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The purpose of this study is to evaluate the relationship between weight status and food environments, peer influence and dietary intake among high-school students in Shiraz, Iran.

Applying a case-control design, 406 adolescents (n = 203 overweight or obese and n = 203 normal weight) aged 14–18 years were selected using a multistage cluster random sampling method. Demographic information, physical activity level and anthropometric indices were collected. Dietary intake was determined using a 147-item food frequency questionnaire. Food environment (home and out of home) and peer influence were determined by a validated questionnaire.

The type of food purchased using pocket money was different between adolescents with overweight or obesity and normal weight adolescents (p < 0.001). The out-of-home food environment score was not different between groups, but the home food environment score (p = 0.004) and the peer influence score (p = 0.001) were higher in normal weight adolescents. Adolescents with overweight or obesity consumed higher amounts of carbohydrate (p = 0.006) and lower amounts of protein (p = 0.01) and more sweet junk foods (p = 0.01), nonstarchy vegetables (p = 0.03) and fruits (p = 0.01) compared to the normal weight group.

Home food environment, peer influence, differences in macronutrient intake and dietary patterns may be contributing factors to adolescent weight status.