Inclusion Criteria:  11 to less than 16 years old BMI > 30 kg/m^2 or 95th BMI percentile Tanner stage 2, 3, or 4  Exclusion Criteria:  Tanner stage 1 and 5 Prior bariatric surgery Current or recent (< 3 months prior to enrollment) use of anti-obesity medication(s) defined as orlistat, metformin, phentermine, topiramate, combination phentermine/topiramate, liraglutide, and/or combination naltrexone/bupropion (monotherapy use of naltrexone or bupropion is not an exclusion) Monogenic and hypothalamic obesity Polycystic ovary syndrome (diagnosed by a physician) Pregnancy or planned pregnancy