Debate on body image and mental health

[RedToothBrush]

Just caught this randomly on twitter. Its a reference to a debate currently going on in parliament this afternoon. Definitely looks worth looking up on Hansard later

Parly @parlyapp
Commons now on the general debate on body image and mental health opened by @JackieDP

[Jackie Doyle-Price Minister for mental health]

At the risk of sounding trite we must tell everyone to learn to love themselves says @JackieDP

Gender should be seen as a spectrum says @JackieDP we should allow children to explore their feelings in the context of a safe environment

Nobody under the age of 18 should be seeking cosmetic procedures says @JackieDP

.@paulasherriff says she sincerely hopes that this is not @JackieDP last appearance in her role

[Paula Sheriff Shadow minister for health]

All too often social media companies are turning a blind eye and refusing to take action on trolling says @paulasherriff

Body image was a core part of people with eating disorders says @DrLisaCameronMP it is so important that there are services locally

[Lisa Cameron SNP]

There don’t appear to be any backbench Tory MPs speaking in the debate on body image.

You don’t need any qualifications to inject someone with Botox says @KevanJonesMP I could inject you - not that you need it Madam Deputy Speaker

[Kevan Jones Labour]

.@SharonHodgsonMP says @JackieDP has taken consensus on board and deals with the issues and not the politics

[Sharon Hodgson Labour]

Even children under the age of six were reported to feel dissatisfied with their bodies says @SharonHodgsonMP

Minister @JackieDP thanks colleagues for their generous comments, even if they are career limiting

.@JackieDP is winding up the debate on body image and mental health

Love Island is not reality TV it is fantasy TV - they are promoting lifestyles are not normal says @JackieDP I like my dramas gritty and real

Where there is clear evidence of harm government must act and Botox is something will be looking closely at says @JackieDP

Now looking through this series of tweets from Parly App i think there's likely to be plenty to unpick, but definitely needs Hansard.

It should be up later today or sometime tomorrow. I'll have a look later.

Gender should be seen as a spectrum says @JackieDP we should allow children to explore their feelings in the context of a safe environment

I personally take this in this context to mean what it should mean; that socially constructed gender is a spectrum, we are all different and can like different things. It's called personality.

Exploring that is important for yp; knowing that it is just freedom of expression (safely - obviously there are limitations.)

Unfortunately as sex and gender are so frequently confused this is likely to be misconstrued.

That's the biggest issue with forcing the gender ideology bullshit on young children. It makes them think there is something wrong with them if they don't conform.

hansard.parliament.uk/Commons/2019-07-23/debates/919E1A70-B3FE-46BF-85FE-93CCFF3B47EF/BodyImageAndMentalHealth

Here's the Hansard link whilst I remember. Not had chance to read through it yet though.

Thanks, I'll attempt to trawl through this at some point.

Absolutely agree whatsnew.

I believe there's huge correlations to the trans issues and the explosion of visual media. Visual media has solidified gender stereotypes enormously.

The Affluenza virus charted how tv advertising impacted mental health including anorexia; this is the next level.

Seems like a step in the right direction?

It's interesting to see anorexia and body image spoken of in the same breathe as trans issues.

I note from skim reading that Lesbian, Gay and Bi sexuals as well as trans people have particularly high levels of issue with body issues.

I also puzzled over the 'career limiting' comment about those talking during the debate. I couldn't work out why tbh. There was very little reference in the debate to trans issues or anything particularly controversial.

Unless it was a reference to members of the public raising issues on the subject at cost to them or MPs raising issues privately about their concerns.

I was also slightly wary of the defence of the Tavistock on the grounds that it was conservative with its treatment of children.

However although not explicit there does seem to be some joining of dots about body image and stereotypes in the context of LGBT issues and it particularly affecting women and girls.

Which yes I do think a step in the right direction.

I have not been able to sit down and read properly and I'm unlikely to have the time until Sunday at the earliest now, but I do want to have a proper read.

Haven’t watched all this yet (it’s a new upload) but it’s really thought provoking:

m.youtube.com/watch?v=EO-Y4VdVOIQ

A young woman had a undiagnosed androgen secreting tumour, and was first diagnosed with body dysmorphia. The tumour made her appear very androgynous and she thought she was attracted to women, but realised she wasn’t after the tumour was treated.

