The most acceptable model explaining the associations between physical exercise and self-esteem is the exercise and self-esteem model (EXSEM). The present cross-sectional study tested the mediating role of body appreciation and physical fitness perception in the associations between physical activity and self-esteem in modified EXSEM. Overall, 1412 Lithuanian adolescents (40.2% were boys, mean age 17.0 (SD = 0.5) years) completed online questionnaires. The study was implemented in 2019 from October to December. Perceived physical fitness and body appreciation mediated the associations in the EXSEM. Physical fitness perception was directly associated with the self-esteem of girls, but not boys. Gender moderated EXSEM associations in body appreciation and perceived physical fitness showed stronger mediation effects for the adolescent girls compared to boys. Increasing physical activity, positive body image and perception of physical fitness might help to foster mental health, especially in girls.
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