Anyone can go mad. But how you do depends on where you are.


In 1982, at 1.6 meters singer Karen Carpenter weighed under 38 kilos. When she died a year later, the US media said that she had suffered what was known as "rich white girl’s" disorder or the “disorder of the 80s”.

At the time, anorexia nervosa in the United States was a fast-growing problem that tended to affect girls from urban, middle class backgrounds who, with stars like Twiggy in their eyes, saw their skinny selves as plump in a mirror. These victims obsessively dieted to lose weight and harbored an extreme fear of dietary fat.

In Hong Kong during the same period, there were only two or three cases of anorexia occurring every year. It affected girls from the poor, rural areas. These girls did not see themselves as fat. Instead, they suffered from more physical symptoms: they would find it difficult to digest food or feel excessively bloated after eating. Then, in 1994, an emaciated 14-year-old named Charlene Hsu Chi-Ying collapsed in a heap on the busy streets of Hong Kong.

Under pressure to cover the very public event, but faced with little local professional knowledge on the subject, Hong Kong news reporters had to come up with a way to explain what had happened. So they looked to a country whose media had been focusing on anorexia for years: the USA.

Following Charlene’s death Chinese-language newspapers ran headlines like “Anorexia Made Her All Skin and Bones: Schoolgirl Falls on Ground Dead”. Doctors and the public alike began to take notice of the anorexic condition, and as interest grew, so too did the US form of the illness: body dysmorphia and a phobia of fat. Instead of seeing two or three cases a year, by the 1990s, one psychiatrist was seeing that many cases in Hong Kong each month.

Now, 90 percent of anorexic cases are due to fat phobia, and anorexia is a fast-growing problem among the inhabitants of an increasingly wealthy China. It no longer just belongs to the rich white girl.


Illustration: Fanqiao Wang