Abstract

Evidence on the interplay between perceived stress, dietary behaviour, and weight-related psychosocial burden in Romanian young adults remains scarce. This cross-sectional study assessed associations between BMI, perceived stress, multi-system somatic symptom severity, and psychosocial burden in 117 participants aged 16 to 20 years (89.7% female; mean age 19.23 ± 0.74 years; mean BMI 22.66 ± 3.85 kg/m2), recruited by convenience sampling in Târgu Mureș, Romania, during June 2025. Non-parametric methods were used throughout. Female participants scored significantly higher than males across digestive (p < 0.001), neurological (p = 0.001), cutaneous (p = 0.014), and total symptom domains (p < 0.001), with a median total symptom score of 21.0 versus 3.0 in males. Perceived stress correlated positively with neurological (rS = 0.445), cardiovascular (rS = 0.350), digestive (rS = 0.316), and total symptom scores (rS = 0.401; all p < 0.001). BMI was not associated with somatic symptoms but correlated with weight-related stigma (rS = 0.391, p < 0.001). Emotional distress was prevalent regardless of weight status: 60.7% reported food-related guilt and 59.8% reduced self-confidence, yet only 6.0% had consulted a mental health professional. Stress management, nutritional counselling, and body image support should target young adults across all BMI categories.

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