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Background: We explored the relationship between adolescent physical activity levels, socio-economic conditions and body mass index (BMI) in order to gain a deeper understanding of the relevant factors affecting adolescent obesity., Methods: A stratified random sampling method was used to conduct a questionnaire survey of middle school students in the Chengdu-Chongqing Economic Zone. Multiple linear and logistic regression analysis methods were used to statistically analyse the data obtained., Results: The level of moderate to vigorous physical activity (MVPA) not only significantly reduces the incidence of obesity in adolescents, it also has a positive effect on avoiding underweight in adolescents. The impact of a father's BMI on a son's weight is higher than that of a daughter, while the impact of a mother's BMI on a child's weight is the opposite. High monthly income has a positive effect on reducing the BMI of male and female adolescents, but full-time working mothers actually increase the risk of obesity in their children. Teenagers who have exercise habits or view exercise as a form of enjoyment have a significantly reduced risk of obesity., Conclusions: The level of MVPA and exercise habits are important factors in inhibiting the development of obesity in adolescent students., (© The Author(s) 2024. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)