WHO's new child obesity guideline: no drugs under 10, cautious use for teens

On 7 October the World Health Organization issued guidance on treating obesity in children, and a 10 October analysis by US Health Digest compared it with American recommendations.

What WHO says

• A strong recommendation against obesity drugs, surgery and devices for children aged 0–9.
• For adolescents aged 10–19 with obesity-related complications, WHO “suggests” medicines only after a supervised lifestyle programme of at least six months has not worked (a conditional recommendation).

How it differs from the US

• The American Academy of Pediatrics’ 2023 guideline says clinicians may offer weight-loss drugs from age 12, and may consider them for ages 8–11.
• US labels for Wegovy and Saxenda start at age 12. The Wegovy teen indication rests on the STEP TEENS trial, in which BMI fell 16.1% versus a 0.6% rise on placebo.

Limitations

The evidence base for medicines in younger children is small and short-term, which is partly why guidance differs. “Conditional” means WHO judged the balance of benefits and harms less certain; decisions should be made with a paediatric clinician.