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Life sciences · Journal article
Turkish Archives of Pediatrics · October 12, 2026
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Pediatric obesity now affects nearly 1 in 5 children and adolescents in the United States, and its consequences reach well into adult life. For years, clinicians offered little beyond brief advice and a plan to recheck later, an approach that quietly allowed a treatable disease to progress. The 2023 American Academy of Pediatrics guideline broke with that tradition. It treats obesity as a chronic disease and calls for early, intensive treatment that may include medication from age 12 years and metabolic and bariatric surgery from age 13 years. This narrative review summarizes what the authors know about the epidemiology, biology, assessment, and management of pediatric obesity, with a focus on the rapidly changing place of drug therapy. Four medications carry US Food and Drug Administration approval for adolescents: orlistat, phentermine/topiramate extended-release, liraglutide, and once-weekly semaglutide. Of these, semaglutide has shown the greatest effect in randomized trials to date, lowering body mass index by roughly 16% in the STEP TEENS study. Intensive lifestyle treatment remains the foundation at every age, and surgery offers benefit for adolescents with severe obesity. Optimal care also means addressing weight stigma and the social conditions that concentrate risk in disadvantaged communities. The hardest problem now is access: the treatments exist, but they reach children unevenly. Tirzepatide and other newer agents are likely to broaden the options in the near future.