WHO backs diet and activity in first global guidelines on child and adolescent obesity

In response to a sharp rise in obesity among children and adolescents, the WHO has released its first global guidelines setting out how health systems and workers can deliver timely, evidence-based, and people-centered care. 

The UN organization notes that obesity prevalence among 5–19-year-olds grew from 2% in 1990 to 8% in 2024. It estimates that 170 million children and adolescents were living with obesity in 2024, of whom 70 million were aged 5–9 while 100 million was aged 10–19. 

The WHO says that preventing and managing obesity is essential to protect the physical and mental health of these populations and support their healthy growth, education, social well-being, and quality of life. 

The guidelines strongly recommend structured dietary, physical activity, and behavior-changing interventions delivered individually or through a multimodal program to support children and adolescents with obesity. 

They also suggest that digital health interventions can provide additional support when supervised by a parent or caregiver. 

“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 behavior change,” says Dr. Luz María De Regil, director of the Department of Nutrition and Food Safety at the WHO. 

WHO recommends a structured physical activity plan that considers age, gender, health status, cultural context, and the child’s interests.“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.”

Effective care

The WHO states that obesity is a chronic, relapsing disease that can be managed with effective care. The guidelines caution that consequences can begin early in life, increasing people’s risk of developing noncommunicable diseases, such as type 2 diabetes and cardiovascular disease. 

Additionally, children and teens living with obesity may experience stigma, discrimination, and bullying. 

For both age groups, the WHO recommends a structured multimodal intervention that includes a combination of diet, physical activity, and behavioral components. 

Moreover, the organization notes interventions should consider age, gender, health status, food preferences, nutrition education, physical fitness, cultural context, and kids’ interests, values, and preferences, as well as resources and support of parents and caregivers. 

While interventions should involve parents or caregivers, the guidelines recommend they be delivered and supervised by health workers who have knowledge of nutrition, physical activity, and behavior-changing interventions.

The organization does not recommend pharmacological treatment, bariatric surgery, or weight-loss devices for children aged 0–9 years, though the guidelines for adolescents note these treatments may be considered under certain conditions.

For example, the guidelines for teens aged 10–19 state that treatment with approved medicines should only be considered when a supervised multimodal lifestyle program did not achieve desired outcomes. They recommend considering bariatric surgery only for adolescents with severe obesity. 

A 2026 Pediatrics study found that GLP-1 use among US children below 12 years increased 310-fold from 2019 to 2026. A different study cautioned that one in six US kids on these medications developed nutritional deficiencies within a year, and that less than 25% of patients received nutritional counseling within six months of starting treatment. 

The WHO documents were developed by its Guideline Development Group (GDG), which assessed evidence for potential interventions, supported by external experts. 

Dietary interventions

The guidelines by GDG recommend a structured dietary intervention as a component of effective care for children with obesity older than two years. 

Behavior-changing interventions that are fun, enjoyable, and consider the specific needs of participants are more likely to be acceptable and feasible, says the WHO.Although the guidelines note that benefits of this intervention are small and vary depending on the type of benefit, they underscore its low risk of related adverse events. The GDG also noted that children, adolescents, and their carers “positively valued the potential benefits of dietary interventions.”

It found limited evidence on these interventions in the number and quality of studies, determining a minor effect of low-calorie or low-glycemic food diets for critical outcomes of children’s weight, body mass index, waist circumference, cholesterol concentrations, and percent body fat. 

According to the guidelines, dietary modifications often aim to reduce total energy intake, restrict caloric content, focus on specific components — such as low-salt, low-sugar, or high-fiber diets, or with food additives — or macronutrients, or follow dietary patterns such as the Mediterranean diet. 

The WHO notes that a healthy diet needs to be adequate, balanced, moderate, and diverse, with a combination of fruits, vegetables, and legumes, moderating fat, and limiting salt and sugar. 

Specifically for children, the organization recommends breastfeeding during the first two years of life, with exclusive breastfeeding for the first six months. 

The guidelines caution: “Dietary behaviors are influenced by complex factors, including gender, culture, socioeconomic status, and parental involvement, with early education and the environment playing crucial roles in long-term health. Low-income communities face higher food insecurity and health disparities, underscoring the need for accessible nutrition resources and better nutritional education.”

Obesity and mental health

The recommendations also underscore the importance of addressing mental health, in addition to obesity. The authors note that anxiety, depression, low self-esteem, and emotional dysregulation can contribute to unhealthy eating behaviors, physical inactivity, and social withdrawal. 

Therefore, they advise health workers to address both obesity and mental health conditions “early and together,” with inclusive and developmentally appropriate strategies. 

Moreover, the guidelines recommend that obesity management extend beyond weight loss, stressing that interventions should aim to improve overall health, functioning, and well-being. 

The WHO also calls for policies and measures to make healthy diets and physical activity more accessible and affordable, noting that “treatment alone cannot reverse the rise in obesity.” It points to policies such as regulatory and fiscal measures, and actions across education, urban planning, transport, and social protection.