Giving blockers and cross sex hormones to a person with a healthy endocrinological system is surely an artificially induced form of similar hormonal disorder?

Her name is Kate and I’m thankful to her for sharing her story, not easy in this climate.

So glad trans and anorexia and body image were all spoken about together.

Need to read the Hansard when I get time but certainly sounds promising.

Some quotes and some thoughts which stem from them:

Bambos Charalambous
Obviously, the harm is done with young people early on, and they are very impressionable—we have mentioned reality TV, and the Digital, Culture, Media and Sport Committee is looking at its impact. Does the Minister not think that we should try to teach positive body image at school and provide support at school for people who have concerns about their body image? That would be a wise investment of Government funds and would actually help young people to address their concerns and anxieties at every stage.

Jackie Doyle-Price
I agree with that. Through the new personal education that will be rolled out next year, we will have the ability to address that issue. I would just say that we need to be careful about this and to give some scrutiny to what the content of that might be. We have to really make sure that people respect the fact that we are all different and we all come in odd shapes and sizes, but everyone is beautiful. That is a really important message to convey. It will be incredibly challenging to get that content right, and we do need to bring some scrutiny to that.

Body image is clearly a strong contributory factor in many cases of mental ill health. I am pleased that we are starting to tackle some of these issues, but there is a long way to go. We have reached a stage at which the herd has gone so far down the road that the idealised view that everyone is a size zero model whose perfectly coiffed, long, naturally blonde or brunette hair has no shades of grey and no curls has taken hold. It will take a long time to turn that juggernaut around, but in the interests of a healthy society we all need to get a grip.

So why do we have groups going into schools actively coming out with this 'born in the wrong body' crap?

Its totally non-compatible with tackling this as an issue.

You CANNOT be born in the wrong body.

Paula Sheriff
Body image concerns are extremely common, and vary in severity. Not all body image issues will affect mental health. However, it is important to be aware of the risk factor, especially among young people, as the risk of developing an eating disorder is closely associated with poor body image. The Mental Health Foundation has undertaken a great deal of research in this area, and recently conducted a survey of 4,505 UK adults aged 18 and above and 1,118 UK teenagers aged between 13 and 19. The results showed that one in five adults felt shame about their body image, 34% felt down or low, and 19% said that they had felt disgusted because of their body image in the last year, with 13% saying, very worryingly, that they had experienced suicidal thoughts and feelings. The survey of teenagers revealed that 37% felt upset and 31% felt ashamed in relation to their body image.

Perhaps more worrying are the results from Be Real’s Somebody Like Me campaign. The researchers spoke to more than 2,000 secondary school pupils aged 11 to 16 from across the UK, and found that 52% regularly worried about how they looked, 30% isolated themselves because of body image anxiety, and 36% said that they would do “whatever it takes” to look good, including considering cosmetic surgery. Similarly, 10% of boys surveyed by the Mental Health Foundation said that they would consider taking steroids to achieve their goals.

So in effect, OVER A THIRD of children have such bad self image that they want cosmetic surgery. At what point is that classed as dsyphoria rather than 'just' anxiety??? Afterall 13% felt suicidal over it.

She then continued

The shocking statistics that I have cited highlight the need for more support and help. Perhaps most worrying is the finding that a desire for the option of cosmetic surgery appears to be more and more widespread. I welcome what the Minister said about the need for stronger regulation, because cosmetic surgery has almost become normalised. Many of my friends have lip fillers and Botox treatments. I have not succumbed to either as yet, but people are now moving away from breast augmentation and talking of “bum lifts” and “Brazilian bums”.

Well isn't that just it?

Normalisation of cosmetic procedures. That would also, in my book, include blockers and hormones since they alter physical appearance.

So WHY do we have organisations going into schools which have an agenda to normalise cosmetic procedures and drugs????

Dr Lisa Cameron
Society is encouraging stereotypes that place great stresses on our young people today, and that has an adverse impact on their mental health. Social media companies must look at this in much more detail in terms of regulation, as we have heard. I have been very pleased to contribute to the work done through the Department, which is looking at issues of social media abuse and the impact of social media on young people’s development and mental health and how they relate to the world. It is almost as if we have become an artificial world rather than engaging with each other in our day-to-day lives just as we are, with all our diverse shapes and sizes being the norm.

