A comparative analysis of generalized additive models for obesity risk prediction

Abstract

Obesity is a growing global health crisis, and traditional regression models often fail to capture the complex relationships between risk factors, limiting predictive accuracy and hindering effective public health interventions. Conventional methods overlook non-linear associations and interaction effects across demographic, socioeconomic, and behavioral predictors, which are particularly important in diverse populations with varying obesity determinants. To address these limitations, we applied Generalized Additive Models for Location, Scale, and Shape (GAMLSS) to analyze obesity predictors in a nationally representative adolescent sample (N $=$ 671). Our framework included comprehensive variable selection across demographic, socioeconomic, behavioral, and clinical domains, comparison with three alternative regression models, and validation using the Generalized Akaike Information Criterion (GAIC). The binomial stepwise GAMLSS model demonstrated superior performance (GAIC $=$ 624.98). Key findings included strong geographic variation, significant gender disparity, a socioeconomic gradient, and important behavioral predictors such as weight gain attempts. The GAMLSS framework improves obesity risk prediction by modeling complex relationships often missed by traditional methods, offering targeted intervention strategies based on geographic, gender, and socioeconomic factors, and challenging assumptions about dietary influences.