A Body to Die for: Body Measurements and BMI Values Among Female and Male Runway Models

Abstract

Runway models play a central role in creating and promoting cultural beauty and body ideals. However, little is known about body measurements (BMs) and anthropometric health parameters among this modeling population. The main purpose of this quantitative study is to describe BMs and anthropometric health parameters to understand the severity of thinness among models. Secondary industry-reported data were analyzed to quantify female and male models’ BMs and to assess anthropometric health parameters over seven consecutive fashion-week seasons. Low and decreasing BMs and body mass index values, over these years, provide alarming evidence that extreme thinness seriously affects models’ lives and general health. Considering the reach of fashion images and their detrimental effects on consumers, as well as the commonality of eating disorders among professional models, this study implores scholars in the field of clothing and textiles to consider feasible and compelling scholarly initiatives and cross-disciplinary collaborations to uncover problem solutions

Keywords

appearance body mass index modeling industry runway models body anthropometry eating disorder

The number of deaths due to starvation in the runway modeling industry is increasing (Soltis, 2009). Extreme occupational standards in the industry force working models to remain excessively thin, leading to health hazards (e.g., eating disorders) and sometimes even severer outcomes (Record & Austin, 2016). For example, in 2006, a female model died of heart failure after stepping off the runway in South America; this was followed by death of another model, her own sister, 6 months later (Soltis, 2009). At the time of their deaths, both models were diagnosed with anorexia nervosa, and their body mass index (BMI) readings were both approximated to be 14.5 (Lennon et al., 2017; Soltis, 2009). The following year, a Brazilian model, with a BMI of 13.4, also died (Gladstone, 2016). Before her death, the model publicly acknowledged that she had starved herself, regularly eating only apples and tomatoes to fit into the required runway clothing sizes and to continue receiving employment contracts (Gladstone, 2016). In 2017, after the Shanghai fashion week, a 14-year-old female model died from starvation and workplace exhaustion (O’Malley, 2017). In spring 2019, the first male model collapsed and died on the catwalk during Sao Paolo Fashion week (L. Brown, 2019). While the cause of his death has not been publicly released, the model was on a strict vegan diet and consumed no food on the day of his death (L. Brown, 2019).

With numerous deaths and prevalent eating disorders, the extreme thinness among the modeling population has become a widely discussed topic in international media. However, according to industry experts (Clements, 2013), scholars (Mears, 2010; Simmerson, 2013), and even models themselves (Model Alliance, 2020), modeling industry officials often remain in denial that this main aesthetic eligibility standard set by the industry (Record & Austin, 2016) is gravely endangering runway models’ health (De Jonge & van Furth, 1999; Treasure et al., 2008). Although extreme thinness among runway models is apparent and can be verified on modeling agencies’ websites, which publish working models’ BMs for recruitment purposes, there is no quantitative research evidence of BMs among the runway modeling population. Relatedly, while several conceptual articles have described the extreme thinness among female models (Mears, 2010; Record & Austin, 2016; Treasure et al., 2008), research has not questioned or assessed thinness among male models.

As runway models play a central role in creating and promoting beauty and body ideals in a culture (Entwistle & Wissinger, 2006; Grogan, 2016), it is critical to understand the level of thinness and related health parameters in this population. Therefore, the main purpose of this study is to describe BMs and anthropometric health parameters. This analysis can provide the basis for future conversations among researchers, industry, and other interested parties about available solutions to prevent the deadly occupational hazards that threaten this population. To accomplish research purpose, we used secondary industry-reported data to address two specific objectives. The first objective was to quantify BMs, including female and male runway models’ height, weight, and circumference of bust/chest, waist, and hip, to understand prevailing occupational aesthetic standards in runway modeling. The second objective was to assess the anthropometric health parameters, including BMI (a measure of body fat based on height and weight proportions) and waist-to-hip ratio (a measure of body fat based on hips and waist proportions), to understand the severity of a model’s thinness.

It is hoped that the findings of this study will encourage researchers in the field of clothing and textiles to collectively support and foster fundamental and permanent aesthetic change (Austin, 2000; Chevalier & Buckles, 2019; Neumark-Sztainer, 2016). Educating new generations of fashion leaders, designers, marketers, and retailers will advocate and create healthier body standards for models who represent this particular promotional labor force (Entwistle & Wissinger, 2006). Consequently, internal aesthetic changes on the promotional side of the industry might ultimately affect social change (Cash & Smolak, 2011). Greater visibility of bodies that vary in size and shape (but also in color, ability, and age) on the runways, as a mirror of mainstream culture, will likely contribute to body satisfaction among consumers of all body types and thereby protect public well-being (Levine & Smolak, 2006).

Literature Review

The Modeling Industry Conundrum

According to New York State Labor and Compensation Law (1992, section 511, subparagraph 3, chapter 668), “a professional model is someone who performs modeling services for the purposes of advertising and/or purposes of trade, and the service includes appearing in photographic sessions or on runways during live shows for remuneration…These services furthermore include transferring the legal right to the client to use their image for advertising purposes of their company, brand or designer.” Sociologists have long debated the conceptualization of modeling (see Entwistle & Wissinger, 2006; Holla, 2016; Mears, 2011). Because the media has predominantly focused on lucrative careers pursued by a small number of high-performing supermodels in the fashion industry, modeling is often perceived as a glamorous and prestigious career (Simmerson, 2013). Consequently, the reality of most working models has been misrepresented, and therefore concrete labor and employment issues remain less understood (Bildfell, 2018). For example, it is rather unknown that models operate in extremely unregulated conditions (Simmerson, 2013; Soltis, 2009).

One reason that makes regulation of the modeling industry almost impossible is its global and fragmented structure (Soltis, 2009). The fashion industry has an international scope, so models are often hired for jobs in different countries (Mears, 2011). Simmerson (2013) reports that this is especially true during bi-annual fashion week seasons, when designers showcase their collections in the four major fashion capitals New York, Paris, London, and Milan, during which models might be booked for two fashion shows in different countries even in a single day. Thus, standardizing industry regulations is difficult because models face a range of employment statuses under the laws of the countries where they work only temporarily (Simmerson, 2013).

