Beyond the Mirror: Psychological Correlates of Body Image Dissatisfaction

Abstract

Background:

Body image dissatisfaction (BID) is associated with compromised psychological well-being (PWB) and quality of life (QoL); however, the mechanisms underlying these associations remain underexplored in non-Western populations. This study tested whether psychological distress mediates the BID-PWB and BID-QoL relationships among college-going young adults in urban India, and examined gender differences across these pathways.

Methods:

A cross-sectional study was conducted with 225 participants (125 females, 100 males; M age = 19.87 years, SD = 1.95) from University of Delhi-affiliated institutions. BID, psychological distress, QoL, and PWB were assessed using validated self-report instruments. Structural equation modelling (SEM) with bootstrapped indirect effect analysis (2,000 resamples; 95% bias-corrected CIs) examined direct and mediated pathways.

Results:

The final model demonstrated excellent fit (χ² [26, N = 225] = 34.99, p = .112; CFI = 0.99; TLI = 0.98; RMSEA = 0.04). BID dimensions—self-aggrandisement, body acceptance, and vitality—exerted significant indirect effects on QoL and PWB via psychological distress, with direct pathways non-significant after accounting for the mediator, indicating full mediation. Physical contact and sexual fulfilment showed additional direct associations with specific QoL and PWB indices. Contrary to prevailing assumptions, no gender differences emerged in psychological distress, suggesting BID-related psychological burden is equitably distributed across genders.

Conclusion:

BID compromises QoL and PWB primarily through psychological distress, identifying distress reduction as an efficient intervention target. These findings extend the body image literature into a collectivistic cultural context, suggesting that sociocultural factors attenuate gender-differential vulnerability patterns observed in Western samples. Culturally adapted, distress-focused interventions within college mental health frameworks are recommended; longitudinal research is needed to establish causal directionality.

Key Messages:

• Question: Is body image dissatisfaction common among young adults, and is it associated with psychological distress and low QoL?

• Finding: Body image dissatisfaction is common in young adults of both genders and linked to distress and low QoL

• Meaning: The study calls for targeted programmes to improve body image and psychological well-being.

Contemporary body image research operates within a multidimensional framework that encompasses three interconnected components: behavioural elements involving body-related actions and avoidance behaviours; perceptual dimensions concerning the accuracy of body size estimation and spatial awareness; and cognitive-affective aspects, including thoughts, attitudes, beliefs, and emotional responses toward one’s physical appearance.^1,2 This tripartite model provides the foundational structure for understanding how individuals experience and respond to their physical selves. Evaluation and investment of body image are associated with social functioning. ³ ‘Body dissatisfaction is defined as people’s negative thoughts and feelings about their body’. ⁴ Body image concerns are particularly more relevant in young adults, who are navigating the complexities of physical, emotional, and social development. Studies have indicated its relevance across age groups, but youth have been found to be a particularly important age group for concerns related to body image. ⁵

A state of emotional suffering characterised by symptoms of stress, anxiety, and depression (lack of interest, melancholy, and desperation) is the standard definition of psychological distress. ⁶ It has been reported in multiple studies that body image dissatisfaction (BID) is highly correlated with psychological distress across different age groups, genders, and cultures.^7–9

Adolescence and young adulthood make individuals susceptible to BID as they are more vulnerable due to the significant physical, cognitive, and social transitions. The physical changes create objective alterations in the body shape and require adaptation and integration into the self. ¹⁰

People with BID may have a fear of being judged or rejected by society, which often leads to the experience of social anxiety symptoms. ¹¹ BID strongly correlates with low self-esteem when individuals base their self-worth on physical appearance and adherence to beauty standards. ¹²

Despite the fact that BID affects both men and women equally, its prevalence and psychological effects differ significantly. Society has more specific standards for women that emphasise a thin body as the ideal. This emphasis leads to body dissatisfaction in women, specifically regarding body weight and size. ¹³ Another study reported that men who are at high levels of body dissatisfaction are at increased risk of developing psychological distress, anxiety, depression, or eating disorders. ¹⁴ While men generally report lower levels of BID, both genders at high dissatisfaction levels face elevated risks of psychological distress, anxiety, depression, and eating disorders.

