How I recovered from the Body Dysmorphic Disorder which took over my life

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appearance, avoidance, body dysmorphic disorder, compulsions, Depression, distortion, perceived flaws, preoccupation, Therapy

How I recovered from the Body Dysmorphic Disorder which took over my life

While the poorly understood condition is often believed to be a simple case of people thinking they are larger or more unattractive than they are, it is actually a distorted view of how they look so much so they become preoccupied with it. It often involves focusing on one perceived flaw and the majority of people with the condition are preoccupied with an aspect of their face, but it can be about any body part. The illness involves avoidance and compulsions and it can have a significant impact on their daily life, becoming very debilitating. Affecting both men and women, the Body Dysmorphic Disorder foundation says the impact of the condition on a person’s life can be so severe they effectively become housebound. Many people who have the condition are also single or divorced, suggesting it is difficult to form or maintain relationships.

Dr Rob Willson from the foundation says around two per cent of the population are believed to have the condition, which usually starts in adolescence.

Omari, 29, told The Independent he can trace the origins of his BDD, which he was finally diagnosed with in 2012, to his 16th birthday. An aspiring model, he took part in a photoshoot  yet immediately before became increasingly “tormented” over the appearance of his eyes – so much so that he even resorted to using his mother’s make-up to try and camouflage them. Things worsened when he went back to look at the photos and the photographer retouched an area around his eyes.

“I was waiting to see the first action he did and he went to the eyes. That was immediately it there, my evidence […] looking back he touched up other things I’m sure but I don’t have that in my memory. All I have is a really vivid, burnt image of him blending the area of my eyes.”

A year after first experiencing BDD symptoms, it was when Omari began studying at Oxford University that they reappeared and took over his life. Studying a humanities subject where he was largely outnumbered by girls and therefore admittedly “in his element” after attending a same sex school, Omari put pressure on himself for everybody to like him.

“I wanted to be the guy all the guys wanted to be and all the girls wanted to be with,” he says. The BDD obsession around his eyes continued and deteriorated to the point he feared not wearing glasses as his eyes would be exposed. One perfectly innocent comment from a girl he liked is something that stands out in his memory: “She said something like: ‘I like you in your glasses’ But what I heard was: ‘Thank god you put your glasses on’ and thought it was code for ‘Jesus, about time, it was horrible to look at you before now.’”

Part of the issue with BDD, Omari explains, is that you actually feel that you are a burden on people because of your appearance. “Part of it is: ‘If I go outside, I will make little children run away from me’.

Wearing his glasses became what is known as a ‘safety behaviour’ which are mental or physical acts aimed at reducing the threat of the perceived flaw, according to Dr Willson. “Examples of this might be checking or examining ones appearance in the mirror, avoiding bright light, avoiding being seen up close, concealing perceived flaws using make-up or seeking cosmetic or dermatological procedures.”

“My main issue was the bags under the eyes but then also the issues of them generally being a weird shape and being evil or looking dead and glassy, so many things really, but the day-to-day issue was worried about the bags and looking tired,” he explains. “There were mornings when I would get ‘dry eyes’ … I wouldn’t leave the room I shared with my best friend and would wait for him to leave. I would sit there getting more and more tense and feeling resentful towards him about not leaving. Then I would hear the door close and I would freak out, begin throwing stuff around, punching walls – everything short of properly screaming basically.

“My glasses became a permanent feature… it really limited my life as I was always active and sporty and couldn’t wear them for football or rugby. There would be days where I would put my contacts in and then put my glasses on top and I couldn’t see any more…. I had to look below the level of the glasses so I wouldn’t fall over. I would bump into someone and have these conversation where I had to pretend I was making eye contact with them, meanwhile they’re a complete blur and I would be getting headaches because my vision was really messed up.”

Further safety behaviours would extend from the accessories he wore to the words he spoke. “I would avoid phrases with the word ‘eye’ in it,” he explains. “I would never say ‘I’ve got my eye on you’ as I was worried that would trigger people to look at my eyes.”

Additionally, he avoided mirrors: “I would go weeks without looking in a mirror or I would only look in one if I had sunglasses on or I found a way to squint so I could never properly focus on my eyes.”

Omari dealt with the thoughts in his head alone for a very long time, scared that if he repeated them aloud they would be met with confirmation from others.

