Sociocultural Appearance-Related Attitudes and Psychological Resources and Their Associations With Moderate-Intensity Exercise, Body Size Perception, and Screen Time Among Female University Students: Cross-Sectional Latent Profile Analysis

BACKGROUND Female university students encounter appearance ideals, comparison cues, and appearance-related pressure across traditional and digital media environments. These sociocultural influences may coexist with psychological resources such as body appreciation and weight-control self-efficacy. However, variable-centered analyses may obscure heterogeneity in how these characteristics are combined within individuals. The measures used in this study assessed broader sociocultural appearance-related attitudes rather than platform-specific digital exposure. OBJECTIVE This study aimed to identify latent profiles characterized by ideal-body internalization, appearance comparison, perceived media pressure, body appreciation, and weight-control self-efficacy among female university students and to examine whether these profiles differed in moderate-intensity exercise duration, self-perceived body size, and screen-based sedentary behavior. METHODS A cross-sectional online survey was conducted between May and June 2025 among 2034 female students recruited by convenience sampling from 1 comprehensive university in China. Latent profile analysis compared 1- through 6-profile solutions. Model selection considered information criteria, likelihood-ratio tests, entropy, profile size, parsimony, and substantive interpretability. Distal outcomes were compared using the Bolck-Croon-Hagenaars (BCH) procedure for continuous outcomes and the distal categorical outcome (DCAT) procedure for categorical outcomes. Sensitivity analyses examined alternative exercise definitions, transformations, extreme-value handling, sociodemographic adjustment, and self-reported BMI. Conventionally calculated weekly moderate-to-vigorous physical activity (MVPA) outcomes were examined among 1056 participants with complete activity data. The primary analysis preserved classification uncertainty, and supplementary models assessed the robustness of associations without treating most-likely profile membership as error-free. No population-prevalence inference was intended. RESULTS A 4-profile solution was retained (entropy=0.874): very low sociocultural attitudes—higher body appreciation (137/2034, 6.74%), average sociocultural attitudes (1081/2034, 53.15%), lower sociocultural attitudes (452/2034, 22.22%), and higher sociocultural attitudes (364/2034, 17.9%). Solutions with 5 and 6 profiles each contained a very small class of approximately 1.7% (35/2034), and the adjusted Lo-Mendell-Rubin test comparing 6 vs 5 profiles was nonsignificant (P=.47). The profiles were differentiated primarily by a low-to-high gradient in appearance comparison, ideal-body internalization, and perceived media pressure. Moderate-intensity exercise duration differed across profiles in the primary analysis (BCH Wald χ23=15.3; P=.002), but complete-case weekly MVPA did not (P=.52). Body-size perception differed in the unadjusted analysis (DCAT χ29=20.4; P=.02), although the overall association was not independent of sociodemographic characteristics and self-reported BMI. Weekly screen-use categories did not differ significantly across profiles (DCAT χ212=16.7; P=.16). CONCLUSIONS The retained profiles were sample-specific statistical configurations that largely represented a sociocultural low-to-high gradient rather than 4 clearly discrete psychological types. Associations with exercise and body-size perception were modest and sensitive to outcome definition or covariate adjustment. The cross-sectional findings do not establish causal direction or digital media mechanisms. Longitudinal, multisite studies incorporating direct measures of digital exposure, exercise motivation, objectively assessed activity, and measured anthropometry are needed.