International consensus on adolescent metabolic health: prevention of obesity and type 2 diabetes

Abstract Background The global rise in adolescent obesity is driving an aggressive phenotype of type 2 diabetes (T2D), which is marked by rapid progression and premature mortality. Therefore, evidence-based, internationally applicable prevention guidelines are urgently needed. Methods A multidisciplinary international panel (n = 21) developed consensus recommendations through a systematic literature review (utilizing Web of Science, Scopus, PubMed, Cochrane, and EMBASE for the years 2000–2025) and a structured meeting process (held from October 2024 to December 2025). Consensus required ≥ 80% agreement. A total of eighty statements were initially proposed, from which sixty achieved preliminary agreement in Phase 1. Following iterative refinement in Phases 2 and 3, fifty achieved final consensus, and thirty were eliminated, either for failing to achieve 80% agreement or by being designated for further research. Results The panel established fifty evidence-based recommendations across nine domains, which include screening, lifestyle intervention, school-based initiatives, digital health, therapeutic options, and policy. Key recommendations are to implement standardized screening protocols in schools, regulate the advertising of unhealthy foods and beverages, promote healthy lifestyle trends through media, and integrate artificial intelligence (AI) to tailor prevention plans. Conclusion This consensus provides a practical, multisectoral framework for the global prevention of adolescent obesity and T2D, designed for application across healthcare, governmental, and non-governmental settings.