Similar to other regions of the world, BID in India is related to a number of psychological distresses, such as anxiety, depression, low self-esteem, and disordered eating behaviours. ¹⁵ Studies have reported that body dissatisfaction among Indian adolescents is linked to unhealthy weight management practices such as fasting, skipping meals, and utilising diet/weight loss pills. ¹⁶

Research indicates that young adults, especially teenagers and college students, are generally concerned about their bodies. ¹⁷ To comprehend the particular difficulties experienced by young people in Delhi-NCR, a rapidly urbanising region of India, it is crucial to investigate their experiences and correlates of body image disorders. ¹⁸ They reported prevalence, associated factors, and the potential implications for mental health and overall well-being. Thus, the relationship between BID and psychological outcomes among college-going young adults in Delhi-NCR warrants specific investigation within this cultural context. What is the level of BID in young adults across genders? Does it add to the experience of any psychological distress? How is BID associated with quality of life (QoL) and well-being? Does psychological distress describe the relationship between BID and its parameters, and QoL and well-being parameters? The present study seeks to address these research gaps in the literature.

Rationale of the Study

BID is a pervasive psychological concern worldwide. However, empirical research examining its psychological correlates and gender differences remains critically underexplored within Indian contexts, representing a significant gap in contemporary literature. Given India’s unique and ever-evolving sociocultural landscape, findings will provide unprecedented insights into how BID operates within this context. The study’s focus on psychological correlates and gender differences fills a crucial empirical void, offering a pioneering, comprehensive analysis of these relationships in Indian young adults. Hence, the study is required to identify the literature gap and pave the way for future studies to develop more specific and effective interventions.

Objectives

The present study aimed to assess BID and its relationship with psychological correlates among young adults in Delhi-NCR. Specifically, the objectives were to evaluate levels of BID across genders, examine its relation with psychological distress, QoL, and psychological well-being (PWB), and determine whether psychological distress is linked to BID and its parameters with QoL and well-being.

Methods

This study employed a cross-sectional research design to examine the level of BID and its relationship with QoL, psychological distress, and PWB among young adults in the Delhi-NCR region. The study received ethical approval from the Institutional Ethics Committee on 7th May, 2025 (Reference No.- 2025/3/17/V-1/146). Data collection began in May 2025 and ended in June, 2025. Authorities of different colleges of the University of Delhi were contacted for consent to collect data from students at their premises. The study was conducted on university or college campuses. Written informed consent was obtained from each participant before the data collection, and all ethical guidelines were followed. All data were anonymised prior to analysis to safeguard participant confidentiality, and the study was conducted in full compliance with the ethical principles governing research with human participants.

A total of 225 participants were recruited, comprising 125 females and 100 males, with ages ranging from 18 to 25 years (M = 19.87; SD = 1.95). This age range corresponds to the developmental phase of emerging adulthood, which constitutes the theoretical focus of the present investigation.

Participants were selected using a purposive sampling technique, targeting individuals who met the study’s eligibility criteria. Individuals were eligible for inclusion if they were currently enrolled in an undergraduate course at a University of Delhi-affiliated institution, within the specified age range, demonstrated sufficient proficiency in the English language to comprehend and respond to the self-report instruments, and had attained a minimum educational qualification of 12th standard. Individuals were excluded from participation if they reported a current or prior diagnosis of any psychiatric disorder or any neurological condition, as such diagnoses may systematically confound self-reported indices of psychological distress, well-being, and body image perception. Individuals with any physical disability that may independently influence body image appraisal were similarly excluded to preserve the internal validity of the findings and ensure that observed variance in the primary study variable was not attributable to factors extraneous to the study’s scope.

