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

Delicious chocolate chip cookies are high-fat traps that trigger a cycle of fear, plunging us into one nightmare after another steeped in dread; the crisp crunch of potato chips offers a crunchy release for pent-up anger, lending a hollow sense of reassurance; sugar-free cola is a ‘cheerful deceiver,’ akin to a falsely perfect partner, pushing us further into dietary imbalance…

This series, titled *Devour*, comprises awareness-raising illustrations on eating disorders. The artist selected eight classic foods, rendering them in a monochrome palette with distorted, fragmented forms to convey how those with eating disorders perceive food: to them, dishes that appear delicious to others carry sombre metaphors, each concealing a trail of scars.

The illustrations form part of *Love, Food and Life*, a public awareness art exhibition on eating disorders hosted this summer by the Shanghai Mental Health Centre (SMHC). The exhibition space, ‘Gallery 600,’ is located within the SMHC campus and takes its name from its address: 600 Wanping South Road.

Eating disorders (EDs) are a group of syndromes characterised clinically by abnormal eating behaviours and an excessive preoccupation with food and body shape. They primarily encompass anorexia nervosa, bulimia nervosa, and binge-eating disorder.

The exhibition uses visually striking imagery to give visceral shape to these cold clinical descriptions.

*DRESSING 1 & DRESSING 2* combines photography with graphic composition. A girl wears a beautiful princess dress, yet its hem is heavily stained with grease and grime. Against a backdrop of mountains of food, the piece hints at the helplessness and struggle experienced throughout the course of the illness.

*Atoning for an Imagined Sin* employs frenzied lines and clashing colours to document a depressive patient’s cycle of bingeing and purging: body anxiety is a fabricated crime imposed upon us. I hypnotise myself with the notion that ‘thin equals healthy.’ The food is purged, yet the escalating craving and self-loathing remain trapped within.

*The Mask of ED* and *Distorted Food* are two sets of physical exhibits. Their twisted, unnatural shapes and chaotic yet vivid colours mirror the inner turbulence and conflict of patients, revealing the painful chasm that splits open between self-identity and external expectations…

What triggers this intertwining of craving and fear extends far beyond food alone.

Eating disorders frequently co-occur with other mental health conditions, such as depression, anxiety, obsessive-compulsive disorder, and issues with self-esteem. The latest edition of the *Chinese Expert Consensus on the Diagnosis and Treatment of Anorexia Nervosa* states: ‘The aetiology of anorexia nervosa is linked to biological, psychological, familial, and social factors.’

One exhibited piece collects personal accounts from eating disorder patients. In a letter addressed to their parents, one writes: ‘Since childhood, you’ve always told me I wasn’t fat. But at a peak weight of 80kg, how could I ignore how others looked at me? Caught between fear and low self-worth, I filled the emptiness inside me with food, only to brutally purge it to keep myself from gaining weight. Yet I always knew that it was just food—it could never replace love.’

A narrative art book featuring interviews with thirty eating disorder patients is titled *The Apples*—the apple being a common diet food, serving as a metaphor for temptation and obsession, restriction and compulsion. The book is displayed page by page. One excerpt reads: the progression of the illness can serve to avert family conflict. For instance, when a child refuses to eat, parents are forced to set aside their disputes and unite to focus on the child, thereby drawing a fracturing family back together.

According to multiple epidemiological surveys, eating disorders most frequently emerge between the ages of 14 and 25. The aforementioned *Expert Consensus* notes: anorexia nervosa tends to onset early, with a median age of just 16; it is most common among adolescent and young women, with a male-to-female ratio of approximately 1:11.

Beyond compromising physical health—leading to malnutrition, electrolyte imbalances, and organ damage—eating disorders carry the highest mortality rate of all mental disorders.，comparable to substance abuse, with the mortality rate for anorexia nervosa reaching as high as 5%–20%.

Yet the dangers of eating disorders remain largely unknown to the public, and the condition itself is often hard to recognise. Zhang Qinwen, one of the curators of Love, Food and Life, lived with an eating disorder for six years. In 2019—her third year since diagnosis—she directed China’s first original documentary on eating disorders. After sharing her experience online—her struggle with anorexia and dropping to just 28.8 kg—she was flooded with messages. Many were from women who had already become mothers, describing similar struggles lasting over a decade, unaware that what they were experiencing was an eating disorder.

This sparked Zhang’s desire to spread awareness. Over the past five years, she has reinvented herself as a humanistic health science communicator under the handle @少女神婆婆; founded a peer-support community of over 3,000 members; launched ED Healer, currently China’s largest peer-support organisation for eating disorders and a co-organiser of this exhibition; served as the lead translator for the book The Golden Cage: The Psychological Origins and Treatment of Anorexia Nervosa; been invited to deliver talks on eating disorder health communication at numerous universities; and taken on the role of curator for exhibitions focused on eating disorder awareness.

Zhang previously sought treatment at the Eating Disorder Centre of the Shanghai Mental Health Centre. The centre supported her while she was filming the documentary. During an exhibition in 2021, the Shanghai Mental Health Centre unveiled China’s first official public welfare helpline for eating disorders and dispatched doctors to provide on-site consultations. Following the establishment of the No. 600 Gallery, a partnership between the two parties to co-organise exhibitions became a natural next step.

– Interviewer –

咸鱼

A Sichuan native with a passion for cooking. Former medical and technology journalist, now a podcast producer. WeChat Official Account Zang Ai Xian Yu, podcast Common Sense Kiosk.

