Body image and the aesthetic sector

Why the industry must lead the way in driving regulatory change

The UK Parliament’s Health and Social Care Committee has launched a report looking at the impact of body image on physical and mental health. The aesthetics sector comes under particular scrutiny in the report, principally in terms of how some within the industry both market themselves and operate.

Dr Ana Cristina Diniz Silva, an established cosmetic practitioner and programme leader for the MSc in Cosmetic Medicine at online education provider,

Learna, discusses the report and the role of the aesthetics sector in driving ideological change and embracing muchneeded incoming regulation.

WHAT IS THE HEALTH AND SOCIAL CARE COMMITTEE?

The Health and Social Care Committee is a cross-party Committee of MPs appointed by the House of Commons to scrutinise the work of the Department of Health and Social Care and related bodies.

The Department of Health and Social Care is the UK government department responsible for government policy on health and adult social care matters in England, along with a few elements of the same matters which are not otherwise devolved to the Scottish Government, Welsh Government or Northern Ireland Executive.

WHAT IS THE REPORT ABOUT?

The new report – “The impact of body image on mental and physical health” – outlines how people think and feel about their bodies and the steps they take to make perceived improvements, both of which have changed significantly in recent years.

A survey done in conjunction with the report found that 80% of respondents agreed or strongly agreed that their body image harmed their mental health, with 61% agreeing, or strongly agreeing, that their body image negatively impacts their physical health. Additionally, among younger age groups in July 2021, one in six children aged five to 16 in England was identified as having a probable mental health issue. The Committee received worrying evidence pointing to rising body dissatisfaction contributing to poorer mental health in young people, in particular, but not limited to, girls.

The report states that body image dissatisfaction and its associated health impacts can affect anyone regardless of gender, sexuality, ethnicity, or age, and this can result in increased health risks among certain groups, including an increased risk of suicide in those suffering from body dysmorphic disorder (BDD).

The report also makes clear that there is little evidence that the Government is doing enough to understand the scale of these risks and pointed out a need for a more thorough understanding of the mechanisms that connect body image and health issues.

DOES THE REPORT PLACE BLAME IN ANY DIRECTION?

The report notes that a principal lever for blame is the advent of social media and the rise in online advertising, which have increased exposure to certain idealised body types. It suggests that there is a potentially harmful link between online content that promotes a flawless, often doctored and unrealistic, body image and the development of low self-esteem and related mental health conditions.

While the report acknowledges the complexities surrounding the debate on digitally altered images, and that progress has been made with the Online Safety Bill, the Committee believes further action is needed in terms of both culture and legislation.

DOES THE REPORT MAKE ANY RECOMMENDATIONS?

Among a multitude of internal Governmental strategic recommendations to improve ways of working, one of the key stipulations they make in the report is for the Government to tackle misleading online content head-on by introducing 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.

This would include static images, as well as video content including Instagram Reels, where filters and other digital tools, like Photoshop, can significantly misrepresent reality.

That means any digital content branded as an #ad or #sponsored will have to include highly visible disclaimers.

In comments to the media, Jeremy Hunt, who chairs the Committee, has said: “… at the very minimum, when commercial companies photoshop images to make people more thin than they would be in real life, we think that should be labelled – we think people looking at those images should know this is not a real human being.”

Furthermore, and in a more wide-ranging approach to the problem, the report also recommends that the Government work with the industry, advertisers and the Advertising Standards Authority to encourage a wider variety of body aesthetics in commercial content, and encourage influencers not to doctor their images in the first place.

WHAT ROLE DOES THE AESTHETICS INDUSTRY HAVE TO PLAY?

The industry has a two-fold responsibility here. The first is an ideologically led role, to act as advocates, pro-active participants and guardians in the delivery of the common-sense recommendations in the Committee’s report to help tackle the issues associated with bad body image.

The second is a more practically led approach, clearly outlined in the report - recommendations which, if and when they are implemented, will overhaul certain aspects of the aesthetics sector from the ground up, bringing with it higher levels of regulation and significant improvements to patient care and outcomes.