So HOW does social lies help this? How does that stop us becoming an artificial world where we can not speak the truth rather than being able to just 'be' without having to conform to a stereotype.

She later says:

When I highlighted this debate online today, my constituents asked me not to forget to mention how men are affected in terms of body image. That is such a good point. We often speak about the impact on women, and I have been doing that in much of my speech. They said, “Please don’t fail to mention how men are impacted because this is increasingly an issue in society, and the same stereotypes apply: having to be really buff, no matter what your day entails or if you are running about trying to juggle lots of different things. Always having time to go to the gym and to look fabulous and have all the best clothes etc—these things also put pressure on young men.” I attended a very sad but poignant tribute at the weekend to my constituent Ryan Coleman, who sadly took his own life. We really cannot underestimate the pressures on young men’s mental health nowadays in society. It is incumbent on Governments across the United Kingdom to ensure that young men as well as young women feel able to come forward, be referred and take up services; there is often much more stigma for young men in accessing services and acknowledging some of these issues.

I actually think this is a really good point and perhaps has been really overlooked - and also at the expense of women because of how this toxic masculinity is manifesting in a variety of ways.

We have spoken about cosmetic procedures. I do not have too much detail to speak about on that, but I am aware that there is not much regulation of such procedures and it is important that we get on top of that. As the Minister and the shadow Minister mentioned, when things go wrong, it is not just like having to go back to the hairdressers and getting a different colour put on. Cosmetic procedures can have a permanent impact on people, or affect them for a very long time, so regulation in this market is important. Other markets may be diminishing, but this market is growing exponentially so we definitely need to have regulation in place.

So what regulation is in place for distribition of puberty blockers and hormones and for gender related cosmetic procedures? I'm thinking along the lines of Webberleys in particular here, or any other GP who is a bit lax with the prescriptions and refers to it being 'dead simple and easy' and without much downsides.

When I worked with people who have eating disorders, we knew from the research that body image was a core part of the issue that people struggled with. It is not just about weight; it is about cognition. It is about how people think about themselves. I worked with young people who were growing thinner by the day and had anorexia nervosa but felt that they were fat. When they looked at themselves in the mirror, they saw themselves as overweight and strove to lose more and more weight. When an eating disorder develops over time, we know that cognition becomes affected. That is why it is very important that people can be referred to local services. I know how difficult that can be.

Is cognition something that is being taken into account of when we talk about gender dysphoria? In anorexia there is an inability to see themselves as they are, and as such there is a lack of mental capacity that creeps in over time.

I think the question needs to actually be asked, because it has a huge implications for informed consent of children.

Mr Kevan Jones
The Minister rightly warned people not to go abroad for such procedures, because standards are not high. Sadly, I have to say that they are not very high in this country either. Dawn’s case and the cases of numerous women that Dawn has documented over the years show that surgery that takes place in this country is sold like a commodity. It is not sold as something that could threaten or change people’s lives; it is sold like any other product. I am sorry, but it is not like any other product. Some of these procedures are very dangerous and can result in death.

The problem is the way the industry is structured. There are groups that give the impression that they employ surgeons and that they are hospitals. One that I have spoken about on behalf of Dawn and other victims—that is what I call them—is the Hospital Group. One would think that it is a hospital that employs surgeons and nurses, but it is not. It is a sort of marketing facility company that has a hospital and flies in surgeons from Europe, sometimes on a daily basis. They fly in, operate and fly out again. The aftercare treatment is non-existent in some cases. As Dawn’s case shows, when people try to sue the individual, they find that their indemnity insurance does not cover the resulting legal case.

What we need is a properly regulated system. The fly-in, fly-out surgeons need to be banned. I am sorry, but it is not acceptable. People say, “We have the General Medical Council,” but that is another of my hobby-horses. It is an organisation that is ripe for reform. The Government have promised reform of how the GMC operates, but they have not brought legislation forward. We need legislation to reform it because, as I will say in respect of another organisation in a minute, I am never a great fan of self-regulation. I was one of those who campaigned to take regulation away from the Law Society. Self-regulation has clearly failed. Nearly five years on from her complaint against the doctor, Dawn Knight is still fighting. It is not a user-friendly process for anyone to get redress for their complaint and we need to address that as a matter of urgency.

