Role of breakfast skipping, depression, and other risk factors for obesity: The Youth Risk Behavior Surveillance System

Background and objectives: Obesity among adolescents is a significant public health concern in the United States. The prevalence of obesity has increased from 13.0% in 2011 to 15.5% in 2019. The association between breakfast skipping and obesity is still controversial, and a mediator role of depression in this association is limited. The purpose of this study was to investigate the independent association between breakfast skipping and obesity and to investigate the mediator role of depressive symptomology between breakfast skipping and obesity prevalence. Materials and methods: In this cross-sectional study, data were extracted from the CDC's Youth Risk Behavior Surveillance System (YRBSS) for 9th to 12th graders from 2011 through 2020. SAS version 9.4 was used to analyze the data using proc survey frequency and proc survey logistic regression models. The adjusted odds ratios (aORs) with 95% confidence intervals (CI) were estimated. The Sobel test also was performed to test the mediator role of self-reported depression. Results: Of the 56,320 adolescents, 13.7% did not eat breakfast, 14.1% were obese, and 15.1% had depressive symptomology. Breakfast non-eaters was associated with a 24% increased odds of obesity (aOR: 1.24; 95% CI: 1.14 to 1.36) after adjusting for race/ethnicity, gender, grade level, and behavioral risk factors. A mediator role of self-reported depression was noted using the regression model and Sobel test (z = 3.90, S.E. = 0.02, p< 0.0001) between breakfast skipping and obesity. Conclusions: Breakfast skipping was independently associated with obesity. Self-reported depression was identified as a mediator factor. Therefore, the mental health condition also needs to be addressed in the prevention of obesity among adolescents. IMC J Med Sci 2022; 16(2): 001 *Correspondence: Azad R. Bhuiyan, Department of Epidemiology and Biostatistics, School of Public Health, College of Health Sciences, Jackson State University, Jackson, MS 39213, USA. Email: azad.r.bhuiyan@jsums.edu