A Systematic Review of Screen Time and Obesity in Children, Adolescents, and Young Adults: Sex-Specific Pathways and Implications for Public Health Interventions

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Flow diagram of study identification and selection: 1,342 records were identified (1,334 from databases and 8 from citation tracking), 367 duplicates were removed, and 975 records were screened. After excluding 524 records, 451 full-text articles were assessed for eligibility. Of these, studies were excluded for reasons including non–screen time exposures, non–obesity-related outcomes, composite exposure measures, lack of sex-specific analysis, or non-eligible populations, resulting in 22 studies included in the review.

Figure 1. Flowchart outlining the study search and selection process in a systematic review of screen time and obesity among children, adolescents, and young adults, with a focus on sex-specific differences.

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Conceptual model showing sex-specific behavioral, physiologic, and psychologic pathways linking screen time to obesity, with indirect effects predominating in males such as increased caloric intake, late-night use, reduced sleep. In females, screen time is linked to obesity through reduced physical activity and more direct and psychosocially mediated effects in females.

Figure 2. Conceptual model for sex-specific pathways linking screen time to obesity among children, adolescents, and young adults.

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