The association between weight control behaviors and health literacy among adolescents: a cross-sectional study

The global rise in adolescent obesity underscores the need for effective weight control behaviors (WCBs) as an integral part of adolescents' lifestyles. Health literacy (HL), widely recognized as a key determinant of health outcomes, is an important factor in supporting informed health decisions. Given the potential influence of HL on health behaviors, this study aims to examine the association between WCBs and HL among adolescents in Tehran, Iran.

A cross-sectional study was conducted from September to November 2021 across ten health service centers in southern Tehran. Adolescents were recruited via multistage random sampling. Data were collected using validated self-administered questionnaires assessing demographics, WCBs (healthy, unhealthy, and very unhealthy), and HL using the Health Literacy in School-Age Children scale. Descriptive statistics summarized participant characteristics and behaviors. A generalized linear model was used to adjust for age and BMI. In all tests, p < 0.05 was considered statistically significant.

Among the 240 adolescents included (mean age 14.25 ± 1.29 years; 48.8% female), 73.8% had a normal BMI, 7.1% were underweight, and 19.1% were overweight/obese. Nearly all (97.1%) reported at least one healthy WCB; 65.5% reported at least one unhealthy, and fewer than 5% reported very unhealthy behaviors. The mean HL score was 34.23 ± 4.48. Higher HL was associated with healthy WCBs, with odds increasing 3.4-fold from low to high HL (p < 0.001). No significant associations were detected between HL and unhealthy or very unhealthy WCBs.

These findings underscore the relevance of HL in promoting healthy WCBs among adolescents. The study highlights the potential value of developing strategies and programs to enhance HL, particularly for adolescents with higher BMI or those at risk of unhealthy behaviors, to support healthier lifestyle choices. Future longitudinal research is needed to further clarify the relationship between HL and WCBs over time.