JOURNAL OF AMERICAN COLLEGE HEALTH

2020, VOL. 68, NO. 2, 148–154

https://doi.org/10.1080/07448481.2018.1536057

MAJOR ARTICLE

Risk and protective factors associated with depressive symptoms in young

adults with overweight and obesity
Caroline C. Kaufman, MSa, Idia B. Thurston, PhDa,b, Courtney Maclin-Akinyemi, MSa, Robin N. Hardin, MSa,
Kristina M. Decker, MAa, and Rebecca C. Kamody, PhDa,c
a
Department of Psychology, University of Memphis, Memphis, TN, USA; bDepartment of Pediatrics, University of Tennessee Health Science
Center, Memphis, TN, USA; cChild Study Center, Yale University, New Haven, CT, USA

ABSTRACT ARTICLE HISTORY

Objective: Approximately one-third of college students are categorized as overweight/obese and Received 23 May 2018
elevated weight has been associated with increased risk of depressive symptoms. Less is known Revised 14 August 2018
about protective factors in this context. This study examined associations between depressive Accepted 9 October 2018
symptoms and health behaviors, as well as body image variables among college students with
KEYWORDS
overweight/obesity, while accounting for contributions of BMI and demographics. Participants: Body positivity; exercise;
College students (N ¼ 175; Mage ¼ 19.87, SD ¼ 1.93; 70% female; 58% Non-Hispanic Black) with diet; body satisfaction; Body
overweight/obesity completed in-person surveys. Methods: Depressive symptoms, exercise and Mass Index (BMI)
diet engagement, body positivity, and body dissatisfaction were assessed. Data were examined
using a hierarchical linear regression. Results: Greater exercise engagement and greater body
positivity were significantly associated with lower levels of depressive symptoms. Conclusions:
Established links between elevated weight and depression are complex but imperative to under-
stand, as mutable factors that contribute to this relationship may provide novel avenues for
intervening.

Introduction depression in the general population and has been shown to

contribute to overall psychological wellbeing.9 Among col-
The U.S. Department of Health and Human Services defines
lege students, exercise is also associated with lowered risk of
overweight as having a body mass index (BMI) between 25
depressive symptoms.10 Results from a meta-analysis of
and 29.9 kg/m2 and obesity as having a BMI >30 kg/m2.1
randomized controlled trials of exercise interventions for
More than one-third of college students in the United States
depression among college students indicated that exercise
between the ages of 19–24 are categorized as overweight or
effectively decreases depressive symptoms in this popula-
obese based on their BMI.2 Elevated weight above a BMI of 25
tion.11 Previous research has also shown that exercise
is one indicator associated with higher mortality risk later in
engagement is associated with higher body positivity among
life3 and cardiovascular disease.4 While current research indi-
college women.12 A meta-analysis of exercise interventions
cates that young adults are at risk for experiencing depression5
to address body image indicated that, among college stu-
with up to 9% of young adults meeting diagnostic criteria for
dents, exercise significantly improves overall body image.13
major depressive disorder,6 these rates are higher among those
Similarly, biological science research has provided ongoing
with overweight/obesity.7 Researchers suggest a reciprocal rela-
support for the neuroimmunological benefit of exercise in
tionship between depression and obesity, such that elevated
decreasing depressive symptoms.14 Thus, overall exercise has
BMI increases the risk of depressive symptoms and having
been associated with decreased depressive symptoms and
depressive symptoms increases the risk of having an elevated
other positive outcomes in college students.
BMI.8 Despite the existence of a body of research on depres-
sive symptoms in young adults with overweight/obesity, other
factors that may influence this relationship, such as exercise, Dieting and depression
dieting, and body image are not fully understood.
Dieting, as characterized by restricting food intake in order
to lose weight, predicts long-term weight gain among adults15
Exercise and depression
and is also associated with depression, distorted body image,
Health behaviors, such as exercise and dieting, may influ- higher weight concerns, and higher perception of weight
ence the relationship between overweight/obesity and importance.16 Approximately one-third of college students
depressive symptoms among college students. Exercise is a report dieting to lose weight.16 College-aged individuals with
known protective factor against the development of overweight/obesity report engaging in dieting behaviors at

