Abstract
BACKGROUND: There is a dearth of studies focused on the impact of self-rated health on life satisfaction among large-bodied adolescents, as well as the moderating role of physical activity in this relationship. Large-bodied adolescents refers to young people (usually aged 10-19 years) whose body size falls within the overweight or obese range as defined by the World Health Organisation's Growth Reference, based on age- and sex-specific body mass index (BMI) percentiles. This study aimed to address the gap in research by examining the association between self-rated health and life satisfaction in a diverse sample of large-bodied adolescents from 39 countries and regions in Europe and North America. The moderating role of physical activity in the association was also examined. METHODS: The study analysed data from the Health Behaviour in School-aged Children (HBSC) survey, involving a sample of 24,839 large-bodied adolescents. Three sequential binary mixed effects logit models were fitted: the first assessing self-rated health alone, the second adjusting for multiple covariates, and the third incorporating an interaction term between physical activity and self-rated health. The analysis was performed using R Software (v4.1.2), with significance determined at a level of 0.05. RESULTS: The results show that adolescents who rated their health as "poor" were a little more than six times (AOR = 6.32, 95%CI: 5.30-7.54, p < 0.001) as likely to report lower life satisfaction compared to those who rated their health as "excellent". Those who rated their health as "good" had 1.71 times higher odds (AOR = 1.71, 95%CI: 1.44-2.04, p < 0.001) of reporting lower life satisfaction compared to those who rated their health as "excellent". The analysis further indicated that physical activity plays a partial moderating role in the relationship between self-rated health and life satisfaction. Participants who considered themselves "somewhat active" reported higher life satisfaction compared to their "inactive" peers (AOR = 0.58, p = 0.031, 95% CI: 0.36-0.95). CONCLUSIONS: The study supports the hypothesis that poorer self-rated health is associated with lower life satisfaction among large-bodied adolescents. It further suggests that increased physical activity can 'partly' buffer the negative effects of poor self-rated health on life satisfaction. These findings emphasise the importance of interventions promoting physical activity and positive self-care to improve general well-being in large-bodied adolescents.