Modeling and Eating Disorders

 

            The issue of risk to fashion models has been very much in the news for a while now, and much of what has been said and done, while perhaps well meaning, has conveyed far more heat than light.  For all the vast number of words being devoted to the issue, the fashion industry itself and, more importantly, parents of models, are left with little reliable guidance.

The truth isn’t easy to find – in fact, truth about many of the claims being made on the issue may not even exist.  But that doesn’t stop the claims from being made, and the actions from being taken. 

So let’s try to sort some of the fact from all the fiction, and see what conclusions should be drawn.  This is a complex issue, and we can’t expect parents and models to do all the reading for themselves, so let’s start with a “Sound Bites” version.  A more detailed discussion will be added for those who are interested.

 

Summary:

The Problem

·        The eating disorder most relevant to modeling is anorexia nervosa.  Briefly, this is a psychological disorder which causes people to maintain an abnormally low body weight, generally through extreme dieting, though it may encompass other behaviors as well.  Anorexic models have unrealistic assessments of their own body, often seeing themselves as “fat” even when they are extremely thin.

·        Anorexia afflicts about 1% of women in America at some time in their lives.  Typically it affects young women age 15-25, most commonly beginning about 16, although it can appear at any age.

·        There is no question that agencies and clients do put pressure on models to be very thin; whether this causes a medically significant disorder is much less clear.

·        Models may greatly restrict food intake, or use other techniques, including dangerous ones like purging to meet industry size requirements, although these rarely meet the definition of an eating disorder.   Bulimia, for instance, is generally an affliction of average- and above-weight people, but its practices can still be harmful even when a clinical case of bulimia is not present.

·        Fashion models, like everybody else, are at risk for anorexia.  That risk is likely amplified by the emphasis put on a very slim body as a requirement for modeling. 

·        Most fashion models are naturally very slim, and a considerable majority of them have normal, healthy eating habits.  Some models do have to take considerable care to control their weight. Nonetheless, despite the appearance, relatively few fashion models are really unhealthy due to weight and diet.

·        Available research does not show that fashion models are afflicted with eating disorders any more than the general population.  There is no lack of exaggerated claims, but they seem unfounded.  Although some studies have been done, there is no authoritative study on the subject. 

·        Other occupations which put a premium on slim body image (dancers, gymnastics, skating, extreme athletics) have been shown to have a higher prevalence of eating disorders (but generally not anorexia) than the general population.  It would not be unreasonable to expect some such effect on fashion models, even though the evidence for it is no more than anecdotal.

·        There is no evidence that anorexia is becoming more common.  There is nothing new about hyper-skinny fashion models, as the “heroin chic” look of the mid 1990s attests.  Epidemiological studies in the US do not support the claims of in increase in anorexia in the general population.

·        The current cases of dangerously thin models seem to come from Eastern Europe and South America, rather than America.  It has been suggested, not without reason, that the need to feed a family may cause a model to acquiesce to pressure more than a model from a more affluent country would.

The Buzz

·        The death of two South American fashion models has drawn a lot of recent attention to the risks.  An unholy alliance of interest groups, politicians and sloppy, sensational journalism has made the risk appear to be severe.  These two deaths, while tragic, are not unlike the many deaths from anorexia which occur annually in the general population.

·        Much of the discussion in the press on the issue has been false.  The Internet is rife with faked pictures of fashion models which purport to show them cadaverously skinny; journalists often make exaggerated claims that are not supported by the evidence. 

Industry Attempts at a Solution

·        There have been several recent attempts by politicians to control the problem.  Most visibly, these have included restrictions on the Body Mass Index (BMI) of models participating in international fashion shows.  However, to date these restrictions have been ineffective, and seem more driven by a desire to be seen “doing something” than by a mature understanding of the problem and solutions.

·        There are legal constraints on what can be done by the industry.  Formal rules to restrict access to jobs because of an arbitrary measure such as BMI likely would run afoul of US labor laws.

