Changing the perfect picture: an inquiry into body image Contents

2The extent, causes and impact of negative body image

The extent of body dissatisfaction

7.Our body image survey found that 61% of adults and 66% of children feel negative or very negative about their body image most of the time. Some 62% of women feel negatively about their body image compared with 57% of non-binary respondents and 53% of men. We found that body dissatisfaction is higher in those with certain protected characteristics: 71% of respondents with a disability reported feeling ‘negative’ or ‘very negative’ most of the time about their body image compared with 60% of respondents without disabilities. No transgender respondents felt ‘very positive’ about their body image and only 1% of Cisgender responders did.12 We heard that over the past 30 years the proportion of young people with body dissatisfaction, or who report trying to lose weight, has grown substantially. University College London (UCL) found that in 1986 only 7% of adolescents said they had exercised to lose weight, whilst in 2015 this proportion was 60%.13

Who is at risk?

8.Often, discussions around poor body image have focused exclusively on young, white able-bodied women but trends indicated that body image concerns were rising amongst many other groups.14 When considering who was most at risk of developing poor body image, we heard that body dissatisfaction and eating disorders are experienced disproportionately by some groups. These include early adolescents, including children as young as five years old;15 and women and girls, when compared with men and boys.16 However, both body image concerns and eating disorders are rapidly rising in men as are mental health conditions such as muscle dysmorphia and Body Dysmorphic Disorder.17 LGBT individuals are also at higher risk when compared to heterosexual or cisgender individuals. Stonewall reported that that 40% of LGBT adults more likely to experience shame due to their body image, compared to 18 per cent of their non-LGBT counterparts. Additionally, 12% of LGBT people said they had experienced an eating disorder in the last year, with this figure rising to 20% of trans people and 25% of non-binary people.18 Those with physical disabilities or with a ‘visible difference’ such as a mark or scar can also be stigmatized and discriminated against based on their appearance which can lead to the development of low self-esteem and poor body image.19 Higher weight individuals of all ages, when compared to lower weight individuals, are more likely to report body dissatisfaction, and this is particularly pronounced for women.20 Finally, there is evidence of poor body image being present across ethnicities and research doesn’t clearly indicate if any individuals of a particular ethnicity are at a higher risk. Ethnic minority groups can report increased levels of body dissatisfaction than white individuals due to additional appearance pressures due to racialised appearance standards, which can lead to dissatisfaction with skin colour, hair, and facial features.21

9.We took an intersectional approach to understand whether those with multiple protected characteristics (such as pregnant women or BAME LGBT men) were at an additional risk of developing poor body image. Stonewall informed us that 22% of LGBT people of colour compared to 11% of white LGBT people had experienced an eating disorder in the last year.22 The Centre for Appearance Research informed us that Black women, for example, may face body image pressures due to both gender and racial oppression.23 Dr Slater from the Centre For Appearance Research told the Committee that more research on intersectional experiences is needed but to presume that, if someone belonged to more than one of the groups described above, their risk of developing negative body image would be compounded.24

The causes of negative body image

10.The most persistent causes for body dissatisfaction reported to us included: colourism affecting people of colour where lighter coloured skin is viewed as more desirable; weight stigma against those with a higher body weight; exposure to media depicting unrealistic and narrowly defined appearance ideals causing body dissatisfaction in those not meeting these ideals;25 appearance-related bullying such being teased, criticised, or bullied based on one’s weight or appearance leads to poor body image, particularly during adolescence; minority stress from chronic experiences of stigma, discrimination, and victimization; gender dysphoria, and broader societal appearance pressure based on binary gendered appearance ideals; widespread use of image editing and digitally altered images; and increased social media use which is a space that emphasises the importance of image and beauty in society.26

The impact of negative body image

11.Thousands of people shared with us the ways in which negative body image has impacted their lives. These included: low self-esteem and lack of confidence; mental health conditions such as depression, anxiety and body dysmorphic disorder (BDD; the development of eating disorders and disordered eating; a reluctance to visit the doctor, exercise, join clubs, speak in classrooms and other important life activities; curtailed academic and career aspirations and performance; suicide ideation and self-harm; risky behaviours such as smoking, high-risk drinking, and substance misuse; reduced quality of life on markers of psychological wellbeing, academic, emotional, and social functioning; and the use of anabolic steroids (particularly in men) and medication to lose weight (including unregulated diet pills and laxatives).27

12.Our survey detailed the negative effects of body dissatisfaction and demonstrated that these can last a lifetime and be passed on to future generations. Reflecting on the range of harmful impacts stemming from negative body image, and the high prevalence of negative body image, Professor Chambers, Nuffield Council on Bioethics, remarked that:

body image is both a public health issue and an issue of equality and discrimination.28

Appearance-based discrimination

13.Appearance-based discrimination is discrimination based on how a person looks.29 This discrimination is also referred to by some academics, including Professor Heather Widdows, as ‘lookism’. She explained:

Clear parallels could be drawn between lookism, sexism and racism. Sexism has always existed but until we had a name for it we couldn’t really address the issue. Nasty comments based on appearance are still as invisible as sexist comments were in the workplaces of the 50s and 60s - we need to name the problem and then start to address it.30

14.Appearance-based discrimination is closely related to body image and has implications for many of the protected characteristics. Including:

Sex: Norms of appearance are highly gendered, enforcing gendered ideals and sexist ideals that affect both gender conforming and gender non-conforming people, whether they identify as trans or not. While women and girls are usually subjected to greater appearance-related pressure in the contemporary social landscape, the beauty ideal is being applied to everybody including men and boys. This can be evidenced by rising body dissatisfaction in all groups, but the rise for men is much higher.31 One respondent to our survey reported her fears that she wouldn’t gain employment in her desired sector as she felt wasn’t attractive enough and her weight was too high.32

