{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:32:02Z","timestamp":1776299522553,"version":"3.50.1"},"reference-count":60,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T00:00:00Z","timestamp":1723766400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>The purpose of this review is to discuss treatment modalities for obesity in children and adolescents, including nonpharmacological, pharmacological, and surgical interventions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>The prevalence of pediatric obesity has dramatically risen, with rates of 20.7% and 22.2% among children and adolescents, respectively. Obesity is a complex medical condition with multifactorial risk factors, including diet and exercise, social determinants of health, and environmental and genetic factors. The management approach among children and adolescents with obesity includes nutrition counseling, increased physical activity, and readiness for behavioral change. Pharmacotherapy may be recommended, yet the literature has not elucidated the most appropriate first-line treatment. Metformin and orlistat have been studied and may be considered in pediatric patients with comorbid complications, including type 2 diabetes and nonalcoholic fatty liver disease. Phentermine and topiramate in combination, as well as glucagon-like peptide-1 receptor agonists, have provided modest benefits in weight reduction among youth. Setmelanotide has a unique mechanism of action and may be considered for those with obesity due to genetic disorders. Bariatric surgery should be reserved for adolescents meeting criteria for severe obesity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Treatment for obesity in children and adolescents includes a comprehensive approach with structured lifestyle programs, mental health support, and mitigation of social determinants of health. Pharmacotherapy may also be considered, yet no medication is recommended over another, giving flexibility for shared decision-making with the patient and family regarding comorbidities and potential drug interactions. Adolescents with severe obesity who meet specified criteria may also be referred for surgical evaluation.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajhp\/zxae236","type":"journal-article","created":{"date-parts":[[2024,8,16]],"date-time":"2024-08-16T16:54:56Z","timestamp":1723827296000},"page":"392-402","source":"Crossref","is-referenced-by-count":7,"title":["Obesity management in the pediatric patient"],"prefix":"10.1093","volume":"82","author":[{"given":"Kelly L","family":"Matson","sequence":"first","affiliation":[{"name":"Department of Pharmacy Practice and Clinical Research, University of Rhode Island, Kingston, RI, and Department of Pharmacy, UMass Memorial Health \u2013 University Campus , Worcester, MA ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"III","given":"Norman E","family":"Fenn","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Natural, and Health Sciences, Manchester University, Fort Wayne, IN, and Department of Pharmacy, Parkview Women\u2019s and Children\u2019s Hospital , Fort Wayne, IN ,","place":["USA"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2024,8,16]]},"reference":[{"key":"2025041702193428100_CIT0001","article-title":"National Health and Nutrition Examination Survey 2017\u2013March 2020 \u2014 prepandemic data files development of files and prevalence estimates for selected health outcomes","author":"Stierman","year":"2021"},{"key":"2025041702193428100_CIT0002","author":"Centers for Disease Control and Prevention"},{"key":"2025041702193428100_CIT0003","article-title":"Prevalence of overweight, obesity, and severe obesity among children and adolescents aged 2\u201319 years: United States, 1963\u20131965 through 2017\u20132018","author":"Fryar"},{"issue":"2","key":"2025041702193428100_CIT0004","doi-asserted-by":"crossref","first-page":"e2022060640","DOI":"10.1542\/peds.2022-060640","article-title":"Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity","volume":"151","author":"Hampl","year":"2023","journal-title":"Pediatrics"},{"key":"2025041702193428100_CIT0005","doi-asserted-by":"crossref","DOI":"10.1001\/jama.2024.11146","article-title":"High body mass index in children and adolescents: interventions","author":"US Preventive Services Task Force","year":"2024"},{"key":"2025041702193428100_CIT0006","article-title":"To the members of the American Academy of