Cosmetic surgery is advertised and sold like any other commodity. There used to be two for one offers on Facebook and elsewhere—buy one procedure and get another procedure free. There were time-limited offers. Those should all be banned; they should not be allowed at all, because some of those procedures are very dangerous and people are often not aware of the dangers. I would argue that such a ban is part of the regulation we need. This is not a multimillion-pound industry, but a multibillion-pound industry and it is exploiting people’s poor body image.

Before anyone had any type of cosmetic surgery, I would insist that they had a mental health assessment. Not only should the risks of the surgery be explained, but we should question whether people actually want the procedure.

A couple of things;

The GMC doesn't seem to have the clout / power / willingness to deal with issues relating to cosmetic procedures and there is a particular problem with doctors based abroad in this area.

I think the situation with the Webberleys stresses to me, just how much blockers and hormones need to be put into the same catergory and classification as all other cosmetic procedures and be treated accordingly with far more robust regulation and over sight because the whole field is hugely lacking and is being sold as a commodity rather than lifechanging.

I think Dr Harrop's social media advertising the other week was particularly compelling in that regard as it was on highly dubious legal ground.

Indeed Mr Kevan Jones then later said.
The Minister also mentioned Botox and fillers. Those procedures are not cosmetic surgery in the sense of people going under the scalpel, but I would argue that they are equally in need of regulation because of the appalling effects when things go wrong. According to some adverts, people can simply go along in their lunch hour and have a Botox or filler treatment and then walk away in the afternoon, but those are medical procedures. They are advertised on social media and elsewhere, but Botox is a prescription drug, and it is interesting that people seem to have access to it even though they have no qualifications at all. No qualifications are needed for injecting someone. Madam Deputy Speaker, I could inject you with Botox this afternoon—not that you need it—without any qualifications or training whatsoever. The Minister was right to say that the problem with the way in which social media algorithms work is that anyone who enters the term “Botox” into a Facebook search, for example, will then be bombarded by adverts not only for Botox and fillers but for training courses on how to administer them. People can actually sign up for those courses in order to earn money.

Wera Hobhouse
Of course, eating disorders are far more complex than stress over body image. They are serious conditions that ruin, define and, all too often, end lives. However, the seeds of emergent eating disorders can often be spotted in stress or anxiety about body image. For the more than 1 million people who were identified as having an eating disorder, the outlook is not good. On average, it takes 85 weeks between someone realising they have an eating disorder and that individual receiving treatment. That lost time can be the difference between full recovery and living with a permanent disability or disorder. The Government targets introduced to limit child waiting times for eating disorder treatments were a positive step, but thousands of adults across the UK need the same measures. We need to consider the waiting times for adult sufferers of eating disorders, and I know that the Minister has already looked into that.

So if you spot the early signs of the problem in eating disorder in terms of body anxiety, you can step in earlier to stop it spiralling into a life long issue.

Interesting.

Early intervention is key. Schools, doctors and support workers must be equipped with the tools to identify when body image concerns are becoming dangerous. Furthermore, we must change the cultural conversation around body image, which can be done on many levels. As we have already heard today, social media companies have a responsibility to police the content on their websites, ensuring that anything that actively incites self-harm is taken down.

Again, this is interesting and coming from the liberal democrats there is a certain amount of cognitive dissonance here. Anything that actively incites self-harm? Yes about that.

But yes when is an issue about body appearance 'getting out of control'? Define it.

There is something no quite right and consistent going on here.

*Mrs Sharon Hodgson^
I pay tribute to the Mental Health Foundation for its comprehensive research and campaigning on this topic. It has found that even children under the age of six have reportedly felt dissatisfied with their bodies, so promoting a healthy body image from an early age is therefore a crucial step. It is obvious from what we have heard today that more needs to be done to ensure that happens.

It is heartbreaking to hear that more than half of children and young people have been bullied because of their appearance, and that one third of teenagers say they have felt shame because of their body image. The Children’s Society has found that children’s happiness with how they look has not improved since the mid-1990s, and young people themselves say that body image is their third biggest area of concern in life, after their education and employment prospects. Why, then, are we failing to address poor body image when it is such a crucial issue?

