Abstract

Introduction Chronic conditions like type 2 diabetes mellitus (T2DM) require a multidimensional understanding of health, especially in low-resource settings. This study examined the association between psychological symptoms (anxiety, depression), cognitive factors (irrational food beliefs), behavioral variables (eating patterns, physical activity), and T2DM risk in adults from Honduras. Methods A cross-sectional survey was conducted with 336 adults using online convenience sampling. Participants completed a modified Finnish Diabetes Risk Score (FINDRISC), Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Irrational Food Beliefs Scale, and the Eating Behavior Phenotype Scale. Most participants had no prior diagnosis of hypertension, elevated glucose, or diabetes, though 61.9% were overweight or obese. Results The findings suggest that when compared to men, women reported higher symptoms of depression and emotional grazing, while also reporting lower hyperphagic eating. No significant differences were found for T2DM risk, irrational food beliefs, anxiety, hedonic eating, disorganized eating, or compulsive eating. On the other hand, anxiety, depression, and age modestly predicted T2DM risk, explaining 18.1% of its variance. Depression was linked to all eating behaviors, while irrational food beliefs predicted some eating phenotypes but not T2DM risk. Although sex was associated with specific eating patterns, it did not predict diabetes risk. Disordered eating did not mediate the relationship between psychological symptoms and T2DM risk. Discussion The cross-sectional design used precludes causal inference, the mediation results should be interpreted as descriptive rather than causal, and the use of non-random sampling limits the generalizability of the findings. These findings highlight the importance of integrating mental health and lifestyle interventions to reduce vulnerability to type 2 diabetes, especially in at-risk populations.