Another reason that makes model workforce regulation almost impossible is the employment classification (Bildfell, 2018; Simmerson, 2013). In the United States, as well as the majority of global modeling markets, models are classified as being engaged in occupational labor because they have a legal status of independent contractors represented by a modeling agency, through which they are hired per job (Mears, 2011; Simmerson, 2013). As contractors, models do not qualify for protection and coverage afforded by the Americans with Disabilities Act and are ineligible for Occupational Safety and Health Administration plans because these protections are available only to full-time employees (Record & Austin, 2016). Thus, modeling is a deregulated occupation because it offers no security or benefits, such as health insurance, workplace protection, retirement, or medical leave (Record & Austin, 2016). Working hours are rarely defined, breaks are not mandatory, and minimum wage requirements often do not apply (Simmerson, 2013). Furthermore, most models begin their careers at a very young age (14 or 15 years, with parental permission), making the modeling industry, in large part, reliant on child labor (Bildfell, 2018; Model Alliance, 2020; Simmerson, 2013; Soltis, 2009).

Given these unique specifications, sociologist Ashley Mears (2011), who used to work as a professional model, describes modeling as a precarious or risky occupation. Yet both Mears and other scholars (e.g., Holla, 2016; Entwistle & Wissinger, 2006) agree that modeling is particularly significant in the context of global retail industries. As models’ images and bodies are universally used for promotional and display purposes for various services and products, the entire retail industry strongly depends on the modeling workforce (Entwistle, 2004).

Occupational Aesthetic Standards in the Runway Modeling Industry

Some models have certain aesthetic advantages for modeling careers, such as adequate height, desirable bone structure, and appealing facial features (Holla, 2016). Furthermore, “whiteness” and Anglo-Saxon facial features were also identified as important but often undisclosed prerequisites for model hiring (see E. H. Brown, 2019; Wissinger, 2012). Furthermore, researchers agree that adequate height (typically taller than average for men and women) or specific skin tone are not guarantors of models’ success, as models need to actively maintain their low body weight to manage a successful modeling career (Holla, 2016; Mears, 2013; Mears, 2011). Using aesthetic categorizations (e.g., tall, thin, curvaceous) that define the types of jobs models can do, modeling agencies around the world classify female and male models in two stratified groups: commercial models and high-fashion or runway models (Mears, 2010).

Commercial models are hired to work commercial jobs, which include advertisements and catalogs and other jobs that target a mass consumer base. To appeal to the masses, commercial models need to be glamorous, with curvaceous body features, larger breasts than average (in the case of women) or a more muscular upper torso (in the case of men), good-quality hair, and symmetric facial features (Jones, 1970; Mears, 2010). By contrast, high-fashion or runway models are mainly hired to work runway fashion shows and magazine covers (Mears, 2010). Unlike catalog commercial models, whose bodies can be re-touched and polished in the post-editing photo process, imperfect fit in clothes cannot be shown in runway fashion shows (Mears, 2013). Hence, to fit into small runway clothing sizes and to appeal to fashion designers, runway models must be tall and thin (Clements, 2013; Holla, 2016; Mears, 2010)

Exploring runway models as a unique type of promotional or aesthetic labor (Enstwistle & Wissinger, 2006) is particularly important for several reasons. Runway models’ bodies serve as hangers for clothing, and they also symbolize occupational aesthetic standards as they portray desirable aesthetic values within the fashion industry (Enstwistle & Wissinger, 2006). Thus, the process of commodification of models’ physicality is evident, and therefore models follow almost a disciplinary regimen of body weight surveillance (Rodgers et al., 2017), which often includes a high investment in corporality (body) and appearance (Mears, 2011). In addition, as competition in the modeling world is fierce (which makes them easily replaceable), models experience high appearance pressures (Rodgers et al., 2017), and they are required to monitor and control their bodies’ size to consistently emulate desirable industry aesthetics (Holla, 2016).

Runway industry preference for an aesthetic ideal for female models that includes a pre-adolescent body shape (a breast-less, hips-less body that can fit into small garment sizes) can be traced as far back as the 1920s, when designers began commonly hiring boyish, straight-body, flat-chested female figures for garment promotion (Keist & Marcketti, 2013). Scholars examining bodies of varying sizes (e.g., plus-size) in the context of 1920s advertising have further confirmed that advertisers have intentionally sanctioned certain body types over others, thus giving prescriptive advice for those who did not have flat and tubular body types (Keist & Marcketti, 2013). Not surprisingly, ever since the 1920s, adult women in Western societies have increasingly resorted to dieting to get back their pre-adolescent body shape (Silverstein et al., 1986). Unlike the BMs for commercial models that in the following decades began changing to be more realistic of adult women (Grogan, 2016), runway model body aesthetics have, to this day, remained narrowly defined and mostly unrealistic of adult women.

Modeling industry preference for female thinness continued throughout the entire 20th century, with extreme thinness being even more salient in the 1990s (Gladstone, 2016). Perhaps the most famous example of this particular aesthetic was the super model Kate Moss, whose body was notoriously labeled as being “size zero” (Grogan, 2016). Likewise, following the rise of male retail and grooming markets in the 1980s and especially during the 1990s, when more young male models began approaching modeling agencies (Nixon, 1996), the similar narrow ideal transferred from the female to male modeling population. As the head of the male model division in the Storm modeling agency in Britain confirmed, the desired look for a male model from the 1990s onward has become a slim and moderately muscular body type (Grogan, 2016).

As thinness became a consistently growing trend portrayed in media and popular culture, various studies began investigating how people perceive models’ body representations in fashion advertisements (e.g., Grogan, 2016; Kim & Lennon, 2007; Rudd & Lennon, 2000). More frequent exposure to idealized media images was correlated with greater body dissatisfaction (Silverstein et al., 1986) and was often consistent among different age (Lennon et al., 2017; Tiggemann & Slater, 2017) and gender (Murray et al., 2016) categories. Studies also showed that body dissatisfaction often causes high investment in physicality and a preoccupation with the body, food, and weight (Lee & Johnson, 2009; Murray et al., 2016), which in cases of certain female and male participants led to the development of anorexia nervosa (Smink et al., 2012; Zhao & Encinosa, 2011). Furthermore, when discussing the link between thin models in the media and public health, scholars (Cash & Smolak, 2011; Levine & Smolak, 2006) agreed that unrealistically thin models’ bodies were ultimately dangerous for most viewers because, at minimum, they shift the public perception of what a normal body looks like (Grogan, 2016; Treasure et al., 2008). From that perspective, extreme thinness among models is not just an internal modeling industry problem; aesthetic ideals in the modeling industry affect the larger population as well (Zancu et al., 2019).

