Despite the established psychological cost of adolescent obesity, current literature fails to thoroughly explore how some psychosocial mechanisms, i.e. bullying, family and body image, are mediating mental health consequences. Moreover, research is largely concentrated in high-income countries, which limits global generalizability.
The review followed the PRISMA 2020 guidelines to promote transparency and replicability. Data mapping and search strategy: Databases searched included PubMed (n = 25), ScienceDirect (n = 15), Emerald Insight (n = 5) and others (n = 25). Keywords used for Boolean search were “adolescent obesity,” “mental health,” “depression,” “self-esteem,” “bullying” and “body image.” Reference management was performed with the help of Zotero software. Screening process: In total, 70 articles were found initially. Duplicate and noneligible studies were removed (n = 10), leaving 50 articles. Another 5 were screened out as irrelevancies, and 45 full texts were screened out, excluding another 5 for lack of peer review or obsolete methodology. Thirty peer-reviewed high-quality articles were finally included. Inclusion criteria: Studies were eligible for inclusion if they were related to adolescents (10–19 years old); assessed mental health outcomes related to overweight or obesity; published in the range 2000–2024 and peer-reviewed; and reported clear data on psychosocial interventions or mediators.
RQ1 – Mental health outcomes: Obese adolescents are at greater risk of depression, anxiety and low self-esteem. This relationship is strengthened by internalized stigma and negative self-perception. RQ2 – Psychosocial mediators: Psychological responses are greatly influenced by stigma, teasing and family dynamics. Adolescent victims of frequent bullying have depressive symptoms regardless of BMI. RQ3 – Methodological and cultural gaps: Few longitudinal studies exist, and most use Western-dominated samples. Cross-sectional studies limit causal inference, and there is heterogeneity in operationalization of psychological constructs. RQ4 – Interventions: Fewer than half of the studies offered interventions. These were most commonly cognitive-behavioral therapy, family-based interventions or school-based body image improvement. Holistically integrated treatments that address mental and physical health at the same time are still scarce.
Limitations include overrepresentation of studies from high-income nations, overreliance on cross-sectional data, decreased focus on resilience development and cultural interventions and inconsistent theoretical model application.
This review critically examines the role of overweight and obesity in the trends of mental health outcomes among adolescents from 1988 to 2024. It also emphasizes the vital role played by weight status in determining psychological health as well as mental health outcomes. Obese status has been associated with risk for anxiety and depression, though interventions for improved mental health are also an area of future study. However, the area is limited by a lack of longitudinal research, methodological balance and varied cultural settings. Future studies should focus on developing resilience and evidence of health-care systems’ capacity in addressing physical and mental health-care needs.
