There is a clear link between several aspects of the appearance culture and increased rates of negative self-image, peer acceptance, and eating disorders among adolescents. Dr. Sylvia Rimm (2004) explores the experience of even slightly overweight children upon entering school which contributes to future eating issues. Girls entering school without an already trim figure begin to associate themselves with overweight which becomes increased as their peers also begin to make these associations. In this cycle, the child continues to gain weight as a result of the emotional turmoil they experience because they can’t keep up with other children on the sports field or they don’t measure up to the social ideals. Going much deeper than simple appearance, these children start to think of themselves as less than average weight children in every way, including those attributes they may possess that are outstanding in other ways. Sadly, adults often reinforce these beliefs consciously or unconsciously as they begin to expect the overweight child to be lazy and less intelligent than other children, again judging the child by appearance (Rimm, 2004).The focus on beauty as a means of gaining social acceptance is also reinforced by adults, mostly women, who consider plastic surgery an acceptable means of attaining it. Attempting to escape the persecution of their childhood, many adolescents frequent these centers as well. In a Scotland study questioning 2,000 girls with an average age of 14, four out of ten said they would consider plastic surgery to make themselves slimmer regardless of their current weight status (Gustafson, 2005).