Source · Select Committees · Health and Social Care Committee
Second Report - The impact of body image on mental and physical health
Health and Social Care Committee
HC 114
Published 2 August 2022
Recommendations
1
Accepted
Initiate comprehensive cross-government strategy to tackle growing problem of body dissatisfaction and its consequences.
Recommendation
We urge the Government to immediately initiate a comprehensive cross-government strategy that brings together, at the very least, the Department of Health and Social Care, the Department for Digital, Culture, Media and Sport, and the Department for Education to tackle …
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Government Response Summary
The government agreed on the need for cross-government work but stated there is no immediate need for a standalone strategy, as departments are already collaborating and existing initiatives like the Every Mind Matters campaign and the Healthy Child Programme address some issues. It committed to considering further actions within broader upcoming major conditions and suicide prevention strategies.
Department of Health and Social Care
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2
Acknowledged
Commission and fund new research into causes of body image dissatisfaction and social media impact.
Recommendation
We recommend that the Department of Health and Social Care, along with the National Institute for Health Research, commission and fund new research to understand the causal pathways that are leading to a rise in body image dissatisfaction across the …
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Government Response Summary
The government highlighted NIHR's significant existing mental health research funding and openness to applications on body image, noting ongoing collaborations for eating disorders research. It stated that NIHR will continue to explore ways to address the recommendation for new research into the causal pathways of body image dissatisfaction.
Department of Health and Social Care
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3
Accepted
Para 44
Prioritise BDD diagnosis and treatment by updating curricula and embedding specialist practitioners.
Recommendation
We urge the Department to ensure more is done to make the diagnosis and treatment of Body Dysmorphic Disorder (BDD) a priority. From a diagnostic perspective, we recommend that Health Education England update the IAPT (Improving Access to Psychological Therapies) …
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Government Response Summary
The government agreed that BDD diagnosis and treatment are a priority, stating this is addressed through current training for mental health professionals and NHS talking therapies (IAPT) in line with NICE guidance. It rejected compulsory BDD training for EMHPs as not clinically appropriate and confirmed body image is already covered in statutory RSHE/PSHE curricula.
Department of Health and Social Care
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4
Accepted
Explore using family hubs to educate young people and parents about body image and self-worth.
Recommendation
We call on the Government to better equip future generations and their families with the skills and resources required to tackle body image issues. These skills and resources include critical thinking, particularly when it comes to appraising images, and self- …
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Government Response Summary
The government committed to improving families' access to resources for body image issues through the £301.75 million rollout of Family Hubs in half of local authorities across England. These hubs will provide guidance on mental health and emotional wellbeing support, connecting families to resources like the Every Mind Matters website and offering advice on nutrition.
Department of Health and Social Care
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5
Rejected
Para 46
Review training for Mental Health Practitioners to include early signs of conditions related to body image.
Recommendation
We commend the Government’s work to date to introduce Education Mental Health Practitioners within school-based Mental Health Support Teams across the country, as well as the commitment to have a Mental Health Lead teacher in schools. We recommend that the …
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Government Response Summary
The government rejected reviewing EMHP training to include spotting early signs of body image issues, believing current arrangements are fit for purpose. It provided an update on the rollout of Mental Health Support Teams (MHSTs), with over 500 planned by 2024 covering 36% of pupils, but did not set a timeframe for establishing them in every school, stating future plans will be set out in due course.
Department of Health and Social Care
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7
Deferred
Para 54
Develop national eating disorder strategy, increase funding, and address regional inequalities in care.
Recommendation
We recommend that the Government develops a national eating disorder strategy that aims to understand the causal mechanisms that lead to the development of eating disorders and earmarks adequate funding to bolster existing services as well as to increase investment …
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Government Response Summary
The government's response entirely focused on Image and Performance Enhancing Drugs (IPEDs) and anabolic steroid use, outlining work by UK Anti-Doping (UKAD), instead of addressing the recommendation for a national eating disorder strategy, research, funding, and addressing regional inequalities in eating disorder care.
Department of Health and Social Care
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8
Deferred
Para 59
Commission national review of anabolic steroid use and launch safe use awareness campaign.
Recommendation
We recommend that the Department commissions a national review of the growing use of anabolic steroids in England as it relates to body image. We further recommend that the Department introduces a national awareness campaign around safe anabolic steroid use. …
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Government Response Summary
The government's response largely deflected the recommendation for a national review and awareness campaign on anabolic steroid use, instead focusing on the Online Advertising Programme (OAP) and its consideration of advertisements that contribute to body image concerns, and engagement with the Advertising Standards Authority (ASA) on digitally altered images.
Department of Health and Social Care
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9
Deferred
Para 66
Introduce legislation to mandate a logo label for all digitally altered commercial body images.
Recommendation
We call on the Government to work with advertisers to feature a wider variety of body aesthetics, and work with industry and the ASA to encourage advertisers and influencers not to doctor their images. We believe the Government should introduce …
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Government Response Summary
The government acknowledges the issue and commits to collaborating with other departments to gather robust evidence on screen time's impact before deciding whether to progress with a nationwide public health campaign. It does not commit to working with advertisers or introducing legislation for image labelling.
