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October 02, 2006

Emaciated fashion models and occupational health

Lately, there's been a lot of discussion in the feminist blogosphere about a new Spanish ban on emaciated models at the Cibeles fashion show:

In accordance with the new regulations for this year's Cibeles fashion show 30% of models who appeared on its catwalk last year have been excluded for being too thin.

The models have been rejected because they do not comply with new rules put into place by Madrid's Regional Government demanding that models present a healthy image with a [body mass index (BMI) of at least 18], i.e. they must weigh at least 56 kilos if their height is 1.75[m2]. These figures are approximately what the World Health Organization (WHO) considers to be the minimum healthy weight.

The designer Jesús del Pozo made the announcement in a press conference during which Concha Guerra, Madrid's Vice-Director of Economy and Innovative Technology laid out the new guidelines for the fashion show which starts on 18th September. She said they had taken this unprecedented step because they were aware of the influence the popular Cibeles catwalk had on young girls' perception of fashion and ideal bodies. She explained that the Madrid government were aiming for healthier-looking models and getting away from the wasting-away appearance of many models which was heavily criticised during the last Cibeles catwalk. [Euroresidente]

As a pro-labor feminist and a civil libertarian, I have mixed feelings about the Madrid rule.

The policy is clearly an infringement on the free speech of fashion designers. Design is a form of expression and a fashion show is an aesthetic undertaking. Designing clothes for aesthetic effect is a creative undertaking. If a designer envisions her creations being worn on a certain shape of body, that's her prerogative. Even if we think her aesthetics are indecent or her politics are blinkered and decadent, we should respect her right to realize her creative goal.

Putting on a fashion show is like staging a play or filming a movie. The whole production is engineered to create a particular aesthetic effect for the designer and the collection. A fashion show is also live action ad, which makes it commercial speech.

The Madrid Regional Government's rationale for the new law is very troubling. Their main argument is that fashion shows should be regulated because they present an unhealthy ideal of beauty to the public and therefore constitute a public health risk. I have no doubt this is true, but I don't want the government to suppress ideas just because the larger society considers those ideas to be destructive. I certainly wouldn't want the US government taking any greater liberties on the censorship front.

However, Amanda raises a compelling counterargument at Pandagon. As she notes, the industry standard in modeling is an occupational health risk. A designer's right to design clothes for emaciated models doesn't necessarily guarantee her right to hire actual people to wear these clothes under dangerous conditions.

The average fashion model has a BMI of 16, which well below what most medical experts consider a normal weight for a well-nourished adult. Only a fraction of post-pubescent women have a BMI below 18 for any reason (CDC).

Even for 15-year-old girls, a BMI of 16 is at the 3rd percentile. (That is, only 3% of American 15-year-olds are at or below the average weight of a fashion model.) If you look at the chart I've linked to, you'll see that it doesn't even bother to quantify exactly how rare BMIs of 16 are in women ages 15-20. Look at the curve and you'll see what I mean--we're talking below the first percentile.

Of course, models are hired precisely because they are physically atypical. Still, it's probably a myth that there are large numbers of people who are naturally thin enough to be catwalk models.

Of the women who currently have BMIs of 16 who are of modeling age, a large percentage are probably suffering from anorexia, substance abuse, and/or other health problems. It has been estimated that one percent of all American women suffer from full-blown anorexia nervosa. If less than one percent of 18-year-olds have a BMI of 16 for any reason, and 1% of 18-year-olds are anorexic. There must be considerable overlap because an extremely low weight is a necessary diagnostic criterion for anorexia nervosa. A person won't be diagnosed as anorexic unless they're lighter than the vast majority of people their height.

The fact that the current modeling industry standard is unhealthy for most aspiring models also contributes to an unhealthy professional culture in which even the thinnest models can become obsessive and paranoid about their weight. After all, one of the hallmarks of anorexia is the conviction that one is too fat despite being extremely thin.

The evidence is overwhelming that the current industry standards for fashion models are unhealthy for the vast majority of models. Professional pressure can contribute to the development of anorexia, the psychiatric condition with the highest mortality rate. Simply staying thin enough to be employable as a model can pose health risks, even in people who don't have anorexia. These include decreased bone density, infertility, slowed heartbeat, and in rare cases, death. I don't know if anyone has quantified the risks of long-term professional starvation and compared them to other occupational risks that we regulate. Aggressively dieting to stay 30 pounds underweight for a year probably is at least as unhealthy as working in a bar with second-hand smoke for the same period of time.

If the current industry standard is dangerous for a lot of the people who work in the industry, it makes sense to submit the industry to some kind of regulation. However, the Madrid model would not be appropriate for the United States.

Restricting the aesthetics of fashion shows is an infringement of First Amendment rights. Don't tell me that fashion show free speech is trivial. I won't argue too strenuously that fashion shows make an important contribution to public discourse, but censorship is censorship. The only question is whether the benefit to the workers is sufficient to offset this infringement.

