Association between beauty standards shaped by social media and body dysmorphia among Egyptian medical students

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Facebook is the main priority social media app in Egypt, with 56 million active users and its greatest user demographic ranging from 18 to 44 years of age.

“Facebook is considered the main priority social media app in Egypt, with 56 million active users and its greatest user demographic ranging from 18 to 44 years of age3.”

• cites [3] Saied, S. M., Elsabagh, H. M. & El-Afandy, A. M. Internet and Facebook addiction among Egyptian and Malaysian medical students: A comparative study, Tanta University, Egypt. Int. J. Community Med. Public Health 3 (5), 1288–1297. https://doi.org/10.18203/2394-6040.ijcmph20161400 (2017). sourcePartly supported

  The study’s results report that Facebook was the most-used social medium among the Egyptian medical students surveyed, but do not establish that it was the leading app across Egypt. The introductory passage estimates 27 million Facebook users in Egypt in November 2015, not 56 million, and describes an 18–34 age group among Facebook members rather than identifying Egyptians aged 18–44 as the largest user demographic. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

Classified as probably not a substantial claim.

Body image is formed through body ideals heavily propagated by media, family, and peers.

“This understanding is formed through body ideals heavily propagated by media, family, and peers1.”

• cites [1] Jiotsa, B., Naccache, B., Duval, M., Rocher, B. & Grall-Bronnec, M. Social media use and body image disorders: Association between frequency of comparing one’s physical appearance to that of people being followed on social media and body dissatisfaction and drive for thinness. Int. J. Environ. Res. Public. Health. 18 (6), 2880. https://doi.org/10.3390/ijerph18062880 (2021). sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

A recent study in Saudi Arabia concluded that almost 9.5% of patients visiting the dermatology clinic have BDD, showing an alarming lack of awareness about this disorder.

“A recent study conducted in Saudi Arabia has concluded that almost 9.5% of the patients visiting the dermatology clinic have BDD, which shows that there is an alarming lack of awareness about this disorder5.”

• cites [5] Al Shuhayb, B. S., Bukhamsin, S., Albaqshi, A. A. & Omer Mohamed, F. The prevalence and clinical features of body dysmorphic disorder among dermatology patients in the Eastern Province of Saudi Arabia. Cureus 15 (7), e42474. https://doi.org/10.7759/cureus.42474 (2023). sourcePartly supported

  The Conclusions report 9.5% prevalence among people visiting dermatology clinics and call that prevalence alarming. They recommend enhancing dermatologists’ awareness, but do not conclude that the finding demonstrates an alarming lack of awareness about BDD. The Discussion also notes that the estimate came from a screening tool and may be high. (LLM, conf=0.86)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

Concerns about abdominal appearance can be explained by the high prevalence of abdominal obesity and metabolic syndrome due to socioeconomic, lifestyle, and nutritional changes in the Egyptian community and some other Arab countries.

“Concerns about abdominal appearance can be explained by the high prevalence of abdominal obesity and metabolic syndrome due to the socioeconomic, lifestyle, and nutritional changes that have been taking place in the Egyptian community and some other Arab countries toward the unhealthy pattern21.”

• cites [21] Assaad-Khalil, S. H. et al. Optimal waist circumference cutoff points for the determination of abdominal obesity and detection of cardiovascular risk factors among the adult Egyptian population. Indian J. Endocrinol. Metab. 19 (6), 804–810. https://doi.org/10.4103/2230-8210.167556 (2015). sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

Western epidemiologic data suggest general population BDD rates of 1.7-2.9%.

“while Western epidemiologic data suggest general population rates of 1.7–2.9%12,14.”

• cites [12] Alghamdi, W. A. et al. Body dysmorphic disorder symptoms: Prevalence and risk factors in an Arab middle Eastern population. Int. J. Gen. Med. 15, 2905–2912. https://doi.org/10.2147/IJGM.S329942 (2022). sourcePartly supported

  The Discussion reports general-population BDD rates of 1.7% in Germany and 2.4% in the United States, supporting the Western comparison. It does not report the claimed 2.9% upper endpoint. (LLM, conf=0.88)

  Experimental — accuracy not yet measured
• cites [14] Phillips, K. A., Hartmann, A. S. & Buhlmann, U. Prevalence and underrecognition of body dysmorphic disorder. In Body Dysmorphic Disorder: Advances in Research and Clinical Practice (ed. Phillips, K. A.) (Oxford Academic, 2017). https://doi.org/10.1093/med/9780190254131.003.0005. Accessed February 19, 2025. sourceNot checked — no full text of the source

May combine two claims.

