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Social Media, Mental Health, and Gender: Correlates of Body Dissatisfaction and Desire for Cosmetic Procedures and Cosmetic Surgery among College Students

This cross-sectional study of Mexican college students reveals that high body dissatisfaction is linked to excessive daily use of TikTok and Instagram as well as depression and anxiety symptoms, while interest in cosmetic procedures is significantly associated with non-cisgender identity, non-heterosexual orientation, high body dissatisfaction, and depressive symptoms.

Original authors: Silvia A. Tafoya, María Alonso-Catalán, Mónica Aburto-Arciniega, Rosalia Vazquez-Arevalo, María Luisa Ávila-Escalante, Santiago Silva-Avalos, Benjamin Guerrero Lopez, Maria Elena Medina-Mora, Claudia

Published 2026-06-30

📖 4 min read☕ Coffee break read

CC BY 4.0

Original authors: Silvia A. Tafoya, María Alonso-Catalán, Mónica Aburto-Arciniega, Rosalia Vazquez-Arevalo, María Luisa Ávila-Escalante, Santiago Silva-Avalos, Benjamin Guerrero Lopez, Maria Elena Medina-Mora, Claudia Díaz-Olavarrieta

Original paper licensed under CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). ✨ This is an AI-generated explanation of the paper below. It is not written or endorsed by the authors. For technical accuracy, refer to the original paper. Read full disclaimer

Imagine your body image as a garden. For a long time, we thought only one type of gardener (women) worried about their flowers looking perfect. But this study, conducted among college students in Mexico, suggests that the weeds of "body dissatisfaction" are growing just as thick in the gardens of men as they are in women.

Here is a simple breakdown of what the researchers found, using everyday analogies:

1. The "Digital Mirror" Effect

Think of social media (like TikTok and Instagram) as a funhouse mirror that doesn't just reflect you; it edits you. It shows you a version of reality where everyone is thinner or more muscular than they actually are.

The Finding: The study found that students who spent more than 70 minutes a day looking into these "digital mirrors" were more likely to feel unhappy with their own reflection.
The Specifics: It wasn't just any screen time; it was specifically the visual-heavy apps like TikTok and Instagram that acted like a magnifying glass on body insecurities. Facebook and X (Twitter) didn't seem to have the same effect.

2. The Gender Surprise

Usually, we assume women worry more about their bodies than men.

The Finding: In this group of students, about 28% of everyone (both men and women) had "High Body Dissatisfaction." The numbers were almost identical: 26% of women and 30% of men.
The Twist: While the amount of dissatisfaction was the same, the cause felt different. For men, the "weeds" were often related to wanting to be more muscular. For women, it was about body shape. However, the study noted that being male was actually linked to a higher likelihood of having these high levels of dissatisfaction when looking at the big picture.

3. The Mental Health Connection

Imagine body dissatisfaction as a heavy backpack. The study found that students carrying this heavy backpack were also more likely to be carrying other heavy loads: anxiety and depression.

The Link: The more anxious or depressed a student felt, the heavier their "body dissatisfaction backpack" became. It's a cycle where feeling bad about your body makes your mental health worse, and feeling mentally down makes you focus more on your body's flaws.

4. The Desire for a "Makeover"

If body dissatisfaction is the problem, what is the proposed solution? For many, it's a "makeover" (cosmetic surgery or procedures).

Who wants it? About 43% of the students said they would be willing to get cosmetic surgery.
Who is most likely to want it? The study found that the desire for a makeover wasn't just about looking "perfect" in the traditional sense. It was strongly linked to:
- High Body Dissatisfaction: The unhappier you are with your body, the more you want to change it.
- Identity: Students who identified as non-cisgender (their gender identity doesn't match their birth sex) or non-heterosexual were much more likely to want surgery.
- Depression: Higher levels of depression also increased the desire for these procedures.

5. What They Wanted to Change

If you asked these students which part of their "garden" they wanted to prune or replant:

The Nose: This was the #1 choice for everyone (both men and women).
The Chest and Stomach: These were the next most popular areas.
Gender Differences: Women were more interested in changing their breasts, hips, and buttocks. Men were more interested in their jawline, ears, and eyes.

The Big Picture Takeaway

The researchers conclude that social media acts like a fertilizer for body dissatisfaction, especially for those who are already feeling anxious or depressed.

While social media didn't directly make students say "I want surgery," it did make them feel bad about their bodies. And feeling bad about their bodies was the main reason they wanted surgery.

Who is most vulnerable?
The study highlights that students who are part of the LGBTQ+ community (non-cisgender or non-heterosexual) face a "double whammy." They are more likely to feel depressed and more likely to want cosmetic procedures, possibly because the tools used to measure body dissatisfaction in this study didn't fully capture the unique struggles of gender identity (like gender dysphoria).

In short: The study suggests that to help students feel better about themselves, we need to teach them how to navigate the "funhouse mirrors" of social media and address the underlying anxiety and depression that often drive the desire to change their appearance.

