Body Matters

For many, having a perfect body is the most important thing in life.

From crash diets to plastic surgery,

we reveal what happens in our bodies and brains as people strive for their ideal figure.

And with more people than ever before going under the knife,

the most popular procedure today is...

the boob job.

Lucy is a 24-year-old beautician from Essex.

MUSIC: "Only Girl (In the World)" by Rihanna

# Like I'm the only girl in the world

# Like I'm the only one that you'll ever love

# Like I'm the only one who know your heart

# Only girl in the world

# Like I'm the only one that's in command... #

Oh, well done!

That was the weirdest thing in the world!

-Did you see me?

-Was it good?

-It was amazing!

Lucy is confident with extreme sports.

I think if you've done a skydive, you can do anything. Hopefully.

But she's never been confident about her body.

I started dieting when I was younger because I was quite big.

And it did massively get me down.

I joined a gym and my mum came with me and I completely changed

what I was eating, and in total, I lost about 4 stone.

In a week, Lucy's going to change her body again

and is having cosmetic surgery to enlarge her breasts.

So after dieting, my boobs are really saggy

and I just need them fuller, so I actually really hate my boobs now.

But her mum has mixed feelings about Lucy's boob job.

At first I thought it was a bit dramatic

but she has got quite an issue with her body

so if it makes her happy...

But I think you're worried because at the end of the day it's an operation, isn't it?

I just look at myself and think no, I'm not happy with

the way I look, and I know I can change it so why not?

Before going ahead with the surgery,

Lucy will be made aware of the potential side-effects.

I've pretty much listened to what my consultant has told me,

and there's no point worrying about it, cos I'm doing it, I'm sure it will be fine.

I've got plenty of faith in my surgeon.

A week after her skydive,

and Lucy is on her way to have her breast surgery.

I feel quite excited. Obviously the nerves have hit in a bit

cos it's a big thing, but I am more excited than anything.

-Good morning, Lucy. How are you?

-Hello. Good, thank you.

Before the operation, Lucy has to agree with her surgeon,

Chris Inglefield, what size implants they're going to use.

I prefer this one.

My concern, especially with the left side is that you don't

have enough tissue to cover the width of the implant.

There's a bit of a balance between getting that extra

bit of fullness and what's going to be in your best interests long term.

OK.

Although Lucy is confident with her decision,

research shows that surgery doesn't necessarily improve people's self-esteem and quality of life.

Sian is a 23-year-old from Manchester who, five years ago,

had the operation Lucy is considering, and now regrets it.

Growing up through secondary school, wasn't very confident.

Everybody around me, my friends, all the girls were getting boobs

and I was still very flat chested.

Then I decided when I was 18 that I would go for it

and have the surgery.

I thought if I can build my confidence, boost my confidence,

I'm quite shy, I thought I'd be a bit more open, talkative.

-That's nice.

-I really like this one, but it's too small.

-If I had no groups, it would fit.

-SHE LAUGHS

I went from probably a AA, if not a bit smaller, to, I think, a DD.

I did feel more confident at first. My friends were complimenting me

because obviously they knew about it.

I love it. I do.

But instead of being the answer to her body image issues,

Sian's bigger cup size began to make her feel self-conscious.

I hate it. I don't wear anything low cut.

I'm really uncomfortable with showing it.

I think it's because I know it's, in a way, not real.

I wished I'd have waited.

You know, I could have had something else with all that money.

I thought having a surgery would boost my confidence,

but it hasn't really.

I've still got body image issues now. I think I always will do.

One study even suggests that ten years after breast surgery,

women are more likely to suffer from depression.

-That's £37.80, please.

-Thank you. There you go.

I think 18 is a very young age to go under the knife and have surgery

for cosmetic reasons, because, I mean, I'm only, you know,

five years down the line and I'm already wishing I'd not done it.

-Thank you very much.

-Thank you.

-Thank you. See you.

Having decided on her new implant size, Lucy is now in theatre.

For all women having their breasts enlarged,

one in five will need their implants replaced within ten years.

In 2012, it was discovered that the controversial PIP implants

were up to six times more likely to rupture.

These were found to be made from industrial, not medical, silicone.

CHANTING Toxic PIPs have got to go! Toxic PIPs have got to go!

And around 47,000 British women had been given them.

PIP implants have now been banned.

Lucy is under general anaesthetic for her operation.

She's 24, but some girls want to have surgery before their breasts have even finished developing.

We need to make sure that their breasts have stopped growing,

so we don't think about breast augmentation at a too young age,

where they may still be developing.

So we say 18 to 20 is a reasonable time.

Most women will have stopped developing their breasts at that stage.

-Dr Irvin, are we OK to start?

-Yeah.

-Thank you.

OK. Just going to get started.

The surgeon starts by making space for the implants.