A 2022 survey of plastic surgery found that 41% of Egyptian women presenting for cosmetic surgery cited 'marriage market competitiveness' as a primary reason, many with female gender role stress.

“The 2022 survey of plastic surgery discovered that 41% of Egyptian women presenting for cosmetic surgery cited “marriage market competitiveness” as a primary reason, many concomitant with female gender role stress (FGRS)16.”

• cites [16] Khattab, N. R., Abdelraouf, N. & Ashour, T. Conflicting cultural and religious views on cosmesis: The modern women’s dilemma. Aesth. Plast. Surg. 46, 2040–2052. https://doi.org/10.1007/s00266-022-02834-6 (2022). sourcePartly supported

  The Discussion (page unavailable) reports that higher female gender role stress was associated with willingness to undergo cosmetic surgery. But the Methodology and Participants sections describe an online survey of Egyptian Muslim women, not women presenting for surgery. The paper does not report that 41% cited “marriage market competitiveness” as a primary reason. (LLM, conf=0.90)

  Experimental — accuracy not yet measured

May combine two claims.

In this sample of Egyptian medical students, 6.3% had BDD, a prevalence significantly higher than the global norms of 2.2% in adolescents, 1.9% in adults, and 3.3% in students.

“The study revealed that 6.3% of individuals had BDD, significantly higher than the global norm of 2.2% in adolescents, 1.9% in adults, and 3.3% in students10.”

• cites [10] Veale, D., Gledhill, L. J., Christodoulou, P. & Hodsoll, J. Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image 18, 168–186 (2016). sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing).

63.4% of persons with BDD in the sample were female.

“In line with previous reports10, 63.4% of persons with BDD were female.”

• cites [10] Veale, D., Gledhill, L. J., Christodoulou, P. & Hodsoll, J. Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence. Body Image 18, 168–186 (2016). sourceSupported

May combine two claims.

Participants in a 2022 study of Egyptian Muslim women reported intense pressure to conform to limiting beauty standards, as deviation risks social exclusion or reduced marriage prospects.

“Participants reported intense pressure to conform to limiting beauty standards, as deviation risks social exclusion or reduced marriage prospects16.”

• cites [16] Khattab, N. R., Abdelraouf, N. & Ashour, T. Conflicting cultural and religious views on cosmesis: The modern women’s dilemma. Aesth. Plast. Surg. 46, 2040–2052. https://doi.org/10.1007/s00266-022-02834-6 (2022). sourcePartly supported

  The Participants section identifies the sample as Egyptian Muslim women, and Results > Secondary Outcomes reports partner pressure to change appearance and greater internalization of beauty standards among women willing to undergo cosmetic procedures. The paper does not report that participants described the pressure as intense or the standards as limiting, nor does it establish social exclusion or reduced marriage prospects as consequences of deviating from them. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The difference in BDD rates could stem from cultural variations in beauty standards, with East Asian cultures emphasizing facial features or skin tone and Middle Eastern and African contexts prioritizing body shape or hair.

“This could stem from cultural variations in beauty standards—for instance, East Asian cultures often emphasize facial features or skin tone13, while Middle Eastern and African contexts may prioritize body shape or hair11,12.”

• cites [13] Cuttilan, A. N., Sayampanathan, A. A. & Ho, R. C. Mental health issues amongst medical students in Asia: A systematic review [2000–2015]. Ann. Transl Med. 4 (4), 72. https://doi.org/10.3978/j.issn.2305-5839.2016.02.07 (2016). sourceNot checked — no full text of the source
• cites [11] Elie, A. et al. Factors associated with body dysmorphic disorder in academia (Benin, 2021). Open J. Psychiatry 13, 461–478. https://doi.org/10.4236/ojpsych.2023.136033 (2023). sourcePartly supported

  Section 4.2 (Prevalence) suggests that sociocultural differences may help explain differing BDD rates, and Section 4.3 (Clinical and Developmental Characteristics) says beauty criteria in the study’s Black African setting differ from Western ones. Section 3.3 mentions hair and weight concerns, but identifies skin, weight and height as the most frequent concerns. The paper does not establish that African contexts generally prioritize body shape or hair, and it provides no such finding for Middle Eastern contexts. (LLM, conf=0.83)

