Pediatric Obesity

Pediatric obesity is excess adiposity that can affect metabolic health, breathing, mobility, development, and quality of life. It is not adequately explained by a failure of willpower. Genetic susceptibility interacts with food access, sleep, medications, stress, built environments, family patterns, and opportunities for activity. Adipose tissue can promote insulin resistance and ectopic fat accumulation; excess weight also increases mechanical load on joints and the work of breathing. The condition is often chronic and relapsing, so care should be planned over time rather than framed as a short course that ends when a target weight is reached. The 2025 pediatric guideline reframes treatment around improved health, physical function, participation, and quality of life. Weight may change, remain stable during growth, or become one of several monitored outcomes. A child does not need to achieve a particular body size for care to be beneficial. A proposed 2025 clinical framework distinguishes preclinical obesity, in which excess adiposity has not yet produced measurable organ dysfunction or activity limitation, from clinical obesity, in which adiposity is accompanied by health impairment. This distinction adds clinical context;...