Objective With the global obesity crisis worsening and China launching the "Weight Management Year" initiative, demand for weight management medical devices has grown significantly. This study focuses on two key issues: the lack of a unified global classification framework for such devices and the fragmented understanding of international regulatory differences. It systematically analyzes the regulatory environments of major regions—including the United States, the European Union, Japan, South Korea, Australia, and Canada—with the goal of providing references for formulating China’s domestic regulatory strategies.

Methods The study adopts a comparative analysis approach from the perspective of medical device classification. It examines the regulatory frameworks applicable to core products like intragastric balloons, cryolipolysis devices, and medical-grade smart body fat scales. Key focus areas include comparing how different countries handle device classification, restrict product claims, and require clinical evidence. Additionally, the study analyzes existing controversies, such as ambiguities in device definitions and inconsistencies in risk assessment standards.

Results The analysis shows notable differences in regulatory philosophies across countries. The United States uses a model centered on risk and efficacy; the European Union emphasizes technical substantiation and full product lifecycle management; Japan and South Korea prioritize adaptability to local populations. A critical problem is the lack of unified core performance parameters: for example, the required fat reduction rate for cryolipolysis devices is ≥20% in the US but ≥15% in the EU, and there are no consistent thresholds for body fat measurement accuracy. This not only creates regulatory ambiguity but also leaves room for regulatory arbitrage. Overall, the global regulatory environment for weight management devices remains uncoordinated, facing challenges from vague definitions and inconsistent standards.

Conclusion Drawing on international experiences and China’s specific regulatory context, this study proposes a framework for a China-specific regulatory system for weight management devices. Core recommendations include: refining technical and clinical standards for key products like medical-grade smart body fat scales; strengthening management of intended use claims to clarify regulatory boundaries; and establishing a closed-loop, full-lifecycle management system integrated with real-world data. These measures are expected to shift China’s regulatory model from reactive response to proactive leadership, ultimately contributing a "Chinese solution" to both high-quality industrial development and global regulatory harmonization.