WHO underlines rise in obesity among children, issues guidelines

Why in the News

Care for obese children is moving from limited treatment options to weight-loss drugs such as semaglutide, now approved for children over 12. The World Health Organization (WHO) has issued guidelines that recommend against these drugs and bariatric surgery for children below nine, and advise restraint for adolescents aged 10 to 19. Obesity in these age groups has quadrupled since 1990, rising from 2% to 8%.

What is childhood obesity, and why act early?

1. What it is: Obesity is an excess of body fat that harms health. In children it sets in during the years when the body and eating habits form.
2. Early disease: Children living with obesity develop lifestyle diseases much earlier in life, so they live longer with the complications these diseases bring.
3. Clinical picture: The Indian Society for Paediatric and Adolescent Endocrinology (ISPAE) president reports a three-fold rise in obese children at his clinic. Most already have fatty liver, high cholesterol or prediabetes (blood sugar above normal, below diabetes level).
4. The takeaway: Obesity in childhood front-loads a lifetime of disease, which is why WHO puts daily habits, not medicines, at the centre of care.

What do the WHO guidelines recommend?

1. Foundation of care: WHO’s Director of Nutrition and Food Safety says care rests on healthy eating, physical activity and sustainable behaviour change, not on medicine or surgery.
2. Lifestyle measures first: Structured diets, physical activity and behaviour-change interventions are rated “strong in favour”, WHO’s firmest backing, for children and adolescents alike. Digital, technology-driven interventions get conditional support.
3. Children below nine: WHO rates pharmacotherapy (treatment with weight-loss drugs) and bariatric surgery (an operation that shrinks the stomach) “strong against”. Surgery can also hamper a child’s growth.
4. Adolescents: Drugs and surgery are conditionally allowed for those with morbid obesity and linked lifestyle conditions, or where other measures fail within six months.
5. Evidence gap: WHO says there is no long-term data on the efficacy and effects of these drugs in children.

What are GLP-1 drugs?

1. What they are: Glucagon-like peptide-1 (GLP-1) drugs are medicines that curb appetite, so patients eat less and lose weight. Semaglutide is one of them.
2. Scope of WHO advice: WHO’s caution for children is not specific to GLP-1 drugs and covers all weight-loss medicines.

How large is the burden, worldwide and in India?

1. Global scale: About 170 million children and adolescents lived with obesity in 2024.
2. India’s projection: India’s obese children and adolescents are set to reach 27 million by 2030, about 11% of the global burden, per the Comprehensive National Nutrition Survey (CNNS).
3. Under-fives: National Family Health Survey (NFHS) data show overweight and obesity among under-fives more than doubled, rising 127%.
4. Adolescent girls and boys: Over the same period, overweight and obesity rose 125% among adolescent girls and 288% among adolescent boys.

Where does the debate on drugs for children stand?

1. Severe cases only: The ISPAE president holds that semaglutide should be limited to children living with morbid obesity and complications.
2. Case for early action: Some diabetologists urge aggressive early intervention, because losing weight can prolong the lives of obese children.
3. National guidelines: ISPAE is drafting guidelines on GLP-1 drugs in children, so that they are not over-used yet still reach those who need them.

Challenges

1. Pressure to medicate: Easier access to GLP-1 drugs creates pressure to prescribe them to children who need only diet and activity changes.
2. Unhealthy food environment: Cheap processed snacks and sugary drinks are easy for children to buy, which makes healthy eating hard to sustain.
3. Double burden of malnutrition: India still has high child undernutrition, so nutrition programmes built around feeding more can overlook rising obesity.

Way Forward

1. National paediatric protocol: Finalise ISPAE’s guidelines and align drug use in Indian children with WHO’s age limits.
2. School-based prevention: Use school health programmes to build daily physical activity and healthier meals into the school day.
3. Routine screening: Record children’s weight and height at school health check-ups, so obesity is caught before co-morbidities set in.
4. Indian safety studies: Fund long-term studies on how weight-loss drugs affect Indian adolescents.

Conclusion

Childhood obesity has become a question of treatment as well as prevention, and WHO has drawn a firm line against drugs and surgery for young children. Whether India’s paediatric guidelines keep weight-loss drugs for severe adolescent cases only is the next thing to watch.

Key numbers

1. Children aged 5 to 9 living with obesity (2024): 70 million (WHO).
2. Adolescents aged 10 to 19 living with obesity (2024): 100 million (WHO).
3. NFHS comparison window for the rises above: 2005-06 to 2019-21.

Matching Previous Year Question

“[2024, GS2, 15 marks] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.”