  Experimental — accuracy not yet measured
• cites [12] Alghamdi, W. A. et al. Body dysmorphic disorder symptoms: Prevalence and risk factors in an Arab middle Eastern population. Int. J. Gen. Med. 15, 2905–2912. https://doi.org/10.2147/IJGM.S329942 (2022). sourcePartly supported

  The Discussion (page unavailable) suggests that cultural factors may help explain differences in BDD rates and describes differences in ideal body weight between Arabian and Western societies. It does not address African contexts or say that Middle Eastern or African cultures prioritize hair. The East Asian comparison is attached to a different citation in the citing sentence. (LLM, conf=0.85)

  Experimental — accuracy not yet measured

May combine two claims.

Traditional beauty standards identify physical beauty with moral virtue, a subject examined in a 2022 study of Egyptian Muslim women.

“This anxiety is fueled by traditional beauty standards that identify physical beauty and moral virtue, a subject examined in a 2022 study of Egyptian Muslim women16.”

• cites [16] Khattab, N. R., Abdelraouf, N. & Ashour, T. Conflicting cultural and religious views on cosmesis: The modern women’s dilemma. Aesth. Plast. Surg. 46, 2040–2052. https://doi.org/10.1007/s00266-022-02834-6 (2022). sourceSupported

May combine two claims.

The 2023 Alexandria University study found that 36.6% of students fixated on skin imperfections and 36.2% on belly size.

“The 2023 Alexandria University study confirmed that 36.6% of students fixated on skin imperfections and 36.2% on belly size—traits subject to extreme scrutiny within Egyptian cultural standards15.”

• cites [15] Alkiek, M., Attia, M., Shata, Z. & Abdelaziz, H. Prevalence and determinants of body dysmorphic symptoms among university students in Alexandria. Egypt. J. High. Inst. Public. Health 53 (2), 46–54. https://doi.org/10.21608/jhiph.2023.327607 (2023). sourcePartly supported

  Figure 1 and the Abstract report skin (36.6%) and belly size (36.2%) as the most common areas of concern among the studied students. The Discussion suggests that cultural opinions may affect which body parts are of concern, but it does not establish the citing sentence’s added claim that these traits face extreme scrutiny within Egyptian cultural standards. (LLM, conf=0.88)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

The majority of participants used social media platforms for more than 4 hours each day.

“Consistent with Alsaidan et al.18, the majority used social media platforms for more than 4 h each day.”

• cites Alsaidan et al. [18] Alsaidan, M. S. et al. The prevalence and determinants of body dysmorphic disorder among young social media users: A cross-sectional study. Dermatol. Rep. 12 (3), 8774. https://doi.org/10.4081/dr.2020.8774 (2020). sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Most participants spend 4 to 7 h and 1 to 3 h daily on social media, 563 (50%) and 374 (33.2%), respectively.

“Most participants spend 4 to 7 h and 1 to 3 h daily on social media, 563 (50%) and 374 (33.2%), respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The majority were from Dakahlia, Cairo, Qena, Damietta, and Giza, with 327 (29%), 282 (25%), 160 (14.2%), 82 (7.3%), and 45 (4%), respectively.

“The majority were from Dakahlia, Cairo, Qena, Damietta, and Giza, 327 (29%), 282 (25%), 160 (14.2%), 82 (7.3%), and 45 (4%), respectively.”

Probably not a substantial claim: may not pass S3 (load-bearing).

793 (70.4%) were from urban residences.

“793 (70.4%) were from urban residences (Table 1).”

Probably not a substantial claim: may not pass S3 (load-bearing).

The economic status of the majority, 1044 (92.7%), was middle level.

“The economic status of the majority, 1044 (92.7%), was middle level.”

May combine two claims.

The appearance problem upset 36.5% of students and interfered with the social activities of 26.9%.

“The appearance problem upset 36.5% of students and interfered with the social activities of 26.9%.”

May combine two claims.

Of those worried, 55.9% thought about it a lot as a problem, mostly their faces (16.7%), abdomen (9.7%), weight (6.1%), noses (7.9%), thighs (4.5%), and all their body (4.3%).

