上海市中学生减重行为及相关因素分析

陈玮丽; 张喆; 翟娅妮; 严琼; 祁月; 罗春燕

doi:10.16835/j.cnki.1000-9817.2025048

上海市中学生减重行为及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2025048

陈玮丽^{1, 2},
张喆¹,
翟娅妮¹,
严琼¹,
祁月¹,
罗春燕^1, ,

1.
上海市疾病预防控制中心儿童青少年健康所，200336
2.
上海体育大学运动健康学院

基金项目:

国家社会科学基金项目 22BTY105

上海市第六轮公共卫生三年行动计划重点学科项目(2023—2025年) GWVI-11.1-3

详细信息

作者简介:
陈玮丽(1999-)，女，浙江丽水人，在读硕士，主要研究方向为儿童青少年健康

张喆(1989-)，女，山东东营人，硕士，主管医师，主要研究方向为儿童青少年健康和学校卫生

通讯作者:
罗春燕，E-mail: luochunyan@scdc.sh.cn

利益冲突声明 所有作者声明无利益冲突。
陈玮丽与张喆为共同第一作者。
中图分类号: R179 Q983^+.23 C913.5
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- 被引次数: 0
出版历程
- 收稿日期: 2024-10-16
- 修回日期: 2024-12-06
- 网络出版日期: 2025-03-05
- 刊出日期: 2025-02-25

Analysis of weight loss behavior and related factors of middle school students in Shanghai

CHEN Weili^{1, 2},
ZHANG Zhe¹,
ZHAI Yani¹,
YAN Qiong¹,
QI Yue¹,
LUO Chunyan^{1
, ,}

1.
Institute of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai (200336), China

摘要

摘要: 目的了解上海市中学生减重行为特征及其相关因素，为指导中学生科学减重提供参考依据。方法于2021年5—6月采用分层整群随机抽样法，选取上海市16个区16 758名初、高中学生为研究对象，采用青少年健康危险行为问卷调查中学生的基本情况和减重行为，运用无序多分类Logistic回归模型分析减重行为的相关因素。结果 5 881名(35.09%)中学生报告有锻炼减重行为，6 344名(37.86%)中学生有节食减重行为，461名(2.75%)中学生有不健康减重行为。无序多分类Logistic回归分析结果显示，以无减重行为组为参照类别，中心城区(OR=1.35, 95%CI=1.10~1.66)、网络成瘾(OR=1.71, 95%CI=1.23~2.38)、受欺凌(OR=2.09, 95%CI=1.68~2.61)、失眠(OR=2.33, 95%CI=1.74~3.11)、伤心绝望(OR=3.10, 95%CI=2.42~3.97)、自觉体重有点重(OR=2.77, 95%CI=2.17~3.55)和很重(OR=3.41, 95%CI=2.44~4.75)的中学生更容易发生不健康减重行为(P值均<0.05)。结论上海市不同特征中学生减重行为存在一定差异，失眠和伤心绝望等不良情绪、网络成瘾、体重认知偏差以及受欺凌等是不健康减重行为的相关因素。应有针对性地采取干预措施，指导学生科学减重。
- 减重 /
- 行为 /
- 回归分析 /
- 学生
Abstract: Objective To investigate the distribution characteristics and related factors of weight loss behavior among middle school students in Shanghai, so as to provide a reference for guiding scientific weight loss among middle school students. Methods From May to June 2021, a stratified cluster random sampling method was used to select 16 758 junior and high school students in 16 districts of Shanghai. Youth Risk Behavior Surveillance System was administered to assess the basic condition and weight loss behaviors of the students. An unordered multinomial Logistic regression model was employed to analyze the factors associated with weight loss behaviors. Results A total of 5 881 (35.09%) reported engaging in exercise for weight loss, 6 344 (37.86%) reported dieting for weight loss, and 461 (2.75%) engaged in unhealthy weight loss behaviors. The unordered multinomial Logistic regression analysis indicated that compared with the no-weight-loss behavior group, students from urban areas(OR=1.35, 95%CI=1.10-1.66), those with Internet addiction (OR=1.71, 95%CI=1.23-2.38), those with victims of bullying (OR=2.09, 95%CI=1.68-2.61), those experiencing insomnia (OR=2.33, 95%CI= 1.74-3.11), those feelings of sadness or despair (OR=3.10, 95%CI=2.42-3.97), and those who perceived their body weight as slightly heavy (OR=2.77, 95%CI= 2.17-3.55) or very heavy (OR=3.41, 95%CI=2.44-4.75) were more likely to engage in unhealthy weight loss behaviors (P<0.05). Conclusions There are significant differences in weight loss behaviors among middle school students with varying characteristics in Shanghai. Negative emotions such as insomnia and feelings of sadness or despair, Internet addiction, cognitive bias in weight and experiences of bullying are identified as related factors for unhealthy weight loss behaviors. Targeted intervention measures should be implemented to guide students towards scientific approaches to weight management.
- Weight loss /
- Behavior /
- Regression analysis /
- Students
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

