For 15 years, Marie Caro watched with a mother’s guilt as her daughter starved herself to death. Marie took her own life on January 19, just two months after her daughter Isabelle succumbed to the effects of anorexia nervosa. Once a moderately successful model in Paris, Isabelle Caro catapulted to much greater fame in 2007, when Italian shock-ad guru Oliviero Toscani used dramatic nude images of the then-27-year-old to illustrate just what “dying to be thin” really means. The billboard campaign ran during Milan Fashion Week across Italy and France—and was banned a week later after residents who lived near the billboards complained that the images were disturbing. The ad—for Italian clothing label No-L-Ita—revealed every inch of Caro’s cadaverous body, which looked like a lab skeleton wrapped in prematurely aged skin. Her breasts were tiny pockets of flesh that hung from her ribcage. Her long fingers looked like broken matchsticks. Toscani’s timely campaign made her the darling of the No Anorexia movement—but also a cult idol in the corner of the blogosphere that promotes dangerous dieting.
The notoriety that followed the poster campaign prompted Caro to start a blog and write her autobiography The Litte Girl Who Didn’t Want to Get Fat (both in French). In the book she blamed her mother for her eating disorder, describing Marie as a “depressed” woman who kept Isabelle in diapers until the age of 7, dressed her in clothing far too small and kept her locked inside their Rome apartment because “fresh air makes children grow.” Isabelle started to starve herself as a means of rebellion, wresting a measure of control from her domineering mother. At one point, she wrote, she lived on tiny squares of chocolate and self-rationed corn flakes.
It was the strain of promoting her book that proved too much for Isabellle’s weakened body—she died just a few days after returning from the Japan leg of her book tour. And it was the content of the book that contributed to her mother’s suicide two months later. “She could not deal with Isabelle’s death and the terrible accusations that she caused it,” Marie’s husband Christian Caro told the Swiss magazine 20 Minuten. “We had been working on a chapel for our daughter. Now it is the grave for my wife and Isabelle.”
Isabelle’s mother may have set the stage for her daughter’s eventual demise, but it was a fashion agent in Paris that put the final nail in her very narrow coffin. Just one year before Caro posed for Toscani, she said she was told by a Parisian modeling scout that she would have to lose 10 pounds to find work. Already well-versed in weight control, she quickly lost nearly 20, dropping to 55 pounds (she is 5 foot 4 inches tall). The extreme weight loss sent her to the hospital, where she drifted in and out of a coma for months. That near-death experience frightened her, and she was determined to stop dieting and become a role model against the disease, which is why she took Toscani’s assignment. “I want to show young people how dangerous this illness is,” she said in an interview with Grazia magazine before her death. “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.”
When someone with a certain genetic predisposition is encouraged to lose weight, the effects can be deadly, which is what makes anorexia an occupational hazard for anyone in the modeling world.
Caro is not the first martyr for the ultra-skinny set. In 2006, Brazilian model Ana Carolina Reston died of kidney failure at the age of 22. She was 5 foot 8 inches and weighed 88 pounds. A few months later, Uruguayan model Luisel Ramos died of heart failure right on the catwalk in Montevideo, Uruguay. She was 5 foot 9 and weighed 97 pounds. In 2007, 5-foot-6 inch-tall Israeli Elite model Ilanit (Hila) Elmalich died in the hospital after dropping to 49 pounds, her tragic death captured on video. Each of these senseless deaths sparked a wave of hand-wringing in the fashion industry, and sparked some efforts at reforming the practices that enable this disease. In 2007 in France, after Caro’s disturbing photos emerged, legistlation was introduced to make all top models pass health tests and carry an international health card. The bill stalled in parliament. In London, Fashion Week organizers have banned size 00 clothing, though critics say many designers have simply resized their samples. In both Milan and Madrid, models must have a body mass index of 18 to work the fashion shows even though anything under 20 is considered underweight and measurements are often taken months before the actual shows. In other words, none of these changes have really altered the catwalk culture.
In the United States, the Council of Fashion Designers of America acknowledges the problem but has stopped short of imposing BMI standards, insisting they would prefer to “educate” and not “police” the designers. CFDA President Diane von Furstenberg issued a statement ahead of this year’s New York Fashion Week, voicing concern that “models are under increasing pressure to be thinner and thinner, and younger and younger.” Without dictating standards, the CFDA does urge sylists and designers to adhere to guidelines set forth in the CFDA’s own 2007 Health Initiative on eating disorcers, basically promising to put the health of the models first when preparing their shows. But not even fashion’s darlings take the problem that seriously. In 2009, Kate Moss—who surely understands that she is an icon for young girls all over the world— famously quipped “Nothing tastes as good as skinny feels.” And when Donatella Versace’s daughter Allegra was hospitalized with anorexia, the Italian designer missed a valuable opportunity to embrace the connection between her industry and her daughter’s disease.
The internal and external pressure to be thin, telegraphed by these images of super-thin models, is the crux of the issue, according to experts who treat patients with anorexia nervosa—a disease that affects as many young people as juvenile diabetes and has a higher mortality rate—between 12 and 20 percent in developed nations. Only a third of anorexia patients recover fully. But Harry Brandt, director of the Center for Eating Disorders at Sheppard Pratt in Baltimore, says there are also clearly genetic factors. When someone with this genetic predisposition is encouraged to lose weight, the effects can be deadly, which is what makes anorexia nervosa an occupational hazard for anyone in the modeling world. “This is an industry that needs to be regulated in the same way that other occupations that carry inherent risks are,” he says. “Should we really be allowing anyone in the workplace to be encouraging their employees to engage in an activity that leads to death or illness?” Brandt plans to petition legislators to look at the industry in the same light as big tobacco companies that once glamorized smoking in the same way fashion glamorizes extreme dieting.
“Our culture is obsessed with getting thin,” he says. “But we actually need to pursue anorexia in the same way we do other health issues like smoking.”
Barbie Latza Nadeau, author of the Beast Book Angel Face, about Amanda Knox, has reported from Italy for Newsweek Magazine since 1997 and for The Daily Beast since 2009. She is a frequent contributor to CNN Traveller, Departures, Discovery and Grazia. She appears regularly on CNN, BBC and NPR.