earticle

영어

Objectives: This study aimed to examine the relationship between body image distortion and depression among female adolescents before and after the COVID-19 pandemic, using large-scale national survey data from South Korea. Methods: A total of 105,393 female students aged 12 to 18 years were included from the 13th to 18th Korean Youth Risk Behavior Web-based Survey (2017–2022). Based on BMI and subjective body image perception, participants were categorized into three groups: accurate perception, underestimation (underweight distortion), and overestimation (overweight distortion). Depression was assessed with a single item about experiencing persistent sadness or despair in the past 12 months. Multiple logistic regression analyses were conducted to examine the effects of body image distortion on depression before and after the COVID-19 pandemic. Results: After the onset of COVID-19, the prevalence of overweight distortion decreased while underweight distortion slightly increased. Depression was more prevalent among those with distorted body image perceptions, especially among those who perceived themselves as overweight. After adjusting for covariates, overweight distortion was associated with significantly higher odds of depression both before (OR=1.25, 95% CI: 1.19–1.30) and after (OR=1.22, 95% CI: 1.16–1.29) the pandemic. Underweight distortion also showed a modest but significant association with depression. Other significant predictors of depression included low academic achievement, low socioeconomic status, sleep dissatisfaction, and frequent fast food consumption. Conclusions : Body image distortion is a significant risk factor for adolescent depression, and this relationship persisted before and after the COVID-19 pandemic. Efforts to improve accurate body perception and promote mental health among adolescents, particularly female students, are needed in the post-pandemic era.