The World Health Organization has released new global guidance recommending that children under 10 should not receive obesity medications or GLP-1 weight-loss injections such as Mounjaro and Wegovy. The recommendations, launched on 7 October 2026, mark the first comprehensive global guidelines addressing obesity care in children and adolescents and fill a significant gap in international clinical guidance.
Although most of these medications carry licensing restrictions for younger age groups, some physicians prescribe them off-label to children below the recommended threshold, and pharmaceutical manufacturers are conducting trials in children as young as six years old. The new WHO guidance prioritizes a different approach for this vulnerable population.
What does WHO recommend instead?
The organization emphasizes that treatment for young children should centre on promoting healthy eating patterns and regular physical activity rather than pharmaceutical or surgical interventions. WHO does not oppose the continuation of drug trials, but maintains that lifestyle-based approaches should form the foundation of obesity management in this age group.
Digital tools may play a supporting role, according to the guidelines. Activity trackers and interactive online games designed to encourage movement show promise based on available evidence, though the research base remains limited. Care should be tailored to each child's individual circumstances and include long-term monitoring, with objectives extending beyond weight reduction to encompass overall health, physical functioning and psychological well-being, according to UN News reporting on the guidelines.
Dr Luz De Rigil, Director of Nutrition and Food Safety at WHO, stated:
For children under 10, WHO does not recommend obesity medicines, bariatric surgery or weight-management devices. This is a strong recommendation.She noted that such interventions might become appropriate for older children and adolescents only when lifestyle modifications have proven unsuccessful and the young person is both mentally and physically prepared for treatment.
Why is childhood obesity a growing concern?
Global obesity in children and adolescents has reached alarming levels. Approximately 170 million children and adolescents worldwide are classified as obese, a figure that encompasses 70 million children aged 5–9. The prevalence of obesity in this youngest group has increased dramatically over recent decades, rising from 2% in 1990 to 8% by the time these guidelines were issued—a fourfold increase. Additionally, in 2024, some 35 million children under five were recorded as overweight.
The health consequences of childhood obesity extend far beyond weight itself. Obesity significantly elevates the risk of developing numerous serious conditions, including type 2 diabetes and other chronic diseases that can persist into adulthood.
What about older children and adolescents?
WHO's approach differs for young people aged 10 and above. For adolescents aged 10–19, approved medications may be considered only if a structured, multimodal lifestyle programme supervised by healthcare professionals has failed to achieve meaningful results, according to guidance from UN News. Bariatric surgery may be considered under strict conditions for adolescents with severe obesity, though this remains a last-resort option.
Regulatory approval varies by region. According to , the European Union permits liraglutide (Saxenda) for certain children aged 6–11, while Wegovy and Saxenda can be used for specific adolescents aged 12 and older in both the US and EU—highlighting the inconsistency between regulatory decisions and WHO's new recommendations.
What are WHO's concerns about early medication use?
Laurence Grummer-Strawn, WHO's head of Nutrition and Food Safety Actions, expressed significant reservations about initiating GLP-1 treatment in very young children. He stated:
We are particularly concerned in this age group, if you are starting children very early on to using a GLP-1 or drugs like this, when does that stop?
His concern reflects a fundamental uncertainty in the medical evidence.
We don't really have evidence that you can use this as a temporary treatment and then turn to something dietary later on in life.He concluded:
We are very cautious about jumping in without clear evidence.
These statements underscore WHO's position that the long-term safety and efficacy of weight-loss medications in young children remain inadequately understood, and that committing children to pharmaceutical treatment without robust evidence of reversibility or long-term benefit carries unacceptable risks.
How does this fit into WHO's broader obesity strategy?
These new guidelines build on WHO's earlier work on obesity management. The organization issued separate guidance on GLP-1 medicines for treating obesity in adults in December 2025, establishing a foundation for understanding these drugs in adult populations before extending recommendations to children.
Dr De Rigil acknowledged that obesity treatment remains an evolving field and that WHO will continue to monitor emerging evidence. This suggests the guidelines may be updated as new research becomes available, particularly regarding the safety and efficacy of newer medications in pediatric populations.
Key Facts
- WHO recommends against obesity drugs, GLP-1 injections and bariatric surgery for children under 10, with preference for lifestyle interventions including healthy eating and physical activity
- Approximately 170 million children and adolescents worldwide are obese, including 70 million aged 5–9, with prevalence in this age group quadrupling since 1990
- For adolescents aged 10–19, approved medications may be considered only after supervised lifestyle programmes have failed and the individual is mentally and physically prepared
- Regulatory approval for weight-loss medications varies globally, with some jurisdictions permitting use in children as young as six despite WHO's new recommendations
- WHO acknowledges uncertainty about the long-term effects of early medication use and emphasizes the need for continued evidence evaluation