CONTACT Idia B. Thurston bthrston@memphis.edu Department of Psychology, University of Memphis, 310 Psychology Building, Memphis, TN 38152, USA.
ß 2018 Taylor & Francis Group, LLC

higher rates than their lean weight peers.17 Among young
adults, dieting may have a bi-directional relationship with
overweight/obesity, such that dieting places individuals at
greater risk of gaining weight over time18 and having ele-
vated weight status places individuals at higher risk of engag-
ing in dieting behaviors.19 Furthermore, it is unknown
whether dieting in the context of elevated weight status pla-
ces individuals at higher risk for depressive symptoms, as
limited work has explored this line of research.
Body dissatisfaction and depression
Another factor potentially associated with depression is
body image, which has been described as a multidimensional
construct incorporating perceptions and attitudes regarding
one’s body.20 Body image has been associated with depres-
sive symptoms among individuals with overweight/obesity.21
Body dissatisfaction is one dimension of body image and is
described as the degree to which an individual has negative
regard for her/his body.22 Body dissatisfaction is considered
as an intrinsic risk factor for depressive symptoms23 and is
associated with other risk factors, including lower self-
esteem, higher BMI, and more weight-related teasing.23 A
meta-analytic examination of the relationship between body
dissatisfaction and obesity revealed that individuals with
obesity report more body dissatisfaction than individuals of
lean weight status and women across all weight classes
report more body dissatisfaction than men.24
Body positivity and depression
Much of the research on the relations among overweight/
obesity, depressive symptoms, and body image has focused on
negative body image.25 This lopsided focus may further stig-
matize individuals with overweight/obesity by inadvertently
assuming that none of these individuals have a positive body
image. However, conceptualizations, such as the spiral of
acceptance movement26 and the health at every size (HAES)
paradigm27 help right this lopsided perspective. Specifically,
these conceptualizations illustrate the importance of body
positivity across every weight classification.27,28 Body positiv-
ity is an aspect of body image that is not merely the absence
of body dissatisfaction, but rather acceptance and appreciation
of one’s body as it is, regardless of society’s standards of phys-
ical beauty.29 Among adults, body positivity is associated with
a variety of positive outcomes, including intuitive eating,29
lower neuroticism,30 high extraversion,30 and higher self-com-
passion.31 Body positivity has yet to be examined in the con-
text of elevated BMI and depressive symptoms.
The present study
Considering the increased risk for depressive symptoms
among college students with overweight/obesity, a clearer
understanding of risk and protective factors that may con-
tribute to this relationship is warranted. Therefore, the aim
of the current study is to examine associations between
depressive symptoms and health behaviors (exercise and
dieting) as well as body image (body dissatisfaction and
JOURNAL OF AMERICAN COLLEGE HEALTH 149
body positivity) among college students with overweight/
obesity, while accounting for contributions of BMI, gender,
and race/ethnicity. Specifically, gender and race/ethnicity
have been shown to influence the relationship between
depressive symptoms and obesity, with a stronger associ-
ation for women than men32 and with some racial and eth-
nic minority groups being at higher risk for depressive
symptoms relative to their White counterparts.33 Given pre-
vious research, we hypothesize that lower body image,23,30
poorer health behaviors,9,16 being female,32 being a racial/
ethnic minority, and having a higher BMI32 would be asso-
ciated with higher depressive symptoms.
Methods
Participants