·        Other suggestions have been made that the industry can implement.  These include banning runway models under age 16, improving the nutrition in food available backstage at fashion shows, encouraging agencies to provide monitoring and support services, discouraging magazines and advertisers from using extremely thin models, and generally raising consciousness on the issue.

·        Mandating use of heavier models will not solve the problem.  Whether the line is drawn at size 0, size 2 or size 4, fashion models will always be much slimmer than average, and “slim” will still be perceived as desirable.  Anorexics will still have unrealistic assessments of their own bodies.  An anorexic girl in a hospital bed will still see herself as “fat” no matter who walks down the runway.

What Parents Need to Know

·        Causes of eating disorders are complex.  The factors which cause a girl to exhibit symptoms are much more than just exposure to media images of thin people or pressures to meet fashion modeling job requirements.  A psychologically healthy girl put into that environment is far less likely to become a victim than one that is already less mature and stable.

·        The government and the fashion industry are not the solution.  The approaches suggested and tried so far are no more than band-aids that feel good, but don’t really address the causes of the problem.

·        A girl who has issues which can lead to eating disorders should consider some other line of work.  Modeling is stressful, often gives girls less responsible supervision than they need, and can exacerbate disorders, or tendencies, which were already present.

·        Young models need supervision and guidance.  Eating disorders are just one of many risks young models face.  Parents need to approach evaluation of that risk like they would any other – from a position of knowledge, judgment and a realistic appraisal of both the risks and their own daughter’s maturity and emotional health.  Models and parents should not ignore warning signs, but neither should they become paralyzed over exaggerated claims about the dangers.

·        The more common problem is not "eating disorders" at all..  Far more models will try rational (if misguided and sometimes dangerous) techniques to reduce or control weight to meet real industry standards, even though they are not suffering from a true eating disorder. Focusing on the extreme cases and on psychological disorders runs the risk of blinding us to the lesser, but real risks that the pressures of the industry can put on models.

·        An excellent resource is available to help guide parents.  The discussions at www.anred.com provide a balanced, knowledgeable source of information on the risk factors and symptoms that will help models and their parents understand the issue in much more depth than they can get from the popular press.

 

Examples and Sources:

The Press Cannot Be Trusted:

A wonderful example of irresponsible journalism that exaggerates the issue is to be found at http://www.medicalnewstoday.com/articles/76241.php  The author of that article starts off with an inflammatory lead paragraph:  “Models seem to be suffering the brunt of the fashion industry's obsession with size zero, according to a new study carried out by the Model Health Inquiry. The study indicates that as many as 40% of models may currently be suffering from some kind of eating disorder.”

In fact, the preliminary report of that study, which is what is claimed as the source of that statement, contains nothing of the sort.  The study says that other fields, not modeling, have been shown to have higher risk of eating disorders, up to 40%.  However, the study is careful not to include modeling in that statement:  “Dr Key has stressed that there have been no detailed studies that have investigated this population and therefore no data to confirm or disprove a high rate of employment related eating disorders in this sector.” http://www.modelhealthinquiry.com/docs/Interim%20Report%201.pdf

 

“Solutions” Have a Life All Their Own

 

Politicians in Madrid opened with a “solution”:  they banned models with a BMI of less than 18.5 from shows at Madrid Fashion Week.  In short order, Milan politicians forced a similar measure there, coupled with a “modeling license” requirement based on a health certificate.  Similar measures have been urged, but not adopted in fashion capitals such as Paris, London and New York.

Generally, responsible observers have concluded that such measures are “a blunt instrument” which target the wrong issues, and have been ineffective.  Again, from the same British study, for example:  “we have no evidence that this has been enforced or that the intervention has been effective.”

