Abstract: 【Abstract】 Objective To explore the influence of psychological cognitive factors on health-related behaviors in obese children, aiming to provide useful imformation for future clinical behavior management targeted at obese children. Method 274 children aged 7 to 16 years who hospitalized at the Department of Children Health Care, Children's Hospital of Nanjing Medical University from July to December 2023 were selected. Children's height, weight,percent body fat were measured, body mass index (BMI) were calculated Based on the BMI reference threshold for overweight and obesity among Chinese children aged 6-18 years, the study subjects were divided into obesity group and control group, with 168 and 106 participants, respectively. General demographic information was collected through questionnaires and scales. Meanwhile, their weight perception, health-related behaviors, including dietary behavior, physical activity, and sleep condition, and mental health status were evaluated. The statistical methods performed by t-test, Mann-Whitney U test, χ2 test, partial correlation analysis, and linear regression analysis. Result The average age of children in the control group was (10.61±1.67) years, while the average age of children in the obese group was (10.88±2.03) years. In terms of health-related behaviors, food avoidant behaviors, including satiety responsiveness and slowness in eating, and Physical Activity Questionnaire for Older Children(PAQ-C) scored significantly lower than those in the control group (t=3.703, 4.562, 2.798, all P<0.05), while food approach behaviors, including food responsiveness, enjoyment of food, desire to drink, and emotional overeating scored higher than those in the obese children (t=-8.759, -9.073, -3.362, -3.277, all P<0.05). The proportion of the obese group children who slept less than 9 hours per day during weekends was significantly higher than that of the control group (χ2=14.536, P<0.001). In terms of mental health status, the obese group exhibited significantly lower quality of life scores in physiological and social functions compared to the control group (t=3.136, 2.792, all P<0.05), and their scores for social avoidance and distress in Social Anxiety Scale for Children were notably higher (t=-2.363, P=0.019). Multiple linear regression analysis showed that,after adjusting for the confounders, social function was negatively associated with emotional overeating (β=-0.195, P=0.014), emotional function was negatively associated with food responsiveness(β=-0.172, P=0.028), BMI was positively associated with enjoyment of food (β=0.318, P=0.001). The mediation effects analysis showed that social function of obese children played a mediating role in the relationship between percent body fat and physical activities, with a mediation proportion of 21.05%. Conclusion Obese children exhibit a range of unhealthy behaviors, including abnormal eating habits, low physical activity, insufficient sleep, and social avoidance. Additionally, their mental health status influences the development of healthrelated behaviors, particularly social interaction. To manage obese children better, it is crucial to focus not only on altering their unhealthy lifestyles but also on enhancing their mental well-being.
2025, Vol. 13 