The adequacy of the sample size was evaluated using power analysis guidelines outlined by Faul et al. (2007). ¹⁹ A sample size of 225 provides sufficient power (>0.95) to detect a medium effect size in the proposed correlational analysis and mediation model. To detect a medium effect (r = 0.30) with a standard power of 0.80 and an alpha of 0.05, a minimum sample size of approximately 82 is required. Our sample is 225. This sample size was chosen based on comparable cross-sectional studies conducted on BID among young adults in India.

Measures

The following tools have been used in the study: Demographic data sheet, Dresden Body Image Questionnaire (DKB-35), ²⁰ Kessler Psychological Distress Scale (K-10), ²¹ World Health Organization (WHO)—Quality of Life Inventory Brief (WHOQOL-BREF), ²² and Ryff’s Psychological Well-being Scale (RPWS). ²³ Permission from all the respective authors was obtained to use these measures in the study.

Participants’ information, including name (optional), age, sex, education, occupation, address, and relationship status, is included in the demographic data sheet.

The DKB-35 had been developed by Pöhlmann et al. (2008). ²⁰ It includes 35 items and has five subscales. This questionnaire is focused on assessing overall body experience. It was originally developed in German and then translated into English. The English version’s psychometric properties also supported its use in assessing body image. Body dissatisfaction was operationalised as the total score on DKB-35, a 35-item self-report measure assessing multidimensional body image constructs including dissatisfaction (e.g., ‘I am unhappy with my body size’), body acceptance (e.g., ‘I accept my body as it is’), and vitality (e.g., ‘My body feels energetic and alive’). Items are rated on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), with dissatisfaction subscales reverse-scored such that higher total scores (range: 35–175) reflect greater overall body dissatisfaction. Although the DKB-35 incorporates positive constructs, empirical validation supports its total score as a valid dissatisfaction index: reverse-scoring aligns acceptance and vitality items inversely with dissatisfaction (e.g., low acceptance amplifies dissatisfaction). Consent was obtained from the author to use the test in this study.

K-10 is a self-report questionnaire. It is a self-report scale. It comprises 10 items designed to assess psychological distress in individuals. Items are scored on a 5-point Likert scale. Consent was obtained from the author to use this scale in the study.

WHOQOL-BREF is a shorter version of WHOQOL-100. It has 26 items in total. This scale measures various subjective aspects of QoL. This is a reliable and valid measure of QoL.

An 18-item, short version of RPWS was used in this study. This scale is a self-report measure that assesses six dimensions of an individual’s positive psychological functioning. Consent was obtained from the author to use the scale in this research.

Procedure

Participants aged 18–25 years were contacted. All participants who met the inclusion criteria were contacted to establish rapport. After obtaining written informed consent to participate in the study, participants were assessed on all the psychological tools mentioned under measures. After the administration, all tests were scored. Data was further analysed using appropriate statistical techniques through software.

Data Analysis

Structural equation modelling (SEM) path analysis was used to investigate the theoretical model shown in Figure 1. Maximum Likelihood was the estimating method used. We used the χ² test statistic and two relative fit indices, the Tucker–Lewis index (TLI) and the Comparative Fit Index (CFI), as well as the RMSEA (Root Mean Square Error of Approximation) as absolute fit indices to assess the model’s goodness-of-fit. When RMSEA values are 0.08 or less, and CFI and TLI values are greater than.90, Byrne states that the model fit is considered adequate. ²⁴

Figure 1. Graphical Representation of the Hypothesised Model (M1) Linking Body Image Experience, Psychological Distress, Quality of Life, and Psychological Well-being.

To determine the importance of indirect effects, we employed a bootstrapping method with 2,000 resamples and 95% (Bias-Corrected) confidence intervals (CIs). ²⁵ IBM SPSS→ Amos 21.0 and SPSS→ Statistics 27.0 were used to analyse the data. ²⁶ IBM SPSS Statistics (Version 27) was used for the analysis under an official academic institutional licence available at the co-author’s institution. The software was used only for research purposes in line with IBM’s licensing terms.

