Persistence and Recovery of Changes in Weight Status Associated With the Covid-19 Pandemic Among Children and Adolescents: A Systematically Informed Narrative Review

Introduction: The COVID-19 pandemic disrupted schooling, physical activity, diet, and daily routines, contributing to excess weight gain among children and adolescents. Whether these changes persisted after restrictions eased remains uncertain. Objectives: To evaluate the persistence of pandemic-associated changes in weight status among children and adolescents after major restrictions were eased. Methods: PubMed, Scopus, and the Cochrane Library were searched through December 2025 for observational studies of general pediatric populations (<18 years) reporting weight-related outcomes before the pandemic, during lockdown, school closure, or other major restrictions, and at least six months after school reopening or restriction easing. Owing to methodological heterogeneity, findings were synthesized narratively without meta-analysis. Results: Ten studies from nine countries were included. Most reported increases in BMI-related measures or the prevalence of overweight or obesity during the pandemic or restriction period. After restrictions eased, adverse trends generally attenuated, but complete normalization was inconsistent. Recovery was more frequently observed among younger children, whereas residual or renewed elevations occurred in some older children and adolescents and in selected groups with obesity or severe obesity. Findings by sex and baseline weight status were inconsistent, while socioeconomic and geographic disparities persisted in several settings. Conclusions: Pandemic-associated changes in pediatric weight status partially or completely resolved in some populations but persisted in others. Continued growth monitoring and longer-term, population-representative studies using standardized outcome definitions are needed to identify children with persistent adverse trajectories.