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Style The BMI approach may not measure up as a health-indicator for fashion models

It started, as most online movements do, with a selfie. In March, Australian model Stefania Ferrario posted a nearly nude photo of herself to Instagram, her doe-eyed gaze fixed intently on the beholder, hands cupping her breasts and the words "I am a model" scrawled across her taut stomach. Its caption was a call to action, asking retailers to drop the "plus" qualifier from clothing lines and agencies to refer to models of all sizes as just "models." Pushback against skinniness is common in the fashion industry, a response to top-tier designers and agencies that have established a hierarchy that promotes young, thin models to the top of the talent roster and relegates everyone else with a sizerelated qualifier to the bottom.

Deciding how to evaluate what constitutes a "natural" or healthy size is a whole other issue. Supermodels like Karlie Kloss and Jourdan Dunn populate their social-media profiles with images of vigorous workouts and tales of clean diets, insisting that a size two can be achieved through a healthy lifestyle, not just starvation and cigarettes. And on the "plus size" end of the spectrum (which is, officially, anything above a size 14), U.K.- based model Rosalie Nelson started a petition asking that the United Kingdom follow France's crackdown on "dangerously underweight" models during London Fashion Week in September. It's since garnered more than 55,000 signatures and is currently under parliamentary review.

France's solution was to pass a bill banning the hiring of models whose body mass index (BMI) is lower than 18 (or approximately 121 pounds for a 5-foot-7 model). Any agency employee caught doing so could face up to six months of jail time and a fine of €75,000. Israel, Italy and Spain have also adopted legislation that prevents the hiring of models according to BMI. But the industry is divided about whether tracking BMI, a tool that was invented in the 1800s to measure total body mass based on height and weight, will result in positive change.

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"The tool doesn't reveal the individual's level of fitness, their quality of life nor the quality of dietary habits and so it's not effective at measuring their overall individual health," says Marbella Carlos, outreach and education coordinator at the National Eating Disorder Information Centre in Toronto.

Ben Barry, assistant professor of equity, diversity and inclusion at Ryerson University's School of Fashion, also finds size and BMI to be limited tools for measuring overall health. "We have to be very cautious when we see a ban on models of a certain size with a BMI," he says. "That doesn't mean that there's going to be diversity on the runway, but it certainly means that we're limiting models who may be perceived to be too thin from being on the runway."

Toronto-born model Jessica Lewis has worked as both a plus-size and "straight" (industry jargon for what's typically a size two) model during her 16-year career. She's currently producing a documentary titled Straight/Curve on the evolution of plus-size modelling, and plans to release it next summer.

For Lewis, a model's lifestyle – including fitness habits and diet – is a better indicator of well-being than her dresssize. "With plus-size models, they're absolutely very aware of their health and that's apparent in their bodies, skin, hair and energy level," she explains. "These women are size 14 to 16 and they're running marathons." Compare that to the women who achieve a straight size with extreme dieting and drug use. "Are they necessarily the picture of health? That's the difference."

Sara Ziff, founder and executive director of The Model Alliance in New York, was one of the first critics of France's BMI legislation. "Doctors and eating-disorder specialists have said that BMI is not an accurate measure of individual health. It doesn't take into account the relative proportions of bone, muscle and fat in the body," she told MSNBC at the time.

To reveal the shortcomings of BMI, New York-based startup Body Labs created a series of 3-D body scans that plainly illustrate how the appearance of individuals with the same height, weight and BMI number can differ. That's because of how weight is distributed across our bodies as either fat or muscle, explains Jonathan Schwartz, the company's director of products. "BMI is highly controversial," he says, adding that the 3-D body scans are meant to show the "blind spots" of the metric and that there isn't a one-size-fits-all number to properly assess individual health. "There are too many factors, like weight and body composition."

A little over a week after France introduced its new law, Denmark revealed a completely overhauled Danish Fashion Ethical Charter. Instead of proposing fines and jail times tied to BMI to police the health of models, Denmark's nonbinding regulations included regular medical checkups for all models under 25, access to healthy food on photo shoots and compulsory wages.

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Here in Toronto, size restrictions for working models are relatively looser. "Clients are booking girls that don't have a 33-inch hip, which is what designers are still casting," says Brandon Hall, creative director of Sutherland Models. "A 36-inch hip is healthy in our industry." Hall notes that modelling agencies are subject to the demands of clients and that it's up to the casting directors and stylists to hire a range of sizes. Barry cites the cost of fabric used in runway prototypes as a likely reason why cash-strapped designers continue to create samples in one (small) size only. "And, of course, there's still this societal belief, and certainly one within the fashion industry, that thinness sells," he says.

There is hope for progress, though, and it lies with young fashion designers who are challenging antiquated industry practices. Last season during World MasterCard Fashion Week, Toronto designer Hayley Elsaesser had an open casting for her show that resulted in a lineup of models with varying heights and body sizes walking alongside professional straight-size models.

"When you're in the audience, not everyone there is size two and 5 foot 10," she said. "It's nice to see someone who you can relate to a little bit more – background, height, weight, whatever."

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