Food and Fear: Confessions and Mutual Support for People with Eating Disorders

Delicious chocolate chip biscuits are high-fat traps that trigger a “cycle of fear”, dragging us into one nightmare after another, saturated in dread; the “crunch” of crisps is a crisp outlet for suppressed anger, providing a hollow sense of security; sugar-free cola is a “happy liar”, like a false perfect partner, pushing us further into dietary imbalance…

This is a series of visual science illustrations regarding eating disorders titled *Devour*. The artist selected eight classic foods, using a black-and-white palette and distorted, fractured forms to express how patients with eating disorders perceive food: to them, the delicacies that others find delicious are laden with dark metaphors, each hiding a trail of scars.

These illustrations are part of the eating disorder science and art exhibition *Love, Food, and Life*, hosted this summer by the Shanghai Mental Health Center (hereinafter referred to as the “Shanghai Mental Health Center”). The venue, “Gallery 600”, is located within the grounds of the center and takes its name from its address: 600 Wanping South Road.

Eating Disorders (ED) are a group of syndromes characterised primarily by abnormal eating behaviours accompanied by an excessive preoccupation with food and body shape. These mainly include three categories: anorexia nervosa, bulimia nervosa, and binge eating disorder.

Through visually striking imagery, the art exhibition vividly interprets these clinical descriptions.

*DRESSING 1 & DRESSING 2* combines photography and printmaking. A girl wears a beautiful princess dress, yet the hem is stained with grease and grime, set against a mountain of food—a suggestion of the helplessness and struggle she faces during her illness.

*Atoning for a Fabricated Crime* uses frenetic lines and clashing colours to record the experience of bingeing and purging suffered by those with depression: body anxiety is a fabricated crime imposed upon us; I hypnotised myself with the belief that “thin equals healthy”. While the food was expelled, an ever-more frenzied appetite and self-loathing remained within.

*The Mask of ED* and *Deformed Food* are two sets of physical exhibits. Their twisted, bizarre shapes and chaotic yet vivid colours reflect the turbulence and conflict within the patient—a painful abyss splitting the gap between self-identity and external expectations…

It is not merely food that triggers this intersection of craving and fear.

Eating disorders often co-exist with other mental health issues, such as depression, anxiety, obsessive-compulsive disorder (OCD), and problems with self-esteem. The latest edition of the *Chinese Expert Consensus on the Diagnosis and Treatment of Anorexia Nervosa* states: “The onset of anorexia nervosa is related to biological, psychological, familial, and social factors.”

One piece in the exhibition collects personal accounts from patients. One written to parents reads: “Since I was little, you always told me I wasn’t fat, but when I hit a peak of 80kg, how could I not care about how others looked at me? Amidst fear and inferiority, I used food to fill the void in my heart, while violently purging it to prevent myself from gaining weight. But I always knew it was just food; it could never replace love.”

A narrative art book featuring interviews with 30 eating disorder patients is titled *An Apples*—apples being a common diet food, serving as a metaphor for temptation and obsession, restriction and compulsion. The book is displayed page by page; one page notes that the progression of the illness can act as a buffer against family conflict. For example, when a child refuses to eat, parents are forced to set aside their disputes and unite to care for the child, thereby drawing a family on the brink of collapse back together.

According to various epidemiological statistics, eating disorders are most prevalent among those aged 14 to 25. The aforementioned *Expert Consensus* notes: anorexia nervosa has an early age of onset, with the median patient age being only 16; it is most common in adolescent and young women, with a female-to-male ratio of approximately 11:1.

Beyond damaging physical health—leading to malnutrition, electrolyte imbalance, and organ damage—eating disorders have the highest mortality rate of all psychological disorders, comparable to substance abuse, with the mortality rate for anorexia nervosa as high as 5% to 20%.

However, the dangers of eating disorders are little known, and the illness itself can be difficult to recognise. Zhang Qinwen, one of the curators of *Love, Food, and Life*, struggled with an eating disorder for six years. In 2019—three years after her diagnosis—she filmed China’s first original documentary on the subject. After disclosing her experience of anorexia and weighing as little as 28.8kg on social media, she received numerous messages; many were mothers who said they had experienced similar conditions for over a decade without knowing it was an eating disorder.

This inspired Zhang Qinwen’s desire to spread awareness. Over the past five years, she has become a humanist health science blogger, @YoungDivineShaman; built a mutual aid community of over 3,000 members; founded ED Healer—currently the largest peer support organisation for eating disorders in China and a co-organiser of this exhibition; served as the lead translator for the book *The Golden Cage: Psychological Causes and Treatment of Anorexia*; been invited to give health communication lectures on eating disorders at various universities; and become a curator for ED-related science outreach.

Zhang Qinwen once received treatment at the Eating Disorder Centre of the Shanghai Mental Health Center. The center provided support while she was filming the documentary. During an exhibition in 2021, the Shanghai Mental Health Center unveiled China’s first official public interest hotline for eating disorders and provided on-site free clinics with doctors. After the establishment of Gallery 600, the partnership to host exhibitions became a natural progression.

– Interviewer –

Xianyu

A Sichuan native with a passion for cooking. Former medical and technology journalist, currently a podcast producer. Creator of the official account “Funeral Love Xianyu” and the podcast “Common Sense Newsstand”.

