Perception versus Actual Weight: Body Image Dissatisfaction as a Stronger Correlate of Anxiety and Depression than BMI among Romanian Health Sciences Students

Background: The high prevalence of anxiety and depression among young adults constitutes a significant public health concern, with body image identified as a key psychological factor. However, the interplay between subjective metrics (perceived body image) and objective measures (Body Mass Index,) remains insufficiently explored within specific populations, such as health sciences students in Eastern Europe. Methods: An observational, cross-sectional study was conducted on a sample of 137 medical and nursing students from a Romanian university. Validated instruments were employed: the Hospital Anxiety and Depression Scale (HADS) and the Eating Disorder Examination Questionnaire (EDE-Q). BMI was calculated from self-reported height and weight. Spearman’s correlation analyses and Mann-Whitney U tests were performed. Results: Subjective body image concerns, particularly those related to shape, weight, and eating, were found to be positively and significantly correlated with symptoms of anxiety and depression (all p<0.05). In contrast, BMI exhibited no significant correlation with either of the HADS subscales. Although nursing students presented a higher mean BMI, no significant differences were recorded between the student groups with respect to psychological symptoms or body image concerns. Conclusions: Subjective dissatisfaction with body image is a more salient correlate of emotional distress than objective body mass in this cohort. Although the sample size was moderate, the observed associations were robust and statistically significant, underscoring the importance of subjective body image over objective metrics such as BMI in this academic population. These findings underscore the necessity for mental health interventions within university settings to focus on the perceptual and cognitive-affective aspects of body image, rather than exclusively on weight management.