This study examined the mediating effect of generalized anxiety disorder (GAD) experiences and the moderated mediating effect of gender in the relationship between subjective body image perception and suicide-related behaviors among adolescents. Using data from the 20th Korea Youth Risk Behavior Survey (2024), we conducted a moderated mediation analysis using Hayes' Process Model 7 with a nationally representative sample of 54,653 middle and high school students (51.4% male, 48.6% female). The results revealed that subjective body image perception influenced suicide-related behaviors through the mediation of GAD experiences, and this mediating effect differed by gender. Specifically, among female students, negative body image perception increased GAD experiences, which in turn elevated the risk of suicide-related behaviors, whereas this pathway was not significant among male students. Notably, the effect of subjective body image perception remained significant only for female students even after controlling for actual body weight, suggesting that the pathway from body image perception to suicide risk through GAD operates specifically among female adolescents. These findings highlight the need for gender-specific intervention strategies in adolescent suicide prevention, emphasizing that programs targeting female students should prioritize the development of healthy body image perceptions and early intervention for GAD rather than focusing on weight management.
