Prevalence and Factors Associated With Obesity Among School-Going Adolescents of Guwahati City

Background Adolescent obesity is a growing public health concern in urban India, but region-specific data from Guwahati are limited. This study estimated the prevalence of obesity and the factors associated with it among school-going adolescents in Guwahati. Methods A community-based cross-sectional study was conducted among 705 school-going adolescents, including 368 (52.2%) boys and 337 (47.8%) girls, aged 10-19 years, selected from government and private schools of Guwahati through stratified random sampling over one year. Anthropometric measurements were taken, and a predesigned and pretested semi-structured schedule was used to collect information on socio-demographic characteristics, dietary habits, physical activity, screen time and substance use. BMI was classified using standard BMI criteria, with obesity defined as BMI ≥25.0 kg/m². Obesity versus non-obese status was the primary outcome. Its association with categorical variables was assessed using the Chi-square test. The independent t-test was used to compare mean values of continuous anthropometric variables (height, weight, body mass index, waist circumference, hip circumference, and waist-to-hip ratio) between male and female adolescents. Because no adolescent in the lowest screen-time category was obese, a dose-response trend test (a trend odds ratio from grouped logistic regression, checking whether obesity risk rose steadily with increasing screen time) was used in place of a category-specific odds ratio. A p-value<0.05 was considered statistically significant. Results Among the 705 adolescents, the prevalence of obesity was 8.1% (57/705); for descriptive context, 112 (15.9%) were overweight, and 130 (18.4%) were underweight. Obesity (versus all non-obese adolescents, i.e. underweight, normal weight, and overweight combined) was significantly associated with regular physical activity (p<0.001; OR 5.14, 95% CI 2.94-8.97), screen time (dose-response trend OR 1.87 per one-category increase, 95% CI 1.43-2.43, p<0.001), fruit consumption (p = 0.032; OR 1.81, 95% CI 1.05-3.14), vegetable consumption (p = 0.025; OR 1.89, 95% CI 1.07-3.31), and trans-fat consumption (p = 0.021; OR 1.98, 95% CI 1.10-3.56). Adolescents with lower levels of physical activity, longer daily screen time, infrequent fruit and vegetable consumption, and frequent trans-fat consumption had a higher prevalence of obesity. No statistically significant association was observed between obesity and age, gender, or socioeconomic status (p>0.05).  Conclusion The substantial burden of obesity among urban adolescents in Guwahati reflects India's ongoing nutrition transition. Interventions targeting screen time reduction, increased physical activity, and healthier dietary habits may help address this emerging epidemic.