Dying to Be Thin, Chapter XXVIXI

This is why I sometimes write about eating disorders and their relationship to the images of extreme female thinness that our print and electronic media fire at young people all day long.

SAO PAULO, Brazil - A 21-year-old anorexic model who weighed only 88 pounds has died of generalized infection, a hospital said. Ana Carolina Reston, who had worked in China, Turkey, Mexico and Japan for several modeling agencies, died Tuesday, according to Sao Paulo's Servidor Publico Hospital.

The hospital said the infection that killed the 5-foot-8-inch model was caused by anorexia nervosa, a disorder characterized by an abnormal fear of becoming obese, an aversion to food and severe weight loss.

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The world of high fashion and modeling has long been targeted by critics who say it encourages women and girls to emulate rail-thin models.

In September, a Spanish fashion show responded to such criticism by banning models with a body mass index of less than 18. Body mass index is a calculation doctors normally apply to study obesity, and anyone with an index below 18.5 is considered underweight.

Reston would have had a body mass index of 13.4 at the time of her death, according to a calculator on the Web site of the U.S. Centers for Disease Control and Prevention.