§ Order for Second Reading read.
§ 1.9 pm
§ Mrs. Alice Mahon (Halifax)
I beg to move, That the Bill be now read a Second time.
It is important to put it on record that when I introduced the Bill last year I was completely overwhelmed by the response and the support that it received. I received great support from the media, national newspapers, women's magazines, the medical profession, eminent nutritionists such as Dr. Tom Sanders of King's college, the Advertising Standards Authority, the Royal Pharmaceutical Society and an active organisation called Diet Breakers founded by Mary Evans Young. Most important, I was also bowled over by the support that I received from thousands of women, and a few men, who have tried dieting, sometimes for years, and have either poured money down the drain and regained any weight lost after a couple of years or damaged their health, sometimes seriously.
It was the health hazards of dieting that first caught my interest as a Member of Parliament. A few years ago, two young girls and their mothers visited me at one of my weekly advice surgeries. Both girls, who were very young, were suffering from serious slimming illnesses. One of them had decided when she was 11 years old that she was too fat. She wanted to look like the skinny models on the catwalks and in girls' and women's magazines. She set about starving herself to fulfil her aim. She did so secretly, without her parents knowing.
For at least two years, her anxious parents fretted about her weight loss, listlessness and mood swings. Only when it was almost too late did they find out what the truth. They then sought help because she was suffering from severe anorexia nervosa. The girl, who is now almost 17 years old, is still ill. She does not have periods and doctors fear for her fertility. There have been many well-publicised extreme cases involving young women who have been slimming. Some have ended in death. I shall deal with slimming diseases in a moment.
Further investigation on my part led to the discovery that we have an epidemic of dieting in the United Kingdom and, indeed, in the western world. In this country, 90 per cent. of women diet at some time in their lives. At any given time, 50 per cent. of women are dieting, including girls as young as seven and eight and women as old as 75.
I also discovered that a multi-million pound diet industry operates in this country—it is worth about £1 billion a year. We spend about six times the gross national product of the Gambia on gimmicks such as patches, tablets and various courses and cures, trying more often than not to be unhealthily thin while many people in the developing world are dying because they do not have enough food and subsequently suffer starvation.
Sadly, many of the people who diet do not need to do so. The vast majority have absolutely no reason to diet. I teamed up with Diet Breakers and Mary Evans Young because I liked their positive approach to the subject. So much about dieting is shrouded in secrecy and misery and depends on people's insecurities. Diet Breakers was like a breath of fresh air. It opposes the diet industry by and large and opposes what it calls the tyranny of thinness 1343 which has gathered so much momentum in this country. Diet Breakers and Dr. Thomas Sanders of Kings college, who wrote the very good book "You Do Not Have To Diet", gave me considerable help when I was drawing up my Bill to regulate the industry. I would like to record my thanks to Mary Evans Young and Tom Sanders.
Mary Evans Young is bringing out a book that I hope will offer help to thousands of women who are going through the misery of dieting. "Diet Breaking: Having It All Without Having To Diet" is an excellent book. It is a fresh approach and full of common sense. Let us hope that many people read it and that the young, especially, have access so it.
My Bill would regulate the diet industry by requiring weight-loss centres to display prominently a health warning that rapid weight loss can be dangerous to health. All weight-loss companies would have to provide consumers with a card which clearly outlines the risk of any rapid weight loss. Anybody selling such products or running a clinic would also have to disclose any additional charges because too often the consumer buys a product and then discovers that extra charges are incurred when the diet programme is devised. There are many cons in the industry.
Most importantly, my Bill would also require that all weight-loss pills, potions and patches are brought under a medicines Act and, of course, that medicines such as amphetamines and amphetamine-type pills are not given to aid slimming. I very much welcome and congratulate the Minister on his press release on 29 March, which was presumably in response to concerns being expressed in the media, by organisations such as Diet Breakers and, indeed, by hon. Members. The Minister said that a move to ban the use of certain amphetamines and amphetamine-type drugs as aids to losing weight would be shortly under way.
The press release says:The Medicine Control Agency, an executive of the Department of Health, is to start consultations with a view to restricting the use of such drugs, under section 62 of the 1968 Medicines Act, under certain circumstances.I know that the Minister has taken an interest in the matter. He clearly and rightly describes in his press release what is so wrong when he says that a number of doctors have set up slimming clinics to prescribe amphetamines, which are addictive drugs, as an aid to weight loss.
Such drugs have dramatic and devastating effects when they are dished out to some women. There have been reports, as the Minister said, of people being damaged mentally and physically by the drugs and of them leading to addiction and psychosis. There have also been reports of hair loss, palpitations and other side effects. I welcome the press release. The Minister has taken a positive move and I hope that that ban does not take too long to implement.
I should like to tell the House about some of the many hundreds of letters that I have received since I started looking into the industry and, in particular, into the use of drugs which are dished out like sweeties in some of the clinics to which the Minister referred. I shall not give the name of the person who wrote this letter, but it says:Dear Mrs. Mahon,I have been meaning to write to you for some weeks following a report on the BBC news about your involvement in trying to have the slimming business regulated. The enclosed newspaper article can only describe to some extent my experiences in what I can only describe as a year of hell.1344 That person goes on to describe how she was horrified by the side effects of the pills, which appear, she said,to be generally well-known among the medical profession",yet doctors still give them out.
