Skinny models could need a doctor's note for London catwalks

Models could have to pay for medical certificates to prove they do not suffer from eating disorders before being allowed on the catwalk at London Fashion Week.

Experts say such certificates - provided by specialist doctors - would help counter endemic health problems in the modelling world such as anorexia and bulimia.

If the recommendation was taken up, agencies would require this written assurance of a model's health before taking her on their books.

The idea was among 14 non-binding suggestions in the Model Health Inquiry report, which was published yesterday.

The biannual London Fashion Week begins today.

But the report's creators hope their proposals will come into force in time for next September's event.

Their inquiry was set up in response to concerns about the use of "size zero" women - the equivalent of a UK size four - and following the deaths of two South American models last year.

Uruguayan Luisel Ramos, 22, suffered heart failure during Fashion Week in Montevideo, having survived on a diet of Diet Coke and lettuce.

Another model, Ana Carolina Reston, 21, died in her native Brazil from an infection brought on by anorexia.

At 5ft 8in tall, she weighed a little over 6st.

Labour peer Baroness Kingsmill, who headed the inquiry, said the investigation had revealed "startling" evidence of the vulnerability of models and a "deep lack of knowledge" about eating disorders in the fashion industry.

As well as recommending the urgent launch of a health education programme, the report also proposed to combat the industry's other notorious scourge, drug abuse, with the introduction of random testing.

But the inquiry panel - which included model Erin O'Connor and designers Giles Deacon and Betty Jackson - stopped short of urging a ban on size zero models, as happened at last year's Madrid fashion week.

The eight-member panel said the use of Body Mass Index - a ratio of height to weight used to calculate a healthy size for each individual - was too blunt an instrument to use to assess models' health.

The report said: "We do not believe a focus on BMI provides the way forward.

"The panel's expert advisers on eating disorders have stated that BMI is not an accurate method of determining health

. . . and its use may worsen eating disorders among models."

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Panel member Dr Adrienne Key, Clinical Director of the Eating Disorders Service at the Priory Hospital, Roehampton, South-west London, said BMI testing could encourage models with eating disorders to binge before a test to pass it, and then vomit or abuse laxatives afterwards to shed the excess weight.

Hilary Riva, chief executive of the British Fashion Council, which commissioned the report, added: "We specifically asked the inquiry to review whether BMI was a useful measure to identify eating disorders.

"The inquiry did not support the introduction of a 'weigh-in' system through BMI-testing due to the risk that it may worsen eating disorders among models and would be both demeaning and discriminatory to our industry.

"We agree with this assessment and the introduction of medical certificates, and subsequent monitoring, will better support the general healthiness of models appearing on the catwalk."

The British Fashion Council said some of the report's recommendations had already been adopted - such as banning under-16s from the runways during London Fashion Week - while others would take further time and funding to develop.

a.dolan@dailymail.co.uk