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Slim waist fad causing huge problems in China

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At 1.69 meters tall and weighing just 39 kilograms, Song Xue is grossly underweight.

Song Xue from Suzhou of Jiangsu province is pictured before losing weight and now, weighing only 39 kg. [Photo/China Daily]

The 19-year-old woman lives in Suzhou of Jiangsu province, together with her parents. Song started dieting to lose weight when she was 17, after learning that some classmates were doing so to "look better".

"I didn't consider myself too fat at the time, but I wanted to do something together with the other girls," Song said.

She began to eat less for breakfast and dinner. She skipped lunch totally.

"Several months later, my weight dropped from 55 kilograms to 50 kilograms," Song said. "The dieting really worked, but the most amazing thing was that I didn't feel hungry frequently.

"Now I know I was really stupid to consider that amazing."

As she continued to diet, Song began to suffer from intestinal disorders－she had diarrhea when she took laxatives but was constipated when she did not. When she started suffering from missed menstrual periods, she told her parents about her dieting and sought help.

"I'm no more than a skeleton," Song said.

"I'm not even the walking dead because I can barely walk. Walking makes me feel exhausted."

The family sought treatment in Suzhou, Wuxi and Shanghai, but found that the medication given by doctors could work for only about a week.

"After consulting many hospitals, my daughter was finally diagnosed with anorexia nervosa," said Song Sheng, the girl's father, who is a taxi driver.

He said the family has spent nearly 400,000 yuan ($65,100) to treat his daughter's eating disorder.

"My wife quit her job to take care of the girl at home. I have to work day and night to support the family and pay for the medication. I often cry secretly at night when I feel hopeless."

Li Xueni, a mental health specialist with the Mental Health Institute of Peking University, one of China's most famous psychiatric hospitals, said that a growing number of people in the country are diagnosed with anorexia nervosa.

"Ten years ago, we had only about 10 cases of anorexia nervosa every year," Li said. "But now the figure has soared to more than 150."

Increasing number

According to the hospital, only 52 people were diagnosed with eating disorders like anorexia nervosa and bulimia from 1983 to 2001.

Figures from the Shanghai Mental Health Center showed that the number of anorexia nervosa patients has quadrupled from a decade ago.

Anorexia nervosa usually haunts girls and young women. It is generally considered by medical experts as a type of mental illness. It also has the highest death rate among mental illnesses.

Its patients may have digestive tract, hormonal and metabolic disorders, which may further lead to dysfunction of the blood and immune system. Sufferers may die from organ failure and malnutrition eventually, or even commit suicide, due to the disorders that often accompany anorexia, including depression, obsessive-compulsive behavior and anxiety.

Many factors may have contributed to the incidence of anorexia nervosa, including biological, environmental and cultural ones, Li said.

"Studies have shown that some elements may influence the incidence of anorexia when the babies are in their mothers' wombs," Li said.

"The popular perceptions of beauty in China and various slimming product advertisements with their skinny models affect people's aesthetics."

Through much of China's history, barring certain periods like the Tang Dynasty (AD 618-907), women with slim figures were considered beautiful. Legend has it that many maids in the palace of Emperor Ling (540-529 BC) of Chu were willing to starve to death because the emperor liked women with slim waists.

Zhao Feiyan (45-1 BC), the empress of Emperor Cheng of the Han Dynasty, together with her sister, sacrificed their fertility to take medication that kept them slim. Zhao, one of ancient China's most famous beauties, was apparently so underweight that she could dance within a man's arms.

"With the country's social and economic development, many single children of Chinese families have become more narcissistic and self-centered," Li said. "They are in pursuit of perfection and cannot tolerate an 'imperfect' body shape."

The incidence of anorexia nervosa in China increased rapidly only after the 1980s, according to the Mental Health Institute of Peking University.

Many anorexia nervosa patients suffer from low self-esteem, which forces them to be obsessed with dieting to present a better figure, said Han Haiying, a doctor with the psychological department of Beijing Anding Hospital.

"Many patients, even serious cases, don't realize that anorexia nervosa is an illness that needs to be treated. That is the most dangerous part of the illness."

Li said that a growing number of teenage boys and young men have also been diagnosed with anorexia nervosa in recent years.

"About one-tenth of the anorexia nervosa patients in China are male," Li said.

"Compared with female patients, the male ones are more reluctant to seek help from their families and hospitals because of their deep-rooted belief that it would be shameful to treat some illness that only girls are supposed to have."

Comprehensive treatment

Zhang Shi, a 19-year-old Nanjing resident, died of anorexia nervosa due to severe organ failure in April.

When he died, he weighed only 30 kg though he was more than 1.7 meters tall.

"He refused to go to hospitals at first," said Yang, the man's mother, who requested not to reveal her full name.

"When we forced him to see doctors, he kept yelling at us and the medical workers.

"The illness changed him into a different person. He used to be a sweet boy who got admitted by a university and made us proud. But he began to go on diets, weighing himself after every bite of food and looking into mirrors," Yang said.

"He was diagnosed too late and the medication proved ineffective. I wish we could have noticed his symptoms earlier."

Anorexia nervosa patients need a comprehensive treatment by dietitians, physicians and psychiatrists, Li said.

"The dietitians help to give proper nutrition, the physicians help to monitor complications and the psychiatrists help to solve the resistance against food and other related disorders.

"Anorexia nervosa symptoms will come and go repeatedly," Li said.

"It may take many years to deal with the illness. When the patients are dying, they are willing to accept treatment, but when they are about to be cured, they begin to resist the treatment to keep slim.

"Many of them enjoy starvation because the feeling makes them self-satisfied. There are two kinds of anorexia nervosa patients－the restrictive type that can control the hunger pangs, and the binge/purge type that induces vomiting after taking food. Many of the binge/purge types said they even envied the restrictive types for their willpower."

High schools need to alert students to varying perceptions of beauty and self-esteem to prevent them from falling victim to the eating disorders, Li said. The media should also avoid feeding readers set perceptions of beauty, the mental health specialist said.

"The government should also prohibit advertisements of diet pills and start to establish more professional agencies to identify and treat the illness."

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