Objective: To optimize diagnosis and treatment of metabolic syndrome in adolescents with exogenously-constitutional obesity Methods: Twenty-nine adolescents with exogenously-constitutional obesity of varying severity were examined, the average age was 13.0 ± 2.6 years living in the Fergana region of Uzbekistan. Diagnosis of the metabolic syndrome was carried out on the basis of diagnostic criteria IDF 2007. The risk of developing the metabolic syndrome was calculated using the computer program developed around the waist circumference in children and adolescents of the Uzbek population. The treatment was carried out using a hypocaloric diet developed for children and adolescents (Rakhimova GN, Azimov S.S., 2016), depending on the age, taking into account the national cuisine Results: In assessing the components of the metabolic syndrome of children and adolescents with exogenously constitutive obesity, WC ≥ 90 and BMI > 97 percentiles were found in all 29 subjects. Metabolic syndrome is diagnosed in 6 (24.0%) adolescents 10~16 years with exogenously-constitutional obesity. Violation of carbohydrate metabolism (fasting glycemia> 5.0 mmol/L) was detected in 3 (10.3%) of the examined. An increase in blood pressure above the IDF criterion (SBP ≥ 130 mm Hg DBP ≥ 85 mm Hg) was detected in 3 (10.3%) patients. Dyslipidemia in particular: hypertriglyceridemia in 4 (13.8%), a decrease in high-density lipoproteins < 1.03 mmol/L was detected in 6 (20.7%). Against the background of hypocaloric diet, after correction of diet and lifestyle, the normalization of fasting glycemia in 2 (6.9%), the level of triglycerides decreased by half, the level of high-density lipoproteins also increased 2-fold. After 3 months, all subjects had normal hemodynamic index. Conclusion: Thus, the initial metabolic syndrome was diagnosed in 6 (24.0%), against a background of lifestyle correction and a hypocaloric diet developed in 2 of them, the metabolic syndrome was not diagnosed.