Organizers of Spain's top annual fashion show on Saturday rejected five models as too thin to appear in this year's event, acting on an earlier decision to bar extremely thin women from the catwalk.

The show, known as the Pasarela Cibeles, decided on Sept. 8 not to allow women below a predetermined body mass to height ratio to take part.

Doctors Susana Monereo of Spain's national endocrinology society and Basilio Moreno, obesity consultant of Gregorio Maranon hospital, were among specialists called on to medically assess the models' suitability.

The doctors told journalists that of 68 models who evaluated, five failed to meet the new criteria.

"They had a body mass index below — well below — that which is considered normal not just by the Spanish endocrinology society, whom we represent, but also by the limits set by the World Health Organization," said Monereo. "They were persons above 175 centimeters (5 feet 7 inches) tall and weighing less, or much less, than 55 kilograms (121 pounds)."

Each model had been allowed to appear at the examination accompanied by an agent and a representative from the fashion industry, Moreno said.

Show organizer, Cuca Solana, said that some well-known models had not gone to the examination.

The show, which is due to start Monday and end Friday, wants to project an image of beauty, elegance and health, Solana said.

In this spirit, a decision was taken to exclude models that paraded gaunt, emaciated styles. The show also banned makeup that makes models appear wan, Solana said.

The body mass index is a calculation doctors normally apply to study obesity.

In metric it is obtained by dividing a person's weight in kilograms by their height in meters squared. In the English system it is calculated by dividing weight in pounds by height in inches squared, and multiplying that total by 703.

If the resulting number is between 18.5 and 24.9, a person's weight is normal. Below 18.5 they are underweight. In the case of the Madrid show, organizers rejected women with an index below 18.