【Objective】 To explore the mediating role of eating disorders in the relationship between body image satisfaction and anxiety symptoms among college students, and further examine the moderating effect of mindfulness on this mediating pathway. 【Methods】 By using convenience sampling, we conducted baseline and follow-up surveys among freshmen and sophomores at two universities in Xizang Autonomous Region from September to December 2021. Measurements included the Generalized Anxiety Disorder Scale, the body image satisfaction subscale of the Multidimensional Body-Self Relations Questionnaire, the Eating Attitudes Test, and the Mindful Attention Awareness Scale. Data analyses performed using SPSS 23.0 included Pearson correlation analysis, mediation (model 4), and moderation (model 58) effect analysis. 【Results】 A total of 2 993 students participated in both the baseline and follow-up surveys, including 1 007 males (34.3%) and 1,666 Tibetan and other ethnic minorities (56.8%), with an average age of 19.8 (SD=1.3) years. Body image satisfaction significantly predicted anxiety symptoms, and this relationship was partially mediated by disordered eating. The presence of mindfulness moderated the impact of body image satisfaction on disordered eating and the influence of disordered eating on anxiety symptoms, indicating varying strengths of these relationships at different levels of mindfulness. 【Conclusion】 This study demonstrates that body image satisfaction can significantly predict anxiety symptoms, with disordered eating playing a mediating role in this relationship. The moderating effect of mindfulness further reveals that students with high levels of mindfulness are less likely to experience eating disorders influenced by body image dissatisfaction. Interventions for college students’ mental health should consider including management of body image and eating behaviors, as well as mindfulness training.