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Article(id=1325500884439937743, tenantId=1146029695717560320, journalId=1256213402557890569, issueId=1325500677975318675, articleNumber=null, orderNo=null, doi=10.16835/j.cnki.1000-9817.2025048, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1729008000000, receivedDateStr=2024-10-16, revisedDate=1733414400000, revisedDateStr=2024-12-06, acceptedDate=null, acceptedDateStr=null, onlineDate=1793953637466, onlineDateStr=2026-11-06, pubDate=1740412800000, pubDateStr=2025-02-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793953637466, onlineIssueDateStr=2026-11-06, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793953637466, creator=13701087609, updateTime=1793953637466, updator=13701087609, issue=Issue{id=1325500677975318675, tenantId=1146029695717560320, journalId=1256213402557890569, year='2025', volume='46', issue='2', pageStart='153', pageEnd='304', issueExtLink='null', onlineDate='null', pubDate='1740412800000', pubDateStr='2025-02-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793953588241, creator='13701087609', updateTime=1793953588241, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext=null, issueFiles=null, downloadFileDto=null}, startPage=223, endPage=228, ext={EN=ArticleExt(id=1325500884830008016, articleId=1325500884439937743, tenantId=1146029695717560320, journalId=1256213402557890569, language=EN, title=Analysis of weight loss behavior and related factors of middle school students in Shanghai, columnId=1259565859148804482, journalTitle=Chinese Journal of School Health, columnName=Health Education and Promotion, runingTitle=null, highlight=null, articleAbstract=
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.

, authors=Weili CHEN1, 2, Zhe ZHANG1, Yani ZHAI1, Qiong YAN1, Yue QI1, Chunyan LUO*, 1, authorsList=Weili CHEN, Zhe ZHANG, Yani ZHAI, Qiong YAN, Yue QI, Chunyan LUO, authorCompany=null, correspAuthors=Chunyan LUO, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2025 Chinese Journal of School Health. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1325500885350101713, articleId=1325500884439937743, tenantId=1146029695717560320, journalId=1256213402557890569, language=CN, title=上海市中学生减重行为及相关因素分析, columnId=1259565859903779205, journalTitle=中国学校卫生, columnName=健康教育与健康促进, runingTitle=null, highlight=null, articleAbstract=
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。

, authors=陈玮丽1, 2, 张喆1, 翟娅妮1, 严琼1, 祁月1, 罗春燕*, 1, authorsList=陈玮丽, 张喆, 翟娅妮, 严琼, 祁月, 罗春燕, authorCompany=null, correspAuthors=罗春燕, authorNote=

陈玮丽与张喆为共同第一作者。

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

, correspAuthorsNote=
罗春燕，E-mail:
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Best Pract Res Clin Endocrinol Metab, 2013, 27(2): 117-127., articleTitle=null, refAbstract=null)], funds=[Fund(id=1325500892543333124, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, awardId=null, language=CN, fundingSource=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-11.1-31), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1325500887094932178, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, xref=1, ext=[AuthorCompanyExt(id=1325500887107515091, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, companyId=1325500887094932178, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Institute of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai (200336), China), AuthorCompanyExt(id=1325500887120098004, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, companyId=1325500887094932178, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1上海市疾病预防控制中心儿童青少年健康所，200336)]), AuthorCompany(id=1325500887308841685, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, xref=2, ext=[AuthorCompanyExt(id=1325500887338201814, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, companyId=1325500887308841685, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2上海体育大学运动健康学院)])], figs=[ArticleFig(id=1325500891947741950, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=EN, label=Tab.1, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
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 3735 992(71.56)606(7.24)2 566(30.65)153(1.83)59(0.70)66(0.79)55(0.66)
女8 3855 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 75811 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95.89366.18384.694.020.150.219.65
P值<0.010.010.010.050.700.650.01
), ArticleFig(id=1325500892014850815, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=CN, label=表1, caption=