2) 陈玮丽与张喆为共同第一作者。

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表 1 不同性别中学生各类减重行为报告率比较

Table 1. Comparison of reported rates of various weight loss behaviors among middle school students of different genders

性别	人数	锻炼	不吃主食	减少食物量和能量摄取或吃低脂食物	≥24 h不吃东西	催吐或腹泻减重	无医嘱擅自吃减肥药	美容院瘦身
男	8 373	5 992(71.56)	606(7.24)	2 566(30.65)	153(1.83)	59(0.70)	66(0.79)	55(0.66)
女	8 385	5 409(64.51)	1 414(16.86)	3 803(45.35)	190(2.27)	55(0.66)	61(0.73)	27(0.32)
合计	16 758	11 401(68.03)	2 020(12.05)	6 369(38.01)	343(2.05)	114(0.68)	127(0.76)	82(0.49)
χ²值		95.89	366.18	384.69	4.02	0.15	0.21	9.65
P值		<0.01	0.01	0.01	0.05	0.70	0.65	0.01
注： ()内数字为报告率/%。

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表 2 不同组别中学生减重行为类别分布比较

Table 2. Comparison of weight loss behavior categories distribution among middle school students with different groups

组别	选项	人数	锻炼减重行为	节食减重行为	不健康减重行为	无减重行为	χ²值	P值
学段	初中	10 088	4 063(40.28)	3 643(36.11)	221(2.19)	2 161(21.42)	341.63	<0.01
	普高	4 979	1 339(26.89)	2 033(40.83)	161(3.23)	1 446(29.04)
	中职	1 691	479(28.33)	668(39.50)	79(4.67)	465(27.50)
性别	男	8 373	3 614(43.16)	2 543(30.37)	191(2.28)	2 025(24.18)	571.63	<0.01
	女	8 385	2 267(27.04)	3 801(45.33)	270(3.22)	2 047(24.41)
年龄/岁	10~12	3 067	1 352(44.08)	1 118(36.45)	53(1.73)	544(17.74)
	13~15	7 524	2 862(38.04)	2 719(36.14)	189(2.51)	1 754(23.31)	359.22	<0.01
	16~18	6 167	1 667(27.03)	2 507(40.65)	219(3.55)	1 774(28.77)
户籍	本市	13 987	4 873(34.84)	5 299(37.89)	363(2.60)	3 452(24.68)	14.35	0.03
	外省市	2 569	937(36.47)	968(37.68)	90(3.50)	574(22.34)
	外籍	202	71(35.15)	77(38.12)	8(3.96)	46(22.77)
住宿	是	1 522	419(27.53)	622(40.87)	64(4.20)	417(27.40)	50.79	<0.01
	否	15 236	5 462(35.85)	5 722(37.56)	397(2.61)	3 655(23.99)
城区	中心	6 138	2 252(36.69)	2 443(39.80)	176(2.87)	1 267(20.64)	70.49	<0.01
	非中心	10 620	3 629(34.17)	3 901(36.73)	285(2.68)	2 805(26.41)
家庭结构	双亲家庭	14 224	5 080(35.71)	5 399(37.96)	346(2.43)	3 399(23.90)	54.65	<0.01
	父母一方缺失	1 853	588(31.73)	704(37.99)	85(4.59)	476(25.69)