While doing this, he is Extremely careful to avoid Lucy's

main sensory nerves, since one in seven women find that their nipples

are less sensitive or completely numb following this kind of surgery.

That's the implant in, then we simply close these incisions with a dissolving suture.

The operation lasts 45 minutes.

Lucy has now got to go through several weeks of painful recovery.

It's been four days since her operation.

I actually felt horrendous the next day. I was feeling really dizzy

and really sicky and I was actually sick quite a few times

which for me is really rare.

I'm never normally sick. I couldn't eat all day.

The thought of food made me feel horrendous.

And that was a pretty awful day.

So, it's Friday today

and I just thought I'd show everybody how my scars are doing.

Well, you can't see my scars, it would be more the bruising.

Let me show you from the side.

They feel really swollen here.

Really swollen here. They're still quite numb underneath.

Can't really feel anything at the moment.

But otherwise I'm really happy.

It's been six weeks since Lucy's breast surgery,

and she has almost fully recovered.

Today she is out with her mate, Georgie.

-How was your work?

-I didn't work today.

I went and had my first bra fitting since the surgery.

What do you reckon I am?

I think 32D.

Try 32F!

For now, Lucy is more confident in her appearance.

Now I've had the boob job, I feel more in proportion.

I guess I feel a bit more womanly, so I definitely much prefer my body now.

For many, striving for a better figure is the main aim in life.

Quite a big stress, to, sort of, have that perfect body.

But, as obesity rockets, many of us are fighting against one thing - fat.

18-year-old Ebonie is a student from Maidstone.

She's decided to go on a crash diet.

Like 60% of women on diets, she wants to shape up for her holiday.

I'm going to Malia, and everyone there is young.

Everywhere you look, people are going to have bikinis on.

For her crash diet to work, shall have to drastically cut down the calories,

which means a massive change in her eating habits.

I snack a lot on packets of crisps and chocolate bars,

or I'll go to McDonald's with my friends.

# Nobody knows what I'm feeling inside... #

Well, I'm having a red carpet theme, so if you just come looking smart-ish.

It's my birthday party tonight. My 18th birthday party.

Loads of people coming.

Ebonie and her mates put in a lot of effort to look good for a night out.

I think my friends worry about their appearance.

I think everyone does, especially in our society now.

Cos everyone cares what everyone, like, thinks about what you look like.

For her diet to work, Ebonie knows it's not just the junk food she'll have to cut out.

I think alcohol has made me put on so much weight, to be fair.

I don't think you realise what you are drinking is fattening.

But what the girls may not know is that alcohol stops the body burning fat.

MUSIC: "Call Me Maybe" by Carly Rae Jepsen

As alcohol passes through Ebonie's body,

it's soon absorbed into her bloodstream.

Once in her liver, it's converted to acetate,

a substance her body uses for fuel.

While her body works harder process acetate,

the breakdown of other nutrients decreases.

So while Ebonie is burning her vodkas off on the dance floor,

her body's ability to burn other fats slows down by 70%.

Having celebrated her 18th birthday in style,

it's time for the diet to begin.

-It's day one of Ebonie's diet.

-I'm doing my first shake.

I haven't actually done one before.

Her diet will restrict her to one evening meal,

three healthy snacks, and two meal shakes a day.

This will give her just 1,200 calories,

just over half of the recommended daily amount.

Although this will trigger the weight loss,

it may leave hungry and tired.

I'm hoping it might taste of ice cream.

Finished.

Ebonie has been on her crash diet for a few days,

and has agreed to have her progress checked from start to finish

by weight and metabolism expert, James Collins.

-Hi.

-Hello.

-Nice to meet you. How are you?

-I'm good, thank you.

He first sends her for a scan to calculate how much body fat she is carrying.

We've now got the results from your DEXA scan,

and this is just basically how it's made up.

As you can see, it's colour-coded.

The red as her fat, the yellow, her muscle.

Ebonie is carrying seven kilos more fat than is healthy.

This is about 28 packs of butter.

The next time we come back, I think that picture is going to look quite different.

Yeah, hopefully, anyway.

It's day five of Ebonie's crash diet, and she can already see the results.

Yeah, it's going good. It's hard, but I am sticking at it.

She's lost almost two kilos.

At least I know this is actually working.

So, to see signs of it already working. That's good.

Ebonie might think the two kilos she has lost is fat,

but it isn't.

the crash diet is forcing her body to use up its carbohydrate stores found in her muscles.

This is mainly made up of water, so as Ebonie slims down,

it is mostly water she is losing, not fat.

This is why the weight drops off so quickly at the start.

It's week three of Ebonie's crash diet.

But things aren't going too well. She can't seem to lose more weight.

I'm not impressed. It just irritates me,

cos I just think, "what have I done wrong now?"