Department of Health and Social Care
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10
Acknowledged
Establish a national ‘Screen Cross Code’ public health campaign for children’s safe screen use.
Recommendation
We echo the call of our witness Professor Sandeep Ranote for the creation of a national public health strategy akin to the 1970s ‘Green Cross Code’. A ‘Screen Cross Code’ would be a nationwide public health campaign, which would use …
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Government Response Summary
Health Education England, the General Medical Council, and the Nursing and Midwifery Council welcome the recommendation and are committed to ensuring healthcare professionals have the necessary resources and training to discuss and address body image issues. However, the response does not commit to the proposed 'Screen Cross Code' national public health campaign.
Department of Health and Social Care
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11
Deferred
Integrate body image training into medical, nursing, and parent-interacting professional programmes within two years.
Recommendation
We urge Health Education England, the General Medical Council and Nursing and Midwifery Council to collaborate with third sector organisations that are currently educating people about, and promoting awareness of, body image issues, and after a period of assessment, integrate …
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Government Response Summary
The government's response does not address the recommendation to integrate body image training into medical, nursing, and midwifery curricula. Instead, it discusses the lack of plans for nationally required annual holistic health and wellbeing assessments and the existing health visiting and school nurse delivery model.
Department of Health and Social Care
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14
Deferred
Para 87
Implement population-level policies to tackle obesity and immediately restrict unhealthy food multibuy deals.
Recommendation
We urge the Government to implement population-level policies that ensure healthier choices and lifestyles are made a priority in tackling obesity rates, rather than schemes that focus solely on weight loss and can engender weight stigma and result in adverse …
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Government Response Summary
The government deflects the recommendation by detailing the National Institute for Health Research's (NIHR) existing portfolio of research on weight management and policy evaluations, and states that NIHR welcomes funding applications for various health topics but does not ring-fence funds.
Department of Health and Social Care
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16
Deferred
Para 96
Integrate weight stigma training into healthcare curricula and review obesity campaign language.
Recommendation
We recommend that the Government undertakes an urgent review of its current campaigns related to obesity and alters any language or media used that fail to 36 The impact of body image on mental and physical health mention being underweight …
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Government Response Summary
The government's response details guidance for doctors offering non-surgical cosmetic procedures and the importance of informed patient choice, but does not address the recommendation to review obesity campaigns for language or integrate weight stigma training into medical, nursing, and allied professional curricula.
Department of Health and Social Care
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17
Deferred
Fund research into tackling obesity, eliminating weight stigma, and weight-neutral interventions.
Recommendation
There needs to be further research to establish how best to tackle obesity while eliminating weight stigma and discrimination, and to establish the efficacy of weight- neutral interventions, and we recommend that the National Institute for Health Research put aside …
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Government Response Summary
The government's response outlines plans to consider specific premises standards for non-surgical cosmetic procedures and work with the CQC to ensure consistency, but does not address the recommendation for the National Institute for Health Research to fund research on tackling obesity and weight stigma.
Department of Health and Social Care
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18
Acknowledged
Para 109
Introduce a licensing regime for non-surgical cosmetic procedures by July 2023.
Recommendation
The risk of exploitation of vulnerable groups seeking non-surgical cosmetic procedures is too great and we recommend that to prevent further exploitation, the Department immediately draws up a clear timeframe for the consultation process. We urge the Government to make …
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Government Response Summary
The government agrees on the need for suitably trained and qualified practitioners for non-surgical cosmetic procedures and commits to working with the Joint Council of Cosmetic Practitioners and other stakeholders to consider whether further education and training requirements are necessary. However, it does not provide a clear timeframe for consultation or commit to introducing the licensing regime by July 2023.
Department of Health and Social Care
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20
Acknowledged
Para 114
Introduce two-part consent and 48-hour cooling-off period for non-surgical cosmetic procedures.
Recommendation
We recommend that the new licensing regime for non-surgical cosmetic procedures includes a commitment to a two-part consent process for anyone considering having a non-surgical cosmetic procedure, including, at a minimum, a full medical and mental health history, as well …
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Government Response Summary
The government stated it will continue to work with relevant stakeholders to ensure consumers can make safe and informed choices about cosmetic procedures, but committed to no specific actions regarding the recommended consent process or cooling-off period.
Department of Health and Social Care
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22
Deferred
Minimum education and training standards for non-surgical cosmetic practitioners are currently lacking.
Recommendation
We are convinced that there is a need for a minimum standard to be met in regards to the education and training of practitioners who perform non-surgical cosmetic procedures. It is essential to ensure patient safety, and thus should be …
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Government Response Summary
The government agrees on the need for suitable training and nationally recognised standards for non-surgical cosmetic practitioners. They will work with stakeholders, including JCCP, to consider whether further education and training requirements are necessary, rather than committing to a specific new regulatory framework.
Department of Health and Social Care
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23
Rejected
Para 123
Review dermal filler licensing to make them prescription-only substances, like Botox.
Recommendation
We recommend that the Department review the licencing of dermal fillers to be prescription-only substances, in line with Botox, in order to provide more protection for people undertaking procedures involving dermal fillers.