不同性别中学生各类减重行为报告率比较

, figureFileSmall=null, figureFileBig=null, tableContent=
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 3735 992(71.56)606(7.24)2 566(30.65)153(1.83)59(0.70)66(0.79)55(0.66)
女8 3855 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 75811 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95.89366.18384.694.020.150.219.65
P值<0.010.010.010.050.700.650.01
), ArticleFig(id=1325500892090348288, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=EN, label=Tab.2, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
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 0884 063(40.28)3 643(36.11)221(2.19)2 161(21.42)341.63<0.01
普高4 9791 339(26.89)2 033(40.83)161(3.23)1 446(29.04)
中职1 691479(28.33)668(39.50)79(4.67)465(27.50)
性别男8 3733 614(43.16)2 543(30.37)191(2.28)2 025(24.18)571.63<0.01
女8 3852 267(27.04)3 801(45.33)270(3.22)2 047(24.41)
年龄/岁10~123 0671 352(44.08)1 118(36.45)53(1.73)544(17.74)
13~157 5242 862(38.04)2 719(36.14)189(2.51)1 754(23.31)359.22<0.01
16~186 1671 667(27.03)2 507(40.65)219(3.55)1 774(28.77)
户籍本市13 9874 873(34.84)5 299(37.89)363(2.60)3 452(24.68)14.350.03
外省市2 569937(36.47)968(37.68)90(3.50)574(22.34)
外籍20271(35.15)77(38.12)8(3.96)46(22.77)
住宿是1 522419(27.53)622(40.87)64(4.20)417(27.40)50.79<0.01
否15 2365 462(35.85)5 722(37.56)397(2.61)3 655(23.99)
城区中心6 1382 252(36.69)2 443(39.80)176(2.87)1 267(20.64)70.49<0.01
非中心10 6203 629(34.17)3 901(36.73)285(2.68)2 805(26.41)
家庭结构双亲家庭14 2245 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 853588(31.73)704(37.99)85(4.59)476(25.69)
父母双方缺失681213(31.28)241(35.39)30(4.41)197(28.93)
独生子女否4 5681 620(35.46)1 755(38.42)144(3.15)1 049(22.96)9.050.03
是12 1904 261(34.95)4 589(37.65)317(2.60)3 023(24.80)
父亲文化初中及以下2 716869(32.00)1 057(38.92)104(3.83)686(25.26)55.51<0.01
    水平高中3 7911 255(33.10)1 463(38.59)113(2.98)960(25.32)
大专3 5731 228(34.37)1 381(38.65)84(2.35)880(24.63)
本科及以上6 6782 529(37.87)2 443(36.58)160(2.40)1 546(23.15)
母亲文化初中及以下3 112997(32.04)1 221(39.24)106(3.41)788(25.32)43.23<0.01
    水平高中3 5731 222(34.20)1 343(37.59)117(3.27)891(24.94)
大专3 7381 299(34.75)1 411(37.75)83(2.22)945(25.28)
本科及以上6 3352 363(37.30)2 369(37.40)155(2.45)1 448(22.86)
网络成瘾是604140(23.18)215(35.60)63(10.43)186(30.79)171.40<0.01
否16 1545 741(35.54)6 129(37.94)398(2.46)3 886(24.06)
受欺凌是5 4251 902(35.06)2 236(41.22)236(4.35)1 051(19.37)178.61<0.01
否11 3333 979(35.11)4 108(36.25)225(1.99)3 021(26.66)
孤独感是1 977513(25.95)880(44.51)126(6.37)458(23.17)187.74<0.01
否14 7815 368(36.32)5 464(36.97)335(2.27)3 614(24.45)
心情郁闷是3 547985(27.77)1 595(44.97)179(5.05)788(22.22)223.09<0.01
否13 2114 896(37.06)4 749(35.95)282(2.13)3 284(24.86)
失眠是1 610405(25.16)758(47.08)136(8.45)311(19.32)318.44<0.01
否15 1485 476(36.15)5 586(36.88)325(2.15)3 761(24.83)
伤心绝望是1 789456(25.49)739(41.31)174(9.73)420(23.48)413.73<0.01
否14 9695 425(36.24)5 605(37.44)287(1.92)3 652(24.40)
自觉体重很轻583221(37.91)67(11.49)30(5.15)265(45.45)1 949.73<0.01
有点轻1 995908(45.51)251(12.58)21(1.05)815(40.85)
有点重6 3621 705(26.80)3 368(52.94)221(3.47)1 068(16.79)
很重1 273286(22.47)663(52.08)78(6.13)246(19.32)
正合适6 5452 761(42.18)1 995(30.48)111(1.70)1 678(25.64)
), ArticleFig(id=1325500892170040065, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=CN, label=表2, caption=

