In the midst of Milan's all-important Fashion Week, the picture that is turning heads in Italy is a shocking one.
It shows what anorexia looks like stripped bare. And, it is re-igniting the debate in the fashion industry over whether designers should make sure that the models who appear on their catwalks are really healthy.
Sheila MacVicar reported on the controversy for CBS News' The Early Show.
On huge billboards above Italian city streets, the emaciated frame of Isabelle Caro, age 27, is stopping traffic.
She weighs less than 70 pounds.
Caro is not a model, but a French comedienne. She has suffered from anorexia since she was 13 years old.
"When I see myself now, I say, 'what a horror,'" Caro told a French TV interviewer. "I'm trying to get out of it, and I want young women to know that is possible."
2The photographer, Oliviero Toscani, is no stranger to controversy. His past work includes highly provocative pictures for advertising campaigns by the Italian chain Benetton, including an image of a dying AIDS victim.
His intention this time, he says, is to focus debate in the fashion industry by showing graphically where the pressure to be thin and thinner is leading some young women; not just young women in the fashion business but those who go on extreme diets in hopes of looking and dressing just like them. "In the end," Toscani says, "that is how you look; if you take off the dress, that is how you look."
In the last two years, at least two models under pressure to get even thinner became anorexic and died. As a result, fashion industry professionals in Madrid and Milan banned super-skinny models from their runways, and are demanding that models hand over doctors' certificates proving their good health.
And earlier this month, during London Fashion Week, at least one model who has acknowledged battling eating disorders was sent home for being too thin to appear on the runway.
British model Charlotte Carter says she thought she was on the verge of recovery from her eating disorder. "However, I wasn't," she acknowledges, "and they basically told me to go home and rest up. They thought I was beautiful but I needed to take care of myself."
Italy's most famous fashion designer, Giorgio Armani, calls the billboard campaign "crude but appropriate."
Armani, who showed his latest collection earlier this week, says "it's not just the fashion world. It's the whole system." He's ready for change. "Skin and bones," he says. "It gives me the creeps, too."
Backstage at her show, another leading designer, Rosita Missoni, argued that the campaign was right. "It's not to be hidden," Missoni says. "We have to talk about it and try to find a way to fight it."
But doctors and specialists who treat anorexics argue these pictures are not improving understanding, and may even damage those who are suffering.
"We need to change the way everybody thinks and talks about an eating disorder," says Susan Ringwood, an expert on eating disorders. "It's not trivial. It's not a fashion accessory. It's a serious mental illness and it's not just about your weight and shape. These images reinforce those stereotypes instead of challenging them."
One last message from Isabelle Caro: She wants people to know that anorexia nearly killed her last year.
The anti-anorexia campaign won approval from Italy's health minister, who reminded people that anorexia is a serious mental illness, and that it's fatal in 20 percent of its sufferers. Health officials here say it's about opening a discussion.
Copyright 2007 CBS. All rights reserved.