“Of them, 55.9% thought about it a lot as a problem, mostly their faces (16.7%), their abdomen (9.7%), weight (6.1%), noses 51 (7.9%), thighs (4.5%), and all their body (4.3%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

1114 (98.9%) were single.

“1114 (98.9%), we’re single.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The platforms of WhatsApp, Facebook, Instagram, YouTube, and TikTok were mostly used, with 729 (64.7%), 626 (55.6%), 601 (53.4%), 485 (43.1%), and 332 (29.5%) participants, respectively.

“The platforms of WhatsApp, Facebook, Instagram, YouTube, and TikTok were mostly used, 729 (64.7%), 626 (55.6%), 601 (53.4%), 485 (43.1%), and 332 (29.5%), respectively.”

May combine two claims.

27.6% reported avoidance behaviors, mostly towards clothes (27.7%), socialization (20.9%), and taking and publishing photos (9.6%).

“27.6% reported avoidance behaviors, mostly towards clothes (27.7%), socialization (20.9%), and taking and publishing photos (9.6%).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

719 (63.9%) were females, and 407 (36.1%) were males.

“719 (63.9%) were females, and 407 (36.1%) were males.”

May combine two claims.

The sample consisted of 1126 undergraduate medical students, with a mean age of 20.8 years (SD 1.6).

“Our sample consisted of 1126 undergraduate medical students, with a mean age of 20.8 years (1.6).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The majority rarely or sometimes take selfies (484 (43%) and 454 (40.3%)), sometimes or never edit selfies with filters (348 (30.9%) and 336 (29.8%)), and rarely or sometimes share them with others (446 (39.6%) and 363 (32.2%)).

“The majority rarely or sometimes take selfies, 484 (43%), 454 (40.3%), sometimes or never edit selfies with filters, 348 (30.9%), 336 (29.8%), and rarely or sometimes share them with others, 446 (39.6%), 363 (32.2%), respectively (Table 2).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Bullying and social anxiety were the most common issues at school or work, accounting for 2.4% and 1.8%, respectively.

“In line with this Saudi study18, bullying and social anxiety were the most common issues at school or work, accounting for 2.4% and 1.8%, respectively.”

• cites Saudi study18Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

A significant difference was found regarding high economic status (p = 0.03), marriage (p = 0.05), and residence (p = 0.03).

“A significant difference was also found regarding high economic status (p = 0.03) marriage (p = 0.05), and residence (p = 0.03).”

May combine two claims.

The prevalence of BDD among Egyptian medical students in this study is 6.7%, higher than worldwide rates.

“The prevalence of BDD among Egyptian medical students is 6.7%, which is higher than worldwide.”

May combine two claims.

A strong association was found between BDD and economic status and place of residence.

“In addition, a strong association was found between BDD and economic status and place of residence.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The majority suggested education about BDD risks (616, 54.7%), promotion of body positivity (536, 47.6%), and restriction of unfavorable content (510, 45.3%).

“The majority suggested education about BDD risks 616 (54.7%), promotion of body positivity 536 (47.6%), and restriction of unfavorable content 510 (45.3%).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Egyptian medical students enrolled in our study believe that promoting body positivity, educating users about the risks of body dysmorphia, restricting content that promotes unrealistic body standards, and providing resources and support for those affected, respectively, are the critical measures that social media platforms should take to address body dysmorphia.

“Interestingly, Egyptian medical students enrolled in our study believe that promoting body positivity, educating users about the risks of body dysmorphia, restricting content that promotes unrealistic body standards, and providing resources and support for those affected, respectively, are the critical measures that social media platforms should take to address body dysmorphia.”

Probably not a substantial claim: may not pass S3 (load-bearing).

About half of participants, 550 (48.8%), strongly support initiatives aimed at raising awareness about social media-related body dysmorphia.

“About half of participants, 550 (48.8%), strongly support initiatives aimed at raising awareness about social media-related body dysmorphia.”

May combine two claims.

445 (39.5%) engage in positive self-talk, 353 (31.3%) participate in offline activities or hobbies, and 343 (30.5%) unfollow accounts promoting unattainable beauty standards.

“445 (39.5%) engage in positive self-talk, 353 (31.3%) participate in offline activities or hobbies, and 343 (30.5%) unfollow accounts promoting unattainable beauty standards.”

