Slim pickings

"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.

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