Results

Preliminary Analysis

Before conducting the actual statistical analysis, we assessed the data to ensure it met the assumptions of normality. Upon examining graphs, plots, and statistical measures of skewness and kurtosis, we found that all variables met the criteria for approximate normality. Specifically, they exhibited skewness values below 3, which is considered acceptable, and kurtosis values below 10. ²⁷

To confirm the assumptions of linearity and homoscedasticity, we scrutinised bivariate scatterplots depicting the relationships among the study measures. Additionally, the variance inflation factors were below 3, indicating no multicollinearity concerns in our analysis.

Descriptive Statistics

Before outlining the main conclusions, two broad observations are required. The descriptive statistics for the self-report measures for the whole sample and for males and females separately are presented in Table 1. All variables were continuous; raw scores were used. Composite mean scores were computed for each scale as per manual guidelines. Independent-samples t-tests did not reveal significant gender differences on the self-report measures, except for the WHOQOL-BREF social relationships component and the DKB-35 vitality, sexual fulfilment, and physical contact subscales (Table 1). On these DKB-35 dimensions, men scored considerably higher than women; but, on the WHOQOL-BREF social interactions dimension, women performed better than men. It is important to highlight that Levene’s test revealed no violations of the assumption of homogeneity (F range: 0.01–3.92; p range: .02–.92). Second, all self-report measures showed moderate to strong correlations and sufficient to good internal consistency (Table 1), except for the contact component of the DKB-35 (Table 2). The DKB-35 dimensions demonstrated the following reliability coefficients: Self-aggrandisement (SA) = 0.73, body acceptance (BA) = 0.89, physical contact (PC) = 0.63, sexual fulfilment (SF) = 0.71, and vitality (V) = 0.86.

Table 1.

Descriptive Statistics and Internal Consistency Ratings (A) of the Self-report Measures (N = 225).

Variables		Total Sample			Males		Females		t	p
		Mean	SD	α	Mean	SD	Mean	SD
1.	Self-aggrandisement (SA)	20.78	5.41	0.73	21.35	5.64	20.33	5.19	1.41	.159
2.	Body acceptance (BA)	22.76	6.85	0.89	23.37	6.62	22.26	7.01	1.21	.229
3.	Physical contact (PC)	17.53	4.45	0.63	18.41	4.12	16.82	4.60	2.69	.008
4.	Sexual fulfilment (SF)	18.57	5.34	0.71	19.43	5.68	17.89	4.98	2.17	.031
5.	Vitality (V)	26.65	6.24	0.86	28.15	5.94	25.45	6.24	3.30	.001
6.	Psychological distress (PD)	25.08	8.90	0.93	24.29	9.01	25.70	8.80	–1.19	.237
7.	Physical health (PH)	24.64	5.07	0.81	25.37	5.41	24.06	4.73	1.93	.055
8.	Psychological health (PSH)	18.93	4.67	0.83	19.18	4.79	18.74	4.59	.71	.480
9.	Social relationships (SR)	9.92	2.51	0.63	9.55	2.75	10.22	2.25	–2.02	.045
10.	Environmental health (EH)	27.86	5.75	0.84	27.32	5.91	28.30	5.62	–1.27	.207
11.	Quality of life and general health (QoL/GH)	6.82	1.75	0.65	6.94	1.66	6.72	1.81	.94	.349
12.	Psychological well-being (PWB)	85.69	12.70	0.74	84.46	12.48	86.67	12.84	–1.30	.195

SA = Self-aggrandisement; BA = Body acceptance; PC = Physical contact; SF = Sexual fulfilment; V = Vitality; PD = Psychological distress; PH = Physical health; PSH = Psychological health; SR = Social relationships; EH = Environmental health; QoL/GH = Quality of life and general health; PWB = Psychological well-being.

Table 2.

Pearson Correlation Coefficients Between the Self-report Measures (N = 225).

