Regional differences in obesity risk, sedentary behavior, and dietary patterns among university students in Saudi Arabia: a multi-region cross-sectional study.
Alkhraiji M & Alaqil A • Frontiers in public health • 2026
Region showed the strongest association with overweight/obesity, with Riyadh students at four-fold higher risk than Makkah students, suggesting that regional structural and environmental factors may contribute to obesity risk in this population.
Key Findings
Results
The overall prevalence of overweight/obesity among Saudi university students was 17.9%, though this is considered a conservative lower bound due to reliance on self-reported anthropometrics.
100 out of 558 students met the overweight/obesity threshold (BMI ≥ 25.0 kg/m²)
BMI was calculated from self-reported weight and height
Authors note this figure represents 'a conservative lower bound' due to self-reporting bias
Study conducted March–May 2023 with 564 students recruited from four Saudi administrative regions
Results
A marked regional gradient in overweight/obesity prevalence was observed, with Riyadh students (27.8%) more than three times as likely to be overweight/obese compared to Makkah students (8.8%).
Regional difference was statistically significant: χ² = 25.48, p < 0.001
Riyadh prevalence was 27.8% versus 8.8% in Makkah
Region was the strongest predictor of overweight/obesity after adjustment
Riyadh students had an adjusted odds ratio of 4.62 (95% CI 2.23–9.59, p < 0.001) compared to the reference region
Results
After multivariable adjustment, region (Riyadh) and male sex were the only statistically significant predictors of overweight/obesity.
Riyadh region: aOR = 4.62, 95% CI 2.23–9.59, p < 0.001
Male sex: aOR = 1.96, 95% CI 1.04–3.71, p = 0.037
Logistic regression was adjusted for sex, age, income, college type, region, and smoking
Students with prior type 2 diabetes were excluded from the study
Results
Sedentary behavior was highly prevalent, with 82.3% of students classified as moderately or highly sedentary (≥ 8 hours/day).
Composite sedentary behavior was classified as low (< 8 h/day), moderate (8–12 h/day), or high (> 12 h/day)
Mobile phone use was the dominant sedentary activity at 3.75 hours/day
Academic study contributed 3.35 hours/day of sedentary time
Physical activity was assessed via IPAQ-SF with sufficiency threshold of ≥ 150 min/week
Results
Overweight/obese students had significantly higher daily sedentary behavior hours compared to non-overweight/obese students.
Overweight/obese students averaged 15.5 hours/day of sedentary behavior versus 13.9 hours/day for non-overweight/obese students
Difference was statistically significant: p = 0.043
Prolonged mobile phone use and screen-based sedentarism were specifically identified as prevalent and associated with overweight/obesity
Results
Nutrition-transition dietary patterns identified through principal-component analysis were not significantly associated with overweight/obesity.
Dietary patterns were identified using principal-component analysis of 17 food groups
A validated 66-item food frequency questionnaire was used
Adjusted odds ratio for dietary patterns and overweight/obesity: aOR = 0.93, p = 0.543
The study was guided by Popkin's nutrition transition theory
Methods
The study used a multistage sampling approach selecting students from three colleges per university across three academic domains in four Saudi administrative regions.
Total sample: 564 students recruited March–May 2023
Within each college, one male and one female class per academic level were invited
All eligible students completed the questionnaire (census within selected classes)
Exclusion criterion was prior diagnosis of type 2 diabetes
What This Means
This research examined rates of overweight and obesity, sedentary behavior, and eating habits among university students across four regions of Saudi Arabia. Using surveys completed by 564 students in 2023, the researchers found that about 18% of students were overweight or obese—though this is likely an underestimate since students reported their own height and weight rather than being measured directly. The most striking finding was a large difference by region: more than one in four students in Riyadh were overweight or obese, compared to fewer than one in ten in Makkah. Being from Riyadh and being male were the only factors that independently predicted higher obesity risk after accounting for other variables like age, income, and smoking.
The study also found that sedentary behavior was extremely common, with over 80% of students spending 8 or more hours per day sitting or being physically inactive. The biggest contributors were mobile phone use (nearly 4 hours per day) and academic studying (about 3.5 hours per day). Students who were overweight or obese were sedentary for notably longer each day (15.5 hours vs. 13.9 hours) compared to students at a healthy weight. Interestingly, the types of foods students ate—analyzed to reflect the shift toward more processed, Western-style diets—were not linked to obesity risk in this group.
This research suggests that where a student lives within Saudi Arabia may matter more than their individual food choices in determining obesity risk, pointing to possible differences in the built environment, food availability, or cultural factors across regions. The findings highlight a potential need for university programs that specifically address excessive screen and phone use, as well as region-level strategies—particularly in Riyadh—to address the factors driving higher obesity rates. Future studies using direct physical measurements rather than self-reported data would give more accurate prevalence estimates.
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Alkhraiji M, Alaqil A. (2026). Regional differences in obesity risk, sedentary behavior, and dietary patterns among university students in Saudi Arabia: a multi-region cross-sectional study.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1980253