Lisa Hilton, an Oxford-educated writer, thinks we should all stop worrying and learn to love the size-zero model.

[A]re women really so pathologically stupid that they are unable to distinguish the fantasy of the runway from the realities of their own bodies? Arguably, the "size zero" debate is merely another side of the infantilized, hysterical box women thought they had clawed their way out of a century ago, an insidious means of suggesting that though we can run companies and governments we're still not quite rational creatures, too dainty and delicate to cope with the dissonances between the Bambi-limbed aspirations of the catwalk and our own wretched, cellulite-smothered carcasses.


It gets worse. Hilton praises girls who probably suffer from eating disorders for their canny choice "to conform to the demands of their industry in order to maximize their earnings"; any questioning of the safety of the standards to which models are required to measure up is "patronizing and disempowering and reduces legitimate concerns over body issues to juvenile whining"; and, amazingly, the most powerful thing we could all be doing is to just shut up and consume. "We could just leave the models to get on with their job," writes Hilton. "Maybe the radical way to look at this season's shows would be to enjoy the spectacle, buy the frock and get on with something more interesting?" On the scale of contrarianism-for-contrarianism's sake, reading this piece, it's as if Slavoj Zizek got a partial lobotomy, mainlined five years of Vogue, and had a week-long hallucination about the "eating disorder lobby." Perhaps someone should tell Hilton she could make a career out of issuing trite "challenges" to "conventional wisdom." Then we'd at least know what and who to avoid at the bookstore.


Though Hilton pays lip service to the health issues presented by eating disorders, and states that sufferers deserve our "respect and support," the most serious problem with her wholly problematic argument is that she seriously under-reports the prevalence of eating disorders. Call her an eating-disorder skeptic: she cherry-picks data from a variety of studies to show that anorexia nervosa only affects 0.5% of the population, blithely ignoring the fact that anorexia is just one kind of eating disorder — bulimia and Eating Disorder Not Otherwise Specified are two others recognized in the DSM-IV, and there are plenty of people with disordered eating habits that affect their health, yet who do not meet all of the diagnostic criteria for the above. And Hilton completely ignores a much recent and unusually comprehensive study by the NHS, which found that 9.2% of adult women living in Britain had eating disorders. Hilton's eagerness to minimize the problem of eating disorders makes one rather doubt her intellectual honesty.

So, too, does Hilton's comparison of her 0.5% prevalence statistic for anorexia with the "39.4 million [American] women suffering from obesity." Obesity, as defined by the medical establishment, is a straightforward matter of Body Mass Index, not health: anyone with a BMI of 27.5 or higher is considered obese. A diagnosis of anorexia — which is, again, just one kind of eating disorder — involves fulfilling multiple clinical criteria. Anorexia is a disease. Obesity is an equation of height and weight, and an individual considered "obese" can be perfectly healthy. To compare the two groups is beside the point.

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But Hilton isn't interested in making an argument based on accurate data. She's interested in criticizing fat people and recasting models who "choose" to subsist on too little food as "empowered" paragons of discipline. (She does this by quoting one former model who admitted that when she was walking for John Galliano and Tom Ford, she "lived on Diet Coke and apples for two years. For the couture, we had to get up at 4 a.m. to be sewn into the clothes and there was huge pressure to be thin. But I made a million dollars by the time I was 20, I bought a town house in Manhattan and put myself through Columbia. Does that make me a victim?" Perhaps Hilton does not realize just how small the modeling world is, but she might consider protecting her anonymous sources a little bit better, given the number of girls who did the couture shows, walked for those clients, and attend Columbia is, well — nevermind.) But the point isn't that the mainstream media is clamoring to paint models — and, by extension, women who approve of fashion — as "victims." Although some of the coverage of the so-called "size zero debate" is undoubtedly sensationalist and less-than-comprehensive, many writers are merely drawing attention to the fact that it is unfair and unsafe for an adult to ask a child of 14 to diet down to 95 lbs, and that it might well be unsound for the culture to idealize exclusively such a tiny point on the spectrum of female beauty. Hilton's only explanation for women who criticize the fashion industry's standards is far more prosaic: jealousy.

