Overweight and Obesity Impair Academic Performance in Adolescence: A National Cohort Study of 10,279 Adolescents in China

OBJECTIVE: This study aimed to examine the associations of overweight and obesity (ov/ob) and changes in weight status with academic performance among Chinese adolescents. METHODS: Self-reported weight and height were collected from adolescents (n = 10,279) each year from seventh grade (baseline, 2013-2014) to ninth grade (2015-2016). Academic performance included standardized scores on math, Chinese, and English examinations and responses to a school-life experience scale. RESULTS: All adolescents with ov/ob had lower academic performance than their counterparts without overweight (β = -0.46 to -0.08; P < 0.05), except for school-life experience for boys. All adolescents with obesity had lower academic performance than their counterparts without obesity (β = -0.46 to -0.17; P < 0.01), except for English test scores for boys. Changes in weight status between grades 7 and 9 impacted academic performance at grade 9. Adolescents with ov/ob throughout grades 7 to 9 and those who developed ov/ob from normal weight had lower test scores (β = -0.80 to -0.25; P < 0.05) than those who maintained normal weight. Those who developed ov/ob after having normal weight had poorer school-life experiences (β = -0.55 to -0.25; P < 0.05). CONCLUSIONS: Ov/ob and maintaining and developing ov/ob had adverse academic impacts on adolescents. Relevant stakeholders should consider detrimental impacts of obesity on academic outcomes.