A Narrative Review of Childhood and Adolescent Obesity: Global Trends, Determinants, and Interventions
Abstract
Childhood and adolescent obesity have emerged as one of the most pressing public health challenges of the 21st century, affecting both high-income and low- and middle-income countries. With increasing urbanisation, dietary transitions, and sedentary lifestyles, the prevalence of obesity among young people continues to rise globally, with significant implications for lifelong health. This narrative review critically examines global trends, key determinants, and evidence-based interventions for childhood and adolescent obesity. A comprehensive literature search was conducted using databases including PubMed, Cochrane Library, Google Scholar, and Semantic Scholar, covering studies published between 2006 and 2026. Keywords and Boolean operators related to obesity, adolescents, risk factors, and interventions were applied. Relevant peer-reviewed articles, policy documents, and global health reports were included, with emphasis on English-language publications. Additional sources were identified through citation tracking and expert consultation. Findings reveal that obesity in children and adolescents is driven by a complex interplay of factors, including unhealthy dietary patterns, physical inactivity, genetic predisposition, socioeconomic influences, and environmental exposures. Emerging contributors such as digital media use and obesogenic urban environments further compound the risk. Effective interventions require a multi-level approach, encompassing individual behaviour change, family engagement, school-based programmes, community participation, and supportive public health policies. The review underscores the urgent need for coordinated, context-specific strategies that prioritise prevention, early identification, and sustainable management. Strengthening health systems, promoting health education, and fostering multisectoral collaboration are critical to reversing current trends and safeguarding the health and future productivity of the younger population.
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Bacchini, D., Licenziati, M. R., Garrasi, A., Corciulo, N., Driul, D., Tanas, R., Fiumani, P. M., Di Pietro, E., Pesce, S., & Crinò, A. (2015). Bullying and victimization in overweight and obese outpatient children and adolescents: An Italian multicentric study. PloS One, 10(11), e0142715.
Burke, C. A., Seidler, K. J., Rethorn, Z. D., Hoenig, H., Allen, K., Tabriz, A. A., Norman, K., Murphy-McMillan, L. K., Sharpe, J., & Joseph, L. M. (2024). Interventions to improve long-term adherence to physical rehabilitation: A systematic review. Journal of Geriatric Physical Therapy, 47(3), E124–E136.
Chen, W., Feng, J., Jiang, S., Guo, J., Zhang, X., Zhang, X., Wang, C., Ma, Y., & Dong, Z. (2023). Mendelian randomization analyses identify bidirectional causal relationships of obesity with psychiatric disorders. Journal of Affective Disorders, 339, 807–814.
Cheng, T. S., Ong, K. K., & Biro, F. M. (2022). Adverse effects of early puberty timing in girls and potential solutions. Journal of Pediatric and Adolescent Gynecology, 35(5), 532–535.
Chen-Patterson, A., Bernier, A., Burgert, T., Davis, V., Khan, T., Geller, D., Paprocki, E., Shah, R., Witchel, S. F., & Pereira-Eshraghi, C. (2024). Distinct reproductive phenotypes segregate with differences in body weight in adolescent polycystic ovary syndrome. Journal of the Endocrine Society, 8(2), bvad169.
Cheung, P. C., Cunningham, S. A., Narayan, K. M. V., & Kramer, M. R. (2016). Childhood Obesity Incidence in the United States: A Systematic Review. Childhood Obesity, 12(1), 1–11. https://doi.org/10.1089/chi.2015.0055
Chu, A. Y., Tin, A., Schlosser, P., Ko, Y.-A., Qiu, C., Yao, C., Joehanes, R., Grams, M. E., Liang, L., & Gluck, C. A. (2017). Epigenome-wide association studies identify DNA methylation associated with kidney function. Nature Communications, 8(1), 1286.
Combs, K. T. (2016). High school students’ physical health: Associations with intrapersonal, family, peer, academic, and risk behavior factors. Wayne State University. https://search.proquest.com/openview/a3bae8f22248660d44cef57e5d110d0e/1?pq-origsite=gscholar&cbl=18750
Communitymedicine4all. (2024). WHO updates fact sheet on Overweight and Obesity (1 March 2024). https://communitymedicine4asses.wordpress.com/2024/03/01/who-updates-fact-sheet-on-overweight-and-obesity-1-march-2024/#:~:text=Over%20390%20million%20children%20and%20adolescents%20aged%205%E2%80%9319,just%208%25%20in%201990%20to%2020%25%20in%202022.
