How Social Media Affects Body Dysmorphia

Scrolling through idealized images on social media can fuel insecurities for anyone. But for people with body dysmorphia—an obsessive focus on perceived appearance flaws—these platforms can worsen symptoms.

“Social media can be associated with some of those negative beliefs that people with body dysmorphia can develop about themselves,” says Ashwini Nadkarni, MD, a Mass General Brigham psychiatrist who cares for patients at Brigham and Women’s Hospital. Here, she explains how social media affects body dysmorphia and how to protect your mental health.

What is body dysmorphia?

Body dysmorphia is more serious than being unhappy with how you look. “It’s an excessive preoccupation with a perceived physical flaw,” Dr. Nadkarni says. Some people with body dysmorphia may spend between 3 and 8 hours a day staring at themselves in the mirror, picking at their skin, grooming themselves, or finding ways to camouflage perceived flaws.

“The excessive preoccupation tends to impair their ability to function,” Dr. Nadkarni says. People with body dysmorphia often struggle with completing tasks at home, work, or school. They may also avoid social interactions.

Body dysmorphia often emerges in adolescence and is more frequently reported by adolescent girls. But in people older than 18, it affects men and women equally. Other risk factors include:

• Having another mental health condition (such as obsessive-compulsive disorder, depression, or anxiety)
• Having a history of being bullied or abused
• A family history of body dysmorphia

The connection between social media and body dysmorphia

For people with body dysmorphia, social media images and messaging can intensify negative thoughts about how they look. For those without the disorder, heavy use of image-based platforms may increase symptoms. A study of teenagers found that more frequent use of Instagram and Snapchat was strongly associated with body dysmorphic symptoms.

Here are a few ways social media can worsen body dysmorphia:

Social comparison makes existing insecurities worse.

"Social comparison is this psychological process by which we assess our appearance, achievements, and abilities based on what others are doing,” Dr. Nadkarni says.

While everyone engages in social comparison on social media, it can be particularly harmful for people with body dysmorphia. Brain imaging studies show that people with body dysmorphia are already more likely to view images of themselves negatively. Social media may provide a way for them to constantly compare themselves to others, intensifying that negative self-perception.

Filters create an impossible standard.

"Body image is a function of the difference between our real selves—what our appearance objectively is—and our idealized selves, or the image that we have in our heads of who we want to be," Dr. Nadkarni says. Social media filters allow people to create and share idealized versions of themselves. This changes what we view as “normal.”

"We're not just comparing ourselves to others anymore—we're comparing ourselves to our idealized selves as a result of these social media filters,” Dr. Nadkarni says. This comparison can be especially harmful for people with body dysmorphia. They may see their filtered self as how they should look. As a result, their real appearance may seem even more flawed.

Negative comments reinforce fears.

Seeing negative comments from other people is one of the most harmful aspects of social media, Dr. Nadkarni says. “There’s no question that that can not only contribute to body dysmorphia but also anxiety and depression.” Even if the comments aren’t directed at the person with body dysmorphia, chronic exposure to body shaming reinforces their fears of being judged by others.

How to treat body dysmorphia

Dr. Nadkarni urges anyone whose negative thoughts about their appearance interfere with work, relationships, or daily activities to reach out to a professional. “Many people with body dysmorphia hesitate to seek treatment, but evidence-based treatments are highly effective,” Dr. Nadkarni says.

The gold standard treatment for body dysmorphia is to combine cognitive behavioral therapy (CBT), a form of talk therapy that helps you identify and change negative thoughts and behaviors, with selective serotonin reuptake inhibitors (SSRIs). These are medications that elevate levels of serotonin, a brain chemical that regulates mood.

Professional treatment is most effective for body dysmorphia. However, there are steps you can take on your own. These are a few behavioral strategies Dr. Nadkarni uses to help patients with body dysmorphia navigate social media.

Reframe negative thoughts.

Thought reframing helps you become more aware of how your thoughts influence your feelings and behaviors.

Start by questioning a negative thought you often have about a specific feature. For example, someone who thinks his or her forehead is too large could ask: “Is that really true? Who’s actually pointed this out to me as a flaw?” Dr. Nadkarni says.

Then, consider an alternative, believable thought. For example, “I may not like my forehead, but my eyes are beautiful,” Dr. Nadkarni suggests.

By swapping a negative thought for a more realistic one, you’re training your brain to think more rationally about your appearance.

Test your fears.

Negative thought replacement is best paired with exposure. “With exposure, you put yourself in a situation where you might be more likely to draw attention to the physical feature you don’t like,” Dr. Nadkarni says.

This approach is best achieved with professional support. However, people can also consider ways to practice this thoughtfully on their own.

For instance, someone who feels self-conscious about their forehead might resist the urge to hide it by wearing their hair pulled back. Then, they could maintain eye contact during conversations to face what they’ve been avoiding. Observing what happens helps the person to reevaluate whether they are actually being judged or criticized.

This reality check helps break the cycle of fear. “When you expose yourself to the stimulus, you desensitize yourself,” Dr. Nadkarni explains. The more you practice, the less power those fears and negative thoughts have.

Audit your social media profile.

“Be intentional and thoughtful about the content you’re exposed to,” Dr. Nadkarni says. “Avoiding content that is toxic to your mental health is key on social media.” She suggests periodically reviewing who you follow on social media and noticing which accounts trigger self-critical thoughts.

What feels toxic varies from person to person. For some, it might be fitness influencers, beauty creators, or even friends posting heavily filtered photos. Consider unfollowing any accounts that consistently make you feel worse about yourself.

Take a social media break.

Staying off social media helps limit exposure to content that triggers negative thoughts. This may be challenging if you’re a frequent social media user, so Dr. Nadkarni suggests cutting back gradually.

Familiarizing yourself with your social media usage can help you determine how to limit your time online. “For instance, if you’re using social media for two-and-a-half hours per day, aim for two hours instead,” Dr. Nadkarni says. Once that becomes easy, scale back another 30 minutes.

You can also take scheduled social media breaks. For example, limit usage to specific hours during the day or days of the week. “Use the free time to do something that brings you genuine joy or connection with others,” Dr. Nadkarni suggests.