The Mediating Role of Health Literacy in the Relationship Between Body Appreciation and Psychological Well-Being Among Women Regularly Exercising at Fitness Centers

This study examined the mediating role of health literacy in the relationship between body appreciation and psychological well-being among women who regularly exercise at fitness centers, controlling for the body mass index (BMI). Using a correlational design, 580 women who had exercised at fitness centers in Malatya and Elazığ, Türkiye, for at least two months and twice weekly completed the Body Appreciation Scale, Psychological Well-Being Scale, and Health Literacy Survey 19-Europe-Q12. Pearson correlations and structural equation modeling were performed, with indirect effects tested using 5000 bootstrap resamples. Body appreciation positively predicted psychological well-being (β = 0.426, p < 0.001) and health literacy (β = 0.509, p < 0.001), while health literacy positively predicted psychological well-being (β = 0.465, p < 0.001). The indirect effect through health literacy was significant (β = 0.237, 95% CI [0.185, 0.291]), supporting partial mediation. BMI negatively predicted body appreciation but positively predicted health literacy and psychological well-being. The model explained 60.1% of the variance in psychological well-being and 29.2% in health literacy. These findings suggest that body appreciation and health literacy may represent psychosocial resources associated with psychological well-being among women exercising regularly, beyond differences in BMI.