The plus size modelling industry has received general criticism on the premise that acceptance of plus-size models sets a poor health example regarding weight management.^[191][192] Consumer-based criticism regarding the lower sizes of plus-size models is also becoming commonplace and wide-spread. While the reputed 'average' dress size of an American women is size 14, the majority of models represented as plus size are between a US size 6-12; therefore the models do not reflect the average consumer size.^[193] Critics have also mentioned the widespread use of padding used to make smaller models appear larger and help smaller models fit the clothing.^[194] Also, plus size models engage in unhealthy habits such as eating salty foods to retain water weight, and fluctuating in size to please different clients^[195] Also, agents have suggested plastic surgery to some models.^[196] German fashion designer Karl Lagerfeld and other fashion designers have deferred on the use of plus-size models through a lack of interest in the consumers associated with the term plus size. Lagerfeld in particular has been vocal on the matter of his preferred clientele ""What I designed was fashion for slender and slim people" and received criticism for demanding that mass retailer H&M not produce their collaboration designs to size 16^{[197][198][199]} In addition, the industry has been criticized for lacking in racial diversity.^[200][201] For example, critics have noted that there are few Asian plus size models, perhaps due to stereotypes of Asian women being small.^[200] Also, others have noted that there are few black plus size models with darker skin tones.^[202]