Fashion photos must bear a notification if they have been retouched to make models look thinner and models will have to possess a medical certificate in order to work, according to a French decree enacted on Friday. The bill was first introduced eight years ago in France and has been making the rounds, including being subject to various alterations, before it was officially passed today.

Beginning on October 1, 2017, “photographie retouchée” (or “retouched photograph”) will have to accompany digitally modified images published in advertising, the media, on the internet and in catalogues if the retouching “has changed the physical appearance of models,” according to a law enacted on Friday.

And starting on Saturday, models in France will have to undergo a medical examination every two years and be issued with a medical certificate certifying that their they are in good enough health to work. Particular attention will be paid to their body mass index (“BMI”), which is calculated by dividing their weight by the square of their height.

The World Health Organization considers a person underweight if their BMI is below 18.5 and seriously underweight if it is below 16.

France’s Minister of Social Affairs and Health, Marisol Touraine, released a statement to WWD on Friday, saying: “Exposing young people to normative and unrealistic images of bodies leads to a sense of self-depreciation and poor self-esteem that can impact health-related behavior. The two texts published today in the Journal Officiel aim to act on body image in society, so as to avoid the promotion of beauty ideals that are inaccessible and to prevent anorexia in young people.”

Italy, India, and Israel have all passed laws over the past decade or so banning the use of underweight models. In 2006, Spain introduced the world’s first ban on overly thin models, requiring that models maintain a body mass index of 18.5; Madrid’s fashion week has reportedly since turned away underweight models after protests that girls and young women were trying to copy their rail-thin looks and developing eating disorders. That same year, Italy followed suit, implementing an Italian mandate, holding that cat walkers would be required to have a body mass index of 18.5.

Also in 2007, the Council of Fashion Designers of America, a New York City-based trade organization, implemented a voluntary health standard. Of the initiative, which was implemented in anticipation of the February 2007 runway shows, CFDA President Diane Von Furstenberg said:

“The CFDA formed a health initiative to address what has become a global fashion issue: the overwhelming concern about whether some models are unhealthily thin, and whether or not to impose restrictions in such cases. Designers share a responsibility to protect women, and very young girls in particular, within the business, sending the message that beauty is health.”

Last but not least, Israel implemented a BMI standard. In 2012, Israel became the first country ever to pass legislation banning the use of “underweight” models in local ads and publications. The new law employs an interesting tactic: Models must prove that their Body Mass Index (BMI) is higher than the World Health Organization’s indication of malnourishment (a BMI of 18.5) by producing an up-to-date medical report — no older than three months — at all shoots to be used in the Israeli market.

Reactions Are Mixed

While some have praised the passage of such bills, no shortage of industry insiders are not please. The ruling already has its detractors. Take Fabien Baron, art director and the former editorial director of Interview magazine, who told WWD in 2015 (in connection with an earlier – but still very similar – version of the bill), “The BMI does not make much sense as many models are naturally very thin and they have no eating disorders nor do they watch very much what they are eating. This law will penalize some perfectly fine models from working.”

Famed photographer Nick Knight called the bill “fundamentally backward looking,” noting that “the problem doesn’t lie on whether people can retouch or not retouch; the problem lies on our understanding of what’s an image. There is no reality in photography, there’s never been any reality in photography – photography has always been about a very subjective opinion of the world around it and the more subjective it is, the more we like it.” 

Designer Damir Doma said the problem is much deeper than the French government is letting on, saying, “The fact is, as long as there is a demand for extra-skinny models, the agencies will continue to deliver.”