Classified as probably not a substantial claim. May combine two claims.

Egyptian medical students in the study believe that promoting body positivity, educating users about the risks of body dysmorphia, restricting content that promotes unrealistic body standards, and providing resources and support for those affected are the critical measures social media platforms should take to address body dysmorphia.

“Egyptian medical students enrolled in our study believe that promoting body positivity, educating users about the risks of body dysmorphia, restricting content that promotes unrealistic body standards, and providing resources and support for those affected, respectively, are the critical measures that social media platforms should take to address body dysmorphia.”

May combine two claims.

There were statistically significant differences between the BDD and non-BDD groups for age and governorate, with the BDD group being slightly older overall and having clear-cut distributions by governorate.

“Our results indicate statistically significant differences between the BDD and non-BDD groups about age and governorate, with the BDD group being slightly older overall and having clear-cut distributions by different governorates.”

May combine two claims.

331 (29.4%) limit social media usage, 269 (23.9%) seek support from friends or family, and 97 (8.6%) consult a mental health professional.

“Also, 331 (29.4%) limit social media usage, 269 (23.9%) seek support from friends or family, and 97 (8.6%) consult a mental health professional.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Only 11.6% of individuals claimed that their looks had caused problems in their community.

“Only 11.6% of individuals claimed that their looks had caused problems in their community.”

May combine two claims.

In the analysis of significant predictors of BDD, age <=21 (OR 2.56), residence in Dakahlia (OR 0.34), residence in Qena (OR 2.56), high economic status (OR 2.29), and rural residence (OR 1.71) were significant predictors.

“| <=21 | 2.56 | 0.004* | 1.36–4.82 |”

• Also stated in: § Results · plain

  “| Qena | 2.56 | 0.001* | 1.48–4.43 |”

• Also stated in: § Results · plain

  “| Rural | 1.71 | 0.03* | 1.04–2.79 |”

May combine two claims.

There was a significant difference between BDD and non-BDD according to Governorate (p = 0.03), especially Dakahlia (p = 0.002) and Qena (p < 0.001).

“We found a significant difference between BDD and non-BDD according to the Governorate (p = 0.03), especially Dakahlia (p = 0.002) and Qena (p < 0.001).”

May combine two claims.

Certain clothes, taking and publishing images, and socializing were the key acts avoided due to appearance, resulting in negative consequences.

“Certain clothes, taking and publishing images, and socializing were the key acts avoided due to their appearance, resulting in various negative consequences”

May combine two claims.

BDD is highly prevalent among social media users in this study, especially users of text-based platforms.

“Our study found that BDD is highly prevalent among social media users, especially text-based platforms.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

They also suggested providing resources and support (484, 43%) and implementing mental health support features (446, 39.6%).

“They also suggested providing resources and support 484 (43%) and implementing mental health support features to 446 (39.6%).”

Probably not a substantial claim: may not pass S3 (load-bearing).

Strategies such as clear communication about the survey's purpose and reminders to encourage participation were implemented to overcome potential biases.

“To overcome potential biases, we implemented strategies such as clear communication about the survey’s purpose and reminders to encourage participation.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Media platforms have had a major impact on body image, with strong evidence suggesting negative effects of objectifying beauty standards presented on mass media such as TV and magazines.

“Media platforms have had a major impact on Body image, as there is strong evidence suggesting the negative effects of objectifying beauty standards presented on mass media such as TV and Magazines2.”

• cites [2] Grabe, S., Ward, L. M. & Hyde, J. S. The role of the media in body image concerns among women: A meta-analysis of experimental and correlational studies. Psychol. Bull. 134 (3), 460–476. https://doi.org/10.1037/0033-2909.134.3.460 (2008). sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

Body dissatisfaction has been linked to psychological stress, which can result in psychological disorders such as BDD and anorexia nervosa.

“Body dissatisfaction has unfortunately been linked to psychological stress, which can result in a variety of psychological disorders, such as body dysmorphic disorder (BDD) and anorexia nervosa4.”

• cites [4] Fardouly, J. & Vartanian, L. R. Social media and body image concerns: Current research and future directions. Curr. Opin. Psychol. 9, 1–5. https://doi.org/10.1016/j.copsyc.2015.09.005 (2016). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The minimum required sample size was 283, and with a 40% expected drop rate, the final minimum sample size was 396.