Pediatrics (special topic)","author":"National Alliance for Eating Disorders","year":"2023"},{"key":"2025041702193428100_CIT0007","article-title":"Criticism emerges over new AAP guidelines for childhood obesity","author":"Curley","year":"2023","journal-title":"Healthline"},{"issue":"1","key":"2025041702193428100_CIT0008","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1001\/jamapediatrics.2023.4852","article-title":"What parents should expect from the new AAP obesity guidelines","volume":"178","author":"Cohen","year":"2024","journal-title":"JAMA Pediatr"},{"key":"2025041702193428100_CIT0009","author":"Morrill","year":"2023"},{"key":"2025041702193428100_CIT0010","author":"Centers for Disease Control and Prevention","year":"2022"},{"issue":"2","key":"2025041702193428100_CIT0011","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/j.orcp.2020.03.002","article-title":"Behavioral factors influencing childhood obesity: a systematic review and meta-analysis","volume":"14","author":"Poorolajal","year":"2020","journal-title":"Obes Res Clin Pract"},{"issue":"5","key":"2025041702193428100_CIT0012","doi-asserted-by":"publisher","first-page":"e20162592","DOI":"10.1542\/peds.2016-2592","article-title":"Media use in school-aged children and adolescents","volume":"138","author":"Council on Communications and Media","year":"2016","journal-title":"Pediatrics"},{"key":"2025041702193428100_CIT0013","article-title":"Pathophysiology of obesity","volume-title":"StatPearls","author":"Khanna","year":"2024"},{"key":"2025041702193428100_CIT0014","doi-asserted-by":"crossref","first-page":"136","DOI":"10.4103\/ijpvm.IJPVM_193_20","article-title":"Adiponectin: role in physiology and pathophysiology","volume":"11","author":"Nguyen","year":"2020","journal-title":"Int J Prev Med"},{"key":"2025041702193428100_CIT0015","first-page":"12","article-title":"Role and significance of ghrelin and leptin in hunger, satiety, and energy homeostasis","volume":"49","author":"Kharbanda","year":"2022","journal-title":"J Sci Soc"},{"issue":"6","key":"2025041702193428100_CIT0016","doi-asserted-by":"crossref","first-page":"1182","DOI":"10.1542\/peds.2011-0965","article-title":"Sports drinks and energy drinks for children and adolescents: are they appropriate","volume":"127","author":"Committee on Nutrition and Council on Sports Medicine and Fitness","year":"2011","journal-title":"Pediatrics"},{"issue":"6","key":"2025041702193428100_CIT0017","doi-asserted-by":"crossref","first-page":"e20170967","DOI":"10.1542\/peds.2017-0967","article-title":"Section on Gastroenterology, Hepatology and Nutrition; Committee on Nutrition. Fruit juice in infants, children, and adolescents: current recommendations","volume":"139","author":"Heyman","year":"2017","journal-title":"Pediatrics"},{"issue":"19","key":"2025041702193428100_CIT0018","first-page":"e1017","article-title":"American Heart Association Nutrition Committee of the Council on Lifestyle and Cardiometabolic Health; Council on Clinical Cardiology; Council on Cardiovascular Disease in the Young; Council on Cardiovascular and Stroke Nursing; Council on Epidemiology and Prevention; Council on Functional Genomics and Translational Biology; and Council on Hypertension. Added sugars and cardiovascular disease risk in children: a scientific statement from the American Heart Association","volume":"135","author":"Vos","year":"2017","journal-title":"Circulation"},{"issue":"3","key":"2025041702193428100_CIT0019","doi-asserted-by":"crossref","first-page":"e20193992","DOI":"10.1542\/peds.2019-3992","article-title":"Physical activity assessment and counseling in pediatric clinical settings","volume":"145","author":"Lobelo","year":"2020","journal-title":"Pediatrics"},{"issue":"6","key":"2025041702193428100_CIT0020","doi-asserted-by":"crossref","first-page":"785","DOI":"10.5664\/jcsm.5866","article-title":"Recommended amount of sleep for pediatric populations: a consensus statement of the American Academy of Sleep Medicine","volume":"12","author":"Paruthi","year":"2016","journal-title":"J Clin Sleep Med"},{"key":"2025041702193428100_CIT0021","doi-asserted-by":"crossref","first-page":"220","DOI":"10.1177\/1060028014557859","article-title":"Pharmacological management of obesity in pediatric patients","volume":"49","author":"Boland","year":"2015","journal-title":"Ann Pharmacother"},{"issue":"3","key":"2025041702193428100_CIT0022","doi-asserted-by":"crossref","first-page":"e20201610","DOI":"10.1542\/peds.2020-1610","article-title":"Efficacy