Potential barriers to prevention and intervention of overweight among adolescents in Baltimore City

Over 33% of children in the U.S. are overweight or at risk for overweight. This study used a cross-sectional design to identify risk factors that may serve as barriers to prevention of overweight status in urban adolescents. The study sample included 926 adolescents (Mean age [SD] 16.6 [1.1]; 83.9% were African American) seen for routine health care in school-based clinics. Health risk behaviors were identified in the following areas: School, Drugs, Safety, Family, Emotional Response, Weight Perception, and Sexual Activity by utilizing the Guidelines for Adolescent Preventive Services (GAPS) questionnaire. Weight status was assessed using body mass index (BMI,kg/m2) percentile categories set by the Centers for Disease Control and Prevention. Thirty-five percent of adolescents were overweight (³95%) or at risk for overweight (85%-95%). Multivariate linear regression analysis, adjusted for race, gender, and age, demonstrated that youth who reported marijuana use was associated with a mean BMI percentile increase of 5.24 percentile points (95% CI, 0.02-10.46, p<0.05) compared to youth who did not use marijuana. Statistically significant associations were found between increased mean BMI percentile and carrying a weapon, 5.51 (95% CI, 0.99-10.04, p<0.05) and ever having sexual intercourse, 5.81 (95% CI, 1.91-9.72, p<0.05). Given the association between these health risk behaviors and increasing BMI, health risk behaviors should be addressed in conjunction with weight management during clinical care. Future research should examine the effects of risk behaviors on programmatic attempts to intervene on overweight status and the maintenance of a healthy weight in urban high school students.