	1	2	3	4	5	6	7	8	9	10	11
Self-aggrandisement (SA)	‒
Body acceptance (BA)	0.30**	‒
Physical contact (PC)	0.29**	–0.01	‒
Sexual fulfilment (SF)	0.33**	0.22**	0.28**	‒
Vitality (V)	0.26**	0.58**	0.01	0.16*	‒
Psychological distress (PD)	–0.09	–0.54**	0.05	–0.09	–0.61**	‒
Physical health (PH)	0.18**	0.42**	0.07	0.19**	0.70**	–0.67**	‒
Psychological health (PSH)	0.30**	0.69**	–0.07	0.19**	0.65**	–0.76**	0.65**	‒
Social relationships (SR)	0.13	0.36**	–0.07	0.33**	0.32**	–0.42**	0.44**	0.53**	‒
Environmental health (EH)	0.16*	0.37**	0.09	0.21**	0.43**	–0.51**	0.60**	0.63**	0.51**	‒
Quality of life and general health (QoL/GH)	0.31**	0.53**	–0.07	0.11	0.67**	–0.61**	0.64**	0.74**	0.42**	0.56**	‒
Psychological well-being (PWB)	0.23**	0.38**	–0.03	0.22**	0.40**	–0.47**	0.45**	0.57**	0.40**	0.48**	0.46**

*p < .05 **p < .01, SA = Self-aggrandisement; BA = Body acceptance; PC = Physical contact; SF = Sexual fulfilment; V = Vitality; PD = Psychological distress; PH = Physical health; PSH = Psychological health; SR = Social relationships; EH = Environmental health; QoL/GH = Quality of life and general health; PWB = Psychological well-being.

Table 2 shows the correlation between the different domains of the DKB-35 questionnaire and QoL and PWB. All domains of DKB-35, except physical contact and sexual fulfilment, show significant (0.01 level) correlations with QoL. Whereas, except for physical contact, all domains of DKB-35 are significantly correlated (0.01 level) with PWB.

Indirect Effects of Psychological Distress in the Association Between Body Image Experience and Indices of QoL and PWB

We employed SEM to assess both the hypothesised model (M₁) and a modified version (M₂). Various fit indices, including the χ² test statistic > 0.05, TLI, CFI, NFI > 0.90, and RMSEA below 0.08, were utilised to determine the adequacy of the SEM.^28–30

The initial assessment of the proposed model (M₁) revealed an inadequate fit with the data (χ² [16, N = 225] = 181.94, p < .001; TLI = 0.42, CFI = 0.88, NFI = 0.88, RMSEA = 0.22, p < .001). The modification indices suggested allowing error terms of Psychological Subjective Happiness (PSH), Quality of Life/General Health (QoL/GH), PWB, and Environmental health (EH) to covary. In compliance with modification indices, we also added paths from EH to Physical Health (PH), PSH, Social Relationships (SR), and QoL/GH. After incorporating the modifications, the revised model (M₂) demonstrated an improved fit to the data. However, upon closer inspection of specific paths, the non-significant paths were removed from the revised model (M₂; see Figure 2), thus, exhibiting a more favourable fit to the data (χ² [26, N = 225] = 34.99, p = .112; TLI = 0.98, CFI = 0.99, NFI = 0.98, RMSEA = 0.04, p = .682).

Figure 2. The Final Model (M₂) Predicts QoL and PWB from Body Image Experiences (SA, BA, and V), With Indirect Effects of PD. Statistics Are the Unstandardised Regression Coefficients.

Figure 2 presents the results of the indirect effect analysis, while Table 3 provides a summary. The expectation was to observe a direct relationship between body image experiences and indicators of QoL and well-being, with Psychological Distress (PD) potentially describing this connection. Figure 2 and Table 3 display both the direct and indirect effects of body image experiences on QoL and well-being. Through bootstrapping, we verified the role of PD.

Table 3.

Indirect Effect of Body Image Experience (SA, BA and V) on Indices of QoL and PWB Via PD.