不同组别中学生减重行为类别分布比较

, figureFileSmall=null, figureFileBig=null, tableContent=
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 0884 063(40.28)3 643(36.11)221(2.19)2 161(21.42)341.63<0.01
普高4 9791 339(26.89)2 033(40.83)161(3.23)1 446(29.04)
中职1 691479(28.33)668(39.50)79(4.67)465(27.50)
性别男8 3733 614(43.16)2 543(30.37)191(2.28)2 025(24.18)571.63<0.01
女8 3852 267(27.04)3 801(45.33)270(3.22)2 047(24.41)
年龄/岁10~123 0671 352(44.08)1 118(36.45)53(1.73)544(17.74)
13~157 5242 862(38.04)2 719(36.14)189(2.51)1 754(23.31)359.22<0.01
16~186 1671 667(27.03)2 507(40.65)219(3.55)1 774(28.77)
户籍本市13 9874 873(34.84)5 299(37.89)363(2.60)3 452(24.68)14.350.03
外省市2 569937(36.47)968(37.68)90(3.50)574(22.34)
外籍20271(35.15)77(38.12)8(3.96)46(22.77)
住宿是1 522419(27.53)622(40.87)64(4.20)417(27.40)50.79<0.01
否15 2365 462(35.85)5 722(37.56)397(2.61)3 655(23.99)
城区中心6 1382 252(36.69)2 443(39.80)176(2.87)1 267(20.64)70.49<0.01
非中心10 6203 629(34.17)3 901(36.73)285(2.68)2 805(26.41)
家庭结构双亲家庭14 2245 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 853588(31.73)704(37.99)85(4.59)476(25.69)
父母双方缺失681213(31.28)241(35.39)30(4.41)197(28.93)
独生子女否4 5681 620(35.46)1 755(38.42)144(3.15)1 049(22.96)9.050.03
是12 1904 261(34.95)4 589(37.65)317(2.60)3 023(24.80)
父亲文化初中及以下2 716869(32.00)1 057(38.92)104(3.83)686(25.26)55.51<0.01
    水平高中3 7911 255(33.10)1 463(38.59)113(2.98)960(25.32)
大专3 5731 228(34.37)1 381(38.65)84(2.35)880(24.63)
本科及以上6 6782 529(37.87)2 443(36.58)160(2.40)1 546(23.15)
母亲文化初中及以下3 112997(32.04)1 221(39.24)106(3.41)788(25.32)43.23<0.01
    水平高中3 5731 222(34.20)1 343(37.59)117(3.27)891(24.94)
大专3 7381 299(34.75)1 411(37.75)83(2.22)945(25.28)
本科及以上6 3352 363(37.30)2 369(37.40)155(2.45)1 448(22.86)
网络成瘾是604140(23.18)215(35.60)63(10.43)186(30.79)171.40<0.01
否16 1545 741(35.54)6 129(37.94)398(2.46)3 886(24.06)
受欺凌是5 4251 902(35.06)2 236(41.22)236(4.35)1 051(19.37)178.61<0.01
否11 3333 979(35.11)4 108(36.25)225(1.99)3 021(26.66)
孤独感是1 977513(25.95)880(44.51)126(6.37)458(23.17)187.74<0.01
否14 7815 368(36.32)5 464(36.97)335(2.27)3 614(24.45)
心情郁闷是3 547985(27.77)1 595(44.97)179(5.05)788(22.22)223.09<0.01
否13 2114 896(37.06)4 749(35.95)282(2.13)3 284(24.86)
失眠是1 610405(25.16)758(47.08)136(8.45)311(19.32)318.44<0.01
否15 1485 476(36.15)5 586(36.88)325(2.15)3 761(24.83)
伤心绝望是1 789456(25.49)739(41.31)174(9.73)420(23.48)413.73<0.01
否14 9695 425(36.24)5 605(37.44)287(1.92)3 652(24.40)
自觉体重很轻583221(37.91)67(11.49)30(5.15)265(45.45)1 949.73<0.01
有点轻1 995908(45.51)251(12.58)21(1.05)815(40.85)
有点重6 3621 705(26.80)3 368(52.94)221(3.47)1 068(16.79)
很重1 273286(22.47)663(52.08)78(6.13)246(19.32)
正合适6 5452 761(42.18)1 995(30.48)111(1.70)1 678(25.64)
), ArticleFig(id=1325500892346200834, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=EN, label=Tab.3, caption=

