title: Association between higher BMI and depressive symptoms in Icelandic adolescents: the mediational function of body image.
abstract: 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.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: 1 Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA.
authors.forename: Sigridur T
authors.initials: ST
authors.lastname: Eidsdottir
authors.affiliation: 2 Department of Social and Behavioral Sciences, School of Public Health, West Virginia University, Morgantown, WV, USA 3 Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavík, Iceland alkristjansson@hsc.wvu.edu.
authors.forename: Alfgeir L
authors.initials: AL
authors.lastname: Kristjansson
authors.affiliation: 1 Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA 3 Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavík, Iceland.
authors.forename: Inga Dora
authors.initials: ID
authors.lastname: Sigfusdottir
authors.affiliation: 4 Department of Biobehavioral Sciences, Teachers College, Columbia University, New York, NY, USA.
authors.forename: Carol E
authors.initials: CE
authors.lastname: Garber
authors.affiliation: 1 Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA 3 Icelandic Centre for Social Research and Analysis, Reykjavik University, Reykjavík, Iceland 5 Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: John P
authors.initials: JP
authors.lastname: Allegrante
mesh_terms: D000293:Adolescent; D001828:Body Image / Q000523:psychology*; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003863:Depression / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D008297:Male; D012307:Risk Factors; D012923:Social Class; D011795:Surveys and Questionnaires; D055815:Young Adult