Hamadan University of Medical Sciences Journal of Research in Health Sciences 2228-7795 26 3 2026 08 15 Behavioural Pathways Linking Fast-Food Consumption and Obesity Among Adolescents of Urban Puducherry: Evidence From a Structural Equation Modeling Study e00687 e00687 10.34172/jrhs.13908 EN Nirupama Kamaraj https://orcid.org/0000-0001-7901-0081 Vedapriya Dande Rajasekar Deena Divakaran Sreelatha https://orcid.org/0009-0003-2014-0967 Suganya Ezhilarasan https://orcid.org/0000-0001-7362-6627 Journal Article 10.34172/jrhs.13908 2026 02 06 2026 06 15 Introduction: Children often consume fast food and junk food due to limited time, taste preferences, peer pressure, and a lack of awareness regarding their harmful effects. These foods are high in calories, salt, and sugar but lack essential nutrients. This study assessed the prevalence of fast-food consumption and examined behavioural pathways linking knowledge, attitude, and practice (KAP) with obesity among urban Indian adolescents. Study Design: This study employed a cross-sectional design. Methods: This study was conducted in selected schools in the urban areas of Puducherry. A total of 455 adolescents aged 15-18 years were selected from the study population. Chi-square test, Pearson’s correlation, receiver operating characteristic (ROC) curve analysis, and structural equation modeling (SEM) were used to analyze the data. Results: The prevalence of fast-food consumption was 93.9%; 11.1% 11.1% of participants were overweight, and 15% were obese. A significant association was found between practice score and obesity (P=0.016). SEM analysis revealed a positive impact of knowledge on attitude (P<0.001) and practice (P=0.045); furthermore, attitude significantly influenced practice (P<0.001). Practice was inversely related to obesity (β=-0.28, P=0.003). ROC analysis indicated that the practice score moderately predicted obesity (AUC=0.692; P<0.001). Conclusion: Dietary practice is a key modifiable behavioural determinant of adolescent obesity. Behaviour-focused school health interventions and nutritional screening strategies may improve obesity prevention among adolescents.