<b>Determinants of obesity and overweight among school-aged children in Bauchi, Nigeria: A mixed-methods study</b>

Background: Childhood obesity is an escalating public health issue with serious long-term implications. This study investigates the factors contributing to overweight and obesity among school-aged children in Bauchi, Nigeria, utilizing a mixed-methods design. Materials and methods: A cross-sectional survey was conducted among 600 students aged 11–15 from primary schools in Bauchi. Quantitative data, that covered socio-demographics, physical activity, and dietary habits, were analyzed using descriptive statistics, chi-square tests, Spearman correlations, Mann-Whitney U tests, and logistic regression. In-depth interviews with school administrators and physical education teachers provided qualitative insights into challenges and facilitators of healthy behaviors. Results: Statistical analysis revealed a significant relationship between gender and obesity status (p = 0.0053), with females exhibiting greater BMI variation. Physical activity was inversely associated with BMI (r = -0.45, p = 0.002). Dietary assessments indicated frequent consumption of sugary snacks and limited intake of balanced meals. Qualitative findings identified major obstacles such as inadequate facilities, weak policy implementation, and low community involvement. Schools that prioritized physical education and nutrition policies saw greater student participation in healthy activities. Conclusion: Tackling childhood obesity necessitates a comprehensive strategy that includes enhancing school infrastructure, expanding access to recreational facilities, and enforcing dietary and physical activity policies. Future efforts should emphasize community-based interventions and stronger policy implementation to achieve lasting change.