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Harvard Experts On Eating Disorders Call For Workplace Ban On Dangerously Thin Models

In April, the country that's arguably most serious about fashion got serious about fighting starvation among its models.

Consider some headlines:

Quartz: "In France, you can now be jailed for employing extremely thin models"

• Reuters: "France bans super-skinny models in anorexia clampdown"

CBS: "In France you can be too thin"

French lawmakers passed a measure that's expected to require models to have a body mass index of at least 18 — that translates to 120 pounds if you're 5-foot-9 and 130 pounds if you're 5-foot-11. It proposes punishments of up to six months in prison and hefty fines for agents who violate it. Israel had passed a ban on ultra-thin models as of 2013.

Now, two Harvard experts on eating disorders are calling for similar measures in the United States. In an editorial in the American Journal of Public Health, they argue that the Occupational Safety and Health Administration (OSHA), which regulates workplace safety, should set rules that bar hiring models below a healthy body mass index for runway work or photo shoots.

I spoke with Prof. S. Bryn Austin, the paper's senior author and director of the Harvard Chan School of Public Health’s Strategic Training Initiative for the Prevention of Eating Disorders. Our conversation, lightly edited:

What exactly are you calling for? 

What we’re calling for is new attention and government intervention from OSHA, to take seriously the risks that are being forced on models in the professional fashion industry. Many of them are girls — they’re teenagers and some young women — and of course we know there are some boys and young men. The majority of models start working as children, some in their very early teens, and they’re very vulnerable to the pressures that adults working in the industry place on them.

One of the pressures we are very concerned about is the expectation that they be extremely thin — thin beyond what anyone would consider healthy and certainly beyond what any physician would consider healthy. They’re really putting pressure on these young women and girls and sometimes boys to risk starvation — self-starvation in a way — to achieve the standards to be able to work in the industry.

Do you want OSHA to consider the French model? Or what are the specifics you're calling for?

We’re specifically asking OSHA to take a look at this problem, and we’re recommending that one way that OSHA could intervene would be to impose limits on how low somebody’s weight could be to be able to work in the industry. The point is not to punish the models themselves — we know they don’t need any more punishment, they’re already working under horrendous conditions. The purpose of these regulations would be to prevent agents, their employers, from forcing them to keep their weight so low, to lose weight in order to get jobs.

We gave 18 as an example of what a BMI limit might be. We already know 18 is a very low BMI, and where doctors start to get concerned about somebody’s health. The World Health Organization considers a BMI of 16, which is just a little lower than that, to be medically dangerous, on its face. And then when you’re working with children, the metric changes a little bit but the idea is the same.

So you're calling for workplace regulation — is that because attempts to do this in a more voluntary way have failed?

There have been efforts over the years, and the fashion industry in the United States and some other places have come up with voluntary guidelines. But what we haven’t seen is any real change in these pressures on models. The degree of extreme thinness really looks the same. The risks that the models are forced to take in order to keep their jobs really is the same. And you often don’t see voluntary measures getting too far if the government isn’t willing to step in and take an issue seriously. You usually need those coupled together. Certainly, the government takes very seriously workplace hazards in factories in farm work, in a number of other settings where the government has set limits on what employers can do to workers, what they can expose workers to, but they have not stepped in with the fashion industry, and they need to.

You can imagine some ripple effects — the fashion industry tends to promote extreme thinness to the whole population.

Yes, the ripple effects will be enormous. Certainly, we are first and foremost concerned about the health and safety of models working in the industry, because they are grossly abused and exploited and we have to say no. We have to stop this. Many of them are children. We have to stand up and protect these models who are working professionally in the industry.

But we also know the fashion industry projects out to the world the most unrealistic standards of female beauty — and more and more, we’re seeing unrealistic standards of male beauty, through the ways they force models to distort their bodies to get jobs. Then they project these images — sometimes with an overlay of Photoshopping, digital manipulation -- that are fed to all of us. And what we’re most worried about is the images projected to girls and young women, which we know from decades of research from psychology is harmful and distorts and disturbs and undermines body image and self esteem.

So you’re saying extreme thinness endangers the models, both from their need to starve themselves and the risk of eating disorders, and then the risk of eating disorders ripples out to the rest of the population.

Yes, the fashion industry for too long has been allowed to create a toxic work environment for professional models and then a toxic social environment, a toxic media environment for all the rest of us, especially for the millions of young people growing up in this country. Every day, they're bombarded by these images that are dangerous. We need to tell the fashion industry, 'No! It’s time to stop, you have to take care of your workers and you need to be projecting healthy images out to the world.'

Is this the launch of something else, like a campaign?

I would say the paper is meant to launch advocacy and new serious attention on the part of our federal government but also the state governments where the fashion industry is most based, so that would be New York State in the United States.

A bill was introduced in Congress this summer to try to get better regulation of child models in particular, through amending the Fair Labor Standards Act at the federal level. And in New York State, there's been some continuing advocacy also to protect child models and to expand that to adult models. Two years ago New York passed a similar law to what's in Congress to protect models, and it became law. It appears that law has reduced the agents and casting directors employing children in large numbers, in order to avoid regulation. It appears they've been tending to employ older people, meaning like 18 and 19, but we need to go further to have more health protections. It’s not that we want the 18-year-olds exploited instead of 16-year-olds, we want none of them exploited.

When you say employers, you mean mostly agents?

Yes, that’s what part of the argument really focuses on. One of the reasons the industry has been able to get away with this is they falsely claim models are independent contractors and not employees. There are a lot of regulation and protections for people classified as employees, however, when it comes to independent contractors, there's not nearly so many protection. OSHA needs to recognize and speak up and make clear that models are employees; they meet the definition of employees and they need to be treated with all the respect and protections that employees deserve.

Was there any particular case that prompted this work?

It’s really the continuing lack of movement. There have certainly been court cases where models have gotten together or individually have tried tried to sue. And interestingly, in those cases, judges have ruled that models are employees and not independent contractors. This is where we need the federal government to step in. And the New York State government should be stepping in here too, because clearly that's the main center point of the industry in the United States.

Because if France already passed this ban, if you could get New York, that would be the heart of the fashion industry?

Absolutely. No designer, no agent, is going to be able to compete on a global scale if they can’t participate in the New York Fashion Week and the Paris Fashion Week. If we have the regulation in place to protect models in New York and in Paris, that will make a massive change in the fashion industry and what they’re allowed to get away with.

Readers? Reactions? 

Headshot of Carey Goldberg

Carey Goldberg Editor, CommonHealth
Carey Goldberg is the editor of WBUR's CommonHealth section.

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