How Thin Is Dangerously Thin? BMs and Eating Disorders Among Runway Models

Runway models are particularly vulnerable to low BM requirements because they need to fit perfectly into extremely small garment sizes preferred for promotional purposes (Records & Austin, 2016). According to the scarce estimates in the literature, the average weight of a female model is at least 23% less than the weight of an average female non-model (Grogan, 2016). Comparison between the body composition of professional fashion models and average women shows that models have significantly thinner biceps (front of upper arm), triceps (back of upper arm), subscapular (shoulder to upper chest), and suprailiac (upper bone of hip) areas than women in general (Park, 2017). In addition, only in 7% of cases is a woman between the ages of 18 and 34 years naturally as slim as a runway model without any extreme dietary strategies (Gladstone, 2016).

Ethnographic studies reveal that since the beginning of the 21st century, promotional dress sizes for female runway models in the United States have fluctuated somewhere between dress size zero and dress size six (Mears, 2010). Measurement-wise, those sizes suggest that a female model’s figure preferably ranges between 30 and 34 inches in the bust, between 22 and 25 inches in the waist, and between 32 and 36 inches in the hips. Nevertheless, with the last longitudinal anthropometric assessment of female model bodies being published 3 decades ago (Morris et al., 1989), when female models were substantially larger, the actual and most recent model BMs remain unknown. However, the average dress size currently worn by adult women is more typically between a size 16 and 18 (Christel & Dunn, 2017). Assessing BM in the case of male models is even more challenging. We find only one study describing male model anthropometrics (Entwistle, 2004); here, field evidence indicates that at the beginning of the 21st century, the standard male model BMs were 38 to 42 inches in the chest and 30 to 32 inches in the waist, and the preferable height for a male runway model was 6 feet 3 inches.

Disciplinary regimens of body weight surveillance among professional models are a commonly discussed topic in academic literature (Entwistle, 2004; Mears, 2011). When compared with their average peers, models exhibit elevated eating disorder symptoms and a higher prevalence of low, medically concerning BMI (Preti et al., 2008; Rodgers et al., 2017). Although they are certainly not the type of laborer pictured when thinking of those who work in poor conditions, thousands of models worldwide experience tremendous industry pressure to achieve the skeletal body shape to become aesthetically eligible to display high-fashion collections on the runway (Record & Austin, 2016), commonly leading to eating disorders among this population (Treasure et al., 2008).

While eating disorders among models are anecdotally common, published evidence of eating disorder types and prevalence is lacking (Zancu et al., 2019). Despite scarce scientific literature, eating disorders among models, which are usually not specified, refer to unhealthy weight control behaviors, including different strategies of weight regulation through self-induced vomiting or use of stimulants (e.g., Ritalin), intravenous drips (e.g., banana bags) (Rodgers et al., 2017), and supplements and drugs (Santonastaso et al., 2002). Industry evidence confirms that unhealthy behaviors among models also often include starvation, food deprivation, or non-food-item consumption (Clements, 2013). For example, models are increasingly using the Tongue Patch Diet (also known as the Weight Reduction Patch, Chugay Patch, and Miracle Patch), in which a hard mesh patch is surgically attached to the top of the tongue to prevent solid food consumption (Chugay & Chugay, 2014; Styles, 2014).

Assessing the level of models’ thinness using BMs and related health parameters in this population is critical for several reasons. First, medical studies reveal that severely low BMI values in women often lead to amenorrhea, while in both female and male populations, they may cause infertility, poor bone density, digestive tract problems, hearing problems, shortness of breath, fatigue, heart arrhythmia, and sudden cardiac arrest (Hudson & Court, 2012). Second, clinical observations for the eating disorder anorexia nervosa confirm that female and male patients have BMI values between 14 and 18.5 and that their mental state is often affected by issues of depression, anxiety, and substance use (Dakanalis et al., 2018). Finally, social work studies have found that malnourished people are incapable of working and earning money for a living, which puts them at increased risk for work impairments (e.g., James, 2018).

Though important to provide a basis for future problem solutions, assessment of the anthropometric health parameters among runway model populations is fraught with challenges. Previous research has found that most modeling agencies either declined to participate in studies or sabotaged the collaboration by denying that extreme thinness is the main aesthetic eligibility standard set by the industry (De Jonge & van Furth, 1999; Mears, 2011). Likewise, exploring eating disorders by interviewing models is often not effective because of their inclination to report desirable behaviors that enable them to keep working (Zancu & Enea, 2017). Systematic review of seven studies examining eating disorders among female models showed that models’ mean BMI was around 18, ranging from 16.9 to 18.9 (Zancu & Enea, 2017). However, studies included in the review captured only self-reported BMI values (waist-to-hip ratio was not reported), the sampling did not include any top-performing runway models, and the studies often mixed commercial and plus-size models in their sample population.

Method

In this quantitative study, we analyzed secondary data to quantify models’ BMs and assess their anthropometric health parameters (Johnston, 2017). The secondary, industry-reported dataset we explored contained de-identified model information, including reported age, assigned sex at birth and BMs, including height, weight, and hip, waist, and bust/chest circumference. The Institutional Review Board evaluated the study protocol and confirmed that, because of model anonymity (names, gender, race, and ethnicity), its approval of the secondary data was not required.

Sample

Modeling agencies worldwide publish BMs of working female and male models on their official websites (https://models.com/agencies/) so that designers and other clients can decide whether the model is suitable for recruitment. These published BMs include height and hip, waist, and bust/chest circumference and, less often, model weight. The lack of weight data prevents the assessment of anthropometric health and BMI calculations. To ensure that we had complete BMs, the lead author of this study used personal connections within the fashion industry to obtain the complete secondary dataset from a leading international casting director’s list of best-performing runway models.