“At that time, I didn’t see any way I could talk to anybody about it because in my head if I told them then they would confirm it. There was a small part of me that thought ‘If I don’t talk about it maybe it’s not real or I’m getting away with it. I’m definitely not going to draw their attention to it’.”

This led him to withdraw from people leading him to sink into a “very deep depression” which he believes was made worse by feeling like he was pretending to everybody. In addition to struggling with the thoughts on his own, Omari felt like a “fake” and would beat himself up about the fact he was presenting a confident external persona yet suffering on the inside.

Eventually, his mother caught him in the midst of a near-breakdown and he told her about his BDD thoughts. However, for a while this strained relations between them as Omari pushed her away for fear she would confirm the thoughts.

“My thinking was that she was my mum and loves me unconditionally and thinks I’m beautiful but if she doesn’t then that must mean I really am hideous… I pushed her away and couldn’t talk to her about it at the time, I have since.”

Omari found out he had BDD when he was 21 after reading an article about the condition. He says most others he knows with the illness also “stumbled upon it” and the symptoms were not identified by a health professional.

After discovering he had the condition, he signed up for a trial of intense therapy dedicated to the illness where he learned to overcome the thoughts and tackle the safety behaviours and compulsions.

Therapy helped and he began to take up hobbies like dancing which he says has also helped with his recovery. Writing a book and tutoring students foreign languages, he now says he is in a good place and his life is “hugely on track now”.

He is currently in the midst of a social media campaign called “In the face of BDD” where he is taking a photo of himself – in any situation and with no filter, edits or retakes – every single day for a year and sharing it on Instagram to raise awareness of the condition and money for the BDD foundation.

“It’s sad because I look back on the years and at family photos and I’m not in any of them. I either made excuses and got away or, more likely, I wasn’t at the event,” he says solemnly.

But now, with his life back on track, he wants to help others overcome the condition.

“Recovery from BDD really is possible. It is a journey. The first step is talking about it and the second is realising that when you do you’re fine.

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Body dysmorphic disorder: charity video reveals the image anxieties that can push people to the edge

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anxiety, appearance, BDD, body dysmorphic disorder, cbt, Depression, diagnosis, distress, isolation, medication, misdiagnosis, physical appearance, professionals, suicide

Body dysmorphic disorder: charity video reveals the image anxieties that can push people to the edge

It is a treatable condition suffered by at least 2% of the population, both male and female, that devastates the lives of those who have it and can lead to prolonged depression and even suicide. Now a fledgling charity, the Body Dysmorphic Disorder Foundation, hopes to raise awareness of the obsessive anxiety condition that leaves people convinced there is something flawed or “ugly” about their looks.

The foundation’s first conference, on 30 May in London, is aimed at health professionals, body dysmorphic disorder (BDD) sufferers and their carers, and is being promoted by a two-minute film, You Are Not Alone, directed by Steve Caplin, which tackles one of the greatest issues surrounding BDD: the idea that the person with it is isolated and cannot fit in.

“One of the biggest problems is that this is an under-researched disorder which is not fully understood by either professionals or laymen,” says clinical psychologist Dr Annemarie O’Connor, director of themindworks, a London-based psychology practice, who will be running a workshop at the conference. “This is not simply a case of feeling low or having to change your clothes a couple of times before you go out. It’s an obsessive anxiety disorder which can lead to huge levels of distress.”

That distress in turn can lead to prolonged bouts of depression and often suicide. “There’s such a high level of hopelessness and a real conviction among sufferers that they are ugly to look at or flawed,” explains O’Connor.

“Many sufferers turn to cosmetic intervention, but when that doesn’t change how they feel or how they see themselves. They become utterly convinced that a better way doesn’t exist, and this makes suicide a real feature of the disorder.”

Robert Pattinson, who was catapulted to fame after getting the role of vampire Edward Cullen in the Twilight films, told Australia’s Sunday Style magazine that he suffers from anxiety and BDD issues, which can become crippling before a red-carpet event.

“I get a ton of anxiety, right up until the second I get out of the car to the event, when suddenly it completely dissipates,” said Pattinson. “But up until that moment I’m a nutcase. Body dysmorphia, overall tremendous anxiety. I suppose it’s because of these tremendous insecurities that I never found a way to become egotistical. I don’t have a six-pack and I hate going to the gym. I’ve been like that my whole life. I never want to take my shirt off.”

