Were you just a tad perplexed by reality TV star Heidi Montag’s extreme plastic surgery? If you don’t get the same guilty glee from following celeb gossip that I do, here’s a recap: The 23-year-old star of reality show The Hills recently underwent 10 plastic surgeries in one day, completely altering the look of her body and face.

The response to her extreme makeover was general shock and confusion. Some articles called her a surgery addict while others suggested her transformation was an elaborate PR stunt. My question: Why would a very young woman want to suffer through so many painful surgeries in order to change her body when she was already quite pretty?

Well, an article I just read in Scientific American may shed some light on why perfectly good-looking people see themselves as extremely ugly. A study published this week in the medical journal Archives of General Psychiatry suggests that the brains of people who have a psychological condition called body dysmorphic disorder (BDD) actually respond differently to images of their own faces. BDD causes sufferers to have an unrealistic view of their bodies. The study used MRI technology to monitor the brains of people diagnosed with BDD when shown different images, including images of their own faces. Researchers found that people with BDD get stuck on details in much the same way as people who suffer from obsessive-compulsive disorder do, which could mean that BDD and OCD are similar disorders.

These results are interesting because they suggest that extreme hatred for one’s own body might not simply be a result of our society’s fixation on physical beauty; that viewing yourself as extremely ugly could, in some cases, be much more than low self-esteem. What's your take on this?