WHO’s first global rules for treating childhood obesity put lifestyle first and limit drugs to teens

The World Health Organization has issued its first global guidelines on the care of children and adolescents with obesity, setting out how health systems and health workers should approach a condition that has quadrupled in prevalence among young people since 1990. The guidance was published on October 7.

According to WHO, roughly 170 million children and adolescents aged 5 to 19 were living with obesity in 2024. Among that age group, prevalence has risen from about 2% in 1990 to about 8%. WHO describes obesity as a chronic, relapsing disease that can be managed with effective care, and notes that it raises early-life risks of type 2 diabetes and cardiovascular disease.

What WHO recommends

• Lifestyle programs come first. WHO strongly recommends structured programs combining diet, physical activity and behavior change, delivered individually or as part of a multimodal program.
• Digital tools, with supervision. Digital health tools receive a conditional recommendation, provided a parent or caregiver supervises their use.
• No medicines, surgery or devices for younger children. For children aged 0 to 9, WHO advises against drug treatment, bariatric surgery and weight-loss devices.
• Medicines as a second step for adolescents. For ages 10 to 19, approved medicines may be considered only when a supervised multimodal lifestyle program has not produced the desired results.
• Surgery only in strict circumstances. Bariatric surgery may be considered for adolescents with severe obesity under strict conditions.

Dr Luz María De Regil, WHO’s Director of Nutrition and Food Safety, said the foundation of care is access to comprehensive support for healthy eating, physical activity and lasting behavior change, rather than medicine or surgery.

Why the timing matters

The guidance arrives as newer weight-loss medicines, including GLP-1 drugs, are increasingly prescribed to adolescents in some countries. Trade press including Becker’s Hospital Review has pointed to rising GLP-1 use among U.S. children as context for the guidance. WHO’s approach does not rule out medicines for teenagers, but it positions them as a step after structured lifestyle support rather than an alternative to it.

What it means for families, clinics and health businesses

• Families can expect pediatric care to emphasize structured, supervised programs before discussing medication.
• Clinics and telehealth providers that serve adolescents will likely face more scrutiny of whether a lifestyle program came first before medicines are prescribed.
• Health and wellness businesses offering nutrition, coaching or activity programs for young people may find the guidance supports supervised, evidence-based offerings, and discourages quick-fix claims.

National health authorities set their own rules, and WHO guidelines are not binding. But first-of-their-kind global guidelines tend to shape clinical practice, insurance coverage and regulation over the years that follow.