Weight Status, Psychosocial Factors, and Health-Related Quality of Life Among Jordanian Adolescents: A Cross-Sectional Study Using Structural Equation Modeling.

Background/Objectives: Childhood and adolescent obesity is a growing public health concern in Jordan, with implications for both physical and psychological well-being. While obesity's physical effects are well-documented, less is known about its broader association with adolescents' quality of life (QoL), particularly in Middle Eastern contexts. This study aimed to investigate the associations between weight status, psychosocial factors, and health-related quality of life (HRQOL) among Jordanian adolescents. This study aimed to investigate the associations between weight status, psychosocial factors, and HRQoL among Jordanian adolescents. Methods: A cross-sectional study was conducted with 719 adolescents (63.3% female) aged 11-18, recruited from public schools and pediatric clinics in three regions of Jordan. Data were collected using validated questionnaires assessing demographics, health behaviors, mental health (PHQ-9, GAD-7, SMFQ), and HRQoL (PedsQL 4.0). Structural equation modeling (SEM) was used to examine direct and indirect pathways predicting physical and psychological QoL. Results: Bullying emerged as a key mediator between weight status and QoL, particularly for physical well-being. Depression and anxiety were significant predictors of poorer psychological QoL. Positive school experience, academic performance, physical activity, and paternal education were positively associated with QoL. Nutritional habits were inversely associated with anxiety levels. Model fit indices supported the adequacy of both the physical and psychological QoL models. Conclusions: The findings highlight the interconnected relationship of weight-related stigma, school environment, and lifestyle behaviors on adolescent well-being. Multi-component, school-based interventions targeting bullying, physical activity, and mental health literacy may be effective in improving QoL in this population.