Objectives: This study analyses screen-use profiles among Polish adolescents and their relationship to body image and weight reduction behavior. The authors aimed to identify different screen-use profiles, determine the prevalence of these profiles in the population, and explore the relationships between these screen time profiles, adolescents’ body image, and weight reduction behavior. Material and Methods: The analysis drew upon data from 5322 students aged 13 years, 15 years, and 17 years who participated in the 2021/2022 Health Behaviour in School-aged Children (HBSC) study. The HBSC questionnaire contains data on various screen-related activities, including gaming, social media usage, internet browsing, and the consumption of audiovisual material, as well as their body image perception and dieting behavior. Using the k-means clustering method, 5 distinct screen-use profiles were identified. Results: The following screen-use profiles were identified: moderate users (40.1%), game-oriented users (21.1%), social-media-oriented users (20.3%), intensive game and social media users (11.1%), and intensive users (7.4%). Girls predominated in the social media clusters, while boys were overrepresented in the gaming clusters. Adolescents in the 2 intensive-use profiles (intensive game and social media users and overall intensive users) exhibited a more than twofold increase in the likelihood of perceiving themselves to be fat and engaging in dieting practices, even after adjusting for BMI, in comparison with students classified in other groups. A higher BMI Z-score independently predicted both body dissatisfaction (OR = 2.36) and active dieting (OR = 2.67). Conclusions: A significant association was found between screen use patterns and both body image perceptions and dieting behaviors among adolescents in the intensive-use groups. This finding highlights the profound psychosocial impact of all forms of screen-based media and underscore the need for targeted interventions promoting media literacy and healthy digital habits, especially among older adolescents, girls, and urban youth. Int J Occup Med Environ Health. 2025;38(4)