Age. The dominant beauty ideals are also highly discriminatory in terms of age, in that older people, especially older women, are particularly susceptible to discrimination if they do not look young. The Nuffield Council of Bioethics had received accounts of older women seeking cosmetic procedures for career reasons, to avoid discrimination in the workplace.33

Ethnicity. We heard that the current dominant body ideal is, itself, highly racialised. Beauty norms about skin tone exist where it should not be too light or too dark—leading people to use skin lightening creams or tanning products. There are also dominant norms about facial features and hair, which can be racialised in terms of certain stereotypically westernised facial features and hair texture sometimes being preferred.34 The Mental Health Foundation reported that Black British girls are more likely to have higher satisfaction with their body image than their white British counterparts, and are less likely to display disordered eating behaviours.35 However, academics have also argued that by focusing predominantly on weight when discussing body image, the discussion can unwittingly miss key risk factors for BAME young people. These include being bullied or discriminated against due to hair style and texture, colourism within BAME communities, and the impact of lack of representation in the media.36

Disability. Disability is a major source of appearance-related discrimination because dominant body ideals do not include the disabled body. People with visible facial differences can face discrimination especially through misrepresentation in the media - for example those with facial scarring being portrayed as villains. Changing Faces found that 36% of people with a visible difference have been discriminated against in job applications because of their appearance.37

Sexuality. We heard that there are often appearance stereotypes associated with LGBT identities and appearance discrimination can affect these groups dependent on the current beauty norms. For example, lesbians could be discriminated against for looking ‘too heterosexual’.38

15.The Equality Act 2010 prohibits discrimination on the grounds of “protected characteristics” such as age, gender, race and disability (including severe disfigurement).39 The 2017 Youth Parliament Select Committee Report on A Body Confident Future also found that the influences on, and impact of, poor body image can only be understood by examining the specific context in which they occur.40 The social expectations and challenges associated with gender, gender identity, sexual orientation, ethnicity, disability, and socioeconomic background are all reflected in body image. The 2017 Youth Parliament and the APPG on Body Image have called for work to be done on how appearance-based discrimination could be tackled.41 These claims have been supported by the Nuffield Council on Bioethics and The Centre for Appearance Research.42 Professor Chambers told the Committee that:

Since all these characteristics are protected under the Equality Act, I do think there should be scope for using the existing legislation, the full range of powers under that Act, to enforce, advise and guide on challenging appearance-based discrimination wherever it occurs.43

Government work on body image

16.Body image is a cross-departmental policy area involving the Department for Health and Social Care (DHSC), the Government Equalities Office (GEO), Department for Education (DfE), and the Department for Digital, Culture, Media, and Sport (DDCMS).44

17.Under the previous Government, the GEO commissioned research ‘looking at the role Government can play in easing concerns of those who feel unhappy with how they look’, and held an event with social media influencers and bloggers to understand how best to raise awareness of the impact of poor body image.45 In its written evidence to the inquiry, the Government acknowledged the far reaching and damaging impacts negative body image can have.46

18.In January 2021, the GEO published its Report on Negative body image: causes, consequences & intervention ideas.47 This Report found that interventions aimed at tackling negative body image would be welcomed and that such interventions should be mindful that experiences of body image vary amongst different groups and change over time. This Report was completed in August 2019 for the previous Government. The current administration chose to publish it with a disclaimer:

This research was commissioned under the previous government and before the covid-19 pandemic. As a result, the content may not reflect current government policy, and the reports do not relate to forthcoming policy announcements. The views expressed in this report are the authors’ and do not necessarily reflect those of the government.48

19.Dr Slater informed us that:

We now have decades of research substantiating many of these things in terms of the appearance ideals and how well entrenched they are in society, and the effect of weight-based biases, stigma, and injustices. We have well established the serious negative consequences of body image dissatisfaction for young people and adults, so all these things now have a really substantial evidence base supporting them [ … ] There is always much, much more we can do, but it is time to do it and not talk about it anymore.49

We questioned Ministers on whether they considered further legislation necessary to protect those at risk of appearance or weight-based discrimination (discussed in the next chapter). Unfortunately, as a Minister from the Government Equalities Office (GEO) was unable to attend the session, we did not receive an adequate response from the Government in this area. Nadine Dorries MP, Minister of State for Mental Health, Suicide Prevention and Patient Safety, Department of Health and Social Care, informed us that protected characteristics are currently being looked at and evaluated in terms of the mental health impact of body image.50 The Minister for Digital and Culture, Caroline Dinenage, told us that the Government should work collaboratively across departments to address the issues around body image.51

20.People face appearance-based discrimination on a daily basis, at work, in schools and in public spaces. Whilst we were disappointed not to hear from the Government Equalities Office on their assessment of appearance-based discrimination, we are pleased that the Government is undertaking research on the relationship between negative body image and certain protected characteristics. Over the past 10 years, both Government and academics have produced a wealth of research and made numerous policy recommendations on how to tackle negative body image for people across the UK. Despite this, Government action in this area continues to be limited. The EHRC should produce guidance for individuals seeking to use the existing Equality Act legislation to challenge appearance-based discrimination within three months. The Government should widely promote the EHRC’s new guidance and publish the proposals resulting from its own research and update us on these within 6 months.

24 Q2

28 Q5

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37 Changing Faces, My Visible Difference, 2019

39 Equality Act 2010, section 4

40 British Youth Council, Youth Select Committee, A Body Confident Future, 2017

41 APPG on Body Image, Reflections on body image, May 2012 ; British Youth Council, Youth Select Committee, A Body Confident Future, 2017

43 Q6

44 Para 35, British Youth Council, Youth Select Committee, A Body Confident Future, 2017

Published: 9 April 2021 Site information    Accessibility statement