Researchers identify risk factors for addictive use of cosmetic procedures

A recent study published in the Journal of Health Psychology suggests that repeated engagement in cosmetic procedures can take on addiction-like qualities for a notable portion of women. The findings provide evidence that low body esteem and problematic social media habits are strongly linked to this compulsive behavior. These insights help explain how digital environments and personal insecurities might interact to encourage repetitive aesthetic treatments.

The research team included Vera Skvirsky, Uri Lifshin, Dvora Shmulewitz, and Mario Mikulincer from the Hebrew University of Jerusalem and the Israel Center for Addiction and Mental Health. They sought to understand the psychological mechanisms associated with repeated cosmetic interventions.

Cosmetic procedures are elective interventions meant to alter a person’s physical appearance. These include surgical operations like liposuction as well as non-surgical treatments like Botox injections. Between 2019 and 2023, the global use of these procedures increased by about forty percent.

With this rapid growth, mental health professionals have started to notice patterns of behavior that resemble addiction. Addiction is typically defined as a compulsive drive to engage in a rewarding behavior despite experiencing negative consequences. Behavioral addictions share many psychological mechanisms with traditional substance abuse, including cravings, habitual actions, and a loss of self-control.

The authors wanted to assess how prevalent this addictive cosmetic behavior might be in a general population. They also aimed to identify specific personality and behavioral factors that might put individuals at a higher risk. They focused particularly on the potential impacts of problematic social media use and body esteem, which is a person’s overall satisfaction with their own physical appearance.

Social media platforms rely heavily on visual content and interactive features like comments and likes. Previous research tends to show that heavy use of these platforms can negatively influence how people view their bodies. The researchers hypothesized that this combination of digital pressure and physical dissatisfaction might make some individuals more vulnerable to pursuing repeated aesthetic treatments.

To explore these relationships, the scientists recruited a sample of 1,614 Jewish women in Israel. The participants ranged in age from 25 to 71 years old. The sample was specifically constructed to match the broader adult female Jewish population in Israel in terms of age and religious observance.

The data was collected through an online survey platform in February 2025. Participants answered a variety of questions regarding their demographic background, their religious affiliation, and their history of cosmetic procedures. Out of the total sample, 710 women reported having undergone at least one cosmetic procedure in the past.

The researchers used an adapted psychological assessment originally designed to diagnose substance-use disorders to measure addictive cosmetic behaviors. This questionnaire asked participants if they had ever tried to stop having procedures but failed, or if they felt a compulsive need to continue despite negative physical or psychological effects. The women who had previous procedures answered these questions based on their lifetime experiences as well as their experiences over the past year.

All participants also completed a battery of psychological questionnaires. These tools measured global self-esteem, which is a person’s overall sense of self-worth. They also measured attachment security, a psychological concept describing how confident a person feels about receiving support from loved ones during times of need.

Other surveys assessed attitudes toward aging and feminist beliefs, specifically measuring the rejection of traditional, passive gender roles. Finally, the authors used a recognized assessment tool to gauge problematic social media behavior over the past twelve months. This tool measures habits such as feeling a constant urge to log on or experiencing distress when disconnected.

The data analysis revealed that addiction-like behavior related to cosmetic treatments is relatively common. Among the 710 women who had previously undergone cosmetic procedures, 20 percent met the threshold for a moderate to severe risk of addictive use over their lifetime. Additionally, 15.4 percent reported experiencing these moderate to severe symptoms within the past year alone.

When looking at the entire sample of 1,614 women, nearly nine percent showed signs of moderate to severe risk during their lifetime. About seven percent exhibited these signs in the past year. Interestingly, the researchers found no significant differences in these risk levels across different age groups or education levels.

Religious affiliation did show a statistical connection to the results within the full sample. Women who identified as traditional reported higher risk scores for addictive behavior than those who identified as secular. Both of these groups scored higher than women who identified as religious or ultra-orthodox.

The statistical models highlighted three specific variables that had unique associations with addictive cosmetic behaviors. Lower body esteem, higher levels of problematic social media use, and weaker feminist attitudes were all linked to higher addiction risk scores. Global self-esteem, attachment security, and negative views on aging did not show unique statistical associations when all factors were analyzed together.

The scientists also found a notable interaction between social media habits and body image. For women who reported high levels of problematic social media use, having low body esteem was strongly associated with a higher risk for addictive cosmetic behaviors. This association did not exist among women who used social media less obsessively, suggesting that digital habits might amplify the negative effects of poor body image.

Readers should note that this study relies on cross-sectional data, meaning all information was collected at a single point in time. This design makes it impossible to prove cause and effect. It remains unknown if problematic social media use directly causes an increase in addictive cosmetic behaviors, or if an underlying psychological issue drives both habits simultaneously.

Another limitation is the study’s reliance on a specific demographic group. The sample only included Jewish Israeli women who were active on an online survey panel. These participants might have higher average internet usage than the general population, which could potentially inflate the observed links between digital habits and cosmetic procedures.

The researchers relied entirely on self-reported questionnaires to gauge addiction levels. These self-assessments can sometimes be influenced by personal biases or memory errors. Future studies might incorporate more objective measurements, such as tracking actual financial expenditures on procedures or conducting formal clinical interviews to assess psychological distress.

Future research should also expand to include men, transgender individuals, and non-binary individuals to see if these patterns hold across different gender identities. Exploring specific psychiatric conditions, such as body dysmorphic disorder, would also provide a deeper understanding of the mental health factors at play. Body dysmorphic disorder is a mental health condition where a person spends a lot of time worrying about flaws in their appearance that are often unnoticeable to others.

Investigating the specific types of cosmetic treatments might yield more detailed insights. The current study did not distinguish between major invasive surgeries and minor non-invasive treatments. Distinguishing between a single surgical procedure and repeated minor treatments might help clarify the exact nature of this emerging behavioral addiction.

The study, “Prevalence of addictive use of cosmetic procedures and risk factors among Israeli women,” was authored by Vera Skvirsky, Uri Lifshin, Dvora Shmulewitz, and Mario Mikulincer.