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Hospital admissions for bulimia and anorexia among girls under 18 leapt by 47 per cent. last year according to House of Commons figures. Media images are not the only factor responsible for that list of health problems, but they are a significant risk factor.

The problem starts at an early age. One study of girls aged from five to seven found that girls had less body esteem and a greater desire for a thinner body after exposure to images of thin Barbie dolls, compared with girls exposed to images of dolls with a healthy body size. People are not necessarily fully aware of the extent to which images are digitally altered. In a poll by Dove last October, 42 per cent. of more than 1,000 women said that they could not tell when an image had been airbrushed or digitally enhanced.

As I mentioned, Dove has used normal women as models in its adverts for the last five years as part of its successful campaign for real beauty, which in itself proves that products can sell without the adverts having to conform to the super-skinny beauty ideal. We need to change the culture that says that in our society only thin is beautiful, and nothing less than perfection will do. There is no magic wand we can wave to create that change overnight, but the Liberal Democrats' Real Women campaign is calling for a few simple steps to start the process: we are seeking to make images used in advertising more honest and to equip people to respond to them in a healthy and appropriate way. Firstly, we propose that in adverts aimed at adults, advertisers should be honest about the extent of digital retouching they have employed. Secondly, in adverts aimed at children, people should be presented realistically, as they actually look, without digital retouching. Finally, the national curriculum should ensure that children receive education about media literacy and body image issues.

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The Advertising Standards Authority already has codes of conduct that regulate what can and cannot be put in adverts, and we are all used to seeing disclaimers on adverts to comply with those rules. For example, L'Oreal has been made to state on its shampoo adverts that Cheryl Cole is actually wearing hair extensions, and admit that Eva Longoria is wearing false lashes in its mascara adverts. However, the ASA acts only in response to complaints about specific adverts.

The Minister may be aware that in response to almost 1,000 complaints received as part of the Real Women campaign, the ASA recently banned an advert for Olay Definity anti-wrinkle products featuring Twiggy. It upheld the complaint that the advert was misleading because viewers were led to believe that Twiggy's appearance was achieved using the product and not through digital alteration. However, it rejected the claim that the advert breached the requirement that

Its report stated that

It appears not to have considered the scientific evidence, which shows that although young people may be especially at risk, media images also cause body dissatisfaction and unhealthy behaviours in adult women.

Rather than a piecemeal, advert-by-advert approach, we need all adverts to be up front about the perfected images they portray. Bringing honesty about retouching into advertising is not rocket science. The ASA should work with the advertising industry to come up with a suitable labelling system, perhaps one that is similar to the traffic light system on food packaging, and amend the advertising codes to require adverts to display the retouching icon showing the level of retouching used in that ad. That would help consumers to distinguish between minor retouching, such as removing the odd blemish, and the extensive digital surgery that is increasingly common in adverts. As with the traffic light scheme, that might also change the behaviour of advertisers, who may be reluctant to airbrush so heavily if consumers know the extent of it.

There is clear public support for a change to the advertising codes. A ComRes poll in October for the Young Men's Christian Association, whose healthy bodies campaign is highlighting current concerns about body image, found that

The Dove poll I mentioned earlier found that 96 per cent. of women would like advertisers to be honest about the extent to which they airbrush or digitally retouch pictures and adverts.

Children are especially vulnerable to body image pressure. The YMCA poll found that 88 per cent. of people believed children to be under more pressure about their physical appearance than they were 20 years ago. That is backed up by research by Girlguiding UK. Shockingly, its focus groups heard that girls as young as seven equated being attractive with being happy. Research that it conducted in July among young women found that 50 per cent. of 16 to 21-year-olds would consider having surgery to change the way they look.

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Because children are more vulnerable, we already have guidelines that apply only to adverts aimed at them. For instance, clause 7.2 of the Broadcast Committee of Advertising Practice's television advertising code rules that

The evidence that I have outlined strongly suggests that airbrushing in advertising does just that. I hope the Minister will state in his response whether he agrees that the ASA should bring advertising companies together to form an agreement that images of people should not be digitally altered in adverts aimed at children. When the Liberal Democrats launched their proposals on airbrushing back in August, the Minister for Women and Equality, the right hon. and learned Member for Camberwell and Peckham (Ms Harman), was quoted as saying:

I hope that the Minister's Department agrees.

