What is the impact of poor body image on people's health?

We launched our inquiry into the impact of body image on mental and physical health in December 2021. We explored the impact that poor body image has on people's physical and mental health, as well as on accessing health-related services and non-surgical cosmetic procedures. We also looked into how the Government can strike a balance between tackling obesity and reducing weight stigma. 

During our evidence sessions we heard from different people with lived experience of body image related issues and we run a survey that received 1550 responses. We are extremely grateful to everyone who made submissions to our inquiry and shared with us their experiences. 

Read on to find out what we heard. 

80% of respondents to our survey agreed or strongly agreed that their body image has a negative impact on their mental health, and 61% said that their body image has a negative impact on their physical health.

Who do body image issues affect?

Body image issues can affect anyone. However, certain groups are considered more vulnerable. They include:

• adolescents
• underweight and overweight individuals
• LGBT individuals
• people with disabilities or visible differences.

We learnt that poor body image develops early and it's becoming more common. While women and girls are often more likely to report being unsatisfied with their bodies, men and boys also experience body image dissatisfaction.

Charlie King, a witness with lived experience of body image related issues, came to speak to us during one of our oral evidence sessions. He told us about how his struggle with his sexuality added to the development of body image issues at a young age:

Another lived experience witness, James Brittain-McVey, has described to us the process by which body image developed for him, and the pressure he felt to conform to stereotypes:

Throughout our inquiry we heard that body image issues don't only affect the young. Body dissatisfaction can persist into mid- and later life and may even be exacerbated by age-related psychological changes.

The impact of physical and mental health

We received a wide range of submissions detailing the different ways that poor body image can result in the development of mental health and physical health conditions.

Body Dysmorphic (BDD) Disorder is one of these conditions. We heard that 2% of the population experience BDD at any point in time, and that BDD is becoming increasingly common over time.

This is how Kim Brooker, who came to speak to us in one of our oral evidence sessions, described her experience of BDD:

Other conditions associated with poor body image are eating disorders and muscle dysmorphia, a subtype of BDD characterised by the preoccupation with the idea that one’s body is not sufficiently lean and muscular.

Advertising and social media

Each of our lived experience witnesses told us that their body image issues started in childhood and adolescence and that social media and online advertising often exacerbated their concerns. We also heard evidence about the potential harm from online content that promotes an idealised, often doctored and unrealistic, body image and the link to developing low self-esteem and related mental health conditions. 

We call on the Government to work with advertisers to feature a wider variety of body aesthetics, and work with industry and the ASA [Advertising Standards Authority] to encourage advertisers and influencers not to doctor their images. We believe the Government should introduce legislation that ensures commercial images are labelled with a logo where any part of the body, including its proportions and skin tone, are digitally altered.

Impact on accessing health-related services

31% of those who completed our survey said that they had accessed or tried to access, health services relating to body image issues. Of these, 64% felt that their experience of accessing services was either negative or strongly negative.

Many respondents to our survey told us about the barriers they experienced when trying to access the services:

Rates of obesity have risen across England in the past few decades. Almost two-thirds of adults in England are currently overweight or obese, and one in three children leave primary school overweight or obese. There has been a significant increase in obesity in the most deprived communities in England in recent years, leading to a widening gap in rates of obesity between the most and least deprived areas. 

The causes of obesity are many and varied. The most important risk factor is an unhealthy diet, while physical inactivity also plays a role. We are aware that people in deprived areas often face significant barriers to accessing affordable, healthy food and to taking regular exercise. 

Government's strategy on obesity and weight stigma

The efficacy of past and current obesity measures was roundly criticised by many of our witnesses. Research from the University of Cambridge shows that Government obesity campaigns over the last 30 years have largely been unsuccessful due to an over-reliance on trying to persuade individuals to change their behaviour rather than addressing the unhealthy environments and emotional and mental health factors that lead to obesity. 

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 action.

Weight stigma is a negative attitude towards someone based on their weight status and it can be experienced by people across the weight spectrum, although it is most commonly directed towards people falling within the overweight or obese weight ranges. 

Dr Flint highlighted the issues weight stigma can present in accessing services: 

We recommend that the Government undertakes an urgent review of its current campaigns related to obesity, and that training on weight stigma is integrated into undergraduate and trainee curricula in all medical, nursing and other allied professional programmes to address stigma early on. 

Non-surgical cosmetic procedures as those which do not require a surgical incision to be made and are usually considered minimally invasive. These include Botox injections, chemical peels, microdermabrasion, and non-surgical laser interventions. 

The number of cosmetic treatments being carried out across the UK has risen considerably over the years and continues to do so. 

During our inquiry we heard about the pressure for people with poor body image to change their bodies via cosmetic procedures. 

Regulation of non-surgical cosmetic procedures

The review into regulation in the surgical and non-surgical cosmetic interventions led by Sir Bruce Keogh in 2013 found that non-surgical interventions were entirely unregulated. From what we heard during our inquiry, there have been little changes to date. 

In an oral evidence session, we heard Kim Booker's experience of a cosmetic procedure: 

A public consultation into a future licensing regime for non-surgical cosmetic procedures such as Botox and fillers was included in the Health and Care Act 2022.

We call on the Government to treat this as a priority and that we want to see a regime in place within a year of our report being published. 

We were told time after time that patient safety must be at the heart of a future licensing regime. Charlie King shared with us his worrying experience of undergoing a procedure (in this case, a surgical cosmetic procedure) when vulnerable:

Education and training for practitioners

There is currently a total absence of mandatory education and training standards for those administering non-surgical cosmetic procedures, which can lead to a wide variety in the quality of interventions, resulting in potential patient safety issues. Anyone can administer a non-surgical cosmetic procedure.

Based on what we heard during our inquiry, 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.

Our report "The impact of body image on mental and physical health" was published on Tuesday 2 August 2022.

The Government has two months to respond to our report.

Detailed information from our inquiry can be found on our website.

If you’re interested in our work, you can find out more on the Health and Social Care Committee website. You can also follow our work on Twitter.

The Health and Social Care Committee is a cross-party committee of MPs that scrutinises the work of the Department of Health and Social Care and its associated public bodies.