An article from Woman's Journal which my correspondent enclosed talked about experiences similar to her husband's. Woman's Journal also outlines a couple of cases that I think are worth putting on the record. One concerns a woman who was brave enough to give her name—Susan Weeks, aged 34. She was a stone heavier than she would have liked to be. Five years ago, six weeks before her marriage, she decided to lose the extra stone before her wedding day. She saw an advertisement in the yellow pages for a local slimming clinic and she made an appointment. In her words:I only saw the doctor for a few minutes. He just asked me a few questions, weighed me and gave me two sorts of pills, plus a vitamin supplement and a diet sheet. On the day I married I was the thinnest I'd ever been. I also felt terrible—hypersensitive, panicky and weak. I put it down to stress, but I knew it was the pills and that diet. When I came back from the honeymoon—nearly back to my old weight and feeling really well—I saw the remaining pills and flushed them down the loo.Other experiences did not end as positively as that.
A well-documented case, which the Daily Mail highlighted fairly well, was that of Christine Malik who died the day after taking pills prescribed to help her lose a few pounds before her holidays. Another woman was not even seen by a doctor before she was given diet pills, although they were a controlled drug described as amphetamine-like and chemically related to ecstasy. As a result, the clinic was searched and two arrests were made. That woman was given the pills although she was not even seen by a doctor. That is an example of the dangerous practice now taking place.
I also put on the record another case which came to me from Mary Evans Young of Diet Breakers as we were collecting evidence and information for the Bill. The case concerns a woman called Mandie who is 5 ft 10 in tall—she is quite a tall woman—and weighs 12 stone. She is 22 and works in a factory. She writes:My one wish is to be able to forget dieting and stop worrying about my body size. I have been dieting non-stop for as far back as I can remember. My mum has always dieted too, and so after 1 received a few jokes about my size at school, I decided I would follow suit.I began to get paranoid and one of my earliest memories of how miserable worrying about my body size is quite funny. I was in the junior school (so I was younger than 11) and besotted with horses like many young girls at that age.She was very much in love with horses. The letter continues:The walls of my room were covered in horse posters and religiously, every night before I got undressed, I would pull the top two pieces of Blue-Tak from the wall so that the horses' heads faced towards the wall and they couldn't see my body as I undressed! Then, before I got back into bed every poster was put back again. This ritual was repeated for years.It is really, really sad that a young girl is so obsessed with how she looks and with her image that she resorts to that when she is less than seven years old.
The letter continues:
Until recently, dieting had become just a part of my life. Every Monday I began a new diet. Although I was not huge I didn't like myself and my body because if you are told something often enough, you start to believe it. Anyway, I got more miserable and tried more and more diets. With each one I lost weight initially, but after sticking to it for a short while I put on everything I had lost plus 1345 some more. I hit rock bottom, became very depressed and would cry for no reason at all. Going out became really hard for me as I was ashamed of myself and couldn't bear to be seen in public. Eventually I got some counselling and as a result I have come to realise that my problems stemmed from the pressure on me to be slimmer than my healthy natural body size.Mandie's experience is the experience of thousands who are daily bombarded with images of unhealthily thin models on the catwalks. Magazines are full of pictures of size 10 women, but we all come in different shapes and sizes; we are not all alike.
When I was young Marilyn Monroe was my role model, and I used to take bottles and bottles of stuff called Weight On in a desperate attempt to put on a few pounds. Later in life I developed gallstones, much to the surprise of my doctors, who said that sufferers were usually people older and fatter than myself. I am pretty sure that all that stuff that I poured into myself contributed to that illness.
So there was pressure even then, although it is far more intense now than when I was younger. A lack of self-esteem and a desire to look like those whom the image-makers portray as beauties makes many young girls dissatisfied with their bodies. And that now applies to boys, too, because sadly the fashion industry is targeting boys. All those advertisements showing boys in slim-fitting jeans are part of that process.
Diet Breakers undertook a survey to establish the patterns of dieting, and asked where the pressure to diet comes from. The survey, which was extremely interesting, covered 516 women, and 45 per cent. of them answered that the pressure came from the media and from the fashion and advertising industries, whereas only 15 per cent. said that it came from doctors.
When asked what part of their bodies they felt most negative about, 25 per cent. said stomach, 15 per cent. thighs and 15 per cent. bottoms. When my Bill of the same name was before the House last year the hon. Member for Mid-Staffordshire (Mr. Fabricant) said that the diet industry provided a useful back-up service for the overstretched national health service. The statistics that I have quoted show that argument to be flawed, although well before the survey, common sense also showed that it was flawed.
Those figures show why the diet industry's chief guru, Rosemary Conley, gives her books titles such as "The Hip and Thigh Diet" and "The Flat Stomach Diet". But Mrs. Conley's own health has not always been good. Like me, she has had gallstones, which is a common ailment among constant dieters.
The survey also asked for the reasons why people could not accept themselves as they were. Low self-esteem was mentioned by 32.5 per cent. of respondents. In other words, that multi-million pound industry is exploiting women's low self-esteem by promising them success, not only in losing weight but with the implied new life that is supposed to go with it.
The Diet Breakers survey also asked, "Did your mother diet?" The results show that dieting runs in families. That has been my experience too. People write to me about it, and one woman in particular sticks in my mind. She said that she had stopped going to Weight Watchers because she had had to rethink dramatically about dieting. She had been taking her 11-year-old daughter, who was very slender, with her to Weight Watchers, and had noticed that even she 1346 was becoming interested in losing pounds as a way of life. I found that quite frightening and very honest, and I was pleased that the woman joined Diet Breakers.
Sixty-four per cent. of the respondents aged up to 41 said that their mothers had dieted too, whereas 72 per cent. of respondents aged 60 and over said that their mothers did not diet. That too is an interesting statistic.
Dieting has become an unhealthy national epidemic. We have been encouraged to believe that a diet for losing weight is the same as a healthy diet, but the two are completely different. A healthy diet means being able to enjoy food without feeling guilty. Only then can people develop a well-balanced diet and a healthy lifestyle. Eating what one fancies and stopping when one is full is natural and healthy.