Another issue that Hilton completely ignores is the question of whether the modeling industry may well attract girls already predisposed to disordered eating — and what implications this might have for the industry's duty to be a safe working environment, if in fact it is the industry's diktats that can push a young and already vulnerable population into seriously unhealthy territory. It's not hard to look for anecdotal evidence of models with eating disorders; Crystal Renn, who lost her teen years to exercise bulimia and anorexia in order to fit into sample sizes, has said "Modeling, basically, pulled the trigger." Three models, Ana Carolina Reston, Luisel Ramos, and Eliana Ramos, died of complications from their eating disorders in 2007 and 2008; one had eaten only Diet Coke and lettuce for the week leading up to her death. Coco Rocha has admitted the use of diuretics to control her weight in the past. Other substances, especially Adderall, for energy without appetite, were commonplace when I was in the industry. Ali Michael, at 17, was sent home from Paris for gaining 5 lbs when she started to recover from her eating disorder, which had cost her her menstrual cycle. Natalia Vodianova's relationship with food changed dramatically when she began modeling — and her sudden, and unhealthy, post-pregnancy weight loss, both spurred her career to new heights and causef her hair to fall out. (When she regained 9 lbs, giving her a total weight of 115 lbs, her clients and agency were displeased.) The model pictured here, Natasha Poly, has not spoken publicly about her eating habits, but I included her photo to show just exactly what kind of beauty standard Lisa Hilton thinks is reasonable and harmless.


Broad-based studies are harder to come by; there are remarkably few surveys of professional models' eating habits and the prevalence of eating disorders. However, this one, published in Psychiatry Research in 2008 [PDF link], found that 18.1% of the 55 models questioned by researchers reported "important restrictive eating" during the previous three months, compared with only 7.2% of the control group, which was made up of women of the same age group and the same cultural background as the models. 60% of the models surveyed reported bulimic episodes in the same timeframe (so did 34% of the control subjects). 9% of models exercised to control their weight, 5.4% used laxatives and/or diuretics. 9% of models had "menstrual difficulties"; only 2% of the control group did. The study authors found that 12.7% of models had at least some of the symptoms of anorexia; 1.8% had all of them. An additional 5.4% of models had been diagnosed with, and received treatment or, anorexia in the past. 1.8% of the models met all the clinical criteria for bulimia; 3.6% met some of them. That's a total of 25.3% of models with some form of eating disorder. Now, 55 models is not a large sample, and more study is clearly needed before the prevalence of eating disorders within the industry can be firmly established. But it seems clear that, at the very least, disordered eating is vastly more common among models than the general population. In Hilton's tortuous construction, acknowledging the very serious health concerns this reality presents for many models is painting them as "victims."

Hilton compares female models with male athletes — some of whom are also required to maintain less-than-healthy physiques to make a living. 69% of jockeys skip meals, and 34% use diuretics for weight control, and — though Hilton doesn't mention it — there was also the death of 23-year-old NFL player Thomas Herrion, whose playing weight was 310 lbs, of heart disease and studies showing a heightened risk of heart disease among very heavy players. But rather than find these working conditions troubling, Hilton excuses them, joking that jockeys would "make any model agency proud," and pointing out that young men who choose to endure the physical risks of these professions are "admired" while models are "portrayed as irrational and deluded." Models aren't admired? It takes an especially nimble mind to at once buy into the persistent glamorization of modeling so completely that all problems, actual and potential, presented by the profession can be written off as the ravings of jealous haters, and simultaneously to deny that the profession is glamorized at all.


"Laying off the Krispy Kremes for a few years in order to shimmy into Paige jeans is hardly on a par with being unable to menstruate, but the rhetoric of the eating-disorder lobby insultingly blurs the difference between harmless faddiness and genuine disease," says Hilton. (This despite the fact that her own source — the only model she apparently spoke to for this story — had to do a lot more than "lay off the Krispy Kremes" to be employable under the industry's standards.) I hadn't heard of Paige jeans when I first read this piece, but it turns out the company has an interesting story: Paige Adams-Geller, the company founder and a former fit model, is an eating-disorder survivor. Adams-Geller's business is dedicated to the (still radical, in fashion) idea that no-one should have to starve to fit into their clothes. In fact, she sells a bracelet to raise money for the National Eating Disorders Asssociation that bears the slogan "Be Comfortable In Your Genes." Funny how Hilton missed that.

What's Wrong With Skinny? [Daily Beast]

Adult Psychiatric Morbidity in England, 2007 [NHS]

Model Perspective: Natalia Vodianova [Too Fat For Fashion]


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Superfreakonomics Not That Super Or Freaky