Obesity in children and adolescents: Scoping exercise and prioritization for World Health Organization clinical guidelines

Current clinical guidance on children and adolescent obesity management is limited in scope and in addressing obesogenic factors, reaching underserved populations, and developing whole-of-society solutions. To address these shortcomings, the World Health Organization (WHO) set out to develop people-centered normative guidance for the integrated management of children and adolescents with obesity using a primary healthcare approach. WHO undertook a prioritization exercise consisting of (1) scoping of initial questions and outcomes, (2) public notice and comment, (3) guideline development group establishment and consultation, and (4) final approval. Initial questions and outcomes were compiled from core outcome sets and documents from WHO, United Nations Children's Emergency Fund (UNICEF), and other UN agencies. Stakeholders and potential guideline development group members were identified from existing WHO resources and a call for experts. The public notice and comment involved assessment of initial questions and outcomes via a Delphi prioritization consensus survey, which received 349 full responses from 78 countries. Results were assessed and refined by the WHO obesity steering committee and two established guideline development groups: children and adolescents. The prioritization exercise resulted in eight background questions, 19 key questions for guideline development, 11 critical outcomes for decision-making, and 10 important but not critical outcomes for decision-making.