Abstract
BACKGROUND: Global childhood obesity continues to rise, particularly in adolescent females. The underlying cause of this change in prevalence is multifactorial with a complex interplay of genetic, socioeconomic and environmental influences. In this review, we aim to emphasize the multiple options available for assisting an adolescent female to improve their overall health and longevity. DESIGN: Experts from each of their respective fields reviewed the current literature regarding the management of obesity in female adolescents. RESULTS: Lifestyle changes, including decreases in overall calorie consumption and simple carbohydrates as well as increases in activity/exercise have been the mainstay of obesity therapy due to their effects on decreasing insulin resistance and associated metabolic disease, as well as weight loss. However, the combination of provider encouraged weight loss and societal obesity stigma leads to an increased risk for disordered eating. The high prevalence of mental health and sleep disorders in female youth with obesity are recent findings, as is the importance in treating these conditions for improved quality of life as well as success with lifestyle changes. The American Academy of Pediatrics' 2023 obesity guidelines are the first across the globe to recommend early adjunctive use of weight loss medications for obesity. These recommendations correspond with the development and increasing availability of new combinations of existing mediations as well as the glucagon like peptide-1 receptor agonist class of medications. Youth with a body mass index in excess of 35-40 kg/m(2), can now undergo bariatric surgery in many countries, with very encouraging short- and medium-term success. CONCLUSION: There are now many approaches to consider when treating an adolescent female for obesity or associated metabolic disease, and customized approaches may be needed for optimal success at the individual patient level.