It is clear that educating young people about their bodies is an important step in improving their body confidence, so do the Government have plans to ensure that schools cover body image concerns as part of the introduction of compulsory relationships and sex education in 2020? More needs to be done to promote healthy body image and good mental health among our young people.

Classroom-based teaching should not only extend to teaching children about their bodies; more needs to be done to ensure that children understand how to use social media safely, understand how to improve their self-esteem and understand their emotions. Can the Minister outline how the Department for Education is tackling these issues in schools? I know the Minister is here representing the Department of Health and Social Care, but the Under-Secretary of State for Education, the hon. Member for Stratford-on-Avon (Nadhim Zahawi), the Children’s Minister, was here a moment ago, and they should be in close contact on this.

As young as six.

So why are we introducing additional pressures and worries about bodies into the classroom at this age, when we should be promoting body confidence instead?

I'm reading this and seeing this angle as one that MPs are seemingly being receptive over and as such, perhaps its an angle that should be used as an approach to discussing the subject in a variety of different ways.

I think there is merit to phrasing and asking particular questions over the cognitive dissonance thats going on and why we are seeing a simulataineous government santioned undermining of exactly the same thing they see as a problem here.

She then goes on to say
It is worrying to hear about body image concerns among lesbian, gay and bisexual people. One third of adults who identify as lesbian, gay or bisexual have reported experiencing suicidal feelings in relation to their body image. It is therefore important that lesbian, gay and bisexual people have access to support that is tailored to them. Has the Minister taken steps to ensure that lesbian, gay and bisexual people have access to appropriate mental health support?

BEFORE then making a completely separate point about trans
As we know, trans body image is often linked to a specific condition called body dysmorphia, which means it is not included in the statistics I just mentioned. Trans people face specific challenges in accessing mental health support, so it is vital that the Government ensure that mental health support tailored to trans people is available throughout the country. Will the Minister explain what steps the Government are taking to provide mental health services for trans people in this regard?

Its important. Are the needs of lesbians, gays and bisexuals being overlooked in terms of body image? Cos the answer seems glaringly obvious to me.

The Government heeded Labour’s call and announced a regulator in the “Online Harms” White Paper, which is great, so it is now imperative for a regulator to be put in place as soon as possible. Will the Minister let the House know when that regulator might be expected? The process might take many months, and meanwhile children, young people and vulnerable adults are left at risk of severe online harms. The Government need to move faster and to go further, and perhaps we might see that under the new Administration—who knows—but it is clear from this debate that more needs to be done to tackle harmful content and body stigma, and to provide appropriate mental health support for everyone who needs it. Following this debate, as we have all said, I hope that the Minister will still be in her job and able to tackle this.

So the 'online harms' things also seems to be another good way into this debate.

Jackie Doyle-Price
This whole area of cosmetic surgery is growing very quickly, and people are quite naive in thinking that perhaps the more money they spend on a procedure, the better it is going to be. Nothing could be further from the truth, because there are the least virtuous of people in this space. As the right hon. Gentleman says, this is the wild west. These people are profiteers. Part and parcel of enabling people to protect themselves in this environment is to really talk about the risks. There are some absolute cowboys out there. The story that Dawn tells about trying to sue the practitioner who undertook her procedure shows that that is frankly impossible. When people want to become engaged in activity that is borderline criminal, they find ways of making sure that they cannot be held to account for it. Whatever our instinctive view about people’s choice, self-regulation and so on, where there is clear evidence of harm, the Government should act. We really must look at this more seriously. I am happy to continue speaking to Dawn and to the right hon. Gentleman about that.

Webberley klaxon.

Clearly, we need to look at the whole issue of dermal fillers. It is classed as a medical device and therefore is not on prescription, but ultimately something is being injected into the face, so we need to make sure that we are doing something about regulation. The right hon. Gentleman mentioned the role of the GMC. As he says, Botox is a prescription drug, but it is clearly being administered by people who are not practitioners. Both the GMC and the Nursing and Midwifery Council have an obligation to uphold their regulatory standards. If someone is using their prescribing power irresponsibly and not being present when the product is administered, then action should be taken, and I shall expect those bodies to do that.

More Webberley klaxon and more GMC klaxon.

