Prevalence and multidimensional associated factors of childhood overweight and obesity in Chengdu, China: A cross-sectional study

Aim To examine the current prevalence of childhood overweight and obesity in Chengdu (China) and identify multidimensional correlates spanning demographics, family influence, behaviors, and psychological factors. Design Cross-sectional data from the Chengdu Positive Child Development (CPCD) survey, using multistage stratified cluster random sampling and ordered logistic regression to analyze weight status as an ordinal outcome. Methods A total of 4597 children and adolescents aged 8–18 years were included in the final analysis. Analyses were conducted in SPSS 26.0 using chi-square tests, Kruskal-Wallis H tests, and ordered logistic regression. Results The prevalence of overweight and obesity was 9.70% and 6.53% (16.23%), respectively. Compared to children with obese fathers, those with underweight fathers (95% CI: 0.148–0.344), normal weight fathers (95% CI: 0.272–0.506), and overweight fathers (95% CI: 0.414–0.818) had significantly lower odds of elevated weight status (all P < 0.05). Likewise, compared to children whose mothers were obese, those with underweight (95% CI: 0.178–0.495), normal weight (95% CI: 0.354–0.593), and overweight mothers (95% CI: 0.465–0.782) had significantly lower odds (all P < 0.001). Higher weight status was associated with meat-based dietary preference (95% CI: 1.164–2.375), balanced dietary preference (95% CI: 1.150–2.229), and binge eating once or twice a week (95% CI: 1.087–2.076) (all P < 0.05). Longer sleep duration (> 7 h vs. < 5 h: 95% CI: 0.163–0.702; 6–7 h vs. < 5 h: 95% CI: 0.228–0.988) and older age (95% CI: 0.741–0.816) were associated with lower odds, whereas male gender (95% CI: 1.111–1.549) was associated with higher odds of elevated weight status (all P < 0.05). Conclusions Childhood overweight and obesity in Chengdu are familial and lifestyle factors, particularly parental body mass index, dietary preference, and sleep duration. Prevention strategies should target family-based approaches, culturally adapted dietary guidance, and systemic policies to improve sleep by reducing academic pressure.