WHO rules out weight-loss drugs for under-10s in first guidelines on childhood obesity

GENEVA: The World Health Organization (WHO) has issued its first global guidelines on managing obesity in children and adolescents, recommending comprehensive lifestyle support over weight-loss medicines for children under 10 and setting strict conditions for considering medication in older teenagers.

The guidelines address a growing global health challenge that affected an estimated 170 million children and adolescents aged 5–19 in 2024. The prevalence of obesity in this age group has quadrupled since 1990, rising from 2% to 8%.

The guidance is particularly relevant as weight-loss medicines, including glucagon-like peptide-1 (GLP-1) drugs, receive growing attention. WHO does not recommend pharmacological treatment for children aged 0–9 years. Reuters also reported that Dr Luz María De Regil, WHO’s Director of the Department of Nutrition and Food Safety, cited insufficient evidence on GLP-1 medicines for this age group.

The recommendations place healthy eating, physical activity, behavioural support and family involvement at the heart of care, with the broader goal of improving children's health and well-being rather than focusing on weight loss alone.

WHO sets clear limits on weight-loss medicines for children

Under the new guidelines, WHO does not recommend pharmacological treatment, bariatric surgery or weight-loss devices for children aged 0–9 years.

This is an important distinction for families navigating an expanding market for weight-management treatments. The guidance does not recommend using weight-loss medicines as a routine response to obesity in younger children. Instead, it prioritises structured interventions that help children and their families establish sustainable habits.

GLP-1 medicines have attracted considerable attention for their role in weight management, particularly in adults. However, the WHO announcement does not specifically name individual GLP-1 drugs or establish a separate drug-by-drug ruling for children.

In reporting on the new guidelines, Reuters quoted Dr De Regil as saying that evidence on GLP-1 drugs remained insufficient, while research into their safety and effectiveness continued. This reinforces the need to distinguish evidence for adults from evidence supporting treatment in children.

For adolescents aged 10–19, WHO says approved medicines may be considered only when a supervised, multimodal lifestyle programme has not achieved the desired results. This is a conditional treatment pathway, not a recommendation for every adolescent living with obesity to take medication.

Bariatric surgery may be considered for adolescents with severe obesity, but only under strict conditions.

The guidelines therefore establish different treatment approaches according to age and clinical circumstances, with comprehensive lifestyle care remaining central to obesity management.

Childhood obesity has quadrupled since 1990

WHO estimates that 170 million children and adolescents aged 5–19 were living with obesity in 2024. This included 70 million children aged 5–9 and 100 million adolescents aged 10–19.

The increase from 2% prevalence in 1990 to 8% in 2024 highlights the scale of the challenge facing health systems, families and communities.

WHO describes obesity as a chronic, relapsing disease that can be managed with effective care. Its consequences can begin early in life, increasing the risk of noncommunicable diseases, including type 2 diabetes and cardiovascular disease.

The impact extends beyond physical health. Children and adolescents living with obesity may experience stigma, discrimination and bullying, affecting their emotional well-being, education, social relationships and quality of life.

Preventing and managing obesity is therefore not simply a matter of achieving a particular weight. It also means supporting healthy growth, protecting mental health and ensuring children can participate fully in school and social life without discrimination.

Structured lifestyle support is the foundation of care

For children and adolescents living with obesity, WHO strongly recommends structured interventions addressing diet, physical activity and behaviour change. These may be delivered individually or combined in a multimodal programme.

Such programmes bring different aspects of care together rather than relying on a single intervention. The approach is intended to help children develop sustainable habits while responding to their individual circumstances and family needs.

WHO also conditionally recommends digital health interventions when used under the supervision of a parent or caregiver. Digital tools may complement treatment, but the recommendation is not an endorsement of unsupervised use.

The emphasis is on making practical, ongoing support available to families, helping them navigate healthy eating, movement and behavioural changes over time.

As Dr Luz María De Regil, Director of the Department of Nutrition and Food Safety at WHO, explained, “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.”

She said the priority must be to ensure 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.

Mental health must be part of obesity treatment

The guidelines also emphasise the importance of addressing mental health alongside obesity, even though mental health is not their primary focus.

Anxiety, depression, low self-esteem and difficulties regulating emotions can contribute to unhealthy eating behaviours, physical inactivity and social withdrawal. At the same time, children living with obesity may experience stigma and bullying that further damage their emotional well-being.

WHO says healthcare professionals should address obesity and mental health conditions early and together. Care should be inclusive, appropriate to the child's stage of development and involve parents or caregivers where appropriate.

This approach recognises that children need support rather than blame. It also acknowledges that weight-related difficulties can involve physical, emotional, behavioural and social factors that cannot be addressed through a number on the scales alone.

Treatment must go beyond weight loss

WHO stresses that obesity management should aim to improve health, daily functioning and overall well-being, not weight loss alone.

Care should be person-centred, age-appropriate and responsive to the needs of each child and family. Long-term follow-up and continuity are important parts of this approach.

The guidance encourages health systems to provide care that evolves with children as they grow, while helping families build habits that can be sustained over time.

The recommendations also underline that access to appropriate care should not depend solely on a family's ability to navigate healthcare services. Health systems need pathways that make evidence-based support available to children and adolescents who need it.

WHO calls for healthier environments, not treatment alone

WHO cautions that clinical treatment alone cannot reverse the global rise in obesity. Broader measures are needed to make healthy diets and physical activity more accessible and affordable.

The organisation calls for regulatory and fiscal measures, as well as action across education, urban planning, transport and social protection. These measures can help create environments in which healthier choices are more practical for children and families.

The new guidelines complement WHO's existing recommendations for adults and form part of a life-course approach to obesity care, spanning childhood, adolescence and adulthood.

The recommendations provide evidence-based guidance for health workers, policymakers and health systems seeking to improve the management of obesity and reduce its associated health burden.

Their central message is that childhood obesity requires sustained, age-appropriate care, supportive families and healthier environments. For younger children in particular, WHO places structured lifestyle support ahead of medicines, surgery and weight-loss devices, while calling for care that protects both physical and mental health.

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