The association between weekend catch-up sleep and the reduction of obesity and overweight risk in adolescents with insufficient weekday sleep

Purpose: This study investigates the association between weekend catch-up sleep (CUS) and overweight/obesity in Korean adolescents, focusing on weekday sleep sufficiency. Methods: A nationwide cross-sectional study was conducted among 12,434 high school students in South Korea. Sleep patterns including total sleep duration and weekend CUS were assessed using self-reported questionnaires. Body mass index (BMI) was calculated and categorized into overweight/obese and normal weight groups based on age- and sex-adjusted Z-scores. Logistic and linear regression models were used to assess the associations between sleep variables and overweight/obesity. Results: Students with 3 or more h of CUS had lower odds of being overweight/obesity (odds ratio = 0.67, 95% confidence interval: 0.57–0.80) compared to those with non-CUS. This protective effect remained significant in the subgroup with perceived insufficient weekday sleep. Furthermore, students with 3 or more h of CUS had significantly lower BMI z-scores (β = -0.18, p < 0.001), an association that was also observed in those with perceived insufficient sleep (β = -0.16, p = 0.003). The analysis showed a dose-dependent pattern, with greater weekend CUS being associated with a stepwise reduction in BMI z-scores. Conclusions: Weekend CUS may serve as an important compensatory mechanism for adolescents to reduce the risk of being overweight or obese. However, no additional benefits of CUS were observed in adolescents with sufficient sleep quality.