When Dr Sing Lee first looked into anorexia in Hong Kong 20 years ago, he found it occurred mostly in women suffering from clinical depression.
Eating disorders remain largely a female problem - 10 women for every man - but the main 'triggers' are now more to do with fat phobia and body image issues, says Lee, a professor of psychiatry at Chinese University.
What's more, health professionals in Hong Kong are now seeing the condition in pre-teens. Hong Kong-based nutritionist Gabrielle Tuscher reports an increase in the number of children and adolescents with eating disorders being referred to her practice. Tuscher's caseload includes children as young as eight, and even a few boys.
At Hong Kong Baptist Hospital, paediatric consultant Dr Lilian Wong also says she is seeing younger patients with eating disorders.
A report co-authored by Lee in the International Journal of Eating Disorders last year said the number of Hong Kong patients suffering from anorexia nervosa or bulimia had doubled over 20 years at a psychiatric clinic they studied. In the first 10 years, the clinic saw 67 patients; during the next decade, from 1998 to 2007, the number rose to 128.
Because sufferers don't fit the usual criteria for diagnosis (female, 13 to 20 years old), doctors have coined a new term - 'eating disorder not otherwise specified' - for the condition in young children.