Associations Between Digital Lifestyle, Social Factors, and Adolescent Obesity: A Case-Control Study in Tasikmalaya Regency, Indonesia
Keywords:
Adolescence, Obesity, Online Gaming, Screen Time, Sleep DurationAbstract
The rising prevalence of overweight and obesity today is associated with various factors, including digital behaviors and the social environment. This study examines the relationships between screen time, sleep duration, attitudes, physical activity, average gaming time, and the number of gaming peers with the incidence of obesity among adolescents. This study is a matched case-control study design. The study population comprises adolescents aged 16–18, encompassing both case and control groups. The case population includes adolescents with obesity in Leuwisari District, while the control population comprises non-obese adolescents from the same location. Case samples were determined based on data from the AUSREM Program, identifying 42 obese adolescents. Meanwhile, the control sample consists of non-obese adolescents selected purposively with a 1:1 matching ratio to the case group, ensuring comparable characteristics. Consequently, the total sample size for this study amounts to 84 participants. Data collection was conducted through questionnaires. Data analysis for screen time, sleep duration, attitudes, and physical activity used the McNemar test. Meanwhile, Pearson correlation was applied to measure the correlation between average gaming time and the number of gaming friends. The results indicate that variables significantly associated with adolescent obesity include screen time (OR=6.33, p=0.000), sleep duration (OR=4.25, p=0.004), Adolescents' attitudes toward obesity (OR=8.17, p=0.004), physical activity (OR=6.00, p=0.004), average gaming time (r=0.624, p = 0.012), and number of gaming friends (r=0.509, p = 0.000).
Downloads
References
Sultana S, Rahman MM, Sigel B, Hashizume M. Associations of lifestyle risk factors with overweight or obesity among adolescents: a multicountry analysis. Elsevier BV; 2021. 742-50 p.
Setiyo Nugroho P, Wijayanti A, Sunarti S, Suprayitno. Obesity and Its Risk Factors Among Adolescents in Indonesia. Malaysian Journal of Medicine and Health Sciences. 2020;16:2636-9346.
BRIN. [Challenges and Strategies for Addressing Child and Adolescent Obesity Jakarta]: Badan Riset dan Inovasi Nasional; 2024 [cited 2025. Available from: https://brin.go.id/reviews/118905/tantangan-dan-strategi-penanganan-obesitas-pada-anak-dan-remaja.
Kemenkes, I BPdPKKKR. [Basic Health Research 2018]. Jakarta: Badan Penelitian dan Pengembangan Kesehatan Kementerian Kesehatan RI; 2018.
Kemenkes. [Recognize Nutrition Problems Threatening Indonesian Teenagers]: Kementerian Kesehatan Indonesia; 2018 [Available from: https://sehatnegeriku.kemkes.go.id/baca/rilis-media/20180515/4025903/kenali-masalah-gizi-ancam-remaja-indonesia/.
Leuwisari P. [High School Health Screening Report]. Tasikmalaya 2023.
Silva A, Silva L, Lopes I, Francisco ACd, Neto ACdA, Monteiro MJ, et al. Association of Dietary Pattern and Physical Inactivity With Hypertension, Obesity, Diabetes, and Metabolic Syndrome. 2024.
Gordon‐Larsen P, McMurray RG, Popkin BM. Determinants of Adolescent Physical Activity and Inactivity Patterns. Pediatrics. 2000;105(6):e83-e.
Gülü M, Yagin FH, Gocer I, Yapici H, Ayyildiz E, Clemente FM, et al. Exploring obesity, physical activity, and digital game addiction levels among adolescents: A study on machine learning-based prediction of digital game addiction. 2023; Volume 14 - 2023.
Kavici S, Ayaz-Alkaya S. Internet addiction, social anxiety and body mass index in adolescents: A predictive correlational design. Children and Youth Services Review. 2024;160:107590.
Şahin N, Kırlı U. The Relationship Between Peer Bullying and Anxiety-Depression Levels in Children With Obesity. Alpha psychiatry. 2021;22(2):94-9.
di Palmo E, Filice E, Cavallo A, Caffarelli C, Maltoni G, Miniaci A, et al. Childhood Obesity and Respiratory Diseases: Which Link? Children (Basel, Switzerland). 2021;8(3).
Fortunato LM, Kruk T, Lima Júnior E. Relationship between obesity and musculoskeletal disorders: systematic review and meta-analysis. Research, Society and Development. 2021;10(13):e119101320212.