Independent Variable	Mediator	Dependent Variable	Estimate	BC 95% CI
				Lower	Upper
Self-aggrandisement (SA)	Psychological distress (PD)	PH PSH SR EH QoL/GH PWB	–0.05 –0.06 –0.02 –0.07 –0.01 –0.14	–0.104 –0.109 –0.047 –0.127 –0.029 –0.264	–0.012 –0.013 –0.006 –0.015 –0.003 –0.026
Body acceptance (BA)	Psychological distress (PD)	PH PSH SR EH QoL/GH PWB	0.10 0.11 0.04 0.12 0.03 0.26	0.055 0.058 0.020 0.067 0.015 0.130	0.153 0.165 0.070 0.196 0.045 0.400
Vitality (V)	Psychological distress (PD)	PH PSH SR EH QoL/GH PWB	0.17 0.19 0.07 0.22 0.05 0.44	0.117 0.136 0.046 0.148 0.030 0.302	0.246 0.248 0.105 0.301 0.070 0.601

SA = Self-aggrandisement; BS = Body acceptance; V = Vitality.

The indirect paths, elucidating the association between specific body image experiences SA, BA, V through PD to Psychological Health (PH), PSH, SR, EH, QoL/GH, and PWB, revealed specific coefficients and 95% bias-corrected confidence intervals (BC 95% CI; Table 3).

Furthermore, the results indicated that the PC and SF dimensions of body image experience exhibited stronger direct associations with QoL and PWB indices. Specifically, PC significantly predicted PSH (b = –0.10, p = .007), SR (b =–0.09, p = .008), and QoL/GH (b = –0.05, p = .006). Similarly, SF emerged as a significant predictor of SR (b = 0.13, p = .001), EH (b = 0.18, p = .009), and PWB (b = 0.32, p = .038). Additionally, EH was identified as a robust predictor of PH (b = 0.26, p < .001), PSH (b = 0.22, p < .001), SR (b = 0.16, p < .001), and QoL/GH (b = 0.08, p < .001).

Discussion

BID represents a significant public health concern among young adults, frequently associated with psychological distress. Research has demonstrated that BID substantially affects individual functioning, including QoL and PWB. ³¹ This study examines the prevalence of BID and its relationship with psychological distress, QoL, and PWB among young adults in the Delhi-NCR region.

While Western literature has extensively explored and documented these variables and their interrelationships in international populations, limited research has examined them in Indian contexts. This investigation addresses the gap by examining the prevalence of BID and its relation with QoL and well-being in a representative sample of young adults from Delhi-NCR. Furthermore, the study investigates psychological distress as a factor in the relationship between BID and well-being outcomes. The research contributes to understanding culturally specific manifestations of body image concerns and their psychological consequences, providing evidence-based insights for targeted interventions among Indian young adults.

The findings indicated no gender difference in BID domains except physical contact, sexual fulfilment, and vitality among the young adults. Research conducted in the past had some possible biases, such as only women participants, a limited sample, or other methodological errors, which may have presented a biased result that BID is significantly high in women. A group of researchers has reported in a study that BID is commonly studied in adolescent and young women, but it is also common in Indian men. ³² These findings point to the necessity for longitudinal research to develop a comprehensive understanding of BID patterns in Indian men and to elucidate potential mechanisms underlying any observed gender differences.

The study’s results corroborate existing literature documenting the significant presence of psychological distress among individuals experiencing BID. Psychological distress demonstrated negative correlations with two critical body image domains: body acceptance and vitality. Notably, the absence of gender differences in psychological distress experiences indicates that body image concerns contribute equally to distress across both genders, challenging traditional assumptions about gender-specific manifestations of body image-related psychological experiences.

The study demonstrates that psychological distress and BID significantly influence QoL outcomes. Results indicate positive correlations between multiple body image domains, including self-aggrandisement, body acceptance, sexual fulfilment, and vitality, and both physical and psychological health dimensions of QoL. Additionally, psychological distress exhibited similar positive associations with these QoL domains.

These findings align with established literature demonstrating that BID increases psychological distress while simultaneously diminishing QoL. A group of researchers has reported comparable associations between psychological discomfort, reduced QoL related to mental and physical health, and BID across both genders. ³³ The present study corroborates these international findings within an Indian context.