It is also difficult to see how a BMI restriction could fit into the existing legal framework for occupational health and safety regulation. The BMI standard looks at worker's bodies, not at their working conditions. So, the law affects people even if they are not putting themselves at risk in order to achieve a particular look. The health risks of having a BMI=n aren't the same for everyone. Some people can achieve the magic number with zero health risk, or minimal risk, while others can't even get close with life-threatening measures.

The issue is not how many people there are who are naturally and safely thin enough to be fashion models today. The BMI standard is arbitrary and that arbitrariness is problematic. You can't just deprive people of their livelihood because you want to send a larger message to an industry.

Furthermore, if anorexia is a work-induced disease, it seems perverse (and possibly illegal) to make women who suffer from the disease unemployable. It would set a very bad precedent to start making people unemployable because of medical/psychiatric conditions that don't affect their ability to do their job.

The best argument for minimum BMI laws is to rid the modeling community of the ruinous pressure to be ultra-thin. It's not that everyone who is that thin is at risk, it's that the current industry standards require most would-be models to put themselves at risk in order to be competitive. A BMI of 18 is still very thin by "civilian" standards. (The difference between BMIs of 16 and 18 amounts to about 10lbs on a 5'9" model.) So, it's not as if the designers are being asked to sacrifice the slender aesthetic for the sake of public health.

The problem is that the current standards create a never-ending cycle of competition to be thinner. If we could somehow step back and say, okay, thin's fine but we shouldn't allow emaciated models to set the industry standard. All models would be better off if an outside force imposed a reasonable minimum weight for the whole profession. However, I don't see how such a rule could be legally imposed.


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By and large and as a matter of principle, I agree with what you've written, but I'm not quite getting your last paragraph. Can you clarify? The way I read it now, it sounds like you're saying the work-induced disease of anorexia doesn't affect the woman's ability to do the work, so we shouldn't stop her from doing it.

It seems to me, though, that if it's a work-induced disease, it does affect her ability to do the job. I mean, technically, black lung doesn't prevent a miner from mining, but it is a work-induced disease, so it seems like maybe that person shouldn't be mining anymore. And, to continue doing the work would be damaging to the worker and, eventually, his/her ability to do the work.

Am I missing something here?

Many of the most successful models in the world don't meet the Madrid standard. As far as they and their employers are concerned, they are able to do their jobs. Anorexia is a psychiatric diagnosis and arguably a disability. I don't want the state sending mixed messages about the employability of people with psychiatric problems or disabilities. Also, I don't like the idea that an employer can be forced to fire you because you look as if you're making unhealthy life choices, or because you're suffering from a work-related disease that's an embarrassment to the industry.

A similar metaphor is professional cycling. The "governing body" of cycling requires a riders' hematocrit level to be below a certain level. It doesn't matter if a rider has exceeded that by illegal drugs or legal high elevation training, they determined that hematocrit over a certain level endangers cyclist health.
Of course, this is a self-imposed standard, not a government mandate. It was started when cyclists started dropping dead during racing and training. If enough bad publicity about health problems suffered by low BMI models were amplified, perhaps a trade association among designers could self-enforce a healthier standard for models.
Lack of a union, as usual, has allowed employers to exploit these workers, not financially necessarily, but by indirectly encouraging eating disorders and substance abuse.

I agree with you that the impact of the "thin culture" on workers in the fashion industry is the most immediately compelling argument in the Madrid law's favour. As to the objection:

Arbitrary, sure it is. So are age-of-consent laws, but some degree of arbitrariness is unavoidable, law being usually a blunt tool.

An impairment of free speech, sure -- arguably in the same way that restrictions on tobacco advertising are an impairment of free speech. What's at issue is not that the speech of the fashion industry is trivial, but rather that there's a specific framing of the argument for restricting that speech in the interests of public health. There's precedent for that, and it's not necessarily bad precedent. (The scale and visibility of the fashion industry as a commercial enterprise comes into this calculus too. In the abstract sense it's nice to think of fashion and small community dance shows as equivalent forms of expression for censorship purposes, but the realities don't really favour this.)

Furthermore, if anorexia is a work-induced disease, it seems perverse (and possibly illegal) to make women who suffer from the disease unemployable. This one doesn't make sense to me. The Madrid law doesn't seem to me make anorexics or ruinously thin women "unemployable" in a global sense; it makes them unemployable in the specific industry where their body type can be used to warp the overall standard, to the detriment of most workers in the industry and arguably of its consumers.

Glad to see that the reporters know their science:

"The models have been rejected because they do not comply with new rules put into place by Madrid's Regional Government demanding that models present a healthy image with at least an 18% Body Mass Index (BMI), i.e. they must weigh at least 56 kilos if their height is 1.75cms."

