Obesity, school obesity prevalence, and adolescent childbearing among U.S. young women

In the United States, adolescent obesity reduces young women's odds of forming romantic and sexual partnerships but increases the likelihood of risky sexual behavior when partnerships occur. This led us to conduct a study examining the relationship between adolescent obesity and adolescent childbearing. Our study has two aims. We draw from prior research to develop and test competing hypotheses about the association between adolescent obesity and young women's risk of an adolescent birth. Drawing from risk regulation theory, we also examine whether the association between obesity and young women's risk of an adolescent birth may vary across high schools with different proportions of obese adolescents. Multilevel logistic regression models are used to analyze data from 4242 female students in 102 U.S. high schools who participated in Wave I (1994–1995) of the National Longitudinal Study of Adolescent Health. Results are the first to show that obesity reduces female adolescents' odds of childbearing, but that this association is not uniform across schools with different proportions of obese students. As the obesity prevalence in a school increases, so do obese young women's odds of childbearing. We conclude that understanding whether and how obesity is associated with young women's odds of having an adolescent birth requires attention to the weight context of high schools.