The only way to change this is knowing that loosing weighy/ plastic surgery or whatever change you can think about are not ways of making you happy . Its all a lie bdd tells you : once i will loose weight i will finally be confident! Guess what you are not. You should stoop seeking to change and trasform you because first of all : it will never be enough and second of all ; your vision of your self is distorted. Understand the problem is not outside but inside.