Physical activity participation and obesity-related risk behaviors among male Saudi adolescents: a social cognitive theory perspective.

BACKGROUND: Compounded by physical inactivity and an obesogenic environment, adolescent obesity represents a significant public health challenge for Saudi Arabia. Drawing on Social Cognitive Theory (SCT) as a conceptual lens, this study aimed to compare obesity-related risk behaviors among physically active and physically inactive male Saudi adolescents. METHOD: Using a cross-sectional design and convenience sampling, male Saudi high school students (N = 124) aged 16-17 years in Riyadh were classified into physically active (n = 70; self-reported vigorous-intensity activity or structured ≥3 days/week) and physically inactive (n = 54) participants. BMI was classified according to International Obesity Task Force (IOTF) cutoffs, and waist-to-height ratio (WHtR) defined abdominal obesity. Lifestyle behaviors (PA, screen time, sleep, and diet) were assessed using the Arab Teen Lifestyle Study (ATLS) questionnaire. RESULTS: Physically inactive participants had a significantly higher BMI than physically active peers (30.28 vs. 23.64 kg/m2; p < 0.001; d = 1.060), waist circumference (97.35 vs. 85.46 cm; p < 0.001; d = 0.866), and WHtR (0.562 vs. 0.488; p < 0.001; d = 0.927). By IOTF criteria, 51.9% of physically inactive participants were obese versus 17.1% of physically active participants, and 72.2% exhibited abdominal obesity (WHtR ≥ 0.50) versus 31.4%. Physically active participants accumulated significantly greater METs-min/week (4,083.9 vs. 2,225.0; p < 0.001; d = 0.667) and PA minutes/week (795.6 vs. 421.9; p < 0.001; d = 0.758); 68.6% were highly active versus 24.1% of physically inactive participants, while 63.0% of physically inactive participants were sedentary. Screen time and sleep did not differ significantly between groups; insufficient sleep was prevalent in both groups (84.3% vs. 83.3%). Of ten dietary behaviors assessed, only fresh fruit consumption was significantly higher among physically active participants (5.44 vs. 4.24 days/week; p = 0.006; d = 0.520). CONCLUSION: Physically active was associated with lower obesity risk in male Saudi adolescents, with large between-group differences in BMI, WHtR, and abdominal obesity. Unsatisfactory screen time and sleep profiles across both groups suggest a pervasive obesogenic environment irrespective of PA status. These cross-sectional findings highlight the potential value of PA promotion, dietary reforms, and screen time and sleep initiatives for this population.