12 OCT 2026 — The World Health Organization has issued its first guidelines on treating obesity in children and teenagers. They are more cautious about weight-loss drugs than some headlines suggest. For children under 10, WHO does not recommend medicines, surgery or weight-loss devices at all. For those aged 10 to 19, it allows medicines only as a later step, for teenagers who already have health problems linked to their weight, after at least six months of supervised lifestyle treatment has failed.
The guidance, published on 7 October, rates the evidence behind that drug recommendation as low quality.
The scale of the problem
In 2024, 170 million children and adolescents aged 5 to 19 were living with obesity, according to WHO's announcement. That figure includes 70 million aged 5 to 9 and 100 million aged 10 to 19. The share of that age group with obesity has quadrupled since 1990, from 2% to 8%. WHO describes obesity as "a chronic, relapsing disease that can be managed with effective care".
What WHO recommends first
The core of the guidelines is the same for every age. WHO strongly recommends structured programmes on diet, physical activity and behaviour change, delivered one-to-one or as a combined programme. Digital health tools are conditionally recommended, with a parent or carer supervising.
"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 Luz María De Regil, who directs WHO's nutrition and food safety department.
The conditions on medicines
The adolescent guideline states the conditions in detail. Medicines are suggested only for teenagers who have obesity and obesity-related complications, such as type 2 diabetes, insulin resistance, uncontrolled high blood pressure, abnormal blood fats or mental health problems. Before that, a structured, supervised programme of diet, exercise and behaviour support must have run for at least six months without success.
Treatment should then be prescribed in a specialised multidisciplinary setting. That should follow an assessment of the teenager's physical development and psychological stability, and include close monitoring for side effects and long-term follow-up.
It is a conditional recommendation. The guideline's authors judged that the drugs "likely provide small to moderate benefits", but that follow-up in the studies was short, "important uncertainties remain regarding adverse effects", and the trials were mostly in high-income countries. The guideline notes that US and European regulators have approved orlistat, semaglutide and liraglutide for adolescent obesity, but it does not single out any medicine.
Surgery and devices
Bariatric surgery may be considered for adolescents with severe obesity after lifestyle treatment has failed. WHO strongly recommends that any such surgery happen only in a specialised team, after checks that include whether the teenager has finished puberty and reached adult height. For weight-loss devices, the guideline makes no recommendation for adolescents because of a lack of evidence.
Beyond the clinic
The guidelines also ask health workers to address mental health alongside weight, noting that anxiety, depression and bullying can feed unhealthy eating and inactivity. WHO says treatment alone "cannot reverse the rise in obesity", and it repeats its call for taxes, regulation and urban planning that make healthy food and activity cheaper and easier.
A BMJ news report on the guidance ran under the headline that children aged 10 and above can have weight-loss jabs prescribed. That is true only for the narrow group the guideline describes, and only after the steps above.
View author profile → · Editorial policy
