Childhood obesity

Also known as: pediatric obesity

Also relevant to Endocrine & Metabolic

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United StatesAAP

Current

Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity

American Academy of Pediatrics (AAP) · 2023 · 2023 guideline (Pediatrics 151(2):e2022060640; erratum 2024)

The AAP's first full clinical practice guideline on evaluating and treating overweight and obesity in children and adolescents aged 2 and older. It sets out assessment for comorbidities and contributing factors and describes behavioural, pharmacological and surgical treatment options.

Published in Pediatrics in February 2023, with an erratum issued in January 2024. source
An accompanying executive summary and a set of key action statements were published alongside the main guideline. source

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EuropeESPGHAN/EAP

Current

Overweight and obesity management

National Institute for Health and Care Excellence (NICE), UK · 2025 · NG246, last updated 8 January 2026

NICE guideline NG246 consolidates the institute's previous overweight and obesity guidance into a single document covering prevention and management in children, young people and adults. It was published in January 2025 and amended in January 2026.

Brings together and replaces seven earlier NICE products issued between 2006 and 2015, including NG7 and CG189. source
The January 2026 amendment clarified that waist-to-height ratio classification of central adiposity applies only to children and young people aged 5 years and over. source

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US vs EU key differences

Drug-treatment age thresholds diverge: the 2023 AAP guideline recommends offering weight-loss pharmacotherapy as an adjunct from age 12, whereas NICE NG246 says weight-management medicines are not generally recommended under age 12 and names only orlistat for those aged 12 and over. source
NICE restricts orlistat in 12- to 17-year-olds to those with physical comorbidities such as orthopaedic problems or sleep apnoea, or severe psychological comorbidity, and requires initiation by a specialist paediatric multidisciplinary team. source
Surgery posture differs sharply: AAP 2023 says adolescents aged 13 and older with severe obesity (BMI at or above 120% of the 95th percentile) should be evaluated for metabolic and bariatric surgery, while NICE states surgery is not generally recommended in children or young people and may be considered only in exceptional circumstances near physiological maturity. source
The AAP anchors behavioural treatment quantitatively, defining intensive health behaviour and lifestyle treatment as at least 26 hours of face-to-face, family-based, multicomponent contact over 3 to 12 months. source

What changed recently

EUCG189 (2014) → NG2462025-01-14
NG246 consolidates CG189 and several other NICE obesity products into one guideline covering children as well as adults, and reframes overweight and obesity as chronic conditions needing continuing support rather than episodic weight-loss episodes. It drops the tiered weight-management service model in favour of a range of services, and adds recommendations on non-judgemental language and on the wider determinants of obesity.
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