Ansari S, Haboubi H, Haboubi N. Adult obesity complications: challenges and clinical impact. 2020;11:2042018820934955.
Almuqbil M, Rabbani SI, Gilkaramenthi R, Aljawadi M, Alsanie WF, Alamri AS, et al. Non-communicable diseases in Saudi adolescents: prevalence, risk factors, and implications for public health. Frontiers in Public Health. 2025;13.
Kocakoğlu U, Karaoğlu N, Kutlu R. The relationship between computer game addiction and obesity in third and fourth-grade elementary school students. Gulhane Medical Journal. 2021;62(2):87-95.
Xiaopeng Ji, Lauren B. Covington FP, Ming Ji, Janeese A. Brownlow,. Review for "Associations between sleep and overweight/obesity in adolescents vary by race/ethnicity and socioeconomic status". National Library of Medicine. 2022.
Chang R-Y, Chen T-L, Yeh C-C, Chen C-H, Wang Q-W, Toung T, et al. Risk of obesity among children aged 2–6 years who had prolonged screen time in Taiwan: a nationwide cross-sectional study. 2023:165-76.
Lin J, Jiang Y, Wang G, Meng M, Zhu Q, Mei H, et al. Associations of Short Sleep Duration With Appetite‐regulating Hormones and Adipokines: A Systematic Review and Meta‐analysis. Obesity Reviews. 2020;21(11).
Chen Y, Zhang L, Wang M, Lu B, Shen T, Gu R, et al. Insights From Multiple Stakeholders Regarding Adolescent Obesity in China: An Exploratory Qualitative Study. Inquiry: The Journal of Health Care Organization Provision and Financing. 2024;61.
Caner N, Evgin D. Digital Risks and Adolescents: The Relationships Between Digital Game Addiction, Emotional Eating, and Aggression. International Journal of Mental Health Nursing. 2021;30(6):1599-609.
Mokhtar MC, McGee R. Impact of Internet Addiction and Gaming Disorder on Body Weight in Children and Adolescents: A Systematic Review. Journal of Paediatrics and Child Health. 2024;61(2):136-47.
Berk LE. Development through the lifespan. Boston: Sage Publications; 2022.
Patton GC, Sawyer SM, Santelli JS, Ross DA, Afifi R, Allen NB, et al. Our future: a Lancet commission on adolescent health and wellbeing. The Lancet. 2016;387(10036):2423-78.
WHO. Obesity and overweight: World Health Organization; 2024 [cited 2025 27]. Available from: https://www.who.int/news-room/fact-sheets/detail/obesity-and-overweight.
Priftis N, Panagiotakos D. Screen Time and Its Health Consequences in Children and Adolescents. Children. 2023;10(10).
Qi J, Yan Y, Yin H. Screen time among school-aged children aged 6–14: a systematic review. Global Health Research and Policy. 2023;8(1):12.
OED. Oxford English Dictionary Oxford: Oxford University Press; 2025 [Available from: https://www.oed.com/dictionary/screen-time_n?tab=factsheet#1215011640.
Haghjoo P, Siri G, Soleimani E, Farhangi MA, Alesaeidi S. Screen time increases overweight and obesity risk among adolescents: a systematic review and dose-response meta-analysis. BMC Primary Care. 2022;23(1):161.
Byun D, Kim Y, Jang H, Oh H. Screen time and obesity prevalence in adolescents: an isotemporal substitution analysis. BMC Public Health. 2024;24(1):3130.
Lahyani Y, Adarmouch L, Sebbani M, Mansoury O, El Mouaddib H, Amine M. Impact of sociodemographic factors, sleep, physical activity, and sedentary lifestyle on central obesity in schoolchildren aged 6–12 years in Marrakech, Morocco. Heliyon. 2025;11(1):e41176.
Widjaja NA, Kurube CF, Ardianah E. Sleep duration and insulin resistance in obese adolescents with metabolic syndrome: is there a correlation? Acta bio-medica: Atenei Parmensis. 2023;94(4):e2023079.
Yıldız F, Tuğrul Aksakal MZ, Yıldız R, Baş F. The Relationship Between Sleep Quality, Sleep Duration, Social Jet Lag, and Obesity in Adolescents. Journal of clinical research in pediatric endocrinology. 2024;16(4):419-25.
Mosavat M, Mirsanjari M, Arabiat D, Smyth A, Whitehead L. The Role of Sleep Curtailment on Leptin Levels in Obesity and Diabetes Mellitus. Obesity facts. 2021;14(2):214-21.
