The Blog

Thigh Gap vs. Insurance Gap

Thigh gap is not commonplace, and advertisers should certainly be ashamed of trying to promote these unhealthy images as common practice. But insurance gap is very real.
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Urban Outfitters -- recently chastised by the U.K.'s Advertising Standards Authority and ordered to pull an image from its U.K. website of an "unhealthily thin" model with prominent "thigh gap" -- is hardly the first to promote this ludicrous measure of "beauty." Most recently, in March 2014, Target also apologized and quickly pulled a junior model's swimsuit photo that was digitally altered to feature thigh gap. There are actually plastic surgeons who now promote procedures to help women achieve "the gap."

Retouched and digitally-altered photography that promotes the "ideal" body type -- from our bottom to our top -- is the norm in the advertising and fashion industries. But the reality is that these images are simply unrealistic and unattainable for most people... and an unhealthy goal to even strive for. This video by shows just how far the practice goes:

The bottom line is that the kind of bone structure that gives the appearance of a thigh gap -- and body type that governs the size and/or shape of many of our features -- is genetic. But women are literally becoming sick in a quest for "perfection," requiring treatment, even emergency hospitalization, for eating disorders developed during their quest for the ideal body image.

The irony is that when these women seek an unattainable thigh gap, they too often end up facing the brutal reality of insurance gap. Insurance coverage has always been -- and remains -- one of the biggest barriers to successful recovery from an eating disorder.

Affected families are frequently forced to take out second mortgages and burn through retirement accounts. Many literally go broke trying to pay for treatment. Too many have lost a loved one because they were denied appropriate care.

60 Minutes recently featured an expose on the tragedy, yet it's one we have been aware of for years. Most insurance companies treat eating disorder care like a fast food drive thru -- feed them and send them home as quickly as possible. Patients lucky enough to get approved for expanded outpatient or inpatient residential treatment are often given a 30-day limit on care, which is woefully inadequate in most cases.

Treatment should be tailored as carefully and individually as any other serious illness. Cancer patients are not threatened by insurers to get better now or be cut off. How dare we do this to those unfortunate enough to have developed an eating disorder?

Thigh gap is not commonplace, and advertisers should certainly be ashamed of trying to promote these unhealthy images as common practice. But insurance gap is very real, and our state and federal policymakers should be even more ashamed of years of inaction and apathy about addressing an issue that has devastated so many lives and families.

Lynn Grefe
President & CEO
National Eating Disorders Association

If you or someone you know needs help, call the National Eating Disorders Association's Helpline at 800-931-2237 or visit