International Journal of Preventive Medicine (Int J Prev Med)2008-780210102020020921802180ENDepartment of Nutrition, Faculty of Medicine, Mashhad University of Medical Sciences, MashhadDepartment of Health Education and Promotion, School of Health, Isfahan university of Medical Sciences, IsfahanDepartment of Behavioral and Environmental Health, Jackson State University, Jackson, MSDepartment of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, TehranDepartment of Epidemiology and Biostatistics, School of Health, Mashhad University of Medical Sciences, MashhadMetabolic Syndrome Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad20200209<p><span class="fontstyle0"><strong>Introduction</strong>: </span><span class="fontstyle2">Childhood obesity has become a global endemic public health problem. Emotional<br />distress has been proposed to be a strong mediator of unhealthy lifestyle behaviors among youth.<br />The aim of this study was to explore the sources and role of stress on developing unhealthy<br />lifestyle practices pertaining to diet and physical activity among overweight and obese adolescents.<br /></span></p><p><span class="fontstyle0"><strong>Methods</strong>: </span><span class="fontstyle2">This qualitative study was conducted in 2016–2017 in two large cities of Iran, Mashhad<br />and Isfahan. Fifty‑two overweight and obese adolescents were selected through purposeful sampling.<br />In‑depth semi‑structured interviews and focus group discussions were conducted to obtain perceptions<br />and experiences regarding underlying factors of obesity and the sources and role of stress in inducing<br />unhealthy lifestyle. Ten parents were also interviewed. Data were analyzed using conventional<br />content analysis with MAXQDA software. Study rigor was verified using criteria proposed by<br />Lincoln and Guba. </span></p><p><span class="fontstyle0"><strong>Results</strong>: </span><span class="fontstyle2">After analyzing the data, two main categories which triggered emotional<br />overeating and physical inactivity among adolescents were: “</span><span class="fontstyle3">school originated stress</span><span class="fontstyle2">” and “</span><span class="fontstyle3">family<br />originated stress</span><span class="fontstyle2">.” Three subcategories of school originated stress were </span><span class="fontstyle3">“Too much homework</span><span class="fontstyle2">,”<br />“</span><span class="fontstyle3">Frequent exams” </span><span class="fontstyle2">and “</span><span class="fontstyle3">Priority for studying at both school and home” </span><span class="fontstyle2">and family originated<br />stress subcategories were “</span><span class="fontstyle3">Parental destructive conflicts</span><span class="fontstyle2">,” “</span><span class="fontstyle3">Divorce</span><span class="fontstyle2">” and “</span><span class="fontstyle3">Socio‑familial issues</span><span class="fontstyle2">.”<br /></span></p><p><span class="fontstyle0"><strong>Conclusions</strong>: </span><span class="fontstyle2">Our findings highlighted the sources and role of stress in emerging unhealthy lifestyle<br />practices including emotional overeating and physical inactivity among adolescents which could lead<br />to weight gain. Therefore, to improve lifestyle behaviors of students and prevent childhood obesity,<br />addressing school, and family stressors is a crucial subject.<br /></span></p><p><span class="fontstyle0" style="color: #00652e;"><strong>Keywords</strong>: </span><span class="fontstyle3">Adolescent, emotional eating, obesity, physical activity, qualitative research</span></p>http://ijpm.mui.ac.ir/index.php/ijpm/article/view/2180http://ijpm.mui.ac.ir/index.php/ijpm/article/download/2180/717717976