Technical Summary: Social Media, Mental Health, and Gender: Correlates of Body Dissatisfaction and Desire for Cosmetic Procedures among College Students

Problem Statement
Body dissatisfaction (BD) is a significant risk factor for poor mental health and a primary motivator for seeking cosmetic surgery and procedures. While social media (SM) is widely recognized as a driver of unrealistic beauty standards—promoting thinness for females and muscularity for males—there is a need to understand the specific interplay between SM use, gender-related characteristics (including sexual orientation and gender identity), and mental health symptoms within the context of Mexican university students. This is particularly relevant given Mexico's high ranking in global aesthetic procedures and the specific epidemiological reality of high obesity rates in the Yucatán region, which contrasts with digitally promoted body ideals. Furthermore, existing literature often lacks comprehensive data on the LGBT+ community regarding aesthetic desires, a gap this study aims to address within a population that has active inclusion programs.

Methodology
The study employed a cross-sectional design conducted in June 2024 among 464 undergraduate health sciences students (Medicine, Rehabilitation, and Nutrition) at the Autonomous University of Yucatan (UADY). The sample consisted of 291 females and 173 males, with a mean age of 20.8 years.

Data collection utilized validated instruments to assess specific variables:

Demographics: Sex assigned at birth, gender identity, sexual orientation, and academic major.
Social Media Use: Daily time spent (in minutes) on specific platforms (TikTok, Instagram, Facebook, X, WhatsApp).
Body Dissatisfaction (BD): Assessed using sex-specific tools. Females completed the Body Shape Questionnaire (BSQ), where scores ≥110 indicate high BD. Males completed the Drive for Muscularity Scale (DMS), where a provisional cutoff of mean + 2 standard deviations (≥3.26) was established to identify high BD.
Mental Health: Symptoms of anxiety and depression were measured using the Hospital Anxiety and Depression Scale (HADS).
Desire for Intervention: Participants were queried on their willingness to undergo cosmetic surgery, non-surgical cosmetic procedures, and bariatric surgery, along with specific body areas of interest.

Statistical analysis was performed using SPSS version 23. Descriptive statistics were compared by sex using chi-square tests and t-tests. Separate logistic regression models were constructed to examine predictors of high BD and the desire to undergo cosmetic surgery, adjusting for age, gender identity, sexual orientation, major, and SM usage.

Key Results

Prevalence of Body Dissatisfaction: The overall prevalence of high BD was 27.8%. Contrary to some prior literature suggesting higher rates in women, this study found no statistically significant difference between females (26.1%) and males (30.3%).
Mental Health Correlates: Male students reported significantly higher levels of anxiety ( $p=.001$ ) and depressive symptoms ( $p<.001$ ) compared to females. However, in the regression model for high BD, higher levels of both anxiety ( $p=.001$ ) and depression ( $p<.001$ ) were significantly associated with increased odds of high BD for the total sample.
Social Media Impact: Greater daily time spent on TikTok ( $p=.044$ ) and Instagram ( $p=.047$ ) was significantly associated with high BD. Total time spent on SM and usage of other platforms (Facebook, X) were not significant predictors in the multivariate model.
Desire for Cosmetic Surgery: 42.9% of participants expressed a desire to undergo cosmetic surgery. Logistic regression identified four significant predictors for this desire:
1. Non-cisgender identity ( $p=.019$ ; OR=13.13).
2. Non-heterosexual orientation ( $p=.008$ ; OR=4.41).
3. High Body Dissatisfaction ( $p=.039$ ; OR=3.31).
4. Depressive symptoms ( $p=.023$ ; OR=1.26).
  Notably, SM use did not show a direct significant association with the desire for cosmetic surgery in the regression model, suggesting BD may act as a mediator.
Specific Procedures and Areas: The nose was the most frequently desired area for surgery (22.0%), followed by breasts (8.4%) and abdomen (8.0%). Interest in non-surgical cosmetic procedures was comparable between sexes (4.8% female vs. 2.9% male).
Subgroup Differences: Among men, 47% of non-heterosexual individuals expressed interest in cosmetic surgery compared to 22% of heterosexual men. Among non-cisgender men, 67% expressed interest compared to 27% of cisgender men.

Significance and Claims
The authors claim that this study provides evidence of the complex interplay between gender-related factors, social media use, and mental health in relation to body dissatisfaction and the desire for aesthetic interventions among young adults in a middle-income country.

Key contributions and claims include:

Gender Paradox in BD: The study challenges the traditional view that women have significantly higher body dissatisfaction than men when sex-specific instruments are used, noting that men in this sample showed a slightly higher (though not statistically significant) prevalence of high BD.
Mediating Role of Body Dissatisfaction: The findings suggest that while social media use (specifically visual platforms like TikTok and Instagram) is a direct predictor of high BD, its influence on the desire for cosmetic surgery is indirect, mediated through the distortion of body image.
Vulnerability of Sexual and Gender Minorities: The study highlights that non-cisgender and non-heterosexual students are significantly more likely to desire cosmetic surgery, a finding the authors attribute partly to the limitations of standard BD instruments (BSQ/DMS) which do not capture gender dysphoria or body incongruence related to secondary sexual characteristics.
Public Health Implications: The authors conclude that public health strategies should focus on promoting digital media literacy and early detection of body image dissatisfaction. They emphasize the need for culturally sensitive interventions targeting vulnerable university students, particularly in regions with high obesity rates where the digital body ideal sharply contrasts with epidemiological reality.

The paper maintains a modest tone regarding its limitations, acknowledging the non-probabilistic sampling, the lack of BMI data, and the inability of the current instruments to fully assess body image concerns within sexual minority populations.