People who anticipate they will be rejected because of their appearance are at risk for mental- and physical-health problems, according to a new study.

College students were measured on an appearance-based rejection sensitivity scale. The students with the highest scores (most sensitive) were more likely to have low self-esteem, base their self worth on their appearance, and compare their physical attractiveness against others’ and feel badly about themselves as a result. These students were also reported greater symptoms of eating disorders and of engaging in obsessive behaviors around food and exercise.

The high-sensitivity students also reported feeling lonely, unwanted and isolated when asked to list the physical attributes they didn’t like about themselves. Students with less sensitivity about their appearance were not negatively affected when completing the same task.

The good news, however, is that when the students with higher sensitivity wrote about a personal strength or a close, caring relationship, the feelings of loneliness and isolation were reduced.

“These findings emphasize the power of self-affirmation and having close relationships in helping people cope with insecurities regarding their appearance,” concludes study author Lora Park, Ph.D., an assistant professor of psychology at the University of Buffalo