Screen time and obesity in children: sex-specific pathways and public health implication
Abstract
Background: Despite accumulated evidence suggesting that increased screen time in children and adolescents may be associated with obesity-related behaviors, potential sex-specific differences have not been fully characterized. This systematic review aimed to synthesize evidence on the association between screen time and obesity-related outcomes in children and adolescents, with a focus on sex-specific pathways and implications for public health interventions.
Methods: A systematic review was conducted following PRISMA 2020 guidelines. Eligible studies included those assessing screen time exposure and obesity-related outcomes in children or adolescents, with sex-specific analyses. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment. Findings were synthesized based on direction of association and patterns of sex differences.
Results: Of the 22 studies included in the review, 18 studies (82%) reported a significant positive association between screen time and obesity-related outcomes. Female-specific associations were more frequently linked to adiposity measures, metabolically unhealthy obesity, and psychological factors such as body image and weight concern. In contrast, male-specific associations were more often related to behavioral pathways, including increased caloric intake, problematic screen use, and sleep disruption.
Conclusions: Screen time is associated with obesity in children and adolescents, but its effects are mediated through sex-specific pathways involving behavioral, physiological, and psychological mechanisms. Public health interventions should incorporate sex-specific strategies which include promoting physical activity and addressing psychosocial factors among girls, and targeting problematic screen use, screen-related eating, and sleep disruption among boys. Integrated approaches across family, school, and digital environments are needed to enhance effectiveness in obesity prevention and management.
Key messages: • Screen time is consistently associated with obesity in children and adolescents, and operates through sex-specific behavioral, physiological, and psychological pathways.
• Effective interventions should move beyond reducing screen time alone and incorporate sex-specific, multi-component strategies targeting behavior, sleep, and psychosocial factors.
Related
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- Negative Appendicectomy Rate and Surgery Despite Negative Triple-Screen Inflammatory Markers in Children: A Single-Centre Retrospective Cohort Study
- Screen time and attention-deficit/hyperactivity disorder in children: a systematic review and meta-analysis
- Home environmental factors associated with screen time among Japanese preschool children: a cross-sectional secondary analysis using exploratory structural equation modeling
BibTeX
@article{jeong2026screen,
title = {{Screen time and obesity in children: sex-specific pathways and public health implication}},
author = {Y Jeong and Y Chae and J Min},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1675},
url = {https://doi.org/10.1093/eurpub/ckag169.1675},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Screen time and obesity in children: sex-specific pathways and public health implication
AU - Y Jeong
AU - Y Chae
AU - J Min
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1675
UR - https://doi.org/10.1093/eurpub/ckag169.1675
AB - Background: Despite accumulated evidence suggesting that increased screen time in children and adolescents may be associated with obesity-related behaviors, potential sex-specific differences have not been fully characterized. This systematic review aimed to synthesize evidence on the association between screen time and obesity-related outcomes in children and adolescents, with a focus on sex-specific pathways and implications for public health interventions. Methods: A systematic review was conducted following PRISMA 2020 guidelines. Eligible studies included those assessing screen time exposure and obesity-related outcomes in children or adolescents, with sex-specific analyses. Two reviewers independently conducted study selection, data extraction, and risk of bias assessment. Findings were synthesized based on direction of association and patterns of sex differences. Results: Of the 22 studies included in the review, 18 studies (82%) reported a significant positive association between screen time and obesity-related outcomes. Female-specific associations were more frequently linked to adiposity measures, metabolically unhealthy obesity, and psychological factors such as body image and weight concern. In contrast, male-specific associations were more often related to behavioral pathways, including increased caloric intake, problematic screen use, and sleep disruption. Conclusions: Screen time is associated with obesity in children and adolescents, but its effects are mediated through sex-specific pathways involving behavioral, physiological, and psychological mechanisms. Public health interventions should incorporate sex-specific strategies which include promoting physical activity and addressing psychosocial factors among girls, and targeting problematic screen use, screen-related eating, and sleep disruption among boys. Integrated approaches across family, school, and digital environments are needed to enhance effectiveness in obesity prevention and management. Key messages: • Screen time is consistently associated with obesity in children and adolescents, and operates through sex-specific behavioral, physiological, and psychological pathways. • Effective interventions should move beyond reducing screen time alone and incorporate sex-specific, multi-component strategies targeting behavior, sleep, and psychosocial factors.
SN - 1101-1262
SN - 1464-360X
ER -