Casting directors choose models for major runway shows based on their performance (number of confirmed fashion shows across four major fashion centers) in a given season (Clements, 2013). Each model in the casting director dataset completed at least eight out of 20 leading designer fashion shows (shows for the most prominent designer brands in the world, such as Versace, Dior, Chanel, Armani) in a given season in the four fashion centers of New York, Paris, London, and Milan. Given that the dataset obtained included the list of runway models who participated in the majority of the leading designer runway shows (on average, these models performed in 16 out of 20 shows) over seven consecutive fashion week seasons—fall/winter (f/w) 2012–2013, f/w 2013–2014, f/w 2014–2015, f/w 2015–2016, f/w 2016–2017, f/w 2017–2018, and f/w 2018–2019, we deemed the sample representative of the runway modeling population.

The complete dataset was included in the analysis, and no models were excluded from this list and no other models were included (Johnston, 2017). The dataset contained de-identified information of international models (N = 609). Each data entry point was representative of one model, and no individual model was repeated in the dataset. According to the industry annual rankings, most of the leading designer shows in a given season in the four major fashion capitals include the same group of top-100 female and top-100 male models (Tai, 2018). Thus, the sample size is adequate to describe runway models who are expected to have the thinness and flattest bodies in the industry (Holla, 2016; Mears, 2010). All other categories of models who are allowed to have larger BMs, such as plus-size models, fitness models, and commercial models (Mears, 2011), were not represented in the study.

Measures

According to the World Health Organization (2008), anthropometry provides a universally applicable, inexpensive, and non-invasive technique for assessing the size and composition of the human body as a reflection of both health and nutritional status. An anthropometric body assessment is essential in various disciplines (e.g., nutrition, medical disciplines, clothes production etc.) that use critical similarities or differences among human BMs to describe certain patterns applicable to human growth (e.g., children growth scales), weight (e.g., weight charts), health (e.g., BMI scales), and size (e.g., standardized clothing size charts). In the modeling industry, trained individuals routinely take anthropometric BMs before each job confirmation (Jones, 1970; Mears, 2011). As models need to perfectly fit into the predetermined, promotional dress sizes, their BMs are taken before fashion show confirmation, as accurately as possible, to avoid wrong fit and possible job cancelation (Mears, 2011). Given such rigorousness of the measuring process, we deemed all BMs in the dataset accurate and reliable.

Anthropometric BMs are carried out with the model standing, without clothes or shoes, aligned so that the shoulders, buttocks, and heels are leaning against the vertical surface of the stadiometer while all the measurements are taken (Jones, 1970). Height is assessed using a stadiometer to the nearest of 0.197 inches. Weight is measured to the nearest quarter pound using a digital scale. Circumference measurements are taken using an inelastic measuring tape. The zero end of the tape is held under the measurement value, and the measurement is read from the right side (Nelms & Sucher, 2015). Bust circumference for women and chest circumference for men is measured around the fullest part of the bust or chest area, without compressing the skin. Waist circumference is taken with the measuring tape around the abdomen at the level of the iliac crest. Finally, hip circumference is measured around the buttocks, rather than around the hip bone area (Jones, 1970).

Data Analysis

We calculated the mean BMs for female and male models. We calculated waist-to-hip ratio as waist measurements divided by hip measurements (w/h). One inch represented a unit of measure. We used height and weight values from the dataset to calculate BMI for adults (age equal to or greater than 20 years) following the established formula (weight [kg]/height [m²]) (WHO, 2008). For the adolescent population (age equal to or less than 19 years), for greater accuracy, we calculated age-adjusted BMI measures using the child and teen BMI calculator from the Centers for Disease Control and Prevention (CDC) ( https://www.cdc.gov/healthyweight/bmi/calculator.html ).

We report the BMI values for adult models using the adult classification system for healthy weight (BMI equal to or greater than 18.5 to 24.9 kg/m²), underweight (BMI less than 18.5 kg/m² and greater than 16.5 kg/m²), and severely underweight (BMI less than 16.5 kg/m²) in the weight status category (Weir & Jan, 2019). We compared BMI values for adolescent models with the classification for the adolescent population. We analyzed the data using descriptive statistics in SPSS (George & Mallery, 2016). Mean values and standard deviations were used to describe central tendencies for male and female models.

Results and Discussion

Sample Characteristics

Our sample included 312 female, and 297 male international runway models. When we divided female and male models into two age groups following the CDC guideline (CDC, 2016) the results showed that during the investigated period, 11 adult (age range: 20–29 years) and 301 adolescent (age range: 16–19 years) female models participated in fashion week shows. In addition, 179 adults (age range: 20–25 years) and 118 adolescent (age range: 16–19 years) male models participated in fashion week shows. Over the seasons, the number of adolescent male models steadily increased. For example, in seasons 2012–2013 and 2013–2014, adolescent male models were not present in the sample, while in seasons 2018–2019, all male models were adolescents.

Objective 1: Quantification of Body Measurements

Our first research objective was to quantify BMs by female and male runway models’ height, weight, and bust/chest, waist, and hip circumference. In exploring BMs across seven fashion week seasons, we found that female and male runway models’ height only slightly changed over the investigated seasons. Female models were approximately one inch taller in 2019 (M = 70.75, SD = 0.35) than in 2012 (M = 69.65, SD = 0.52). When we calculated the average female model’s height by feet and inches, models were on average (and approximately) between 5 feet 9 inches and 5 feet 11 inches tall. By contrast, male models were on average one inch shorter in 2019 (M = 73.46, SD = 0.42) than in 2012 (M = 74.40, SD = 0.36). Across the seasons, male models in the sample were on average (and approximately) between 6 feet 1 inch and 6 feet 2 inches tall. These results further reveal that, in contrast with the beginning of the 21st century, when the average height for a male runway model was 6 feet 3 inches (Entwistle, 2004), desirable male model height has slightly decreased. Consequently, maximal and minimal height of female and male models have become closer.

In terms of body weight, the average weight was 108 pounds (SD = 0.53) and 141 pounds (SD = 6.11) for female and male models, respectively. While female model weight has been consistent over the years, male model weight has clearly decreased. For example, the results showed that in season 2018–2019, the average male model weight (M = 133.68, SD = 1.02) was 18.34 pounds less than the average male model weight in 2012–2013 (M = 152.02, SD = 2.90). The dramatic drop in male model weight confirms the growing industry preference for thin male models (Siddons, 2016). Over the seven fashion week seasons, female model BMs were consistently low and thus only slightly changed (Table 1). Female models had an average hip circumference of 34.52 inches, average waist circumference of 23.76 inches, and average breast circumference of 32.12 inches.

