The World Health Organisation (WHO) has warned of the sharp rise in childhood and adolescent obesity globally as it issued its first global treatment guidelines for managing the condition among children and young people.
The guidelines, released on Wednesday, set out evidence-based recommendations for health systems and health workers to provide timely, people-centred care for children and adolescents living with obesity.
WHO said 170 million children and adolescents aged five to 19 were living with obesity in 2024, comprising 70 million children aged five to nine and 100 million adolescents aged 10 to 19.
It said obesity prevalence among children and adolescents had quadrupled since 1990, rising from two per cent to eight per cent.
The global health body described obesity as a chronic, relapsing disease that could be managed with effective care, warning that its consequences could begin early in life and increase the risk of non-communicable diseases such as type 2 diabetes and cardiovascular disease.
It also noted that children and adolescents living with obesity could face stigma, discrimination and bullying, with implications for their physical and mental health, education, social well-being and quality of life.
Under the new guidelines, 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, provided they are delivered with supervision from parents or caregivers.
WHO, however, does not recommend pharmacological treatment, bariatric surgery or weight-loss devices for children aged zero to nine.
For adolescents aged 10 to 19, the guidelines state that approved medicines may be considered only when a supervised multimodal lifestyle programme has not produced the desired results.
Bariatric surgery may also be considered for adolescents with severe obesity, but only under strict conditions.
“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.
De Regil said the priority should be to ensure that every child and adolescent had access to quality care and supportive environments from an early age, helping them achieve and maintain a healthy weight and laying the foundation for lifelong health and well-being.
Although mental health was not the primary focus of the guidelines, WHO said obesity management should also address mental health conditions.
It said anxiety, depression, low self-esteem and emotional dysregulation could contribute to unhealthy eating, physical inactivity and social withdrawal, while stigma and bullying associated with obesity could further harm emotional well-being.
WHO therefore advised health workers to address obesity and mental health conditions early and together, using inclusive, developmentally appropriate and family-engaged approaches.
The guidelines also stress that obesity management should go beyond weight loss to improve health, functioning and overall well-being.
Care should be person-centred, age-appropriate and responsive to the needs of each child and family, with long-term follow-up and continuity of care, WHO said.
The organisation warned that treatment alone could not reverse the global rise in obesity, calling for policies that make healthy diets and physical activity more accessible and affordable.
It urged governments to consider regulatory and fiscal measures and coordinated action across education, urban planning, transport and social protection.
The new guidelines complement WHO’s existing recommendations for adults and form part of a life-course approach to obesity care, providing evidence-based recommendations for the management and treatment of obesity from childhood through adolescence to adulthood.
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