Scarlett Bagwell’s 19-year-old daughter, Alannah, first began exhibiting signs of BDD at the age of 14. “I noticed that she had lost a lot of weight fast and at first I thought it was anorexia, but then other things began to happen – she would refuse to come out with us, didn’t want to leave her room … I still thought it might be teenage angst, but then one day she dropped out of school, despite having always loved it.

“There was so much turmoil in her head – she couldn’t get on the bus, I’d drive her to school but she wouldn’t go in. She really wanted to, but she couldn’t physically get out of the car. She’s a beautiful girl, but she was convinced there was so much wrong with her – she’d insist that her nose was too big and deformed, that she had tiny, piggy eyes and funny hair.”

As Alannah’s condition worsened, including bouts of self-harm and suicide attempts, so her family struggled to get a diagnosis. “I had to fight the system to get the proper treatment for her,” says her mother. “Just getting a diagnosis was so hard and meanwhile Alannah went from being very independent to being a baby again. At times I even had to force her to wash and I would wash her hair for her. Everything was a struggle. I felt I was failing my daughter.”

The hard-won key to her recovery was a combination of cognitive behavioural therapy (CBT) specifically tailored for BDD sufferers and anti-depression medication.

Alannah is now sitting her A/S exams at a local college and intends to go to university. Her mother hopes that the establishment of a regular conference will lead to further understanding, help and support for those with BDD. “I think that because everybody has slight issues with their appearance – they don’t like their hair, or they think a particular dress makes them look bad – they can’t understand the struggle that actual body dysmorphics go through,” she says. “It stops you functioning. People with body dysmorphia are very isolated; they often can’t bring themselves to go out, no matter how much they want to, they don’t want to be seen.

“We were lucky that Alannah has had help and the support of her family, but I wonder how many people struggle without that support because they are diagnosed later, undiagnosed or misdiagnosed,” she said.

How university stopped me hating my face

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anxiety, body dysmorphic disorder, obsessions

How university stopped me hating my face

Suffering from body dysmorphic disorder (BDD) was like living trapped in a box lined with distorting mirrors. All I could see was my face, contorted and disgusting.

BDD is a form of obsessive compulsive disorder that affects around 1 in 200 people, according to the International OCD Foundation. Sufferers mistakenly believe an aspect of their appearance is deformed, which can drive them to undergo repeat plastic surgery procedures and, in some cases, even attempt suicide.

Five years ago, my disorder was at its height. I used to scratch at my face, or slap it, when looking in the mirror because I was so disgusted by my reflection. Now when I see myself I think I look fine – maybe pretty, certainly not hideous.

What brought about this change? Recovering from BDD is a long and ongoing process, made up of lots of small steps, but moving to university definitely made a huge difference.

If you are beautiful, everyone will love you forever and you’ll be perfectly happy. If you’re ugly, you’ll be hated and miserable. Clearly these assumptions are just plain wrong, but I believed them for years.

It wasn’t until year 12 that I first heard of BDD, and it took another six months for me to realise that I was suffering from it. The revelation that it was my mind (and not my face) that needed fixing marked a turning point. I started receiving counselling, doing more exercise, and making attempts to manage my anxiety. I began to feel like a different person…

But at school I was always shy, introverted and chronically lacking in confidence – it wasn’t easy to get people to notice that I’d changed. University was different. Being in a new environment, with new people, helped me leave my obsessions behind.

Battling against BDD, I felt like an electrician trying to rewire my short-circuiting brain. The same image-obsessed thoughts used to play on a loop in my head. Preoccupied only by my hideous appearance, my world was a very narrow place. But with moving away from home, that began to change.

My university has 240 societies for students to join – 240! Signing up to take on lots of new challenges inspired me to think differently. BDD can be self-perpetuating: the more you hate the way you look, the more you isolate yourself; the more you isolate yourself, the more time you have to dwell on your physical imperfections. Simply being busy helped me break the cycle.

“Think critically.” This maxim, hammered into my head by university professors, pushed me to reconsider my ideas about “beauty” and “body confidence”. At school I was always flicking through fashion magazines, eager to soak up their advice on how to be thinner, prettier and all-round better. But as I got older I started to lose faith in these glossy weeklies and their pages full of perfect, primped models.

In my first year, I made the decision to stop buying women’s magazines. I traded in Heat for books like The Beauty Myth by Naomi Wolf. Suddenly, I started to see that some of my most deeply held beliefs (like the idea that beauty equals happiness) were just nonsense – and it felt pretty good.

