Background: Weight status and depressive affect in adolescents are positively related constructs, but the nature of this relationship is not well understood, especially in European populations. The objective of this study was to examine the interplay between body mass index (BMI) and depressive symptoms, while accounting for the possible mediational role of body image, in a sample of older adolescents in Iceland.
Method: We utilized data from a population-based cross-sectional sample of 11 388 junior college students (16-20-year-olds) to conduct structural equation modelling to test the relationship between BMI, body image and depressive symptoms while controlling for socioeconomic status and other background variables.
Results: Higher levels of BMI are associated with higher depressive symptoms. However, this association was mediated entirely through perceptions of body image. The association is gender dependent, with the relationship between BMI levels and depressive symptoms being significantly stronger among junior college girls than boys.
Conclusion: Body image is a key contributor in the relationship between weight status and depressive symptoms among adolescents. Future interventions with adolescents should take this association into account and focus on such factors as physical confidence and self-esteem.
© The Author 2013. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.