Background: The double burden of malnutrition (DBM) is an emerging nutritional problem of the coexistence of underweight, and overweight and/or obesity affecting adolescents from both affluent and poor countries and nutritional status of adolescents in Ethiopia is not well documented, and they are the neglected segment of the population. Objective: The study aimed to assess prevalence and associated factors of double burden of Malnutrition among School Adolescents in Burayu town, Oromia special Zone, Oromia Region, Ethiopia. Methods: A school-based cross-sectional study was conducted from October, 2018` to January, 2019. A Stratified sampling was used to select a random sample of 627 adolescents from selected schools. Data on socio-demographic information were collected by using an interviewer-administered questionnaire, and anthropometric measurements were made by using a digital Seca scale and height measuring board by trained data collectors. Data was entered into Epi-Data version 3.1software and exported to SPSS version 24. World Health Organization Anthro-plus software was used to analyze anthropometric data. Both binary and multinomial logistic regression analyses was done to identify factors associated with the malnutrition of adolescents. Result: Prevalence of stunting, thinness and overweight / obesity was 11.1%, 3.9% and 12.1 %respectively. Having small number of children [AOR=2.069(95%CI: 1.161, 3.686)] significantly associated with stunting. Sex of adolescents [AOR=4.454(95%CI: 1.616, 12.278)], Primary School adolescents [AOR=.233 (95%CI: .066, .821)] and secondary school adolescents [AOR=.229(95%CI: .056, .931)] and food sources [AOR=3.750(95%CI: 1.446, 9.728)] were significantly associated thinness. Sex of adolescents [AOR=536(95%CI: .318, .901))], school type[AOR=.326(95%CI: .186, .571)] and number of children[AOR =1.855(95%CI: 1.086, 3.166)] were significantly associated to overweight /obese. Conclusion: This study revealed the coexistence of double burden of malnutrition among in-school adolescents. There is an increasing trend in the level of stunting and overweight /obesity. Number of children per family had being associated with stunting and overweight /obesity. Food source and school level was positive association with thinness. School type and sex of school adolescents associated with overweight /obesity.

Keywords: Double Burden of Malnutrition, Stunting, Overweight, Food Source