Participants included 175 undergraduate students with over-
weight/obesity between the ages of 18 and 25 (M ¼ 19.87,
SD ¼ 1.93). The majority of our sample was female (n ¼ 122,
69.7%) with 57.7% (N ¼ 101) self-identifying as Non-
Hispanic Black, 26.3% (N ¼ 46) as Non-Hispanic White,
10.9% (N ¼ 19) as Hispanic, and 1.1% (N ¼ 2) as multiracial.
Participants were recruited and participated in the study
from February 2014 to December 2015.
Procedures
Following approval from the university’s institutional review
board, undergraduate students from an urban, public univer-
sity in the U.S. mid-south were recruited via flyers and
announcements of the study in introductory psychology
courses. Interested students were enrolled into the current
study via an online student research portal. Once enrolled,
students selected a preferred day and time and arrived at the
second author’s (study principal investigator) research lab.
Upon arrival, participants provided electronic informed con-
sent, reported on their demographic information, and com-
pleted several questionnaires as part of a larger study on
factors contributing to weight reporting in college students.
After participants completed all questionnaires, each young
adult’s height and weight were measured by trained research
assistants. Weight was recorded in kilograms using a Tanita
BWB 800S Doctors Scale (Tanita Corporation, Arlington
Heights, IL) and height was measured in centimeters using a
standard PE-WM-BASE Stadiometer (Perspective Enterprises,
Portage, MI). To ensure data accuracy, two height and two
weight measurements were recorded for all participants and
averaged. Students received psychology course credit for study
participation.
Measures
Demographics and BMI
Participants reported on their age, gender, race, and ethni-
city. BMI was calculated by dividing each participant’s weight
in kilograms (kg) by their body height in meters squared;
expressed in units of kg/m2.34 Only participants with BMI in
150 C. KAUFMAN ET AL.
the overweight and obese category (ie, at or above 25) were
included in this sample. BMI was categorized into weight
classes according to Center of Disease Control guidelines,
such that individuals with a BMI between 25 and 29.9 were
categorized as “overweight” and those with a BMI at or
above 30 were categorized was as “obese.”34 In our sample,
60% (N ¼ 105) were categorized as overweight and 40%
(N ¼ 70) were categorized as obese. The average sample BMI
was 30.98 kg/m2 (SD ¼ 6.16, range: 25.01–57.23).
Center for Epidemiological Studies Depression
(CES-D) Scale
The CES-D is a widely used measure of depressive symp-
toms. It includes 20 items with six domains reflecting major
dimensions of depression over the past week including:
depressed mood, feelings of guilt and worthlessness, feelings
of helplessness and hopelessness, psychomotor retardation,
loss of appetite, and sleep disturbance. Sample items include
“I thought my life had been a failure” and “I felt that I
could not shake off the blues even with the help from my
family and friends.” Participants reported how often they
experienced these symptoms on a four-point Likert scale
from 0 (rarely or none of the time/less than 1 day) to 3 (most
or all of the time/5–7 days). Scores on the CES-D range
from 0 to 60, with higher scores indicating more depressive
symptoms and having a clinically significant cutoff score of
16.35 The CES-D has adequate construct and discriminant
validity.35 The measure also has excellent internal consist-
ency reliability, with alpha coefficients ranging from .90 to
.93.35 In this study, reliability was a ¼ .90.
Multidimensional Body Self-Relations Questionnaire
The Appearance Evaluation (AE) Subscale of the
Multidimensional Body Self-Relations Questionnaire
(MBSRQ) was used to assess participants’ evaluation of their
bodies (ie, body positivity).36 The AE subscale consisted of
seven items rating feelings of physical attractiveness or