and safety of metformin for obesity: a systematic review","volume":"147","author":"Masarwa","year":"2021","journal-title":"Pediatrics"},{"key":"2025041702193428100_CIT0023","year":"2009"},{"issue":"11","key":"2025041702193428100_CIT0024","first-page":"D012436","article-title":"Drug interventions for the treatment of obesity in children and adolescents (review)","volume":"11","author":"Mead","year":"2016","journal-title":"Cochrane Database Syst Rev"},{"issue":"3","key":"2025041702193428100_CIT0025","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1007\/s00431-023-05369-3","article-title":"The effect of orlistat in the treatment of non-alcoholic fatty liver in adolescents with overweight and obese","volume":"183","author":"Zahmatkesh","year":"2024","journal-title":"Eur J Pediatr"},{"key":"2025041702193428100_CIT0026","year":"2012"},{"issue":"9774","key":"2025041702193428100_CIT0027","doi-asserted-by":"crossref","first-page":"1341","DOI":"10.1016\/S0140-6736(11)60205-5","article-title":"Effects of low-dose, controlled-release, phentermine plus topiramate combination on weight and associated comorbidities in overweight and obese adults (CONQUER): a randomised, placebo-controlled, phase 3 trial","volume":"377","author":"Gadde","year":"2011","journal-title":"Lancet"},{"issue":"6","key":"2025041702193428100_CIT0028","doi-asserted-by":"crossref","first-page":"EVIDoa2200014","DOI":"10.1056\/EVIDoa2200014","article-title":"Phentermine\/topiramate for the treatment of adolescent obesity","volume":"1","author":"Kelly","year":"2022","journal-title":"NEJM Evid."},{"issue":"3","key":"2025041702193428100_CIT0029","doi-asserted-by":"crossref","first-page":"251","DOI":"10.1056\/NEJMcp2102062","article-title":"Obesity in adolescents","volume":"389","author":"Hannon","year":"2023","journal-title":"N Engl J Med"},{"issue":"2","key":"2025041702193428100_CIT0030","doi-asserted-by":"crossref","first-page":"364","DOI":"10.1038\/oby.2011.337","article-title":"Exenatide as a weight-loss therapy in extreme pediatric obesity: a randomized, controlled pilot study","volume":"20","author":"Kelly","year":"2012","journal-title":"Obesity (Silver Spring)"},{"issue":"4","key":"2025041702193428100_CIT0031","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1001\/jamapediatrics.2013.1045","article-title":"The effect of glucagon-like peptide-1 receptor agonist therapy on body mass index in adolescents with severe obesity: a randomized, placebo-controlled, clinical trial","volume":"167","author":"Kelly","year":"2013","journal-title":"JAMA Pediatr"},{"key":"2025041702193428100_CIT0032","doi-asserted-by":"crossref","first-page":"e12624","DOI":"10.1111\/ijpo.12624","article-title":"A 6-month randomized, double-blind, placebo-controlled trial of weekly exenatide in adolescents with obesity","volume":"15","author":"Weghuber","year":"2020","journal-title":"Pediatr Obes"},{"key":"2025041702193428100_CIT0033","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1002\/oby.23395","article-title":"Exenatide for weight-loss maintenance in adolescents with severe obesity: a randomized, placebo-controlled trial","volume":"30","author":"Fox","year":"2022","journal-title":"Obesity (Silver Spring)"},{"issue":"22","key":"2025041702193428100_CIT0034","doi-asserted-by":"crossref","first-page":"2117","DOI":"10.1056\/NEJMoa1916038","article-title":"A randomized, controlled trial of liraglutide for adolescents with obesity","volume":"382","author":"Kelly","year":"2020","journal-title":"N Eng J Med"},{"issue":"24","key":"2025041702193428100_CIT0035","doi-asserted-by":"crossref","first-page":"2245","DOI":"10.1056\/NEJMoa2208601","article-title":"Once-weekly semaglutide in adolescents with obesity","volume":"387","author":"Weghuber","year":"2022","journal-title":"N Engl J Med"},{"issue":"8","key":"2025041702193428100_CIT0036","doi-asserted-by":"crossref","first-page":"2139","DOI":"10.1002\/oby.23808","article-title":"Reducing BMI below the obesity threshold in adolescents treated with once-weekly subcutaneous semaglutide 2.4 mg","volume":"31","author":"Kelly","year":"2023","journal-title":"Obesity (Silver Spring)"},{"key":"2025041702193428100_CIT0037","doi-asserted-by":"crossref","first-page":"960","DOI":"10.1016\/S2213-8587(20)30364-8","article-title":"Efficacy and safety of setmelanotide, an MC4R agonist, in individuals with severe obesity due to LEPR or POMC deficiency: