A Path Analysis Revealing Influential Factors of Weight Loss Willingness and Behaviour in 8–15 Years Overweight Children: A Cross‐Sectional Investigation

PURPOSE: To explore the association between parental and child correct cognitions of the child's weight and child weight loss willingness and behaviours. METHODS: Data from the 2007-2020 NHANES database were used, focusing on overweight children aged 8-15 years with age- and sex-specific BMI ≥ the 85th percentile. Both parental and child correct cognitions of the child's weight were assessed by comparing subjective questionnaires with objective BMI measurements. Multivariable logistic regression was conducted. Path analysis was employed to confirm the effect of child correct cognition on the relationship between parental correct cognition and child weight loss willingness and behaviour. RESULTS: A total of 1383 overweight children were included. Parental correct cognition was independently associated with both child correct cognition and child weight loss willingness, but not with child weight loss frequency. Path analysis further demonstrated that child correct cognitions were linked to the relationship of parental correct cognitions on child weight loss willingness, establishing a significant path: 'Parental correct cognitions → Child correct cognitions → Child weight loss willingness → Child weight loss behaviour'. CONCLUSION: Among overweight children, parental correct cognitions of the child's weight do not directly relate to children's willingness. Instead, they were indirectly associated with child weight loss willingness and behaviour by shaping child correct cognitions of weight. This finding suggests that family weight management interventions should focus not only on parental correct cognitions but also on helping children establish objective correct cognitions of weight.