unattractiveness and satisfaction or dissatisfaction with one’s
physical appearance. Participants rated their agreement with
statements (eg, “My body is sexually appealing”) on a Likert
scale ranging from 1 (definitely disagree) to 5 (definitely
agree). Scores on the MBSRQ-AE range from 7 to 35; items 6
(“I dislike my physique”) and 7 (“I am physically
unattractive”) are reverse coded so that overall higher scores
indicate higher body positivity. The MBSRQ has good
internal consistency reliability (alpha coefficients ranging
from .88 to .91) and adequate construct and discriminant val-
idity.37 In this study, reliability of the total scale was a ¼ .90.
Eating Disorder Inventory-3 (EDI-3) Body
Dissatisfaction Subscale
The EDI-3 is a widely used self-report measure of eating
disorder psychopathology.38 The Body Dissatisfaction
Subscale of the EDI-3 was used to assess dissatisfaction with
one’s body parts and shape, including hips, buttocks, and
thighs. Specifically, participants responded to statements
such as, “I like the shape of my buttocks” and “I think that
my thighs are too large” on a Likert scale from 1 (always) to
6 (never). Scores on the EDI-3 range from 10 to 60 and
were coded so that higher scores indicated greater body dis-
satisfaction. The Body Dissatisfaction Subscale of the EDI-3
has good internal consistency, with alpha coefficients rang-
ing from .87 to .92, and adequate construct and discriminant
validity.39 Reliability of the total scale was a ¼ .85.
Diet and exercise engagement
Exercise and diet engagement were assessed using the
following question, “During the past 30 days, which of the
following things did you do in order to lose weight or to
keep from gaining weight?” Participants reported whether
they had engaged in “diet” and/or “exercise.” Endorsement
of dieting behavior and exercise engagement were entered
into the model separately.
Data analytic plan
Analyses were completed in SPSS v23. Of an initial 424 par-
ticipants who were recruited into the study, 247 were
excluded due to having a BMI below 25 kg/m2 and an add-
itional two participants were excluded who did not identify
as male or female. In the final analysis sample of 175 partic-
ipants, 0% has missingness on depressive symptoms, 0% had
missingness on body positivity, and 7% had missingness on
body dissatisfaction. Visual examination of residual scatter-
plots indicated the data met the assumption of homoscedas-
ticity and review of Tolerance and VIF statistics indicated
assumptions of nonmulticollinerity were also met. Missing
data were addressed using mean imputation based on the
means of each individual participant. Hierarchical multiple
regression analyses were used to assess relationships between
each independent variable and the outcome of depressive
symptoms. Model 1 included gender (dichotomous), BMI
(continuous), and race/ethnicity (dichotomous [Black versus
non-Black]). Model 2 added health behaviors (exercise
engagement [dichotomous] and diet engagement [dichotom-
ous]). Model 3 added body image variables (body dissatis-
faction [continuous] and body positivity [continuous]).
Models assessed the influence of these variables on depres-
sive symptoms (continuous).
Results
Overall, participants had a mean BMI which fell in the obese
weight status range (see Table 1). With respect to depressive
symptoms (ie, CES-D scores), as shown in Table 1, partici-
pants had an average score close to the 16-point cutoff for
“at-risk of clinical depression.”35 Scores on our measures of
body positivity and body dissatisfaction were similar to
scores obtained from college samples in previous
research.40,41 Almost three-quarters of our sample (70.9%)
reported having engaged in exercise and less than half of
our sample (41.7%) reported dieting in the past 30 days. See
Table 1 for additional descriptive statistics, as well as corre-
lations between continuous independent variables and
depressive symptoms.
 JOURNAL OF AMERICAN COLLEGE HEALTH 151