Ewart-Pierce, E., Mejía Ruiz, M. J., & Gittelsohn, J. (2016). “Whole-of-Community” Obesity Prevention: A Review of Challenges and Opportunities in Multilevel, Multicomponent Interventions. Current Obesity Reports, 5(3), 361–374. https://doi.org/10.1007/s13679-016-0226-7
Force, U. P. S. T., Nicholson, W. K., Silverstein, M., Wong, J. B., Chelmow, D., Coker, T. R., Davis, E. M., Donahue, K. E., Jaén, C. R., & Krousel-Wood, M. (2024a). Interventions for high body mass index in children and adolescents: US Preventive Services Task Force recommendation statement. Jama, 332(3), 226–232.
Force, U. P. S. T., Nicholson, W. K., Silverstein, M., Wong, J. B., Chelmow, D., Coker, T. R., Davis, E. M., Donahue, K. E., Jaén, C. R., & Krousel-Wood, M. (2024b). Interventions for high body mass index in children and adolescents: US Preventive Services Task Force recommendation statement. Jama, 332(3), 226–232.
Ge, C., Xiong, J., Zhu, R., Hong, Z., & He, Y. (2025). The global burden of high BMI among adolescents between 1990 and 2021. Communications Medicine, 5(1), 125.
Guerra-Carvalho, B., Alves, M. G., & Oliveira, P. F. (2022). Obesity and Male Infertility: An Overview. Int J Diabetol Vasc Dis Res, 8(1e), 1–3.
Haqq, A. M., Kebbe, M., Tan, Q., Manco, M., & Salas, X. R. (2021). Complexity and Stigma of Pediatric Obesity. Childhood Obesity, 17(4), 229–240. https://doi.org/10.1089/chi.2021.0003
Hassan, M. A., Zhou, W., Ye, M., He, H., & Gao, Z. (2024). The effectiveness of physical activity interventions on blood pressure in children and adolescents: A systematic review and network meta-analysis. Journal of Sport and Health Science, 13(5), 699–708.
Hunter, K. E., Nguyen, D., Libesman, S., Williams, J. G., Aberoumand, M., Aagerup, J., Johnson, B. J., Golley, R. K., Barba, A., & Sotiropoulos, J. X. (2025). Parent-focused behavioural interventions for the prevention of early childhood obesity (TOPCHILD): A systematic review and individual participant data meta-analysis. The Lancet, 406(10509), 1235–1254.
Ibáñez, L., Oberfield, S. E., Witchel, S., Auchus, R. J., Chang, R. J., Codner, E., Dabadghao, P., Darendeliler, F., Elbarbary, N. S., & Gambineri, A. (2017). An international consortium update: Pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Hormone Research in Paediatrics, 88(6), 371–395.
Ijoma, A., Akanbi, S. A., Idemudia, E. A., Aderemi, L., Titus, V. O., Okoye, T. O., Adeyemo, D. A., O’dare, R. A., Okobi, O. E., & AKANBI, S. A. (2024). Prevention strategies in obesity management: A systematic review comparing canadian and american guidelines for adults. Cureus, 16(10). https://www.cureus.com/articles/291903-prevention-strategies-in-obesity-management-a-systematic-review-comparing-canadian-and-american-guidelines-for-adults.pdf
Juhola, J. (2017). Tracking of cardiovascular risk factors from childhood to adulthood and their predictive value for adult outcome. https://www.utupub.fi/bitstream/handle/10024/130581/AnnalesD1267Juhola.pdf?sequence=2
Kêkê, L. M., Samouda, H., Jacobs, J., Di Pompeo, C., Lemdani, M., Hubert, H., Zitouni, D., & Guinhouya, B. C. (2015). Body mass index and childhood obesity classification systems: A comparison of the French, International Obesity Task Force (IOTF) and World Health Organization (WHO) references. Revue d’epidemiologie et de Sante Publique, 63(3), 173–182.
Koletzko, B., Demmelmair, H., Grote, V., & Totzauer, M. (2019). Optimized protein intakes in term infants support physiological growth and promote long-term health. Seminars in Perinatology, 43(7), 151153. https://www.sciencedirect.com/science/article/pii/S0146000519300795
Leung, A. K. C., Wong, A. H. C., & Hon, K. L. (2024). Childhood Obesity: An Updated Review. Current Pediatric Reviews, 20(1), 2–26. https://doi.org/10.2174/1573396318666220801093225
Li, A. (2016). Genetics of human obesity in the post-genome wide association study era [PhD Thesis]. https://macsphere.mcmaster.ca/handle/11375/19220
Liu, S., Wang, X., Zheng, Q., Gao, L., & Sun, Q. (2022). Sleep deprivation and central appetite regulation. Nutrients, 14(24), 5196.
