A topic which is receiving 
much publicity as I write 
is the banning of  5 skinny 
models from participating 
in the Madrid fashion week. 
Madrid’s regional govern-
ment imposed the rules ‘to 
protect the models as well as 
teenagers who may develop 
anorexia as they try to copy 
underweight catwalk stars’.

1
 

They used a body mass  
index of  18 as their cut-

off  value. The ‘anti-thin’ move has been criticised in Paris 
and New York, two of  the world’s leading fashion centres.  
However, in Italy the move was supported by the mayor who 
intimated that she would like to apply the same rulings when 
the fashion show moves to Milan.  

The motive for imposing the ban is noble, as the ‘skinny 
trend’ is not showing signs of  abating. A recent report by 
the British Medical Association identifies a link between the 
images of  ‘abnormally thin’ models that dominate television 
and magazines, and the increase in cases of  anorexia 
nervosa and bulimia.

2
 The incidence of  anorexia is at an  

all-time high with predictions of  0 - 5% of  all females having 
eating disorders. While eating disorders were previously 
usually regarded as a female syndrome, the situation is 
changing with a steady increase in the number of  men being 
diagnosed with eating disorders. A recent estimate predicts 
that of  the 60 000 people with eating disorders in the UK, 
10% are male.

2
 This trend can most likely be explained by 

the contemporary lean, hungry look of  male stars. To get a 
snapshot view of  changing body beautiful images of  different 
eras one only has to compare the ‘hunks’ of  the 1960’s movies 
(i.e. Sean Connery as James Bond) to modern day hunks to 
see how the masculine image has changed. Marilyn Monroe, 
with her curvy body shape in the 1950s would probably be 
regarded as too fat for a leading role 50 years later.  

While the organisers of  the fashion shows should be 
complimented for taking a bold stand against their skinny, 
unhealthy-looking models, they can be criticised for the way 
in which they have gone about it. Using a body mass index of  
18 as a cut-off  value is inappropriate and may penalise some 

models who live normal healthy lives. Instead of  this approach 
the organisers should establish a structure that evaluates the 
health status of  the models including their eating, sleeping 
and substance abuse habits and make decisions accordingly. 
The information on how to do this is available; it just needs 
to be applied.

This third issue of  the journal for 2006 has 4 interesting 
papers. The first paper by Professor Mars and colleagues 
examines the cooling of  skin, subcutaneous fat and muscle 
with an icepack, at rest and after short-duration exhaustive 
exercise. This study produced some interesting results with 
important clinical applications. The next paper by Ian Cook 
examines the accuracy of  different types of  pedometers. It is 
well known that people who use pedometers are encouraged 
to be more physically active, so therefore there is great 
value in making pedometers available to the general public. 
However, the enthusiasm to make and distribute pedometers 
has exceeded the concern about their accuracy. This study 
addresses this point with a comprehensive research design. 
The results make a valuable contribution to the literature.  

The third paper, by Dr McHardy and colleagues from 
Macquarie Injury Management Group, Macquarie University, 
Sydney, Australia, is a clinician’s perspective of  the modern 
and classic golf  swing. This paper is relevant to sports 
physicians, biokineticists and physiotherapists and provides 
a clear analysis of  the different types of  golf  swing and their 
possible link to injury, particularly lower back pain.  

Finally the paper by Dr Draper and her colleagues 
describes the state of  the fitness industry in South Africa. 
This comprehensive study gathered data from 442 facilities 
around the country. The data provide an important benchmark 
for the state of  the industry and will make a significant 
contribution to the development of  perceived weaknesses in 
the industry. 

Mike Lambert
Editor-in-Chief

1.   Milan fashionistas fear Spanish skinny model ban. news.yahoo.com/s/
nm/20060914/od_nm/italy_models_dc (accessed 18 September 2006) 

2.   The changing shape of  the model. news.bbc.co.uk/1/hi/uk/769460.stm (ac-
cessed 18 September 2006)

Skinny fashion – a role for sports medicine?

SAJSM  voL 18  No. 3  2006                                                                                                                        57

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