Of course, we cannot protect children from such images for ever, which is why we must also empower them to develop the resilience that they need to be able to think critically about media messages. The 45 experts to whom I have referred agreed in their summary of evidence that

Some 50,000 people signed to a "Body confidence" petition on the No. 10 website last autumn calling for the school curriculum to include lessons to help to deal with body image issues. They were backed by Gok Wan, whose "How to Look Good Naked" TV series has been a breath of fresh air in giving women of all shapes and sizes more body confidence.

In December, the Department for Children, Schools and Families published an independent report by Professor David Buckingham entitled "The Impact of the Commercial World on Children's Wellbeing". It concluded that the Department should set up a panel to look at how media literacy can be incorporated into the national curriculum. I was glad to hear that the Secretary of State for Children, Schools and Families agreed with that conclusion. I wonder whether the Minister could give us an update today on what progress has been made on that so far.

The steps that I have outlined are only a start. They need to precipitate many more wide-reaching changes. It is not only advertisers who are at fault. The trend towards using increasingly skinny models is worrying. Frankly, it is about time that the recommendation of the model health inquiry was implemented-for instance, at London fashion week next month-for models to have a health certificate, signed off by an eating disorder specialist, in order to protect their health and well-being, as well as that of their audience. Fashion designers have a role to play too. The sample sizes of their clothes are so small that the editor of Vogue magazine recently admitted to retouching to make models look bigger, as the only models who fit into them look so unhealthy.

Mr. Pelling: I am sorry to interrupt the hon. Lady, who is trying to get in as much as possible. Her party colleague on the London assembly, Dee Doocey, has
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been campaigning on London fashion week. Does the hon. Lady think it is time that the Mayor put his foot down and decided that size zero models are not acceptable at London fashion week?

Jo Swinson: The hon. Gentleman rightly raises the excellent piece of work that my colleague Dee Doocey has been doing on the issue, which has involved looking at the evidence and coming up with a set of proposals. The answer is probably not as simple as a crude body mass index measure, because some models are naturally very slender girls. However, that is why we need a proper system, whereby the model goes to a doctor and gets a certificate. That would be a sensible way to proceed. It would be helpful if the Mayor could implement that. Indeed, London fashion week takes place next month, so there might even be time for him to do so.

The media also must take some responsibility, for choosing to show such a narrow range of body shapes and ages. Curvy women and older women are too often airbrushed away, as if they did not exist, whether on entertainment programmes, reading the news, or in the fashion and beauty pages of magazines. The models and celebrities depicted in such media images are often under considerable pressure to change their bodies through surgery or extreme dieting. In an interview with Sky News in December, Martine McCutcheon responded to the news about the Twiggy Olay advert by saying:

Most women look at Martine or Twiggy and see examples of strong and beautiful women, yet even they are deemed not perfect enough just as they are. In fact, polls show that women and men want to see more realistic models. This week's Grazia magazine features a picture of Sadie Frost, naked, un-airbrushed, and beautiful exactly as she is. She says:

Wise words indeed. Media images are creating pressure that prevent too many women and girls from being happy and healthy in their own skin, sometimes with disastrous consequences. The steps that I have outlined today would be moves in the right direction to tackle this problem, and I look forward to hearing the Government's response.

10.56 pm

The Parliamentary Under-Secretary of State for Culture, Media and Sport (Mr. Siôn Simon): I thank the hon. Member for East Dunbartonshire (Jo Swinson) for bringing this issue to the House's attention, and for making these arguments in public. I am sympathetic to the points that she has made; I think that there is an issue here that we should be talking about. This subject cuts across many different sectors, from the broadcast and print media to advertising and fashion. In each of those sectors, mechanisms exist to enable the responsible
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bodies to conduct themselves responsibly and to work towards promoting healthy body images, particularly where children are concerned.

Notwithstanding the title of this evening's debate, it is worth noting that, although it is often assumed that it is women who suffer from extreme dissatisfaction with their body image, there is much medical evidence that men are almost equally as likely to be unhappy with the way they look. In fact, estimates suggest that there are three times as many men suffering from body dysmorphic disorder now as there were 25 years ago.