Malakar, S., Singh, S. K., & Usman, K. (2025). Efficacy of Lifestyle Interventions in Reducing Weight and BMI Among People With Type 2 Diabetes: A Six-Month Clinical Trial. Cureus, 17(9). https://www.cureus.com/articles/395150
Malik, V. S., Schulze, M. B., & Hu, F. B. (2006). Intake of sugar-sweetened beverages and weight gain: A systematic review–. The American Journal of Clinical Nutrition, 84(2), 274–288.
Mamun, A. A., & Alam, M. (2025). Promoting Equity in Public Health: Addressing Inequality and Social Disparities. Health Science Reports, 8(5), e70821. https://doi.org/10.1002/hsr2.70821
NHS,England. (2024). Children’s overweight and obesity. https://digital.nhs.uk/data-and-information/publications/statistical/health-survey-for-england/2022-part-2/childrens-overweight-and-obesity
Nittari, G., Scuri, S., Sagaro, G. G., Petrelli, F., & Grappasonni, I. (2020). Epidemiology of obesity in children and adolescents. In Teamwork in Healthcare. IntechOpen. https://books.google.com/books?hl=en&lr=&id=dpUtEAAAQBAJ&oi=fnd&pg=PA149&dq=Epidemiology+of+Obesity+in+Children+and+Adolescents+Written+By++Giulio+Nittari,+Stefania+Scuri,+&ots=qf6ANzCswb&sig=z_7QijOLrl0b48FfM8sPWrri1RE
on the Evaluation, I. W. G. (2021). Body fatness. In Absence of excess body fatness. International Agency for Research on Cancer. https://www.ncbi.nlm.nih.gov/books/NBK591875/
Patel, J. P., Hardaswani, D., Patel, J., Saiyed, F., Goswami, R. J., Saiyed, T. I., Patel, H., & Amin, T. H. (2025). Comparative effectiveness of semaglutide, liraglutide, orlistat, and phentermine for weight loss in obese individuals: A systematic review. Cureus, 17(3). https://www.cureus.com/articles/337491-comparative-effectiveness-of-semaglutide-liraglutide-orlistat-and-phentermine-for-weight-loss-in-obese-individuals-a-systematic-review.pdf
Phelps, N. H., Singleton, R. K., Zhou, B., Heap, R. A., Mishra, A., Bennett, J. E., Paciorek, C. J., Lhoste, V. P., Carrillo-Larco, R. M., & Stevens, G. A. (2024). Worldwide trends in underweight and obesity from 1990 to 2022: A pooled analysis of 3663 population-representative studies with 222 million children, adolescents, and adults. The Lancet, 403(10431), 1027–1050.
Pitsillidou, M., Roupa, Z., Farmakas, A., & Noula, M. (2021). Factors affecting the application and implementation of evidence-based practice in nursing. Acta Informatica Medica, 29(4), 281.
Popkin, B. M., & Ng, S. W. (2022). The nutrition transition to a stage of high obesity and noncommunicable disease prevalence dominated by ultra-processed foods is not inevitable. Obesity Reviews, 23(1), e13366.
Pulungan, A. B., Puteri, H. A., Ratnasari, A. F., Hoey, H., Utari, A., Darendeliler, F., Al-Zoubi, B., Joel, D., Valiulis, A., & Cabana, J. (2024). Childhood obesity as a global problem: A cross-sectional survey on global awareness and national program implementation. Journal of Clinical Research in Pediatric Endocrinology, 16(1), 31.
Putri, R. R., Danielsson, P., Ekström, N., Ericsson, Å., Lindberg, L., Marcus, C., & Hagman, E. (2025). Effect of pediatric obesity treatment on long-term health. JAMA Pediatrics, 179(3), 302–309.
Reinehr, T. (2018). Long-term effects of adolescent obesity: Time to act. Nature Reviews Endocrinology, 14(3), 183–188.
Shaikh, S. R., Beck, M. A., Alwarawrah, Y., & MacIver, N. J. (2024). Emerging mechanisms of obesity-associated immune dysfunction. Nature Reviews Endocrinology, 20(3), 136–148.