The diet is making her irritable and tired,

causing her brain to crave fatty and sweet foods.

I've done a bit more cheating.

Yesterday I had a Country Bar instead, cos I didn't have one of my shakes,

so that sort of stood in for it.

Ebonie may lack willpower, but it's not really her fault.

We evolved when food was scarce,

so our bodies are programmed to hold onto fat at all times.

Her crash diet has forced her body into starvation mode,

and will do everything to top up her fat stores.

# Sweet like chocolate... #

So a picnic with mates isn't going to be easy.

The sight and smell of food triggers nerve impulses to race to

the hypothalamus, the control centre for hunger in our brain.

On her diet, Ebonie's brain now has heightened sensitivities

to these cues, which is tempting her even more to eat.

-What is the hardest part of being on a diet?

-Smelling food.

That is the most hardest part.

I'm just happy that I'm only on it for a short period of time.

After four weeks on her crash diet, Ebonie is back in Harley Street,

curious to find out how successful it's been.

Good, so the day is here. Finally.

This is our scan here. Now, I think the most important thing we want to look at

is that we've gone from 69 kilograms to 66.

Is that what you expected?

-No.

-So you've lost three kilos. That's getting up to seven pounds.

-Oh.

Although Ebonie has lost weight, the overall results aren't so good.

We've actually lost 1.5 kilos in muscle. Is that what you expected?

No, not really.

I'd have thought when you lose weight, it's just straight away fat.

I wouldn't even have thought muscle.

On her crash diet, Ebonie has used up her carbohydrate stores in her muscles,

but a lot of this is water, which are body will suck back like a sponge

once she starts eating normally.

-Would you recommend this diet?

-Honestly? No.

And the reason I say that is, it's an extreme diet and a short-term approach,

and unfortunately with that, they are doomed to failure.

Has been a good experience, but I wouldn't do this shakes again.

Like James has said, as well, it's only a short-term diet,

so, you know, it's not best in the long run.

After long periods on a crash diet, your body can start to eat away

at protein in your vital organs, which can cause irreversible damage.

# Un, deux, trois

# Turn it up a little bit more... #

Having lost three kilos on her crash diet,

Ebonie is finally in Greece with her new beach bod.

But how long will the weight stay off?

I'd rather enjoy myself than think, "I can't eat this."

But I'm still happy I dieted. At least I lost a bit of weight.

While the crash diet wasn't as successful as Ebonie

had hoped for, it taught her a valuable lesson.

Exercise and a balanced diet including fruit and veg will be key to staying in shape.

But any concerns about her weight are now on hold.

After her holiday, she has decided to do things a little differently.

My goal when I get back is to keep healthy and not snack.

That's not just losing weight. I want to keep normal.

Which is probably not a bad idea, as research shows

that in the long-term, 95% of crash diets don't work.

Our growing obsession to be slim can often damage our relationship with food.

Research shows that over 60% of 15 to 24-year-olds eat chocolate

or fast food when feeling anxious or stressed.

# A fix... #

In Bristol, 22-year-old Hayley has taken this to the extreme.

I think I started bingeing and overeating when I was about eight.

Someone called me fat, basically, in class.

I remember looking down at my school jumper and thinking,

"Oh, I'm different, I'm fat."

From that age, Hayley has been caught in an extreme cycle of dieting and binge eating.

Girls who diet are 12 times more likely to binge eat,

which can lead to eating disorders.

I was working at a supermarket, and the house was completely empty. My parents were away.

I ended up getting a big bag of Doritos that are meant to be shared,

and dip, and two big slabs of dairy milk chocolate,

and I ate it all within about three hours.

And then I'd wait and then I'd start again.

After that, unsurprisingly, I was sick for quite a few hours.

Hayley is one of the 2% of people in the UK who suffer from binge eating disorder,

a condition now recognised to be as serious as bulimia and anorexia.

Scientists believe binge eating is a way of blocking emotions.

I think I was using food as a coping mechanism for

my hatred of my body and dissatisfaction with myself.

For Hayley, food became a distraction from her problems.

As you start to eat, it's a feeling of relief that you've finally got the food,

you can finally do what you want to do.

And there is a good biological reason for this.

Eating fatty and sweet food can trigger a huge

surge of endorphins and dopamine, our body's feel-good chemicals.

When endorphins are released,

they travel quickly through the neighbouring nerve cells

to the pleasure centres in our brain, inducing a natural high.

But soon after the high, comes the low.

As the rush of endorphins drop off,

the feelings of pleasure subside, causing our moods to slump.

After a binge, it's very guilt-ridden.

You feel awful, physically and mentally.

You've just sabotaged yourself again, you've just binged.

You feel greedy, disgusting, horrible.

There's nothing really pleasant about a binge.

You couldn't have a worse relationship with your body.

Which was made worse by society's reaction to her weight.

