But body image remains a big issue for many women and teenage girls. Fourteen-year-old Jasmine Johnson of Sacramento often hears girls at her school complain about their weight.
"Everyone wants to be size zero, and I think that's kind of stupid," says Johnson, a high school freshman. Her classmate Robbie Ginther agrees, and he wonders if girls realize the skeletal look is something most guys aren't into.
"I mean, I like girls that are thin, but not so much that their ribs are showing," says Ginther, who's 15 and a sophomore.
Zidenberg and Paulson tell the teen girls they treat that shrinking celebs such as Nicole Richie and Kate Bosworth aren't normal — no matter if magazines insist they're "just like us." Zidenberg says constantly seeing such images can be very destructive to girls and women.
"If I see one more picture of Nicole Richie, I'll scream," Zidenberg says.
Zidenberg would rather have the perception of beauty be the "healthy at any size" image she tries to promote. And there is evidence the attitude in fashion may be heading that way, says fashion expert Sam Saboura, former host of ABC's Extreme Makeover and author of Sam Saboura's Real Style: Style Secrets for Real Women with Real Bodies.
During Madrid's fashion week in September, Spanish officials banned severely underweight models from participating in the shows, blaming the superthin models for helping spur eating disorders in young women.
And Dove, already running print ads featuring "real" women of all sizes, this fall launched a viral video ad campaign called Evolution. A YouTube favorite, the video shows a normal-looking young woman with limp hair and acne scars getting made up into a flawless supermodel, with the video sped up to show the entire process in a minute and 15 seconds.
It's encouraging, Saboura says, but it's not enough.
"I think what's happening is it's becoming in vogue to protest against all these things, but it's really not catching on," says Saboura.
"It really has to come from the top of the fashion industry, and I don't think that we're ever going to give up that lean, tall model look, because the clothes look best on those types of bodies," Saboura says.
Still, health care providers hope for a positive change in the ideal women's body type.
"I really hope so," Paulson says, "'cause my business would go away, and I would love that."
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