Canada Releases Pediatric Obesity Guidelines

Written By Dr. Ryan Oughtred

Obesity Canada’s 2025 Pediatric Obesity Guidelines: What to Expect
By Dr. Ryan Oughtred, Weight Doctor in Vancouver

A Long-Awaited (But Somewhat Underwhelming) Release

Obesity Canada has finally published its 2025 Pediatric Obesity Guidelines. It’s been a long wait—especially considering that the United States released comprehensive guidelines nearly two years ago, and treatments have been approved by Health Canada and available during that time. While these Canadian guidelines do offer some direction, and they’ve done an incredible job from an evidence-informed perspective, I have to say that I’m feeling underwhelmed and a bit disappointed.

During the time we’ve been waiting for guidelines, children and families have struggled with progressive weight challenges. Clinicians have often taken a “hands-off” stance in recommending treatments, citing “no guidelines” for pediatric weight management or simply saying, “I don’t treat kids.” Meanwhile, effective medications like semaglutide (Wegovy/Ozempic)—approved for ages 12+ since 2023—have gone underutilized.

I’ve discussed these concerns before on my blog:
Pediatric Obesity Guidelines Delay

So let’s talk about how the new guidelines might affect you—or the people you care about.

How Will These Guidelines Change the Conversation with Your Doctor?

1. Focus on Quality of Life, Patient Values and Health Over Weight

  • Hopefully this is not new for most health care providers.

    1. Body fat impacts health differently in different bodies.

    2. Diagnosis is nuanced and not made solely through one measure like weight.

    3. So... it follows that treatment is also complex and nuanced—not just about weight.

  • If your doctor was previously hyper-focused on the scale, these guidelines could shift that conversation in a more holistic, supportive direction.

  • The guidelines re-emphasize patient-centred care. In pediatrics, that becomes even more complex as the additional values of family members or unchangeable aspects of a child’s environment come into play.

  • Of course, patient-centred care isn’t new. If your doctor isn’t taking your values or your unique context into account when discussing weight or treatment, that’s not acceptable. Be prepared to advocate for yourself and your child, and seek to be understood before recommendations are made.

2. Weight Bias and Stigma Exist—Don’t Contribute to them

  • Using non-stigmatizing language is critical—avoiding labelling anyone as "obese" and focusing instead on the medical condition of obesity.

    1. I still attend conferences where experts refuse to adopt this language, so just expect that you might receive some of it and don’t let it get you down!

  • Neutral, descriptive, or medical language like “larger bodies,” “weight,” or “body fat” is preferable to judgmental terms like “too fat,” which carry harmful societal biases.

  • Since bias has long influenced care, the guidelines recommend professionals ask for permission before discussing body weight and that they make efforts to foster a blame-free environment - hopefully your doctor was already doing this.

  • I’d love to see the guidelines go a step further—encouraging doctors to take responsibility for the harm caused by past messaging, and to sit with patients in that discomfort. Empathy and acknowledgement of lived experience matter.

    1. I would have loved to see a recommendation like: “Stop blaming patients’ health problems on their weight” and they can explicitly go the other direction and state that this is “not your fault”.

    2. Old habits die hard - be prepared to take your child’s side whenever there is any insinuation that their situation is their own doing.

3. Medications Are on the Table, but you may have

  • The guidelines finally recommend treatment with GLP-1 receptor agonists like semaglutide (Ozempic/Wegovy), but they don’t offer a particularly strong endorsement, which is surprising when you look at how well Wegovy performs. If you’re considering this medication, come informed and ready to advocate for yourself.

  • Metformin almost gets a more enthusiastic nod—even though its use for pediatric obesity is off-label and benefits are modest when compared to semaglutide (Wegovy). It is cheaper, more familiar than GLP-1 drugs, and is widely available, so don’t be surprised if this drug gets mentioned first.

4. Psychological and Behavioural Interventions

  • No surprises here: the guidelines recommend nutrition counselling, physical activity programs, and behaviour-change support. In other sections they do highlight that these professionals—dietitians, psychologists, or exercise specialists—should have specific training in obesity (as they do in the clinical trials), but I am concerned that message doesn’t get across.

    1. I would say, the odds are that the referral you receive for additional treatment won’t be obesity-specific. Ask about Obesity Canada trained professionals.

  • The guidelines also recommend 26+ hours of therapy over 6–12 months for best treatment outcomes. Realistically, most families don’t have the time or resources for this. So don’t assume a few dietitian appointments and a personal trainer constitute comprehensive, “multimodal” care toward significant weight, health and QoL improvements.

  • Note - I am a unique provider in that I offer comprehensive obesity care, all the way from assessment through to medical and multimodal cognitive behavioural treatment. But this is unusual.
    (Shameless plug)

5. Medication and Surgery Not the “Primary” Therapies - offered as Supplementary Therapies

  • This is the one part of the guideline that I am quite surprised by.

  • I’ll quote directly from Obesity Canada:

    “The recommendations prioritize behavioural/psychological support, particularly multi-component interventions that include physical activity, nutrition and psychological support, supplemented when needed and appropriate by medications and surgery.”

  • Historically, Obesity Canada has advocated for informing patients about all evidence informed treatment options, and empowering them to choose which ones they think are best for them. All treatments could be “first line” treatments, and patients could decide how to prioritize them based on their values and unique situations. Patients should not have to “earn” therapy by completing one approach before gaining access to another, so I am not sure I agree with how this is worded.

    • Be wary of doctors asking you to earn treatments that would work for you - push back if it doesn’t make sense to you.

  • Considering that children lack the executive function of adults—and given the very real practical challenges in accessing psychological or behavioural therapies—I disagree with any suggestion that medication or surgical options could be withheld until a person spends their time and money on treatments that may not work for them.

    1. The takeaway: You may have to advocate for access to medications or surgical options if your doctor “doesn’t want to go there just yet”.

The Bottom Line

Canada finally has a pediatric obesity guideline and the most noticeable result will likely be the increased rates of medical prescribing in this group. Multi modal behavioural treatment is recommended, but it is largely unavailable practically speaking unless you are my patient or you live close to one of the rare obesity clinics in Canada.

If you want access to all of the evidence-based obesity treatments for your child, you’ll still need to be proactive: ask questions, read about treatments like semaglutide (Wegovy) before your visit, and seek out clinics that offer truly multidisciplinary care—including personalized behavioural counselling, medical nutrition therapy, and physical activity support that’s actually designed for youth living with excess weight.

Need Help Now?

  • If you’re in the Vancouver area and looking for a weight loss doctor—or simply want to learn more about weight management programs, assessment options, or treatment with medications like semaglutide (Ozempic/Wegovy) or tirzepatide (Mounjaro)—feel free to reach out.

Remember:
Weight is largely determined by genes and our modern environment—not by willpower or personality strength. ABCD (Obesity) is a medical condition with real, effective treatments. Science is evolving. Unfortunately, weight bias still lingers. So seek out an obesity care professional who hears you, sees you, and treats you or your child with dignity and evidence-informed tools that work.

References

Dr. Ryan Oughtred
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