Author: Ya-Ke (Grace) Wu, PhD, RN

Studies of the prevalence of eating disorders have been mainly based on populations in the United States and Western Europe, but recent studies indicate that eating disorders are also emerging in Asia [1]. Since Asia contains about 30% of Earth’s total land area and 4.5 billion people, it should be included in collaborations and professional dialogues about eating disorders research, treatment, and prevention. Below I introduce the prevalence of eating disorders in four Asian countries and list useful local resources for healthcare providers and patients with eating disorders in each of the four countries.

Taiwan

A recently published study examined the prevalence of eating disorders in Taiwan from 2002 to 2013 [2]. It reported a total of 1,893 Taiwanese with anorexia nervosa (AN) and 10,542 Taiwanese with bulimia nervosa (BN) from 2002 to 2013. In Taiwan, the overall incidence rates of AN and BN during this time period were 1.1 and 6.1 per 100,000 people, respectively. Most of the Taiwanese with AN and BN were 20–29 years old (41.7 and 51.3%, respectively). The study also pointed out that the most individuals with AN were between 15–19 years old, and most individuals with BN were between 20–29 years old. In addition, the overall incidence of AN and BN from 2002 to 2013 had increased (0.96 to 1.27 per 100,000 people). Although research on eating disorders in Taiwan is still in its infancy, the Taiwanese Society of Psychiatry (http://www.sop.org.tw/video/list.asp?/3.html) provides online education about eating disorders for healthcare providers to better assist Taiwanese with eating disorders and to raise awareness of eating disorders in Taiwan.

Japan

According to the data from Our World in Data [3], the number of Japanese of any age diagnosed with an eating disorder was 397,994 people in 2017. For individuals of all ages, the prevalence of eating disorders in Japan was 0.33%, but prevalence was 1.03% for those between 20-24 years old in 2017 [4]. A review study reported that the prevalence of AN in 2013 was 0.02-0.03% in Japanese senior high school boys but 0.19-0.26% in Japanese senior high school girls [5]. The Japanese Society for Eating Disorders (http://www.jsed.org/) provides workshops, seminars, and clinical guidelines for eating disorders treatment and prevention for healthcare providers and patients. The Society also promotes international eating disorders conferences such as International Conference on Eating Disorders (ICED) to Japanese clinicians and researchers. 

South Korea

There is a rising concern about how the popular K-pop culture (i.e., Korean pop music culture) is feeding eating disorders by promoting extremely thin body shape and skinny-obsessed society among K-pop celebrities. In addition the Mukbang internet phenomenon (watching people eat often large amounts of food) that also originated in Korea has been linked to both restricting and loss of control eating. An early epidemiological study showed that 8.5 % of South Koreans reported abnormal eating pathology [6]. Lifetime prevalence of AN and BN among Koreans is 0.01% and 0.1%, respectively [7]. In 2011, the number of eating disorders cases reported among South Koreans ages 19-30 was 159 [8]; however, by 2017, the number of South Koreans with an eating disorder of any age was 189,698 [3]. Seoul Paik Hospital’s Eating Disorder Clinic Program (https://www.paik.ac.kr/bh/da/jin/eatingclinic/) provides education and treatment to South Koreans who suffer from eating disorders, such as Motivation Therapy, Cognitive Behavioral Therapy, and Nutritional Recovery. The Clinic also offers support and resources to family and friends of people with eating disorders, such as how to care for a child with an eating disorder.

Singapore

Early evidence showed that there was a total of 126 Singaporeans with AN from two eating disorder clinics at the Singapore Institute of Mental Health between 1994 and 2002 [9]. The number of new AN cases per year has increased fourfold from 1994 to 2002 [9]. Recent data showed that the number of Singaporeans with an eating disorder across all ages was 30,956 in 2017 [3]. The Eating Disorders Programme by LIFE Centre at Singapore General Hospital (https://bit.ly/35Co99k) was established in 2003. It provides treatment and support to Singaporeans with eating disorders. The program offers clinical services such as dietetics, family therapy, and individual psychotherapy. It also provides a variety of support groups to those coping with an eating disorder, such as Eating Disorder Meal Support and Support for Eating Disorders Singapore.  In summary, each of the four Asian countries discussed has seen a dramatic increase in the number of individuals diagnosed with an eating disorder. Given the growing numbers, it is important that eating disorders research continues to expand beyond the United States and Western Europe where much of the research to date has been based. Thankfully, Taiwan, Japan, South Korea, and Singapore have resources available for providers, patients, and families within their counties that promote awareness and treatment of eating disorders.

References

1.  Pike, K.M. and P.E. Dunne, The rise of eating disorders in Asia: A review. J Eat Disord, 2015. 3: p. 33.

2.  Tseng, M.M., et al., Rates and trends in healthcare-detected incidence of anorexia nervosa and bulimia nervosa: A national health insurance claim data study in Taiwan, 2002-2013. Int J Eat Disord, 2020. 53(3): p. 331-338.

3.  OurWorldinData. Number of people with an eating disorder. 2017; Available from: https://ourworldindata.org/grapher/number-with-eating-disorder-country.

4.  OurWorldinData. Prevalence of eating disorders by age. 2017; Available from: https://ourworldindata.org/grapher/prevalence-of-eating-disorders-by-age?tab=table.

5.  Hotta, M., et al., Epidemiology of anorexia nervosa in Japanese adolescents. Biopsychosoc Med, 2015. 9: p. 17.

6.  Lee, Y.H., et al., Epidemiology of eating disordered symptoms in the Korean general population using a Korean version of the Eating Attitudes Test. Eat Weight Disord, 1998. 3(4): p. 153-61.

7.  Jung, J.Y., et al., Binge eating is associated with trait anxiety in Korean adolescent girls: A cross sectional study. BMC Womens Health, 2017. 17: p. 8.

8.  Hwangbo, R., H. Chang, and G.H. Bahn, Diagnostic distribution of psychiatric disorders among Korean young adults. Soa Chongsonyon Chongsin Uihak, 2020. 31(2): p. 80-87.

9.  Lee, H.Y., et al., Anorexia nervosa in Singapore: An eight-year retrospective study. Singapore Med J, 2005. 46(6): p. 275-81.