Self-examination gone too far

At times, the beauty industry can be very destructive. But I believe that, even though we are 'caught' within this world where we are constantly bombarded with brands and body image messaging, we do have a choice. Of course, this choice is made within an already existing framework, but not everybody who is exposed to the beauty industry becomes a plastic surgery addict or a victim of body dysmorphic disorder.  So how do we explain plastic surgery or diet addicts? Does it all have to do with self-confidence, or is there more to it?