Table 1. Means, standard deviations, and correlations of variables.

BMI Depressive symptoms Body positivity Body dissatisfaction
BMI 30.98 (6.16) .02 .19 .04
Depressive symptoms 15.81 (10.30) .40 .17
Body positivity 22.73 (6.47) .23
Body dissatisfaction 30.75 (4.84)
Note. Diagonal of table provides means (and standard deviations) for continuous variables. BMI ¼ Body Mass Index.
p < .05; p < .01.

Table 2. Unstandardized (B) and standardized regression coefficients (b) and overweight/obesity, including diet behavior, exercise engage-
R2 statistics for variables entered into the hierarchical regression predicting ment, body dissatisfaction, and body positivity while
depressive symptoms. accounting for contributions of BMI, gender, and race/ethni-
Variable B SE b t R2 䉭R2 F city. The results of this study add to a growing body of lit-
Model 1 0.03 0.00 1.73 erature that highlights the importance of body image and
Gender 2.48 1.70 0.11 1.46
BMI 0.05 0.13 0.03 0.38 health behaviors on depressive symptoms among college stu-
Race/Ethnicity 2.95 1.58 0.14 1.87 dents with overweight/obesity. While previous researchers
Model 2 0.08 0.05 2.72 have shown relationships between negative body image and
Gender 2.22 1.68 0.10 1.32
BMI 0.04 0.13 0.02 0.32 depressive symptoms, these study findings moved the field
Race/Ethnicity 3.44 1.57 0.17 2.20 forward by examining body positivity in addition to these
Exercise habits 4.85 1.73 0.21 2.80
Diet behavior 0.04 1.59 0.00 0.02
other known negative associations. Consistent with hypothe-
Model 3 0.20 0.12 6.04 ses, body positivity, and exercise engagement were associated
Gender 0.67 1.60 0.03 0.42 with lower depressive symptoms.
BMI 0.10 0.12 0.06 0.80
Race/Ethnicity 0.82 1.55 0.04 0.53
Our findings support the idea that body positivity may
Exercise habits 3.57 1.64 0.16 2.18 bear a meaningful association with well-being among college
Diet behavior 0.71 1.50 0.03 0.47 students categorized with overweight/obesity. This finding is
Body positivity 0.58 0.12 0.36 4.72
Body dissatisfaction 0.19 0.15 0.09 1.23 well situated in the literature given that previous studies
Note. p < .05; p < .01; p < .001. have found that body image mediates the relationship
between BMI and depressive symptoms.42 The importance
As displayed in Table 2, Model 1 of the hierarchical lin- of body positivity has also been underscored by Erdman,26
ear regression included covariates of gender, BMI, and race/ who proposed the Spiral of Acceptance, an identity develop-
ethnicity. This model was not statistically significant and ment model of size acceptance. Erdman theorizes that per-
ceiving and accepting one’s body as it is, is an important
only accounted for 1% of the variance in depressive symp-
precursor to living a life congruent with one’s desires and
toms. In this model, gender, BMI, and race/ethnicity were
values. Without such acceptance, Erdman proposes that
not significantly associated with depressive symptoms. To
negative expectations and feelings about one’s size or shape
examine the association between health behaviors and
will be associated with inhibition or restriction (eg, percep-
depressive symptoms, we added endorsement of exercise
tion that one is “not thin enough” to engage in cer-
engagement and diet behavior to the model. This second
tain activities).
model was significant, F(5, 169) ¼ 2.72, p < .05 and the
Findings align with the Health At Every Size (HAES)
amount of variance explained by these variables increased
paradigm,27 an empirically supported approach associated
(R2 ¼ 7.4%; DR2 ¼ 5%). In this model, identifying as Black with improved psychological and physical health. This para-
(b ¼ 0.17, p < .05) and engaging in exercise in the past 30 digm espouses tenants of health enhancement without spe-
days (b ¼ 0.21, p < .01) were associated with lower depres- cific focus on weight loss, and instead focuses on acceptance
sive symptoms. Gender, BMI, and diet behavior were not and appreciation for one’s own weight and size.27 Research
significantly associated with depressive symptoms. To exam- has shown that adults with overweight/obesity demonstrate
ine the association between body image variables and improvements in physiological health, health behaviors, and
depressive symptoms, body dissatisfaction and body positiv- mental health following HAES informed interventions.28
ity were added to the model. This third model was signifi- While much of existing literature focuses on the application
cant, F(7, 167) ¼ 6.04, p < .001 and accounted for 20% of of the HAES paradigm with adults, findings from the pre-
the variance in depressive symptoms (R2 ¼ 20.2%; sent study suggest that these tenants may be relevant for col-
DR2 ¼ 12.8%). In this final model, engaging in exercise in lege students categorized with overweight/obesity and
the past 30 days (ß ¼ .16, p < .05) and greater body posi- should be investigated further. Notably, some researchers
tivity (ß ¼ .36, p < .001) were significantly associated with believe that individuals with overweight/obesity need to be
lower levels of depressive symptoms. made aware of their elevated weight status43 and need to be
body dissatisfied44 in order to engage in healthy lifestyle
changes (eg, healthy eating, exercise engagement). However,
Comments
recent work has shown that individuals with overweight/
This study examined risk and protective factors that may obesity who do not report their status as such (ie, they mis-
impact depressive symptoms among college students with perceive their weight as “just about right”) actually gain less
152 C. KAUFMAN ET AL.
weight,45 are less depressed,46 and are less likely to engage
in disordered eating47 over time than young adults who per-
ceive their weight as overweight/obese.
Contrary to our study hypotheses, dieting behavior was
not associated with depressive symptoms in this sample.
Given that participants were asked to indicate whether or
not they had dieted in the past 30 days to lose weight or
prevent from gaining weight, it is possible that subjective
