Obesity has become more common among adolescents (approximately 10 to 21 years of age) (1, 2), and approximately 1 in 5 adolescents in the United States has obesity (3). Obesity during adolescence tends to persist into adulthood. Elevated weight in adolescence can be associated with health consequences that warrant clinical attention, including metabolic, cardiovascular, and orthopedic concerns. Addressing these risks effectively requires open, respectful conversations free from judgment or shame that focus on health outcomes rather than weight itself (4).
Although most of the complications of obesity occur in adulthood, adolescents with obesity are more likely than their peers to have hypertension (5). Type 2 diabetes mellitus is occurring with increasing frequency in adolescents due to insulin resistance related to obesity. Other obesity-related conditions include dyslipidemia, asthma, and liver steatosis.
(See also Obesity in adults.)
General references
1. World Health Organization. Adolescent health. Accessed August 18, 2026.
2. Hagan JF, Shaw JS, Duncan PM, eds. Bright Futures: Guidelines for Health Supervision of Infants, Children, and Adolescents, (4th ed). Elk Grove Village, IL: American Academy of Pediatrics; 2017
3. Centers for Disease Control and Prevention (CDC): Childhood Obesity Facts. May 6. 2026. Accessed August 21, 2026.
4. Ozbardakci EV, Lydecker JA. Reframing How Providers Advocate for Adolescent Well-Being in Body Image, Eating, and Weight. J Am Acad Child Adolesc Psychiatry. 2023;62(9):957-962. doi:10.1016/j.jaac.2023.03.008
5. Chetty AK, Chen AS, Hajduk AM, et al. Proportion of Obesity-Related Conditions Attributable to Obesity and Overweight in US Youth. JAMA Pediatr. 2025;179(10):1123-1126. doi:10.1001/jamapediatrics.2025.2716
Etiology of Obesity in Adolescents
Many environmental factors are associated with obesity in adolescents, including various social determinants of health, ubiquity of foods with a high glycemic index, lack of access to healthy foods, sedentary habits associated with the use of digital and electronic media, and sleep disorders (1). Genetic factors appear to play a major role, and specific genetic polymorphisms are being investigated.
Endocrine disorders are a rare cause of obesity, and potential underlying diseases include hypothyroidism, pseudohypoparathyroidism, cortisol excess, and growth hormone deficiency. Adolescents with weight gain caused by endocrine disorders usually have other signs of the underlying disorder.
Etiology reference
1. Kelly AS, Armstrong SC, Michalsky MP, et al. Obesity in Adolescents: A Review. JAMA. 2024;332(9):738-748. doi:10.1001/jama.2024.11809
Diagnosis of Obesity in Adolescents
History and physical examination
Body mass index (BMI)
Evaluation for comorbidities or endocrine disorders, if indicated
Clinical definitions include the following (percentiles are in comparison to children and adolescents of the same age and sex) (1):
Overweight: BMI ≥ 85th to < 95th percentile
Obesity: BMI ≥ 95th percentile
Class 2 obesity: ≥ 120% to < 140% of the 95th percentile for age and sex or BMI ≥ 35 kg/m2 to < 40 kg/m2 (whichever is lower)
Class 3 obesity: ≥ 140% of the 95th percentile for age and sex or BMI ≥ 40 kg/m2 (whichever is lower)
BMI is commonly used as a measure in clinical care; however, this number is imperfect, and may be misleading in some cases because it does not take into account muscle mass, bone density, overall body composition, and racial and sex differences (1).
Primary endocrine (eg, cortisol excess, hypothyroidism) or metabolic causes are uncommon but should be ruled out if height growth slows significantly (1). In children with short stature and hypertension, Cushing syndrome should be considered.
If comorbidities (eg, diabetes, hypertension, dyslipidemia, obstructive sleep apnea, mental health disorders) are diagnosed or suspected, laboratory evaluation and additional testing is performed and/or referrals to specialists made.
Diagnosis reference
1. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity [published correction appears in Pediatrics. 2024 Jan 1;153(1):e2023064612. doi:10.1542/peds.2023-064612]. Pediatrics. 2023;151(2):e2022060640. doi:10.1542/peds.2022-060640
Treatment of Obesity in Adolescents
Behavior and lifestyle interventions
For adolescents ≥ 12 years with BMI ≥ 95th percentile, weight-loss medications may be considered
For adolescents ≥ 13 years with BMI ≥ 120% of 95th percentile, evaluation for metabolic and bariatric surgery
All children and adolescents with obesity should be given intensive health and lifestyle change strategies that address nutrition, physical activity, and health behavior (1).
Adolescents ≥ 12 years with obesity (BMI ≥ the 95th percentile for age and sex) may be offered medications for weight loss (1).
Adolescents ≥ 13 years old with class 2 or class 3 obesity (BMI ≥ 120% or ≥ 140% of the 95th percentile for age and sex) may be referred for evaluation for metabolic and bariatric surgery (1).
Treatment reference
1. Hampl SE, Hassink SG, Skinner AC, et al. Clinical Practice Guideline for the Evaluation and Treatment of Children and Adolescents With Obesity [published correction appears in Pediatrics. 2024 Jan 1;153(1):e2023064612. doi: 10.1542/peds.2023-064612]. Pediatrics. 2023;151(2):e2022060640. doi:10.1542/peds.2022-060640
