Factors associated with normal-weight obesity in adolescents

A new phenotype of obesity has been studied: normal-weight obesity (NWO), which describes individuals with normal-weight by BMI and excess body fat. Despite normal-weight, individuals with NWO have a higher cardiometabolic risk. There is still a gap in the literature on the subject, especially in adolescents, as studies with this population are scarce. This study aims to investigate the sociodemographic factors, family history of chronic non-communicable diseases, body perception, lifestyle and food consumption associated with NWO in adolescents. This is a cross-sectional study, with 506 normal-weight adolescents aged 10-19 years, of both sexes. Weight and height were obtained, and BMI/ age was calculated. Body fat analysis was performed using dual-energy X-ray absorptiometry. Sociodemographic data, level of physical activity, food consumption, body self-perception and lifestyle habits were also obtained. Logistic regression with hierarchical approach was used to analyse the associations. The odds of NWO are greater with age (OR = 1.14; 95 % CI = 1.04, 1.26), lower in male adolescents (OR = 0.21; 95 % CI = 0.11, 0.41) and higher in those with a history of familial dyslipidemia (OR = 1.81; 95 % CI = 1.01, 3.28). Adolescents satisfied with their body (OR = 0.30; 95 % CI 0.16, 0.56) and physically active (OR = 0.44; 95 % CI = 0.24, 0.81) have a lower odds of NWO, compared with the others. In addition, it was observed that the odds of NWO is greater among adolescents who use sweeteners (sugar substitutes) (OR = 3.84; 95 % CI = 1.70, 8.65). The factors associated with NWO were female sex, older age, positive family history of dyslipidemia, lower body satisfaction, lower level of physical activity and greater use of sweeteners.