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The global impact of the COVID-19 pandemic has made 2020 one of the most turbulent and unpredictable years in living memory, changing the way we live, work and interact with each other on a daily basis. In the midst of all this social upheaval, it is little wonder that many individuals have experienced a significant impact on their mental wellbeing during this time.

One of the most significant examples of this is the effect that lockdown conditions have been having on self-esteem and body confidence among individuals who are suddenly finding themselves stuck at home, with all of their social interactions carried out via webcams and video calls. This is a particular issue among young people, who were already more susceptible to experiencing doubt about their body image.

Our recent survey of more than 1,100 people has highlighted the impact of this trend, showing that 47% of people have felt negatively about the way they look when using video conferencing software since the start of the pandemic. People aged between 21 and 25 years old were the most likely to feel very unhappy, and also reported the biggest decrease in satisfaction with their own appearance during lockdown.

As this is such a potentially harmful trend, we sought out the guidance of Dr Karen Graham, a psychiatrist and author of two companion self-help guides, Mind What You Think and Accept How You Feel. With more than two decades of experience as an adult and child psychiatrist, Dr Graham was able to share with us some key insights into the impact of lockdown on the nation’s self-esteem - and advice on how people can deal with this stress in a healthier, more constructive way...

Have you observed a trend of people becoming more self-conscious about their own appearances since the beginning of lockdown? If so, what would you identify as the main drivers of this trend?

Various psychological factors are involved with how self-conscious we tend to be, such as how self-critical we are, how much we compare ourselves to others, how anxious we are to please people and how easily embarrassed we can be, as well as our general self-esteem and life satisfaction. Exposure to unfamiliar social circumstances can also intensify any concerns we already have about ourselves.

Being in front of a camera can make anyone feel self-conscious about their appearance because it’s normal to want to look good. Today, due to the COVID lockdown requiring us to be in front of a camera for work and social connections, for the majority of people there is a heightened awareness or concern about the way they look.

As with anything like this, sustained repetition will have a reinforcing effect. This means it could be anticipated that an effect of restriction to online communication and networking over time will involve becoming more self-conscious about our appearances.

Do you think the growing reliance on technologies like Zoom and social media for communication is going to have a negative impact on people's body image? What advice would you give to people who use these platforms a lot to help them avoid developing an unhealthy fixation on their own appearance?

Body image is closely related to how attractive or good we feel about ourselves, but it can also become distorted when we over-focus on appearance or aspects of our body, rather than encompassing a broader view that involves general health, fitness and what our body is capable of doing.

As we utilise more technology to interact with people, we could be at risk of viewing ourselves in a negative way, because our appearance on a screen can dominate over having a more balanced perspective about our whole body. It’s like a stressful habit of constantly scrutinising our appearance in the mirror, which leads to us noticing more and convincing ourselves about having physical flaws.

Caring about our appearance is important for self-respect, but fixating about the way we look can’t end well. It is essential to maintain a bigger, more helpful view about our body that includes how our body is feeling, what we like about our appearance, what we enjoy doing with our body, and how to appreciate our physical uniqueness. Also, we need to remember that what people look like is not who they are!

Pre-lockdown, how often did you encounter individuals who would be tempted to use cosmetic surgery and beauty procedures as a means of addressing their own body confidence issues? Are you expecting this trend to get better or worse as a result of lockdown?

The decision to have a cosmetic procedure is fine when it isn’t expected to radically change how you feel about yourself. However, seeking surgical options for low body confidence can be the result of having anxiety and low self-esteem to begin with.

When people are honest with themselves about this, they usually identify that the priority is to seek psychological assistance. Otherwise, there is considerable risk that they won’t be genuinely pleased after having a cosmetic procedure, or that the initial gain in self-esteem won’t be sustained. Having chronic anxiety about appearance is an internal problem and attempting to rectify it externally could lead to more disappointment, frustration or reduced self-esteem.

There has been a significant increase in cosmetic procedures over the last decade, in both men and women, reflecting their growing availability and affordability to the general population, as well as improvements in less invasive techniques. This trend is likely to continue, but the COVID-19 lockdown could result in more people wanting to improve their online appearance this way who previously hadn’t considered it.

For those who are considering getting cosmetic surgery - what kind of questions would you recommend that they ask themselves before agreeing to surgery, in order to make sure that they are not doing so from a mentally unhealthy place?

Cosmetic surgery might seem like the answer; the outcome of surgery, however, will also depend on perceived quality of life preceding the surgery. ‘Fixing’ a body part won’t change everything about your life; less invasive or permanent beauty procedures can be uplifting, but again, won’t magically transform general dissatisfaction with life.

It is important to have specific and realistic goals about any procedure to avoid a depressing result because it didn’t change your life enough. Try and think about the following questions:

  • Clarify your expectations. Ask yourself: “What do I think surgery will really do for me? Am I expecting it to resolve a complicated issue in my life? Do I already have reasonable self-esteem?”
  • Consider whether you have a mental health issue that first needs addressing: “How anxious am I? Am I depressed?”
  • Make sure that you are doing it for yourself; ask yourself: “Am I doing this to try to impress or make someone else happy? Do I feel under any pressure about it?”

With COVID-19 still a major threat and future lockdowns an ongoing possibility, what actions can people take to improve their self-image and body confidence at this current time? For those who are particularly struggling, what support measures and services would you recommend for them to explore?

It’s easy to lose body confidence after being more sedentary and gaining weight. Avoid chastising yourself in front of a mirror, and instead look to physically do things that make you feel happy.

Think about moving a bit more with some regular stretching and exercise; however, don’t commit to an intense programme that could make you fail and feel worse about yourself. Likewise, trying to be suddenly strict about a healthy diet can be unsustainable; you will have more chance of gradually feeling better about yourself if you make small adjustments at a time.

Also, be discerning about what you are looking at online: don’t make comparisons, and remind yourself that the too-good-to-be-true photos have been edited. Enjoy being real!

Finally, if your body confidence remains low or has always been low, consider getting some help. You could talk to a dietician, arrange a personalised programme with an exercise therapist, or start a small friend group so you can support each other about a particular, achievable goal. If it is causing too much stress or is part of a bigger issue that needs addressing, then see a mental health professional.

Thanks once again to Dr Karen Graham for taking the time to speak to us! To find out more about her work and her books Mind What You Think and Accept How You Feel, click here.

If you are looking for more information on the way that lockdown has affected body image among people in the UK, check out the full results of our national survey, or read our interviews with Dr Tony Ortega and Dr Earim Chaudry.

Meanwhile, if you have had a negative experience with cosmetic surgery as a result of medical negligence, don’t hesitate to get in touch with the team at Cosmetic Surgery Solicitors.

Contact us today

If you have experienced problems following eyelid surgery and think they are the result of negligence, you may be entitled to make an eyelid surgery claim for compensation. Talk to our expert cosmetic surgery negligence team today. Call 0808 273 2903 or request a callback by completing the contact form.



Mike Saul


Michael Saul is a partner at Cosmetic Surgery Solicitors, where he brings his extensive specialist legal expertise and passion for helping people to the forefront of his work. With a proven track record of success in cosmetic surgery negligence cases, Michael has dedicated his career to providing clients with the highest level of representation and achieving favourable outcomes.

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Dr Karen Graham - Dan Molloy Photography

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