An assessment of the prevalence of fast-food consumption among adolescents in the Tamale Metropolis of Ghana

The study aims to assess the influence of socio-demographic characteristics on fast-food consumption; analyse the role of convenience in adolescents’ fast-food choices; examine the moderating effect of education on the relationship between health-risk perception and consumption of fast food; and investigate the association between fast-food consumption and obesity (BMI) among adolescents. A cross-sectional quantitative design using multi-stage sampling was used to collect data from 406 adolescents (mean age 15.39 years, SD 1.69) across urban, suburban, and rural zones. Data was collected using a structured questionnaire to collect data on socio-demographic characteristics, consumption frequency, health-risk perceptions, and convenience factors using anthropometric measurements. Descriptive and inferential analyses were conducted. Convenience emerged as the primary driver, with 74% reported choosing fast food for convenience, and 62.6% rated outlet proximity as always important. Adolescents who “often” chose fast food because of quick access had much higher odds of frequent consumption (AOR = 14.38; 95% CI: 2.97–69.77; p = 0.001). Perceiving fast food as more convenient than cooking raised odds (AOR $$\:=$$ 2.59; 95% CI: 1.62–4.15; p < 0.001). Older adolescents (15–19 years) were more likely to consume fast food frequently than younger adolescents (AOR = 1.74; 95% CI: 1.05–2.88; p $$\:=$$ 0.031). Suburban residence was protective compared with rural residence (AOR = 0.11; 95% CI: 0.05–0.24; p < 0.001), and larger households (> 5 members) had lower odds (AOR = 0.14; 95% CI: 0.04–0.48; p = 0.002). Although many recognized health risks, 59.9% scored low on composite risk perception, and perception was not significantly associated with lower consumption (OR = 0.48; p = 0.386). No significant association was found between fast-food frequency and BMI after adjustment (adjusted β = 0.38; p = 0.133). Age predicted higher BMI (β = 1.325; p < 0.001). The study concludes that environmental and convenience factors outweigh risk knowledge in shaping adolescent fast-food behavior. Due to the effect of both factors in shaping behavior on fast food consumption, policy responses should combine environmental regulation, incentives for healthy, quick options, and tailored education.