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How the Fashion Industry Is Killing Women

The pressure on models to be thin—and the resultant pressure on girls, boys, women and men to conform to an unattainable ideal—is immense.

On Nov. 17, 2010, anorexia nervosa claimed the life of 28-year-old French model Isabelle Caro, who had spent the last years of her life publicizing the horrors of the disease. Her mother, devastated by grief and guilt, committed suicide several weeks later. In 2007, Caro had appeared in “No Anorexia,” an ad campaign by provocative fashion photographer Oliviero Toscani, shown above on a billboard in Rome. The images of her naked, grotesquely emaciated body shocked and revolted. The campaign, intended to disassociate unhealthy thinness with connotations of glamour, sparked controversy, in part because some pro-anorexia and -bulimia websites used its ads as “thinspiration” (collections of images or videos of slim to skeletal women used by those suffering from eating disorders for weight-loss motivation). Despite her commitment to heightening awareness of anorexia, Caro could not escape its demons.

Caro’s unsettling death recalled a string of fatalities in 2006 and 2007 of fashion models who suffered from eating disorders, which, while highly publicized at the time, had since largely faded from the public’s—and the fashion industry’s—memory.

On Aug. 2, 2006, moments after stepping off a catwalk in Montevideo, Uruguay, 22-year-old fashion model Luisel Ramos collapsed and died from heart failure believed to have been triggered by self-imposed starvation. Ramos’ father reported that she had been subsisting on a diet of lettuce and Diet Coke in anticipation of the show. On Nov. 15, 2006, 21-year-old Brazilian model Ana Carolina Reston died in a São Paulo hospital from generalized infection. Her body had been rendered powerless to fight it by an extended battle with anorexia and bulimia. And on Feb. 13, 2007, Ramos’ sister, Eliana, also a model and only 18 years old, was found dead at her grandparents’ home, apparently having suffered a heart attack linked to malnutrition.

This rapid succession of casualties provided a wake-up call for the international fashion industry. One detail in particular made it impossible to ignore: All three women, even on the brink of death, were taking home paychecks as working models. The industry responded with regulations varying by country in substance and severity. But the effects of voluntary measures adopted in the United States are unknown, thanks in no small part to the continuing silence of industry leaders and insiders in New York City.

The industry’s reaction

Within months, the fashion capitals of Madrid, Milan and São Paulo introduced new procedures for their runway shows, such as requiring that participating models pass a doctor’s examination or meet a minimum Body Mass Index (BMI) of 18. (BMI is a measure of body fat based on height and weight; the World Health Organization classifies someone with a BMI of less than 18.5 as “underweight.”)

Other industry leaders, however, shied away from such specificity. The fashion establishments in London and New York did take steps to address model health, but both opted for conspicuously less explicit regulations. London’s British Fashion Council forwent minimum BMI requirements and doctors’ assessments, but did produce an action plan of concrete steps to shift the international culture of fashion in a healthier direction. New York’s industry leaders, on the other hand, elected only to frame a set of vague guidelines known as the Health Initiative.

The Council of Fashion Designers of America (CFDA), a trade association, issued the initiative in January 2007. It recommends creating a healthy backstage environment at runway shows and referring models with eating disorders to professional help. It also advises that models participating in runway shows should be 16 or older. As in London, missing from the guidelines are minimum BMIs and medical evaluations for models. Also absent: any means to ensure the implementation of the recommendations, which are voluntary.

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