The diet industry, with its gadgets and gimmicks, its meal replacements and low-calorie dinners—we have all seen them—does not teach people to develop a healthy relationship with their bodies and their food. That is why the British Dietetic Association supports my Bill.
Another element of the diet industry rip-off is the so-called "meal replacement" such as biscuits, bars, milk shakes and "healthy" ready-made meals. Those products can cause people to lose weight too quickly, which means a loss of lean tissue and a lowering of the metabolic rate. They can cause people to have poor nutritional value, as most of the products are high in fat and sugar. All the biscuits and bars are low in protein, and we need protein to live for any length of time.
Many of the meal replacements are not significantly lower in calories than many snack foods. They also encourage unhealthy eating habits because of their emphasis on biscuits, sweets and high-fat snacks. They are also enormously expensive, and people are getting ripped off. They are much more expensive than buying fruit and vegetables and having a balanced and healthy diet.
We have also mentioned the diet pill part of the industry, and I am pleased to say that the Royal Pharmaceutical Society—the professional body of pharmacists—supports what I am trying to do. It says that the marketing of products and the claims made for them are a matter of concern. The society believes that the products should be subject to the controls of the marketing of medicinal products.
In addition, the society is concerned about the widespread and inappropriate use of appetite suppressants, and the extent to which these are supplied through slimming clinics to customers who may be unaware of the effects of the medicines. Another young woman who had taken slimming pills told Diet Breakers about what happened to her, and I received similar letters during my campaign.
The young girl said that the first diet pill that she took made her feel dizzy and unwell. She went back to the clinic, and was given a different bottle of pills. These made her hair grow thin and start to fall out. She was worried, stopped taking the pills and returned to the clinic, where it was suggested that she try a third type of diet pill. She took those and her hair regrew, but this time it was permanently grey. She was only 23 years old.
Some 5,000 children in this country are being treated for eating disorders on the NHS. Children as young as seven and eight are dieting and feeling that they are too fat. As legislators and people interested in health, we must 1347 teach children to be positive about their body image. The Department of Health is trying to promote healthy eating in its documents on health, and we must teach children that they can look attractive if they are a different shape from the person sitting next to them, or if they have more weight, are taller or have longer arms. Those differences do not mean that a person cannot be attractive and important.
The all-pervasive arm of the diet industry reaches out. The recent survey by Diet Breakers showed the effect that mothers had on their children, but there is also evidence to show that the attitude gets into the classroom. There are now sponsored slims being held in classrooms, and that is irresponsible. "Home Alone", a children's film recently shown on television, was sponsored by Diet Coke, but healthy children who are getting plenty of exercise and who have a healthy diet do not need Diet Coke. It is the subtle introduction to the diet mentality that is worrying. People are losing their right to be viewed and valued for who they are and for their personality.
On 6 May this year it is international No Dieting Day. I have to give it a plug before I finish my speech. It is important that people get together and support each other. No Dieting Day has now become international. We have contacts with people all over the world who have been on the treadmill of dieting and want to get off or celebrate the fact that they are off it.
People throw the accusation at us that serious slimming diseases such as anorexia nervosa and bulimia are complex and simply dieting does not bring them on. I have done some work on eating disorders. The Eating Disorders Association is made up mainly of parents or people who have suffered slimming illnesses. They all say that all serious slimming illnesses start with people dieting. There may be other causes, although I am not medically qualified to say yes or no. The Eating Disorders Association says:Exciting, new, and miraculous diets, promising weight loss with minimum effort or discomfort are featured every week in various women's magazines, followed by pictures and recipes for delightful, easy to bake treats. As a result, many women worry continually about what they can and cannot eat and it is not surprising that so many turn to dieting.Most people with eating disorders start by dieting. They start by reading how they should look and how they should not look.
Rachel Bryant-Waugh, the principal clinical psychologist working on slimming diseases at the Hospital for Sick Children at Great Ormond street has written an excellent article which goes through the complexities of slimming diseases. I do not pretend that such illnesses are caused simply by dieting. She says:
Predisposing background conditions include cultural factors such as the current obsession with slimness … and possibly factors related to family, school or work.I pay tribute to a woman whose daughter killed herself recently. Her story was in the Mail on Sunday magazine. She wanted to speak out about her daughter Karen's suicide. It must have been incredibly difficult for her to speak out. Mrs. Ros Frewer told her story to the press because she wanted to warn other parents to watch out for such problems. The young woman had been starving herself. She was bulimic. She had seen a GP and a counsellor, but had kept the illness secret. She was a lovely girl with her whole future in front of her.
1348 Mrs. Frewer said:It's clear that Karen desperately wanted to be thin. In fact, she was an attractive, fashion-conscious girl, who hovered between sizes 12 and 14—a long way from fat, but she couldn't see it.The image makers got to her. She decided that she could not cope with how she was.
The British Dietetic Association, which supports moves legally to regulate the diet industry, says:Western society tends to see 'thin as good' encouraging many people, especially women to 'diet' unnecessarily.It goes on to say how many women diet. It points out thatonly 16 per cent. are obese ie have a body mass index of 30 or more. This may be detrimental to their physical and psychological health".It will be more detrimental to them if they do not go to a doctor and reduce their weight properly. It can positively harm them if they go on extreme diets or use patented slimming medicines or potions. Such medicines are ineffective with someone who has a genuine problem of obesity.
State registered dieticians are well-qualified people. They will tell you that it is a healthy diet that matters. It is not all these gimmicks and quacks.
