Top Uruguayan model Luisel Ramos swanned down the catwalk in August of 2006 to applause and approval from the fashion elite who sat staring from the rows below her. Yet, minutes after stepping from the catwalk, she complained of feeling unwell and, suddenly and instantaneously died from heart failure.

Ramos had been told by her modeling agency that she could make it big if she lost an undisclosed amount of weight to reach the scarily-tiny size 0. The impressionable 22-year old took this as read and for three months prior to Fashion Week survived on a pitiful calorie intake consisting solely of salads, greens and Diet Coke. It failed to keep her alive. Later the same year two other models, Ana Carolina Reston and Hila Elmalich, also died from complications relating to the eating disorder, anorexia nervosa.

The noughties have been the focus of endless fashion discussions: skinny jeans, big shoulders, boho-chic yet the most significant issue raised has been it’s relationship with body image and the shrinking size of models everywhere.

After these three tragic deaths in 2006, the Health Authorities of the Region of Madrid and the Annual Cibeles Fashion Show banned thin models from participating in this year’s event. Models with a Body Mass Index (BMI) below 18kg/m2 (30% of the participants) were refused a position on the catwalk but instead offered medical help. (The average BMI for a healthy woman is between 19 to 25kg/m2 and to be diagnosed with anorexia nervosa a BMI of less than 17.5 is needed.) London took notice too, after Janet Treasure Head of the Eating Disorder Unit at King’s College London wrote to the British Fashion Council stating her concerns. Treasure wrote that fashion’s exaggerated and idealized image of beauty was unhealthily influencing women everywhere and a contributing factor in many a patient’s demise to anorexia. There seemed real action taken when 2007 the British Fashion Council set up the Model Health Inquiry to debate Treasure’s concerns and also consider the issue of retouching and airbrushing in shoots which “perpetuate an unachievable aesthetic”.

Yet, here we are in 2009, and no statements have been made and no solid guidelines, in the way of Madrid or Milan’s, have been set. The fashion industry seems to have a tendency to brush over these remarks sticking by their adage that skinny girls make the clothes look better and women are more likely to buy a magazines with a size 2 girl on the cover than a curvaceous size 12. It seemed that those of us outside the fashion industry were the only ones genuinely worried about what these skeletal images of pretty girls frolicking down the catwalks would be doing to the fragile minds of today’s youth.

Most designers have kept their mouths zipped on the subject, worried not to upset customers, buyers and advertisers alike. The formidable designer at Chanel, Karl Lagerfeld, know for his right-wing fashion views provocatively stated those complaining about fashion being too thin was, “fat mummies sitting with their bags of crisps in front of the television”. Other fashion royality such as Editor-in-Chief of French Vogue Carine Roitfeld continues to by-pass this issue without comment but is nearing size 0 herself and frequently photographed in leather leggings proudly showing the world her pencil-like legs.

A Vogue editor who has seemingly broken the mold is British Vogue’s Alexandra Schulman, who in June this year sent an unprecedented letter to a host of designers accusing them of supplying magazines with “minuscule” sample-size garments for their shoots. Schulman described how she had been forced to hire models with “jutting bones and no breasts or hips” in order to fit into the clothes and was frequently “retouching” photographs to make models look larger; the latter sounding highly disconcerting to those of us who think the majority of shoots feature all too-thin girls already. What worried her was that “the established star models,” were suddenly unable to fit into the designer pieces, meaning they were getting obviously smaller. One would believe a letter written with such conviction and by such a prestigious name would coax numerous responses , but yet again, we heard nothing.

A more public yearning for more curvaceous and realistically shaped women was found in Glamour magazine’s September issue in which little known ‘plus-size model’ Lizzie Miller was captured in the nude. More shocking than anything was the fact this beautiful girl was plus-size at all. A curvy size ten with little more than a small roll of fat round her stomach, Miller reaches 5ft 11 and weighs 12.5 stone- hardly plus size. Within minutes of this un-touched and un-airbrushed image being published, Glamour’s Editor Cindi Leive was inundated with emails from readers excited by the picture of a woman who was more like them than any of the other hundred bony ladies donned in Lanvin throughout the entire magazine. The photograph gained international press and Miller herself stated it was clear “how keen the world [was] to see all different body types”.

On the wave of this publicity, Mark Fast, a young designer who has won prestige from the harshest of fashion’s critics used three plus-size models in his S/S 2010 catwalk show, unheard of within such high realms of fashion. The flurry was exaggerated when renowned stylist Erika Kurihara pulled out of the show at last minute claiming the three plus-sizes, “didn’t have the walk down as well as the more experienced slimmer girls”. Fast, on the other hand, attempting to play the situation down, stated, “I wasn’t trying to make a huge statement… I just thought it was time: I see so many beautiful women out there, I just want to put them on the catwalk.” But how long will it really be before we see these realistic sizes on catwalks all over? Not in Karl Lagerfeld’s lifetime, that’s for sure.

Slowly but surely, small groups of people within the fashion industry are coming together and fighting for a change. Andreas Lebert, editor-in-chief of German’s most popular women’s magazine’s Brigette, declared she was “fed up” of having to retouch pictures of underweight models. Lebert believes these girls had no resemblance to her readers and is now adamant in using ‘real’ women throughout the publication. In October the Institute of Contemporary Arts held The Real People’s Catwalk Show, an attempt to break stereotypes with a catwalk made up of different shapes, sizes, ages and ethnicity. Created by Designer Sales UK (DSUK) it saw students, artists, and stylists come together to embrace diversity. The event gained a little attention but was soon enough forgotten about amongst the hubbub of Spring Summer buying on the fashion calendar.

Above all, it is crucial to understand the power of the fashion industry and the extensive imagery that we are bombarded with. The picture perfect never-ending magazine editorials and advertisements that give us unrealistic ideas of what is obtainable. The late noughties has magnified the fact we are no longer a text based culture, but an image-based one and the ability to read and understand images is essential to our well being. As Janet Treasure, the Head of the Eating Disorders Service stated herself, “people may say that clothes look better on skinny models but do not forget there was a time when smoking looked good too.”