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Tonight's much-anticipated "Hills" premiere was a bit of a bummer. Not because it didn't deliver the drama or hold our attention -- it did that 10-fold -- but because it was actually painful to hear Heidi Pratt confess to having little confidence prior to her plastic surgeries.

Doesn't just about every late-bloomer stuff her bra when she's younger? (Maybe not with "water balloons," but still...) Don't many women feel fat/fug once in a while, even to the point of obsessing over diet and exercise? But at what point does this type of body-consciousness cross the line from normal female behavior into something that greatly affects your self-esteem, as well as your relationships with loved ones?

For "Hills" fans who don't get a chance to watch MTV's "True Life" series, a few weeks ago we aired an episode entitled "True Life: I Hate My Face." It featured two young women with Body Dysmorphic Disorder (BDD), a condition described by the Mayo Clinic as "a type of chronic mental illness in which you can't stop thinking about a flaw with your appearance -- a flaw either that is minor or that you imagine." At the end of the doc, neither girl was "cured" of her BDD (or even became more comfortable in her own skin) despite undergoing plastic surgery.

By no means are we diagnosing Heidi with BDD -- we're not doctors. Plus, as she said in tonight's show, she's never been happier. Unfortunately, it's probable that many viewers who watched the episode or have been following Heidi's transformation do in fact suffer from BDD, so we thought it was important to help raise awareness and point out resources.

Our outsides matter very much in America -- we're not approving or condemning it, rather simply acknowledging it. The closest thing we have to royalty are Brad Pitt and Angelina Jolie, two of the most attractive people you could ever lay eyes upon, but the vast majority of us don't look like glamorous celebrities. By now, we've put superstars like "Brangelina" on such a pedestal and on the covers of so many magazines that they've ceased to be real people. So here we are, getting real and suggesting you do some research, talk to a friend and/or seek professional help if you suspect you may have BDD.

+ Have you ever considered getting plastic surgery? Take the poll and see where you stand amongst your peers.

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Forget about 15 minutes. Now, Spencer and Heidi Pratt are well into their third year in the spotlight, and the Hills' newlyweds (they got hitched on the show ... twice ... after three proposals) have never looked back. Their secret? They've got the paps on speed-dial, over a million combined Twitter pals and a special talent for churning out celebrity feuds, TMI interviews and the best reality TV meltdowns we've ever seen.

So what'd the press-loving pair -- who, literally, wrote the book on fame -- do for Halloween this year? They grabbed eight plastic baby dolls and dressed up as fellow reality stars-turned-tabloid fixtures Jon and Kate Gosselin. Natch, they were (likely) going for shock factor, exposure and an easy punchline, but seeing Speidi all decked out in their Gosselin garb made us wonder: has the reality torch been passed?

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Stop the presses! Serial dater/celebrated author Tila Tequila says she might just be ready to settle down, move to the suburbs and pluck an unsuspecting child out of third world obscurity (just like Brangelina!) and spoil him rotten! Well, not today -- or tomorrow -- but someday! That is, assuming the Shot at Love 2 alum ever gets rich enough to buy her way into Bill Gates' country club...

"Sometimes I think, like, let's just run away from Hollywood and adopt a son, and do my own thing," Tila told reporters at Usmagazine.com. "But then I realize, you know what? I want to make at least another billion dollars before I adopt children so I can just focus on them. Like, just move to an island and give them everything."

Um, Tila? In case you haven't noticed, we're kinda on the brink of an economic depression here. (You know, the one that's already left thousands of Americans overmortgaged, jobless and strapped for cash and even inspired blingmaster P. Diddy to hang up his pimp jewelry in solidarity?)

So we're guessing the whole private isle/parenting thing will have to wait just a bit. (Unless you count Roosevelt Island, of course, but FYI, watch five minutes of campy horror flick Dark Water and you'll never ride the tram again.)

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