Obesity in children and adolescents: epidemiology, causes, assessment, and management

Hiba Jebeile, Aaron S. Kelly, Grace O'Malley, Louise A. Baur

Research output: Contribution to journalReview articlepeer-review

225 Scopus citations


This Review describes current knowledge on the epidemiology and causes of child and adolescent obesity, considerations for assessment, and current management approaches. Before the COVID-19 pandemic, obesity prevalence in children and adolescents had plateaued in many high-income countries despite levels of severe obesity having increased. However, in low-income and middle-income countries, obesity prevalence had risen. During the pandemic, weight gain among children and adolescents has increased in several jurisdictions. Obesity is associated with cardiometabolic and psychosocial comorbidity as well as premature adult mortality. The development and perpetuation of obesity is largely explained by a bio-socioecological framework, whereby biological predisposition, socioeconomic, and environmental factors interact together to promote deposition and proliferation of adipose tissue. First-line treatment approaches include family-based behavioural obesity interventions addressing diet, physical activity, sedentary behaviours, and sleep quality, underpinned by behaviour change strategies. Evidence for intensive dietary approaches, pharmacotherapy, and metabolic and bariatric surgery as supplemental therapies are emerging; however, access to these therapies is scarce in most jurisdictions. Research is still needed to inform the personalisation of treatment approaches of obesity in children and adolescents and their translation to clinical practice.

Original languageEnglish (US)
Pages (from-to)351-365
Number of pages15
JournalThe Lancet Diabetes and Endocrinology
Issue number5
StatePublished - May 2022

Bibliographical note

Funding Information:
HJ was supported by the Sydney University Medical Foundation. GO was supported by funding from the Royal College of Surgeons in Ireland StAR programme (grant number 2151).

Publisher Copyright:
© 2022 Elsevier Ltd


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