The Endocrine Society has issued a clinical practice guideline for the assessment, treatment, and prevention of pediatric obesity. The guideline emphasizes the use of body mass index (BMI) and CDC percentiles to diagnose overweight and obesity in children and adolescents aged 2 years and older. Children with a BMI of 85th percentile or higher are considered overweight, while those at or above the 95th percentile are classified as obese. Extremely obese children have a BMI of 120% of the 95th percentile or 35 kg/m². For children under 2 years, obesity is diagnosed using WHO charts based on sex-specific weight for recumbent length. The guideline recommends evaluating children for potential comorbidities if their BMI is 85th percentile or higher. It also advises against routine laboratory evaluations for endocrine causes of obesity unless there are signs of attenuated growth. The guideline highlights the importance of genetic testing in cases of extreme early-onset obesity, particularly when there are clinical features of genetic obesity syndromes or a family history of extreme obesity. Prevention strategies include promoting healthy diets, physical activity, and sleep patterns, as well as involving the entire family in these efforts. Lifestyle modifications, including dietary changes and increased physical activity, are recommended for children and adolescents with obesity. Pharmacotherapy is suggested only after failed lifestyle interventions, and bariatric surgery is reserved for severe cases with specific criteria. The guideline also emphasizes the need for early screening for comorbidities such as diabetes, dyslipidemia, and sleep apnea. It notes that BMI alone may not be sufficient for diagnosing obesity due to variations in body composition and racial/ethnic differences. The guideline recommends a comprehensive approach to obesity prevention and treatment, including education, behavioral interventions, and family involvement. It also stresses the importance of addressing the psychological impact of obesity and providing counseling when necessary. The guideline underscores the need for further research into the genetic and biological factors contributing to pediatric obesity and the effectiveness of prevention and treatment strategies.The Endocrine Society has issued a clinical practice guideline for the assessment, treatment, and prevention of pediatric obesity. The guideline emphasizes the use of body mass index (BMI) and CDC percentiles to diagnose overweight and obesity in children and adolescents aged 2 years and older. Children with a BMI of 85th percentile or higher are considered overweight, while those at or above the 95th percentile are classified as obese. Extremely obese children have a BMI of 120% of the 95th percentile or 35 kg/m². For children under 2 years, obesity is diagnosed using WHO charts based on sex-specific weight for recumbent length. The guideline recommends evaluating children for potential comorbidities if their BMI is 85th percentile or higher. It also advises against routine laboratory evaluations for endocrine causes of obesity unless there are signs of attenuated growth. The guideline highlights the importance of genetic testing in cases of extreme early-onset obesity, particularly when there are clinical features of genetic obesity syndromes or a family history of extreme obesity. Prevention strategies include promoting healthy diets, physical activity, and sleep patterns, as well as involving the entire family in these efforts. Lifestyle modifications, including dietary changes and increased physical activity, are recommended for children and adolescents with obesity. Pharmacotherapy is suggested only after failed lifestyle interventions, and bariatric surgery is reserved for severe cases with specific criteria. The guideline also emphasizes the need for early screening for comorbidities such as diabetes, dyslipidemia, and sleep apnea. It notes that BMI alone may not be sufficient for diagnosing obesity due to variations in body composition and racial/ethnic differences. The guideline recommends a comprehensive approach to obesity prevention and treatment, including education, behavioral interventions, and family involvement. It also stresses the importance of addressing the psychological impact of obesity and providing counseling when necessary. The guideline underscores the need for further research into the genetic and biological factors contributing to pediatric obesity and the effectiveness of prevention and treatment strategies.