WHO says medicines, surgery not first-line treatment for childhood obesity

The World Health Organization said medicine and surgery should not be the first-line treatment for overweight children, as it issued its first guidelines addressing the rising prevalence of obesity among children and adolescents.

The WHO recommended structured diets, physical activity and behavioural changes as the foundation of obesity care for those aged 19 and below.

The UN health agency said it does not recommend weight-loss medicines, bariatric surgery or weight-loss devices for children aged 0-9 years.


For adolescents aged 10-19, approved medicines may be considered only when a supervised, multimodal lifestyle programme has failed to achieve the desired results. Bariatric surgery may also be considered under strict conditions for adolescents with severe obesity.

The recommendations differ from the WHO's adult obesity guidelines issued in December 2025, following the growing popularity of appetite-suppressing GLP-1 drugs, including Ozempic and Mounjaro. The WHO said such weight-loss and diabetes medicines could be used to treat obesity in adults.

170 million children and adolescents affected

Around 70 million children aged five to nine were obese in 2024, along with 100 million adolescents aged 10 to 19 worldwide, according to the WHO.

Among those aged five to 19, the global prevalence of obesity increased from 2% in 1990 to 8% in 2024.

“The rise of obesity is observed everywhere in all regions,” said Luz Maria De Regil, director of the WHO's nutrition and food safety department.

She said obesity is increasing in low- and middle-income countries, while some high-income countries are beginning to halt the rise, although they have not yet recorded reductions.

“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,” De Regil said.

WHO stresses mental health support

The recommendations also highlighted the need to address mental health alongside obesity.

The WHO said anxiety, depression and low self-esteem can contribute to unhealthy eating, physical inactivity and social withdrawal. Children and adolescents living with obesity may also face stigma and bullying.

Maria Nieves Garcia Casal, a scientist in the WHO's nutrition and food safety department, said bariatric surgery may be considered during adolescence in cases of severe obesity accompanied by complications such as type 2 diabetes or hypertension, if diet and lifestyle changes have failed.