Caregivers' Perception of Child Weight and Its Implications on Children's BMI: Examining the Role of Weight Concern and Pressed Eating Behaviors as Mediators.

OBJECTIVE: This study aims to investigate the relationship between caregivers' perception of child weight, their concern about children's weight, pressed eating behaviors, and children's BMI.

METHODS: A Child Feeding Questionnaire was administered to 442 primary caregivers of school-aged children (6-12 y old) in Hangzhou, China.

RESULTS: Significant differences were observed in age, family average monthly income, and family care type among children with different weight statuses (P<0.05). Caregivers' perception of child weight was positively correlated with children's BMI. Caregivers' perception of child weight and children's BMI were negatively correlated with pressed eating behaviors. Caregivers' perception of the child's weight, BMI, and pressed eating behaviors were positively correlated with caregivers' weight concerns. Caregivers' perception of child weight not only had a direct positive predictive effect on children's BMI but also influenced children's BMI through three paths: via the independent mediation of children's weight concern, the independent mediation of pressed eating behaviors, and the chain mediation of children's weight concern and pressed eating behaviors.

CONCLUSIONS: Caregivers need to rectify perception biases regarding child weight, adopt reasonable feeding strategies, nurture children's self-regulation abilities regarding diet, and prevent the occurrence of childhood overweight and obesity.