single-arm, open-label, multicentre, phase 3 trials","volume":"8","author":"Clement","year":"2020","journal-title":"Lancet Diabetes Endocrinol"},{"issue":"7","key":"2025041702193428100_CIT0038","doi-asserted-by":"crossref","first-page":"882","DOI":"10.1016\/j.soard.2018.03.019","article-title":"ASMBS pediatric metabolic and bariatric surgery guidelines, 2018","volume":"14","author":"Pratt","year":"2018","journal-title":"Surg Obes Relat Dis"},{"issue":"3","key":"2025041702193428100_CIT0039","doi-asserted-by":"crossref","first-page":"709","DOI":"10.1210\/jc.2016-2573","article-title":"Pediatric obesity \u2014 assessment, treatment, and prevention: an Endocrine Society clinical practice guideline","volume":"102","author":"Styne","year":"2017","journal-title":"J Clin Endocrinol Metab"},{"issue":"22","key":"2025041702193428100_CIT0040","doi-asserted-by":"crossref","first-page":"2136","DOI":"10.1056\/NEJMoa1813909","article-title":"Teen\u2013LABS Consortium. Five-year outcomes of gastric bypass in adolescents as compared with adults","volume":"380","author":"Inge","year":"2019","journal-title":"N Engl J Med"},{"key":"2025041702193428100_CIT0041","doi-asserted-by":"crossref","first-page":"100066","DOI":"10.1016\/j.obpill.2023.100066","article-title":"Clinical review: guide to pharmacological management in pediatric obesity medicine","volume":"6","author":"O\u2019Hara","year":"2023","journal-title":"Obes Pillars"},{"issue":"4","key":"2025041702193428100_CIT0042","doi-asserted-by":"crossref","first-page":"e55","DOI":"10.1542\/peds.107.4.e55","article-title":"The effects of metformin on body mass index and glucose tolerance in obese adolescents with fasting hyperinsulinemia and a family history of type 2 diabetes","volume":"107","author":"Freemark","year":"2001","journal-title":"Pediatrics"},{"issue":"12","key":"2025041702193428100_CIT0043","doi-asserted-by":"crossref","first-page":"1457","DOI":"10.1053\/meta.2001.28078","article-title":"Beneficial effects of metformin in normoglycemic morbidly obese adolescents","volume":"50","author":"Kay","year":"2001","journal-title":"Metabolism"},{"issue":"6","key":"2025041702193428100_CIT0044","doi-asserted-by":"crossref","first-page":"2074","DOI":"10.1210\/jc.2006-0241","article-title":"Randomized, controlled trial of metformin for obesity and insulin resistance in children and adolescents: improvement in body composition and fasting insulin","volume":"91","author":"Srinivasan","year":"2006","journal-title":"J Clin Endocrinol Metab"},{"issue":"6","key":"2025041702193428100_CIT0045","doi-asserted-by":"crossref","first-page":"817","DOI":"10.1016\/j.jpeds.2008.01.018","article-title":"Addition of metformin to a lifestyle modification program in adolescents with insulin resistance","volume":"152","author":"Love-Osborne","year":"2008","journal-title":"J Pediatr"},{"issue":"6","key":"2025041702193428100_CIT0046","doi-asserted-by":"crossref","first-page":"567","DOI":"10.1111\/j.1399-5448.2008.00434.x","article-title":"Short-term metabolic and cardiovascular effects of metformin in markedly obese adolescents with normal glucose tolerance","volume":"9","author":"Burgert","year":"2008","journal-title":"Pediatr Diabetes"},{"issue":"4","key":"2025041702193428100_CIT0047","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1515\/JPEM.2008.21.4.339","article-title":"Use of metformin in obese adolescents with hyperinsulinemia: a 6-month, randomized, double-blind, placebo-controlled clinical trial","volume":"21","author":"Atabek","year":"2008","journal-title":"J Pediatr Endocrinol Metab"},{"issue":"1","key":"2025041702193428100_CIT0048","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1007\/s12020-009-9196-9","article-title":"Metformin in combination with structured lifestyle intervention improved body mass index in obese adolescents, but did not improve insulin resistance","volume":"6","author":"Clarson","year":"2009","journal-title":"Endocrine"},{"issue":"2","key":"2025041702193428100_CIT0049","first-page":"116","article-title":"Metformin extended release treatment of adolescent obesity: a 48-week randomized, double-blind, placebo-controlled trial with 48-week follow-up","volume":"164","author":"Wilson","year":"2010","journal-title":"Arch Pediatr Adolesc Med"},{"issue":"4","key":"2025041702193428100_CIT0050","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1530\/EJE-10-0570","article-title":"Metformin and placebo therapy both improve weight management and