Social appearance anxiety and adult picky eating: Associations with sleep quality, depressive symptoms, and body mass index.

BACKGROUND: Although adult picky eating has traditionally received limited attention, it is now recognized as a persistent eating behaviour with important psychosocial implications. However, its associations with sleep quality, depressive symptoms, body mass index (BMI), and social appearance anxiety remain insufficiently investigated, especially in non-Western settings. This study explored the relationships between adult picky eating and these psychological and health-related variables among Turkish adults. METHODS: A cross-sectional study was conducted with 386 adults aged 18 years and older in Türkiye using an online snowball sampling method. Participants completed the Adult Picky Eating Questionnaire (APEQ), the Pittsburgh Sleep Quality Index (PSQI), the Beck Depression Inventory (BDI), and the Social Appearance Anxiety Scale (SAAS). Sociodemographic information and BMI were also obtained. Between-group comparisons were performed using the Mann-Whitney U and Kruskal-Wallis tests. Spearman's rank correlation and multiple linear regression analyses were used to examine the associations and independent correlates of picky eating. RESULTS: In multivariable linear regression analysis, social appearance anxiety showed a modest, independent positive association with picky eating (B = 0.103, β = 0.201, p < 0.001), whereas BMI exhibited a weak inverse association (B = -0.176, β = -0.121, p = 0.033). Depressive symptoms and sleep quality were not independently associated with total picky eating scores. The overall model explained 7.7% of the variance. Exploratory bivariate correlations indicated a modest positive relationship between social appearance anxiety and total APEQ scores (ρ = 0.264, p < 0.001) with similar patterns observed across subscales, while associations involving depressive symptoms and sleep quality were largely weak or non-significant. CONCLUSIONS: = 0.077), and the modest internal consistency of the APEQ require cautious interpretation and preclude causal, physiological, or clinical inferences. Future prospective studies incorporating comprehensive assessments of sensory sensitivity, food neophobia, body image, and dietary intake are needed to clarify the temporal and contextual factors associated with adult picky eating.