Government Response Summary
The government rejects the recommendation to make dermal fillers prescription-only, stating there are no current plans to do so because they are classified as medical devices rather than medicinal products like Botox. However, they note that the MHRA intends to introduce more stringent rules for dermal fillers under UK medical device regulations.
Department of Health and Social Care
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24
Accepted
Para 124
Establish a 'Non-Surgical Cosmetic Procedures' safety taskforce for coordinated regulation and patient safety.
Recommendation
We recommend that the Department establish a ‘Non-Surgical Cosmetic Procedures’ safety taskforce that comprises each of the regulatory bodies that have input into the sector, including the MHRA, the nine statutory bodies, the ASA and stakeholders like the JCCP, Save …
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Government Response Summary
The government states it already has effective working relationships with various regulatory bodies and key industry stakeholders. They will continue to work with these groups to ensure consumer safety, thus implicitly declining the recommendation to establish a new safety taskforce.
Department of Health and Social Care
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26
Rejected
Mandate display of kitemark and warning logo on all non-surgical cosmetic procedure advertisements.
Recommendation
We recommend that the new licensing regime should include the requirement to display a kitemark and a warning logo on any advertisement for treatments that fall within the regime’s scope. (Paragraph 129) 38 The impact of body image on mental …
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Government Response Summary
The government implicitly rejects the recommendation for a kitemark and warning logo, citing existing robust regulations for cosmetic surgery advertisements (e.g., ban on targeting under-18s) and explaining that a BSI Kitemark is not a prescribed requirement for medical devices, which follow CE or UKCA marking.
Department of Health and Social Care
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Conclusions (7)
6
Conclusion
Rejected
Para 53
While we commend the funding set aside for eating disorders to date and the actions taken by the Government so far, we are now of the opinion that a more co- ordinated approach is essential to properly understand and tackle this growing issue
Government Response Summary
The government rejected publishing a separate national eating disorder strategy, stating that eating disorders will be considered as part of a broader major conditions strategy under development. It noted NHS England's £54 million investment to expand eating disorder services for children and young people and the refreshing of guidance to improve early identification and integrated support.
12
Conclusion
Accepted
Para 85
We were extremely disappointed that during the inquiry, the Government delayed the introduction of restrictions on multibuy deals on food and drinks high in fat, salt, or sugar, including buy-one-get-one-free deals. It is essential that the Government prioritises interventions that provide a healthy environment, rather than focusing solely on individual …
Government Response Summary
The government details existing population-wide interventions, such as calorie labelling and location restrictions for high fat, salt, or sugar (HFSS) products, along with successes in reformulation programmes. However, it does not address the committee's disappointment over the delay in implementing multibuy restrictions or commit to their immediate introduction.
13
Conclusion
Accepted
Para 86
We propose that, in line with the introduction of Integrated Care Systems which seek to tackle health inequalities and focus on prevention, the Department ought to bolster the Healthy Child Programme, the programme for prevention and public health of children and young people aged 0–19-year-old and their families. We propose …
Government Response Summary
The government details existing work by OHID on person-centred language for obesity and the Better Health campaign, and mentions that the National Child Measurement Programme is trialling new approaches to help parents and professionals discuss weight supportively. However, it does not commit to introducing annual holistic health and wellbeing assessments for every child or specifically bolstering the Healthy Child Programme.
15
Conclusion
Deferred
Para 95
Throughout the inquiry, we have been aware of the importance and complexities involved in tackling obesity rates to improve population health and reducing weight stigma to not perpetuate mental and physical health issues.
Government Response Summary
The government's response discusses the introduction of a licensing regime for non-surgical cosmetic procedures, including the scope of work and a plan for delivery by July 2023, but does not address the committee's conclusion regarding the importance of tackling obesity rates and reducing weight stigma.
19
Conclusion
Deferred
Para 113
The dangers posed by non-surgical cosmetic procedures in vulnerable groups have been evident throughout the inquiry. The new licensing regime provides an opportunity to ensure that anyone planning to undertake a non-surgical cosmetic procedure has the time and space to consider their decision, and weigh up the risks and benefits. …
Government Response Summary
The government explained the current regulation of dermal fillers as products by the MHRA, mentioning that the MHRA intends to introduce more stringent rules for aesthetic and non-medical products, but stated there are no plans to make dermal fillers prescription-only.
21
Conclusion
Acknowledged
Para 117
There should be specific premises standards for all beauty salons and non-CQC registered premises providing non-surgical cosmetic procedures. Local Authority Enforcement Officers should be given extended powers to enforce compliance with a nationally agreed set of premises standards.
Government Response Summary
The government stated its general desire for the public to trust medicines and devices used in non-surgical cosmetic procedures and for practitioners to market responsibly, but committed to no action on premises standards or enforcement powers.
25
Conclusion
Acknowledged
Para 127
We welcome the decision to prohibit advertising for cosmetic procedures being directed at under-18s and we look forward to the results of the 12-month review of this new measure
Government Response Summary
The government acknowledges the committee's welcome of the ban on advertising cosmetic procedures to under-18s, confirming the ban came into effect on 25 May 2022 through CAP rules covering all media.