	父母双方缺失	681	213(31.28)	241(35.39)	30(4.41)	197(28.93)
独生子女	否	4 568	1 620(35.46)	1 755(38.42)	144(3.15)	1 049(22.96)	9.05	0.03
	是	12 190	4 261(34.95)	4 589(37.65)	317(2.60)	3 023(24.80)
父亲文化	初中及以下	2 716	869(32.00)	1 057(38.92)	104(3.83)	686(25.26)	55.51	<0.01
水平	高中	3 791	1 255(33.10)	1 463(38.59)	113(2.98)	960(25.32)
	大专	3 573	1 228(34.37)	1 381(38.65)	84(2.35)	880(24.63)
	本科及以上	6 678	2 529(37.87)	2 443(36.58)	160(2.40)	1 546(23.15)
母亲文化	初中及以下	3 112	997(32.04)	1 221(39.24)	106(3.41)	788(25.32)	43.23	<0.01
水平	高中	3 573	1 222(34.20)	1 343(37.59)	117(3.27)	891(24.94)
	大专	3 738	1 299(34.75)	1 411(37.75)	83(2.22)	945(25.28)
	本科及以上	6 335	2 363(37.30)	2 369(37.40)	155(2.45)	1 448(22.86)
网络成瘾	是	604	140(23.18)	215(35.60)	63(10.43)	186(30.79)	171.40	<0.01
	否	16 154	5 741(35.54)	6 129(37.94)	398(2.46)	3 886(24.06)
受欺凌	是	5 425	1 902(35.06)	2 236(41.22)	236(4.35)	1 051(19.37)	178.61	<0.01
	否	11 333	3 979(35.11)	4 108(36.25)	225(1.99)	3 021(26.66)
孤独感	是	1 977	513(25.95)	880(44.51)	126(6.37)	458(23.17)	187.74	<0.01
	否	14 781	5 368(36.32)	5 464(36.97)	335(2.27)	3 614(24.45)
心情郁闷	是	3 547	985(27.77)	1 595(44.97)	179(5.05)	788(22.22)	223.09	<0.01
	否	13 211	4 896(37.06)	4 749(35.95)	282(2.13)	3 284(24.86)
失眠	是	1 610	405(25.16)	758(47.08)	136(8.45)	311(19.32)	318.44	<0.01
	否	15 148	5 476(36.15)	5 586(36.88)	325(2.15)	3 761(24.83)
伤心绝望	是	1 789	456(25.49)	739(41.31)	174(9.73)	420(23.48)	413.73	<0.01
	否	14 969	5 425(36.24)	5 605(37.44)	287(1.92)	3 652(24.40)
自觉体重	很轻	583	221(37.91)	67(11.49)	30(5.15)	265(45.45)	1 949.73	<0.01
	有点轻	1 995	908(45.51)	251(12.58)	21(1.05)	815(40.85)
	有点重	6 362	1 705(26.80)	3 368(52.94)	221(3.47)	1 068(16.79)
	很重	1 273	286(22.47)	663(52.08)	78(6.13)	246(19.32)
	正合适	6 545	2 761(42.18)	1 995(30.48)	111(1.70)	1 678(25.64)
注： ()内数字为构成比/%。

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表 3 中学生减重行为相关因素的无序多分类Logistic回归分析(n=16 758)

Table 3. Unordered multinomial Logistic regression analysis of related factors of the weight loss behavior among middle school students(n=16 758)

