Geneva: The World Health Organization has issued new global guidelines on managing obesity in children and adolescents, putting healthy diets, physical activity and behavioural support at the centre of care while recommending a cautious and age appropriate role for medicines and surgery.
The new guidance comes as childhood and adolescent obesity continues to rise worldwide. WHO estimates that 400 million children and adolescents aged 5 to 19 were overweight in 2024, including about 170 million living with obesity. The prevalence of obesity in this age group has quadrupled since 1990.
The guidelines provide recommendations for the integrated management of obesity in children and adolescents. They are intended to help health systems provide timely, evidence based and people centred care for children and young people living with obesity.
WHO recommends tailored diets, physical activity and behavioural support, with caregivers involved in supporting children and adolescents. The approach recognises that obesity is a complex health problem that requires more than a focus on body weight alone.
The guidance takes a cautious approach to medicines used for weight management, including GLP 1 drugs. WHO said pharmacological treatment may be considered for adolescents aged 10 to 19 with obesity when supervised lifestyle interventions have not been sufficient.
The recommendation does not mean that GLP 1 medicines are being rejected for young people. Instead, WHO places their use within a broader treatment programme that includes lifestyle and behavioural support.
For children under the age of 10, WHO recommends against pharmacological treatment, bariatric surgery and weight management devices for obesity because evidence on their long term safety and effectiveness is insufficient.
Bariatric surgery may be considered for adolescents with severe obesity under strict conditions. WHO says such adolescents should be physically and mentally mature and should have undergone at least six months of unsuccessful treatment before surgery is considered.
The guidance comes as the use of GLP 1 medicines is expanding and research into their use among younger patients is developing rapidly. Some medicines in this class are already approved for certain children and adolescents in some countries.
In September, drugmaker Novo Nordisk reported results from a late stage trial involving children aged 6 to under 12 with obesity. The company said 40.4 percent of children receiving semaglutide were no longer classified as having obesity after 68 weeks, compared with none of those receiving placebo.
The children in the trial also received lifestyle support, including a reduced calorie diet and increased physical activity. The results were reported by Novo Nordisk and add to the growing evidence on the use of semaglutide in younger children. They do not change the WHO guidance described above.
WHO has previously recognised a role for GLP 1 medicines in treating obesity among adults, while stressing that they should be used as part of comprehensive obesity care.
The global scale of childhood obesity is also changing the wider nutrition picture.
UNICEF reported in 2025 that obesity among children and adolescents aged 5 to 19 had surpassed underweight globally for the first time. The organisation estimated that about 188 million children and adolescents were living with obesity.
The change is not the same everywhere. Underweight remains a major problem in several parts of the world, including sub Saharan Africa and South Asia. Countries therefore continue to face different forms of malnutrition at the same time.
UNICEF has also warned about the growing influence of unhealthy food environments. Children are increasingly exposed to cheap, highly marketed ultra processed foods and sugary drinks, while nutritious food can remain difficult to access or afford.
WHO says treatment must therefore be combined with wider support for healthier living. Healthy food, opportunities for physical activity and supportive environments need to be accessible and affordable to families.
The new guidance also recognises the role of health systems and wider environments in helping children and families manage obesity. It seeks to ensure that children living with obesity receive appropriate care while avoiding unnecessary or premature use of medicines and surgery.
The recommendations may evolve as new evidence becomes available. Research into GLP 1 medicines among younger age groups is continuing, meaning that the treatment landscape is likely to change further.
For now, WHO's message is that childhood obesity should be addressed through comprehensive care, with healthy eating, physical activity and sustainable behaviour change forming the foundation of treatment. Medicines may have a role for selected adolescents, while surgery remains an option only for carefully selected cases.