City Weekend

Why Hong Kong needs to start talking about eating disorders

With mental health issues often overlooked in the city, it’s no surprise that topics like binge eating are rarely discussed. But a new film is raising awareness on social media and giving hope to sufferers

PUBLISHED : Saturday, 22 July, 2017, 2:02pm
UPDATED : Saturday, 22 July, 2017, 2:23pm

“It’s a constant tug of war with yourself,” says recovering eating disorder struggler Maya Lee Wing-sum.

“It’s an abusive relationship with that unignorable voice in your head, and no amount of logic or reasoning can convince you that your voice is wrong, that the words you, essentially, are telling yourself are harmful and untrue.”

While the Hong Kong government has yet to establish a specialised plan for eating disorder treatment, or route the city towards increasing conversations about the topic, traction is slowly gaining on social media with the release of the Netflix film To the Bone.

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The lead, Hollywood actress Lily Collins, and writer/director Marti Noxon have both overcome past struggles with eating disorders and are using the film, which premiered at the Sundance Film Festival in January, to “start a conversation”.

“Owning my past, being open, and having no shame or regrets about my experiences. Sharing my history with eating disorders and how personal this film has been is one of the most fulfilling experiences of my life,” Collins posted on her Instagram account, sparking thousands of comments from users across the world.

People are too busy in this bustling city environment and mental health care has taken a back seat
Stephanie Ng, body-postive activist

To the Bone highlights that eating disorders are not caused by any single desire or circumstance, and similarly cannot be solved like the flick of a switch. A complicated network of underlying factors contribute to the development of an eating disorder, not merely a fear of “fat” as many often assume.

“At the moment, there is far too little emphasis on the importance of mental health in general in Hong Kong,” said ED battler turned body-positive activist Stephanie Ng.

“People are too busy in this bustling city environment and mental health care has taken a back seat. This means that there is little effort to raise awareness about the importance of mental health in HK, and thus people often don’t even know what eating disorders are, let alone know how to treat them.

“The fact that there is little awareness and emphasis on mental health causes a vicious cycle whereby there is a continued shortage of mental health resources and therefore a continued legitimation of the lack of mental health care options.”

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According to the Hong Kong Eating Disorder Centre at the Chinese University of Hong Kong, over 80 per cent of young people are afraid of being fat, so suppressed diets or overexercising are omnipresent in society. Of this percentage of the population, roughly 3 per cent will develop serious eating disorders.

“My eating disorder began inconspicuously, with what I (and others around me) thought was simply an effort to get ‘healthier’,” Ng said. “This mindset is precisely what allowed for my eating disorder to progress so smoothly. I was utterly convinced right until the day I almost died that I was doing something good for my body.”

In 2012, the Hong Kong Eating Disorder Association reported that among women trying to lose weight, 60 per cent were of a healthy weight, and 10 per cent were actually underweight. Moreover, the number of individuals between the ages of 20 and 29 who are clinically underweight doubled from 1995 to 2010.

People aren’t ashamed of having the flu or breaking their leg, so why should their mental health be any different?
Maya Lee Wing-sum, recovering eating disorder struggler

The film reminds its audience that eating disorders do not discriminate, nor are they confined to starvation, overexercising or self-induced vomiting, but also binge eating and Other Specified Feeding or Eating Disorder.

According to the Hong Kong Polytechnic University’s Integrative Health Unit, “people from all gender, age, nationality, social class and culture can suffer. Female adolescents and young women are the most at risk. An increasing number of young men are reported to have the disorders”.

Up to 50 per cent of those who battle against eating disorders meet the criteria for depression. However, research has proven that as many as six out of 10 sufferers will go unidentified and not speak up about their struggles out of shame or fear.

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“Eating disorders and other mental health issues are often seen as choices in Chinese culture, which puts a lot of blame and shame on the sufferer, and the more personal insight past patients are willing to share, the more lay people will learn to see that mental struggles are just as valid and worth attending to as physical struggles,” Ng said.

Former sufferer Lee said: “We need to start public conversations. People aren’t ashamed of having the flu or breaking their leg, so why should their mental health be any different?

“The public needs to be educated about the severity and existence of body image issues, and be open to having open and honest discussions.”

Ng agreed that more openness was vital.

“I truly believe that taboo only becomes more taboo if it is not actively talked about. It may seem awkward and uncomfortable to bring up the topic of body positivity during regular social occasions, but that is the only way this issue can be brought to the attention of the general public,” she said.

“Topics are sensitive because we cringe when we talk about them, or we whisper them to others. If we say what we need to say with confidence and say it out loud, those around us will get that positive vibe too and follow suit.”