“Assuming that the estimated proportion of the general population who met the criteria of BDD from a previous study in Saudi Arabia is 24.4%, according to Ateq Khadijah. et al.8 (p), with a 5% margin of error, and a 95% confidence interval, the minimum required sample size is 283. By adding a 40% expected drop rate, the final minimum sample size is 396.”

• cites Ateq Khadijah. et al. [8]Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

No formal weighting was applied to balance representation across regions.

“While we aimed to include students from various governorates to reflect geographic diversity, no formal weighting was applied to balance representation across regions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

BDD is most common in adolescents ranging between 13 and 18 years of age.

“According to various studies, BDD is most common in adolescents ranging between 13 and 18 years of age, and according to the CAPMAS (Central Agency for Public Mobilization and Statistics), the percentage of youth in EGYPT in 2021 statistics is 21 million, which forms about 21% of the population.”

• cites [7] EgyptToday. CAPMAS: Youths constitute 21% of Egypt’s population (2025). Available from: https://www.egypttoday.com/Article/1/55806/CAPMAS-youths-constitute-21-of-Egypt-s-population. Accessed February 19.Not checked yet

  Not checked in the free run.

May combine two claims.

The structured questionnaire was developed based on a review of existing literature and was validated by a panel of experts in public health and psychiatry.

“A structured questionnaire comprising four sections: demographic information, social media usage, body dysmorphic disorder concern questionnaire, and coping mechanisms and solutions, was developed based on a review of existing literature8,9 and was validated by a panel of experts in public health and psychiatry departments.”

• cites [8] Ateq, K., Alhajji, M. & Alhusseini, N. The association between use of social media and the development of body dysmorphic disorder and attitudes toward cosmetic surgeries: A national survey. Front. Public Health 12, 1324092. https://doi.org/10.3389/fpubh (2024). sourceNot checked yet

  Not checked in the free run.

• cites [9] Krebs, G., de la Fernández, L. & Mataix-Cols, D. Recent advances in Understanding and managing body dysmorphic disorder. Evid. Based Ment. Health 20 (3), 71–75. https://doi.org/10.1136/eb-2017-102684 (2017). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Facebook was used to reach all demographic groups because it is the main communication tool for the vast majority of men, women, and both younger and older populations in Egypt.

“Since Facebook is the main communication tool utilized by the vast majority of men, women, and both younger and older populations in Egypt, we specifically employed it to reach all demographic groups.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Concerns about physical appearance increased as a result of redefining selfies, per another systematic review.

“Concerns about physical appearance increased as a result of redefining selfies, per another systematic review27.”

• cites [27] Lee, M. & Lee, H-H. Social media photo activity, internalization, appearance comparison, and body satisfaction: The moderating role of photo-editing behavior. Comput. Hum. Behav. 114, 106579. https://doi.org/10.1016/j.chb.2020.106579 (2021). sourceNot checked — no full text of the source

May combine two claims.

When using photo editing apps, social media users pay greater attention to how they look, which promotes acceptance of fake beauty.

“When using photo editing apps, social media users pay greater attention to how they look, which promotes acceptance of fake beauty28.”

• cites [28] Tiggemann, M. & Anderberg, I. Social media is not real: The effect of ‘Instagram vs reality’ images on women’s social comparison and body image. New. Media Soc. 22 (12), 2183–2199. https://doi.org/10.1177/1461444819888720 (2020). sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

The questionnaire can yield quantifiable data that can be statistically analyzed, allowing clear associations and trends to be identified.

“Furthermore, the questionnaire can yield quantifiable data that can be statistically analyzed, allowing for clear associations and trends to be identified.”

Classified as probably not a substantial claim.

Participants who self-reported having a mental health disorder were excluded because the study aimed to isolate the impact of social media on BDD in individuals without pre-existing mental health conditions that could influence body image.

“We excluded participants who self-reported having a mental health disorder because the study aimed to isolate the impact of social media on BDD in individuals without pre-existing mental health conditions that could significantly influence body image.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

In Asian medical schools, academic pressures are intense, yet BDD rates remain relatively low compared to Egypt and Africa.

“In Asian medical schools, academic pressures are intense, yet BDD rates remain relatively low compared to Egypt and Africa.”