Can BDD be permanently cured? I’m not convinced. When things are going well for me, I forget I ever suffered from it. But when my life isn’t running smoothly, I notice the obsessional thoughts and behaviours starting to creep back, so I know I can’t become complacent.

Thankfully there are a number of organisations that provide information and ongoing support for BDD sufferers, including the BDD Foundation and the OCD Foundation. Going to university has played an important part in my recovery from BDD by showing me just how many exciting opportunities the world has to offer. I want to focus on them, not my face.

The science and ethics of voluntary amputation

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body dysmorphic disorder, Body Integrity Identity Disorder, voluntary limb amputation

The science and ethics of voluntary amputation

Earlier this month I gave a talk about a condition called Body Identity Integrity Disorder, which is characterised by the desire to amputate a healthy limb. I described the possible neurological basis of the condition, and then argued that surgical amputation should be offered to those sufferers who request it. Here’s a summary of the talk.

In January 2000, the mass media ran several stories about Robert Smith, a surgeon at the Falkirk and District Royal Infirmary who had amputated the legs of two patients at their own request and was planning a third amputation. The news stories incorrectly described the patients as suffering from Body Dysmorphic Disorder. They further stated that the director of NHS trust running the hospital at which Smith works described the amputation of healthy limbs as “inappropriate”; since then, no British hospital has performed a voluntary amputation.

The patients were, in fact, suffering from Body Integrity Identity Disorder (BIID), an apparently rare condition characterized by a burning and incessant desire to amputate an otherwise perfectly healthy limb. The first documented case of BIID dates back to a medical textbook published in 1785, by the French surgeon and anatomist Jean-Joseph Sue, who described the case of an Englishman who fell in love with a one-legged woman, and wanted to become an amputee himself so that he could win her heart. He offered a surgeon 100 guineas to amputate his leg and, when the surgeon refused, forced him to perform the operation at gunpoint.

Subsequently, the pioneering neuropsychiatrist Richard von Krafft-Ebing described three cases of what appear to be BIID in his classic 1906 book,Psycopathia Sexualis. “Even bodily defects become fetishes,” wrote von Krafft-Ebing. He describes a 28-year-old factory engineer, who “complained of a peculiar mania, which caused him to doubt his sanity.” He continues:

Since his 17th year he became sexually excited at the sight of physical defects in women, especially lameness and disfigured feet. Normal women had no attraction for him. If a woman, however, was afflicted with lameness or with contorted or disfigured feet, she exercised a powerful sensual influence over him, no matter whether she was otherwise pretty or ugly. In his dreams… the forms of halting women were ever before him. At times he could not resist the temptation to imitate their gait, which caused vehement orgasm with lustful ejaculation… He thought it would cause him intense pleasure to mate with a lame woman. At any rate, he could never marry any other than a lame woman.

This is followed by a second case:

He used to limp about the room on two brooms in lieu of crutches, or when unobserved, go limping about the streets… in his erotic dreams, the idea of the limping girl was always the controlling element. The personality of the halting girl was a matter of indifference, his interest being solely centered in the limping foot. He never had coitus with a girl thus afflicted. His perverse fancies revolved around masturbation against the foot of a halting female. At times he anchored his hope on the thought that he might succeed in winning and marrying a chaste lame girl… His present existence was on of untold misery.

Finally, Krafft-Ebing describes the case of a 30-year-old civil servant:

…since his 7th year he had for a playmate a lame girl of the same age. At the age of 12, puberty set in, and it lies beyond doubt that the first sexual emotions towards the other sex were coincident with the sight of the lame girl. For ever after only halting women excited him sexually. His fetish was a pretty lady who, like the companion of his childhood, limped with the left foot. He sought early relations with the opposite sex but was absolutely impotent with women who were not lame. Virility and gratification were most strongly elicited if the woman limped with the left foot, but he was also successful if the lameness was in the right foot. His sexual anomaly rendered him very unhappy and he was often near committing suicide.

The first modern case studies of BIID were published in the Journal of Sex Research by John Money. Money referred to the condition as apotemnophilia, meaning, literally “amputation love,” and distinguished it from acrotomophila, or a sexual attraction to amputees. The suffix “philia” denotes that BIID is a paraphilia, or what is commonly called a perversion. To this day, few psychiatrists know of the condition; and most of those that do know consider it as a fetish in which the stump of the amputated limb is fetishized because it resembles a phallus.