The present investigation demonstrates a significant negative correlation between PWB and psychological distress, establishing the fundamental relationship between these constructs within the study population. Analysis of body image domains revealed positive correlations between PWB and three specific dimensions: self-aggrandisement, body acceptance, and vitality. These findings indicate that enhanced bodily perception directly corresponds to increased PWB, supporting the theoretical framework that positive body image serves as a protective factor for mental health outcomes.

The study provides empirical evidence suggesting that BID relates to PWB via psychological distress. These results suggest that reduced body image satisfaction influences PWB primarily through its association with psychological distress levels, rather than through direct pathways. The identification of this mechanism contributes to the theoretical understanding of how body image concerns translate into broader psychological difficulties within Indian cultural contexts.

These findings align with international research patterns while revealing culturally specific manifestations. Researchers conducted parallel investigations examining gender variations in these relationships. They reported that males demonstrated stronger negative associations between body dissatisfaction and both psychological discomfort and mental health-related QoL. ³³ The discrepancy between international findings and the present study’s results suggests that cultural factors may moderate gender-specific associations between body image experiences and psychological outcomes.

Implications

Future investigations should expand the scope of inquiry by using larger, more representative samples to enhance the generalizability of findings on body image perception among young adults and its cascading effects on QoL and PWB. Increased sample sizes will enable more sophisticated statistical analyses, including subgroup comparisons across demographic variables such as socioeconomic status, educational background, and regional variations within India.

The identification of psychological distress as a link between body image experiences and QoL outcomes represents a significant theoretical and practical advancement. This indirect relationship provides a clear intervention target, suggesting that therapeutic approaches addressing psychological distress may effectively interrupt the pathway from BID to deteriorated QoL. Clinical interventions should therefore incorporate dual-focused strategies that simultaneously address body image concerns and psychological distress reduction.

The present findings offer substantial guidance for evidence-based intervention design. Treatment protocols should integrate cognitive-behavioural approaches targeting distorted body image perceptions with stress management techniques aimed at reducing psychological distress. Additionally, interventions should incorporate culturally appropriate elements that acknowledge the collectivistic nature of Indian society, particularly the emphasis on social harmony and group well-being identified in this research.

Longitudinal research designs represent a critical next step for advancing theoretical understanding and clinical application. Such studies would enable the examination of causal relationships among variables, the identification of developmental trajectories in body image concerns, and the assessment of intervention effectiveness over extended periods. Furthermore, future research should incorporate neurobiological markers and cultural assessment instruments to develop comprehensive models of BID within diverse populations.

Limitations

The primary limitation of this investigation is the small sample size, which limits the generalizability of the findings to the broader young adult population in Delhi-NCR and India. While the current sample provides valuable insights into the relationships between BID, psychological distress, QoL, and PWB, the statistical power and external validity would be substantially enhanced through larger-scale investigations. Findings are generalisable to urban young adult populations in India with similar sociocultural backgrounds but may not extend to rural or older populations due to the limited regional sample. Other potential limitations include the purposive sampling technique; reliance on self-report measures, which are prone to social desirability biases; the cross-sectional design, which limits causal inferences; and low reliability coefficients (PC = 0.63). Additionally, larger samples would facilitate examination of potential moderating variables such as socioeconomic status, educational attainment, urban versus rural backgrounds, and regional cultural variations within India.

The implementation of multi-site studies across different geographical regions would further enhance the external validity of findings and provide insights into how local cultural factors influence the relationships between body image concerns and psychological outcomes. Such comprehensive investigations would establish a stronger foundation for developing targeted interventions and informing policy decisions related to mental health promotion among Indian young adults.

Conclusion

BID significantly predicts psychological distress and poor well-being in young adults of both genders within an Indian context. The results highlight body image concerns as a universal pathway to mental health issues across genders, challenging gender-biased assumptions and emphasising cultural relevance in non-Western settings. The findings advocate for gender-inclusive screening and interventions, informing public health strategies to curb rising psychological distress linked to body image in diverse demographics. Longitudinal studies and targeted psychological intervention programmes like Acceptance and Commitment Therapy, Dialectical Behaviour Therapy are recommended to further validate the correlation among variables and promote resilient body image across cultures.