Psychological pathways linking body mass index and depression in women and men in a Colombian sociodemographic context

Body mass index (BMI) shows inconsistent associations with depressive symptoms, and it remains unclear whether body self-esteem and eating disorder symptoms mediate this association, and whether this mediation differs by gender. Therefore, this study used multigroup structural equation modeling to examine these mediators in Colombian young adults, separately for women and men. A total of 662 participants aged 18 to 30 years (398 women, 60.1%; Mage = 21.75, SD = 3.11) were recruited through snowball sampling and completed an online survey with self-reported weight and height and validated measures of body self-esteem, eating disorder symptoms and depressive symptoms. BMI showed no total association with depressive symptoms in women or men. Nevertheless, higher BMI was associated with lower body self-esteem and more eating disorder symptoms, and both mediators were associated with more depressive symptoms, yielding positive indirect effects in women ( b = 0.033, 95% CI [0.022, 0.045]) and men ( b = 0.015, 95% CI [0.006, 0.028]). In men, mediation was indirect-only, whereas in women a negative direct effect offset the indirect effect, a pattern of competitive mediation. The path from BMI to eating disorder symptoms was stronger in women, but the relative weight of the two pathways did not differ by gender. Body self-esteem and eating disorder symptoms link BMI to depressive symptoms in both women and men, with quantitative rather than qualitative gender differences, which suggests that both processes deserve attention in prevention and intervention efforts with young adults.