The debate rages on: some doctors and mental health experts insist that one of the causes of anorexia is the fashion industry, thin models, and a desire to be on the catwalk. Others (such as fashion designers and models) say the main cause of anorexia isn't the fashion industry – it's a psychological problem that isn't related to the fashion world.
An Italian advertising campaign is creating controversy and increased debates about the causes of anorexia by featuring photos of an emaciated, anorexic young woman. "No Anorexia" is the slogan. Italian photographer Oliviero Toscani was praised by the Italian Health Minister and the European Affairs Minister as effectively discouraging women to be anorexic.
Not everyone views these "no anorexia" ads the same way.
Emilia Costa, the director of an eating disorders center in Rome, views the Italian ad campaign as using ill people for publicity. The anorexic model in the photograph, Isabelle Caro, could cause young girls and women to compete for thinness. Anorexia could be glorified with this publicity.
What impact do thin models have on the psyches of women, as a cause of anorexia? It depends on several variables, but the underlying factor is the psychological state of individual women. Perfectionism and control are often the foundation of eating disorders; women who tend towards perfectionism and control may be more susceptible to struggling with anorexia, bulimia, or binge eating.
Anorexia – or any psychological problem – is rarely "caused" by a single factor. It's more likely that environmental, family, personality, genetic factors, and experiences combine to make anorexic or bulimic tendencies harder to ignore.
Environmental factors include exposure to thin, gorgeous models – who are often impossibly thin and gorgeous. Through movies, TV, magazine ads and billboards, the media creates impossible standards of perfection, which many young girls and women try to achieve.
Domenico Dolce and Stefano Gabbana are fashion designers who viewed Isabelle Caro's "no anorexia" photos very positively. "Finally, someone tells the truth, which is that [anorexia] is not the fault of the fashion industry but a psychological problem," they say.
"I thought this could be a chance to use my suffering to get a message across, and finally put an image on what thinness represents and the danger it leads to – which is death," says Isabelle Caro. "You feel as if you master everything, that you are in total control, and then little by little you fall into this hellish spiral, a spiral of death."
Anorexia is a psychological problem, but outside influences such as the media and the fashion industry could contribute to the struggle. They may, as Isabelle Caro hopes, also contribute to the solution.