There are controls in place that aim to strike a balance between freedom of expression, which we must not neglect, and the protection of the public, and they should be proportionate to the potential harm that might be caused. A number of consultations and reports touching on this issue have recently been published or are currently in progress, notably as part of the cross-government violence against women and girls consultation, and we look forward to the findings of those reports.

The hon. Lady mentioned the Buckingham review on the impact of the commercial world on children's well-being. This recognised the concerns being raised about body image, but it also concluded that evidence of the effects was "mixed and inconclusive". I do not think that I have seen the other survey that the hon. Lady mentioned, although one does slightly lose track of which survey is which. I will seek it out, however. We need more information in order to build a better case.

The impact of the media in this regard is widely recognised by the Government, by media regulators, by broadcasters and by the press. I will come back to that a little later. However, it is ultimately the responsibility of the individual advertisers, broadcasters and publishers, working within the law and the guidelines, to promote and distribute their material responsibly. That includes the kind of issues that the hon. Lady has raised. She focused mainly on advertising, and it is in that area that the issue is most obvious and visible.

The regulation of broadcast advertising-although not print advertising-is controlled under the Broadcast Committee of Advertising Practice code, through a co-regulatory partnership between Ofcom and the Advertising Standards Authority. The BCAP rules aim to ensure that advertisements do not mislead or cause harm or serious or widespread offence and include specific regulations about the portrayal of children. Similar rules exist in the non-broadcast advertising sphere, strictly controlled through industry self-regulation, this time solely under the Advertising Standards Authority.

The ASA advertising codes do not contain specific rules relating to the portrayal of body image in adverts, but the principles that underpin the approach mean that the ASA can take action against advertisers that portray the body image in an unhealthy or irresponsible manner, under clauses relating to harm or offence, for example. We expect the new advertising codes across all the media to contain new rules relating to social responsibility that would allow the ASA to take action.

Jo Swinson: It is interesting to hear the Minister speak about the new rules. Do I take it from what he says that he thinks the existing rules are not adequate, which is why the new rules will, as he hopes, subsequently enable action to be taken? As I pointed out, the evidence shows that the ASA tends to take action about adverts
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that can be proved to be misleading, but it does not have a strong track record of dealing with adverts in terms of socially irresponsible images and the harm they can do.

Mr. Simon: My sense is that the codes as they are already give the powers to the bodies in question to deal with those issues. What needs to happen is for the bodies in question to be persuaded through evidence and argument. This is not a new debate, but we are relatively early in the stage of what can consistently be argued in the public arena. The bodies have the powers; they need to see more evidence and more argument.

Jo Swinson: I appreciate the Minister's generosity in giving way. Given that the bodies can currently act and exercise their powers only where there has been a specific complaint, does the Minister believe that the balance is right? Should members of the public have to spot that an advert has been airbrushed? Let us face it, if airbrushers are doing their job properly, people might not be able to spot it or tell that it has happened. Does not the Minister think that a more proactive approach such as the labelling scheme that I outlined earlier to give consumers information would be a better way of tackling the problem than expecting individual members of the public to complain about specific adverts that have gone too far?

Mr. Simon: I understand the hon. Lady's point, but I think her argument against complaints goes a bit far, as that is generally how regulation and law work. It is not the case that when people do not complain, the system is not working. If the intent of the enforcement of the codes is right, the outcomes should follow, too. We do not measure success by the number of complaints-that is what I am saying.

Mr. Pelling: Putting to one side the application of complaints against specific advertisements, does not the Government take seriously the evidence of young women-either at the Priory or within the NHS-who are bulimic and are quite clearly suffering as a result not only of that illness, but of the impact of the false image that advertisers have put out about the merits of being an entirely thin, skinny and bony woman?

Mr. Simon: I am sympathetic to the hon. Gentleman's and the hon. Lady's arguments, but it is clear to me, having looked at the evidence, that it is not clear. The Buckingham review itself specifically concluded that the evidence was "mixed and inconclusive", as I said. The hon. Gentleman needs to help to make the case and find the evidence. If there is conclusive evidence that particular behaviour by the media leads to particular dysfunction not just in young people and not just in women but in people in general, all media regulators will need to take account of that and to act in whatever way deals with it appropriately. Currently, there is no such clear evidence.

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