Zhang Qinwen: I want to tell everyone that eating disorders are not that simple. Take the exhibit *On My 22 Days in a Psychiatric Ward* (Excerpt)—the cover says “Longing to be the favourite”, without mentioning food a single word.

Zhang Qinwen: Too many to count. A doctor once mentioned in passing how difficult it is to get patients to eat. When he saw the photograph of chopsticks with thorns in the exhibition, it suddenly became vividly clear to him that an eating disorder is a form of pain.

Many parents have also messaged me on social media saying they hadn’t realised the suffering caused by eating disorders was so great and that it needs more attention. Some said the exhibition opened their minds and that they want to bring their children to see it. That is what moves me the most.

Foodthink: In previous media interviews, you disagreed with the statement that eating disorders are a “social disease”. Why?

Zhang Qinwen: An eating disorder is a bio-psychosocial illness. Its causes are extremely complex, potentially linked to personality, genetic factors, and family environment; there is a high degree of family clustering. For example, if your parents are perfectionists with very strict demands and you have a highly sensitive personality, you are inherently more predisposed to an eating disorder. Others develop them due to later traumatic experiences, such as school bullying, emotional trauma, or being ridiculed. Everyone’s perception and reaction to these things differ. If the broader social environment were more inclusive, it would certainly help. However, I do not believe that eating disorders are caused entirely by body image anxiety driven by the external gaze, nor do I think every patient develops the disorder solely because of societal judgment.

The public still lacks sufficient understanding, which is why they don’t know how to correctly help this group. Telling someone with anorexia to “just eat more” or “just eat properly” is like telling someone in a wheelchair to “just try harder to stand up”.

Foodthink: The workload for this art exhibition must have been enormous, and the ED Healer official account posts quite frequently. How did you organise yourselves?

Zhang Qinwen: We have very grassroots origins. In 2020, while I was doing public outreach, my Weibo account received too many pleas for help from people wanting to commit suicide or self-harm. Some girls who had recovered also messaged me privately and we became close; some worked in media, others in clinical psychology. There were nine of us at the time, and our skills complemented each other perfectly, making us a great team. That’s how ED Healer was suddenly born. The subsequent growth of ED Healer was like that of a fast-growing child; from those original nine people, we now have 23 formal members working on this long-term. Additionally, we have over 100 long-term volunteers, including university professors and their students, as well as journalists interested in the issue. We even have people from the modelling and luxury industries who view eating disorders as an “occupational disease” of the modelling world and want to offer advice. It’s a vast universe of diverse people, a very vibrant community.

Foodthink: Over the years, have you sensed any progress?

Zhang Qinwen: When I was ill and searched for eating disorders on Xiaohongshu, there were only about a hundred posts. Now, topics related to anorexia and eating disorders on Xiaohongshu have reached hundreds of millions of views. This reflects some progress. (Editor’s note: The number of patients visiting the Eating Disorder Diagnosis and Treatment Centre of the Shanghai Mental Health Center rose from 122 in 2002 to nearly 4,300 in 2021.) From my personal experience, I was the first to establish an eating disorder “Super Topic” on Weibo and one of the earliest users to talk about eating disorders on Xiaohongshu. Back then, as soon as I started providing public education, I received so many pleas for help regarding self-harm and suicide that I felt overwhelmed. This showed that the demand was huge, but the attention and help were far too scarce.

In 2021, perhaps 90% of people nationwide had no idea what an eating disorder was. That year, at the Shanghai Himalayas Art Museum, my partners and I organised the first exhibition of its kind in China. While creating work in an air-raid shelter, many older locals gathered around out of curiosity, but no matter how many times I explained, they couldn’t grasp what an eating disorder was. It was only when I mentioned dieting for weight loss that they understood a little. Consequently, I changed the theme of the exhibition from “Eating Disorders” to “Body Image Anxiety”.

This group also faces the risk of privacy leaks, where personal stories may be made public without consent, and the media may use sensationalist or intentionally misleading narratives. There is also inequality brought about by various prejudices and stigmatisation, which affects career development and can even lead to unemployment. All these negative elements can be incredibly cruel.

As I mentioned earlier, the growth and expansion of the ED Healer team is also a form of progress. We hope that through interdisciplinary public education, we can raise awareness for prevention, provide an empathetic support environment for those struggling, encourage diverse lifestyles, and explore individual beauty and value.

Foodthink: As someone who has been through this, how do you know when you have recovered? Is there an experience you can share with us?

Zhang Qinwen: Recovery from an eating disorder is a state that you can perceive yourself, and it is very distinct. You reach a point where you understand yourself, no longer feel that food is a source of distress, and feel that the way you interact with others and your attitude toward society have gradually stabilised. You also find new ways to cope with stress. It is actually a very comprehensive shift, but your own feeling is the only standard.

In many previous interviews, I said I was perhaps eighty or ninety percent recovered. After 2021, it became clear to me: I am recovered. On the day of the exhibition sharing, I said, beginning to enjoy every single mouthful of food—that is recovery.

Interview by: XianyuEdited by: Caofan

Images: Xianyu, ED Healer official account