fasting insulin in obese insulin-resistant adolescents: a prospective, placebo-controlled, randomized study","volume":"163","author":"Wiegand","year":"2010","journal-title":"Eur J Endocrinol"},{"issue":"4","key":"2025041702193428100_CIT0051","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s12519-010-0232-x","article-title":"A randomized, triple masked, placebo-controlled clinical trial for controlling childhood obesity","volume":"6","author":"Rezvanian","year":"2010","journal-title":"World J Pediatr"},{"issue":"2","key":"2025041702193428100_CIT0052","doi-asserted-by":"crossref","first-page":"477","DOI":"10.2337\/db10-1185","article-title":"Effects of metformin on body weight and body composition in obese insulin-resistant children: a randomized clinical trial","volume":"60","author":"Yanovski","year":"2011","journal-title":"Diabetes"},{"issue":"1","key":"2025041702193428100_CIT0053","doi-asserted-by":"crossref","first-page":"322","DOI":"10.1210\/jc.2012-2710","article-title":"Metformin in obese children and adolescents: the MOCA trial","volume":"98","author":"Kendall","year":"2013","journal-title":"J Clin Endocrinol Metab"},{"issue":"1","key":"2025041702193428100_CIT0054","doi-asserted-by":"crossref","first-page":"e20164285","DOI":"10.1542\/peds.2016-4285","article-title":"Metformin for obesity in prepubertal and pubertal children: a randomized controlled trial","volume":"140","author":"Pastor-Villaescusa","year":"2017","journal-title":"Pediatrics"},{"issue":"1","key":"2025041702193428100_CIT0055","doi-asserted-by":"crossref","first-page":"48","DOI":"10.4067\/S0370-41062012000100006","article-title":"Metabolic effect of metformin in obese adolescents at risk of diabetes mellitus type 2","volume":"83","author":"Prado","year":"2012","journal-title":"Rev Chil Pediatr-Chile"},{"issue":"8","key":"2025041702193428100_CIT0056","doi-asserted-by":"crossref","first-page":"e228","DOI":"10.1038\/nutd.2016.37","article-title":"van der Vorst MM. Long-term treatment with metformin in obese, insulin-resistant adolescents: results of a randomized double-blinded placebo-controlled trial","volume":"6","author":"van der Aa","year":"2016","journal-title":"Nutr Diabetes"},{"issue":"8","key":"2025041702193428100_CIT0057","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1089\/chi.2018.0043","article-title":"Metformin in the management of childhood obesity: a randomized control trial","volume":"14","author":"Warnakulasuriya","year":"2018","journal-title":"Child Obes"},{"issue":"12","key":"2025041702193428100_CIT0058","doi-asserted-by":"crossref","first-page":"738","DOI":"10.1007\/s00431-004-1534-6","article-title":"Addition of orlistat to conventional treatment in adolescents with severe obesity","volume":"163","author":"Ozkan","year":"2004","journal-title":"Eur J Pediatr"},{"issue":"23","key":"2025041702193428100_CIT0059","doi-asserted-by":"crossref","first-page":"2873","DOI":"10.1001\/jama.293.23.2873","article-title":"Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial","volume":"293","author":"Chanoine","year":"2005","journal-title":"JAMA"},{"issue":"1","key":"2025041702193428100_CIT0060","doi-asserted-by":"crossref","first-page":"18","DOI":"10.4158\/EP.12.1.18","article-title":"Randomized, double-blind, placebo-controlled trial of orlistat for weight loss in adolescents","volume":"12","author":"Maahs","year":"2006","journal-title":"Endocr Pract"}],"container-title":["American Journal of Health-System Pharmacy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajhp\/advance-article-pdf\/doi\/10.1093\/ajhp\/zxae236\/58954737\/zxae236.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/8\/392\/58954737\/zxae236.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajhp\/article-pdf\/82\/8\/392\/58954737\/zxae236.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,17]],"date-time":"2025-04-17T06:19:48Z","timestamp":1744870788000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajhp\/article\/82\/8\/392\/7734673"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,16]]},"references-count":60,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2024,8,16]]},"published-print":{"date-parts":[[2025,4,17]]}},"URL":"https:\/\/doi.org\/10.1093\/ajhp\/zxae236","relation":{},"ISSN":["1079-2082","1535-2900"],"issn-type":[{"value":"1079-2082","type":"print"},{"value":"1535-2900","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,4,15]]},"published":{"date-parts":[[2024,8,16]]}}}