I cannot sit down without paying tribute to the media. It is most unusual for Members—especially Opposition Members—to pay tribute to newspapers such as The Mail on Sunday, the Daily Mail, The Sun and the Daily Mirror. I must also pay tribute to The Guardian, The Daily Telegraph, the Bolton Evening News, the Yorkshire Post and Central Television, Scottish Television and the Kilroy-Silk show. I apologise if I have left out anyone who has mounted a major campaign. In the past few years, all have responsibly looked into clinics and the Jack-the-lads who are peddling all sorts of rubbish and nonsense and highlighted some of the extreme end of the market. We should say congratulations.
Women's Realm, which has been responsible for selling some of the foods in the past, produced an excellent article not long ago, entitled, "Made ill by diet doctors." I have only received one bad report from a newspaper—Maggie Drummond in The Daily Telegraph suggested that I only had half a brain because I was taking this issue seriously. The fact that only one journalist failed to recognise that the issue is serious is not bad going and the press should be congratulated.
The proposals in the Bill are fairly modest. The Minister is going to tackle the most wicked side of the diet industry, but I want to go much further. I might introduce another Bill later this year, as I want to add the provision that anyone offering weight loss or spot reducing services and advertising them to the public should have to register annually with the Department of Health and submit the following information. Such services should be provided by trained and qualified personnel, who also provide counselling as well as weight loss services. Ingredients and nutritional information should be provided for any food, formula or drug products sold or provided as part of a weight-loss programme so that everyone can see what is in them.
If the service has been on offer for a year or more, a record should be kept of the number of clients in the previous year who successfully achieved weight loss according to the programme's goals. Information on the total number of clients served in the previous year should be provided and, in the case of diet clubs, a breakdown 1349 between new members and those rejoining because they have failed. We should also know how many clients have reported medical problems linked to the weight loss service.
Every person, firm or corporation registering pursuant to the legislation would be charged a fee so that the service would not cost the Department of Health anything. The Department should compile the information and make it available to the public in a report every year.
We are going for healthy eating and we recognise that what we eat when we are young often dictates our health in later life. A healthy diet is good preventive medicine and could save the national health service a lot of money. The Department of Health could periodically review the records of firms and corporations advertising weight-loss services, to verify the accuracy of the information submitted. Those aims are fairly moderate and could be worked into another Bill.
The Advertising Standards Authority has tightened its code of practice, which is very welcome, and I was interested to see recently that a company in Birmingham had been fined £15,000 for selling misleading slimming aids. Vitahealth Ltd., which supplies the aids by mail order, was charged with six offences under the Trade Descriptions Act 1968. I am pleased about the fine because there are no miracle pills or slimming cures—I will not go into the worst excesses now as I did so when I moved the Bill. They do not exist. Nothing replaces exercise and healthy eating. We should accept how we feel about ourselves. Fat, thin or indifferent, we all have something to offer.
The fourth international No Dieting Day on 6 May will give us a good opportunity to promote and celebrate good health and self-acceptance. People from Canada, Australia, New Zealand, the United States and Norway will participate. The other weekend, I took part in a radio phone-in to a live Australian chat show which was dealing with this matter, and the Australian health department is taking the matter extremely seriously. Common sense recognises that peddling ill health works to the cost of the health service.
We shall hold a press conference in the House of Commons on 3 May; I shall present a further early-day motion, which I hope will have all-party support; and a book by Mary Evans Young will be published on 20 April. So good things are happening. I hope that the Minister will act quickly against the peddlers of misery in slimming clinics. I commend the Second Reading of my Bill to the House.
§ Lady Olga Maitland (Sutton and Cheam)
I congratulate the hon. Member for Halifax (Mrs. Mahon) on introducing this important Bill. It deals with a matter that has always worried me, and I am delighted that the hon. Lady is acting while we have stood around waving our hands in anguish and concern.
The time has come to stop peddling quack remedies and to bring an end to the neurotic obsession with dieting, which began not in recent years but some 70 years ago. It gathered speed after the memorable phrase by the late Duchess of Windsor, who said that one could not be too rich or too thin. I do not mind being a little too rich, but she put on the map the idea that, if one wants to be successful and smart and to make one's way in the world 1350 and attract good-looking men, such as we have in the Chamber today, one must be extraordinarily pencil slim to the point that, ultimately, it is dangerous to one's health.
We must pay serious attention to this matter. I applaud the plea by Dr. Tom Sanders for more common sense about eating habits. He said that we should bring to an end the soothsayers of slimming pills and magic potions and return to a sensible approach to our lives.
I am sorry that I did not have a chance to meet the Diet Breakers organisation. From what I have heard and read, it sounds as though it is doing excellent work in breaking a myth. That myth has built a billion pound industry in this country alone. In America, which is the founder of many of our cultural developments, it is a $50 billion industry. That is an export to this country which I am happy to send back.
The Bill wisely does not try to tackle too much. If one goes for a limited area, one has a chance of getting it into operation. I congratulate the hon. Lady on suggesting that we should bring a little rationality into our lives and ensure that people understand the risks involved. I agree that risks must be properly advertised so that people understand that rapid weight loss can be dangerous to their health. Likewise, any book, recording or video that is promoted on that subject must carry a health warning, as customers should know not only the benefits but the risks. The customer is entitled to know the timetable of those diets. They appear to be never-ending.
The customer also needs to know the charges. If there is one industry in which an enormous scam is going on, it is the diet industry which is making a fortune having promoted itself through a host of media.
The Daily Mirror conducted some research about the clinics that promote those different drugs and diets. It sent out some researchers—I have to say, anonymously—to investigate what was on offer. The Daily Mirror described how a researcher, Kate,visited … the Kings Private Clinic in Paddington Street … she was charged £25 and given a six-week supply of ionamin. She wasn't told that the drug can cause nervousness, nausea and insomnia.That is highly dangerous.At Dietmania in London's Harley Street, she was given a three-week supply of ionamin for £50 and told not to worry about side-effects.Another researcher, Sue, visited the Swiss Cottage DIET Clinic in North London, where they gave her a one-week supply of duromine for £13, with a limited explanation of the side-effects.At the Medical DIET Centre in Harley Street she was not given any drugs but was charged £50 for a consultation and single sheet of paper"—talk about an easy way to make money.
