Daijiworld Media Network - Geneva
Geneva, Oct 8: The World Health Organization (WHO) has urged health authorities to prioritise lifestyle-based interventions in treating obesity among children and adolescents, recommending that medicines and other medical interventions should not be the first approach.
In its first global guideline on the prevention and management of obesity among children and adolescents, the WHO has outlined how health systems and healthcare workers can provide appropriate care to young people affected by obesity.
The guidelines come amid a sharp rise in childhood and adolescent obesity. The number of children and adolescents aged between five and 19 years living with obesity has quadrupled since 1990, reaching an estimated 170 million in 2024, according to the WHO.
The agency recommends structured interventions combining healthy diets, physical activity and behavioural changes. These measures can be delivered together as a comprehensive programme or through individual interventions, while digital health programmes may also be used under appropriate supervision.
A key recommendation is that pharmacological treatment, weight-loss devices and bariatric surgery should not be used for children aged nine years and younger as part of obesity treatment.
"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, WHO director of the Department of Nutrition and Food Safety.
The guidelines come as weight-loss medicines have become increasingly prominent, particularly with the rapid growth of glucagon-like peptide-1 receptor agonists (GLP-1RAs). Drugs such as semaglutide and tirzepatide have become widely used for weight management among adults, raising questions about their potential use in children and adolescents.
The WHO, however, has not completely ruled out medicines for older adolescents. For those aged 10 to 19 years, approved anti-obesity medicines may be considered when a supervised, comprehensive lifestyle intervention has failed to produce adequate results. Any such treatment should form part of a broader package of care rather than being used on its own.
Bariatric surgery may also be considered for adolescents with severe obesity, but only under appropriate specialist care and in cases where other interventions have not provided sufficient benefit.
The global obesity-treatment market has undergone significant changes with the rapid expansion of GLP-1-based medicines. Eli Lilly's tirzepatide, marketed as Zepbound for obesity and Mounjaro for type 2 diabetes, and Novo Nordisk's semaglutide have emerged as major products in the sector.
Despite the growing availability of these medicines, the WHO stressed that obesity care for children and adolescents should begin with healthy food, regular physical activity, behavioural support and environments that make healthy choices easier.
"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," De Regil said.
The WHO guidelines therefore place lifestyle and behavioural interventions at the centre of childhood obesity care, while reserving medicines and surgical options for selected older adolescents with severe or persistent obesity under professional supervision.