%0 Journal Article
%@ 2369-2960
%I JMIR Publications
%V 11
%N 
%P e52928
%T Association Among BMI, Self-Esteem, and Nonsuicidal Self-Injury in Young Adults to Understand the Influence of Socioenvironmental Factors: Longitudinal Study
%A Zhang,Yi
%A Ying,Ruixue
%A Lu,Wan
%A Liu,Xuemeng
%A Hu,Keyan
%A Feng,Qing
%A Yu,Zixiang
%A Wang,Zhen
%A Lu,Fangting
%A Miao,Yahu
%A Ma,Nanzhen
%A Tao,Fangbiao
%A Jiang,Tian
%A Zhang,Qiu
%K nonsuicidal self-injury
%K chronotype
%K BMI
%K self-esteem
%K body mass index
%K adolescent
%K young adult
%K teenager
%K social environmental factor
%K self-injury
%K sampling method
%K undergraduate
%K college student
%K linear regression
%K regression
%K regression model
%D 2025
%7 21.2.2025
%9 
%J JMIR Public Health Surveill
%G English
%X Background: Nonsuicidal self-injury (NSSI) is a major public health problem leading to psychological problems in adolescents and young adults, similar to disorders such as depression and anxiety. Objective: The aims of this study were to investigate (1) the interaction between BMI and socioenvironmental factors (including chronotype and mental health) that contribute to NSSI, and (2) whether self-esteem plays a mediating role in this association. Methods: From May to June 2022, the multistage cluster sampling method was used to sample college students in four grades, including freshmen and seniors. The baseline participants were followed up 6 months later, excluding those who did not qualify, and the participants included 1772 college students. Socioenvironmental factors (chronotype/mental health), self-esteem, and NSSI were measured using a questionnaire. Multivariate linear regression models and chi-square analysis were used to evaluate the linear relationship between BMI, socioenvironmental factors, and self-esteem and the NSSI status. We use a process approach (mediation-moderation analysis) to explore the complex relationships between these variables. Results: The mean age of the participants was 20.53 (SD 1.65) years at baseline. A significant association was revealed, suggesting that a high BMI (β=.056, 95% CI 0.008‐0.086, P=.018) was associated with a higher NSSI. There was also an interaction among BMI, socioenvironmental factors, and NSSI. Socioenvironmental factors played both moderating and mediating roles in the relationship between BMI and NSSI, whereas self-esteem only played a mediating role. Conclusions: Paying attention to factors such as overweight and obesity is important for early BMI control to identify other potential risk factors for NSSI and to evaluate how self-esteem can be improved considering multiple perspectives to improve the effect of BMI on NSSI in adolescents. 
%R 10.2196/52928
%U https://publichealth.jmir.org/2025/1/e52928
%U https://doi.org/10.2196/52928