Background: The rise of social media parallels a mental health epidemic. The effect of social media usage on rates and severity of body dysmorphic disorder is not well-understood. 

Objective: To determine if an association exists between social media engagement, body dysmorphia symptoms, and/or interest in cosmetic surgery in a demographically diverse cross-section of the U.S. adult population. 

Methods: In a Qualtrics platform-based survey study of the general U.S. adult population, responses to demographic information, social media activity questionnaire and the body dysmorphic disorder screening questionnaire, and interest in cosmetic surgery were collected. Descriptive statistics and a multivariate logistic regression model were carried out. 

Results: A total of 1,013 respondents completed the survey. The average age was 40.9 (SD, 14.8) years, 72% were women. Median time spent on social media (IQR) was 4 (2-7) h/day. Respondents who screened positive for symptoms of body dysmorphia had higher daily mean social media usage time (odds ratio [OR] 1.49), tend to be female (OR 2.17), younger (OR 0.97), identify as Caucasian (OR 1.65), and are more likely considering a cosmetic procedure in the next year (OR 2.98). 

Conclusion: This study demonstrates a positive association between daily social media usage, self-reported symptoms of body dysmorphia, and interest in cosmetic procedures.