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

, figureFileSmall=null, figureFileBig=null, tableContent=
自变量选项锻炼减重行为节食减重行为不健康减重行为
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)0.010.93(0.73~1.19)0.560.48(0.29~0.81)0.01
普高0.90(0.77~1.05)0.180.83(0.71~0.96)0.010.60(0.44~0.81)<0.01
中职1.001.001.00
性别男1.71(1.57~1.86)<0.010.77(0.71~0.84)<0.010.74(0.60~0.92)0.01
女1.001.001.00
年龄/岁10~121.80(1.40~2.31)<0.011.44(1.12~1.85)0.011.13(0.64~1.98)0.68
13~151.21(0.97~1.51)0.091.04(0.83~1.29)0.751.18(0.74~1.87)0.49
16~181.001.001.00
城区中心1.45(1.33~1.59)<0.011.43(1.31~1.57)<0.011.35(1.10~1.66)<0.01
非中心1.001.001.00
家庭结构双亲家庭1.33(1.08~1.63)0.011.36(1.11~1.67)<0.010.84(0.56~1.28)0.43
父母一方缺失1.17(0.93~1.48)0.191.21(0.95~1.52)0.121.22(0.76~1.94)0.42
父母双方缺失1.001.001.00
网络成瘾是0.60(0.48~0.75)<0.010.61(0.50~0.76)<0.011.71(1.23~2.38)<0.01
否1.001.001.00
受欺凌是1.34(1.22~1.48)<0.011.58(1.44~1.75)<0.012.09(1.68~2.61)<0.01
否1.001.001.00
孤独感是0.80(0.68~0.93)<0.010.87(0.75~1.01)0.070.80(0.60~1.08)0.14
否1.001.001.00
心情郁闷是0.91(0.80~1.02)0.111.06(0.94~1.19)0.371.10(0.86~1.43)0.45
否1.001.001.00
失眠是1.07(0.90~1.27)0.471.47(1.25~1.74)<0.012.33(1.74~3.11)<0.01
否1.001.001.00
伤心绝望是0.78(0.67~0.90)<0.010.95(0.82~1.10)0.483.10(2.42~3.97)<0.01
否1.001.001.00
自觉体重很轻0.42(0.35~0.51)<0.010.20(0.15~0.26)<0.011.34(0.86~2.08)0.20
有点轻0.60(0.54~0.68)<0.010.26(0.22~0.30)<0.010.36(0.23~0.59)<0.01
有点重1.03(0.93~1.14)0.552.63(2.39~2.89)<0.012.77(2.17~3.55)<0.01
很重0.75(0.62~0.90)<0.012.21(1.88~2.61)<0.013.41(2.44~4.75)<0.01
正合适1.001.001.00
), ArticleFig(id=1325500892425892611, tenantId=1146029695717560320, journalId=1256213402557890569, articleId=1325500884439937743, language=CN, label=表3, caption=

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)

