When 22-year-old fashion model Luisel Ramos died of a heart attack brought on by extreme dieting following a runway show last August, some in the fashion industry reacted with horror. Spain and Italy swiftly banned models whose body mass index (BMI), the ratio of height to weight, falls below 18, just under the lower limit of what medical doctors believe is healthy - a BMI of 18.5 to 24.9.
In La Jolla, modeling agencies and therapists are weighing in on the underlying issue behind Ramos death: eating disorders in the fashion industry and beyond. Eating disorders such as anorexia nervosa - the inability to take the nourishment the body needs to thrive - and bulimia - a disorder characterized by bingeing and purging cycles - are common in the fashion industry. Camie Carpenter, owner Hollywood Talent Associates LLC, which represents models in nine different areas of work, acknowledges that distorted body images are a problem in high fashion and runway modeling, but emphasizes that most modeling does not call for extreme thinness.
“There are nine different types of modeling,” Carpenter said. “The people who do the ramp work – that’s high fashion work, have to physically qualify – meet the height and weight requirements, 5'8" and stick thin. But most modeling is not like that.”
Carpenter represents models who work in a wide variety of settings.
“There’s catalogue modeling, commercial print, glamour – that’s jewelry and makeup where you might not even see a person’s body - music videos, and specialty and character modeling,” Carpenter said.
For these other types of modeling, “Weight is not that big of an issue because it’s everyday people who are doing the work.”
What companies really want is someone who can sell their products, Carpenter said, and that often means models that the public can relate to, or who look right for a particular ad campaign.
“Clients tell us what they want,” Carpenter said. “And a lot of times they tell us ‘no model types.”
Carpenter’s models come in all shapes and sizes. “Plus-size models also have to be tall, but they are a little hippier,” Carpenter said. Carpenter also represents children, adults and even senior citizens.
“I just booked an 86-year-old client for a 6-year Secure Horizons ad campaign,” Carpenter said. “Her grandson models for us, and we were looking for someone to do this work, and she said yes.”
As for the high fashion work requiring extreme thinness, Carpenter says there’s not a lot of that sort of work in San Diego.
“I’ve had some very thin models,” Carpenter said, “And when they’ve moved on to a larger market they’ve had to lose weight.”
Carpenter says she knows how to recognize eating disorders, and would not choose to work with a client with such problems.
“If I have an inkling that someone has a problem, we don’t want to work with them,” Carpenter said. Eating disorders are not about food, she said. They are extreme psychological problems. And working with mentally unstable models is more trouble than it is worth.
Jacqueline Platnik is clinical coordinator for Puente de Vida, or Bridge of Life, a residential treatment facility in La Jolla for people suffering from eating disorders. She agrees that eating disorders – anorexia, bulimia and other related disorders -- are severe psychological conditions with extreme physical consequences ranging from loss of bone density to loss of fertility to death. And recovery, she says, is a long process.
“Recovery can take two to four to even seven years,” Platnik said. “There is high rate of relapse because while eating disorders are like any addiction, you have to maintain a relationship with food,” the object of the addictive behavior.
In the fashion industry, sports and the arts, being thin is valued. And that often makes eating disorders difficult for parents to recognize, according to Sarah Swift, director of Peunte de Vida’s partial program, in which former residents receive ongoing outpatient care at the facility.
“At first they get reinforcement for their behavior,” Swift said. “When your daughter starts losing weight, the first thing you think is ‘you look great’ until it starts going too far. And then obsessions become entrenched before you know it.”
Michael Fields, 19, is an anorexic who has been in recovery at Puente de Vida for 8 months. His illness began as an ordinary fitness routine, but gradually got out of control.
“I was compulsively exercising and under eating,” Fields said. “I felt I was improving my body. I thought was getting better stamina.”
But a visit to his family doctor told a different story. “My medical doctor told my parents that based on my weight, I was clinically anorexic.” His failure to realize he had a problem was compounded by his lack of nourishment, Fields said.
Fields believes that girls are more often anorexic than boys because of societal expectations that girls be thin.
“My family encouraged me to eat more and bulk up,” Fields said. “For girls, they’re usually encouraged to be thinner.”
Carpenter of Hollywood Talent agrees that the fashion industry encourages girls to have unrealistic notions of their bodies. But she believes that recent media articles and programs are helping the public understand that the pictures they see in magazines do not represent how models look in real life.
“The photos you see in the magazine are not what the person looks like,” Carpenter said. “They’ve altered the photos so much - they stretch the bodies, chop off any bump, and airbrush everything.”
Carpenter and therapists at Puente de Vida believe that the greatest immunization a child can have against developing an eating disorder is having parents who listen well and communicate openly.
“Parents modeling healthy coping skills and open communication,” Platnik said, “is the most important thing in preventing an eating disorder. Children who are experiencing societal pressures toward unhealthy behaviors are more likely to avoid those behaviors if they are able to talk about it with a trusted parent.”