From screens to snacks: social media exposure and food consumption triggers among overweight and obese adolescents – Evidence from a cross-sectional, mixed-methods approach

Background Exposure to food-related digital media has been recognized as a determinant of eating behavior, although this remains less known during adolescence, particularly among overweight and obese individuals. Our study aimed to analyze the influence of food-related digital media content on the eating behavior of overweight and obese adolescents by integrating dietary intake data, screen time, and adolescents' subjective narratives about advertising stimuli, while considering potential sex differences. Methods This cross-sectional mixed-methods study included 35 adolescents aged 10–17 years with overweight or obesity from southern Brazil. Data collection comprised sociodemographic questionnaires, daily screen time assessment, 24-hour dietary recalls classified according to the NOVA system, and anthropometric measurements via bioelectrical impedance analysis. Open-ended responses regarding food advertisements were analyzed using IRaMuTeQ® software through Descending Hierarchical Classification, word clouds, and similarity analysis. Results Adolescents exhibited high daily screen exposure (5.4–7.2 h·day⁻¹), with no sex differences except for greater computer use among boys (p = 0.013). Dietary patterns showed predominant consumption of ultra-processed foods, without sex-specific differences. Qualitative analysis revealed that food desire was strongly associated with sensory and audiovisual stimuli, digital influencer presence, and brand recognition. Girls demonstrated heightened sensitivity to visual and aesthetic elements of advertisements, whereas boys showed stronger associations with traditional media formats and explicit brand advertising. Conclusions Digital food-related content functions as a symbolic and emotional driver of eating behavior among overweight and obese adolescents, operating through sex-specific persuasive mechanisms that reinforce unhealthy dietary patterns. Strategies must address the qualitative dimensions of digital food environments as active determinants of adolescent eating behavior.