Sex Differences in the Association between Mental Health and Obesity Among Korean Adolescents

Vollständiger Abstract

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Objectives: Adolescent obesity has become an increasingly important global public health issue, and mental health problems are recognized as possible contributing factors. This study aimed to examine the associations between various mental health indicators and obesity among Korean adolescents, with differences by sex.Methods: This study analyzed data from the 19th Korea Youth Risk Behavior Survey (2023), including 49,126 students aged 13-18 years (24,941 males and 24,185 females). Mental health indicators included perceived stress, depression, suicidal ideation, suicide plans and attempts, loneliness, sleep sufficiency, smartphone overdependence, and generalized anxiety disorder. Obesity was defined as ≥95th percentile of body mass index according to the 2017 Korean Growth Chart. Rao–Scott chi-square and logistic regression analyses were conducted, accounting for sampling design and weights, and adjusting for covariates.Results: The prevalence of obesity was 16.1% in males and 9.6% in females. Perceived stress differed by obesity status in both sexes, but was positively associated with obesity in males only (odds ratio, OR=1.13; 95% confidence interval, CI: 1.07-1.20). In fully adjusted analyses, sleep insufficiency and loneliness showed negative associations with obesity in males. Among females, depression was negatively associated with obesity (OR=0.88; 95% CI: 0.78-0.98) and suicidal ideation was positively associated (OR=1.18; 95% CI: 1.01-1.38).Conclusions: These findings suggest that mental health factors are associated with obesity in Korean adolescents, with notable sex differences in the pattern of associations. These sex-specific patterns highlight the importance of incorporating mental health considerations into sex-specific adolescent obesity prevention strategies.