Dr Veya Seekis, Ph.D. is a lecturer and researcher at the School of Applied Psychology at Griffith University. Her research focuses on how social media influences body image in young people, the impact objectification processes such as body checking, appearance anxiety and shame has on young people, and the role self-compassion plays in preventing negative body image as well as promoting positive body image. The Art of Healing spoke with Veya about this and also the proposed cosmetic surgery reforms, including a ruling that will require cosmetic surgery procedures (including nose jobs, breast implants, lip filling, botox etc) to get a GP referral and undergo a psychological test first.

With regard to demographics Veya, what agegroups are we referring to whose body image and appearance is being most effected by social media?
It’s not necessarily social media use in general that affects people’s body image but rather the regular viewing, following, liking, and posting of appearance-related content on social media. Based on data reported in peer-reviewed research, young girls and women, typically between the ages of 15-30 are most likely to be affected when engaging with appearance-focused content regularly. Examples of such content includes, beauty, fashion, celebrities, fitspiration (inspirational health images), get dressed with me – and is usually posted by girls and young women who comply with societal beauty ideals (facial symmetry, small nose, full lips, lean and toned bodies). So it’s easy to see how young girls and women might feel insecure about their own body image when comparing themselves with these images.

Your most recent research was specifically about the use of Tik Tok and its influence on appearance in young people?
Yes It’s hard to ignore the impact that TikTok has had on our culture and young people in particular. It seems that they are drawn to TikTok’s video format where they can watch bite-size content presented by creators. Perhaps this is why TikTok has been the most downloaded app in the past couple of years.
My research focused on engaging with beauty content and there are two main reasons for this. First, it’s among the most viewed content on TikTok, and secondly, the culture of TikTok has been identified as contributing to the increase in facial cosmetic procedures by the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS). You may have heard of the term ‘digitised dysmorphia’ which refers to people’s excessive concern about perceived flaws online – which typically affects younger women. In fact, the societal pressures women face on- and off-line about “being young and beautiful” contribute to appearance anxiety or shame when women feel they fall short of these unrelenting standards. Interestingly, the ideal features presented in beauty content (such as flawless skin and high cheekbones) are typically only attainable using digital modification apps. So the combination of engaging with idealised creators and the use of filters to achieve unrealistic beauty standards may be triggering appearance concerns for young women who then seek cosmetic procedures to achieve those benchmarks. It’s a vicious circle.

Can you give some examples of what you are seeing?
We found that after just 7 minutes of watching beauty TikTok videos, young women reported higher levels of appearance anxiety and shame, and lower levels of positive mood and self-care, compared to women who watched self-compassion or travel TikTok videos.
We also found that women in the beauty group compared themselves much more to the women in the videos than the women in the other two groups. These findings suggest that the pressure to comply with ideal beauty standards is very high for young women. And it’s this pressure that may lead to consideration of facial cosmetic procedures, particularly given that people cannot change their facial features through other means (such as diet).
Our earlier research also shows that women who regularly engage with beauty content on social media are more likely to compare themselves to others they deem more beautiful than themselves, which can lead to dysmorphic appearance concerns (constant worry about perceived appearance flaws) ultimately leading to the consideration of cosmetic surgery.

So what are some of the things that are driving these young people to be so overly concerned about their appearance? I mean peer pressure is big – but hasn’t that always been there? Is it because this is amplified through social media? Do you have any stats on this?
True! Peer pressure has always been around (I can even remember my own experience). However, the culture of social media means that that peer pressure follows young people 24/7.
Another driver is the intense focus on social media metrics – likes and comments – which can increase or decrease one’s popularity. My research shows that young people who are more likely to place importance on likes and comments are also more likely to engage in comparisons with others, do body checking, and experience social appearance anxiety – all of which can lead to eating disorder symptoms such as body dissatisfaction. Some of the reasons that young people desire to achieve those unrealistic beauty standards lie in the rewards that attractiveness can bring them such as popularity and a large number of followers on social media, which then leads to endorsements and financial gains. Young people watch others do it and they think they can do it as well.