First of all, BMI is an index, not a percentage. Secondly, if you're only 1.75 cms tall, you're likely a cockroach. Thirdly, if you're a cockroach that weighs 56 kilos, you must be part neutron star. Or else very, very wide.

I think the BMI thing may be a red herring. What if it were simply a case of passing a health exam in order to perform a job that requires physical activity? I don't see how that would an arbitrary standard.

Heavy football players are twice as likely to die before 50 as their teammates. A coach would never tell a player to lose weight unless he was too slow or couldn't play enough downs. I don't like the idea of a government being able to say someone is too thin or too fat. You could use the health risk excuse for everything. Bachelors don't live as long as married men. That would be a tricky one to solve.

I'm glad I'm not the only one who noticed the BMI/Metric abuse in the quote. Neutron Cockroach, indeed.

I don't think a full physical exam for every model before every show is feasible or productive. If you are going to test them it has to be 'simple'. BMI is simple.

BMI has its problems however. Highly trained athletes fail the BMI test as well, as muscle weighs more than fat, so its really only intended as a general idicator for health amongst 'average' populations.

Models, by definition, are part of an 'extreme' group, just like athletes, but for different reasons.

I don't know if a legislative mandate is something I would support long term, but its a good wakeup call to the industry, which I think should be strongly encouraged to self-regulate. Wouldn't models have to be part of a 'performers' union? I'd think advocacy for worker health really falls under that sort of area.

How about a drug test like they do with athletes? Get rid of the drugs in modelling and you would eliminate a huge part of the problem, and probably most of the models.... but you have to start somewhere.

It seems pretty clear to me that you could legislate this (were you so inclined) not by requiring models be a certain weight, but by requiring designers design their clothes for a certain size. Models could be whatever size they want, but all their clothes must fit a size 2 (or whatever) woman.

Cue the world's smallest violin. There are even worse occupational health risks in, say, meatpacking or coal mining, except the men in those jobs will never earn anything close to what a fashion model does, and generally have few or no other career options open to them.

Just typing and thinking:

Why not have models take physicals to determine if someone is anorexic instead of just naturally thin? Forget about the BMI and examine all the other physiological symptoms. According to Wikipedia, anorexics have numerous tell-tale signs a doctor could identify, such as slow heart rates, elongated QT intervals, low phosphate levels, high cortisol levels, disturbed electrolyte levels, anemia, and zinc deficency, just to name some. Let's say that if a majority of symptoms are positively identified then they cannot work until they receive treatment to improve their health.

Anorexia nervosa is deadly. It has the highest mortality rate of any psychiatric disorder. Fully 10% of those who are diagnosed with this disorder end up dying. There are numerous professions that require physicals. Why not modeling? Anorexia is an occupational hazard for models. I know it's not like black lung or other work hazards because the condition is self-inflicted, but due to its deadly nature I think we have to give more weight to the individual's health than that person's right to emaciate herself.

There's no easy answer to this, and maybe my suggestions and opinions on this issue are too facile. But I don't think we can just say "Free Speech" and drop the issue without further ado.

If you agree that a governmental entity can enact a smoking ban for pucliv health reasons, you've already conceded that it is ok for that entity to ban models excessively thin models for the same reason.

I don't understand how the fashion mavens came to the conclusion that the ultra-thin emaciated look is attractive. As a blatant heterosexual, I have zero interest in those bony chicks with a scowl on their face and their glitzy clothes that appear to be crafted out of some kind of exotic metals.

It seems like the fashion industry has bought into a particularly rigid aesthetic, and now they are trapped in it.


I do not put myself forward as any sort of fashion industry expert, but from my limited understanding it is said that clothes look best on tall and skinny models. If the models don't have the altitude (like Kate Moss, for example) they still must be skinny because they can always put the shorter models in heels to give the illusion of height. Thinness, however, cannot be faked.

I also find bony woman unappealling. Some say that models are unattractively too skinny because the fashion industry is run mostly by women and gay men who have a different conception of what the ideal woman should look like when compared to a heterosexual male's ideal. I have no idea if there is any truth to that or not; the only evidence supporting this hypothesis of which I am aware seems to be purely anecdotal. Who knows for sure? However I do know that anorexia nervosa is a serious disorder, and I think that something could be done to improve working conditions for models so that they don't need to starve themselves to an early grave just to work.

I think there's a catch-22 regarding how clothes look on the tallest, thinnest women. On the one hand, it's much easier to tailor mass-market clothing to look it's best on a thin body. If you're an old-world tailor/clothier/dressmaker you would blanch at that suggestion because your entire trade is making attractive clothing to measure. In that case, if what you design and craft doesn't look good on your real-life clients, you're considered a piker.

