From self-perception to behavioral drive: the dual-motivational interactive pathways of how body satisfaction and health evaluation affect physical activity

This cross-sectional study examined the associations between body satisfaction, health evaluation, and physical activity among university students. It investigated the mediating roles of intrinsic and extrinsic motivation and tested whether body satisfaction moderates the relationship between health evaluation and these motivational pathways. The study aims to elucidate an integrated mind-body synergy framework for understanding health behaviors. A survey was conducted among 2016 Chinese university students (mean age 19.50 ± 1.57 years; 71.4% male) from November to December 2025. Participants completed the Multidimensional Body-Self Relations Questionnaire, the Sport Motivation Scale, and the Physical Activity Rating Scale. Data were analyzed using SPSS 25.0 and PROCESS v4.0 for mediation, moderation, and moderated mediation analyses. Structural equation modeling was performed using Stata 16.0. Body satisfaction and health evaluation were positively correlated with physical activity (r = 0.228, p < 0.01; r = 0.059, p < 0.01). Intrinsic motivation mediated the associations of both body satisfaction (indirect effect = 2.444, 95% CI [1.744, 3.257]) and health evaluation (indirect effect = 1.286, 95% CI [0.443, 2.208]) with physical activity. Extrinsic motivation also served as a mediator for body satisfaction (indirect effect = 0.774, 95% CI [0.321, 1.291]) and health evaluation (indirect effect = 0.924, 95% CI [0.427, 1.529]). Body satisfaction moderated the associations between health evaluation and both intrinsic (β = 0.031, p < 0.05) and extrinsic motivation (β = 0.041, p < 0.05), with stronger associations observed at higher levels of body satisfaction. The moderated mediation model demonstrated acceptable fit (RMSEA = 0.057, CFI = 0.921, TLI = 0.926). These findings suggest that health evaluation and body satisfaction are associated with physical activity through intrinsic and extrinsic motivational pathways, with body satisfaction potentially enhancing the motivational impact of health evaluation. The observed interplay between affective experience (body satisfaction) and rational cognition (health evaluation) may inform future health promotion strategies. Interventions that foster positive body image alongside health knowledge dissemination could potentially support physical activity engagement.