Hirshkowitz M, Whiton K, Albert SM, Alessi C, Bruni O, DonCarlos L, et al. National Sleep Foundation's updated sleep duration recommendations: final report. Sleep health. 2015;1(4):233-43.
Ayran G, Karaca O. Relationship Between Obesity Awareness and Nutrition Attitude: A Sectional Study Among Secondary School Students. Galician Medical Journal. 2023;30(4):e-GMJ2023-A02.
Özer Ö, Uyhan O, Devrilmez E, Orhan İ, Bilgiç M, Uğurlu A, et al. The relationship between attitude toward physical activity and weight gain in children and young adolescents. 2024; Volume 12 - 2024.
Kedir S, Hassen K, Melaku Y, Jemal M. Determinants of overweight and/or obesity among school adolescents in Butajira Town, Southern Ethiopia. A case-control study: Public Library of Science (PLoS); 2022.
Kim EK, Munro T. Associations between Physical Activity and Depressive Symptoms through Obesity and School Bullying among Adolescents. International Journal of Depression and Anxiety. 2021;4(1).
Li H, Choi J, Kim A, Liu G. Association between physical activity, smartphone usage, and obesity risk among Korean adolescents: A cross-sectional study based on the 2021 Korean adolescent health behavior survey. Acta Psychologica. 2025;252:104648.
Djannah SN, Tentama F, Sinanto RA. Game addiction among adolescents and its health impacts. International Journal of Public Health Science. 2021;10(3):480-92.
Olsen M, André F, Delfin C, Håkansson A, Claesdotter-Knutsson E. Children and adolescents' self-reported gaming habits – An exploratory, cross-sectional study of gaming among 9–15-year-old school children. Emerging Trends in Drugs, Addictions, and Health. 2024;4:100058.
Aguirre MdJX, Andrade FCD, Aguirre MAC, Justino JR, Maciel BLL. Social Network, Food Patterns, Physical Activity, and Associations with Overweight and Obesity in Adolescents from a School in Rural Brazil. Nutrients. 2023;15(15):3305-.
Malobická E, Zibolenová J, Baška T, Bakalár P, Madleňák T, Štefanová E, et al. Differences in the frequency of selected risk factors of overweight and obesity in adolescents in various social environments within Slovakia. Public Health. 2025;240:203-8.
Aziz N, Nordin MJ, Abdulkadir SJ, Salih MMM. Digital addiction: Systematic review of computer game addiction impact on adolescent physical health. Electronics (Switzerland). 2021;10(9).
Hendy A, Soliman SM, Tantawi H, Salman S, Ibrahim RK, Hendy A, et al. The weight of words: investigating the role of weight stigma and body mass index in shaping children and youth’s emotional experiences. Journal of Eating Disorders. 2025;13(1).
Julia Tong T, Mohammadnezhad M, Salem Alqahtani N, Salusalu M. Perception of students on factors contributing to overweight and obesity among high school students in Kiribati: A qualitative study. PLOS ONE. 2022;17(1):e0260900.
Cheon BK, Bittner JMP, Pink AE. Contributions of subjective status to eating behaviors, obesity, and metabolic health across development. Appetite. 2025;204:107735.
Rakhman A, Buludawa M, Hijrah H, Ariani A. The Relationship between the Intensity of Gadget Use, Eating Patterns, Mukbang Watching Habits and Changes in Eating Behavior with the Incidence of Overweight in Adolescents. J Health Nutr Res. 16 Desember 2024;3(3):221–9.
Rakhman A, Hamid MAbd, Nurulfuadi N, Nadila D, Aiman U. Relationship between Fast Food Consumption, Sedentary Lifestyle, and Physical Activity with Body Mass Index (BMI) among Students of Madrasah Aliyah Alkahiraat Pusat Palu Post-Covid-19 Pandemic. J Health Nutr Res. 4 April 2025;4(1):8–14.
Damayanti DS, Humairah AT, Darmayanti F, Isnaenil M IP, Maarif R. Relationship Between Eating Patterns, Physical Activity, and Obesity Incidence Among Madrasah Tsanawiyah (MTs) Students. J Health Nutr Res. 21 Agustus 2024;3(2):133–7

Published
How to Cite
Issue
Section
Copyright (c) 2025 Andy Muharry, Iseu Siti Aisyah, Dadan Yogaswara

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.