daxue consulting_eating disorders in China

A food-loving culture with strict beauty standards, why we don’t hear more about eating disorders in China

Many decades ago, eating disorders in China were extremely rare as the population’s focus was on putting food on the table. However, young Chinese women today face different societal pressures as the associations of ‘being thin’ have become more toxic. Nowadays, thinness is not only connected to beauty, but also to self-discipline, success, and even social class.

How is China’s eating disorder epidemic different from other countries?

Together with the development of social media, young internet users have been exposed to various ‘skinny challenges’, such as comparing one’s waist size to a A4 sheet of paper, and this has resulted in more cases of eating disorders being reported throughout the country.

According to CGTN (a Chinese news outlet), the Shanghai Mental Health Centre reported that eating disorder outpatients grew from 8, in 2002 to over 3,000, in 2020. Although in China detailed data related to eating disorders is hard to come by because of the shame and lack of awareness attached to the illness, CGTN found that the number of eating disorder patients in China had increased five-fold over the past decade.

Treating this illness comes with its difficulties due to the cultural stigma associated with mental illness, and so many people do not want their friends or family to know and choose not to talk about it. The perception of eating disorders has become heavily influenced by parents who in the past never had the information or even language available to discuss mental health. Therefore, it is no surprise that today, many cases go unreported and the incidence of women suffering from eating disorders continues to rise.

daxue consulting_Chinese person suffering from eating disorder in China
Source: CGTN, courtesy of Zhang. A women called Zhang Qinwen, a sufferer of anorexia, interviewed by CGTN

On a positive note, there has been an increase in awareness of mental health and body image in China as more women try to pushback, on the country’s toxic beauty standards. This has already somewhat shifted the marketing tactics of brands to be more body inclusive, but will this help decrease the number of young women being diagnosed with eating disorders?

The drivers of eating disorders in China

One driver of eating disorders in China is the influence of social media and image filters and editing apps such as ‘Meitu’ that allow women to reshape and re-sculpture their faces. The obsession to become thin to ‘fit into society’ has been amplified through viral ‘skinny enough challenges’. For example, the challenge to fit into Uniqlo children’s clothes on Weibo (China’s Twitter) went viral and the hashtag received over 680 million views. Whilst this phenomenon also exists in the West, in China, there is a lack of education on eating disorders and as a result, many believe that they don’t need help. The popularisation and normalisation of ‘being thin is beautiful’ has spread across the internet and this has caused more people to unintentionally develop eating disorders. 

The intense social competition otherwise known as ‘social involution’ in Chinese society has also fuelled an increase in cases. For example, according to Chinese psychiatrists, more young teenagers have been influenced to skip meals to fit in at school as their peers increasingly obsess over dieting. Further, the anxiety of COVID-19 has not assisted the situation. The isolation and lack of structure for people to maintain their extreme diets and exercise routines have further triggered more cases.

Will China’s growing acceptance of body positivity help decrease the growing number of women suffering from eating disorders?

On a more positive note, it does seem that there is a rise in interest in brands expressing body positivity to better reach female consumers. A good example is the ‘My Beauty, My Say’ campaign launched by the beauty brand Dove this year to challenge beauty stereotypes in China. The campaign consisted of a documentary-style film following several Chinese women who shared their personal experiences regarding their beauty anxiety. But one striking element of the campaign was Dove’s effort to take the conversation beyond the film

daxue consulting_eating disorders in china_body positivity in China
Source: Sohu’s WeChat page. Dove’s ‘My Beauty, My Say’ campaign

To spread awareness and change the narrative of beauty to be more body-inclusive, Dove partnered with China’s popular content platform Sohu, and sponsored the popular reality talk show ‘On Her Way Home’. Through this social engagement, Dove encouraged young women to take photos of themselves and post them online to show their ‘real beauty’. As a result, Dove’s Weibo page about this topic was visited by an estimated 1.01 billion users. Participants in the campaign praised Dove’s message to the extent that one of the interviewees was inspired to buy ‘bright’ colour clothing to show off their body shape that was previously hidden by black ‘baggy’ clothing.

Moreover, there has been a noticeable pushback by Chinese Gen Z towards campaigns that are not body inclusive. For example, the Italian clothing brand Brandy Melville launched a picture on social media showing off its ‘ideal weight chart’ for its clothing. The related hashtag went viral, and the brand faced a backlash for pushing unrealistic beauty standards on women and for ‘body shaming’. Whilst, body inclusivity is starting from a relatively low base, there is an increasingly strong movement towards diversifying sizes for females.

Opportunities for mental health services in China

China’s mental health market is still underdeveloped. Whilst psychotherapy and inpatient treatment are often recommended to ED patients, many do not follow through as it is very expensive. For example, a research paper published in the International Journal of Eating Disorders in 2020 on eating disorders in China showed that a single counselling session costs 400 to 500 RMB (~ 70 USD); which is roughly the same price as Western countries with higher per capita GDPs.

A possible solution for these sufferers is to seek help via mental health apps, which have seen a surge in downloads due to COVID-19. For many, seeking online help is slightly cheaper and more confidential, and so this industry will continue to present opportunities for future market entrants.

The outlook on eating disorders in China

  • Over recent years, the number of women suffering from eating disorders in China has risen sharply. Many do not seek treatment due to social shame associated with the illness and thus the true number of cases remains unknown.
  • The cultural standard that being thin equates to beauty is being challenged both by the Gen-Z generation and by brands wanting to shift the narrative to be more body inclusive to aid the portrayal of ‘real beauty’. This will help increase women’s self-esteem and make society more accepting of women that are naturally of a bigger size.
  • Through conversation and documentaries, there has been a general increase in public awareness and knowledge about eating disorders. This will give likely present more opportunities for market entrants to gain a foothold in China’s mental health market.

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