Ugly? Miss GB finalist thinks she is

As she stood on the stage under spotlights, Racheal Baughan should have been beaming with pride. Her eyes sparkled, her dark hair shone and judges had decreed she was one of the most beautiful women in Britain. But inside she was shaking with fear. For the striking 25-year-old is convinced she is ugly.

Ms Baughan, a Miss Great Britain finalist, suffers from a condition that was virtually unknown 20 years ago, but now afflicts more than 600,000 people across the UK. Those struck by Body Dysmorphic Disorder (BDD) sink into months of deep depression, with some of them turning to self-harm and even contemplating suicide. Now medics fear that the condition could be spreading rapidly, thanks partly to television makeover shows. They are warning that a new programme due to air on Five this summer could exacerbate the situation.

Bride and Grooming follows six unmarried couples who are separated from each other while they undergo a surgical transformation before being reunited on their wedding day.

Plastic surgery specialists and psychiatrists say this is exactly the type of programme that has led to BDD taking a grip on young people. Britain's first BDD clinic has been set up at London's Maudsley Hospital and guidelines will be released later this month for cosmetic surgeons to screen prospective patients for signs of the disorder.

The illness, which has been compared to eating disorders such as bulimia, usually starts in adolescence but remains largely unnoticed. Many sufferers can remain undiagnosed for years, often resorting to endless cosmetic treatments in a futile attempt to fix their "problem".

Racheal Baughan's teenage years were blighted by bouts of imagined ugliness. "There were times when I hated the look of myself so much that I couldn't face anyone," said Ms Baughan, who is from Sussex. "On a bad day I'd wake up and hide myself in my room.

"I'd have panic attacks and cut my arms. Once, things got so bad that I took an overdose and tried to kill myself. I was desperate to have plastic surgery."

Dr David Veale, an expert on the disorder, warned: "BDD is getting worse and is being culturally defined by a society where there is an emphasis on the importance of appearance. There has been a change in the values and culture of our society and surgery has become acceptable."

He and other medics are now convinced that the rise of reality television shows which urge participants to embrace cosmetic surgery is a fundamental factor in the spread of the disorder.

"They are encouraging individuals to seek cosmetic surgery, especially those who are already vulnerable," said Dr Fugen Neziroglu, a New York-based behavioural expert. "Cosmetic surgery does not help people with BDD. Often they get worse. Surgery is a last resort and once that hope is taken away from them they feel more depressed."

Even plastic surgeons have attacked Bride and Grooming. Dr Adam Searle, president of the British Association of Aesthetic Plastic Surgeons, said: "The premise of Bride and Grooming beggars belief. I find it not only inadvisable from a medical view, but appalling from a social standpoint. It is clear that shows such as these are for the benefit of television and not the patients."

A spokesman for Five claimed the show was merely reflecting society. "There are hundreds of thousands of people who undergo cosmetic treatments every year and it would be odd if this trend wasn't reflected on television," he said.