The problem of overweight among minors has acquired a global character. According to statistics, about 20–22% of children and adolescents suffer from excess body weight [1]. Obesity is a complex multifactorial disease whose development is influenced by genetic predisposition, dietary habits, physical activity levels, as well as socio-economic and environmental factors [1, 4]. Timely detection and proper treatment help prevent severe cardiometabolic and psychosocial complications [4].
The Basis of Therapy: Lifestyle Modification
The fundamental approach to combating childhood obesity remains Health Behavior and Lifestyle Treatment (HBLT) [3, 4]. This approach includes:
- Counseling on healthy and balanced nutrition with the restriction of simple carbohydrates and calories [1, 7].
- Regular increase in physical activity [1, 7].
- Psychological support and working with the motivation of the child and their family for behavioral changes [1, 4].
Despite the fact that lifestyle modification is the basis of treatment, maintaining such results in the long term can be extremely difficult, which is why doctors often have to resort to additional methods [5, 6].
Pharmacotherapy for Obesity
If lifestyle correction does not yield the desired result, pharmacotherapy may be prescribed in addition to it [2, 3]. The choice of a specific drug depends on the individual characteristics of the patient and the presence of comorbid conditions, such as type 2 diabetes mellitus or non-alcoholic fatty liver disease [1]. Historically, metformin and orlistat were used for these purposes [1, 6], but today the arsenal of agents is expanding.
According to recent network meta-analyses, glucagon-like peptide-1 (GLP-1) receptor agonists, such as semaglutide and liraglutide, demonstrate high efficacy in reducing body weight and improving metabolic parameters in adolescents [2, 5, 8]. Nevertheless, the body's response may vary: for example, studies show variability in the response to GLP-1 receptor agonist therapy among certain patient groups, which requires further monitoring and selection of optimal dosages [5, 8].
Comprehensive Approach and Associated Risks
Obesity in adolescence is often accompanied by insulin resistance, impaired carbohydrate metabolism, and psycho-emotional difficulties, including the risk of developing eating disorders against the background of weight stigmatization [4, 7]. The use of modern drugs, including GLP-1, in combination with standard therapy (for example, in type 1 diabetes mellitus with comorbid obesity) helps to significantly improve glycemic control and reduce insulin requirements [8].
Surgical Treatment Methods
In severe clinical cases, when conservative methods and pharmacotherapy do not provide the proper effect, and the degree of obesity poses a direct threat to health, the possibility of performing metabolic and bariatric surgery is considered [1, 4]. Such interventions require careful evaluation of indications, patient readiness, and supervision by a multidisciplinary team of specialists.
Sources
- 1. Management of Obesity in Pediatric Patients (American Journal of Health-System Pharmacy, 2025)
- 2. Pharmacotherapy in children and adolescents with overweight or obesity: a systematic review and network meta-analysis (Diabetes, Obesity & Metabolism, 2026)
- 3. Pharmacotherapy and Lifestyle Treatment in Childhood Obesity: A Systematic Review and Network Meta-Analysis (JAMA Pediatrics, 2026)
- 4. Management of Obesity in Children and Adolescents (Gastroenterology Clinics of North America, 2023)
- 5. Efficacy and tolerability of GLP-1 analogues in the treatment of obesity in adolescents (Archives de Pédiatrie, 2026)
- 6. Trends in pediatric obesity management: A survey of the Pediatric Endocrinology Society (Journal of Pediatric Endocrinology & Metabolism, 2020)
- 7. Obesity management in adolescent girls (Clinical Endocrinology, 2025)
- 8. Effects of semaglutide on body weight and insulin requirements in two adolescents with type 1 diabetes mellitus (Pediatrics, 2026)
Disclaimer: This article is for informational purposes only and does not replace an in-person consultation with a pediatrician or endocrinologist.