Observational Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatry. Sep 19, 2025; 15(9): 109611
Published online Sep 19, 2025. doi: 10.5498/wjp.v15.i9.109611
College students' depression and body image: Unraveling the Link
Zhao-Jun Cheng, Hu Tao, Hua-Guo Huan, Chun-Mei Wu, Qi Wang, Ming Hao
Zhao-Jun Cheng, Hu Tao, Chun-Mei Wu, Qi Wang, Ming Hao, School of Public Health and Health Management, Gannan Medical University, Ganzhou 341000, Jiangxi Province, China
Hua-Guo Huan, Jiangxi College of Applied Technology, Ganzhou 341000, Jiangxi Province, China
Co-first authors: Zhao-Jun Cheng and Hu Tao.
Author contributions: Cheng ZJ and Tao H were responsible for data collection, data analysis, and manuscript writing as the co-first authors of the paper; Huan HG was responsible for study design, and data analysis; Wu CM was responsible for data collection, study design and data analysis; Wang Q was responsible for study design, data collection, and funding acquisition; Hao M was responsible for study design, data collection, data analysis, manuscript writing, and funding acquisition; all of the authors read and approved the final version of the manuscript to be published.
Supported by Starting Research Fund from the Gannan Medical University, No. QD202121.
Institutional review board statement: This study was approved by the Ethics Committee of the Gannan Medical University. This study was conducted according to the guidelines in the Declaration of Helsinki.
Informed consent statement: All study participants provided informed consent, agreeing to the required measurement and survey completion procedures. All methods were performed in accordance with the relevant guidelines and regulations.
Conflict-of-interest statement: The authors declare no conflict of interest.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ming Hao, Associate Professor, School of Public Health and Health Management, Gannan Medical University, No. 4 Experimental Building, Rongjiang New Area, Ganzhou 341000, Jiangxi Province, China. hm48922200@yahoo.co.jp
Received: May 19, 2025
Revised: June 11, 2025
Accepted: July 15, 2025
Published online: September 19, 2025
Processing time: 101 Days and 20.9 Hours
Abstract
BACKGROUND

With the increasing global incidence of mental illness, depression has become a serious problem among college students.

AIM

To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression, examine the effects of binge eating, physical activity, and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction.

METHODS

We conducted a cross-sectional survey of 1286 college students in South China. Physical activity level, depressive symptoms, and binge eating behavior were assessed using the Physical Activity Scale-3, Zung Self-Rating Depression Scale, and Dutch Eating Behavior Questionnaire, respectively. The absolute difference between actual body mass index (BMI) and ideal BMI was used to indicate the level of body dissatisfaction. Structural equation modeling (SEM) and receiver operating characteristic (ROC) curve analysis were used to examine the relationships between these variables and depression.

RESULTS

The findings showed that female college students reported higher levels of depression. Physical activity, body dissatisfaction, and binge eating behavior were significantly associated with depression. SEM revealed that body dissatisfaction played a mediating role. A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression, with an area under the ROC curve of 70.0%, providing a basis for targeted interventions.

CONCLUSION

This study demonstrated a significant positive correlation between body dissatisfaction and depression. Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression. Therefore, promoting physical activity and healthy eating habits among adolescents is essential. Additionally, the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening. Future longitudinal studies are recommended to further refine this diagnostic criterion.

Keywords: College students; Depression; Physical activity; Binge eating; Body dissatisfaction; Structural equation modeling; Receiver operating characteristic curves

Core Tip: This study investigates the relationship between depression and body dissatisfaction among Chinese college students, revealing that body dissatisfaction is a significant mediator. It identifies a critical cutoff value (body mass index difference ≥ 1.73) for predicting depression, highlighting the importance of promoting physical activity and healthy eating behaviors to reduce depression risk.