Taneya Singh, Deepa Velankar, Sumedha Joshi, Mugdha Kamble, Surekha Aishwarya R.
Background: Body image concerns are an escalating public health issue among medical undergraduate students, a cohort facing intense academic pressure and heightened social scrutiny. Social media exposes this vulnerable group to idealized appearance standards, contributing to body dissatisfaction and detrimental social comparisons. Methods: A cross-sectional study was conducted among 352 medical students. Data was analysed using Jamovi 2.6. One-way ANOVA, Chi-square tests, and binomial logistic regression was applied. Results: 60.2% of students reported requiring a break from social media due to mental health impact. ANOVA found that mere usage duration was not a significant predictor of body image perception (p=0.361). Chi-square confirmed strong behavioural links between following influencers and the intention to modify appearance (χ2(2)=47.6, p<0.001). Regression identified photo-editing (aOR=2.90, p<0.001), following influencers (aOR=2.34, p=0.001), and higher BMI (aOR=1.67, p=0.043) as significant positive predictors of body image dissatisfaction. Conversely, following influencers (aOR= 0.50, p=0.015; SCS: aOR=0.40, p=0.003) and photo-editing (aOR=0.39, p=0.001) acted as significant negative predictors of social comparison and body shape concerns, suggesting a complex, paradoxical effect in these domains. Conclusions: Content quality and active engagement are the primary influences, not duration. High distress prevalence and an observed Gen Z digital literacy paradox highlight the urgent need for colleges to implement targeted digital health literacy and de-stigmatized student wellness programs to foster healthier self-perception.