Adolescent obesity in the digital age: navigating risks and opportunities

Prevalence of adolescent obesity is rising globally, driven by structural and commercial determinants of health (eg, food marketing, built environment inequities, and socioeconomic disadvantage), including through increasingly digitalised environments. Although digital technologies offer scalable opportunities for obesity prevention, most interventions to date have been narrowly focused, weight-centric, and poorly integrated into adolescents' lived realities. This narrative review synthesises evidence on the design, implementation, and evaluation of digital health interventions targeting adolescent obesity prevention, particularly from a nutrition and food systems perspective. We review four key areas: the low effectiveness of current digital interventions; the commercial and algorithmic pressures shaping digital ecosystems; the importance of meaningful co-creation of digital interventions with adolescents; and the need to embed digital interventions within broader health systems. Frameworks that better reflect adolescents' lived experiences should be evaluated. To drive impact on adolescent obesity prevention, digital interventions should be developed with and for adolescents, integrated across sectors, and evaluated using metrics that extend beyond bodyweight to include engagement, wellbeing, and the interplay between structural, commercial, and digital determinants of health.