Body image disturbance, compensatory exercise, and exercise avoidance: cross-sectional conditional process associations in university students.

Body image disturbance is known to be associated with physical activity, yet the pathways linking them remain unclear. Drawing on self-regulation, self-conscious emotion and social cognitive theories, this study examines those pathways within a moderated dual-path model. In this cross-sectional study based on a convenience sample, data from 336 Chinese university students were collected via an online questionnaire and analyzed using confirmatory factor analysis (CFA; AMOS 24.0) for measurement validation and the PROCESS macro (Model 8; v4.1) for moderated mediation analysis with bootstrap confidence intervals (SPSS 27.0). The results showed that body image disturbance was positively associated with both compensatory exercise behavior and exercise avoidance behavior, reflecting a dual pattern of promotion and inhibition. Goal-oriented motivation partially accounted for the association between body image disturbance and compensatory exercise behavior, b = 0.184, 95% CI [0.119, 0.255], and shame partially accounted for the disturbance to avoidance association, b = 0.125, 95% CI [0.068, 0.191]. Exercise self-efficacy moderated both pathways. Compared with students reporting low self-efficacy, those reporting high self-efficacy showed a stronger association between body image disturbance and goal-oriented motivation and no significant association between body image disturbance and shame, and correspondingly stronger compensation and weaker avoidance. Because the data are cross-sectional, these findings describe conditional statistical associations rather than temporal or causal mechanisms.