As London Fashion Week sashayed to a close on 20 September, most of the media coverage was of the clothes, rather than the skeletal frames of the girls inside them. Yet the week coincided with the publication of recommendations from a controversial inquiry into the health of fashion models, set up after two Latin American models died from eating disorders, one after collapsing on the catwalk.
In her report, the chair of the Model Health Inquiry, Baroness Kingsmill, said she had found “startling” evidence of the vulnerability of models, who are at “high risk” of eating disorders. The inquiry heard evidence from an editor who said she’d sat through “innumerable shows where I have been unable to take in the clothes through shock at the emaciated frames of models”. A writer said the fashion world was “numb”, looking at models only as “clothes hangers” and “failing to see whether they are healthy or not”. The inquiry made 14 recommendations to improve the working lives of models, including banning under-16s from the catwalk and introducing compulsory medical checks and a trade union.
The importance of the report, however, is not just that it reveals exploitation of young women in the fashion industry. There is now a whole body of evidence that links fashion and media images directly to the health and well-being of the wider population of teenage girls.
In a study of 3,200 young women carried out in February this year by Girlguiding UK, over half of 16- to 25-year-olds said the media made them feel that “being pretty and thin” was the “most important thing”. A quarter of girls aged between ten and 15 said the same. The most influential role models by far (cited by 95 per cent of girls) were Kate Moss and Victoria Beckham, both of whom are famously thin. In another study – Sex, Drugs, Alcohol and Young People, by the Independent Advisory Group on Sexual Health and HIV, published in June this year – nearly 30 per cent of 11-year-old girls expressed dissatisfaction with their body weight, and one in ten was on a diet. By age 15, 46 per cent of girls were unhappy with their weight, and a quarter of them were dieting.
Professionals working in this field are convinced that the number of teenage girls with an eating disorder is going up, and that sufferers are getting younger. The majority are aged 14-25, but girls as young as eight have been diagnosed. The last reliable survey into eating disorders across Britain dates back to 1990, but in Scotland, where new research was conducted in 2006, there had been a 40 per cent increase since 1990.
Teenage girls say they are influenced by pictures of impossibly skinny women, even when they don’t want to be. At a recent conference in London about teenagers and the media, organised by the campaign group Women in Journalism, one teenager encapsulated the views of many of the 50 or so girls present, saying the fashion to be super-skinny made her “feel really ugly. I know it’s really stupid but I still follow it. It makes me feel really insecure.”
This young woman’s experience is all too common, according to Professor Janet Treasure, director of the eating disorders unit at the South London and Maudsley NHS Trust, who has conducted research into the impact of the “size zero culture”. She says looking at pictures of thin women reduces self-esteem – and adolescents are among the most susceptible to these pressures. Adolescents are also the group most likely to suffer long-term ill-effects from eating disorders because their bodies are still developing.
Susan Ringwood, chief executive of beat, the eating disorders charity, gave evidence to the inquiry. She supports its conclusions, but says restricting its remit to protecting young women in the modelling industry, rather than tackling the impact of “size zero” culture on the wider population, was an opportunity missed.
Ringwood accepts that it’s a gross oversimplification to blame the rise in eating disorders entirely on the media’s focus on thinness and dieting, but says it does play a part. “Eating disorder sufferers say: ‘How come it’s OK for celebrities to look like that and not me? How come they’re being celebrated on the front of a magazine and I’m in hospital being told I’m going to die?'”
Although the Model Health Inquiry acknowledged this is an area outside its remit, it included a recommendation for a code of conduct to govern the digital manipulation of photos. The inquiry heard evidence of retouching to make models look thinner or even to make ill models look well – something of great concern to those working with eating disorder sufferers. “These processes add pressure to models to meet an unattainable ideal,” it said. One suggestion was for retouched photos to carry a “health warning” so that the reader knows what she’s looking at isn’t real. The teenagers at the London conference were previously unaware that magazine images are routinely airbrushed: thighs slimmed, wrinkles smoothed and blemishes removed.
Of course, media coverage of skinny women is far from universally positive. But even critical coverage of celebrities who are deemed to be “too thin” can make matters worse for eating disorder sufferers, according to Ringwood. Low self-esteem is a recognised factor: sufferers don’t think they are worthy of taking up any space in the world, and shrink accordingly. Seeing bodies that look similar to theirs being pilloried and described as revolting reinforces their own lack of self-worth, she says.
Ringwood acknowledges that the causes of eating disorders are many and complex; they include factors such as genetic disposition and personality type, often compounded by traumatic events – for instance, bereavement or bullying. “But the final piece of the jigsaw is the social context,” she says. Add the media, which celebrate impossibly skinny bodies over all other types, and numbers of sufferers are bound to increase. She would welcome a move for magazines to specify when images have been retouched.
It is a view shared by many of the sufferers themselves. Asked what was the one thing that would help prevent such conditions, most sufferers said it would be for the media to show more “real” bodies. They ranked this as more important than greater understanding from parents, or even greater medical knowledge. “Why can’t the media promote healthy, normal-sized people?” lamented one typical respondent.
Ringwood says the media and the fashion industry should present a more diverse mix of body types as beautiful and acceptable. Such a change would not be a total solution by any means, but it would help, she argues. “We can’t change brain chemistry and we can’t protect young women from all forms of trauma. Of all the factors involved in eating disorders, images in the media are the one area we can change.”
4 is the UK dress size equivalent to the notorious US “size zero”
23 inches is the size of Victoria Beckham’s waist
34 inches is the waist size of the average British woman
40% of teenage girls consider cosmetic surgery
1.15m estimated cases of eating disorders in the UK
92% of young people with an eating disorder can’t talk about it
3 catwalk models have died after starvation diets in the past year
90% of those suffering from eating disorders are female