Association of objective body shape and perceived body image with depressive symptoms in men and women.

Aims: Mental health issues related to negative body image are growing concerns. We explored the association between objectively and subjectively measured body shape and depressive symptoms.

Method: A nationwide sample of 26,204 Korean adults was analyzed. Objective body shape was measured using the A Body Shape Index (ABSI), where a higher score indicates greater central obesity. ABSI scores were categorized into three groups: low, medium, and high. Perceived body image was classified into five categories: (i) very thin, (ii) slightly thin, (iii) normal, (iv) slightly fat, and (v) very fat. Depressive symptoms were assessed using the Patient Health Questionnaire-9. Logistic regressions were employed to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

Results: An increase in ABSI score was positively associated with depressive symptoms in men (OR = 1.27; 95% CI = 1.09-1.49) but not in women. Among men, those who perceived their body shape as very thin or very fat had 2.62-fold (95% CI = 1.70-4.05) and 2.34-fold (95% CI = 1.57-3.47) higher odds of having depressive symptoms, respectively, compared with those who perceived their body shape as normal. Among women, those who perceived their body shape as very thin or very fat had 2.73-fold (95% CI = 1.92-3.86) and 2.48-fold (95% CI = 1.97-3.14) increased odds of having depressive symptoms, respectively. The association between perceived body image and depressive symptoms manifested differently depending on ABSI group and gender.

Conclusion: Negative body image was associated with depressive symptoms, and this relation was differently observed across genders and different categories of actual body shape.