Weight loss dietary knowledge, attitudes, and practices among different body weight groups in Northeast China

Unhealthy dietary habits are prevalent in Northeast China, contributing to a high prevalence of obesity. This study aimed to assess the knowledge, attitudes, and practices (KAP) of the general population regarding weight loss dietary patterns in this region, with additional analysis of normal weight or underweight versus overweight and obesity subgroups. A cross-sectional study was conducted from September to November 2024 in Liaoning Province, China, using a self-administered questionnaire to collect demographic information and KAP scores. A total of 595 valid responses were analyzed (representing 91.4% of eligible participants), with 450 females (75.63%) and 145 males (24.37%). The overall knowledge score was 13.64 ± 5.88, with median attitude and practice scores of 28[25,31] and 35[32,42], respectively. Participants with overweight and obesity demonstrated higher scores in weight loss plateau understanding (p = 0.015) and realistic goal-setting (p < 0.001) compared to those with normal weight or underweight. Structural equation modeling identified significant associations between knowledge and both attitude (β=-0.40, 95% CI: -0.54,-0.20, p < 0.001) and practice, with knowledge showing a positive direct association with practice (β = 0.44, 95% CI: 0.30,0.58, p < 0.001) and a significant indirect association through attitude (β = 0.23, 95% CI: 0.14,0.31, p < 0.001) in the overall population. While participants demonstrated moderate levels of knowledge and attitudes regarding weight management, their practice levels were relatively low. Knowledge was significantly associated with both attitudes and practices, suggesting that educational interventions might be considered as a component in comprehensive approaches to weight management behaviors.