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."

Contact the writer at cangwei@chinadaily.com.cn