According to statistical summaries provided by Our World in Data, mental health illnesses have experienced a worldwide surge in the recent few decades—not only did the total number of suffering people increases by about 45% globally, the areas of infliction have also crawled out from developed countries to those less developed (Ritchie). It is never an overstatement that mental health issues are indeed the modern epidemic that no single person is inherently immune with. While illnesses like major depression disorder, anxiety disorder, and bipolar disorder receive most public and professional attention, eating disorders are indeed the most deadly ones among all. Unfortunately for China, the country where fabulous food culture and extreme aestheticism collide, eating disorders rampage throughout the nation—particularly for the young generation—with increasing intensity, imposing significant personal and social costs to the society. Here in this review of literature, the problem of eating disorders in China has been identified and discussed from three progressive topics, focusing on the historical and current situations, the complicating factors, and the possible solutions, respectively.
Eating disorders are a group of psychological and behavioral abnormalities regarding food that belong to the same spectrum, outstretching from one extreme, excessive appetite control, to another extreme, complete loss of appetite control. The Diagnostic and Statistical Manual of Mental Disorders categorizes eating disorders into three major subtypes: anorexia nervosa (AN), bulimia nervosa (BN), and binge eating disorder (BED) (American Psychiatric Association), each fitting into different positions on the spectrum. Hence, quite unlike the stereotypical impression of skeletal Caucasian girls among Chinese, people suffering from eating disorders can have very different external characteristics, be it weight, height, gender, or ethnicity.
Though far from the most well-known mental health illnesses, according to the study of Swanson et al., eating disorders have an elevated level of social impairment (34.6-97.1%), comorbidity (55.2-88.0%), mortality (0.4-20%), and suicidal rate (5.3-35.1% attempted) in adolescents depending on disorder subtypes, cited as a major public health concern (Swanson et al. 722). The top Chinese professional in eating disorders Dr. Jue Chen also agrees with the conclusion of the study, endorsing the idea that eating disorders should be placed the highest in diagnostic levels among functional mental disorders, which include schizophrenia and major depression (Chen 875).
Nonetheless, eating disorders are on rise worldwide, presenting an alarming exigency to healthcare sectors. A review published on 2019 indicates a doubled rate of point eating disorder prevalence, increasing from 3.5% for the 2000–2006 period to 7.8% for the 2013–2018 period (Galmiche 1412). Traditionally seen as a “western” disease for women in developed nations, eating disorders have, as a matter of fact, developed in a similar trend in China for the past decades. M. J. Getz mentions the first few cases occurred by the end of twentieth century in his paper: one diagnosis in the early 1980s. some in Beijing and Taipei by 1993 and then in Shanghai by 1995 (Getz 752). It can then be safely argue that before the advent of twenty-first century, the disorders—or at least the diagnosed cases—remained relatively obsolete for the Chinese. Yet based on limited sources of nationwide epidemiological survey for eating disorders, the estimated prevalence among young female Chinese students aged from 11 to 25 years old surged to about 1.47-4.62% during 2003-2013 period, and the numbers were even higher among training dancers and gymnasts (Chen 875). In her paper published last year, Chen also surmised that eating disorders prevalence in China has been gradually approaching that in western nations, predicted from her extensive studies and close observation as an outpatient and inpatient doctor at Shanghai Mental Health Center (875).
With the increased flow of information exchange and disease incidences, the Chinese civilians have garnered a lurking awareness of eating disorders’ presence as a mental health condition. It is manifested by the sporadic curious speculations about some skinny celebrities on the internet. The Chinese netizens embroiled both Luyu Chen, the talkshow host, and Shuang Zheng, the actress, in heated discussions about whether their frailty and thinness stemmed from eating disorders. The debate terminated inconclusive, of course, but it hints that this mental issue, once deemed impossible to occur in China, is walking in to the public view for the Chinese people. But more steps ahead need to be taken.