Approved obesity medicines can now be considered for adolescents aged ten to 19, and bariatric surgery for the most severe cases, under new global guidelines published by the World Health Organization (WHO) on Wednesday. Both options are subject to strict conditions.
In Cyprus, one in five nine-year-olds lives with obesity, rising to one in four among boys. The figures come from the latest WHO Europe childhood obesity data, which put the country at the top of the comparison.
About a year ago, the WHO issued its first global guidelines on the use of GLP-1 therapies in the long-term treatment of obesity in adults. It recognised then that drugs such as liraglutide, semaglutide and tirzepatide can, under certain conditions, form part of long-term obesity treatment for adults. These active ingredients are better known through products such as Ozempic, Wegovy and Mounjaro. The new guidelines extend that framework to younger age groups.
Age ten threshold
The WHO stresses that a healthy lifestyle, a proper diet and exercise remain the first line of treatment. For children under ten, it does not recommend obesity medication, bariatric surgery or weight-loss devices. Treatment should continue to rely on structured, age-appropriate lifestyle interventions that involve the whole family.
For adolescents aged ten to 19, approved obesity medicines may be considered when lifestyle interventions have not worked. The WHO does not recommend medication for all children with obesity. Instead, it sets specific criteria, and describes medication as an option for certain adolescents within a comprehensive treatment plan that includes diet and exercise.
For adolescents with severe obesity who have not responded to lifestyle interventions, medication or both, bariatric surgery may also be considered. This would happen under specific and strict conditions, and only after proper assessment.
The WHO says obesity should now be treated as a chronic, relapsing disease that may need organised, multifactorial and long-term care, and that persistent obesity calls for additional treatment.
Cyprus and global figures
The Cypriot data come from the WHO European Region’s Childhood Obesity Surveillance Initiative (COSI) and cover nine-year-olds over the period 2022 to 2024. Among girls, the rate is 15 per cent, well below the 25 per cent recorded for boys. For boys and girls combined, Cyprus is followed by Greece at 18 per cent, and Italy and Malta at 17 per cent.
Worldwide, 170 million children and adolescents aged five to 19 were living with obesity in 2024, according to the WHO. About 70 million of them were aged five to nine, and 100 million were aged ten to 19. The WHO says obesity prevalence in these age groups has quadrupled since 1990, from 2 per cent to 8 per cent.
Beyond the scales
The guidelines also cover how a child’s progress is assessed. The number on the scales cannot be the only measure of whether treatment has succeeded, the WHO says. Instead, obesity management should go beyond weight loss and aim to improve the child’s health, functioning and wellbeing, including mental health.
The WHO highlights anxiety, depression, low self-esteem and emotional difficulties, which can coexist with obesity. These can affect a child’s eating habits, physical activity and social life, among other things. It also points to the effects of stigma: children and adolescents with obesity may face discrimination and bullying, which can harm their emotional stability.
The WHO recommends an approach tailored to each child’s age and needs, with family involvement. It stresses the need for long-term follow-up and continuity of care.
Wider measures
The WHO says treatment alone cannot reverse the rise in child and adolescent obesity.
Tackling the problem cannot be confined to the child, the family or the clinic, it says, because the environment in which children grow up and form daily habits plays a decisive role. The measures it considers necessary include action in education and social protection, as well as regulatory and fiscal measures to help create a healthier food environment.
