Hidden Hunger in Adolescent Obesity: Micronutrient Deficiencies and the Neglect of Male Adolescents

Adolescent obesity is increasingly classified as a paradoxical form of malnutrition where an excessive caloric intake exists alongside clinically significant micronutrient deficiencies that are commonly referred to as hidden hunger. This scoping review aims to summarize all of the evidence found from 2021-2026 related to micronutrient deficiencies found in adolescents with obesity while emphasizing both the lack of representation for male adolescents as well as all the other populations considered underrepresented in the literature such as adolescent athletes, and adolescents who have undergone surgery for weight loss (bariatric). The articles included in this review were obtained via various databases including PubMed, Scopus, Web of Science, Google Scholar and ScienceDirect, using pre-established search terms and keywords related to nutrition and obesity. The findings from the studies included in this review indicate that adolescents with obesity continue to suffer from deficiencies in vitamin D, iron, zinc, folate, vitamin B12 and other micronutrients despite consuming excessive calories. Major contributing factors to these deficiencies are poor quality diets, high consumption of ultra-processed foods, chronic lowgrade inflammation, altered metabolism of micronutrients, and a lack of physical activity/sedentary lifestyle. In addition, findings from this review indicate that males are currently underrepresented in the nutritional research and assessment of adolescents and as a result, the data collected on this population is insufficient. Overall, findings from this review indicate that improved assessment and screening of micronutrients and improved surveillance of adolescent nutrition is necessary in order to address the issue of hidden hunger in adolescents who are obese and the long-term metabolic and developmental consequences associated with this condition.