The terrifying thing is that, as the Consumers Association, which has investigated the industry very carefully, says,Anyone can set up a clinic. And although you need to be registered to buy the drugs and prescribe them … there is concern thatthere are clinic doctors operating in the field who are not registered.
We must be sure that patients and people understand the harmful effects of those appetite suppressants, the diuretics and thyroid hormones. Some people definitely must not take those potions, especially people with heart diseases, high blood pressure, asthma, epilepsy or glaucoma and those who are pregnant.
1351 All those are serious warnings that the industry has spun out of control. We should listen carefully to people who have studied the industry and who utter health warnings of their own. For instance, I draw the attention of the House to the words of Peter Bazalgette, the executive producer of the BBC's "Food and Drink" programme, who has studied the matter for a long time. He says:It's heartening to see scientific research mustered to join the attack on our appalling 'dieting' mania. The triple tyrannies of the diet, fashion and health industries have conspired to give us a wholly misleading idea of what a healthy weight is. In fact, we now know that the plump live longer than the very thin.There is hope for us all.
I refer again to Professor Tom Sanders, because I think that he has managed to strike the key note on the topic. He is the professor of nutrition and dietetics at King's college, London. He said on one occasion:
The health risks of obesity are often exaggerated compared with other lifestyle aspects such as smoking and drinking. It does increase the risk of diabetes and arthritis. But the health risks of plumpness are negligible: it may even offer advantages to women. The evidence against weight cycling isn't sufficiently compelling to deter the very obese or people with metabolic conditions such as diabetes from controlling their weight.As time is getting short, I simply want to place on record the support that I give to the hon. Member for Halifax.
I have noticed the way in which our culture has spread dieting mania throughout the country, especially among the young. There is barely a teenage girl who has not said to me, "I am dieting." I have a lovely daughter of my own, aged 19. She watches her weight, but I would be extremely angry with her if I found her going down that obsessive road. It led one or two of her friends to suffer from anorexia, which is the curse of the modern age and, in a sense, of prosperity. One would never find people of the third world opting to diet in such an obsessive and extraordinary way.
We need to enhance education about healthy eating and healthy living habits. It is a curious paradox that today's teenagers are far larger than their parents. They are all giants. One need only visit any university to see that they are bigger people than those in older generations. That is why they should not try to judge their ideal weight according to standards set in the past. They all weigh in at a bigger, healthier weight than their predecessors. That is all the more reason why we should tell them to accept that weight and be proud of that. It will guarantee that they have healthy lives unless they wreck them by falling for the media hype of the diet industry, which, frankly, has conned thousands and thousands of women to profit the pockets of those who run that industry without offering any benefit to others.
I have one word of advice. Let us go back common sense. I believe in moderation, but a little bit of what you fancy does you good.
§ Mr. Jacques Arnold (Gravesham)
I came to the House this morning to support the Proceeds of Crime Bill. I am also interested in a number of other Bills before the House, should we discuss them today. When I noticed from the Order Paper that the second Bill set down for 1352 consideration was the Regulation of Diet Industry Bill, I saw red, because anything that starts with the word "regulation" has that effect on me.
When I got a copy of the Bill, which was introduced by the hon. Member for Halifax (Mrs. Mahon), I noticed that it was sponsored by a further 11 hon. Members, all of whom could be described as luminaries of the trendy left. I therefore began to smell an appalling rat.
When I looked at the names of the 11 sponsors, two things came to mind: first, they are all enthusiasts for the description of being politically correct and, secondly, not a single one of them is in the Chamber now to support the Bill. When I looked down the list of sponsors, I also thought that some of them were structurally challenged, but you would rule me out of order, Mr. Deputy Speaker, if I said who I meant, which would, indeed, be ungallant.
I am grateful to the hon. Member for Halifax, however, because her speech was an extremely useful opportunity to air the subject of slimming and the dangers that can arise in far too many circumstances. In that sense, the debate is useful.
I approached the debate with some trepidation, because I have just come from the Members' Dining Room, having had a good lunch. I thought that I could get into immense trouble if I spoke, particularly when the menu in the Dining Room offers an array of hefty puddings, including syrup pudding, coconut sponge, bread and butter pudding, jam roll and chocolate sponge. A diet of such puddings would almost have the diametrically opposite effect of the general meaning of that word on those who consumed them.
I agree with the hon. Member for Halifax that it is far better to rely on fresh vegetables, salads, fruits, good red meat, good healthy eating and a lot of exercise. The House will not be surprised to learn that, with my French name, I adopt that approach.
I have considered the Bill in detail and I should like to draw the attention of the House to a number of its clauses and subsections. Clause 2(1)(a) requires that any person in the diet industry shouldensure that at any premises where he carries on his business a notice is prominently displayed stating that rapid loss of weight is dangerous to health".That is an extremely broad generalisation, because in a number of cases—only medically qualified people could state it case by case—it may be beneficial to lose a lot of weight. It would be rather dangerous to put up such broad-brush notices as that suggested by the subsection.
Clause 2(1)(b) also requires that a person engaged in the diet industry shouldcause any book, recording or video work which he produces to carry a notice stating that permanent loss of weight is unlikely and cannot be guaranteed".That is a broad statement, which could not be said to be the case. It is wrong to produce a propaganda statement in such a generalised form.
