Exploring the Link Between Body Appreciation and Health-Related Lifestyle in Adolescents: A Cross-Sectional Study

Adolescence is a critical developmental stage at which body image and lifestyle behaviours intersect. Research shows that having a positive body image during this period is linked to better mental health and certain aspects of a healthy lifestyle. However, more empirical evidence is needed, especially concerning boys. This cross-sectional study explored the association between body appreciation (BA) and lifestyle factors in a large sample of Lithuanian adolescents. These associations were examined while controlling for body mass index (BMI), and the role of sex in these relationships was evaluated. A cross-sectional study involved 1412 adolescents (59.6% girls) aged 16-17 years (mean age of 16.97 ± 0.46 years). Participants completed questionnaires assessing BA, self-esteem, life satisfaction and lifestyle factors such as physical activity and perceived fitness, sleep duration, screen time and disordered eating (DE) attitudes and behaviours. Data were analysed using descriptive statistics, analysis of covariance (ANCOVA), and binary logistic regression analysis. Higher BA was associated with greater life satisfaction, self-esteem, perceived physical fitness and healthier eating behaviours independent of BMI in boys and girls. Adolescents with high BA had significantly higher odds of participating in sports, having a healthy BMI, accurate body weight estimation, good self-rated health and non-smoking behaviours compared to those with low BA. BA was also associated with healthier sleeping hours, lower screen time and lower unhealthy and DE behaviour in girls. Boys with high BA were more likely to abstain from alcohol. Interaction effects indicated that the effect of BA on self-esteem, BMI and DE behaviours was stronger in girls than in boys. BA is strongly linked to positive lifestyle outcomes and self-esteem in adolescents, particularly in girls. The findings of this study indicate that initiatives designed to promote healthy lifestyles among adolescent boys and girls may be enhanced by the incorporation of education on positive body image. Interventions should be tailored to gender-specific needs, emphasizing prevention of dysfunctional eating for girls, and reducing substance use for boys. Incorporating body-positive education into schools and health programs can help create supportive environments that enhance both psychological well-being and physical health.