WHAT ARE THESE RECOMMENDATIONS?

While the report calls for major changes to the way the industry portrays itself online, it also calls for significant offline regulatory updates which will greatly impact the way the sector can legally operate.

Many of the recommendations, including an end to the dangerous ‘conveyor belt’ of procedures undertaken by underqualified practitioners by bringing forward a licensing regime, as well as the introduction of mandatory prescriptions for dermal fillers - echo many of the provisions in the Health & Care Act, that is currently making its way through Parliament.

The Act, which received Royal Assent in April, enables the Health Secretary to roll out comprehensive new legislation which will work to regulate a sector that until now has operated largely free from legal oversight.

The new legislation will likely cover many aspects of the sector, from health and safety to insurance, banning treatments to under 18s and outlawing adverts across all forms of media which target those under that age group.

Crucially, a new licensing scheme will also establish mandatory education levels for practitioners, which include the necessity for certain qualifications, as well as the legal requirement for practitioners to register to be licensed to practice non-surgical cosmetic procedures.

HOW CAN PRACTITIONERS REGISTER AND WHAT QUALIFICATIONS WILL LIKELY BE REQUIRED?

It is expected that the Government will work with the Joint Council for Cosmetic Practitioners (JCCP) to manage the licensing requirements of practitioners. The JCCP is the body that registers practitioners and approved education and training providers with the key remit of ensuring patient safety.

The JCCP has long been lobbying to administer the new license and has outlined its proposal in a “Ten Point Plan for Safer Regulation in the Aesthetic Sector”.

It is expected that to register, and ultimately to legally practice, cosmetic practitioners will be required to hold an accredited qualification, such as a Level 7 qualification, e.g. - apostgraduate certificate in aesthetic medicine. Alternatively, there will likely be the option to pass a Fast Track Assessment (FTA).

Online medical learning platform, Learna, is the exclusive provider to the JCCP to deliver part one of the JCCP Fast Track Assessment (FTA). The Learna/JCCP FTA is specifically designed for aesthetic practitioners looking to register with the JCCP who don’t already hold a Level 7 postgraduate qualification. It offers an alternative to more costly and time-consuming qualifications for practitioners who do not have the time or resources to gain postgraduate medical qualifications.

The successful completion of the FTA will not only provide practitioners with a more convenient way of applying for JCCP registration but subsequently reassure clients of a practitioner’s competency of practice and demonstrate clear prioritisation of public protection and safety.

ARE THERE ANY RECOMMENDATIONS IN THE HEALTH AND SOCIAL CARE COMMITTEE’S BODY IMAGE REPORT, SPECIFIC TO THE AESTHETICS SECTOR, THAT AREN’T ALREADY IN PLACE WITHIN THE INCOMING HEALTH & CARE ACT?

While the specific details of the Health & Care Act that relate to the aesthetics sector are yet to be confirmed, the new body image report goes further in its demands than the incoming legislation is likely to cover.

One of the key recommendations in the Committee’s report is 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 as a mandatory 48-hour cooling off period between the consent process and undergoing the procedure.

Such a recommendation has been made with the full weight of the report firmly in mind, following the inclusion of numerous first-hand accounts of rushed treatments organised via text, done in poor environments, with little to no consultation beforehand, and often conducted on patients who could be considered vulnerable due to their compromised mental health due to poor body image.

Introducing new legislation of this nature would ensure that anyone planning to undertake a non-surgical cosmetic procedure is given the time and space to consider their decision and weigh up the risks and benefits.

DR ANA CRISTINA DINIZ SILVA

Dr Ana Cristina Diniz Silva is the Programme Leader for the MSc in Cosmetic Medicine at online education provider Learna. Dr Silva has years of experience as a cosmetic practitioner, providing treatments including botulinum toxin injections, non-surgical lifting with threads, hyaluronic acid and calcium hydroxyapatite fillers, and fractional laser treatment.