Obesity and its relationship with lifestyle behaviors among Kuwaiti adolescents revisited after 15 years: a study protocol

Background Lifestyle behaviors such as physical activity, sedentary time, sleep, and dietary habits play a central role in shaping adolescent health. In Kuwait, the Arab Teens Lifestyle Study (ATLS), conducted in 2009/2010, reported that nearly half of adolescents were overweight or obese, with physical inactivity and unhealthy dietary patterns emerging as key correlates. Over the past 15 years, profound societal changes, including accelerated digitalisation and shifts in food environments, may have further altered these patterns, yet updated nationally representative data are lacking. Objectives This study will reassess the prevalence of overweight, obesity, and lifestyle behaviors among Kuwaiti adolescents and directly compare findings with the 2009/2010 ATLS using the same methodological framework. For the first time in Kuwait, psychological wellbeing, grip strength, and objectively measured physical activity and sleep will also be assessed. Methods A school-based cross-sectional survey designed as a methodological revisit to the 2009/2010 ATLS will be conducted among a representative sample of 14–19-year-old students from public and private secondary schools across Kuwait using a multistage stratified cluster sampling design (target n ≈ 1,320–1,350). Data collection will include standardized anthropometric measurements, validated questionnaires covering physical activity, sedentary behaviors, sleep, dietary habits, and psychological wellbeing, grip strength dynamometry, and wrist-worn accelerometery where funding permits. All inferential analyses will be conducted using survey-adjusted procedures accounting for the complex sampling design. Expected outcomes This study will generate nationally representative, contemporary evidence on adolescent health behaviors in Kuwait, enable direct temporal comparisons with 2009/2010 baseline findings, and support the development of targeted public health strategies aimed at reducing obesity and improving the wellbeing of Kuwaiti adolescents.