Fashion models in the U.S. who are dangerously thin should be banned from participating in fashion shows or photo shoots, just as their counterparts in France are, public health experts say.

Models have died of starvation-related complications, sometimes just after stepping off the runway, two Harvard researchers say in Monday's online issue of the American Journal of Public Health.

The average runway model's body mass index (BMI) is below the World Health Organization's threshold for medically dangerous thinness for adults.

France is so prominent in fashion circles that international models are referred to as "Paris thin,"  S. Bryn Austin and Katherine Record of the Harvard Chan School's Strategic Training Initiative for the Prevention of Eating Disorders (STRIPED) say.

But last April, the French government passed a law that would ban the hiring of excessively thin models.

Austin and Record say that given the prevalence of starvation in the modelling industry and its health harms, the U.S. Occupational Safety and Health Administration should have similar restrictions on the American fashion industry.


Isabelle Caro, a French actress and model whose emaciated image appeared in a shock Italian ad campaign, died in 2010. (Reuters)

"Runway models are, by definition, starving to death," they said.

The pair noted that one former fashion editor was quoted in The Guardian explaining the ideal body shape for a designer's collection is "a female on the brink of hospitalization from starvation."

In the U.S., anorexia nervosa has the highest mortality rate of all mental illnesses.

If the U.S. joined France in regulating the hiring of dangerously thin models, it "would shake the fashion industry, even if enforcement dollars were few and far between. Designers would be hard pressed to maintain a presence in the fashion industry without participating in the New York City and Paris Fashion Weeks."

The authors also offered rebuttals to likely counter-arguments, such as using an arbitrary metric like BMI. They said BMI is a valid indicator of being dangerously underweight.

The work was funded by the Ellen Feldberg Gordon Challenge Fund for Eating Disorders Research and the Strategic Training Initiative for the Prevention of Eating Disorders.