After all, far too often a certain product is advertised on our television screens—time and again, it is thrust down the throats of the British public. It is presented by a young salesman with a winsome smile and using warm words. He even comes from a Tory family. The product he sells is very dubious. It includes advertising slogans such as being tough on crime and the causes of crime and other similar soundbites. Should we necessarily attach to the product the description that that is unlikely and cannot 1353 be guaranteed? With that product, I would certainly say that because of the Labour party's record over the last few decades. Therefore, we must be careful about obliging people to put a description on a particular product.
Clause 2(1)(c) requires that other notices should be displayed, for example, to outline clearlythe benefits and risks of loss of weightor to providean estimated or actual timetable for any diet which he"—the practitioner—proposes that the customer should follow".Surely much of that is common sense, so I wonder whether it should be included in a notice, a booklet or in straight medical advice, which we receive from our doctors if we are worried.
It is important that the House ensures that a Bill such as this draws a careful distinction between the overwhelming majority of responsible doctors and the minority of quack doctors. We must not throw out the baby with the bath water by tarring good, responsible doctors—of whom there is a vast number—with the same brush as those quack doctors who are guilty of disgraceful and unscrupulous behaviour.
Quack doctors are nothing new; we need only go back through the centuries to see the many quack remedies which existed and which, in fact, are an absolute disgrace. Queen Elizabeth I covered her face with a white material that had a lead base because it was deemed to make her beautiful. All the lead did was to corrode the body. Many of the ancient quack remedies were stuffed with lead components that had a disastrous corrosive effect. It was all done in the interests of so-called good appearance.
We do not have to go back through many decades to recall women squeezing themselves into corsets to produce a wasp waist, with all the damage that that did to internal organs. The wish to look good can be extremely dangerous, but to produce broad generalisations that will sweep up the good doctors as well as the quack doctors, to whom we are all opposed, is a bad idea.
The hon. Member for Halifax introduced a ten-minute Bill last year in which she gave examples of products. She said that for one cream it was claimed thatall one has to do is to lie on one's back, rub the tummy and the fat will disappear."—[Official Report, 29 June 1994; Vol. 245, c. 816–17.]She advised people not to try it as it did not work. That is likely to be true, because it seems to be far too easy. Some of the more generously proportioned hon. Members would immediately resort to it if it were that easy. We come back to the old adages such as, "There's one born every day" and "A fool and his money are soon parted".
We must proceed with caution on the Bill. After all, we already have remedies against quack medicines. A good example of that was given recently when the Under-Secretary of State for Health, my hon. Friend the Member for Bolton, West (Mr. Sackville), proposed a ban on a number of products that make use of amphetamines as slimming aids. My hon. Friend is operating under section 62 of the Medicines Act 1968. His proposal is subject to consultation, but he has rightly drawn on the advice of highly qualified medical practitioners. He is exercising an Act that has already been passed by the House and that deals with products that are clearly demonstrably harmful.
1354 As we go through the Bill, we immediately identify a considerable number of points on which we should act exceedingly cautiously. My hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland) referred to her concern about her daughter having an obsession with slimming. I have a similar concern with my own daughters, but, so far, they seem to have exercised a remarkable amount of common sense.
We need common sense. We need to eat less and to do more exercise. A number of hon. Members can be seen teetering to and fro around the courtyard on their bicycles. How much better it would be if so many more of us in the population did likewise. We need to rely on legislation that provides conditions by which we can obtain the necessary ban on individual products.
If I were to give any advice to the House, I would say that if the Bill receives a Second Reading today after sufficient consideration by hon. Members, it will need careful consideration in Committee.
§ 2.5 pm
§ Ms Tessa Jowell (Dulwich)
I congratulate my hon. Friend the Member for Halifax (Mrs. Mahon) on her speech, on her extraordinary success in raising public concern about the issue, and on securing the debate today. The measure is remarkably practical. It seeks to impose some minimal standards of responsibility on an industry that, in part, flagrantly exploits the anxieties of vulnerable people.
The Bill's provisions cannot simply be parodied as busybody interference. As the hon. Member for Gravesham (Mr. Arnold) reminded us, it is extremely important to safeguard the Bill's proposals against misrepresentation. The Bill does not propose a new regulator—no Off-Fat is proposed—or any cumbersome bureaucracy. No one reading this short Bill could possibly argue that its propositions are unreasonable. On the contrary, its proposals are so obviously fair and sensible that the diet industry will have to demonstrate why on earth it is not prepared to adopt the proposed practices. An industry it certainly is, and one which grows fat on stimulating millions of fit and healthy people into believing that there is something wrong with the way that they are.
People come in all shapes and sizes, but the slimming industry wants to turn us all into Barbie dolls. Its targets, of course, are overwhelmingly women—and increasingly, young women. Estimates suggest that, at any time, about 50 per cent. of women are on a diet of some sort. As the incidence of unhealthy weight is about 16 per cent. of the population, it follows that about a third of all women are being induced to diet for no good reason. In doing so, they put about £1 billion a year into the pockets of the diet industry.
Many young girls are tortured by anxiety about their weight anyway. To some extent, that is a normal part of adolescence and growing up. But instead of encouraging girls to love their bodies, whatever their shape or size, the diet industry perniciously feeds on those anxieties, occasionally with tragic results. At present, 125,000 women suffer from bulimia, 70,000 suffer from anorexia nervosa, and the number is doubling every decade. Great Ormond Street hospital has seen a fourfold increase in the number of children treated at its eating disorder clinic.
1355 There are two main strands of opposition to the Bill. The first is that we already have all the regulation that we need, primarily in the form of the Advertising Standards Authority. The other is that the diet industry is performing a valuable public service in tackling a plague of obesity, with its attendant health risks. Neither of those claims stands up. The Advertising Standards Authority monitors only advertisements, whereas the Bill refers to the conduct and practice of so-called dieting experts at their slimming centres and clinics. Nor could that authority deal with the numerous magazines whose editorial content is an endless assault on the normal shape of normal people.