The old model is like any other service-oriented creative industry. The best modern-day counterpart is advertising. It doesn't matter how clever your ads are, or how much they impress advertising awards banquets, it's all about whether they move your client's product. Likewise if your couture dresses didn't look good on the folks who actually paid for them, you were SOL. Nowadays, through the miracle of global marketing, high-end designers can afford to create clothes scarcely fit anyone, but distribute them widely enough to make a profit somewhere.

There are a couple of empirical reasons for the ultra-skinny models. The clothes hang better--in the sense that the seams and the cuts show more clearly without any distraction--and the models don't jiggle as they walk down the unforgivingly well-lit runway.

That said, I do admit to having sympathy for both the "invidious effects on young'uns" argument and the "bad workplace conditions argument." When I was twenty, a working model told me that I might have a chance in the profession, if I lost about 10 pounds. At the time, I was 115 pounds, at 5'8", and not really eating enough. Fortunately, I recognized that meeting this industry standard would be harmful to my health, and fortunately, I had other career options.

A lot of working runway models are from Eastern Europe.

Couture is almost dead, btw. There are a vanishingly few houses that even bother pretending to be able to afford that kind of attention for the, again, vanishingly few people who can and do bother to afford that kind of attention.

Damn, I should have proofread that BMI data. That's really bad.

JM, I agree. For any given level of tailoring skills, clothes will hang better on a very thin frame than on a curvier one, if only because curves are more idiosyncratic. If you can't build the entire garment around a body, it's safer to hire people who are very thin to show it off.

On the other hand, I don't believe that models in the 1950s looked worse in the clothes they were assigned to model than models do today, even though models are considerably skinner nowadays. The onus was on the designer to create clothes that fit people with stylish but not medically extreme proportions.

Are models in general skinnier today than in the 1950s? I've read the statistic that models today are skinnier relative to the average woman than they were fifty years ago. But that may be because the average woman of today is more likely to be overweight, not because the average model of today is more likely to be underweight.
Despite all the brouhaha over anorexia, obesity is much more common, and a much more serious public health problem.

"Restricting the aesthetics of fashion shows is an infringement of First Amendment rights."

I wouldn't have thought it necessary to point out that Spain doesn't have the First Amendment. There is a tendency among Americans to assume that the system of individual rights that has developed in US law via the Constitution is universal - as if these historically contingent legalisms are some sort of platonic ideal. I would think, Lindsay, that you might try to understand a European view of individual rights versus the public good before you opine that rights that do not even exist in Europe have been "infringed."

Compare the First Amendment ("Congress shall make no law") with Article 10 of the European Convention on Human Rights (freedom of expression may be restricted as "necessary in a democratic society, in the interests of national security, territorial integrity or public safety, for the prevention of disorder or crime, for the protection of health or morals, for the protection of the reputation or the rights of others, for preventing the disclosure of information received in confidence, or for maintaining the authority and impartiality of the judiciary.")

So the legal attitude toward freedom of expression is very different. You might conclude that Americans are free while Europeans are not. But do you really believe that?

You might conclude that Americans are free while Europeans are not. But do you really believe that?

If their freedom of expression can be restricted for just about any reason the government finds convenient, and those restrictions are written into the law, then I doubt they're really free.

Honestly, fuck the fashion industry, the things these models and the people choosing them do to the minds of young girls can't possibly be justified in economic or fashion benefits. I went to a what's usually considered a women's college, and roughly a fifth of the girls had eating disorders to the level they were apparent in some way. Maybe 2/3rds had some personal experience of some kind with the problem. Intelligent girls who were studying to be doctors would purge in the bathroom stall next to me after dinner.
While it's not absolutely fair to blame only the fashion industry, forcing them to take some responsibility for the impact of their choices is overdue. Whatever aesthetic value the current ideal image of a model may possess, in reality it does real damage to actual people. Fashion isn't that important.
Sorry if this seems overheated for the issue, but even though I'm a guy with a genetic predisposition towards being thin, I've been in love with someone with these issues, so it's sort of personal, or at least was sort of personal.

JR, I'm not assuming that Spain has the First Amendment. The BMI test might work just fine in Spain because the Spanish constitution is different than that of the US.

I can imagine it working in Canada where constitutional protections for individual rights aren't as strong as they are here.

My point is that I don't think this strategy for protecting models can't work within the US.

My point is that your post assumes that American views of freedom of expression are the correct views and that divergence from those views are necessarily erroneous and troubling. It may be that a BMI-type rule would fail a First Amendment challenge in the US. That doesn't mean the rule is a bad thing. IMHO opinion, First Amendment jurisprudence of the past forty years is a decidedly mixed bag - some has been beneficial and some has been destructive. It is one thing to say, "X is an unconstitutional infringement of freedom of speech," and a very different thing to say, "X would be undesirable public policy."

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