Table 1.

Body Measurements (BMs) Change over Seven Fashion Seasons.

	Fashion Week Seasons
	2012/13	2013/14	2014/15	2015/16	2016/17	2017/18	2018/19
BMs	M(SD)	M(SD)	M(SD)	M(SD)	M(SD)	M(SD)	M(SD)
Female Height	69.65(0.52)	69.93(0.70)	70.05(0.56)	70.13(0.67)	70.52(0.68)	70.64(0.72)	70.75(0.35)
Female Weight	106(2.66)	107(2.74)	108(2.09)	107(2.61)	108(2.32)	108(2.89)	109(2.35)
Female Hips	34.58(0.36)	34.56(0.36)	34.73(0.35)	34.49(0.36)	34.51(0.35)	34.32(0.34)	34.35(0.50)
Female Waist	23.84(0.29)	23.77(0.36)	23.84(0.39)	23.86(0.45)	23.73(0.33)	23.58(0.31)	23.66(0.42)
Female Bust	32.58(0.62)	32.47(0.55)	32.46(0.66)	31.88(0.62)	31.56(0.53)	31.74(0.64)	32.38(0.51)
Male Height	74.40(0.36)	74.28(0.51)	74.07(0.56)	73.29(0.40)	73.87(0.61)	73.71(0.57)	73.46(0.42)
Male Weight	152(1.02)	149(1.80)	144(2.37)	141(2.51)	137(3.71)	136(3.76)	133(2.90)
Male Hips	37.59/(0.20)	37.40(0.20)	36.81(0.33)	36.47(0.27)	35.31(0.44)	35.10(0.61)	35.13(0.42)
Male Waist	29.70/(0.20)	29.44(0.25)	28.93(0.35)	28.39(0.31)	27.83(0.53)	27.85(0.71)	27.63(0.53)
Male Chest	38.53(0.13)	38.01(0.52)	37.35(0.38)	36.90(0.33)	35.60(0.56)	34.62(0.83)	35.11(0.67)

Note. This table demonstrates body measurements change over seven fashion week seasons. Inch is a unit of measure for height, waist, hips bust/chest; pound is a unit of measure for weight

Similar to female model BMs, which were consistently low, male model hip, waist, and chest circumferences also decreased during the investigated period (Table 1). Consequently, male models had higher measurement variability in the hips, waist, and chests. Male models had an average hip circumference of 36.22 inches, average waist circumference of 28.59 inches, and average chest circumference of 36.52 inches. These results indicate that male model bodies have become substantially thinner than at the beginning of 21st century, when standard male model BMs were somewhere between 38 and 42 inches in the chest and between 30 and 32 inches in the waist (Entwistle, 2004; Siddons, 2016). With female and male bodies, especially in the hips and bust/chest area, becoming similarly structured, the findings further confirm that an extremely thin, shapeless body is in fact the normative occupational aesthetic standard.

Objective 2: Assessment of Anthropometric Health Parameters

Our second research objective was to assess anthropometric health parameters, including BMI and waist-to-hip ratio. For that purpose, we calculated BMI for adult and adolescent models following the CDC guideline and formulas (CDC, 2016). The results revealed concerningly low BMI values among the female and male models no matter the age category (Table 2). In the investigated period, the average BMI for adult and adolescent female models was 15.59 (SD = 0.18) and 15.40 (SD = 0.25), respectively. Regardless of their age (M-age = 17.4 years, SD = 1.23), all female models (n = 312) in the sample fell below the severely underweight BMI cutoff (<16), corresponding to one percentile of the world’s population (CDC, 2016).

Table 2.

Body Mass Index Change over Seven Fashion Week Seasons.

Body Mass Index		Fashion Week Season
Body Mass Index		2012/13	2013/14	2014/15	2015/16	2016/17	2017/18	2018/2019
Sex	Age group	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)	M (SD)
Female	Adult	15.48(0.17)	15.65(0.17)	15.60(0.24)	—	—	—	—
	Adolescents	15.94(0.32)	15.44(0.18)	15.60(0.23)	15.34(0.19)	15.36(0.19)	15.26(0.26)	15.31(0.26)
Male	Adult	19.30(0.18)	18.85(0.22)	18.51(0.17)	18.17(0.20)	17.76(0.28)	17.74(0.39)	—
	Adolescents	—	—	18.57(0.08)	18.24(0.12)	17.69(0.22)	17.66(0.28)	17.41(0.21)

Note. This table demonstrates Body Mass Index Change over seven fashion week seasons. Body Mass Index = weight (kg) / height (m²); healthy BMI is equal to or greater than 18.5 to 24.9 kg/m².

^a= Dash line (—) indicate that a cell cannot be filled because there were no models in that particular age group in the selected season.

Across the seasons, when considering the entire male model sample (n = 297), BMI values changed from a healthy weight (BMI = 19.30, SD = 0.18) to underweight (BMI < 18). Adult male models on average had a mean BMI of 18.54 (SD = 0.50). The BMI values for 80 adult male models (45% of the total sample) were in the underweight category (BMI < 18.5) (Table 2). Male adolescents on average had a mean BMI of 17.67 (SD = 0.34). Moreover, 92% (n = 109) of adolescent male models fell in the 1st-, 2nd-, 3rd-, or 4th-percentile underweight category (CDC, 2016). In addition, there was no significant difference in models’ waist-to-hip ratio values. Such findings confirm that waist and hip circumference of models either remained stagnant (for women) or proportionally changed (waist and hip circumference proportionally decreased for men); thus, waist-to-hip ratio values across the seven investigated seasons remained more stable (female models = 312; M-ratio = 0.68, SD = 0.01; male models = 297; M-ratio = 0.78, SD = 0.013). When comparing the maximal female (.74) and minimal male waist-to-hip ratio (.75), the 10% points of difference indicate that the lower part of the models’ bodies (including waist and hips) is similarly structured.

