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Extreme Measures

Extreme Measures
In 2002, fresh off her Blue Crush breakthrough, the actress – a champion equestrian as a teen – appeared slender but fit. As a leading lady at a premiere in June, her face, bust, arms and waist were notably thinner in 2006.

09/28/2006 AT 06:00 AM EDT

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.

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"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."
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