Nearly 90% of fashion models made negative remarks about their bodies, and more than two-thirds tightly controlled what and how much they ate, according to a new groundbreaking international research of fashion models by Semmelweis University. It is the first qualitative survey of this depth, with almost 90 per cent of respondents also found to be moderately or severely underweight, despite recent years ‘plus size’ fashion movement. Researchers are highlighting the mentally and physically damaging effects of extreme beauty ideals, which could trigger eating and body image disorders, posing a threat not only to models but also to young girls who often see them as role models.

The study involving 84 international high-fashion models has provided an in-depth look into their experiences and perceptions within the industry. Conducted between June 2016 and May 2021, the research explored models’ careers, views on industry demands, and personal challenges regarding body image and health habits using a 23 open-question anonymised survey. Data was meticulously gathered from participants – from 17 different countries, including American, Canadian, Dutch, English, French, Hungarian, Polish, Russian, and Spanish models (with an average age of 23 years) – through email and video interviews. The researchers divided their answers into a few-word segments. They analysed the responses by using 31 different codes such as weight, exercise, abuse, dietary control, extreme calorie restriction, etc.

The analysis revealed concerning trends about their body mass index (BMI), with a significant 88.7% of the models falling below the underweight threshold. 

“This study is unique because it involves a more diverse group of female fashion models than previous studies. It’s also the first qualitative research to apply thematic content analysis to look into eating disorders and body image problems within this group, making it a notable contribution to the field,” – explains Dr. Nikolett Bogár, a PhD student at Semmelweis University’s Institute of Behavioural Sciences and the lead author of the study recently published in the journal Frontiers in Psychiatry.

In the interviews, the most mentioned topic was the models’ comments about their bodies. A majority, 89.3%, expressed negative views (e.g., ‘I felt fat and hated it’). In comparison, 64.3% also commented positively (e.g., ‘I think that my body is perfect’). Those who had a positive view of their bodies often spoke of extreme dieting and were more likely to discuss symptoms related to body image disorders and psychological issues. Additionally, even those who felt positively about their appearance frequently made negative remarks about their weight.

Almost half of the participants (45.2%) expressed negative feelings about their eating habits, such as not being able to enjoy food normally. Conversely, 23.8% shared positive views on eating, like a love for food and cooking. Models who spoke negatively about their eating habits often reported symptoms of body image disorders and a tendency to overeat.

A significant 78.6% mentioned they control their food intake, frequently skipping meals or eating very little. Additionally, 27.4% ate minimal diets, like three apples a day, while 40.5% exercised extreme calorie restriction. About 22.6% felt they had lost control over their eating, and these individuals frequently experienced binge eating, self-induced vomiting, extreme dieting, and excessive exercise. They also often mentioned eating disorders and were more likely to be in psychotherapy.

Most comments about exercise were positive (e.g., ‘I love doing Pilates’) or neutral (e.g., ‘I work out six times a week’), with 40.5% and 91.7% of participants expressing these sentiments, respectively. Only 14.3% had negative things to say about exercising, such as lacking motivation. A notable 23.8% described engaging in intense workout routines, like exercising two hours daily, while 11.9% reported compulsive exercise behaviours, such as not stopping until they burned a certain number of calories.

Young models who follow strict diets, exercise excessively, purge, or use laxatives are facing serious health issues like digestive problems, hair loss, hormonal imbalances, osteoporosis, and heart issues,

says Dr. Bogár, a former fashion model herself who worked with the biggest names in the industry for five years all over the world. 

Dr. Bogár, who also holds a degree in pharmacy, adds: “On top of these physical health concerns, the modelling world also presents significant mental and emotional challenges, including a higher risk of developing eating disorders which could be linked to traumatic experiences and a lack of emotional support. This situation highlights the urgent need for better health screenings and support systems to protect models from these severe risks.”

The analysis indicates that 83.3% of the participants faced criticism from others in the industry (e.g., ‘My agent told me that I’m ugly’), while 44.0% received compliments (e.g., ‘The sicker I was, the more approval I was getting’). 

Furthermore, 63.1% of the models reported feeling overweight even at very low weights (e.g., feeling fat at 45 kgs). About 36.9% mentioned having current or past eating disorders, displaying both clinical or subclinical symptoms of anorexia and bulimia. Psychological issues like anxiety, depression, and suicidal attempts were noted by 48.8% of the models, with 16.7% undergoing psychotherapy. Additionally, 25% reported experiencing some form of abuse, whether physical or psychological.

The data suggests that fashion models face much pressure to meet the industry’s skinny beauty standards. This pressure significantly increases their risk of developing eating disorders, either in clinically severe forms or, more often, manifested as subclinical symptoms. 

“There’s a call for the industry to rethink its unrealistic size requirements and for agencies to stop pushing models into unhealthy behaviours to fit these standards.

This is even more pressing when it comes to young girls, who often encounter these unrealistic expectations on social media and regard fashion models as their role models. It’s a burning issue not only for a small segment of fashion models but as a society as a whole,

warns Dr. Bogár.

The World Health Organization estimates that 14 million people experienced eating disorders in 2019, including almost 3 million children and adolescents. Many recent news reports suggest that eating disorders have been on the rise amongst teenage girls in the last few years with a notable increase during the COVID-pandemic.

Anorexia nervosa is marked by extreme food restriction due to a fear of gaining weight, often leading to dangerously low body weight. Bulimia nervosa involves binge eating followed by purging behaviours like vomiting or excessive exercise. In contrast, binge eating disorder includes episodes of consuming large amounts of food rapidly, without subsequent purging, causing feelings of shame. Each disorder carries severe health risks and requires professional intervention.

Photo: Nikolett Bogár – Semmelweis University; Cover photo and illustrations: Envato Elements – NomadSoul1, daryasever