Relative contributions of health behaviours versus social factors on perceived and objective weight status in Canadian adolescents

Abstract

Objectives Public health interventions for adolescent “obesity prevention” have focused predominantly on individualistic health behaviours (e.g., diet and physical activity) at the expense of recognizing body weight diversity and the array of social factors (e.g., stigma and discrimination of marginalized identities) that may be linked to weight status. Research is needed to examine the extent to which individualistic health behaviours versus social factors contribute to weight status in adolescents. As such, the aim of this study was to investigate the relative contribution of individualistic health behaviours versus social factors to objective and perceptual indices of weight status. Methods Cross-sectional survey data were collected as part of the Toronto Public Health Student Survey and comprised students 12 to 19 years of age (N = 5515). Measures included perceived and objective weight status, social and demographic factors (e.g., gender, sexual orientation, school connectedness), and health behaviours (e.g., physical activity, nutritious consumption). Results Findings from latent variable regression models partially supported hypotheses, whereby social factors (i.e., age, sex, socio-economic access, sexual minority status) contribute similar amounts of variance, or relatively more variance in weight indices, compared to health behaviours (e.g., physical activity, nutritious consumption). Conclusion Contrary to traditional views of adolescent weight status, physical activity (i.e., school-based, individual, active transport) and nutritious consumption (i.e., fruits, vegetables, milk) were not associated with weight status, when considering social factors. These findings challenge the utility of public health approaches that target individualistic behaviours as critical risk factors in “obesity prevention” efforts in adolescence.