^
Mr Kevan Jones
I agree with what the Minister says, but if we look at some of the adverts—for example, on Facebook—there is no way that people who are signing these prescriptions can actually be present. Her Department should look at this area, because there are clearly people signing prescriptions and then either selling them on for a profit or giving them to people to make money out of these procedures.

More klaxon

Jackie Doyle-Price
I am grateful to the right hon. Gentleman for amplifying that point, because we must do that. We give very clear indications that we expect the NMC and the GMC to deal with this. However, we must also send a message to people out there that people will get these adverts about how to become a dispenser of dermal fillers and think that that is all they need to do, having no idea that they are committing a criminal offence. We need to educate them as well.

Very much an argument for outright banning of online consultations for any cosmetic or appearance altering drug, and prescriptions must be in person.

And international cooperation is an essential part of that - and not beyond what is achievable at least with European countries.

So yes, something to ponder.

Think thats all the bits that stuck out to me. Plenty else in there too though.

I got a new phone a few months ago and I hadn't realised that the camera was automatically set up with a 'beauty' filter turned on. After taking a few pictures of my DD and thinking that she looked weird, and a few pictures of myself and thinking that I looked amazing, I discovered this filter. It reduced the sight of pores and blemishes, made faces look narrower, noses smaller, eyes bigger. I took the filter off and felt phsyically repulsed by the sight of my own face for a few days. That's just my phone camera. Then you remember that nearly every picture and image you see online or in magazines is like this. I think that's a big problem.

Does the Minister not think that we should try to teach positive body image at school and provide support at school for people who have concerns about their body image?

I am not sure that positive body image can be taught - or that it should be. I think we need more focus should be on what our bodies can do and less on how they look.

Yes I think my phone has this. Kids are going to find mirrors even more distressing in the future.

Totally runined my attempts to boast how spotty my son was with hf and m.

Actually it's reminded me of when I upgraded to a new phone around 6 mo post party when you really start to look haggard, and simply as it had a better camera and bigger screen I suddenly noticed all the eye wrinkles (I'm also v short sighted so don't see it as well in mirrors). I then fell down an enormous rabbit hole of retinols etc online - actually watching a coupe of YouTube films before coming out of it an accepting them (didn't actually get round to using but I do now use a good sunscreen.)

I was genuinely quite obsessed and stressed for a week and I was surprised at the force of feeling so if an individual has a weakness for self image (and I do from a skin condition growing up) it's very easily put in to motion via screens, social media, google and YouTube.

*post partum.

My hang overs don't quite that long!

The weird mirrors in changing rooms do nothing for me.

I've just started a thread on a young NB woman which is extremely chilling and being played out on Instagram. This should be debated in parliament.

"Self care shouldn't be gendered" - top surgery scars www.mumsnet.com/Talk/womens_rights/3648583-self-care-shouldn-t-be-gendered-top-surgery-scars

I can't even look in mirrors myself. And if I catch a glimpse, I am repulsed. I can't go clothes shopping because you can't escape from mirrors. DH will grab clothes for me because he knows trying on things just sends me into a spiral of body loathing. It's gotten bad enough that I once panicked outside a lingerie shop when I desperately needed new bras because there were too many mirrors in it.

And then I worry as I don't want DD1 and DD2 to feel like that. They're wonderful and gorgeous little people and right now they love seeing themselves in mirrors. But if I feel actual revulsion at my own appearance, then how can I protect them from that feeling when they're older? I deflect with 'mummy just doesn't like mirrors' and don't mention why I don't.

I am not sure why I am posting. I guess because this relates to body image and maybe it's partly the way people with gender dysphoria feel. I honestly don't know.

Isay

Of course it's relevant- this affects many of us but teens are in a way more vulnerable,

I had a type of body dysphoria growing up due to skin. At uni it got terribly bad and I remember being unable to walk down the street without needing to pretend to try some clothes on in order to "check" the skin on my face. I both hated the mirror and needed it to reassure me so I could continue to walk down the street. I was ashamed though as I was actually brought up not to spend ages bothering too much about how you looked beyond basic smart.

These days you'd take a selfie in the street.

(Ironically when I fell down the YouTube rabbit hole last year I discovered via that American dermatologist obsessed with suncream and herbal tea that it was common to feel self conscious with that particular skin condition if it was v bad like mine, and she gave some great advice about it.)