The association of cannabis use with fast-food consumption, overweight, and obesity among adolescents aged 12-15 years from 28 countries

Background Cannabis legalization and use have risen globally. However, the association between cannabis use, eating behaviors and body weight among adolescents is yet unexplored. Objectives This study examined the association between cannabis use, fast-food consumption, overweight and obesity in 28 countries using data from the 2010–2016 Global School-Based Student Health Survey. Methods Multivariable logistic regression and meta-analysis were performed among a sample of 83,726 adolescents (48.7% females) aged 12–15 years, mean (SD) age of 13.8 (0.9) years. Results The overall prevalence of cannabis use (in past 30 days) and fast-food consumption (in past 7 days) were 2.8% and 57.3% respectively. The overall prevalence of overweight and obesity was 14.7% and 4.2%, respectively. Cannabis use was significantly associated with fast-food consumption (OR = 1.33; 95%CI = 1.13–1.57) but not with overweight (OR = 0.95; 95%CI = 0.80–1.14) or obesity (OR = 1.16; 95%CI = 0.85–1.59). For obesity, there was a moderate level of between-country heterogeneity (I2 = 51.9%) and significant positive associations with cannabis use were observed in Bahamas, Bangladesh, Namibia and Nepal. Conclusion The results highlight the association between cannabis use and dietary risks, providing evidence for public health interventions on the interrelated nature of cannabis use and fast-food consumption.