Social media use frequency, body image, and weight-control behavior among U.S. high school students

BACKGROUND: Weight perception among U.S. adolescents associates with weight-control behaviors, disordered eating, and depressive symptoms. High-frequency social media use may amplify weight perception through social comparison mechanisms. OBJECTIVE: To examine the association between social media use frequency, weight perception, and weight-loss intentions among U.S. high school students. METHODS: We analyzed a nationally representative, school-based sample of students in grades 9 through 12 using the 2023 National Youth Risk Behavior Survey, which introduced the first granular measure of social media use frequency. Measures include self-reported weight perception (perceiving oneself as overweight), weight-loss intentions and the primary exposure measure (eight-point social media frequency item from no use to more than once per hour). Using linear probability models with state fixed effects and a comprehensive set of behavioral and psychosocial covariates, we examined associations between social media use and weight-related outcomes. RESULTS: We find that hourly or more frequent social media use associates with an 8.1 percentage point higher probability of perceiving oneself as overweight (p < 0.01) and a 6.6 percentage point higher probability of trying to lose weight (p < 0.05), relative to non-users. In a decomposition analysis (n = 9388), weight perception was responsible for about 30% of the observed association between high-frequency social media use and weight-loss intention. Associations are stronger for females and Non-Hispanic White adolescents. CONCLUSIONS: These findings provide law makers with nationally representative evidence that high frequency social media use-the type of engagement pattern targeted indirectly by youth online safety proposals, including the Kids Online Safety Act-is associated with adolescent weight perception and weight-loss intentions.