The synergic relationship of social anxiety, depressive symptoms and waist circumference in adolescents: Mediation analysis

•We observed a synergic relationship between scores of social anxiety, depression, and waist circumference in adolescents.•Socially anxious adolescents presented higher depressive symptoms and higher waist circumference.•Overweight adolescents with any symptomatology of anxiety should receive a thorough evaluation of their mental health. It is not well established whether depression leads to weight loss or weight gain, or whether a relationship exists among depression, social anxiety, and weight status. The aim of this study was to evaluate the synergic association among social anxiety, depressive symptoms, and waist circumference (WC) during adolescence and examine whether depression mediated the relationship between social anxiety and WC. A cross-sectional study was performed with 1296 adolescents from a northeastern district in Brazil. It was used the Social Anxiety Scale for Adolescents (SAS-A) to evaluate symptoms of social anxiety and the Depression Scale of the Center for Epidemiologic Studies (CES-D) for symptoms of depression. Structural equation modeling was used to determine whether depression, social anxiety, and WC were synergically associated. Analysis was adjusted for sex, age, height, and mother's educational level. Symptoms of social anxiety were directly associated with symptoms of depression and WC, whereas symptoms of depression were not associated with WC. This is a cross-sectional study, and so we cannot infer causality in the interpretation of results. Social anxiety was found to be associated with depressive symptoms and WC. General medical doctors and health practitioners who observe overweight adolescents with any symptoms of anxiety might consider a thorough evaluation of the patient's mental health.