自变量	选项	锻炼减重行为		节食减重行为		不健康减重行为
自变量	选项	OR值(95%CI)	P值	OR值(95%CI)	P值	OR值(95%CI)	P值
学段	初中	1.37(1.07~1.76)	0.01	0.93(0.73~1.19)	0.56	0.48(0.29~0.81)	0.01
	普高	0.90(0.77~1.05)	0.18	0.83(0.71~0.96)	0.01	0.60(0.44~0.81)	<0.01
	中职	1.00		1.00		1.00
性别	男	1.71(1.57~1.86)	<0.01	0.77(0.71~0.84)	<0.01	0.74(0.60~0.92)	0.01
	女	1.00		1.00		1.00
年龄/岁	10~12	1.80(1.40~2.31)	<0.01	1.44(1.12~1.85)	0.01	1.13(0.64~1.98)	0.68
	13~15	1.21(0.97~1.51)	0.09	1.04(0.83~1.29)	0.75	1.18(0.74~1.87)	0.49
	16~18	1.00		1.00		1.00
城区	中心	1.45(1.33~1.59)	<0.01	1.43(1.31~1.57)	<0.01	1.35(1.10~1.66)	<0.01
	非中心	1.00		1.00		1.00
家庭结构	双亲家庭	1.33(1.08~1.63)	0.01	1.36(1.11~1.67)	<0.01	0.84(0.56~1.28)	0.43
	父母一方缺失	1.17(0.93~1.48)	0.19	1.21(0.95~1.52)	0.12	1.22(0.76~1.94)	0.42
	父母双方缺失	1.00		1.00		1.00
网络成瘾	是	0.60(0.48~0.75)	<0.01	0.61(0.50~0.76)	<0.01	1.71(1.23~2.38)	<0.01
	否	1.00		1.00		1.00
受欺凌	是	1.34(1.22~1.48)	<0.01	1.58(1.44~1.75)	<0.01	2.09(1.68~2.61)	<0.01
	否	1.00		1.00		1.00
孤独感	是	0.80(0.68~0.93)	<0.01	0.87(0.75~1.01)	0.07	0.80(0.60~1.08)	0.14
	否	1.00		1.00		1.00
心情郁闷	是	0.91(0.80~1.02)	0.11	1.06(0.94~1.19)	0.37	1.10(0.86~1.43)	0.45
	否	1.00		1.00		1.00
失眠	是	1.07(0.90~1.27)	0.47	1.47(1.25~1.74)	<0.01	2.33(1.74~3.11)	<0.01
	否	1.00		1.00		1.00
伤心绝望	是	0.78(0.67~0.90)	<0.01	0.95(0.82~1.10)	0.48	3.10(2.42~3.97)	<0.01
	否	1.00		1.00		1.00
自觉体重	很轻	0.42(0.35~0.51)	<0.01	0.20(0.15~0.26)	<0.01	1.34(0.86~2.08)	0.20
	有点轻	0.60(0.54~0.68)	<0.01	0.26(0.22~0.30)	<0.01	0.36(0.23~0.59)	<0.01
	有点重	1.03(0.93~1.14)	0.55	2.63(2.39~2.89)	<0.01	2.77(2.17~3.55)	<0.01
	很重	0.75(0.62~0.90)	<0.01	2.21(1.88~2.61)	<0.01	3.41(2.44~4.75)	<0.01
	正合适	1.00		1.00		1.00

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上海市中学生减重行为及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2025048

作者简介:
陈玮丽(1999-)，女，浙江丽水人，在读硕士，主要研究方向为儿童青少年健康

张喆(1989-)，女，山东东营人，硕士，主管医师，主要研究方向为儿童青少年健康和学校卫生

通讯作者:
罗春燕，E-mail: luochunyan@scdc.sh.cn

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Analysis of weight loss behavior and related factors of middle school students in Shanghai

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留言板

上海市中学生减重行为及相关因素分析

doi: 10.16835/j.cnki.1000-9817.2025048

作者简介: 陈玮丽(1999-)，女，浙江丽水人，在读硕士，主要研究方向为儿童青少年健康 张喆(1989-)，女，山东东营人，硕士，主管医师，主要研究方向为儿童青少年健康和学校卫生

通讯作者: 罗春燕，E-mail: luochunyan@scdc.sh.cn

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Analysis of weight loss behavior and related factors of middle school students in Shanghai

计量

出版历程

目录

作者简介:
陈玮丽(1999-)，女，浙江丽水人，在读硕士，主要研究方向为儿童青少年健康

张喆(1989-)，女，山东东营人，硕士，主管医师，主要研究方向为儿童青少年健康和学校卫生

通讯作者:
罗春燕，E-mail: luochunyan@scdc.sh.cn