System Dynamics Group, Department of Geography, University of Bergen, Bergen, Norway.
Department of Human Biology, University of Cape Town, Cape Town, South Africa.
Obes Rev. 2023 Sep;24 Suppl 2:e13628. doi: 10.1111/obr.13628.
Both obesity and poor mental wellbeing have a high prevalence in European youth. Adolescents in six countries identified mental wellbeing factors as main drivers of youth obesity through systems mapping. This study sought to (1) explore the dynamics of the interplay between poor mental wellbeing, energy balance-related behaviors, and adolescent overweight and obesity prevalence and (2) test the effect of intervention point scenarios to reduce adolescent obesity. Drawing on the youth-generated systems maps and a literature synthesis, we built a simulation model that represents the links from major feedback pathways for poor mental wellbeing to changes in dietary, physical activity, and sleep behaviors. The model was calibrated using survey data from Norway, expert input, and literature and shows a good fit between simulated behavior and available statistical data. The simulations indicate that adolescent mental wellbeing is harmed by socio-cultural pressures and stressors, which trigger reinforcing feedback mechanisms related to emotional/binge eating, lack of motivation to engage in physical activity, and sleep difficulty. Targeting a combination of intervention points that support a 25% reduction of pressure on body image and psychosocial stress showed potentially favorable effects on mental wellbeing-doubling on average for boys and girls and decreasing obesity prevalence by over 4%.
肥胖和心理健康不良在欧洲青年中都很普遍。通过系统映射，六个国家的青少年确定心理健康因素是导致青年肥胖的主要驱动因素。本研究旨在：（1）探讨心理健康不良、与能量平衡相关的行为以及青少年超重和肥胖流行之间相互作用的动态；（2）测试减少青少年肥胖的干预点情景的效果。本研究利用青少年生成的系统地图和文献综述，构建了一个模拟模型，该模型代表了从心理健康不良的主要反馈途径到饮食、身体活动和睡眠行为变化的联系。该模型使用来自挪威的调查数据、专家意见和文献进行了校准，模拟行为与可用统计数据之间具有良好的拟合度。模拟结果表明，青少年心理健康受到社会文化压力和压力源的影响，这些压力和压力源引发了与情绪性/暴食、缺乏参与身体活动的动机以及睡眠困难有关的强化反馈机制。针对支持减少身体形象和心理压力 25%的干预点组合显示出对心理健康的潜在有利影响——男孩和女孩的平均水平提高了一倍，肥胖流行率降低了 4%以上。
