Overweight, Obesity and Associated Factors Among Private Lower-Secondary School Adolescents of Yeka Sub-City Addis Ababa, Ethiopia. A Cross Sectional Study

In many parts of the world, a quiet shift is taking place in the health of children. For decades, the focus of public health has often been on hunger and malnutrition, but a new challenge is rising alongside it: the rapid increase in excess body weight. This condition, where a person carries more body fat than is healthy, is not just about appearance; it is a gateway to serious long-term illnesses like diabetes and heart disease. The risk begins early. When children and teenagers carry extra weight, they are far more likely to remain overweight as adults, locking them into a cycle of health problems that can last a lifetime. This trend is driven by a complex mix of factors, including the availability of processed foods, changes in how families move through their day, and the environments in which children grow up. Understanding exactly who is at risk and why is the first step toward protecting the next generation.

In a specific corner of Ethiopia, researchers set out to measure this growing problem among a group that is often overlooked: students attending private schools in the capital city, Addis Ababa. They focused on adolescents, young people between the ages of ten and nineteen, within the Yeka sub-city. The team, led by public health experts, wanted to know how many of these teenagers were carrying excess weight and, more importantly, what daily habits or family circumstances were pushing them toward it. They chose private schools because these institutions often serve families with different economic means than public schools, and the researchers suspected that lifestyle factors in these households might be driving the trend.

To find the answers, the team visited schools across four different neighborhoods in the Yeka sub-city. They did not rely on guesswork or self-reported stories; instead, they measured the students directly. Using precise scales and height rods, they recorded the weight and height of 419 students who agreed to participate. They also sat down with each student for a face-to-face conversation, asking detailed questions about their lives. The interview covered everything from how they traveled to school and how much time they spent sitting in front of a television, to what they ate for breakfast and how many hours they slept. The researchers were looking for patterns, trying to see if certain behaviors consistently appeared in the lives of the students who were overweight or obese.

The results revealed a significant public health concern. Nearly one in four students, or 24.1 percent, was found to be either overweight or obese. This means that in a classroom of twenty students, roughly five would fall into these categories. The researchers broke this down further, finding that 19.1 percent were overweight and 5 percent were obese. These numbers are notably higher than what has been seen in other parts of Ethiopia, suggesting that the environment in these private schools and the homes of their families plays a critical role. The study confirmed that this is not a random occurrence but is linked to specific, observable parts of daily life.

The investigation uncovered several clear drivers behind these numbers. One of the strongest factors was age. The study found that younger adolescents, specifically those around twelve years old, were significantly more likely to be overweight than their older peers. This might seem counterintuitive, as one might expect weight issues to accumulate with age, but the data showed that the younger group in this specific setting was at higher risk. Another major factor was the work of the students' mothers. When a mother ran a private business, her children were much more likely to be overweight compared to children whose mothers were housewives or government employees. The researchers suggest this connection exists because mothers working in private businesses may have more exposure to markets and supermarkets, making processed and packaged foods more accessible to their families.

Diet and movement were the other pillars of the findings. The students who frequently ate burgers or fast food were far more likely to be overweight than those who ate traditional meals like injera. Similarly, the amount of physical activity mattered deeply. Students who exercised less than three times a week faced a higher risk of carrying excess weight. Interestingly, the way students traveled to school also told a story. Those who rode bicycles one or two times a week were at higher risk than those who rode three or more times a week. The researchers noted that riding a bicycle is a form of physical activity, but doing so only occasionally may not be enough to offset other lifestyle factors, or it might indicate a lifestyle where the bicycle is used sporadically rather than as a primary mode of transport. In contrast, students who walked or cycled frequently as part of their daily routine appeared to have better outcomes.

The study did not find a link between the number of siblings a child had or the specific type of oil used in cooking and the risk of obesity. It also showed that while many students watched television for long periods, the most significant predictors remained the specific types of food eaten, the frequency of exercise, and the family's economic activities. The researchers concluded that the high prevalence of overweight and obesity in these private schools is a real and emerging problem. It is not caused by a single mistake but by a combination of dietary choices, movement habits, and family circumstances. By identifying these specific factors, the study provides a clear map for health planners and school officials. It suggests that to protect these children, interventions must go beyond simple advice to eat better; they must address the specific routines of these families, encouraging more consistent physical activity and guiding food choices away from the fast foods that are becoming increasingly common in these households.