Understanding The Factors Contributing To Obesity Among Adolescents In Indonesia: A Systematic Review And Meta-Analysis

Background: Adolescent obesity is an escalating public health issue in Indonesia, with long-term implications for morbidity and quality of life. While numerous studies have investigated individual risk factors for adolescent obesity, to date, no systematic review and meta-analysis has comprehensively synthesized the evidence within the Indonesian context. This study aims to identify and analyze the risk factors for adolescent obesity in Indonesia through a systematic review and meta-analysis of available observational studies. Methods: A literature search was conducted in PubMed, Web of Science, EMBASE, and Google Scholar up to April 1, 2025, following PRISMA and MOOSE guidelines. Studies that met the inclusion criteria were analyzed both narratively and quantitatively using Review Manager 5.4.1. A random-effects model was applied for meta-analysis in cases of significant heterogeneity. Results: A total of 30 studies were included in the meta-analysis. The analysis revealed that low physical activity (OR: 1.90; 95% CI: 1.45–2.49), consumption of sugar-sweetened beverages (OR: 1.03; 95% CI: 1.01–1.06), unhealthy dietary patterns (OR: 1.89; 95% CI: 1.00–1.01), poor sleep patterns (OR: 2.23; 95% CI: 1.07–4.44), and stress (OR: 5.28; 95% CI: 2.64–10.53) were significantly associated with increased risk of obesity among adolescents in Indonesia. Vegetable consumption had a protective effect (OR: 0.96; 95% CI: 0.94–0.98). Family-related factors, including genetic history (OR: 1.05; 95% CI: 1.01–1.09), father's education (OR: 1.11; 95% CI: 1.06–1.17), and mother's education (OR: 1.38; 95% CI: 1.04–1.83), also significantly increased the risk. Additionally, adolescents residing in urban areas were found to have a higher risk of obesity (OR: 1.31; 95% CI: 1.28–1.34). No evidence of publication bias was detected based on funnel plot assessment. Conclusion: Individual, familial, and environmental factors significantly contribute to the risk of adolescent obesity in Indonesia. These findings underscore the need for comprehensive and context-specific interventions, including family education, promotion of healthy lifestyles, and policy support that fosters healthier obesogenic environments.