The models’ thinness is especially concerning when comparing the average model anthropometrics against corresponding averages in the non-model peer population. The CDC (2016) indicates that anthropometric data for average adolescents aged 16–19 years increased in comparison with 2011. According to the latest publicly available CDC (2016) report, the average anthropometric measurements for female adolescents 19 years of age (n = 152) in the United States were as follows: a weight of 150 lbs. (SD = 4.77), a waist circumference of 33 inches (SD = 1.76), and an approximate height of 5 feet 4 inches (SD = 0.40). Male adolescents 19 years of age (n = 144) in the United States had a weight of 174 lbs. (SD = 4.95), a waist circumference of 34 inches (SD = 1.90), and an approximate height of 5 feet 8 inches (SD = 1.12).

This study demonstrates that, with the exception of height, all anthropometric measurements of the models were dramatically lower than their general population peers. For example, the waist circumference for female and male adolescents was 24 and 28 inches, respectively, which is 9 and 6 inches less than in the peer population, respectively. Similarly, the average female and male model weight of 110 and 134 pounds, respectively, is 40 pounds (or 30%) less than their average peer weight. Compared with Grogan’s (2016) findings that female model weight is 23% less than the weight of an average female non-model, the results of this study showed that the weight gap is currently 30%. Nevertheless, both female and male models were significantly taller, and the height gap between models and their peers was approximately 6 inches for both women and men.

Conclusion

The results of this study extend previous qualitative research (Entwistle, 2004; Mears, 2010; Record & Austin, 2016; Treasure et al., 2008) by providing quantitative evidence of concerningly low BMs among female and male runway fashion models. Anthropometric body analysis across seven consecutive fashion week seasons confirmed that extreme thinness in the modeling industry represents a universal and normative occupational standard, regardless of age. All female models in the sample fell below the severely underweight BMI cutoff (BMI < 16). The average male model weight cumulatively decreased approximately 12%, with 45% of underweight adult male models and 92% underweight adolescent male models.

Study Implications

Implications for Academia

Low BMs and decreasing BMI values of runway models are life-threatening, as they are indicative of extreme body malnutrition, which can seriously affect models’ lives and general health. The findings regarding male model BMs and BMI are especially significant because male modeling has been neglected in academic literature to date, even though male fashion weeks have an equally important place and meaning in the official fashion industry calendar. Medical studies reveal that severely low BMI values in both female and male populations may cause infertility and other risky health issues (Hudson & Court, 2012), so it is critical to closely monitor the runway modeling industry for its occupational labor pressures, which may further encourage legislative proposals and policy implementation (Rodgers et al., 2017). This study’s findings also raise important questions that require further investigation, such as whether female and male models who are starving themselves to retain their extensively thin bodies are actually capable of working without jeopardizing their own lives (James, 2018).

Implications for practice

Prevention of occupational hazards among the runway modeling population faces practical challenges. Most models, even when they have eating disorders, are uninterested in seeking treatment because they know that maintaining an unrealistically thin appearance is the precondition to maintaining employment (Gladstone, 2016; Preti et al., 2008). Seeking treatment for eating disorders is also not often encouraged by modeling agencies (Clements, 2013; Simmerson, 2013), and industry representatives may even argue that BMI is an arbitrary metric and thus is an imperfect measure of human health (Treasure et al., 2008).

Industry regulation, through legislation, is the most urgent and adequate response, and legislative interventions have already been initiated in France and Israel (Bildfell, 2018). In 2016, California State Assembly member Marc Levine introduced a bill that would require the Occupational Safety and Health Standards Board to adopt new occupational standards that would support the prevention of eating disorders in the modeling industry (Bildfell, 2018). At the time of this study, this bill remained under consideration. However, if the bill is passed, modeling agencies in California would operate under the auspices of the Labor Commissioner, and modeling agencies would be inspected for the health and well-being of its workforce (Bildfell, 2018). As a law in one country, especially in the context of the global and fragmented modeling industry, is insufficient to create behavioral change world-wide, an additional step to prevent eating disorders in the modeling industry must include collective efforts to raise acute awareness about unhealthy occupational aesthetics and eating disorders that affect not only female models but male models as well. From that perspective, industry-based, targeted prevention programs within existing fashion community networks (e.g., Council for Fashion Designers of America, Model Alliance) might stimulate early disease recognition and alter attitudes and behaviors.

Implications for public health

Elaborated differences in BMs between models and their peers reveal a serious discrepancy between models’ bodies and those in the average population. With models’ bodies becoming substantially thinner and the world population getting substantially larger (CDC, 2016), the already existing gap between actual and ideal bodies is further exaggerated (Levine & Smolak, 2006). Such discrepancies may directly affect consumers’ mental and physical health by contributing to body dissatisfaction, body image disturbances, and the practice of unhealthy appearance management behaviors (Rudd & Lennon, 2000; Tiggemann & Slater, 2017). Although the etiology of eating disorders is multifactorial, thin imagery often contributes to the development of anorexia nervosa, especially among young girls (Smink et al., 2012) and boys (Zhao & Encinosa, 2011). From that standpoint, occupational aesthetics in the modeling industry not only is an internal problem affecting model health and well-being but also extracts a high external toll on the general public who view fashion media (Cash & Smolak, 2011; Kim & Lennon, 2007).

Limitations

While the secondary data present some limitations over the empirical data, the BMs for the modeling population are the main casting criteria and were collected using a controlled and consistent method and may be less biased than secondary data that used self-reported, or collected BMs for the general population. The authors want to acknowledge that models’ BMs and weight through the year may fluctuate, yet industry practice shows that despite the fashion week season, fluctuating weight of one pound is a big enough reason for models to get fired before the show (Bruk, 2017). Knowing this rigidness about body weight, we believe that if we obtained and included a dataset of models that performed in spring season shows, BMs and weight would not have been significantly different within the same year.

Indirect health assessment via anthropometrics represents a limitation of the study. In addition, there are ethnic and race differences in BMI markers (CDC, 2016), which, due to the lack of ethnic/racial information for working models, we did not consider in this study. Yet, considering that racial diversity is still rather limited in top runway modeling, with the majority of models (approximately 70%) being Caucasian (Tai, 2018), the current findings serve as a solid baseline for further health and work safety research. The BMI may be unreliable when working with populations having a high level of muscle mass, classifying them in the unrealistically high BMI category (Treasure et al., 2008). However, deficiencies associated with BMI for underweight populations have not been reported, and the metric is frequently used as a screening tool for eating disorders (Dakanalis et al., 2018). Limitations in the current study might be addressed in future studies through the use of primary data collection. Optimally, anthropometric measurements should be accompanied with medical tests to evaluate malnutrition-related health risks.

