Childhood obesity is a growing global health concern with significant cardiometabolic consequences. While conventional treatment approaches often fail to achieve sustained outcomes, emerging digital health interventions (DHIs)—including mobile applications, educational video games, wearable devices, telemedicine, and social media—offer innovative tools to support lifestyle modifications and enhance therapeutic adherence. In this narrative review, we focus on the main evidence regarding the effectiveness of DHIs for pediatric obesity treatment according to target (children vs. children with families) and duration (short- and long-term interventions). We also review their impact on clinical (e.g. body mass index, body composition, etc.), behavioral (physical activity, nutrition, adherence) and psychosocial (motivation, engagement) outcomes. In addition, future trends in the field are also discussed. DHIs demonstrate short-term effectiveness, especially when they incorporate personalization, interactivity, and family involvement. Mobile applications and educational video games boost nutritional literacy and promote healthy behaviours. Wearable devices encourage physical activity awareness, though adherence often varies. Long-term, family-based interventions help reduce dropout rates and reinforce lasting healthy habits. Guided use of social media can facilitate health education but also exposes users to risks such as misinformation and unhealthy food marketing. Despite these advancements, DHIs still face major challenges, including unequal access, data privacy concerns, and a lack of long-term outcome evaluations. The increasing prevalence of pediatric obesity underscores the urgent need for effective and sustainable treatment strategies. DHIs represent a promising, scalable approach for managing childhood obesity, but their long-term sustainability and effectiveness remain to be fully established. Ongoing technological advancements—and their thoughtful integration into existing healthcare frameworks—present significant opportunities to develop innovative, patient-centered therapeutic solutions that can improve engagement, adherence, and long-term health outcomes in children and adolescents with obesity.

The role of obesity as a risk factor for chronic kidney disease (CKD) in adulthood has been well established. Over the last years, kidney damage (KD) has emerged as a significant consequence of obesity since childhood. Indeed, a complex interplay of metabolic factors, including insulin resistance (IR), hypertension, oxidative stress, adipose tissue dysfunction, and systemic inflammation, might affect renal hemodynamics, contributing to CKD development over time in at-risk young patients. As the prevalence of pediatric obesity continues to rise globally, understanding the implications for kidney health in terms of early intervention is of paramount importance. Careful monitoring of kidney function within a multidisciplinary approach in children with obesity is crucial for detecting early KD, allowing for timely lifestyle modifications and treatment. In this framework, continued research is essential to further elucidate mechanisms linking obesity and KD and to explore not only effective preventive strategies but also the long-term impact of obesity on kidney health in children with obesity. Given the intimate link of KD with the metabolic milieu in children with obesity, we aimed to provide a comprehensive and insightful overview on KD and its implications in pediatric obesity by reviewing the most recent literature in the field.

Pediatric obesity represents a growing global health challenge, closely associated with increased cardiometabolic risk and long-term adverse outcomes. Although lifestyle modifications remain the cornerstone of treatment, sustained success is often limited. Emerging evidence suggests that the gut microbiota (GM) plays a pivotal role in the pathogenesis of obesity, influencing host metabolism, energy homeostasis, and systemic inflammation. This narrative review aims to provide a comprehensive and up-to-date overview of the complex interplay between GM and pediatric obesity, with a particular emphasis on microbiota-targeted interventions. These include probiotics, prebiotics, synbiotics, postbiotics, dietary modulation, and fecal microbiota transplantation (FMT). Findings from preclinical studies and early-phase clinical trials indicate that gut dysbiosis may contribute to obesity-related mechanisms, such as altered nutrient absorption, increased adiposity, and dysregulated appetite control. Interventions targeting the microbiota have shown promise in modulating inflammatory pathways and improving metabolic profiles. While preliminary findings underscore the potential of the GM as a novel adjunctive target in managing pediatric obesity, current evidence remains heterogeneous, and robust clinical pediatric data are limited. Further research is needed to clarify the therapeutic efficacy, safety, and long-term outcomes of microbiota-modulating strategies in children with obesity.

Background/Objectives: Unlike rhabdomyolysis and neuroleptic malignant syndrome (NMS), massive asymptomatic creatine kinase elevation (MACKE) represents a condition commonly detected during routine screening in patients receiving antipsychotic drugs. In particular, current evidence indicates a greater incidence of this condition in patients without signs of NMS, rhabdomyolysis, or other causes of CK increase during exposure to second-generation antipsychotics (SGAs) than first-generation antipsychotics (FGAs) with a variable onset and duration. Although its pathophysiology is still not fully elucidated, MACKE has usually been recognized as a self-limiting condition, but drug discontinuation might also be required to successfully revert it. Overall, knowledge in this field is mainly extrapolated from adult data, while similar evidence in youths is still limited. As clinicians might often deal with MACKE, its understanding needs to be expanded to avoid misdiagnosis, potentially leading to wasteful healthcare spending and unfavorable patient outcomes. Methods: By reporting the first case of MACKE in an adolescent receiving an SGA, namely paliperidone, we also aimed to provide a comprehensive overview of this medical condition. Conclusions: Making a MACKE diagnosis is essential since its relevant clinical and economic implications are mainly related to unnecessary closer laboratory monitoring or therapeutic changes (e.g., drug discontinuation or switch to another medication).