Extreme Measures

At a party for designer Zac Posen in New York City on Sept. 14, the scene was fashion meets young Hollywood. There was Kate Bosworth looking whisper-thin in a black dress, dancing to Justin Timberlake’s “SexyBack” and smoking cigarettes. There was the always minuscule Mary-Kate Olsen, who stopped by just long enough to puff a cigarette and pose for a few photos. At the center was Posen, 25, a current red-carpet favorite who has dressed a range of young actresses, from the plus-size Marissa Jaret Winokur to the sub-zero Bosworth. “I like women’s bodies – I emphasize them in my clothing,” Posen told PEOPLE on Sept. 21. “Healthy women are much sexier.”

And yet the questions of who is healthy and what is sexy cut to the heart of a renewed debate that is currently raging everywhere from message boards to movie sets to modeling agencies. What makes this controversy new is that for the first time both designers and stars have been put on the defensive: In Hollywood, stylemakers like Bosworth, 23, and Nicole Richie, 25, are setting troubling new standards for thinness, while in the fashion world, frail-looking runway models drew gasps at New York City’s Fashion Week.

“In the past, some young models have had issues with eating disorders – but they were rapidly singled out and left with very little options other than to address their problem,” says David Bonnouvrier, head of DNA Model Management. “The latest trend of skinny models, however, has allowed many of these young women to continue working, living in total denial.” Adds Dr. Ira Sacker, a Manhattan-based eating disorder specialist and the coauthor of Dying to Be Thin: “I have a lot of A-list celebrities as clients, both actresses and models, and what they are telling me is that the pressure to be thin has never been greater. Why? Because whoever is thinner gets the job, and the competition is enormous.”

To be sure, scrutiny of the thinnest stars is more intense than ever. On Sept. 25 Richie went so far as to issue a denial on her MySpace page after a false report surfaced that she’d checked herself into an eating disorder clinic: “I do not have an eating disorder, and I don’t know how many times I have to say it. I’ve repeated myself so many times, I feel like a broken record. . . . I am happy, and healthy, and living my life.”

In the wake of Madrid Fashion Week’s controversial ban on underweight models, battle lines have been drawn in Hollywood and the fashion world. There are those like model Frederique van der Wal, 39, host of TLC’s style show Cover Shot, who in her heyday walked for Ralph Lauren and Donna Karan but says, “This season, it seems they went too thin on the runway – I could have never been in the uniform of what you see today.” Others, however, are crying foul at Spain’s stance, which has drawn support in countries like India and Israel but was flatly rejected by major fashion capitals Paris and London. “I think it’s not fair that people who can be naturally thin are getting attacked for it,” says superstylist Rachel Zoe, 35, who has been criticized for her roster of skinny clients – including Richie, Lindsay Lohan and Mischa Barton – even as she transforms them into Gen-IM style icons. Has she ever suggested to any of her clients that they lose a few pounds in the name of fashion? “Not in a million years,” says Zoe, “would I do that.”

So who is responsible for the heightened pressure to get thin? Stylists and fashion-show bookers blame designers for creating clothes that barely fit a size 2. “Maybe back in the day a size 6 could slide through, but [recently] it really has been a 2/4 dress size,” says casting director Drew Linehan, who booked models for 12 shows during New York’s Fashion Week. Designers, meanwhile, blame the bookers for hiring young, barely pubescent models, and models blame their alien metabolisms for keeping them insanely thin. In the midst of all the finger-pointing, experts are sounding the alarm: A new poll of college students conducted by the National Eating Disorders Association found that a shocking 20 percent of respondents had at some point suffered from an eating disorder. Additionally, “I am seeing younger and younger girls being affected – as young as 8 years old,” says Carolyn Costin, director of the Monte Nido Treatment Center in Malibu.

