Geographic variation and temporal trends in adolescent obesity prevalence in India: A systematic review and meta-analysis
Keywords:
adolescent obesity, India, meta-analysis, temporal trend, BMI reference standardAbstract
Background: Adolescent obesity is an increasingly serious public health issue in India, with prevalence estimates varying significantly across studies due to differences in populations, geographic areas, and inconsistent methods for classifying body mass index (BMI). This study aims to estimate the pooled prevalence of obesity among Indian adolescents using a larger study pool (k=56), based on BMI reference standards, geographic regions, and study settings, assess trends through cumulative meta-analysis and meta-regression, and test for publication bias.
Methods: A systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines. Searches spanned 1 January 2002 to 31 December 2024 across PubMed, MEDLINE, Embase, and Google Scholar, yielding 2,847 records. We included 56 cross-sectional studies, comprising a total of 35,161 adolescents from 24 states. A random-effects meta-analysis of logit-transformed proportions (using the DerSimonian–Laird method) was conducted, along with five subgroup analyses and dual sensitivity analyses.
Results: The pooled prevalence of adolescent obesity was 7.0% (95% CI, 6.6–7.4; I²=57.8%; τ2=0.34; prediction interval: 4.9%–9.9%). The first regional subgroup analysis identified West India (7.8%) as the highest -prevalence zone. Among regions with multiple studies, South India was lowest (6.8%). The World Health Organization (WHO) criteria (k=32) demonstrated near-acceptable within-subgroup homogeneity (I²=34.0%). Meta-regression showed no statistically significant temporal trend across 2002–2024 (P=0.44). The leave-one-out range was 6.9%–7.1%.
Conclusion: Adolescent obesity in India is a substantial public health burden. West India, the highest-burden region, requires prioritised intervention. WHO BMI standardisation criteria provided the most homogenous estimates. There was no temporal trend in the prevalence over a span of 22 years.
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Copyright (c) 2026 Diptimayee Dash, Ankita Sarmaa, Saurav Anand, Narmata Kharat, Meet M Chauhan, Hemeswari Bhuyan, Manas Ranjan Behera, Paramjot Panda
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