SEOUL — Thirty miles south of the border with starving North Korea, young women in the South Korean capital are starving themselves, victims not of famine but of fashion.
Dr. Si Hyung Lee has seen this dark side of affluence and modernity. He remembers best the patient who died of respiratory failure. "She was a pediatrician's daughter," said Lee, director of the Korea Institute of Social Psychiatry at Koryo General Hospital in Seoul. "Her father and mother were both doctors."
But her parents failed to realize that their teenager suffered from anorexia nervosa--a disease almost unheard of in Korea a decade ago--until it was too late to save her.
If Asia is a reliable indicator, eating disorders are going global.
Anorexia--a psychiatric disorder once known as "golden girl syndrome" because it struck primarily rich, white, well-educated young Western women--was first documented in Japan in the 1960s. Eating disorders are now estimated to afflict about 1 in 100 young Japanese women, almost the same incidence as in the United States, according to retired Tokyo University epidemiologist Hiroyuki Suematsu.
Over the past five years, the self-starvation syndrome has spread to women of all socioeconomic and ethnic backgrounds in Seoul, Hong Kong and Singapore, Asian psychiatrists say. Cases also have been reported--though at much lower rates--in Taipei, Beijing and Shanghai. Anorexia has even surfaced among the affluent elite in countries where hunger remains a problem, including the Philippines, India and Pakistan.
Doctors in Japan and South Korea say they also have noticed a marked increase in bulimia, the "binge-purge syndrome" in which patients gorge themselves, then vomit or use laxatives to try to keep from gaining weight, sometimes with lethal consequences.
Experts debate whether these problems are caused by Western pathologies that have infected their cultures via the globalized fashion, music and entertainment media or are a generic ailment of affluence, modernization and the conflicting demands now placed on young women. Either way, the effects are unmistakable.
"Appearance and figure has become very important in the minds of young people," said Dr. Ken Ung of National University Hospital in Singapore. "Thin is in, fat is out. This is interesting, because Asians are usually thinner and smaller-framed than Caucasians, but their aim now is to become even thinner."
