France turns to fines, jail to combat ultrathin ideals

A young woman with flagging self-worth, she already had enough to grapple with in Paris, where fashion dictates ultrathin ideals.

"I've lost 12 kilos [26 pounds], but I feel heavy," wrote a blogger identifying herself only as Leila this month in an online journal devoted to her eating disorder. "Heavy, and at the same time, empty."

But the fact that Leila's blog advocates anorexia has made her something of an outlaw overnight. On Tuesday, France's lower house of parliament passed a bill that makes it a crime to promote "excessive thinness" or extreme dieting.

Coming on the heels of related initiatives in Spain and Italy, the ban is the latest and most far-reaching attempt to stem a disorder – and an image of womanhood – with which hundreds of thousands of Europeans wrestle. But how effective will the measures – and some are quite creative – be?

France's bill, which must now be approved by the Senate, won unanimous support from Nicolas Sarkozy's ruling UMP party, empowers judges to punish with prison terms and fines of up to €45,000 ($72,000) any publication, modeling agency, or fashion designer who "incites" anorexia. It also allows for the prosecution of websites whose pages and blogs, like Leila's, promote eating disorders.

On these sites, young women chart behavior associated with anorexia, in which individuals driven by a deep-seated fear of weight gain deprive themselves of food, and bulimia, characterized by binge eating and purging. The sites – part of a growing genre of sites that glorify destructive eating patterns – offer encouragement, contests, and tricks for those attempting to starve themselves.

"The sociocultural and media environment seems to favor the emergence of troubled nutritional behavior, and that is why I think it necessary to act," said Valery Boyer, the lawmaker who proposed the bill, in an interview with the Associated Press.

Several prominent French families, including former President Jacques Chirac's, have raised awareness of the issue by going public about their anorexic daughters' struggles.

But the problem is hardly limited to France. "The rates of anorexia and bulimia are fairly constant across Europe and the United States," says Eric van Furth, clinical director of the Center for Eating Disorders Ursula in the Netherlands and former president of the Academy of Eating Disorders. "Genetics plays a significant role, but the environment – and that includes culture – helps determine whether those genes are expressed."

In Spain, where some experts say that eating disorders affect 1 in 200 young women, the country's major fashion show provoked controversy two years ago when it tried to address the issue. Banning from the catwalk models with an unhealthily low body mass index (or BMI – a weight to height ratio) of below 18, the vicecouncilwoman for the Economy in Madrid's regional government, Concha Guerra, said, "Our intention is to promote good body image by using models whose bodies match reality and reflect healthy eating habits."

Milan followed suit, requiring a BMI of at least 18.5 for all models in its prominent fashion shows. And although organizers of London fashion week refused to enact a similar restriction, they did require all models to present a certificate from an eating disorder specialist that attested to their good health.

There have been other creative efforts in Europe to reduce the media presence of the ultrathin and bring standards of female beauty in closer alignment with real, healthy women.

In the Netherlands, Unilever agreed to restrict models in its advertising campaigns to women with BMIs between 18 and 25. Last month, Italy's health and sports ministries launched a campaign that, in addition to providing eating disorder education in the schools, provides media guidelines intended to discourage ultrathin beauty ideals. That campaign came just months after one of the country's clothing labels began its own anti-anorexia campaign with billboards depicting the nude, emaciated body of anorexic French model Isabelle Caro.

In Spain, the national government is taking a more positive approach. It recently persuaded 90 percent of the country's apparel manufacturers to agree to standardize their female clothing sizes. The new sizes will be based on a study, conducted under the auspices of the ministry of health, that measured the shape and size of 8,000 Spanish girls and women between the ages of 10 and 70. By making clothing sizes for real women's bodies, says Angeles Heras, general director of the ministry's consumer office, "the measure promotes a healthy model of beauty." So, too, she says, does another provision of the agreement, which prevents shops from using display mannequins smaller than a Size 38 (US Size 6).

Philippe Jeammet, a Paris psychiatrist and author of several books on eating disorders, supports the new French legislation and other measures that question fashion and the media's celebration of ultrathinness. "I think it's time for our society, which has benefited for so long from so much freedom, to start to think about limits. With respect to our children, we can't accept any glorification of destructive behavior."

But other experts question whether the French law by itself will have a significant impact. Janet Treasure, director of the Eating Disorders Unit at King's College London's Institute of Psychiatry, notes that although the law "may be helpful," there are many reasons why an individual may struggle with anorexia and bulimia – media images are just part of it.

Dr. van Furth, who classifies the disorders as mental illnesses, sees the main value of the French law as alerting the public to the issue. "[It's] a clear sign to society that we need to do things differently when we present these ideals to women," he says. But he nevertheless agrees that media and the fashion industry are only part of the problem and admits that he has "great doubts that legislation like this can be enforced."

He also worries that the provision that criminalizes websites advocating eating disorders and abetting such behavior is misplaced. "I don't think it's smart to punish the sufferers," he says. "The websites are part of their illness."