# Social Media Exposure and Muscle Dysmorphia Risk in Young German Athletes: A Cross-Sectional Survey with Machine-Learning Insights Using the MDDI-1

**Authors:** Maria Fueth, Sonja Verena Schmidt, Felix Reinkemeier, Marius Drysch, Yonca Steubing, Simon Bausen, Flemming Puscz, Marcus Lehnhardt, Christoph Wallner

PMC · DOI: 10.3390/healthcare13141695 · Healthcare · 2025-07-15

## TL;DR

This study finds that heavy social media use increases muscle dysmorphia risk in young German athletes, with machine learning highlighting time spent and influencer comparisons as key factors.

## Contribution

The study introduces machine-learning insights to identify key drivers of muscle dysmorphia risk linked to social media in athletic youth.

## Key findings

- Heavy social media use (≥60 min/day) correlates with higher muscle dysmorphia scores.
- Comparison with fitness influencers and 'likes'-seeking behavior are top predictors of dysmorphia risk.
- A CatBoost model outperformed linear regression in predicting elevated MDDI scores.

## Abstract

Background and Objectives: Excessive social media use is repeatedly linked to negative body image outcomes, yet its association with muscle dysmorphia, especially in athletic youth, remains underexplored. We investigated how social media exposure, comparison behavior, and platform engagement relate to muscle dysmorphia symptomatology in young German athletes. Materials and Methods: An anonymous, web-based cross-sectional survey was conducted (July–October 2024) of 540 individuals (45% female; mean age = 24.6 ± 5.3 years; 79% ≥ 3 h sport/week) recruited via Instagram. The questionnaire comprised demographics, sport type, detailed social media usage metrics, and the validated German Muscle Dysmorphic Disorder Inventory (MDDI-1, 15 items). Correlations (Spearman’s ρ, Kendall’s τ) were calculated; multivariate importance was probed with classification-and-regression trees and CatBoost gradient boosting, interpreted via SHAP values. Results: Median daily social media time was 76 min (IQR 55–110). Participants who spent ≥ 60 min per day on social media showed higher MDDI scores (mean 38 ± 7 vs. 35 ± 6; p = 0.010). The strongest bivariate link emerged between perceived social media-induced body dissatisfaction and felt pressure to attain a specific body composition (Spearman ρ = 0.748, Kendall τ = 0.672, p < 0.001). A CatBoost gradient-boosting model out-performed linear regression in predicting elevated MDDI. The three most influential features (via SHAP values) were daily social media time, frequency of comparison with fitness influencers, and frequency of “likes”-seeking behavior. Conclusions: Intensive social media exposure substantially heightens muscle dysmorphia risk in young German athletes. Machine-learning interpretation corroborates time on social media and influencer comparisons as primary drivers. Interventions should combine social media literacy training with sport-specific psychoeducation to mitigate maladaptive comparison cycles and prevent downstream eating disorder pathology. Longitudinal research is warranted to clarify causal pathways and to test targeted digital media interventions.

## Full-text entities

- **Diseases:** Muscle Dysmorphic Disorder (MESH:D009135), eating disorder (MESH:D001068), Muscle Dysmorphia (MESH:C537340)

## Full text

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## Figures

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## References

22 references — full list in the complete paper: https://tomesphere.com/paper/PMC12294503/full.md

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Source: https://tomesphere.com/paper/PMC12294503