
If Eligible — Initiation Notes
- Same 16-week escalation schedule as adults (0.25 → 0.5 → 1 → 1.7 → 2.4 mg).
- If 2.4 mg not tolerated → may remain on 1.7 mg as maintenance.
- If 1.7 mg not tolerated → discontinue (adolescent-specific rule).
- Reassess at 12 weeks on maintenance — discontinue if no meaningful BMI improvement.
- Pediatric GI AE rates: nausea 42%, vomiting 36%, diarrhoea 22%, abdominal pain 15%.
- Pediatric cholelithiasis rate higher: 3.8% vs 0% placebo — counsel on RUQ pain.
Hard Stops
- Pregnancy-capable adolescent: contraindicated in pregnancy AND breastfeeding. Discuss contraception.
- MTC / MEN-2 personal or family history → absolute contraindication.
- Active suicidal ideation or history of suicidal attempts → do not use.
Reference
WEGOVY Product Monograph, Novo Nordisk Canada, revised 2024-03-22. Table 1 (BMI cutoffs), §1.1 (Pediatrics), §4.2 (Pediatric dosing).
