Afrin Khan, Alexis Karamanos, Amal R Khanolkar
Adolescents who experienced socioeconomic disadvantage, exposure to adversity, and with SM identity were more likely to show persistent or new-onset MH-OB comorbidity, with associations generally stronger in females than in males. These findings highlight the importance of early, integrated interventions that address both mental health and weight-related risks in structurally disadvantaged groups.
BACKGROUND: Depression and obesity are common chronic conditions in adolescence with major health consequences. While adverse childhood experiences (ACEs), socioeconomic disadvantage, and sexual minority (SM) identity are linked to higher mental health-obesity (MH-OB) comorbidity, evidence on predictors of change during adolescence is limited.
METHODS: Data came from 10,353 UK adolescents (49% male, 80.9% White, 9.1% SM) in the Millennium Cohort Study. MH-OB comorbidity was defined using overweight/obesity (International Obesity Task Force criteria) and depression/anxiety symptoms (Strengths and Difficulties Questionnaire emotional symptoms subscale) at ages 14 and 17. Change in comorbidity was categorised as none, persistent, resolved, or newly developed. Predictors included sex at birth, ethnicity, sexual identity, socioeconomic position, and cumulative ACEs. Multinomial logistic regression estimated adjusted relative risk ratios (aRRRs).
RESULTS: At age 14, 7.7% of adolescents were obese, 19.5% overweight, and 27.8% reported depression/anxiety symptoms. By age 17, 2.5% had persistent MH-OB comorbidity, 6.2% newly developed comorbidity, and 2.8% resolved; 88.0% had no comorbidity. Female sex, SM identity, lower household income, and increasing ACE exposure were associated with persistent and newly developed comorbidity. Associations were strongest among SM adolescents and females. Exposure to three or more ACEs increased risk of persistent comorbidity.
CONCLUSION: Adolescents who experienced socioeconomic disadvantage, exposure to adversity, and with SM identity were more likely to show persistent or new-onset MH-OB comorbidity, with associations generally stronger in females than in males. These findings highlight the importance of early, integrated interventions that address both mental health and weight-related risks in structurally disadvantaged groups.