            Nonetheless, activists, politicians and the media are not the sort to be put off by little practical difficulties such as the fact that a “solution” doesn’t work.  Recently a journalist who is also director of the Fashion Fair in Perth, Australia decided to “do something” and send out a press release.  Sure enough, what they decided to do was to mimic the ineffective BMI restrictions imposed in Madrid and Milan, rather than some more difficult, thoughtful and effective measure.  The appearance of “doing something” is more powerful than actually having a beneficial effect.  Needless to say, her action was widely reported with approval by activists.  http://www.news.com.au/perthnow/story/0,21598,22149536-5008620,00.html

 

Anorexia is Not a Growing Problem

 

One of the claims made by activists on this issue is that anorexia nervosa, the eating disorder which most concerns modeling is a growing problem – even becoming “an epidemic”.  Certainly it is a problem, and one that has a higher fatality rate than almost any other psychological disorder.  It also appears to be appearing at a younger age than has been true in the past.  Even so, the incidence of anorexia has remained unchanged in the United States in recent years.  Source:  The Prevalence and Correlates of Eating Disorders in the National Comorbidity Survey Replication. James I. Hudson, Eva Hiripi, Harrison G. Pope, Ronald C. Kessler, Biological Psychiatry, Volume 61, Issue 3, 1 February 2007, Pages 348-358. 

The experience in Australia seems to be similar, where patients are younger, but their numbers overall remain stable.  Source:  Dr Michael Kohn, director of The Eating Disorder Service, (a 12-year research program at the Westmead Children's Hospital, Australia).

 

Research on Eating Disorders in Models

 

            There is no authoritative scientific study on the real incidence of eating disorders in models.  However, the most recent, and largest study to deal with the issue concludes that fashion models have no more problems with eating disorders than the general population (in this case, in Canada).  A report of a study included the following statements:

            Not unexpectedly, the models scored an average BMI of only 17.4, compared to a more "normal" 22.7 for the students. But their eating and exercise habits showed little difference, and more than 80% of both groups had normal, healthy eating behaviours and displayed positive attitudes toward food. The other 20% or so don't necessarily have eating disorders but may have some questionable eating habits such as skipping breakfast . . .

 In the meantime, McWhirter hopes her study will encourage the fashion industry and others to look beyond a model's BMI before deciding if she's healthy.  “Possessing a certain body type," she says, "cannot and should not be equated with having an eating disorder."  http://www.canada.com/nationalpost/news/artslife/story.html?id=934179b3-e31a-46cb-9f1f-568e6a7f012a&k=54762&p=2

 

Is the Problem Caused by “Size 0 Models”?

 

A lot of the press coverage and statements by activists has focused on the claim that a major cause of eating disorders in models, and in the general population, is that models are extremely thin.  True, we do seem to be in the part of the cycle where even skinnier than normal models are seen on the runways and in fashion magazines.  So is that really the cause?  Will changing it fix the problem?

No.  The media bombard us with images of thin people presented as desirable, from actors and actresses to dancers and models.  Very few of them are “size 0”, and yet the point is made in an impressionable mind:  “thin = attractive”.  “How thin” turns out not to matter much, since the anorexic cannot properly assess how she compares to the “standards” anyway. If anything, a fashion model does have reference points:  she has a preferred size to get hired, and needs to fit the clothes.  There is such a thing as “too skinny” to be hired in most cases, and that point will be made to the model.

Of course, no single change, no matter what it is, will make the psychological issues that lead to eating disorders go away.   And the great majority of causes have little to do with media presentations of anything, let alone fashion models.  Still, presentation of slim people as desirable and beautiful does have some impact.

One of the most respected sources of popular information on eating disorders discusses the contribution that media presentations may make, but summarizes as follows:

“While all of these images, advertisements, and messages may be counterproductive to a good self-image, and society's overall acceptance of each person's different size and shape, they are NOT the reason so many men and women develop an Eating Disorder. These images may not help, and for those already open to the possibility of negative coping mechanisms and/or mental illness, the media may play a small contributing role -- but ultimately, if a young man or woman's life situation, environment, and/or genetics leave them open to an Eating Disorder (or alcoholism, drug abuse, depression, OCD, etc.), they will still end up in the same place regardless of television or magazines. Ultimately it's important to know that Anorexia, Bulimia and Compulsive Overeating are NOT about weight and food. Rather they are complex disorders where each sufferer is plagued with low self-esteem, an inability to cope with their own emotions and stress, and many underlying issues that have lead them to their disordered eating.” http://www.something-fishy.org/prevention/society.php

 

 

           

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