Eating Behavior and Depression in Chinese Female College Students: The Role of Social Appearance Anxiety and Physical Activity

Background: Depression is prevalent among female college students, with eating behavior potentially related to this issue. This study examines the relationship between eating behavior and depression, focusing on the role of social appearance anxiety and physical activity. Methods: We recruited 2161 female college students from nine universities in China via convenience sampling. Data was collected via an online questionnaire. Eating behavior was assessed via the Eating Behavior Scale short form (EBS-SF), depression was measured via the Center for Epidemiological Studies Depression Scale (CES-D), social appearance anxiety was evaluated via the Social Appearance Anxiety Scale, and physical activity was assessed via a single-item question. Descriptive statistics were analyzed via SPSS 26.0, and moderated mediation analysis was conducted via PROCESS version 3.5. Results: Unhealthy eating behavior was significantly associated with higher levels of depression (β = 0.285, p < 0.001). Social appearance anxiety mediated this relationship, accounting for 46% of the total effect (β = 0.132, 95% CI = [0.108, 0.158]). The interaction effect between eating behavior and physical activity was significantly and negatively correlated with depression (β = −0.052, p < 0.01). The association between eating behavior and depression was stronger under conditions of low physical activity (β = 0.210, p < 0.001) than under conditions of high physical activity (β = 0.105, p < 0.001). Conclusions: Integrating nutritional guidance, body image acceptance training, and exercise promotion into campus mental health programs is crucial for addressing depression in female college students. Future research should use longitudinal designs and broader participant ranges to increase the general applicability of the findings.