Obesity in Adolescents: Understanding the Combined Role of Food Security and Emotional and Behavioral Disorders



      To examine the associations and interactions between levels of food security and emotional and behavioral disorders with obesity in adolescents.


      Multiple logistic regression modeling was used to analyze the association of adolescent obesity with levels of food security and emotional and behavior disorders in children aged 12–17 years using data from National Health Interview Survey 2016–2018 combined years. Presence of emotional and behavioral disorders within food security categories was added to logistic regression modeling to examine interactions.


      When added individually to multiple logistic regression models, marginal and low food security, Attention Deficit Hyperactivity Disorder (ADHD) and anxiety were associated with increased odds of obesity, but very low food security and depression were not. Within the group of adolescents with very low food security, those with anxiety, depression, or ADHD had a nearly two to three-fold increase in odds of obesity compared to adolescents with very low food security and no emotional and behavioral disorders. A similar increase in the odds of obesity with the presence of anxiety, depression, or ADHD was not seen in the adolescents with high food security.


      This study finds a significant interaction between food security level and emotional and behavioral disorders. The distinction that very low food security in adolescents is only associated with obesity when either anxiety, depression or ADHD are present, but not independently, is an important contribution to understanding complex interactions contributing to obesity.


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