Suggestions for Educational Outreach

There is widespread concern among clothing and textiles scholars that the modeling industry, by promulgating extremes of thinness, is creating a “toxic” public environment in which eating disorders and other unhealthy appearance-related behaviors flourish (e.g., Kim & Lennon, 2007; Lee & Johnson, 2009; Lennon et al., 2017; Rudd & Lennon, 2000). Considering the reach of fashion images and their detrimental effects on consumers, we call for scholars to consider feasible and stimulating scholarly initiatives (e.g., Body Positivity programs) and curriculum activities (e.g., lectures on body positivity, self-care, well-being and resilience) to promote health and well-being inside and outside classrooms as the part of the problem solution (Chevalier & Buckles, 2019; Neumark-Sztainer, 2016; Rudd & Jestratijevic, 2019). Although scholars in the clothing and textiles discipline have greatly expanded the study of body image, appearance management behaviors, and their contributing factors in the past 30 years, it is important to continue such endeavors to become agents of change in the fashion and modeling industry by advocating the message that in this diverse world, beauty comes in all shapes and sizes. Furthermore, cross-disciplinary collaborations may represent another feasible means to advance local and national eating disorder prevention efforts (Austin, 2000). It is now time to acknowledge that unhealthy occupational aesthetics, appearance pressures, and eating disorders of models represent both labor issues and serious public health issues and that these issues need to be addressed by extending research collaborations across disciplinary lines.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) received no financial support for the research, authorship, and/or publication of this article.

ORCID iD

Iva Jestratijevic

References

Austin

S. B.

(2000). Prevention research in eating disorders: Theory and new directions. Psychological Medicine, 30(6), 1249–1262.

Bildfell

(2018). Legislating away illness: Examining efforts to curb the development of eating disorders through law. Dalhousie Journal of Legal Studies, 26, 37.

Brown

E. H.

(2019). Work! A queer history of modeling. Duke University Press.

Brown

(2019, April 28). Brazilian model Tales Soares dies after collapsing on catwalk. New York Post. https://nypost.com/2019/04/28/brazilian-model-tales-soares-dies-after-collapsing-on-catwalk/

Bruk

(2017, May 18). This model was fired from Louis Vuitton for being “too fat”. Observer. https://observer.com/2017/05/model-ulrikke-louise-lahn-hoyer-fired-from-louis-vuitton-for-being-too-fat/

Cash

T. F.

Smolak

(Eds.). (2011). Body image: A handbook of science, practice, and prevention. Guilford Press.

Centers for Disease Control and Prevention. (2016). National center for health statistics: Anthropometric reference data for children and adults: United States, 2011–2014. https://www.cdc.gov/nchs/data/series/sr_03/sr03_039.pdf

Chevalier

J. M.

Buckles

D. J.

(2019). Participatory action research: Theory and methods for engaged inquiry. Routledge.

Christel

Dunn

(2017). Average American women’s clothing size: Comparing national health and nutritional examination surveys (1988–2010) to ASTM international misses & women’s plus size clothing. International Journal of Fashion Design, Technology and Education, 10(2), 129–136.

10.

Chugay

P. N.

Chugay

N. V.

(2014). Weight loss tongue patch: An alternative nonsurgical method to aid in weight loss in obese patients. American Journal of Cosmetic Surgery, 31(1), 26–33.

11.

Clements

(2013). The Vogue Factor. Melbourne University Publishing.

12.

Dakanalis

Timko

C. A.

Colmegna

Riva

Clerici

(2018). Evaluation of the DSM-5 severity ratings for anorexia nervosa in a clinical sample. Psychiatry Research, 262, 124–128.

13.

De Jonge

P. v. H.

van Furth

E. F.

(1999). Eating disorders in models: Fiction of fact? European Eating Disorders Review, 7(4), 235–238.

14.

Entwistle

(2004). From catwalk to catalog: Male fashion models, masculinity, and identity. In Thomas

Ahmed

(Eds.), Cultural bodies: Ethnography and theory (pp. 55–75). Wiley.

15.

Entwistle

Wissinger

(2006). Keeping up appearances: Aesthetic labor in the fashion modelling industries of London and New York. The Sociological Review, 54(4), 774–794.

16.

George

Mallery

(2016). Descriptive statistics. In IBM SPSS Statistics 23 Step by Step: A simple guide and reference (pp. 126–134). Routledge. https://doi.org/10.4324/9781315545899

17.

Gladstone

(2016). The skinny on BMI-based hiring: An assessment of the legality and effectiveness of Israel’s weight restriction law. Washington University Global Studies Law Review, 15, 495.

18.

Grogan

. (2016). Body image: Understanding body dissatisfaction in men, women and children. Routledge.

19.

Holla

(2016). Justifying aesthetic labor: How fashion models enact coherent selves. Journal of Contemporary Ethnography, 45(4), 474–500.

20.

Hudson

L. D.

Court

A. J.

(2012). What pediatricians should know about eating disorders in children and young people? Journal of Pediatrics and Child Health, 48(10), 869–875.

21.

James

W. P. T.

(2018). From treating childhood malnutrition to public health nutrition. Annals of Nutrition and Metabolism, 72(3), 202–209.

22.

Johnston

M. P.

(2017). Secondary data analysis: A method of which the time has come. Qualitative and quantitative methods in libraries, 3(3), 619–626.

23.

Jones

(1970). Modelling and other glamourous careers. Simon & Shuster.

24.

Keist

C. N.

Marcketti

S. B.

(2013). “The new costumes of odd sizes”: Plus-sized women’s fashions, 1920–1929. Clothing and Textiles Research Journal, 31(4), 259–274.

25.

Kim

J.-H.

Lennon

S. J.

(2007). Mass media and self-esteem, body image, and eating disorder tendencies. Clothing and Textiles Research Journal, 25(1), 3–23.

26.

