Association of Overweight and Obesity with Health-Risk Behaviors among US Youth

Background:

Adolescents who are overweight or obese are especially vulnerable to risky behavior, given the high prevalence of social and psychological problems among this group. The purpose of this study is to examine the association between selected adolescent health-risk behaviors (substance-use, violence, bullying) and degree of overweight among US adolescents.

Methods:

Self-reported height and weight, substance use (cigarette, alcohol, cannabis use), violence (physical fights, weapon-carrying) and bullying (bullying-victim, bullying-perpetrator, bullying-victim/perpetrator) were assessed in a nationally representative sample of students aged 11 to 16 years (n=6,664) who participated in the 2005 Health Behaviors in School-Aged Children survey. African-American and Hispanic students were over-sampled to provide better population estimates. The association between overweight and obesity status, and each of the risk behaviors, was examined using logistic or multinomial regression. Analyses were performed separately for boys and girls. Interactions by age and race were examined.

Results:

Overweight and obese girls were significantly more likely than normal-weight girls to smoke, drink and use cannabis. Obese girls were significantly more likely to be bully-victims, bully perpetrators, and to engage in physical fights. For boys, no difference in the association of overweight/obesity with smoking, drunkenness, cannabis use and weapon carrying was noted. Obese boys were more likely to drink and to be bully-victims. Some associations varied by race and age.

Conclusion:

Substantial gender differences in the relationship of overweight/obesity with health risk behaviors are noted, with overweight/obese girls experiencing more adverse outcomes than overweight/obese boys.