interpretation of “dieting” contributed to this null finding.
The term “dieting” could capture an array of positive and
negative eating behaviors that may be differentially associ-
ated with depression. For example, Gillen, Markey, Marjey19
found that individuals with higher BMIs were more likely to
engage in healthy and unhealthy dieting behavior than those
with lower BMIs. Interestingly, Gillen, Markey, Marjey19
also found that healthy diet behaviors (eg, eating more fruits
and vegetables) were associated with decreased depression,
while unhealthy diet behaviors (eg, meal skipping) were
associated with increased depressive symptoms.
Our results also indicate that exercise engagement is asso-
ciated with lower depressive symptoms. This finding is well
situated in the literature given that exercise has been shown
to be a protective factor against depressive symptoms.9
While findings in the literature highlight factors that are
negatively associated with exercise engagement (eg, experi-
ence of weight stigma) among those with overweight or
obesity,48 current findings highlight a more nuanced, hetero-
geneous exercise experience that warrants further research.
Specifically, the present findings indicate that exercise
engagement is associated with lower depressive symptoms,
even after accounting for several demographic, dieting
behavior, and body image variables. Thus, one major contri-
bution of this work is highlighting the potential protective
tenants of exercise engagement on depressive symptoms for
college students with overweight/obesity, and thus, a poten-
tial avenue to address depressive symptoms in this popula-
tion while still promoting positive body image.
Surprisingly, body dissatisfaction was not significantly
associated with depressive symptoms. This finding is some-
what at odds with previous research indicating that body
dissatisfaction is a risk factor for depressive symptoms in
this population.23 However, our null finding reinforces the
importance of addressing lope-sided research that primarily
examines risk factors among individuals with overweight/
obesity. Specifically, while body dissatisfaction was positively
correlated with depressive symptoms when examined alone,
in the context of other demographic, health behaviors, and
protective body image variables, this relationship was no
longer significant. Thus, our results suggest that protective
factors, such as body positivity, may be more salient in this
context than typical risk factors and feeling good about
one’s body may override feelings of dissatisfaction. This war-
rants future research attention.
Overall, these results have significant implications for
interventions supporting college students with overweight/
obesity. While findings need to be replicated, the association
of higher body positivity and lower depressive symptoms
suggests the value of focusing on increasing body positivity
in healthy lifestyle interventions for young adults. Our study
reinforces the message of the HAES movement, which pro-
motes positive body-image and self-love to improve health,
well-being, and quality of life among all individuals, includ-
ing those with overweight/obesity.27 Furthermore, our
results suggest that exercise may be a potential protective
factor against depressive symptoms among young adults
with overweight/obesity, irrespective of dieting behavior and
demographic factors. Given known associations between
feeling positive about one’s body and engaging in exercise,
these two variables are a worthwhile exploration in interven-
tions for healthy living.
Limitations
The present findings should be considered within the
context of several limitations. The cross-sectional design of
our study limits our ability to make temporal or causal
statements about the relationship between body image
variables, exercise, and depressive symptoms among young
adults with overweight/obesity. For example, positive body
image and exercise engagement may buffer against depres-
sive symptoms, alternatively, having lower depressive symp-
toms may allow young adults with overweight/obesity to
perceive their bodies in a more positive way and feel more
empowered to engage in exercise. Furthermore, because our
sample consisted solely of 18–25 year old college students
and was majority Black female, generalizability to young
adults who are not in college and are from more varied
racial, ethnic, and gender backgrounds may be limited.
College is a unique time period that comes with its own set
of challenges and opportunities, as well as class differences,
so our sample may be very different from young adults who
are not in college. However, given that Black women have
among the highest rates of obesity in the U.S., these findings
are still very relevant. Another limitation lies in our use of
self-report measures, which may have resulted in social
desirability bias, and thus, may have decreased the accuracy
of responses. Finally, and perhaps most significantly, our
study is limited by the dichotomous measurement of diet
and exercise behaviors. Specifically, because we only assessed
if participants engaged or did not engage in these health
behaviors over a 30-day period, we are unable to explore
how the frequency (ie, number of times college students
exercised or dieted) and quality (eg, intensity of exercise or
type of diet restriction) of these health behaviors may be
related to depressive symptoms. Thus, we missed the oppor-
tunity to capture how nuances in exercise and dieting
behaviors contribute to depression in college students.
Interpretation of our findings leads us to suggest several
directions for future research examining depressive symp-
toms among young adults with overweight/obesity. The first
being that studies should explore the frequency and quality
of exercise and diet behaviors and their association with
depressive symptoms among college students with over-
weight/obesity. Understanding how specific exercise and
dieting behaviors contribute to depressive symptoms across
time will move this research forward. Researchers could use

