Abstract: Childhood and adolescent obesity has become a global challenge in public health.Its high weight regain rate and risks of metabolic complications highlight the limitations of traditional intervention strategies.This review systematically explores individualized intervention strategies for obesity in children and adolescents in the context of precision medicine,breaking the traditional "one-size-fits-all" model.It integrates multi-omics technologies with intelligent management methods,proposing a multidimensional framework for precise intervention.First,a precise diagnosis and evaluation system is constructed based on multi-modal data,including genomics,radiomics,and gut microbiomics,to identify genetic susceptibility,metabolic phenotypes and microbiome characteristics,laying the foundation for stratified interventions.Secondly,individualized intervention plans are developed based on genetic risk scores,epigenetic regulatory mechanisms,and gut microbiome-targeted therapies:gene-guided strategies aim to optimize dietary structure through multi-gene risk assessments; epigenetic interventions aim to regulate DNA methylation and histone modification by taking advantage of nutrients (such as methyl donors and short-chain fatty acids),reversing metabolic dysregulation; microbiome remodeling aims to improve energy metabolism balance through probiotics and synbiotics.Furthermore,artificial intelligence and wearable devices are employed for dynamic monitoring in multiple scenarios.By collaborating with multidisciplinary teams in nutrition,sports medicine,and psychology,a smart management model of "hospital-family-community" network is established.While precision medicine offers groundbreaking directions for childhood obesity treatment,challenges such as biomarker validation,data integration,and long-term efficacy evaluation remain to be addressed.This review provides theoretical foundations and practical pathways for the improvement in the effectiveness and sustainability of interventions,emphasizing the need to integrate interdisciplinary innovative technologies in the future in order to promote the transformation of childhood obesity management toward precision and intelligence.

Key words: Obesity, Precision medicine, Epigenetics, Gut microbiome, Adolescent, Child