The increased prevalence of
adolescent obesity and associated short-term and long-term complications emphasize the need for effective treatment. In this Review, we aim to describe the evidence for, and elements of, behaviour management and adjunctive
therapies and highlight the opportunities and challenges presented by
obesity management in adolescence. The broad principles of treatment include management of
obesity-associated complications; a developmentally appropriate approach; long-term behaviour
modification (dietary change, increased physical activity, decreased sedentary behaviours and improved sleep patterns); long-term weight maintenance strategies; and consideration of the use of
pharmacotherapy, more intensive dietary
therapies and
bariatric surgery.
Bariatric surgery should be considered in those with
severe obesity and be undertaken by skilled bariatric surgeons affiliated with teams experienced in the medical and psychosocial management of adolescents.
Adolescent obesity management strategies are more reliant on active participation than those for
childhood obesity and should recognize the emerging autonomy of the patient. The challenges in
adolescent obesity relate primarily to the often competing demands of developing autonomy and not yet having attained neurocognitive maturity.