Shields, M., & Tremblay, M. S. (2010). Canadian childhood obesity estimates based on WHO, IOTF and CDC cut-points. International Journal of Pediatric Obesity, 5(3), 265–273. https://doi.org/10.3109/17477160903268282
Singh, G. K., Kogan, M. D., Van Dyck, P. C., & Siahpush, M. (2008). Racial/ethnic, socioeconomic, and behavioral determinants of childhood and adolescent obesity in the United States: Analyzing independent and joint associations. Annals of Epidemiology, 18(9), 682–695.
Soroceanu, R.-P., Silistraru, I., Ciubara, A., Azoicai, D., Timofte, D., Platon, L. R., Ciuntu, B., & Maxim, M. (n.d.). OBESITY AND DEPRESSION INTERTWINED–A NARRATIVE. Retrieved March 24, 2026, from https://www.academia.edu/download/99277693/18-Obesity-and-Depression-Intertwined-A-Narrative-Review.html.pdf
Steinberger, J., Daniels, S. R., Eckel, R. H., Hayman, L., Lustig, R. H., McCrindle, B., & Mietus-Snyder, M. L. (2009). Progress and Challenges in Metabolic Syndrome in Children and Adolescents: A Scientific Statement From the American Heart Association Atherosclerosis, Hypertension, and Obesity in the Young Committee of the Council on Cardiovascular Disease in the Young; Council on Cardiovascular Nursing; and Council on Nutrition, Physical Activity, and Metabolism. Circulation, 119(4), 628–647. https://doi.org/10.1161/CIRCULATIONAHA.108.191394
Steptoe, A., & Frank, P. (2023). Obesity and psychological distress. Philosophical Transactions of the Royal Society B, 378(1888), 20220225.
Telford, D. M., Meiring, R. M., & Gusso, S. (2025). Moving beyond moderate-to-vigorous physical activity: A longitudinal study on adherence to 24-hour Movement Guidelines in adolescents. Journal of Science and Medicine in Sport, 28(2), 147–153.
Wadden, T. A., Webb, V. L., Moran, C. H., & Bailer, B. A. (2012). Lifestyle Modification for Obesity: New Developments in Diet, Physical Activity, and Behavior Therapy. Circulation, 125(9), 1157–1170. https://doi.org/10.1161/CIRCULATIONAHA.111.039453
Westbury, S., Oyebode, O., Van Rens, T., & Barber, T. M. (2023). Obesity Stigma: Causes, Consequences, and Potential Solutions. Current Obesity Reports, 12(1), 10–23. https://doi.org/10.1007/s13679-023-00495-3
WHO. (2025). Nutrition and Food Safety. https://www.who.int/teams/nutrition-and-food-safety/monitoring-nutritional-status-and-food-safety-and-events/joint-child-malnutrition-estimates/latest-estimates#:~:text=In%202024%2C%20globally%2C%20150.2%20million%20children%20under%20age,children%20under%20age%205%20affected%20in%202024%20worldwide.
World Obesity. (2025). Ranking (% obesity by country). https://data.worldobesity.org/rankings/
Xu, S.-T., Sun, M., & Xiang, Y. (2025). Global, regional, and national trends in type 2 diabetes mellitus burden among adolescents and young adults aged 10–24 years from 1990 to 2021: A trend analysis from the Global Burden of Disease Study 2021. World Journal of Pediatrics, 21(1), 73–89.
Yogev, Y., & Visser, G. H. (2009). Obesity, gestational diabetes and pregnancy outcome. Seminars in Fetal and Neonatal Medicine, 14(2), 77–84. https://www.sciencedirect.com/science/article/pii/S1744165X08001133
Yu, T., Zhou, Y., Wu, X., Fang, Z., & Liu, C. (2025). Association Between Obstructive Sleep Apnea and Non-Alcoholic Fatty Liver Disease: Epidemiological Cross-Sectional Study and Mendelian Randomization Analysis. Nature and Science of Sleep, Volume 17, 1361–1376. https://doi.org/10.2147/NSS.S524675
Zhang, B., Gao, B., Zheng, J., & Li, J. (2026). Prenatal exposure to multidimensional environmental factors and the risk of childhood obesity: A review. Metabolism and Target Organ Damage, 6(1), N-A.
Zou, Y. (2024). Diet in the Digital Food Environment: Food Ordering Impacts and Wellbeing in Urban Chinese [PhD Thesis, University of Liverpool]. https://livrepository.liverpool.ac.uk/3184527/
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