Compounding the persistent cultural emphasis on skinniness is the fact that actresses are increasingly replacing models as designer muses and spokesmodels (Bosworth, for example, represents Revlon) and are feeling heightened stakes when they turn up at awards shows. “When you’re walking down [the red carpet], there are truly like 100 photographers, and you do want to look your best,” says Curb Your Enthusiasm’s Cheryl Hines.

The result can be a saturation of relentlessly thin images from movies to magazines. “Young girls see celebrities losing weight, and the more famous they are, the more weight they lose,” says Costin. “It creates a climate that says it’s unnatural to be a natural size.”

In interviews with PEOPLE at malls across the country, most teenage girls rejected Richie’s body as “nasty” and “too skinny” but acknowledged that she and other stars serve as style role models. “Nicole’s body is gross because her skeleton shows,” says Kailey Koepplin, 17, of Eden Prairie, Minn. Other teens said they admire healthier-looking stars like Jessica Simpson (“She has cute clothes and she doesn’t show too much”), Beyoncé and Jessica Alba (“She’s tiny, but she’s not too tiny”).

Of course, the ongoing thin-thinner-thinnest sweepstakes is as much a part of certain fashion and showbiz circles as coffee and cigarettes. But beyond those perennial appetite suppressants, experts and industry insiders alike say that some Hollywood starlets – in an attempt to out-thin their runway counterparts and each other – are adopting drastic ways of slimming down. “There are a lot of girls taking horse tranquilizers, which are so incredibly dangerous,” says former View cohost Debbie Matenopoulos, 31, who now cohosts Daily 10 on E! Adds Sara Albert, 23, a finalist on last season’s America’s Next Top Model who has been working steadily since then: “There’s a huge drug scene. You have to have energy to model, but if you’re not eating . . . So yeah, people turn to different methods of staying skinny.”

Such talk is an open secret in Hollywood, says one source who has worked closely with a number of young celebrities. “If you’re in these circles, people aren’t quiet about it,” says the source, who says the prescription ADHD drug Adderall XR has become a weight-loss favorite. “To them, taking a diet pill is like drinking a beer. It has simply become an acceptable part of the young Hollywood culture.”

In an era when even healthy-looking stars like Reese Witherspoon and Jennifer Lopez provoke preg- nancy chatter at the slightest appearance of a less-than-taut tummy, stars say the pressure to be hyperthin is out of control. And with television stars like Jaime Pressly and Portia de Rossi opening up about their struggles to conform to Hollywood standards of slimness, the question of how far TV pushes actresses has taken on new urgency. “Does [TV] put pressure on [actresses] to become anorexic? No,” says Desperate Housewives star Felicity Huffman, 43, who has talked of battling bulimia and anorexia in her teens and early 20s. “Does it put pressure on them to become excruciatingly thin? Yes.”

Like many actresses who hit it big on television or in film, Huffman herself appears noticeably slimmer since she started on Housewives three years ago. “You get so nervous about the way you look [on TV] that you just get skinnier and skinnier – it’s happened to me a bunch of times,” says actress Lea Thompson, 45. “Any stomach shows.”

If that kind of extreme pressure is unlikely to change anytime soon, some stars are hoping that by bringing it out into the open, progress will come slowly – even if it means acknowledging their own insecurities. At the Emmys this year, Matenopoulos says she was three pounds heavier than she’d recently been. “I tried my hardest to look in the mirror and say, ‘You know what? Nobody’s gonna be able to tell you’ve gained three pounds,’ ” she says. “And nobody noticed – except for me, in my ridiculous little head.”

• By Michelle Tauber and Ashley Williams. Alexis Chiu, Vicki Sheff-Cahan, Julie Jordan Jenny Sundel, Jed Dreben, Nicholas White and Jessica Herndon in L.A., Jeffrey Slonim, Steve Erwin, Nina Burleigh, Kelly Carter, Kristen Mascia and Lesley Messer in New York City, Courtney Rubin in Milan, Monique Jessen and Pete Norman in London and Sheree Curry in Minneapolis

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