Most BIID sufferers, however, describe their feelings in terms in terms of identity, instead. “My left foot is not a part of me,” said one of Smith’s patients. “It feels right,” says another sufferer, “the way I should always have been and for some reason in line with what I think my body ought to have been like.” “I didn’t understand why,” says yet another, “but I knew I didn’t want my leg.”

So while there can be a sexual component to the condition, most BIID sufferers do not give sexual motives for wanting an amputation. This led Michael First, a psychiatrist at Columbia University in New York, to remane the condition. He initially considered calling it “amputee identity disorder,” but then settled with BIID.

To date, there have been approximately 300 documented cases of BIID. Most of these are male, almost all of whom desire amputation of a limb on the left side of the body. More often, it is the arm that is affected rather than the leg. All of these so-called “wannabe amputees” know exactly where they want the limb to be cut off, to the millimetre, and almost all of them remember seeing an amputee at a very young age and thinking that they should have been born like that themselves. “When I was 3yrs old, I met a young man who was completely missing all four of his fingers on his right hand,” said one 21-yr-old female BIID sufferer, “and ever since that time I have been fascinated by all amputees, especially women amputees who were missing parts of their arms and wore hook prostheses.”

Most wannabes also pretend to be an amputee prior to having the limb removed, by tying the limb back, or using a wheelchair or crutches to move around the house. This behaviour could be analogous to cross-dressing in transgender individuals before they undergo sex reassignment surgery. But just as some transgender people are content cross-dressing regularly without going through hormone treatment and surgery, so too are some wannabe amputees are content pretending.

This suggests that BIID occurs with varying severity, with the mild form manifesting itself as an attraction to amputees, and more severe forms manifesting as a desire to amputate. There is overlap between the two, with some wannabes also being attracted to amputees. And if people who are attracted to amputees (or “devotees”) are also considered as suffering from BIID, then the condition may not be so rare.

BIID came into the public eye in the early 1970s, with the publication of a series of readers’ letters in Penthouse. The letters were sent in response to an intiial letter from a one-legged woman describing men who were attracted to her, and became so popular that they led to a regular column called Monopede Mania.

It’s not just limbs that are affected, however. Some BIID sufferers desire having their spinal cord severed; others feel strongly that they should have been born with multiple sclerosis or some other affliction. In Psycopathia Sexualis, Krafft-Ebing notes that the French philosopher Rene Descartes was attracted to cross-eyed women – and may, therefore, have suffered from a mild form of the condition.

BIID can be thought of as a body image disorder. The body image concept dates back about one hundred years, to the work of the neurologist Henry Head, who studied many patients with damage to the parietal lobe of the brain. Head found that these patients had profound disturbances of bodily awareness, and postulated that this region of the brain encodes what he called the body schema, a postural model of the body. Subsequently, the pioneering neuropsychiatrist Paul Schilder built on this and coined the term body image.

We now know that the brain encodes multiple neural representations of the body, some of which are static, and others dynamic. These representations manifest themselves as a mental picture of the body, its form and movements. The brain generates these representations by integrating touch, proprioceptive, and visual information, and this occurs in a region called the right superior parietal lobule.

It is currently thought that BIID occurs because the affected limb is not represented in the body image, so that sufferers have no sense of ownership over it. Early evidence for this idea comes from Vilayanur S. Ramachandran‘s lab at the University of California, San Diego. In a very simple experiment, Ramachandran and his colleagues recruited a small number of BIID sufferers seeking leg amputation, and then prodded the affected limb while recording their brain activity using a technique called magnetoencephalography.

The study showed that the touch elicited a response in the primary somatosensory cortex, where sensory information from the leg is initially processed, but not in the superior parietal lobule, where the information would normally be integrated with the other types of sensory information to generate the body image. These findings suggest that BIID occurs as a result of a discrepancy between the body image and the physical form of the body, which would create cognitive dissonance, or contradictory thoughts and feelings.

The idea of amputating healthy limbs is anathema to most surgeons, but I would argue that in some cases it might be the best possible treatment option. My rationale is simple. Psychotherapy and drugs are completely ineffective in alleviating the condition, and BIID sufferers will go to any length to be rid of the unwanted limb. Some build home-made guillotines, blast their unwanted limbs off with a shotgun, or try lie under a jacked-up car and try to crush it. One particularly popular method is to submerge the limb in dry ice for several hours, in order to damage the limb irreparably and thus force doctors to amputate. In May 1998, a 79-year-old man from New York travelled to Mexico for a black-market leg amputation, and then died of gangrene in a motel about a week later.

