The World Health Organization (WHO) on 7 October released its first guidelines addressing the sharp rise in obesity among children and adolescents, setting out how health systems and health workers can deliver timely, evidence-based and people-centred care. According to WHO, 170 million children and adolescents aged 5 to 19 were living with obesity in 2024, including 70 million children aged 5 to 9 and 100 million adolescents aged 10 to 19. The agency said prevalence in this age group has quadrupled since 1990, rising from 2 per cent to 8 per cent.
Lifestyle Support First
WHO describes obesity as a chronic, relapsing disease that can be managed with effective care, and says its consequences can begin early in life, raising the risk of noncommunicable diseases such as type 2 diabetes and cardiovascular disease. Children and adolescents with obesity may also face stigma, discrimination and bullying, it said.
For children and adolescents with obesity, WHO strongly recommends structured dietary, physical activity and behaviour-changing interventions, delivered individually or as part of a multimodal programme. Digital health interventions are conditionally recommended with parent or caregiver supervision.
The guidelines do not recommend pharmacological treatment, bariatric surgery or weight-loss devices for children aged 0 to 9. For adolescents aged 10 to 19, WHO says approved medicines may be considered only when a supervised multimodal lifestyle programme has not achieved the desired results, and bariatric surgery may be considered under strict conditions for adolescents with severe obesity.
“The foundation of obesity care for children and adolescents is not medicine or surgery, but access to comprehensive support that enables healthy eating, physical activity and sustainable behaviour change,” said Dr Luz María De Regil, Director of WHO’s Department of Nutrition and Food Safety.
Mental Health and the Wider Environment
While not the primary focus, the recommendations emphasise addressing mental health alongside obesity. WHO said anxiety, depression, low self-esteem and emotional dysregulation can contribute to unhealthy eating, physical inactivity and social withdrawal, and that health workers should address obesity and mental health conditions early and together. Care, it said, should go beyond weight loss to improve health, functioning and well-being, and should be person-centred, age-appropriate and followed up over the long term.
WHO also stressed that treatment alone cannot reverse the rise in obesity. It continues to call for policies that make healthy diets and physical activity more accessible and affordable, including regulatory and fiscal measures and action across education, urban planning, transport and social protection. Together with its existing recommendations for adults, the new guidance forms part of what WHO calls a life-course approach to obesity care.
Why It Matters
By placing everyday support for eating, movement and mental health ahead of medical and surgical options, the guidelines frame childhood obesity as something families, schools and health systems share responsibility for. Their message that treatment cannot do the job alone also directs attention to the settings in which children eat, play and travel.
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