Association of adolescent obesity with Anxiety, Depression and Attention-Deficit/Hyperactivity disorder in the Arab population in Israel - a nationwide study.

The health ramifications of adolescent obesity are understudied in the Israeli Arab population, and the impact of ethnicity on the association of obesity with mental health problems is unclear. To examine the association of weight categories with Anxiety, Depression and Attention-Deficit/Hyperactivity Disorder (ADHD) among Arab adolescents in Israel and to compare this association to a Jewish comparison group. A cross-sectional nationwide study of 313,936 Arab adolescents aged 14-19 years between the years 2007-2022, and 289,616 Jewish adolescents in a comparison group. The aORs for Anxiety, Depression and ADHD in Arab adolescents increased from a reference 'normal weight' category to 'class 3 obesity', reaching aORs (95 % CI) of 1.31 (1.16-1.47), 1.64 (1.31-2.02) and 1.51 (1.40-1.63) in 'class 2 obesity', and 1.51 (1.20-1.87), 2.81(2.00-3.84) and 1.69 (1.45-1.96) in 'class 3 obesity', respectively. The dose-dependent association between weight categories and psychiatric comorbidity was confirmed in sensitivity analyses with comorbidity with the purchase of medications serving as the dependent variable. The Jewish comparison group demonstrated a comparable increment in aORs with increase in weight category. The association between excessive weight categories and psychiatric comorbidities was stronger in Arab females, than in males. Relying on the recorded weight and height measurements and the diagnoses of psychiatric comorbidity could lead to bias. The study findings emphasize the need to relate to the mental health of adolescents with excessive weight, which can improve their overall quality of life and the success of adolescent weight loss intervention programs.

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Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.