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Life sciences · Journal article
Texas Family Medicine Research Journal · September 27, 2026
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Background Childhood obesity is a chronic, relapsing disease with significant short- and long-term cardiometabolic, psychosocial, and economic consequences. Over the past decade, advances in clinical research and updated professional guidelines have reshaped the evaluation, prevention, and management of pediatric obesity. Methods This narrative review synthesizes contemporary evidence published between 2016 and 2026, including major clinical practice guidelines, randomized controlled trials, systematic reviews, and implementation studies addressing screening, prevention strategies, intensive lifestyle treatment, pharmacotherapy, and metabolic and bariatric surgery in children and adolescents. Results Body mass index (BMI) percentile remains the primary screening tool, with annual assessment recommended for children aged 2–18 years. Early identification should be followed by structured evaluation for comorbidities, including dyslipidemia, abnormal glucose metabolism, hypertension, and nonalcoholic fatty liver disease. Intensive health behavior and lifestyle treatment (IHBLT), defined as ≥26 hours of family-based, multicomponent counseling over 3–12 months, is the foundation of therapy and consistently produces clinically meaningful BMI reductions. For adolescents aged ≥12 years with persistent obesity, pharmacotherapy — particularly glucagon-like peptide-1 (GLP-1) receptor agonists such as semaglutide and liraglutide — has demonstrated significant additional BMI reductions. Metabolic and bariatric surgery offers the greatest and most durable weight loss for adolescents with severe obesity, with substantial remission of cardiometabolic comorbidities. Prevention efforts are most effective when multicomponent, school- and community-based, and supported by structural and policy changes. Conclusions Pediatric obesity requires early identification, active treatment, and longitudinal management within a chronic disease framework. Evidence supports a stepped, multimodal approach integrating family-centered behavioral interventions, pharmacotherapy when indicated, and surgical referral for severe disease. Addressing health inequities, improving access to evidence-based treatments, and reducing weight stigma remain essential to optimizing outcomes for diverse pediatric populations. Key Points • BMI percentile remains the standard screening tool for childhood obesity; annual assessment and structured comorbidity evaluation are recommended for all children aged 2–18 years. • Intensive health behavior and lifestyle treatment (IHBLT) providing ≥26 hours of family-based multicomponent counseling is first-line therapy; GLP-1 receptor agonists and bariatric surgery are evidence-based adjuncts for eligible adolescents. • Effective prevention and treatment require sustained, multicomponent strategies that address social determinants of health, reduce weight stigma, and expand equitable access to evidence-based interventions.