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The World Health Organization (WHO) has released its first guideline on managing obesity among children and adolescents, ruling out weight-loss medicines, bariatric surgery and weight-loss devices for children under the age of 10.
The global health body disclosed this in a press release issued on Wednesday, October 7, setting out evidence-based recommendations for health systems and health workers treating children and adolescents living with obesity.
The guideline comes amid a sharp rise in childhood obesity globally, with about 170 million children and adolescents aged five to 19 living with obesity in 2024, while prevalence among the age group has quadrupled from 2% in 1990 to 8%.
WHO prioritises lifestyle treatment
Despite obesity affecting about 70 million children aged five to nine and another 100 million adolescents aged 10 to 19 in 2024, WHO is prioritising dietary changes, physical activity and behavioural support rather than medicines or surgery as the foundation of treatment.
The organisation strongly recommends structured dietary, physical activity and behaviour-change interventions, either delivered individually or as part of a broader multimodal programme, while digital health interventions may also be used with parental or caregiver supervision.
- “WHO does not recommend pharmacological treatment, bariatric surgery (weight-loss surgery that changes the stomach or digestive tract) or weight-loss devices for children aged 0–9 years.”
For adolescents aged 10 to 19, WHO said approved weight-loss medicines may be considered where a supervised multimodal lifestyle programme fails to produce the desired outcome, while bariatric surgery should be considered only under strict conditions for adolescents living with severe obesity.
- “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, Director of WHO’s Department of Nutrition and Food Safety.
WHO also stressed that treatment should extend beyond weight reduction to improvements in overall health, functioning and well-being, while mental health concerns such as anxiety, depression, low self-esteem, stigma and bullying should be addressed alongside obesity.
Obesity adds to NCD burden
The new guideline comes against a broader rise in the global burden of noncommunicable diseases, which increasingly account for a large share of deaths worldwide.
- According to WHO’s 2026 Global Health Estimates released on October 2, eight of the world’s 10 leading causes of death in 2023 were noncommunicable diseases, accounting for 47% of all deaths globally and 88% of deaths attributable to the top 10 causes.
- Ischaemic heart disease, stroke and chronic obstructive pulmonary disease ranked as the three leading causes of death globally.
- Overall, the 10 leading causes accounted for about 33 million deaths in 2023.
- That represented 54% of the approximately 61 million deaths recorded worldwide during the year.
WHO said obesity is a chronic and relapsing disease whose health consequences can begin early in life, increasing the risk of noncommunicable diseases including type 2 diabetes and cardiovascular disease.
Nigeria faces obesity policy gaps
Nigeria is also facing significant challenges in its response to obesity and other diet-related noncommunicable diseases.
- A recent Obesity Response Index: Country Profiles assessment published by Economist Impact and supported by Eli Lilly and Company gave Nigeria an overall score of 13.1 out of 100, the lowest among the 20 countries assessed, with the country scoring zero in both obesity treatment and physical activity.
- Nigeria currently imposes an excise duty of N10 per litre on sugar-sweetened beverages, including carbonated and energy drinks, as part of efforts to discourage consumption while generating revenue for healthcare.
- In June, the Senate approved a new excise duty framework that would replace the existing flat N10-per-litre charge with a percentage-based levy linked to retail prices.
The measures come as policymakers face growing pressure to curb risk factors associated with obesity, diabetes, hypertension and cardiovascular diseases.
