Recent decades have seen a steady rise in kid obesity and both nationally and internationally, severe childhood obesity has become a significant public health issue. Lockdown caused by the coronavirus disease 2019 (COVID-19) pandemic has raised concerns that it may worsen childhood obesity and widen the obesity risk gap. Recent research findings show that obesity rates increase after schools close. Compared to mild to moderate obesity, the effects of extreme childhood obesity are more severe. Severe obesity in children increases the risk of adult obesity, atherosclerosis, metabolic syndrome, type 2 diabetes, hypertension, and other diseases such non-alcoholic fatty liver disease and metabolic syndrome. Implementing effective therapy requires a precise assessment and diagnosis of a child with severe obesity. To improve the success of weight control, psychosocial aspects should be examined, including eating habits. Pediatric patients with severe obesity may benefit from metabolic and bariatric surgery, medication, and lifestyle change therapy. However, altering one’s lifestyle should come first.