Food is on her mind "every minute of the day," said Hsu, but whenever she eats, she feels guilty. The easiest way for her to deal with the guilt is to get rid of it. Bulimia is an eating disorder characterized by binge eating followed by self-induced vomiting, and it's a disorder Hsu has been dealing with for the last five years.
The young Taiwanese high school teacher, who asked to remain anonymous, said her eating disorder began when she was a third year university student. At 168cm and 55kg she wanted to lose weight. "I've never felt like I was good at anything. I thought I would have more confidence if I was thin, but the more I lost, the less confident I felt, because I was never thin enough," she said.
In less than a year, her weight fluctuated between 42kg and 63kg. Her friends and family watched the rapid loss and gain without comment and when she returned to her current weight of 55kg, they thought her problem was over.
Actually it had only begun.
Hsu is one of 20 patients under the care of Dr Chen Kuan-yu (
"This is a hidden problem. Most people don't come forward; either they are in denial or they don't know where to go," Chen said. Having treated 300 patients in the last eight years, he said the numbers, compared to five years ago, have doubled. The actual statistics of people living with eating disorders, he expects, is substantially higher: "My patients talk about their friends and mothers having these problems, but these mentioned people never come forward."
Once known as the "golden girl syndromes" because they primarily struck rich, white, well-educated women, bulimia and anorexia nervosa, a disorder in which a person becomes exceedingly thin yet still believes he or she is overweight, have spread to women of different economic and ethnic backgrounds. Considering one of the hallmarks of an eating disorder is denial, diagnosing people is difficult and calculating percentages nearly impossible. However, according to statistics published in an Asian medical journal and those cited by Chen, the percentage of females who suffer from anorexia and bulimia in Japan, South Korea and Singapore is nearly 1 percent. The figures are not as high as North America and Europe, which fall between 0.5 percent and 5 percent of the female population.
With the collaboration of doctors at National Taiwan University Hospital (NTUH), however, Chen published a recent survey-study of high school students that showed an average of one in 100 girls to be bulimic. He says: "We don't have any statistics of anorexia because it involves interviewing each person individually and we don't have the time and financial resources to do a very accurate study in Taiwan."
From his report on bulimia and experience counseling patients, he estimated the instance to be at 0.2 percent among women in Taiwan.
Thin is in
Eating disorders, said Chen, are to some extent Western cultural conditions that have infected Taiwan culture with the fear of being fat introduced via the entertainment industry "Most of my patients are very sensitive about their body weight. Fear of eating in public and fear of getting fat are relatively new issues here and I think this is more of a western notion ?. Not so long ago, being slightly overweight was viewed as a sign of wealth, but over time modern society sees only skinny as beautiful and now this idea has spread to Asia," he said.