Obesity certainly exists, but it is not cured by miracle diets. On the contrary, the evidence is that the preoccupation with unnatural slimness is itself the cause of a great deal of physical as well as psychological illness. It cannot be a coincidence that the number of people reported to have a serious eating disorder has grown so rapidly over the past 20 years. Of course, not everyone who starts dieting ends up with an eating disorder, but everyone with an eating disorder started by dieting.
There is all the difference in the world between public health policies which promote healthy eating and a diet industry which promotes an obsession with dieting. Yesterday I bought a batch of magazines from the corner newsagent, which were on sale to all and sundry. They promise, "You can be 14 lb lighter in four weeks" or "Lose a stone in a month" and offer "50 top tips for the new you". What can possibly be wrong with requiring the sellers of this stuff to warn readers of the risks attendant on such promises?
The diet industry thrives on its failure. American figures show that 97 per cent. of the people who diet put any lost weight back on and probably lose self-esteem in the process. The industry spends 13 per cent. of sales revenue on advertising, endlessly stimulating demand for a product that seldom works.
The Minister's announcement that the prescription of amphetamines for slimming is to be banned is very welcome, as is the promise of stiffer penalties for doctors who breach the rule. Norway, Australia, New Zealand, Canada and the United States have stricter regimes for regulation than we do.
There is clearly a strong measure of cross-party support for the Bill and a belief that action must be taken. I hope that, as an expression of that determination, the House will give this practical and important Bill a Second Reading.
§ The Parliamentary Under-Secretary of State for Health (Mr. Tom Sackville)
I congratulate the hon. Member for Halifax (Mrs. Mahon) on introducing this important Bill, which certainly merits discussion.
I welcome something that we seldom hear from the hon. Lady, namely her praise for the Government's initiative on amphetamines. She also praised many parts of the media, which is something she also does but rarely. She included the Bolton Evening News, my excellent local newspaper, which did an enormous amount of work on this subject some months ago and came up with numerous 1356 examples of people who had been damaged by slimming mania and specifically by amphetamine or amphetamine-like substances.
The Government are concerned that industry, including that which claims to aid weight loss, is properly regulated. We are also concerned to ensure that consumers are not misled by inaccurate or misleading claims about products, that they have sufficient information to make an informed choice and that the products themselves are safe. Our philosophy is therefore very much in tune with the good intentions of the Bill in as much as both seek to protect the public.
I understand very well the concerns that have prompted the Bill, but I am confident that when I have explained the broader picture surrounding the whole issue hon. Members will question the necessity of the Bill's provisions.
Obesity among men and women is a serious and growing problem in this country. People's personal appearance is a matter for them, of course, and the Government would not seek to influence such choices, but when people's personal weight becomes a risk to their health more generally it becomes a matter of concern to the national health service. Obesity contributes to raised plasma cholesterol and raised blood pressure and is a risk factor for both coronary heart disease and stroke—two major causes of premature death in the UK—as well as for diabetes, gall-stones, as the hon. Member for Halifax mentioned, arthritis and a number of other less well known conditions.
For that reason, the problem of rising obesity as it is clinically defined has to be addressed, which is why a target for reducing the prevalence was included in the coronary heart disease and stoke section of the White Paper, "The Health of the Nation". At the time those targets were set, the figures showed that 8 per cent. of men and 12 per cent. of women were obese. The latest position, portrayed by the recent report from the Health Survey for England, showed that those figures have increased to 13 per cent. for men and 16 per cent. for women. Regardless of whether the two sets of figures are exactly comparable, they show a fairly alarming increase.
Perhaps it would be helpful at this stage if I defined exactly what we mean by obese, which was touched on by the hon. Member for Dulwich (Ms Jowell). It is a matter of having a body mass index of greater than 30. If I may explain further, body mass index is calculated by dividing an individual's weight, expressed in kilograms, by the square of his or her weight in metres.
§ Mr. Sackville
I am so sorry. I should have said height in metres. It was worth having a Whip within earshot.
Just to clarify matters for hon. Members who do not understand those European terms, obesity would therefore mean a woman of 5 ft 6 in having a weight of more then 13 stone or a man of 6 ft having a weight of more than 15½ stone. I will not try to define what my hon. Friend the hon. Member for Gravesham (Mr. Arnold) described as structurally challenged, but perhaps he will give us his own definition of what he may have meant.
§ Mr. Jacques Arnold
I felt that it would be excessively cruel to ask which of the sponsors of the Bill could be referred to as fat, and "structurally challenged" seemed fashionably correct on the Labour Benches.
§ Mr. Sackville
Well, now we know.
It is important to make the distinction between the term clinical obesity and people whom the Bill seeks to protect—victims who believe that they are overweight when very often they are not at all. I have already explained that there are good medical and health reasons for concern about being overweight. I should also point that the problem of increasing obesity is not confined to this country but is prevalent throughout the developed world. It is a serious problem with no easy solutions and for those reasons, as I have already mentioned, we must address it.
The nutrition task force was created to devise a strategy for achieving the diet and nutrition targets in "The Health of the Nation" White Paper, which included a target for obesity. It was proposed that, in the first instance, attention should be particularly directed towards the prevention of obesity. As overweight and obesity result from taking in more energy from food than that expended on physical activity, exercise is required to address the problem. The nutrition task force also agreed that action to achieve the targets should be considered jointly with the physical activity task force.
