Body image and mental health: our policy perspective

This policy summary is part of a series setting out the major changes needed to improve mental health in the UK. It draws upon Mental Health Foundation (MHF) research and analysis which can be found in the 'further reading’ section.

Content

• What is body image?
• Overview of the evidence
• Core principles and approach
• Recommendations for action

‘Body image’ describes how we think and feel about our bodies. Having body image concerns is not itself a mental health problem, but being concerned about body image heightens the risk of experiencing mental health problems.¹

Thoughts and feelings about our bodies can be complex. The concept of body image can include: how we view our bodies and how accurate this perception is; how satisfied we are with our bodies and appearance; and how much other people’s opinions about our appearance affect our feelings about ourselves.^2,3,4,5  

Having a positive body image means being satisfied with our body, holding respect for it, appreciating and accepting its abilities, and having a healthy balance between valuing our body and valuing other aspects of ourselves.^6,7,8  

The relationship between body image and people's mental and physical health

Higher body dissatisfaction is associated with a poorer quality of life and psychological distress,⁹ a higher likelihood of depression symptoms,^10,11 and the risk of unhealthy eating behaviours and eating disorders.^12,13 There is a close link with mental health problems such as body dysmorphic disorder (BDD) and anorexia and bulimia. 

Young People

Our 2019 research found that 40% of teenagers felt worried, 37% felt upset, and 31% felt ashamed because of their body image.¹⁴  

Body dissatisfaction and a pressure to be thin have been linked to both depressive symptoms among young people,^15,16and anxiety.¹⁷ Weight and body mass index (BMI) are correlated with body dissatisfaction, with young people who are overweight or obese reporting more depressive symptoms and lower self-esteem than their peers.^18,19 There is a higher likelihood of suicidal thoughts among young women who report extreme weight control behaviours (e.g. taking diet pills, diuretics or laxatives).²⁰  

In contrast, body satisfaction and appreciation are linked to better overall wellbeing²¹ and fewer unhealthy dieting behaviours.^22,23

Adults

Body image concerns affect adults, too. Surveys we carried out in 2019  found that only 21% of adults felt satisfied because of their body image in the last year, while one in five adults (20%) felt shame, and 19% felt disgusted because of their body image. Just over one third said they had ever felt anxious (34%) or depressed (35%), and one in eight (13%) had experienced suicidal thoughts or feelings because of their body image. 

What influences our body image?

Body image is influenced by a variety of societal factors: our relationships with our parents, wider family and friends;²⁴ how our parents, wider family and peers feel and speak about bodies and appearance;^25,26 exposure to images of ‘idealised’ or unrealistic bodies through mass media and social media^27,28,29 image-editing apps,³⁰and pressure to look a certain way or to match an ‘ideal’ body type,^31,32 image-editing apps,³³ and pressure to look a certain way or to match an ‘ideal’ body type.³⁴ 

Public mental health approaches to prevent harm, and foster resilience to such influences, must start in childhood. Prevention efforts should include widespread sharing of advice on how parents and carers can foster a positive body image in young children;³⁵ this is also important knowledge for the early years workforce.
 
Interventions and campaigns have mostly targeted predominantly white, female and middle-class populations and few are culturally specific.³⁶ There is therefore a need to carry out specific work targeted at other demographics, in order to understand how effective interventions are for different groups, including people from racialised communities.
 

• Everyone has a right to feel comfortable and confident in their own skin and we can take small actions in our daily lives to help foster a more accepting environment. 
• Much of the damage done to our mental health in society is driven by commercial practice. Governments, regulators and corporations themselves have a role in protecting us from this harm.
• Advertisers and social media companies have a particular role in damaging many people’s body image, and their regulators must do more to improve practice. 
• Instead of striving towards a single body ideal, we should all – individually, professionally and corporately – look to shape a society that embraces and champions the diversity of the human race. Body image is a public health issue that cuts across many parts of society, and responsibility for addressing it cannot sit in just one government department.
   

Government departments should work with arms-length bodies and industry to mitigate the body-image pressures people experience and interrupt the causal pathways that can lead to these significant harms to people’s mental health, as follows.

Regulating the online environment to reduce body image-related harms

• The UK government’s recently-passed Online Safety Bill is welcome, but looks unlikely to protect users from excessive levels of content that projects unrealistic body standards which can harm people. The legislation should be revisited to fully keep children safe from being algorithmically served excessive content that presents idealised body images, and to give adults the clear choice over whether they see it.
• Legislation should be introduced to put mandatory age restrictions on body- and face-editing apps, so that they can only be used by adults. Currently most apps have no age restrictions, thus often allowing children as young as five to download and use them. 
• Social media companies should investigate new ways of using their platforms to promote positive body image and to ensure that a diversity of body types is presented positively to their users.

Advertising

• DHSC should work closely with the Advertising Standards Authority (ASA) to tackle body-image pressures linked to advertising: 
• DHSC should encourage the ASA to update its Social responsibility: body image guidance to reflect a broader definition of unhealthy body image.
• The ASA’s sister organisation, the Committee of Advertising Practice (CAP), should recognise body image as a distinct harm and reflect this in the Codes governing non-broadcast and broadcast advertising.

Education and media literacy

• Early intervention in schools can be an effective way to reduce the impact of appearance-based bullying on people’s body image and wider mental health, and this should be an explicit focus of programmes to tackle bullying.  
• Departments for education across all nations of the UK should include education on promoting body positivity in the Health Education curriculum.³⁹ An example of this can be found in Scotland where a key action of the Mental Health & Wellbeing Strategy Delivery Plan 2023-25 is to develop a resource for schools to support conversations with young people on topics such as body image, screen time and social media.⁴⁰
• A body image and media literacy toolkit co-produced with young people, that includes content on critically appraising how commercial interests seek to influence consumers through use of body ‘ideals’, should also be a compulsory element of the curriculum. 

Public health advice, training, and campaigns

There is a role for many parts of government to help support people’s body image. For example:

• The Office for Health Improvement and Disparities (OHID) and public health agencies in the devolved administrations should update their parenting advice to include how parents and carers can from a very early age positively influence children’s feelings about their bodies,  and the NHS should ensure that training and guidance on parenting and healthy eating is provided to GPs, health visitors, dietitians, social care staff and other frontline practitioners.
• The UK government should review and critically evaluate the psychological impact of its obesity campaigns and move towards a more evidence-based strategy of this type, while also tackling the unhealthy environments that lead to obesity, as recommended by the UK Parliament’s Women and Equalities Committee.