• cites [13] Cuttilan, A. N., Sayampanathan, A. A. & Ho, R. C. Mental health issues amongst medical students in Asia: A systematic review [2000–2015]. Ann. Transl Med. 4 (4), 72. https://doi.org/10.3978/j.issn.2305-5839.2016.02.07 (2016). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The survey avoided suggestive language and any leading questions.

“We make sure to avoid suggestive language and any leading questions.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Ateq et al. reported that the majority of participants spent less than 4 hours per day on social media.

“At the same time, Ateq et al.8 reported that the majority of participants spent < 4 h per day.”

• cites Ateq et al. [8] Ateq, K., Alhajji, M. & Alhusseini, N. The association between use of social media and the development of body dysmorphic disorder and attitudes toward cosmetic surgeries: A national survey. Front. Public Health 12, 1324092. https://doi.org/10.3389/fpubh (2024). sourceNot checked yet

  Not checked in the free run.

Classified as probably not a substantial claim.

The link between text-based platforms and BDD is because in Egypt text-based sites like WhatsApp are focal points of daily communication and social interaction.

“This is because, in Egypt, text-based sites like WhatsApp are focal points of daily communication and social interaction.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The disparity between the BDD prevalence found here and rates in other regions may reflect methodological differences (diagnostic tools, sampling strategies) or sociocultural factors.

“This disparity may reflect methodological differences (e.g., diagnostic tools, sampling strategies) or sociocultural factors.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The study involved platform frequencies of use, not types of content consumed.

“Finally, our study involved platform frequencies of use, not types of content consumed.”

Probably not a substantial claim: may not pass S3 (load-bearing).

Experimental research has demonstrated a causal relationship between BDD and social media.

“Nonetheless, experimental research has demonstrated a causal relationship between BDD and social media29.”

• cites [29] Fardouly, J., Diedrichs, P. C., Vartanian, L. R. & Halliwell, E. Social comparisons on social media: The impact of Facebook on young women’s body image concerns and mood. Body Image. 13, 38–45. https://doi.org/10.1016/j.bodyim.2014.12.002 (2015). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The survey was kept short to avoid responder bias due to fatigue.

“We also ensured that the survey was short to avoid responder bias due to fatigue.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Frequent usage of filters and selfies can lead to an obsession with unrealistic beauty standards and a desire to alter one's appearance.

“Frequent usage of filters and selfies can lead to an obsession with unrealistic beauty standards and a desire to alter one’s appearance.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Egypt's BDD prevalence may be an artifact of underdiagnoses rather than a difference in actual incidence.

“Egypt’s BDD prevalence may be an artifact of underdiagnoses, not differences in actual incidence.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The survey was delivered anonymously through the web to avoid observer bias and to increase confidentiality and privacy.

“In addition, we have delivered the survey anonymously through the web to avoid observers’ bias and to increase confidentiality and privacy.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

The high BDD percentage can be explained by complex interactions of cultural, social, and psychological factors unique to the Egyptian context.

“For instance, the complex interactions of cultural, social, and psychological factors unique to the Egyptian context can explain this high percentage.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

Respondents may feel more comfortable providing honest answers about sensitive topics like body image and mental health in an anonymous survey than in a face-to-face interview.

“Respondents may feel more comfortable providing honest answers about sensitive topics like body image and mental health in an anonymous survey than in a face-to-face interview.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The influence of socioeconomic factors, age range, and cultural context on perceptions of beauty standards means the findings may not be directly transferable to other populations.

“Additionally, the influence of socioeconomic factors, age range, and cultural context on perceptions of beauty standards emphasizes that our findings may not be directly transferable to other populations.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The use of social media can impact mental health in different ways.

“This is supported by20, which posits that the use of social media can impact mental health in different ways.”

• cites [20] Vannucci, A., Flannery, K. M. & Ohannessian, C. M. Social media use and anxiety in emerging adults. J. Affect. Disord. 207, 163–166. https://doi.org/10.1016/j.jad.2016.08.040 (2017). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

Social media exposure to beauty standards exacerbates body image problems, per a recent comprehensive assessment of experimental investigations.

“Social media exposure to beauty standards exacerbates body image problems, per a recent comprehensive assessment of experimental investigations25.”