Hayley is among the one in five people who are victimised because of their size.

Bigger people do tend to be chastised

for their weight and made fun of, and there is this stereotype

of being greedy and lazy, and it's your fault that you are fat.

It's really not the case.

After years of having no self-worth,

Hayley has made the brave step to get help.

Absolutely, and I'm very, very pleased.

And with the help of therapy she has boosted her self-esteem

and is slowly coming to terms with her condition.

She now feels confident enough to go out with her mates.

LAUGHTER

Do you find yourself bingeing less at the moment?

Yeah, I think so.

Supermarkets are still quite challenging,

but around areas like this it's a bit different,

and binge food isn't really, for me, it's not the same food as I would eat on a day-to-day basis.

-I guess it'll only just get better.

-Yeah.

Being open about her condition has been part of the cure,

so Hayley now writes her own blog so others can better understand.

I'm definitely moving forward, trying to combat it.

I haven't really binged in a couple of months now, so that's good.

A recent survey found over 60% of people

are not happy with their body image.

I'd say my least favourite part of my body is probably my legs.

But why are we so insecure?

People have told me I have a strange-looking nose.

This part of my chin!

-There's no hair over there.

-There's no hair over there.

# Just bust a move

# Huh, huh, yeah... #

Psychologist Dr Martin Tovee is a body image expert.

He's with a group of volunteers to see the sort of pressures

that are making people today feel bad about their body.

He believes the way in which celebs and models are photographed,

and even airbrushed can have a massive impact.

They are impossibly attractive,

because they don't exist in real life -

it gives you an artificial bar you have to try and reach.

So you're always going to be striving for this unrealistic ideal.

And do the volunteers agree?

I think the media has a big effect on how I feel.

You have all these images shoved into you all the time.

You still aspire to be as perfect as them

even though you know it's not real.

Less than 5% of people can naturally attain the body ideals

being portrayed in the media today.

You can't achieve these bodies in real life

other than by artificially changing your body

in a very invasive and sometimes quite dangerous way.

Nearly half of Brits between 16 and 24 would have cosmetic surgery to change their bodies.

These procedures are meant to make us more appealing, yet research

shows there are many different ways to appear more attractive to others.

Generally I look for personality more.

I want somebody who is going to make me laugh.

Honestly, 100%, it's their personality.

To investigate whether personality really counts,

Martin is going to run an experiment.

He has planted two volunteer actors, Thomas and Rhys in the crowd.

During the experiment, Thomas has been asked to be mean and selfish,

and Rhys, friendly and kind.

A week earlier, everyone was asked to rate how attractive

they found 40 random faces including Rhys and Thomas's.

The scores showed how attractive

they were from their appearance alone.

Now Rhys and Thomas

spend the whole day interacting with the other volunteers.

Nice to meet you too!

-There are so many students here.

-Yeah.

Rhys made eye contact,

was interested in other people and smiled a lot.

-I know.

-Hello, Australia...

Thomas didn't make eye contact,

wasn't interested in what people said and interrupted them.

I was asking a question.

-I didn't hear what you said.

-You've had a good time?

Yeah, I have. A really good time.

Rhys was a nice guy.

He was lovely. He was really nice.

I thought Rhys was a really nice guy, really chatty, lovely.

Thomas, I really didn't like him towards the end.

Thomas was being a bit brash and it did affect my opinion of him.

But did it actually change how attractive people found

Rhys and Thomas?

So, what we're going to do is hand out some questionnaires.

The volunteers are asked to rate each other on attractiveness.

Scoring on a scale of one to ten

where one is unattractive, ten is attractive.

Do it separately - no conferring.

Rhys and Thomas will be scored again

but this time their behaviour will be taken into account.

Four hours later, and the results are now in.

Now, we haven't been entirely honest with you.

Two of you are not actually volunteers. Two of you are actors.

Tom and Rhys, would you like to step forward?

Tom and Rhys have been playing a part.

One of them has been nice, friendly, outgoing.

Everything I said was true.

One of them was being a bit surly.

He said that Mikela had oil-drum thighs!

LAUGHTER

And how did this impact on the results?

What we found was the nice guy

scored significantly higher on the second presentation,

when you knew something about him.

Personality counts.

That's a rule of life, really.

Yeah, you just don't judge somebody on how they look. It's like...

With his personality taken into account, Rhys's score

for attractiveness went up by over 20%.

Martin conducted similar experiments on a much larger scale with

over 2,000 people.

The results proved the same. Personality is important when it comes to attractiveness.

These kinds of results show that how you judge someone,

even if you think you're just judging them

on their physical characteristics, you can't exclude their

personality and behaviour. People like smiles.

You can spend thousands changing your body,

but these results show that you can

appear far more attractive to people just by being nice.

Subtitles by Red Bee Media Ltd