The lure of popularity has led many a teen to jump through social hoops, with behavior ranging from harmless to unhealthy to life-threatening.
It turns out adults are just as vulnerable, and their needs to fit in can have serious health consequences.
New research suggests that men and women alike experience anxiety over so-called appearance-based rejection. And the recurring and sometimes constant worries can fuel serious mental and physical health problems, including eating disorders.
The root cause could be an inherent desire to connect with others, the study's lead psychologist said.
"We see people who look attractive on television or in the media, and we think that if we were to look attractive — like them, maybe — we would feel accepted and approved of and admired by people," said Lora Park of the University of Buffalo in New York.
"We're all kind of searching for that acceptance and approval by others, and some people in particular develop a real heightened preoccupation with looking that way."
How do I look?
Certain individuals were found to obsess over their appearance more than others.
Park surveyed 242 college students, ranging from 18 to 35 years old. Each participant answered questions designed to gauge personality traits as well as physical and mental health.
Subjects also imagined how they would feel in 15 made-up, interpersonal scenarios.
For instance, one item stated: "You are leaving your house to go on a first date when you notice a blemish on your face."
The subject would rate from 1 to 6 how anxious they might feel and if they would expect the date to find them less attractive.
About half of the subjects had a high sensitivity for appearance-based rejection. The high scorers also showed more signs of low self-esteem, neuroticism and eating disorders.
Park suggests that fear of social rejection could spur these unhealthy attributes and behaviors.
"Both men and women who reported being sensitive to appearance-based rejection were preoccupied with their body and weight in unhealthy ways," Park said. "They avoided eating when they were hungry, exercised compulsively and engaged in binging and purging."
Change your focus
Park found one way to ease worries over appearance-related rejection by the "cool kids." When participants set their minds on their strengths or close friends, anxiety diminished, she said.
Appearance isn't everything, Park said.
"It's just one aspect of a person's life. But when it becomes the main focus and people develop these excessive concerns about it, then it really hinders them from developing close relationships."
The constant worries over looks and comparisons with peers ultimately make for distant friendships, Park explained.
"We have this warped message," Park told LiveScience, "that if we look attractive, then we'll feel good about ourselves and then we'll have close relationships."
The research will soon be published in the journal Personality and Social Psychology Bulletin.
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