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自变量选项锻炼减重行为节食减重行为不健康减重行为
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)0.010.93(0.73~1.19)0.560.48(0.29~0.81)0.01
普高0.90(0.77~1.05)0.180.83(0.71~0.96)0.010.60(0.44~0.81)<0.01
中职1.001.001.00
性别男1.71(1.57~1.86)<0.010.77(0.71~0.84)<0.010.74(0.60~0.92)0.01
女1.001.001.00
年龄/岁10~121.80(1.40~2.31)<0.011.44(1.12~1.85)0.011.13(0.64~1.98)0.68
13~151.21(0.97~1.51)0.091.04(0.83~1.29)0.751.18(0.74~1.87)0.49
16~181.001.001.00
城区中心1.45(1.33~1.59)<0.011.43(1.31~1.57)<0.011.35(1.10~1.66)<0.01
非中心1.001.001.00
家庭结构双亲家庭1.33(1.08~1.63)0.011.36(1.11~1.67)<0.010.84(0.56~1.28)0.43
父母一方缺失1.17(0.93~1.48)0.191.21(0.95~1.52)0.121.22(0.76~1.94)0.42
父母双方缺失1.001.001.00
网络成瘾是0.60(0.48~0.75)<0.010.61(0.50~0.76)<0.011.71(1.23~2.38)<0.01
否1.001.001.00
受欺凌是1.34(1.22~1.48)<0.011.58(1.44~1.75)<0.012.09(1.68~2.61)<0.01
否1.001.001.00
孤独感是0.80(0.68~0.93)<0.010.87(0.75~1.01)0.070.80(0.60~1.08)0.14
否1.001.001.00
心情郁闷是0.91(0.80~1.02)0.111.06(0.94~1.19)0.371.10(0.86~1.43)0.45
否1.001.001.00
失眠是1.07(0.90~1.27)0.471.47(1.25~1.74)<0.012.33(1.74~3.11)<0.01
否1.001.001.00
伤心绝望是0.78(0.67~0.90)<0.010.95(0.82~1.10)0.483.10(2.42~3.97)<0.01
否1.001.001.00
自觉体重很轻0.42(0.35~0.51)<0.010.20(0.15~0.26)<0.011.34(0.86~2.08)0.20
有点轻0.60(0.54~0.68)<0.010.26(0.22~0.30)<0.010.36(0.23~0.59)<0.01
有点重1.03(0.93~1.14)0.552.63(2.39~2.89)<0.012.77(2.17~3.55)<0.01
很重0.75(0.62~0.90)<0.012.21(1.88~2.61)<0.013.41(2.44~4.75)<0.01
正合适1.001.001.00
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上海市中学生减重行为及相关因素分析
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陈玮丽 1, 2 , 张喆 1 , 翟娅妮 1 , 严琼 1 , 祁月 1 , 罗春燕 *, 1
中国学校卫生 | 健康教育与健康促进 2025,46(2): 223-228
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中国学校卫生 |健康教育与健康促进 2025 , 46 (2) : 223 -228
上海市中学生减重行为及相关因素分析
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陈玮丽1, 2, 张喆1, 翟娅妮1, 严琼1, 祁月1, 罗春燕*, 1
作者信息
  • 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
通讯作者:
罗春燕，E-mail:
作者简介:

