CONTEMPORARY MANAGEMENT OF PEDIATRIC OBESITY: A NARRATIVE REVIEW

Wiktoria Modrzejewska; Łukasz Lamparski; Grzegorz Szmit; Zofia Wcisło; Weronika Basak; Maria  Chmielewska; Patrycja Piekarska; Adrianna Purwin; Katarzyna Siwiec; Anna Kułach; Karolina Lach; Gabriela Krok

doi:10.31435/ijitss.2(50).2026.5342

Authors

Wiktoria Modrzejewska National Medical Institute of the Ministry of the Interior and Administration, ul. Wołoska 137, 02-507 Warsaw, Poland https://orcid.org/0009-0006-9165-7404
Łukasz Lamparski National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland https://orcid.org/0009-0005-3143-3583
Grzegorz Szmit Military Institute of Medicine, Warsaw, Poland https://orcid.org/0009-0000-5695-0388
Zofia Wcisło Military Institute of Medicine, Warsaw, Poland https://orcid.org/0009-0009-9058-4882
Weronika Basak Military Institute of Medicine, Warsaw, Poland https://orcid.org/0009-0007-1788-3259
Maria Chmielewska Mazovian Brodnowski Hospital, Warsaw, Poland https://orcid.org/0009-0002-7702-8282
Patrycja Piekarska Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0007-0085-6617
Adrianna Purwin Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0008-5697-3721
Katarzyna Siwiec Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0001-6411-9727
Anna Kułach Medical University of Warsaw, Warsaw, Poland https://orcid.org/0009-0000-6476-8869
Karolina Lach Medical University of Warsaw, Warsaw, Poland https://orcid.org/0000-0002-0529-1623
Gabriela Krok Henryk Klimontowicz Hospital in Gorlice, Gorlice, Poland https://orcid.org/0009-0000-3969-9929

DOI:

https://doi.org/10.31435/ijitss.2(50).2026.5342

Keywords:

Pediatric Obesity; Childhood Obesity; Adolescent Obesity; Obesity Managements; GLP-1 Agonists; Surgery, Bariatric; Surgery, Metabolic

Abstract

Background: Pediatric obesity is widely regarded as a heterogeneous, chronic disease associated with metabolic, cardiovascular, and psychosocial consequences. Its increasing prevalence highlights the need for comprehensive, evidence-based management strategies.

Aims: This narrative review aims to synthesize current evidence on therapeutic approaches for pediatric obesity, including behavioral management, pharmacologic and surgical treatment, and to highlight emerging treatment directions.

Methods: A narrative review was based on a PubMed search, covering studies published through February 2026. Search terms included keywords related to pediatric obesity and related management strategies. Eligible studies included clinical trials, observational studies, systematic reviews, meta-analyses, and clinical guidelines evaluating treatment outcomes in patients aged under 18 years. Evidence was synthesized according to SANRA guidelines.

Results: Lifestyle and behavioral interventions persist as the foundation of pediatric obesity management. However, their long-term effectiveness is often suboptimal. Glucagon-like-peptide-1 receptor agonists demonstrate meaningful reductions in BMI along with improvement of obesity-related comorbidities, representing a substantial advancement in pharmacologic therapy. In cases of children with severe obesity not responding to conservative and medical treatment, the most significant weight reduction is provided by metabolic and bariatric surgery. Emerging therapies that target metabolic pathways and the gut microbiome appear promising, yet require additional validation.

Conclusions: The treatment and management of pediatric obesity is shifting toward a tailored approach integrating behavioral, pharmacologic, and surgical strategies. Novel pharmacotherapies have significantly expanded treatment options, but long-term safety data and comparative studies remain limited. Multidisciplinary, individualized care is crucial to optimize outcomes in this complex disease.

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