Multidimensional Analysis of Obesity in Middle School Students: Causes, Effects and Systematic Intervention Strategies

Abstract

This study conducts a systematic analysis of the multidimensional causes, health impacts, and intervention strategies related to obesity among Chinese middle school students. Through a systematic review of 98 Chinese and English literature articles published between 2018 and 2023, adhering to the PRISMA protocol, three core mechanisms contributing to obesity were identified: dietary imbalance (17.3%–53.1% of students had irregular breakfast routines, OR = 1.325–2.833), reduced physical activity (only 18.4% met daily exercise standards), and psychological compensation (33.2% engaged in emotional eating, OR = 3.11 for bullying-related depression). Obesity was found to increase systolic blood pressure by 4.36–10.79 mmHg (P < 0.01) and reduce academic performance by 2.743 standard deviations. Systemic risks are also associated with community environments, with low-income areas having only one-third the sports facility density of high-income regions. The study validated the distinct benefits of resistance training (reducing acylated ghrelin, SMD = -1.05) and high-intensity interval training (reducing ghrelin, SMD = -0.88). A four-tier intervention framework based on the socio-ecological model—encompassing individual micro-behavioral adjustments, family contracts, school policies, and social legislation—was proposed. This framework provides a viable approach for achieving the "Healthy China 2030" goal of zero growth in adolescent obesity adolescent obesity.