I adore Louis Theroux – he goes where no one else goes. He has a humanity and a very unpatronising way of trying to get at what makes people tick. And yet i find that he always gently asks the questions one is longing to ask. He doesn’t care if the people he meets are pariahs or oddballs in other people’s eyes. This was especially clear in his hugely enjoyable book The Call of the Weird – in which he revisits people that he’s filmed in the past to see how they’ve got on 
(including UFO contactees in Arizona, porn stars in LA and neo-Nazis in Idaho).
But last night he was back on form with his BBC2 programme, Under The Knife. He wanted to get under the skin (pun intended – sorry) of the USA plastic surgery industry. Having been uncertain before, he even decided to have liposuction himself (at his own expense, apparently), even though he is clearly not overweight. But what was particularly striking was the things that some of the patients he talked to had in common. They seemed nice enough people – but what clearly motivated the cosmetic changes were deep emotional scars or persistent insecurities. I couldn’t help but be moved by Adrian, the German sales rep now living in the States. At the age of 50 had had a whole load of procedures (including pecs and bicep implants) – as Louis gently probed, it became obvious why. His step-father for 15 years had called him ‘an ugly bastard’. 
Decades later, the pain is still with him and he has to do something about it. Then there was the already pretty woman who had been in an on-off relationship with a bloke upstairs for 8 years – who decided to have all kinds of things (including breast implants, brow-raise and liposuction) to improve her confidence and attractiveness. The bloke upstairs came down to inspect and was impressed – and she was pleased. But as my wife Rachel commented, what would have been better for her was if he’d actually said “You look fantastic … but I love you anyway, regardless of how you look”. But he clearly wasn’t going to do that.
If we have to have reality TV, then this is the only sort they should allow. A key question that Theroux asked the surgeons (the breast-sculpting surgeon was particularly oleaginous) was whether or not they contributed to the culture of vanity and self-obsession. At least the guy who did Louis’ lipo had the honesty to give a clear yes. But with a few of those interviewed, vanity wasn’t their primary problem. It was a profound sense of personal insecurity. When Louis asked one of them how she knew it would improve her life, she simply replied, ‘I just know’. And Louis could sense that that was not necessarily enough in the end. As ever, self-esteem boils down not to self-love, but true love – the faithful and stable love from another. Which of course only a death on a cross can ultimately provide.