Bem Comer and indigenous pathways of healing: prevalence of overweight and food coloniality among Xukuru do Ororubá Brazil

Background Indigenous adolescents are increasingly exposed to nutritional transitions resulting from historical processes of food coloniality, territorial disruption, and transformations in traditional food systems. Territory plays a central role in Indigenous health, shaping food practices, social organization, and systems of care. However, evidence on overweight among Indigenous adolescents remains scarce, particularly analyses that integrate epidemiological findings with Indigenous epistemologies of healing and well-being. Objective To estimate the prevalence of overweight among adolescents of the Xukuru do Ororubá people and to analyze its association with socioeconomic conditions, lifestyle factors, and body weight perception, interpreting the findings within the territorial and cultural context in which Indigenous systems of care are produced. Methods Cross-sectional analytical study grounded in a critical public health framework, in which quantitative epidemiology is used as an interpretative tool rather than an epistemologically neutral endpoint. The study was conducted in 2022 with self-identified Indigenous adolescents aged 12 to 18 years residing in villages within the Xukuru do Ororubá territory, Pernambuco, Brazil. Data were collected through structured questionnaires and anthropometric measurements. Overweight was defined using BMI-for-age z-scores according to WHO criteria. Associations were estimated using Poisson regression with robust variance. The study followed ethical principles for research with Indigenous peoples, including community authorization and adherence to CARE principles. Results A total of 225 adolescents participated. The prevalence of overweight was 14.2%, higher among females. In the multivariable analysis, overweight was associated with household sanitation conditions, maternal schooling, school shift, and dissatisfaction with body weight. Lifestyle variables were not independently associated. Conclusion Overweight among Xukuru do Ororubá adolescents reflects na interplay between socioeconomic vulnerability, school organization, body perception, and structural transformations affecting Indigenous territories and food systems. By articulating epidemiological evidence with Indigenous knowledge of Bem Comer and territorial healing practices, this study contributes to a decolonial interpretation of adolescent health in Indigenous contexts.