The number of children who are obese globally has quadrupled since 1990. Now, for the first time, the World Health Organization (WHO) has issued global guidelines for treating obesity in children and teens, prioritizing lifestyle support and also setting out when medications and surgery might be appropriate.

The most recent statistics from 2024 estimate that 170 million children worldwide aged between 5 and 19 were obese including 70 million children aged 5-9 and 100 million aged 10-19. In total, 8% of all children and adolescents globally are now obese, up from just 2% in 1990.

In the report, the WHO describes obesity as a chronic, often relapsing disease that can be effectively managed with the right interventions and treatments. Children and adolescents with obesity face an increased risk of conditions such as diabetes and heart disease and often face social challenges such as bullying and discrimination.

The report strongly recommends that any treatment starts with changes to diet, physical activity and behavior and that children should be supported with these changes by caregivers, clinicians and support programs. Digital health interventions were also mentioned as potentially useful, but only with supervision by caregivers.

“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 the Department of Nutrition and Food Safety, WHO. “Our priority must be to ensure that every child and adolescent can access 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.”

The report also discusses drug-based and surgical interventions, recommending that neither should be recommended for children under nine years old. For older children 10 and up, medications such as GLP-1 drugs can be considered only if other lifestyle interventions have not been effective. The report recommends surgery is considered only for older children and adolescents in extreme circumstances.

A recent study reported the soaring use of GLP-1 prescriptions for children aged between 8-11 in the U.S. where 1 in 5 children are obese , with experts stressing that the overall use was still very small and lifestyle interventions are still the most commonly recommended form of treatment.

The WHO report stresses that any treatment should not only focus on weight loss, but also take into account overall health, functioning and well-being including mental health. Anxiety, depression, low confidence and emotional issues can also contribute to disordered eating, lack of physical activity and socialization. Also noted are the contributions of poverty and lack of access to healthy food and physical activities for many families worldwide.