Australia's Miss Universe contest was thrown into controversy on Thursday with doctors and dieticians complaining a leading finalist was "skin and bones" and dangerously malnourished.
Sydney model Stephanie Naumoska, 19, was one of 32 contestants from more than 7,000 hopefuls to make the glittering final at an event promoting "healthy, proportioned, bodies."
"Bony or beautiful?" newspaper headlines said over photographs of a gaunt Naumoska posing in a red string bikini.
Health professionals said Naumoska, who is 1.8 m (5 ft 11 in) tall and weighs just 49 kg (108 lbs), had a body mass index of just 15.1, well under the official 18 benchmark for malnutrition.
"She would be categorized as underweight and I would certainly want to be doing an assessment of her diet to make sure she doesn't have some type of eating disorder," dietician Melanie McGrice told local newspapers.
"She needs blood tests, diet analysis and an overall assessment."
Pageant director Deborah Miller said brunette Naumoska, who was defeated in the final by 20-year-old television presenter and model Rachael Finch, had Macedonian heritage, which accounted for her extreme thinness.
"They have long, lithe bodies and small bones. It is their body type, just like Asian girls tend to be small," Miller said.
But Australian Medical Association president Rosanna Capolingua, whose organization represents Australian doctors, said the contest should impose a minimum BMI cut-off of 20.
"The most unhealthy part about it, though, is the image it is showing other young women who may view this as normal, when clearly it s not," Capolingua said.
While Naumoska refused to speak to media, nutritionist Susie Burrell told the Herald Sun newspaper there was no such thing as a Macedonian body type.
Eventual winner Finch will compete in the Miss Universe world finals in the Bahamas in August.