Prevalence and predictors of unhealthy weight control practices among postpartum women attending public health facilities in Southwest Ethiopia

Unhealthy weight control practices (UWCPs), such as fasting, meal skipping, and the use of diet pills, are increasingly prevalent among postpartum women, even in low- and middle-income countries like Ethiopia. These behaviours, fuelled by body image dissatisfaction, media influence, and societal pressure, pose considerable health risks to both the mother and the child. Despite growing evidence from high-income settings, data on the prevalence and predictors of UWCPs among Ethiopian postpartum women remain scarce, hindering the development of targeted interventions in postnatal care. The aim of this study was to assess the prevalence and predictors of unhealthy weight control practices among postpartum women attending public health facilities in Southwest Ethiopia. A facility-based cross-sectional study was conducted from 1 May to 30 June 2025. The calculated sample size was 332 postpartum women (6–9 months post-delivery) attending selected public health facilities; 320 women completed the interview (response rate 96.4%). Participants were selected using systematic random sampling. Data were collected through interviewer-administered structured and semi-structured questionnaires and anthropometric measurements. Descriptive statistics and multivariate logistic regression were used to identify predictors of unhealthy weight control practices (UWCP). The prevalence of unhealthy weight control practices was 41.0% (95% CI: 35.6–46.4%). Factors independently associated with UWCP in the multivariate analysis included body image dissatisfaction (AOR = 4.50; 95% CI: 2.40–8.40), social pressure (AOR = 3.20; 95% CI: 1.70–6.00), media influence (AOR = 2.30; 95% CI: 1.20–4.30), primiparity (AOR = 2.65; 95% CI: 1.40–5.00), low household income (AOR = 2.10; 95% CI: 1.18–3.75), unplanned pregnancy (AOR = 2.20; 95% CI: 1.10–4.30), non-exclusive breastfeeding (AOR = 2.10; 95% CI: 1.10–4.00), and lack of counselling (AOR = 2.40; 95% CI: 1.30–4.30). A substantial proportion of postpartum women engaged in unhealthy weight control practices, influenced by psychosocial, economic, and reproductive factors. There is an urgent need for targeted interventions, including integration of weight management counselling into routine postnatal care, promotion of exclusive breastfeeding, and addressing media and societal pressures.