Self-Esteem as a Mediator Between Body-Esteem and Depression Among Korean Adolescents: Differences by Weight Status

BACKGROUND/OBJECTIVES: Body-esteem during adolescence is associated with depression, potentially through self-esteem, a key indicator of global self-worth. However, evidence regarding whether this mediating pathway differs by weight status remains limited. This study examined the mediating role of self-esteem in the relationship between body-esteem and depression among normal-weight adolescents and those with overweight or obesity. METHODS: This cross-sectional secondary analysis utilized data from 1168 nationally representative 14-year-old adolescents who participated in the 15th wave of the Panel Study on Korean Children (2022). Data were collected between July and December 2022 through home visits conducted by trained interviewers. Mediation analysis was conducted using PROCESS Macro Model 4, adjusting for sociodemographic and psychosocial covariates. RESULTS: Based on BMI classification, 77.7% of participants were normal weight and 22.3% were overweight or obese. Body-esteem was higher in normal-weight adolescents than in those with overweight or obesity. In both groups, body-esteem was positively associated with self-esteem and negatively associated with depression. After covariate adjustment, self-esteem partially mediated the association between body-esteem and depressive symptoms in normal-weight adolescents and fully mediated this association in adolescents with overweight or obesity. CONCLUSIONS: The psychological pathways linking body-esteem and depression differed by weight status. Self-esteem mediated this association in both groups, with a stronger mediating role identified among adolescents with overweight or obesity. These findings highlight the importance of considering weight status when examining psychological pathways related to body perception and emotional well-being.