张沁文：I want people to understand that eating disorders are not as straightforward as they seem. Take the exhibited piece Twenty-Two Days Hospitalised in Psychiatry (excerpt), for instance. The cover reads “Wishing to Be the Favourite”, not mentioning food or eating at all.

Zhang Qinwen: Far too many. A doctor once remarked in passing during a chat, “Why is it so difficult to get patients to eat?” When he saw a photograph at the exhibition depicting chopsticks with thorns, he suddenly and vividly realised that (an eating disorder) is a profound form of pain.

Quite a few parents have messaged me through (social media) direct channels, saying they never imagined the suffering caused by eating disorders could be so severe, and that it deserves serious attention. Some mentioned that after visiting the exhibition, their perspectives have opened up considerably, and they want to bring their own children to see it. That really moves me.

Foodthink: During a previous media interview, you took issue with the claim that eating disorders are a socially driven condition. Why?

Zhang Qinwen: Eating disorders are mind-body conditions with highly complex causes. They can be linked to personality traits, genetic factors, and family environments, and they tend to run strongly in families. For instance, if your parents are highly perfectionistic and demanding, and you yourself have a highly sensitive temperament, you inherently belong to a high-risk group. Many others develop them following later traumatic experiences, such as school bullying, emotional trauma, or being mocked. Everyone’s perception and reaction to these experiences differ. A more inclusive societal environment would certainly play a very positive role. However, I do not believe eating disorders are solely triggered by body image anxiety under the external gaze, nor does every patient develop one entirely due to social judgement.

Currently, public understanding remains insufficient, which means people simply do not know how to properly support this group. If you tell someone with anorexia, “Just eat more and you’ll be fine,” or “Just focus on eating properly,” it is akin to telling someone in a wheelchair to try harder and they will be able to stand up.

Foodthink: The workload for this art exhibition must have been immense, and the ED Healer official account publishes articles quite frequently. How did everyone get organised?

Zhang Qinwen: We started from a completely grassroots background. In 2020, while I was creating educational content, my Weibo account was flooded with cries for help from people wanting to self-harm or commit suicide. In the direct messages, girls who had recovered would also reach out, forming close bonds with me. Some worked in media, others in clinical psychology. At the time, there were nine of us. Our skills complemented each other perfectly, making us well-suited to form a team, and so ED Healer came into being almost overnight. Its subsequent growth has been like a rapidly developing child. We have grown from those initial nine members to 23 core team members now, all committed to this work long-term. On top of that, we have over a hundred long-standing volunteers, including university professors and their students, as well as journalists passionate about this issue. There are also models and professionals from the luxury fashion sector who view (eating disorders) as an occupational hazard in their field and wish to offer guidance. It is a diverse mix of people, a vast universe that has become a highly vibrant and energetic community.

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

Zhang Qinwen: When I was ill and searching for eating disorders, there were barely more than a hundred posts on Xiaohongshu (Little Red Book). Now, topics related to anorexia and eating disorders have accumulated hundreds of millions of views on the platform. This certainly reflects some progress. (Editor’s note: The number of patients visiting the Eating Disorder Treatment Centre at Shanghai Mental Health Centre rose from 122 in 2002 to nearly 4,300 in 2021.) From my own experience, I was among the first to create a dedicated topic for eating disorders on Weibo, and one of the earliest users to discuss the subject on Xiaohongshu. Back then, as soon as I posted educational content, I was overwhelmed with pleas for help from people wanting to self-harm or commit suicide, which was utterly crushing for me. It highlighted a massive unmet need alongside a severe lack of attention and support.

Around 2021, perhaps 90% of people across the country had never even heard of eating disorders. That year, my partners and I organised the first domestic exhibition on the subject at the Himalayas Museum in Shanghai. While creating artwork in a bomb shelter, many older visitors would gather curiously around us. Yet, no matter how many times we explained, they struggled to grasp what an eating disorder actually was. It was only when I linked it to dieting and weight loss that they began to understand a little. Consequently, I shifted the exhibition’s theme from eating disorders to body image anxiety.

This community also faces the risk of privacy breaches. Personal stories may be exposed without consent, and the media might sensationalise or deliberately mislead. Furthermore, various prejudices and stigmatisation breed inequality, hindering career progression and even leading to unemployment. All these negative factors can be incredibly harsh.

As mentioned earlier, the growth and expansion of the ED Healer team is itself a sign of progress. We hope that through cross-disciplinary educational outreach, we can raise public awareness of prevention, foster an empathetic support environment for those struggling, and encourage diverse lifestyles that allow individuals to explore their own beauty and self-worth.

Foodthink: As someone who has been through it, how do you know you have recovered? Are there any experiences you would like to share?

Zhang Qinwen: Recovery from an eating disorder is a state you can sense yourself, and it is unmistakable. You come to understand yourself, no longer see food as a source of distress, and feel your interactions with others and your attitude towards society gradually steadying, along with new ways of coping with stress. It is, in truth, a deeply complex process, but your own experience is the only true measure.

In numerous past interviews, I used to say I was perhaps eighty or ninety per cent recovered. After 2021, it became unequivocally clear to me: I was simply recovered. As I said on the day of the exhibition sharing session, learning to savour every single bite is recovery itself.

Interview: XianyuEditor: Caofan

Images: Xianyu, ED Healer WeChat Official Account