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The shape we're in

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After moving on from having small dogs as accessories the latest celebrity craze is to be super skinny. But after the death of a model who dieted on nothing but green leaves and Diet Coke earlier in the year Helen Earnshaw asks is size 0 a step too far?

Just how far are you willing to go to get the perfect figure? Cut out dairy products, go without chocolate and do that extra half hour in the gym? It appears that some of the world's most glamorous women are prepared to go to dangerous lengths to achieve the elusive size 0, the epidemic that is sweeping the world of celebrity.

Kate Bosworth, Nicole Richie and Mischa Barton may pose on the red carpet and grace the covers of our magazines but for over a year the argument has been made in many publications, under headlines 'Most Men hate These Skinny Babes' and 'The Strange Case of Our Disappearing Stars', that not only are these women short of a hearty meal but they are promoting an unhealthy body image.

In August this argument intensified when Luisel Ramos, a 22-year-old South American model suffered a heart attack after stepping off the catwalk at Uruguay's fashion week. It was revealed that in the three months leading up to her death the model had endured an extreme diet of green leaves and Diet Coke in a bid to lose weight.

It is the death of this young woman that has prompted the fashion industry to lead the fight against super-skinny stars on the catwalk. Madrid fashion week banned models with a body mass (which is a ratio of height to weight) of less than 18, this means that a model who has a height of 170cm has to weigh at least 52kg. To highlight the real impact of this ruling if Kate Moss had been present in Madrid she would have been banned from taking part.

The fashion industry has furthered this ruling by announcing that all models will have to present a doctor's certificate of good health if they want to walk in the autumn shows in March.

This may appear on the surface to be a silly dispute about dress size but the real concern is about what size 0 represents. Size 0 is the equivalent of a UK size 4 and size 00 is a UK size 2. This may mean nothing to most people but put in its simplest terms the waist of one of these size 0 celebrities is 23"-23.5", which is the waist size of a 7-8 year old girl.

Not only has this argument raised the point that these women could be inflicting serious damage on their bodies and health such as lethargy, depression, the collapse of their immune system and at worst osteoporosis, but it has thrown into question the level of influence they have over young girls.

Deanne Jade, from the National Centre for Eating Disorders said, "Yes I do think they have an influence, but usually on girls who are already sensitive about their size and shape. They have internalised an ideal body shape and this makes them vulnerable."

Despite agreeing that celebrities have a high level of influence she refuses to let them take the blame, "No they don't have a responsibility to promote a healthy body image and you can't point the finger at anyone in particular. They are simply reflecting the pre-occupation women have with image."

However, women who have suffered from eating disorders are more willing to point the finger of blame at those in the public eye.

Lucy, a 21-year-old psychology student, who suffered from bulimia said, "Super skinny celebs I believe are responsible for unhealthy eating and eating disorders, leading to a large proportion of unnecessary distorted body images amongst the general public. Plus I don't think that size 0 models should be on the catwalk, clothes can be made for any shape and size. Also shops sell clothes to size 20 so why can't catwalks cater for a range of women?"

Similarly Eloise, a 20-year-old fashion student, who suffered from anorexia which led her to be hospitalised, believes that celebrities are creating a bad impression.

"They are successful, beautiful and thin. This could be seen as what you should look like to get looked at, get a boyfriend and a good career. Size 0 models definitely do not belong on the catwalk. It's old fashioned, times need to change as they are portraying a negative image."

Yet despite putting their health at risk by extreme dieting celebrity starlets are now reported to be popping pills to remove those excess pounds, as the smokescreen surrounding A-lister's diets begins to evaporate.

The drug Clenbuterol which is banned in Canada and the USA, but is used in Europe for asthma, is a beta-2-agonist with great fat-burning properties. The long acting agent within the drug increases heart rate and body temperature to burn fat even when the individual isn't exercising. Clenbuterol has major side effects including insomnia, heart palpitations, hypertension, and heart muscle necrosis has been demonstrated in animal studies.

Adderall which is a prescription drug used to treat attention deficit hyperactivity disorder is being taken because its major side effect is weight loss as it suppresses the appetite for up to nine hours. But the drug can also lead to psychotic episodes, depression and even serious heart problems.

Even though these drugs aren't readily available over the counter of a pharmacy, those desperate to lose weight have resorted to using laxatives, but these are ineffective and dangerous. Deanne Jade explains how to diet safely, "Eat a healthy diet high in nutrition, don't go hungry, have an active lifestyle but get plenty of sleep. But do not go on strange diets recommended to you as this leads to eating problems."

But with no end in sight to the celebrity slimming craze it's only the education of women and young girls about healthy eating and body image that will stop this obsession with food and what we look like.

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