Association Between Symptoms of Body Dysmorphia and Social Media Usage: A Cross- Generational Comparison

Clinical Question

Is increased social media use associated with symptoms of body dysmorphia and interest in cosmetic procedures in U.S. adults?

Bottom Line

Greater daily social media usage is associated with higher odds of screening positive for body dysmorphia and increased interest in cosmetic procedures, particularly among younger individuals and women.

Background: Social media use has increased dramatically over the past decade and has been linked to rising rates of anxiety, depression, and body image concerns. Image-based platforms and photo-editing tools may promote unrealistic beauty standards and increase dissatisfaction with physical appearance, potentially contributing to body dysmorphic symptoms.

Study Design: Cross-sectional survey study using the Qualtrics platform. Adult U.S. participants completed demographic data, a validated social media activity questionnaire (SMAQ), a body dysmorphic disorder screening questionnaire (BDDQ), and questions regarding interest in cosmetic procedures. Multivariate logistic regression was used to assess associations.

Setting: Nationwide U.S. adult population survey

Synopsis: A total of 1,013 respondents (mean age 40.9 years; 72% female) were included. Median social media usage was four hours per day, with higher use among younger participants. Overall, 25.2% screened positive for body dysmorphia symptoms using the BDDQ.

Multivariate analysis demonstrated that increased daily social media use was significantly associated with a higher likelihood of screening positive for body dysmorphia (OR ~1.46 per increase in usage). Additional predictors included female sex (OR 2.17), younger age (OR 0.97 per year increase), white race (OR 1.65), and interest in cosmetic procedures (OR 2.98).

Importantly, individuals with positive BDDQ screening reported greater social media use (median five versus four hours per day) and were more likely to consider cosmetic procedures within the next year (24% versus lower rates in BDD-negative individuals). Conversely, increased social media use was independently associated with a higher likelihood of planning cosmetic procedures (OR ~2.5), and positive BDDQ screening further increased this likelihood (OR ~3.1).

Generational differences were observed, with the highest social media usage and BDD symptom prevalence among younger cohorts (Generation Z and Millennials). Notably, snoring-based or platform-specific differences were not strong predictors.

Limitations include cross-sectional design, inability to establish causality, potential selection bias, and reliance on screening rather than diagnostic criteria for body dysmorphic disorder.

Citation: Losorelli S, et al. Association between symptoms of body dysmorphia and social media usage: a cross-generational comparison. Facial Plast Surg Aesthet Med. 2025;27:483-490. doi:10.1089/fpsam.2024.0230.

Comment: This cross-sectional study demonstrates a positive association between social media use, symptoms consistent with body dysmorphia, and interest in cosmetic surgery. This data is an important reminder for surgeons to consider the psychosocial candidacy of patients prior to performing aesthetic procedures, especially with the increasing prevalence of body dysmorphia symptoms as social media use increases and as younger generations express more interest in cosmetic surgery. —Matthew Miller, MD