陈玮丽与张喆为共同第一作者。

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

Analysis of weight loss behavior and related factors of middle school students in Shanghai
Weili CHEN1, 2, Zhe ZHANG1, Yani ZHAI1, Qiong YAN1, Yue QI1, Chunyan LUO*, 1
Affiliations
  • 1Institute of Child and Adolescent Health, Shanghai Municipal Center for Disease Control and Prevention, Shanghai (200336), China
出版时间: 2025-02-25 doi: 10.16835/j.cnki.1000-9817.2025048
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摘要
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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
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
陈玮丽, 张喆, 翟娅妮, 严琼, 祁月, 罗春燕. 上海市中学生减重行为及相关因素分析. 中国学校卫生, 2025 , 46 (2) : 223 -228 . DOI: 10.16835/j.cnki.1000-9817.2025048
Weili CHEN, Zhe ZHANG, Yani ZHAI, Qiong YAN, Yue QI, Chunyan LUO. Analysis of weight loss behavior and related factors of middle school students in Shanghai[J]. Chinese Journal of School Health, 2025 , 46 (2) : 223 -228 . DOI: 10.16835/j.cnki.1000-9817.2025048
正文
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近年来，随着饮食结构的改变和生活方式的转变，全球青少年肥胖问题日益严重[1]。在中国，青少年肥胖率持续上升[2]，而受社会环境影响形成的“以瘦为美”观念也愈发普遍，导致青少年减重行为发生率不断增加[3-4]。部分青少年会选择不健康的减重方式，主要包括长时间不进食、服用减肥药物、催吐等，不仅无法长期有效地控制体重，反而可能带来严重的生理和心理健康问题[5]。如极端节食行为可能导致营养不良，影响青春期的正常发育，甚至引发电解质失衡、心律失常等严重问题，极端情况下可能导致心脏骤停[6-8]；自我催吐和滥用泻药则可能引发牙齿腐蚀、腺体肿大、食道损伤，以及消化系统和代谢功能的紊乱[9]。同时，不健康减重行为还与情绪障碍密切相关，研究表明采取不健康减重行为的青少年更容易患上抑郁症[10-12]。不健康减重行为的发生情况与多种因素有关，现有研究表明，不同性别、不同学段学生的不健康减重行为发生率有显著差异[3, 13-14]。本研究对上海市中学生进行调查，了解中学生减重行为的分布特征以及相关因素，为指导青少年科学减重干预工作提供参考依据。
1　对象与方法
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1.1　对象
于2021年5—6月，采用分层整群随机抽样方法，在上海市16个区开展抽样调查。按初中、普通高中(普高)和中等职业学校(中职)分层，通过人口比例概率抽样方法(probability proportional to size, PPS)随机抽取学校和年级，共抽取61所学校，年级范围从预初到高三年级(含中职学校一至三年级)，在每个年级中采用随机数字表法抽取2~4个班级，以班级为单位进行问卷调查(每年级至少调查80人，不足80人则在同类别学校同年级补齐)。问卷剔除标准：(1)研究所需变量缺失的问卷；(2)不符合研究人群(10~18岁)的年龄特征。共发放调查问卷19 662份，回收有效问卷16 758份，有效率为85.23%。其中男生8 373名，女生8 385名；初中生、普高生、中职生分别是10 088，4 979，1 691名。年龄范围为10~18岁，平均年龄(14.64 ± 2.02)岁。本研究方案通过了上海市疾病预防控制中心伦理审查委员会的批准(编号：2022-1)，调查前学生及家长均已签署知情同意书。
1.2　方法
1.2.1　调查问卷
