Integrated Wellness Needs of Saudi University Students: Mental Health as a Key Determinant of Lifestyle and Quality of Life

The transition to university is a critical period for establishing lifelong health habits, particularly in Saudi Arabia, where non-communicable diseases linked to lifestyle are increasingly prevalent. To address this, our study sought to comprehensively assess lifestyle behaviors, mental health status, and their combined impact on health-related quality of life (HRQoL) among students at King Khalid University. We conducted a cross-sectional study between September 2024 and February 2025, recruiting 865 undergraduates via a two-stage stratified random sampling technique. Data were collected using a validated online questionnaire that included the FANTASTIC lifestyle and EuroQol 5-Dimension 3-Level (EQ-5D-3L) instruments. Our results indicated a dual health burden, with a significant proportion of students being overweight or obese (37.6%) and a high prevalence of self-reported anxiety or depression (55.9%). Although the mean lifestyle score was generally positive, regression analysis revealed that anxiety/depression was the strongest predictor of a poorer lifestyle (OR = 2.94, 95% CI: 2.02–4.28). This study concludes that a profound negative association exists between mental health, lifestyle, and overall HRQoL, highlighting the urgent need for integrated wellness policies and support systems within the university setting to address these interconnected challenges.