Prevalence and factors associated with overweight and obesity among secondary school students in Djoungolo Health District, Cameroon: a household-based cross-sectional study

Background The rapid nutritional transition in sub-Saharan Africa (SSA) has escalated the burden of overweight and obesity among students. However, localised epidemiological data from urban health districts in Cameroon remain scarce. This study aimed to determine the prevalence and factors associated with overweight and obesity among secondary school students in Djoungolo Health District (HD), Yaoundé, Cameroon, and to assess the concordance between self-perceived and objectively measured weight status. Methods We conducted a household-based cross-sectional study from November 2024 to October 2025 among secondary school students residing in Emana and Mballa II Health Areas (HAs). We used a two-stage non-probability sampling approach, purposively selecting the HAs and then using convenience sampling of eligible participants. We collected data using a structured questionnaire. Overweight and obesity were defined using the International Obesity Task Force (IOTF) age- and sex-specific body mass index (BMI) cut-offs for participants below 18 years and standard adult thresholds (≥ 25‍ kg/m 2 and < 30 kg/m 2 for overweight, ≥ 30‍ kg/m 2 for obesity) for t‍hos‌e aged ≥ 18 years. We used generalised estimating equations (GEE) with robust standard errors to identify factors associated with overweight and obesity. Agreement between measured BMI and self-perceived weight status was assessed using Cohen’s kappa (κ) statistic. Results Of the 2‍74 participants, the mean age was 15.6 ± 2.5 years (57.7% female). The overall prevalence of overweight and obesity was 14.2% (95% CI: 10.3–18.9%), comprising 11.3% overweight and 2.9% obesity. In multivariable GEE analysis, two factors were associated with overweight and obesity: female sex (adjusted odds ratio [aOR] = 3.22; 95% CI: 1.41–7.36; p = 0.005) and students aged 11–15 years (aOR = 2.54; 95% CI: 1.01–6.39; p = 0.049). Agreement between measured BMI and self-perceived weight status was moderate (κ = 0.418; p < 0.001), with 46.2% of overweight or obese students underestimating their weight status. Conclusions School-based interventions promoting healthy lifestyles, routine anthropometric screening, and improved body weight awareness, particularly among younger students and girls, are needed to reduce the growing burden of overweight and obesity among secondary school students in urban Cameroon. Trial registration: Not applicable.