问卷参考中国疾病预防控制中心的青少年危险行为调查问卷(Youth Risk Behavior Surveillance System, YRBSS)[15]，结合上海市监测需要进行修改，并设计上海市青少年健康相关行为调查问卷，分为初中版和高中版。既往研究显示，问卷重测信度为0.93[16]。问卷内容包括学生的一般情况、自觉体重、减重行为、网络成瘾行为、欺凌等。
1.2.2　健康危险行为及判定标准
根据《中国青少年健康相关/危险行为调查综合报告2005》界定[17]。(1)减重行为，指过去30 d里，采用某种方法减轻体重或防止体重增加的行为，包括以下7种行为：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。将7种减重行为进一步分为3类[3, 14]，①不健康减重行为：≥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，存在其中之一，则为不健康减重行为；②锻炼减重行为：只存在锻炼减重行为；③节食减重行为：存在不吃主食、减少食物量、能量摄取或吃低脂食物其中之一，但不存在不健康减重行为，则为节食减重行为。(2)网络成瘾行为，指过去7 d内每天非学习原因上网≥4 h，且符合以下至少4项表现：①经常上网，即使不上网，脑中也一直浮现与网络有关的事情；②一旦不能上网，就感到不舒服或不愿意干别的事，上网则缓解；③为得到满足感增加上网时间；④因为上网而对其他娱乐活动(爱好、会见朋友)失去兴趣；⑤多次想停止上网，但总不能控制自己；⑥因为上网而不能完成作业或逃学；⑦向家长或老师、同学隐瞒自己上网的事实；⑧明知负面结果(睡眠不足、上课迟到、与父母争执)而继续上网；⑨为了逃避现实、摆脱自己的困境或郁闷、无助、焦虑情绪才上网。(3)受欺凌，指过去30 d里遭受过恶意取笑、威胁恐吓、被索取财物、被孤立/被有意排挤在集体活动之外、被踢/打/推/挤或关屋里，存在其中之一则为受欺凌。(4)孤独感，指过去12个月里经常/总是感到孤独。(5)心情郁闷，指过去12个月里，因学习压力或成绩问题经常/总是感到心情不愉快。(6)失眠，指过去12个月里因担心某事而经常/总是失眠。(7)伤心绝望，指过去12个月里曾连续2周或更长时间因为伤心绝望而停止平常的活动。
1.3　质量控制
问卷调查遵循自愿、独立、匿名填写的原则，调查员由上海市各区疾病预防控制中心的工作人员担任。所有调查员经过统一培训，确保在调查过程中无学校教师在场。问卷现场发放并当场回收，学生填写的所有信息严格保密。
1.4　统计学分析
采用SPSS 25.0软件进行统计分析，符合正态分布的计量数据采用(x ±s)进行描述，计数资料采用频数(百分率)描述。采用χ2检验分析不同特征中学生间的减重行为报告率差异；采用无序多分类Logistic回归模型分析中学生减重行为的相关因素。检验水准α=0.05。
2　结果
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2.1　不同性别中学生减重行为报告率
参与调查的中学生锻炼、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7种减重行为的报告率分别为68.03%，12.05%，38.01%，2.05%，0.68%，0.76%，0.49%。除催吐或腹泻减重、无医嘱擅自吃减肥药以外，其余5种减重行为报告率在不同性别间的差异均有统计学意义(P值均<0.05)，男生在锻炼、美容院瘦身的减重行为报告率均高于女生，而女生在不吃主食、减少食物量和能量摄取或吃低脂食物、≥24 h不吃东西的减重行为报告率均高于男生。见表1。
2.2　不同特征中学生减重行为类别比较
参与调查中学生锻炼减重行为者有5 881名(35.09%)，节食减重行为有6 344名(37.86%)，不健康减重行为有461名(2.75%)，无减重行为有4 072名(24.30%)。对不同特征中学生的减重行为进行比较显示，不同学段、性别、年龄段、户籍、住宿、城区、家庭结构、独生子女、父亲文化水平、母亲文化水平、网络成瘾、受欺凌、孤独、心情郁闷、失眠、伤心绝望、自觉体重的中学生减重行为分布差异均有统计学意义(P值均<0.05)。见表2。
2.3　中学生减重行为相关因素的无序多分类Logistic回归分析
将减重行为分类(以无减重行为为参照)作为因变量，以单因素分析中有统计学意义的变量为自变量进行向后逐步无序多分类Logistic回归分析，结果显示，与无减重行为组相比，初中、男生、10~12岁、住中心城区、双亲家庭、受欺凌的中学生采取锻炼减重行为的可能性更高；网络成瘾，孤独，伤心绝望，自觉体重很轻、有点轻和很重的中学生采取锻炼减重行为的可能性较低(P值均<0.05)。与无减重行为组相比，10~12岁、住中心城区、双亲家庭、受欺凌、失眠、自觉体重很重和有点重的中学生采取节食减重行为的可能性更高；普高生、男生、网络成瘾、自觉体重有点轻和很轻的中学生采取节食减重行为的可能性相对较低。与无减重行为组相比，住中心城区、网络成瘾、受欺凌、失眠、伤心绝望、自觉体重很重和有点重的中学生采取不健康减重行为的可能性相对较高；初中生、普高生、男生、自觉体重有点轻的中学生采取不健康减重行为的可能性相对较低(P值均<0.05)。见表3。