Offering a clean surgical amputation to those BIID sufferers who really want it would therefore minimize the harm that they might cause to themselves by taking matters into their own hands.

Five-year-olds now worry about body image

Tags

body dysmorphic disorder, Bullying, cosmetic surgery, Eating Disorders, health problems, Self-esteem

Five-year-olds now worry about body image

More than half the British public suffers from a negative body image, an inquiry by MPs has heard.

The problem is so acute that girls as young as five now worry about their size and appearance, with children in danger of picking up their parents’ body-related anxieties, their report said.

Cosmetic surgery rates have increased by nearly 20% since 2008 and the rise was said to be fuelled by advertising and “irresponsible” marketing ploys, the cross-party group of MPs was told.

According to Reflections on Body Image, co-authored by the MPs and health and education charity Central YMCA, negative body image was seen as an underlying cause of health and relationship problems, a key contributor to low self-esteem and a major barrier to participation in school and progression at work.

Appearance is also the greatest cause of bullying in schools, evidence suggested.

The report, published by the All Party Parliamentary Group (APPG) on Body Image after a three-month public inquiry, identified a growing amount of evidence that body image dissatisfaction was on the increase, with the issue seen to be one affecting all of society regardless of age, ethnicity, gender, sexuality, disability, body size or shape.

Children and adolescents were seen to be more vulnerable to body image concerns however.

Around half of girls and up to one third of boys have dieted to lose weight and children and young people with body image dissatisfaction were less likely to engage in learning and participation in school, the report said.

Parents were identified as one of the main influences on children but by secondary school age, the peer group was seen to become a more important influence.

The inquiry heard that health issues attributed to excess body weight may be overstated meanwhile because body mass index, the measure commonly used, was seen to be an inaccurate way of classifying all individuals and their health risks.

And although being overweight or obese was associated with a range of health conditions, the inquiry received evidence challenging the notion that weight always entailed poor health.

The diet industry acknowledged the public had “unrealistic expectations” about weight loss, while critics argued there was no evidence diets work in the long term.

The inquiry, which took evidence from academics, the public, industry, charities and other experts, heard that:

:: Getting rid of dieting could wipe out 70% of eating disorders;

:: More than 95% of dieters regain the weight they lost;

:: 1.6 million people in the UK suffer eating disorders;

:: Up to one in five cosmetic surgery patients could suffer from body dysmorphic disorder;

:: One in three men would sacrifice a year of life to achieve their ideal body;

:: One in five people have been victimised because of their weight;

The report made a series of recommendations targeted at policy-makers, healthcare professionals, industry and the education sector designed to change public perceptions, attitudes and behavioural patterns.

These include compulsory body image and self-esteem lessons for primary and secondary schools, getting advertisers to commit to running campaigns that reflect consumer desire for “authenticity and diversity”, and reframing public health messages in “weight-neutral” language.

It also called for a review of broadcast and editorial codes on reporting body-related issues, a review of the evidence base to support the long term efficacy and safety of diets and a separate code of regulations governing cosmetic surgery advertising.

Patients should be screened before undergoing cosmetic surgery and a review should be carried out into whether the Equality Act ought to be amended to include appearance-related discrimination, the recommendations said.

Central YMCA will launch a campaign on the issues in the autumn after consulting the public beforehand.

APPG chairwoman Jo Swinson MP said: “Body image dissatisfaction in the UK has reached an all-time high and the pressure to conform to an unattainable body ideal is wreaking havoc on the self-esteem of many people.”

Central YMCA chief executive Rosi Prescott branded the report’s findings shocking.

“It’s clear that there’s something seriously wrong in society when children as a young as five are worrying about their appearance, based on the messages they are seeing all around them,” she said.

“Body image has become more important in our culture than health, and children are mimicking their parents’ concerns about appearance.

“We all have a responsibility to act now to bring about the attitudinal and behavioural change that’s necessary to prevent damage to future generations.”

The British Association of Aesthetic Plastic Surgeons agreed a separate code of regulations should be drawn up governing cosmetic surgery advertising and called for an outright ban on adverts of this type in public places like billboards and public transport.

BAAPS also announced it was funding long-term research into psychological assessment of patients.

:: The finding that more than half of people have a negative body image comes from a study by the Centre for Appearance Research at the University of the West of England, to be published in full later this year.