Risk factors of overweight/obesity among children aged 48-59 Months in Wajo, South Sulawesi: A cross-sectional study

Problem considered Childhood obesity plays a crucial role in the emergence of chronic diseases and has become a global public health challenge. This study aims to identify the risk factors associated with overweight/obesity among children aged 48-59 months. Methods This study used a cross-sectional design involving 763 children in 9 districts. The districts were selected based on the highest number of students and demographic variation. Bivariate analysis was conducted to identify risk factors associated with overweight/obesity, followed by logistic regression to calculate adjusted odds ratios with 95% CI. Results The prevalence of overweight/obesity was 7.1%. Related factors include boys, high maternal education level, working mothers, high screen time, inadequate sleep duration, early initiation of breastfeeding, and the combined effect of delivery method and exclusively breastfed history. The final multiple regression indicated that children delivered vaginally and not exclusively breastfed had a 6.37 times (95% CI: 2.80-14.47) higher risk. Children born by cesarean section but exclusively breastfed had a 3.41 times (95% CI: 1.38-8.40) higher risk, while children born by cesarean section and not exclusively breastfed had a 5.01 times (95%CI: 2.04-12.31) higher risk of being overweight/obese. Boys had a higher risk (aOR = 2.96; 95% CI: 1.56-5.62). High maternal education level resulting in a 1.94 times (95%CI:1.08-3.50). Conclusions The combined effect of delivery method and non-exclusively breastfed was the strongest predictor for childhood overweight/obesity. Integrating postpartum breastfeeding support and visual-based educational tools into routine immunization visits can effectively mitigate obesity risks across all social groups.