By Laura Smith-Spark
You can never be too rich or too thin, or so the saying goes. But moves at major catwalk shows to stem the use of underweight models suggest the tide may be turning.
British model Lily Cole has attracted attention for her waif-like build
The debate kicked off when Madrid fashion week decided, in response to local government pressure, to ban models with a body mass index (BMI) of less than 18.
UN health experts recommend a BMI - a calculation based on height and weight - of between 18.5 and about 25.
Milan fashion week then opened with a plus-size show - and the announcement of a new code of conduct from February, under which models will have to carry a health certificate.
Action may have been prompted by the death of a 22-year-old Uruguayan model who collapsed after a catwalk show in August. She had reportedly eaten little but leafy vegetables for months in order to lose weight.
Commentators have also questioned the negative impact of underweight models on ordinary girls' and women's body image, amid concerns over anorexia.
Of course, whether the move away from the super-skinny gathers weight will not be down to the models - it's the modelling agencies, designers and fashion magazines who hold the clout.
The question is, will the powerhouses of the industry listen to the chorus of concern - or argue they are simply meeting the desire of the buying public to see clothes on waif-like women?
The French Couture Federation told the BBC News website it had decided not to speak on the topic in the run-up to Paris Fashion Week, which starts on Sunday.
US-UK SIZE CONVERSION
US size 6 - UK size 10
US size 4 - UK size 8
US size 2 - UK size 6
US size 0 - UK size 4
Federation President Didier Grumbach had previously been quoted in the media as saying "everyone would laugh" if the measures taken in Madrid were seen in Paris.
The British Fashion Council, which runs London Fashion Week and has close links to the UK's top design colleges, says it is willing to participate in the debate - but is not taking a lead.
"It's not our role to interfere in the aesthetic of any designer but we are open to a broader discussion about these issues," a spokeswoman said.
Italian designer Giorgio Armani, writing in the UK's Independent newspaper before London Fashion Week, admitted he preferred models "on the slender side" because "the clothes I design and the sort of fabrics I use need to hang correctly on the body".
However, there is some evidence of a shift away from the current trend for American size 0 (British size 4) women, among them one of the UK's most successful models, 18-year-old Lily Cole.
British designer Sir Paul Smith, speaking during London Fashion Week, said he believed the measures taken in Madrid might persuade casting agencies to consider slightly larger women for the catwalk.
And the Clothes Show Live, a high-profile UK fashion event, has said that from December no models smaller than a British size 6 will be used.
But observers warn it may take a long time for attitudes to change.
Lerato Moloi, a successful South African model and former Face of Africa finalist who was told to lose weight when she went to New York, told the BBC News website that the problem was the culture that had developed in the US and Europe.
"It's a problem that has been going on for decades but the designers still use [underweight girls] because they can - and they will as long as they have a clientele that prefer it," she said. "At the end of the day, it's the designers' prerogative."
She cites South Africa, where models are a "peachier" size, as an example of a country whose growing fashion industry is not dictated to by the West.
"We've embraced a completely African sense of everything. The African woman's body is fuller naturally and, even though we have a mixture of cultures in South Africa, we tend to prefer a woman who looks normal or healthy."
Dr Emma Halliwell, a psychologist at the University of the West of England, says she hopes the moves in Madrid and Milan mean the fashion industry will start to take more responsibility for models' health.
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She points to studies showing that over the past 30 years models in magazines have grown steadily thinner, so that now they tend to be about 15% underweight.
"There's a growing disparity between the bodies women have and the ideal being displayed to them," she said.
Meanwhile, research conducted jointly with Dr Helga Dittmar, of Sussex University, suggests models do not have to be ultra-thin to sell products effectively - an argument often used by advertisers.
Nonetheless, Dr Halliwell foresees a lot of resistance in the fashion industry to a move towards healthier-looking models.
Ms Moloi agrees: "I'm hoping it's not just a trend and they will stick with it - but it will be a while before it changes lock, stock and barrel."