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Screen-based sedentary behavior and BMI among Chinese adolescents: weight concern as a mediator moderated by body image perception #MMPMID40611060
Tan S; Zhou L; Abdukerima G; Yin W; Chen N; Yuan L; Gao Y; Sung-Chan Po Lin P; Wang Z; Shi J
BMC Public Health 2025[Jul]; 25 (1): 2302 PMID40611060show ga
OBJECTIVE: Screen-based sedentary behavior (SB) is associated with elevated BMI; however, the underlying mechanisms remain poorly understood. This study investigates the mediating role of weight concern in the SB-BMI relationship and examines how body image perception and gender moderate this mediation. By focusing on body image as a critical contextual factor, the study aims to inform targeted interventions for adolescent obesity and overweight. METHODS: In 2016, self-report questionnaires assessing screen-based SB, weight concern, and body image perception were collected from 508 Chinese adolescents (grades 7-9), yielding 438 valid responses (response rate: 86.22%). Path analysis and bootstrap procedures with bias-corrected 95% confidence intervals were used for data analysis. RESULTS: Screen-based SB was positively associated with weight concern (b = 1.115, p = 0.009) and BMI (b = 0.183, p < 0.001). The mediation analysis showed that weight concern partially mediated this relationship, with an indirect effect of 0.056 (95% CI = [0.006, 0.114]). This mediation was moderated by body image perception and gender. Specifically, the interaction between BMI overestimation and weight concern was negatively associated with BMI (b=-0.157, p = 0.011), whereas the three-way interaction of gender, weight concern, and overestimated body image perception showed a positive association with BMI (b = 0.080, p = 0.025). CONCLUSIONS: Screen-based SB influences BMI, with weight concern as a mediator and body image perception and gender as moderators. These findings highlight the importance of targeting sedentary behavior and body image concerns in gender-sensitive interventions for adolescents.