advanced technology and methods to explore details about
health behaviors, such as examining data from body sensors
or actigraphy to capture exercise engagement, 24-hour diet-
ary recall and phone applications that monitor food intake,
as well as interviewing other reliable informants about diet-
ing and exercise habits of participants. Secondly, researchers
should examine the potential contribution of weight percep-
tion on the association between exercise and depressive
symptoms given the growing body of research indicating
that weight misperception is associated with decreased
depression in this population.46 For example, college stu-
dents categorized with overweight/obesity who misperceive
themselves to be of lean weight may consider exercise to be
less stigmatizing than those who accurately perceive them-
selves as having overweight/obesity. Such studies may con-
tinue to balance lope-sided research examining only risk
factors in this population and may provide information
about potential causal mechanisms.
Conclusions
This study is novel in that our examination of both risk and
protective factors in the context of depression and over-
weight/obesity moves the discourse beyond the ubiquitous
examination of negative factors among individuals with ele-
vated weight, to instead consider positive factors as well.
Our cross-sectional study has shown that being body posi-
tive is associated with better mental health, as is engagement
in exercise. While findings will need to be replicated in vari-
ous demographic groups, it is important to highlight that
messaging about the need for “self-hate” in order to “lose
weight” is not necessarily true. In fact, as evidenced by this
paper, college students experiencing overweight and obesity
appear to be psychologically healthier when they do not
hold such negative views of their bodies. Longitudinal stud-
ies of these concepts may provide a novel route for interven-
tion development. Further, examination of other protective
factors, such as self-esteem, self-compassion, optimism, and
weight misperception, could shed much-needed light on
other protective factors at play in the lives of young adults
with overweight/obesity. Such knowledge could provide
insights for developing future strength-based programs.
Conflict of interest disclosure
The authors have no conflicts of interest to report. The
authors confirm that the research presented in this article
met the ethical guidelines, including adherence to the legal
requirements, of the United States and received approval
from the Institutional Review Board of the University
of Memphis.
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