People could be forgiven for thinking that if the problem is caused by eating more than one needs for daily activity, the solution is simple—to eat less and to be active. We know, however, that it is not so easy as it sounds. One of the main contentions behind the Bill is that diets, in the sense of diets for weight loss, do not always work. Many diets help people to lose weight, but the problem lies in keeping the weight off in the long term. That is why the two task forces decided on a preventive approach both to help to prevent the population as a whole from getting fatter and to target help at those groups of the population most at risk from obesity.
As a first step, a symposium of experts was convened last year. Those attending were asked to suggest courses of action to prevent further rises in levels of obesity. The symposium considered trends in obesity in the United Kingdom, the factors controlling energy imbalance and the potential contribution that might be made by local authorities, schools, industry, the NHS and everyone else concerned. Consideration is currently being given to the future course of action to be taken within the task forces for improving dietary habits, together with the strategy of the task force on physical activity aimed at increasing levels of physical activity. One important point that we have identified is the need for more research into long-term solutions.
To turn to the central matter of the Bill, we must always make the important distinction between medically desirable weight, which forms the basis of Government advice, and cosmetically desirable weight. What is commonly portrayed as being cosmetically desirable is often thinner than what would be considered medically desirable. It is also true that the long-term efficacy of relatively short-term proprietary slimming products has rarely been demonstrated. Just as it is not healthy to be overweight, it is not healthy to be underweight. By not eating enough for the body's needs and becoming 1358 underweight, people may not be getting all the nutrients that they need from their food and they run the risk of suffering ill health as a result.
I agree with everything that the hon. Member for Halifax said about the pernicious influence of the fashion industry, especially through magazines and television. Obsession with weight has been a problem at various times in history, but it is probably much more of a problem in the age of the mass media, with the power of television and the power of attractive and cleverly presented magazines. I remember reading in the press of a recent survey which said that a certain percentage—it may have been 60 per cent.—of women reading a well-known mass weekly magazine became severely stressed after three minutes of looking at the various role models in front of them. Whether or not that is an exaggeration, there is no doubt that there is a powerful wave coming all the time, particularly at women, telling people that they need to be thinner. We must consider such attitudes dangerous.
My hon. Friend the Member for Sutton and Cheam (Lady Olga Maitland) mentioned putting an end to all this and to the various quack medicines and products. I am not sure that we shall be able to put an end to them. We are really asking people to change their attitudes to themselves. We are asking for a complete alteration in the way in which people look at themselves, in their relationships with others and in their self-esteem. That is a very tall order and I am afraid that it is a problem much wider than the provisions in the Bill.
It makes sense, therefore, for people to try to be sensible and to maintain a healthy weight in relation to their height. The best way to do that is simply by eating a healthier diet and by participating in some form of regular exercise. That message form the cornerstone of Government advice on the issue. However, those ideas, especially those concerning diet and exercise, are not welcome to a large part of the population, and although enormous activity has been generated over the past two or three years by our White Paper, "The Health of the Nation", in the end we still need an enormous shift in national attitudes to get people to realise that their health and how they look after their bodies is to some extent their own responsibility.
Even in terms of the Bill there needs to be a great change in the way in which people view themselves and their weight. The Bill's use of the term "diet" suggests that it should be interpreted as a food regimen for weight loss, but diet should really be considered as involving the way in which we eat in everyday life. Diet is not something that we go on or off, but a vital part of our whole lives.
It rather worries me that the Bill appears to be based on the premise that a large proportion of the people professionally involved in slimming, other than medically qualified practitioners, are various sorts of charlatan. Although we know that many people active in the slimming industry could be described in that way, we must be careful to distinguish between good and bad advice. The activities of many professionals well qualified to advise individuals on diet and nutrition would undoubtedly be restricted. Dieticians and nutritionists are obvious examples, but there are others who play a vital role—
§ Mrs. Mahon
May I point out to the Minister that the dieticians and the Royal Pharmaceutical Society of Great Britain support the Bill? Most of the professionals involved with dieting support it.
§ Mr. Sackville
I appreciate and welcome that fact in terms of the spirit of the Bill, but we must be careful when we talk about the slimming industry. I have had some experience of that this week following an announcement that I made about amphetamines.
We must be careful not to lump everybody into the same pot. Dieticians, nutritionists and others with a role to play in assisting people with dietary matters—such as pharmacists, nurses, midwives, health visitors, dentists, practitioners of other profession allied to medicine, or health promotion specialists—are all active in giving people the right advice about diet and exercise, and sometimes about weight loss. In order to help to achieve "The Health of the Nation" targets a project team from the nutrition task force has drawn up a core curriculum in nutrition for the education of health professionals, which was published last year.
The Bill does not refer to the activities of a group of people who, as many hon. Members have said, are especially culpable—doctors who set up private slimming clinics so that they can prescribe addictive amphetamine-type products to assist with weight loss. As the House knows, I have announced that we are considering a ban on amphetamine-type slimming pills under section 62 of the Medicines Act 1968, and intend to consult on the topic. We are considering action because we know that many qualified practitioners are prescribing inappropriately, although legally, slimming pills which were not designed for people who are, or who believe themselves to be, slightly overweight. The pills contain substances licensed for various purposes, including treating people with moderate or severe obesity, as defined earlier in my speech. In terms of the Bill and also the proposals which I announced this week, we must make sure that there is a distinction between people who are properly using certain substances to help people with a real clinical problem, and those people who are using it to make money and prescribing entirely inappropriately.
The Bill proposes that any book, recording or video produced would need to state that permanent weight loss is unlikely and cannot be guaranteed. I am sure that hon. Members will not need me to describe the regulatory machinery that such a provision would entail. The Act resulting from any such Bill would also oblige anyone giving advice to provide—
§ It being half-past Two o'clock, the debate stood adjourned.
§ Debate to be resumed on Friday 28 April.