Originally published in May 2003.

They breezed down the runway at the European shows this winter, wisps with swizzle-stick arms and sunken chests. Yes, waifs are nothing new in the underfed fashion world, but there’s a difference: These were the men. It makes one wonder: Aside from the scrawny Larry Clark-style models for Hedi Slimane, the Christian Dior designer, could any fully grown man fit into these clothes? Well, Karl Lagerfeld can. Last year he whittled himself down by 93 pounds with a strict diet of fish, vegetables, horse meat (really), and Diet Coke. As Karl likes to proclaim, “Muscles are out. Bones are in.”

Skinny-chic may be as foreign to the average man as Dior’s razor-cut sleeveless top, but lately some guys who live far from the catwalk have been pursuing their own version of radical dieting. Even Howard Stern obsesses about his waistline. Look around: Men’s Health cover boys have zero percent body fat surrounding those six-pack abs, and every rock band from the Strokes to Coldplay appears slightly malnourished. (And they still land the hot girlfriend!) No wonder men who once took a perverse pride in their beer bellies are now hopping aboard the Atkins express.

Or the Karen Carpenter diet. By some estimates, 1 million American men suffer from anorexia—or, if you prefer, manorexia. That’s almost 15 percent of all cases. “I think the figure is probably higher,” says Dr. Doug Bunnell, president of the National Eating Disorders Association, who claims men “have trouble acknowledging the disease.” It’s embarrassing to admit you’re afflicted with a syndrome traditionally associated with teenage girls. But just like their Britney-worshipping kid sisters, manorectics suffer from body-dysmorphic disorder—an obsession with an imagined flaw in one’s appearance.

As a result, they adopt bizarre eating habits. Dr. Christopher Athas, the vice president of the National Association of Anorexia Nervosa and Associated Disorders, cites one karate buff whose bulimia was so extreme “he’d lie exhausted on a bathroom floor because he was so tired from purging.” Bunnell adds that “for many men, weight is a control issue.” Which was the case with Daniel Johns, the 24-year-old singer from Silverchair whose five-foot-eleven frame at one point weighed in at 110 pounds. “Each day I would test myself to see how much I could endure,” says Johns, who even penned a tune called “Ana’s Song” (as in anorexia) about his struggles. “If I hadn’t eaten anything, it was an accomplishment. ... Within a few months, it got to the point where I was eating just so I wouldn’t collapse.”

Not all manorectics are swooning from starvation; some see their diet as a way to get ahead. As one 33-year-old fashion publicist explains, “Being fat is considered being unsuccessful—in my business there’s no room for that.” He tried carb-free regimes and yoga classes and had liposuction—three times. “I want to do it a fourth time to spot-tone certain areas,” he admits. “For me, this is career maintenance.”