# Obesity Phenotyping in Children and Adolescents: Next Steps Towards Precision Medicine in Pediatric Obesity

## TL;DR

This paper reviews the need for better obesity classification in children to improve treatment effectiveness through precision medicine.

## Contribution

The paper highlights the lack of obesity phenotyping data in children and adolescents and emphasizes its importance for precision medicine.

## Key findings

- Current interventions for pediatric obesity show significant variability in treatment response.
- Energy balance obesity phenotypes in adults can predict weight loss outcomes but are understudied in children.
- Precision medicine approaches in pediatric obesity could improve treatment selection and outcomes.

## Abstract

Pediatric obesity is an increasingly prevalent, chronic, and multifactorial disease. Achieving successful and sustained weight reduction with current interventions remains challenging due to significant heterogeneity in treatment response. This review summarizes current evidence describing variability in outcomes across lifestyle, pharmacologic, and metabolic/bariatric surgery interventions in children and adolescents, and examines key biological, metabolic, behavioral, environmental, and psychosocial factors that influence response. In adults, recent findings on energy balance obesity phenotypes (characterized by abnormal satiation, abnormal postprandial satiety, abnormal hedonic eating, and reduced energy expenditure) have demonstrated promise in predicting weight loss outcomes and guiding tailored interventions. However, data on obesity phenotyping within children and adolescents remain limited. Addressing this gap is essential for advancing precision medicine approaches in pediatric obesity, with the potential to improve treatment selection, enhance effectiveness, and optimize long-term clinical outcomes.