You talked about subconscious eye tracking when we are teleconferencing. Can you describe this and its impacts?
This is interesting as video conferencing has also been identified by the AAFPRS as another contributing factor to the increase in facial cosmetic surgery. Researchers have used eye-tracking and self-reporting to see what people tend to look at when they are on video conference calls. Their findings show that young women, when compared to men, spend most of their time glancing at their facial features and this tendency can highlight areas they hadn’t noticed before. Such findings has led to the term ‘mirror anxiety.’ As with beauty content on social media, this focus on the face can trigger anxiety and shame about certain features which may then be prompt people to seek cosmetic procedures to fix the perceived flaws.

So do you think these new cosmetic surgery regulations are a good thing?
Mostly yes! Let me explain. In most instances people seek cosmetic surgery to look (and feel) better and there is no judgement in that. However, there are also instances where people seek these procedures for more complex reasons. Some of those reasons include:

  • constant comparison with others and wanting to look like others they consider to be more beautiful
  • believing that they have flaws when they aren’t there
  • experiencing appearance anxiety or shame
  • potentially experiencing other mental health symptoms

So yes, for the most part, completing an assessment prior to having a procedure may pick up some of these complex issues so that the person can be referred to a mental health professional first.
A pre-assessment could also provide people with a time to reflect about their decision to have the procedure. There is also evidence to support pre-assessment. Research tells us that people with body dysmorphic disorder (BDD) or those who show symptoms of BDD are more likely to feel worse after having a procedure as their expectations are never fulfilled. Conversely, some people feel so emboldened by one procedure that they seek more and more; more fillers, more Botox, fixing more body parts which can then lead to an unhealthy obsession. And of course, younger and younger women are having unnecessary procedures such as Botox, filler, and breast augmentations so it is important that they fully understand the risks involved in those procedures but also the mental and physical health issues they may experience as a consequence. Disturbingly, the cosmetic surgery industry is unregulated which means that if a procedure goes wrong, people may find it difficult to have their complaint heard and managed and this may lead to mental and physical health issues (or they may worsen if they were pre-existing). The reason I say mostly, is because I also understand that pre-assessment is likely to put more strain on GPs – however, I think people’s health is the priority.

When you refer to appearance issues you call it dysmorphic appearance concerns, how does this differ from eating disorders?
Body dysmorphic concerns are when people excessively worry about perceived physical appearance flaws (particularly with facial features) and these concerns can develop into BDD. Eating disorders also focus on the way one looks but eating disorders focus on weight and shape rather than perceived “flaws”. Both disorders severely impair one’s daily functioning and often go hand in hand, however people can also be diagnosed with one or the other.

You have also done a lot of research into self-compassion – how does that work to help these young people?
I have been conducting research into the effectiveness of self-compassion on young women’s body image for about 8 years ago now. Self-compassion is about three things when people are feeling distressed:

1) acknowledging that you’re in pain rather than ignoring or ruminating on it (acknowledging painful feelings addresses the issue and you’d be surprised how quickly this helps reduce the intensity)

2) understanding that pain is a shared human experience rather than thinking it’s unique to you (group therapy and support groups are a great example of this)

3) showing yourself some kindness and comfort rather than self-criticism.

These three steps can really help to neutralise emotional pain so it’s ideal to use in moments of appearance-related distress. For example, if you’re feeling dissatisfied with how your body looks in clothes one morning, acknowledge that dissatisfaction (ok, this feeling of dissatisfaction sucks right now), put it into perspective, and think about the millions of other women who feel the same on any given day (you’re not alone!). And finally, think about what your body does for you on a daily basis (it’s like your house) so show it some kindness and respect.

And I really feel sorry for some of the parents out there …  what have you been finding helps them?
This is a tricky one as adolescence is a time when children are trying to develop their own identity. They tend to spend more time with and listen to friends more than parents, and of course much of their spare time is spent on social media so it can be hard for parents to get a look in! There are some things to keep in mind however:, keep the lines of communication open with teens, be curious about their interests rather than judgemental, follow them on social media (but don’t be active!), chat to them regularly about their social media interactions, encourage creative or sports outlets, take a walk with them and get some fresh air when time permits, practice self-compassion together in times of emotional pain! Remember that parents are incredibly influential role models so the child’s social media use (as well as how they feel about their body image) will also likely reflect their parents’ social media use and other attitudes and behaviour.