Demanding Doctor’s Notes Won’t Work: Models in France

Before I get into this topic, I just want to say to my regular readers this blog post will be more of a sociopolitical statement piece and therefore may not be of any particular interest to you, as it doesn’t really touch upon facets of recovery from eating disorders. However, it’s something I want to talk about and running this site gives me that prerogative.


I get the intent of the decision made by French members of parliament to require of models that they provide medical certification of their health (Guardian Article), but sadly it will not solve the very thing they hope to redress and will further oppress and victimize those close to the bottom of the entire fashion industry food chain.

People generally assume that models make obscene amounts of money and live glamorous jet setting lives of ease reflecting both extreme beauty and status. We likely maintain this sense of the industry because we have not updated our data points from when supermodels ruled the world in the 1990s. However there has been a huge increase in supply (the models) without any commensurate increase in demand (the fashion industry) in the past two decades. We also need to take into account that the most lucrative and prestigious of modeling gigs (such as fragrance advertising) are now often awarded to working actors and celebrities, rather than working models, to the tune of $100,000++. Desired work is underpaid, and undesirable work provides merely a living wage. It’s now the undesirable workhorse world of catalog and showroom work in which models can still earn a living wage and maintain serviceable debt levels. 1

The median income for these unglamorous workhorse models in the United States is $27,330 (with no benefits). There are varying definitions of income and class in the United States, but this median income for models would constitute a working class (not middle-class) income. 2

Models working in the more prestigious areas of high-end runway and magazine work today are predominantly children often plucked from developing nations in struggling backwater towns where an ever increasingly competitive number of scouts and recruits for the industry will find them.

Here are some statistics from the Model Alliance that may help us all to update our outdated sense of the ‘elite’ world of modeling:

  • 69% have anxiety and/or depression.
  • 55% begin their careers between the ages of 13-16.
  • 52% of the time, parents and guardians do not accompany their children to castings and jobs.
  • 64% have been asked to lose weight by their agency.
  • 77% have been exposed to alcohol and drugs on the job.
  • 51% exposed to cocaine on the job.
  • 49% apply extreme restrictive behaviors over short periods to lose weight.
  • 30% have active eating disorders.
  • 30% lack any health insurance coverage.
  • 87% asked to change nude at a job or casting without advance notice.
  • 28% pressured to have sex with someone at work.
  • 30% experience inappropriate touching.
  • 30% felt they could tell their agency of the harassment and even then,
  • 66% of agents didn’t see any problem with the situation/event in question.

The Model Alliance successfully lobbied for the introduction of legislation to at least grant child models the same protections as other child performers. However that legislation is applicable to New York only. There is now a bill before congress to roll out these same protections nationwide. 3

Here’s the fundamental problem with enforcing the need for doctor’s notes in France for working models: it’s essentially attempting to regulate the slave trade by requiring that slaves provide proof of their ability to survive slavery. You don’t regulate any industry from the bottom up; you do so from the top down.

All that will likely happen now is that there will be a need to source a regular roster of doctors for agencies and recruiters who are comfortable rubber-stamping a model’s ability to work while at her current emaciated state. It will actually increase the need for models with anxiety, eating disorders and trauma from sexual harassment to remain silent or lose any hope of being called out for casting at all.

Many of you are likely familiar with the documentary: Girl Model [2011].* One of the models portrayed in the film, Nadya Vall, has stated that although she has not seen the film, she does not support its negative portrayal of the industry. However it should be noted that another model and consultant portrayed in the movie, Rachel Blais, has been quoted as saying she does not get as much work since the film was released. Given that Nadya Vall still works as a freelance model in Asia with the same modeling agency through which she was originally contracted, it’s hard to determine how much her distancing herself from the film is not just an expression of needing to continue to get work.

I realize that there are many who disavow any link between emaciated models in the fashion industry and the onset of eating disorders. While it is true that exposure to images of thinness do not cause eating disorders, internalizing thin idealization in our society is predictive of eating disorder activation and perseveration. 4, 5, 6 The armed camps of nature or nurture that dominate discussions of eating disorder causes and treatment frankly irritate me. All neurobiological chronic conditions (or what we commonly call mental illnesses) are de facto genetically founded and socioculturally activated, framed and expressed.

The fashion industry itself pulls in $1.5 trillion globally each year and yet in a Joint Committee Economic Impact Overview by congressional representative Carolyn B. Maloney [D] modeling is not even listed in the Employment in Selected Fashion and Apparel Industries and Occupations table in the overview. 7 In fact most statistics and documentation on the fashion industry do not list modeling at all. If that doesn’t reflect a model’s inherent invisibility and disposability in the industry, I don’t know what would. There are no definitive global numbers for how many earn their living as fashion models. The United States lists 4,800 individuals working as fashion models in the country. Best guess from extrapolation might be in the realm of 75,000-100,000 fashion models worldwide.

Therefore even if we pretend that emaciation in the modeling industry only impacts the models themselves and has no greater influence on young people in our society at large, should we not still care that tens of thousands of children work in an utterly unregulated industry and 30% of them have a chronic condition that will kill between one in four to one in five of them within twenty years? 8

Doctor’s notes won’t protect these child laborers.  We need laws, fines and legal recourse that actually impact where the $1.5 trillion flows (which is up to the top 1%). When you regulate the weakest, most powerless and voiceless segments of any industry, you generate more overall oppression of the very group you hope to protect.

* I have not linked to the trailer in this piece although I believe it to be a necessary exposé on the fashion industry with its agent/scout/pimp relationships to very vulnerable young (predominantly) girls. It is actually a disturbing documentary and is likely not suitable for those in recovery from active eating disorders.

1. Lerner HG. “The dance of anger: A woman's guide to changing the patterns of intimate relationships.” (New York: Harper & Row; 1985).

1. Chloe Schama. “The Skin Trade.” New Republic, September 18, 2011. TW imagery triggering to those pursuing recovery from eating disorders.

2. Thompson WE, Hickey JV. Social Stratification in the US class system. Social Focus. 5th ed., Boston: Pearson. 2005:183-7.

3. .

4. Groesz LM, Levine MP, Murnen SK. The effect of experimental presentation of thin media images on body satisfaction: A meta-analytic review. International Journal of Eating Disorders. 2002 Jan 1;31(1):1-6.

5. Thompson JK, Stice E. Thin-ideal internalization: Mounting evidence for a new risk factor for body-image disturbance and eating pathology. Current directions in psychological science. 2001 Oct 1;10(5):181-3.

6 Austin JL, Smith JE. Thin ideal internalization in Mexican girls: A test of the sociocultural model of eating disorders. International Journal of Eating Disorders. 2008 Jul 1;41(5):448-57.


8. Sullivan, Patrick F. “Mortality in anorexia nervosa.” American Journal of Psychiatry 152, no. 7 (1995): 1073-1074.