3　讨论
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本次调查发现，上海市中学生锻炼减重行为、节食减重行为、不健康减重行为报告率分别为35.09%，37.86%，2.75%，不健康减重行为比例低于2010年北京市延庆县(4.12%)[18]和2019年上海市报告率(3.2%)[19]。
本研究发现，初中、男生、中心城区的学生更有可能采取锻炼减重行为，与以往研究一致[3, 14, 20-21]。有证据表明，个体情绪和体重认知偏差可能会阻碍锻炼行为[22-23]。本研究发现，存在伤心绝望不良情绪和体重认知偏差的中学生锻炼减重行为较少，可能由于伤心绝望情绪与消极思维有关，进而导致他们对锻炼缺乏兴趣，削弱了锻炼的动机[24]。体重认知偏差的学生可能因对自身体型的不准确认知[25]，低估锻炼的必要性。本研究还发现，网络成瘾者采取锻炼减重行为的可能性较低。Chan等[26]发现，网络成瘾与促进健康的生活方式(包括锻炼行为)呈负相关，可能由于网络成瘾者过度使用网络导致日常体力活动的显著减少，进而降低通过锻炼实现体重管理的可能性。
本研究还发现，对于节食减重行为，除了自觉体重有点重和很重的中学生发生风险较高以外，受欺凌、失眠的中学生发生节食减重行为的风险也较高。Berg等[27]研究显示，受欺凌、失眠的瑞典学龄儿童与节食减重行为发生风险增大有关，与本研究结果相近。受欺凌和失眠可能会导致个体情绪不佳，从而影响大脑分泌多巴胺和血清素，而血清素是参与情绪稳定的关键神经递质，低水平的血清素可能引发个体抑制食欲的倾向[28]，增加节食减重行为的发生。
本研究结果显示，居住在中心城区，经历失眠、伤心绝望等不良情绪以及自觉体重有点重和很重的中学生更容易发生不健康减重行为，与已有研究结果一致[14, 20]。本研究还发现，有网络成瘾行为的中学生发生不健康减重行为的风险较大，与已有研究结果相似[29-30]。中学生可能通过网络频繁接触理想化的身体形象，增加对完美身材的渴望与压力，从而加剧对自身外貌的不满[31]，导致不健康减重行为发生。Patte等[32]研究结果显示，自觉体重和欺凌均会独立影响心理健康，体重过重会增加受欺凌的风险，反过来又加剧了青少年的心理健康问题。因体重过重被嘲笑、遭受欺凌的青少年更有可能采取不健康减重行为，例如暴饮暴食、长期节食、呕吐和不健康地使用减肥药或泻药[33]。因此，学校应重视学生的心理健康，积极开展网络成瘾的预防教育，并加强对校园欺凌行为的管理，以减少不健康减重行为的发生。
本研究具有一定的局限性：研究采用问卷调查对过去行为进行自我报告，可能存在回忆偏倚和报告偏倚；其次，基于横断面的调查不能推断减重行为与各相关因素之间的因果关系，未来的研究应考虑采用纵向研究设计，以更好地揭示各因素对减重行为的潜在因果影响。
综上所述，失眠、伤心绝望等不良情绪，网络成瘾以及受欺凌等因素是青少年不健康减重行为的相关因素。针对青少年的干预措施应关注他们的心理健康、网络使用行为以及校园欺凌问题，以预防和减少不健康的减重行为，促进青少年身心健康的发展。
基金
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  • 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-11.1-31)
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2025年第46卷第2期
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doi: 10.16835/j.cnki.1000-9817.2025048
  • 接收时间：2024-10-16
  • 首发时间：2026-11-06
  • 出版时间：2025-02-25
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  • 收稿日期：2024-10-16
  • 修回日期：2024-12-06
基金
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-11.1-31)
作者信息
    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

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
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