New Delhi: The World Health Organization on Thursday 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.
The WHO, in its statement, said in 2024, 170 million children and adolescents aged 5–19 years were living with obesity, including 70 million children aged 5–9 years and 100 million adolescents aged 10–19 years. Obesity prevalence in this age group has quadrupled since 1990, rising from 2% to 8%.
Stating that obesity is a chronic, relapsing disease that can be managed with effective care, the WHO warned that the consequences of obesity can begin early in life, increasing the risk of noncommunicable diseases, including type 2 diabetes and cardiovascular disease.
Children and adolescents living with obesity may also experience stigma, discrimination and bullying, it said. Preventing and managing obesity is essential to protect the physical and mental health of children and adolescents and support their healthy growth, education, social well-being and quality of life, the WHO 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, it said.
“WHO does not recommend pharmacological treatment, bariatric surgery (weight-loss surgery that changes the stomach or digestive tract) or weight-loss devices for children aged 0–9 years,” it said.
For adolescents aged 10–19 years, treatment with approved medicines may be considered only when a supervised multimodal lifestyle programme has not achieved the desired results,” the global body said.
Bariatric surgery, it added, may be considered under strict conditions for adolescents with severe obesity.
Dr Luz María De Regil, Director of the Department of Nutrition and Food Safety, WHO, said 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.
“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,” she said.
While not the primary focus of the guidelines, the recommendations also emphasize the importance of addressing mental health alongside obesity.
“Anxiety, depression, low self-esteem and emotional dysregulation can contribute to unhealthy eating behaviours, physical inactivity and social withdrawal, and children and adolescents living with obesity may experience stigma and bullying that harm their emotional well-being. Health workers should address both obesity and mental health conditions early and together, using inclusive, developmentally appropriate and family-engaged strategies,” the WHO said.
The guidelines stress that obesity management should go beyond weight loss and aim to improve health, functioning and well-being. Care should be person-centred, age-appropriate and responsive to the needs of each child and family, ensuring long-term follow-up and continuity, it said.
Treatment alone cannot reverse the rise in obesity, the WHO said, adding that it continues to call for policies and measures 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 WHO’s existing recommendations for adults, these new guidelines 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. The guidelines are part of WHO’s broader response to the global obesity epidemic, including the WHO acceleration plan to stop obesity,” the WHO said.
