I stared aghast at the photo of long-time fashion model Filippa Hamilton in a recent Ralph Lauren ad. We know that if the doll Barbie was a real woman, her dimensions are such that she would be unable to stand upright. Well, the dimensions of Hamilton’s photo made me wonder how the woman could possibly be alive. She looks emaciated in the extreme.

Hamilton spoke out after the release of the photo to say that it had been significantly digitally altered. She also claims that she was fired from Ralph Lauren because they said she was overweight. At 5’10” and 120 pounds, she has a Body Mass Index (BMI) of 17. A BMI of 18.5 or under is considered underweight. Ralph Lauren’s defense was that the photo should not have been released in the US (apparently releasing it in Japan somehow makes it acceptable) and claims that Hamilton was fired for breach of contract and not for being overweight.

I am not writing to deliberate about the real reason for Hamilton’s firing. I am writing because I am angry and frustrated beyond words at a fashion industry that promotes waif-like men and women as the ideal.

Some European countries like Spain have in the past three years enforced strict guidelines forbidding models that have a BMI of 18 or less to walk the runway.

The UK and the US fashion industry associations have refused to put such guidelines in place.

The Council of Fashion Designers of America (CFDA) deals with this matter by recommending education on weight issues for models. As if being educated on healthy weight standards is going to help models get a job in the current “underweight is ideal” US fashion world. This is a quote from their so called Health Initiative: “ The CFDA Health Initiative is about awareness and education, not policing. Therefore, the committee does not recommend that models get a doctor's physical examination to assess their health or body-mass index to be permitted to work.”

I am a registered dietitian who has specialized in weight management and disordered eating. I have worked with many men and women who are starving themselves or engaging in other eating disordered behavior in an attempt to attain the kind of cultural body ideal that is exemplified in the fashion industry. I am not saying that the fashion industry causes eating disorders – they are a complex set of disorders that are influenced by many factors. But I can tell you from my clinical experience that they do play a significant role for many people.

So what can we do to protect ourselves and our children from these images? Here are a few ideas: Don’t buy fashion magazines. Email the editors of those magazines to demand that they feature normal weight men and women on their pages. In my opinion, those are men and women with a BMI of 19 or above. Email fashion designers and let them know that you will not buy their clothes until they use models that are at healthy weights. Let CFDA know that you disagree with their policy.

It is also vital talk to your kids about images on billboards or on TV so that they understand why the underweight people pictured are not attractive or healthy. Discuss how the vast majority of even normal weight people (especially women) have bulges, round bellies, cellulite, and stretch marks. The Dove “Campaign for Real Beauty” website is a valuable resource. Check out the “Evolution” video which shows how photos of models are airbrushed and digitally altered to allow them to meet unrealistic beauty standards. Watch the video here.

Lastly, engage in a healthy lifestyle for just that reason – health! Not to achieve an unreasonable weight standard that is potentially damaging to our wellbeing.