Lee

Johnson

K. K.

(2009). Factors related to engagement in risky appearance management behaviors. Clothing and Textiles Research Journal, 27(3), 163–178.

27.

Lennon

S. J.

Johnson

K. K.

Rudd

N. A.

(2017). Social psychology of dress. Fairchild Books.

28.

Levine

M. P.

Smolak

(2006). The prevention of eating problems and eating disorders: Theory, research, and practice. Psychology Press.

29.

Mears

(2010). Size zero high-end ethnic: Cultural production and the reproduction of culture in fashion modeling. Poetics, 38(1), 21–46.

30.

Mears

(2011). Pricing beauty: The making of a fashion model. University of California Press.

31.

Mears

(2013). Made in Japan: Fashion modeling in Tokyo. In Entwistle

Wissigner

(Eds.), Fashioning models: Image, text and industry (pp. 134–156). A & C Black.

32.

Model Alliance. (2020, April 14). How eating disorders in the fashion industry are labor issue. https://modelalliance.org/2017/how-eating-disorders-in-the-fashion-industry-are-a-labor-issue/how-eating-disorders-in-the-fashion-industry-are-a-labor-issue

33.

Morris

Cooper

P. J.

(1989). The changing shape of female fashion models. International Journal of Eating Disorders, 8(5), 593–596.

34.

Murray

S. B.

Griffiths

Mond

J. M.

(2016). Evolving eating disorder psychopathology: Conceptualizing muscularity-oriented disordered eating. British Journal of Psychiatry, 208(5), 414–415.

35.

Nelms

Sucher

(2015). Nutrition therapy and pathophysiology. Nelson Education.

36.

Neumark-Sztainer

(2016). Eating disorders prevention: Looking backward, moving forward; looking inward, moving outward. Eating Disorders, 24(1), 29–38.

37.

Nixon

(1996). Hard looks: Masculinities, spectatorship and contemporary consumption. Palgrave Macmillan.

38.

O’Malley

(2017, October 30). A 14-year-old model reportedly dies after 13-hour fashion show in China. Elle. https://www.elle.com/uk/fashion/news/a39622/russian-model-dies-fashion-show-china/

39.

Park

(2017). Comparison of body composition between fashion models and women in general. Journal of Exercise Nutrition & Biochemistry, 21(4), 22–26.

40.

Preti

Usai

Miotto

Petretto

D. R.

Masala

(2008). Eating disorders among professional fashion models. Psychiatry Research, 159(1), 86–94.

41.

Record

K. L.

Austin

S. B.

(2016). “Paris Thin”: A call to regulate life-threatening starvation of runway models in the U.S. fashion industry. American Journal of Public Health, 106(2), 205–206.

42.

Rodgers

R. F.

Ziff

Lowy

A. S.

Austin

S. B.

(2017). Results of a strategic science study to inform policies targeting extreme thinness standards in the fashion industry. International Journal of Eating Disorders, 50(3), 284–292.

43.

Rudd

N. A.

Jestratijevic

(2019). Body positivity. In Eicher

Tortora

(Eds.), Berg encyclopedia of world dress and fashion: Global perspectives. Berg.

44.

Rudd

N. A.

Lennon

S. J.

(2000). Body image and appearance-management behaviors in college women.Clothing and Textiles Research Journal,18(3), 152–162.

45.

Santonastaso

Mondini

Favaro

(2002). Are fashion models a group at risk for eating disorders and substance abuse? Psychotherapy and Psychosomatics, 71(3), 168–172.

46.

Siddons

(2016, June 7). The hidden dangers of male modelling. Newsweek. https://www.newsweek.com/2016/06/17/male-modeling-edward-siddons-467068.html

47.

Silverstein

Peterson

Perdue

(1986). Some correlates of the thin standard of bodily attractiveness for women. International Journal of Eating Disorders, 5(5), 895–905.

48.

Simmerson

A. R.

(2013). Not so glamorous: Unveiling the misrepresentation of fashion models’ rights as workers in New York City. Cardozo Journal of International & Comparative Law, 22, 153.

49.

Smink

F. R.

Van Hoeken

Hoek

H. W.

(2012). Epidemiology of eating disorders: Incidence, prevalence and mortality rates. Current Psychiatry Reports, 14(4), 406–414.

50.

Soltis

C. A.

(2009). Dying to be a supermodel: Can requiring a healthy BMI be fashionable. Journal of Contemporary Health Law & Policy, 26(1), 49–71.

51.

Styles

(2014, February 7). I have plastic sewn to my tongue so it hurts too much to eat solids. Daily Mail. https://www.dailymail.co.uk/femail/article-2553686/I-piece-plastic-sewn-TONGUE-hurts-eat-solids-reveals-extreme-beauty-queen-desperate-stay-thin.html

52.

Tai

(2018, October 18). The spring 2019 runways were the most racially diverse ever. The Fashion Spot. https://www.thefashionspot.com/runway-news/807483-spring-2019-runway-diversity-report/

53.

Tiggemann

Slater

(2017). Facebook and body image concern in adolescent girls: A prospective study. International Journal of Eating Disorders, 50(1), 80–83.

54.

Treasure

J. L.

Wack

E. R.

Roberts

M. E.

(2008). Models as a high-risk group: The health implications of a size zero culture. British Journal of Psychiatry, 192(4), 243–244.

55.

Weir

C. B.

Jan

(2019, December 7). BMI classification percentile and cut off points. https://www.ncbi.nlm.nih.gov/pubmed/31082114

56.

Wissinger

(2012). Managing the semiotics of skin tone: Race and aesthetic labor in the fashion modeling industry. Economic and Industrial Democracy, 33(1), 125–143.

57.

World Health Organization. (2008). Primary health care: Now more than ever. World Health Report. https://www.who.int/whr/2008/whr08_en.pdf

58.

Zancu

S. A.

Enea

(2017). Eating disorders among fashion models: A systematic review of the literature. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(3), 395–405.

59.

Zancu

S. A.

Rodgers

R. F.

Enea

(2019). Self-determined motivation for eating behavior regulation and sociocultural influences among Romanian fashion models. Body Image, 31, 150–159.

60.

Zhao

& Encinosa

W. E.

(2011). An update on hospitalizations for eating disorders, 1999 to 2009. Agency for Healthcare Research and Quality.