New global guidance emphasises structured support and continuity through primary care
The World Health Organization has issued its first guidelines on managing obesity in children and adolescents, placing coordinated support and continuing care at the centre of the response.
The recommendations address a growing burden: WHO estimates that 170m people aged five to 19 were living with obesity in 2024. Prevalence in that age group has quadrupled since 1990.
The guidelines strongly recommend structured dietary, physical activity and behaviour-changing interventions, delivered individually or through a combined programme. Digital interventions are conditionally recommended with parent or caregiver supervision.
For children aged under ten, WHO does not recommend obesity medicines or bariatric surgery. For adolescents aged ten to 19, approved medicines may be considered only when a supervised combined lifestyle programme has not achieved the desired result. Surgery may be considered under strict conditions for severe obesity.
The adolescent guideline uses a primary care approach and considers benefits and harms alongside feasibility and the preferences of young people and caregivers. It is intended to help countries adapt care pathways to their circumstances.
WHO also stresses that care should address mental health and aim to improve wellbeing and functioning, rather than focus solely on weight loss. The recommendations call for age-appropriate, family-engaged support with long-term follow-up.
For health systems, this approach requires a service patients can return to over time. A single consultation cannot provide the continuing support envisaged by the guidelines, particularly where a young person needs help from different professionals.
Digital support could form part of that relationship, but its contribution would need to fit the wider care plan. Families need to understand how a tool is intended to help and when to seek advice from a clinician. If structured programmes are recommended before medicines are considered, systems need sufficient capacity to provide those programmes consistently and assess how young people respond.
The new guidance gives policymakers a basis for organising that work. Its practical value will depend on accessible services that recognise the needs of each child and family, with evaluation extending beyond changes in weight to the experience and health of the young person receiving care.
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