Mental health matters in obesity prevention: Exploring the dynamic relationships between mental well-being and obesity-related behaviours in adolescents

Background and Objective: Poor mental well-being is a complex public health problem with a high prevalence in adolescents in Europe, especially those with excess weight. For instance, previous studies have reported that adolescents with excess weight have a higher risk of developing depression and anxiety over their lifetime compared to adolescents with a normal weight. As the systemic complexity of mental well-being processes poses challenges in efforts to curb persistent obesity trends, this study seeks to understand the dynamic relationships between complex mental well-being processes, affecting energy-balance-related behaviors, and youth obesity. Methods: Applying System Dynamics methods, we build a conceptual model which maps the key mental well-being feedback pathways leading to changes in dietary, physical activity, and sleep quality behaviors based on empirical literature synthesis and youth-generated systems maps. We then formalize the conceptual model using the Health Behaviour in School-aged Children (HBSC) data to analyze, through computer simulation, the psychological well-being dynamics resulting from feedback pathways and the impact of potential mental health-based interventions on youth obesity prevalence. Results: The preliminary results from the simulations show that mental well-being is mainly influenced by social pressures related to an ideal body image, stressors such as school pressure and bullying, and digital device use. The core model structure is defined by three major reinforcing feedback loop structures that involve binge eating, motivation to do physical activity, and sleep quality. Identified leverage points related to coping mechanisms for psychosocial stress and increased motivation to engage in physical activity show promising results, particularly among girls. Conclusion: These findings reveal that addressing the underlying feedback pathways between young people’s weight status and mental well-being is relevant for public health professionals and others working in the field of adolescent health. More model-based studies are needed to investigate further such feedback mechanisms in country-specific contexts.