• cites [25] Fioravanti, G., Benucci, S. B., Ceragioli, G. & Casale, S. How the exposure to beauty ideals on social networking sites influences body image: A systematic review of experimental studies. Adolesc. Res. Rev. 7, 419–458. https://doi.org/10.1007/s40894-022-00179-4 (2022). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

The academic pressure of medical students could uniquely combine with their social media use, indirectly exacerbating stress and BDD symptoms.

“Moreover, the academic pressure of medical students could uniquely combine with their utilization of social media.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Social media's role in amplifying appearance ideals appears more pronounced in regions with rapidly digitizing populations, such as Egypt and Saudi Arabia.

“Additionally, social media’s role in amplifying appearance ideals appears more pronounced in regions with rapidly digitizing populations, such as Egypt and Saudi Arabia, where platforms like Instagram and Snapchat are widely used for image-centric interactions.”

May combine two claims.

The exclusion of participants with self-reported mental health disorders significantly limits the generalizability of the findings, which apply only to individuals without self-reported mental health disorders.

“We acknowledge that this exclusion significantly limits the generalizability of our findings and that our results only apply to individuals without self-reported mental health disorders.”

Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

Disliking one's face leads to suffering from bullying in school or work.

“The majority reported that they do not like their face, and this leads to suffering from bullying in school or work, resulting in avoiding certain clothes as an avoidance behavior.”

May combine two claims.

The explicit, personalized censure common in text-based communication could be more emotionally charged than passive social comparison on image-based sites and trigger BDD-related issues.

“Compared to the relatively passive social comparison which is typical of image-based websites, the explicit, personalized censure which is common in text-based communication could be more emotionally charged and trigger BDD-related issues20.”

• cites [20] Vannucci, A., Flannery, K. M. & Ohannessian, C. M. Social media use and anxiety in emerging adults. J. Affect. Disord. 207, 163–166. https://doi.org/10.1016/j.jad.2016.08.040 (2017). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Focusing on medical students allows for a demographic likely to be aware of mental health issues, potentially leading to more insightful responses.

“Regarding the strength of the study, focusing on medical students allows for a specific demographic that is likely to be aware of mental health issues, potentially leading to more insightful responses.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

The demanding academic environment of medical students could limit their social media use compared to other groups, potentially underestimating the impact of social media on body image and BDD.

“The demanding academic environment could limit their social media use compared to other groups, potentially underestimating the impact of social media on body image and body dysmorphic disorder (BDD).”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Western medical students face comparable academic stressors, which are known to exacerbate body image concerns.

“However, Western medical students face comparable academic stressors, which are known to exacerbate body image concerns13.”

• cites [13] Cuttilan, A. N., Sayampanathan, A. A. & Ho, R. C. Mental health issues amongst medical students in Asia: A systematic review [2000–2015]. Ann. Transl Med. 4 (4), 72. https://doi.org/10.3978/j.issn.2305-5839.2016.02.07 (2016). sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

Cultural and social pressures can exacerbate facial concerns, especially in females, increasing the likelihood of developing BDD.

“Cultural and social pressures can exacerbate facial concerns, especially in females, increasing the likelihood of developing BDD.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A study of Chinese medical students found a BDD prevalence of 1.3%.

“For example, a study of Chinese medical students found a BDD prevalence of 1.3%13”

• cites [13] Cuttilan, A. N., Sayampanathan, A. A. & Ho, R. C. Mental health issues amongst medical students in Asia: A systematic review [2000–2015]. Ann. Transl Med. 4 (4), 72. https://doi.org/10.3978/j.issn.2305-5839.2016.02.07 (2016). sourceNot checked — no full text of the source

Classified as probably not a substantial claim. May combine two claims.

The high prevalence of social media usage and selfie retouching among medical students highlights the potential effect of digitally altered images on body image perception.

“The high prevalence of social media usage and selfie retouching among medical students highlights the potential effect of digitally altered images on body image perception.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

Cross-sectional studies that use self-reported responses have an inherent constraint that could compromise response accuracy.

“Cross-sectional studies that use self-reported responses have an additional inherent constraint that could compromise response accuracy.”

Probably not a substantial claim: may not pass S3 (load-bearing).

A far larger sample size than the suggested predicted power was used for the survey.

“Furthermore, a far larger sample size than the suggested predicted power was used for the survey.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing), S4 (based).

The underlying relationships observed may still be analytically generalized to other groups facing similar pressures.

“we suggest that the underlying relationships observed may still be analytically generalized to other groups facing similar pressures”