The Dieting Phenomenon in Hong Kong The changing attitudes towards dieting amongst young women in Hong Kong By: Jessica Leung King George V School Intern 24 June to 5 July 2002
Introduction Dieting can be defined as a restricted intake of food and drink, designed for weight loss, health or religious reasons.1 Since the number of overweight children in Hong Kong has increased steadily over the past few years due to changed eating habits, weight loss is necessary for medical reasons. According to the Student Health Service, the obesity rate of school children in Hong Kong increased from 11% in 1997 to 13.6% in 2000.2 In response to these alarming figures, the Department of Health launched a “Healthy Exercise for All” campaign in April 2000 aimed at promoting the benefits of physical exercise and encouraging citizens to participate in all kinds of activities. However, dieting, which used to be something exclusively for people who were overweight, is now becoming more widespread amongst people in Hong Kong. Over the past few years, attitudes towards dieting have changed dramatically. People no longer diet solely for health reasons. It has become increasingly common for non-obese people in Hong Kong, particularly women, to diet. Even those who are at a healthy weight strive to look thinner. Also, a growing number of young children have expressed the desire to diet. Studies carried out early in 2001 revealed that even children as young as five in Hong Kong wanted to become thinner.3 It may be that children fear being teased by their peers if they are fat, and so develop a negative attitude towards overweight people from a very young age. Dieting is so prevalent in Hong Kong today that it has become the norm. As a result, the number of young women and girls with eating disorders such as anorexia has been on the increase. Although dieting in men should not be excluded, the number of diet-related advertisements targeted at women suggest that dieting is much more common amongst women than in men. Thus, this paper will focus largely on the dieting of women rather than men.
Marketing through the Media The media is responsible for the unhealthy messages projected onto society. TV commercials, magazine advertisements, posters and MTR billboards surround us, constantly reminding us that “thin is beautiful.” These advertisements, which do not necessarily relate to slimming products and services, often feature slim-looking models. It is rare to find an advertisement featuring an overweight model, or one that does not fit in with society’s idea of what is thin. For example, even an advertisement for a Philips computer monitor uses a slender model to market its product. Many advertisements associate thinness with money, success, beauty and happiness, which results in the formation of a widespread ideology in society that equates thinness with these material possessions.
1
Encarta World English Dictionary (2001), “diet”, http://dictionary.msn.com/find/entry.asp?refid=1861604596, 4 July 2002. 2 Hong Kong Government Department of Health (2002), “”World Health Day” reminds public to “Move for Health””, 6 April 2002, http://www.info.gov.hk/dh/new/bulletin/02-04-06e.htm, 25 June 2002. 3 Martha Irvine (2001), “Fretting about Fat!”, Canadian Online Explorer, 23 July 2001, http://www.canoe.ca/Health0107/23_fat2-ap.html, 30 June 2002. 1
A study of a Chinese language gossip magazine found that more than 30% of the advertisements inside the magazine were related to slimming products and services (Oriental Sunday, Edition 213, January 2002). According to admango.com, a company that monitors advertising media in Hong Kong, advertisements on slimming products and services increased by almost 75% in the past year. 4 From January to May 2002 alone, a record HK$500 million was spent on slimming advertisements. 5 More money is spent on advertising in the diet industry than in any other industry in Hong Kong.6 However, the advertisements used by these companies are often misleading. They promise potential customers instant magical body transformations, which are often too good to be true. Advertisements use many tactics to persuade consumers to purchase newest slimming products or to join weight-loss programs. For instance, celebrity endorsements are used to elevate the status of the company. Local celebrities are used as models in advertisements. This makes the advertisements more convincing and narrows the gap between the general public and the celebrities. In a media-oriented society such as Hong Kong, many people are eager to keep up with the latest celebrity trends, and so if their idols are using these slimming products and services, it is likely they will follow. Advertisements also frequently feature “before and after” measurements and photos, sometimes of non-celebrities too. These provide a more realistic view and enable consumers to see the results of a certain product or service. However, the accuracy and credibility of these photos and measurements may be questioned. Some advertisements on slimming products on the market place great emphasis on the “naturalness” of their products. These often boast of their herbal extracts and natural ingredients. Many consumers opt for these products, thinking that as they are “natural”, they should be healthier and safer to use than other products on the market.7 However, despite their claims, companies give little regard to the health of consumers; their intention is to sell a product or service. Many “natural” or “herbal” weight-loss products on the market can in fact have negative effects on our health, such as heart attacks, seizures and even death.8 It is also common for advertisers to include scientific evidence such as doctor’s recommendations and approvals, to increase the reliability of their products and services.9 Slimming advertisements can be found everywhere: in magazines, on MTR billboards and in TV commercials. Local Chinese newspapers also play a part in promoting dieting. Not only do they feature slimming advertisements, they often criticise celebrities for not being “thin enough”. Even healthy looking celebrities who are at their normal weight are advised to lose some of their “excess fat”. In conclusion, the media plays a big part in shaping the thin ideal in Hong Kong. It has an immense power and influence over society.
The Diet Industry Dieting has generated many commercial opportunities. Companies exploit consumer willingness to spend in achieving the “perfect body”. The diet industry has an ever-expanding market of consumers who are willing to pay for these weight-loss products and services. Companies are making vast amounts of money
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Tom Hilditch & Vivienne Chow (2002), “Slim Pickings”, South China Morning Post Online Edition, 28 June 2002, http://totallyhk.scmp.com/thkarts/ZZZDB75YG2D.html, 30 June 2002. 5 Ibid. 6 Ibid. 7 New York-Presbyterian (2002), “Weighing in on Herbal Weight Loss Products”, http://www.nyp.org/news/2002/greystone_articles/5_8_02_6.html, 5 July 2002. 8 Ibid. 9 Hong Kong Baptist University Department of Journalism, “Wanna have a model figure? Think twice before slimming: medical expert”, The Young Reporter Online Edition, Vol. 34 Issue 1, http://www.hkbu.edu.hk/~tyrej/focus/focus0101.htm, 30 June 2002. 2
out of women blindly chasing unattainable supermodel physiques.10 With all their slimming products and services, companies are making huge profits out of consumers, who are effectively putting their money to waste. In the past year, many products and services have been launched on the market, ranging from slimming beauty centres, liposuction, natural herbal remedies, DIY home appliances to bizarre methods such as plastic wraps and hot gels that promise to burn away all body fat. Many fitness clubs and gyms have also been established to keep up with this dieting trend. The California Fitness Centre gym opened its first centre in Hong Kong in 1996, and within seven years, expanded to five outlets. Hong Kong has a greater number of California Fitness Centres than other Asian countries such as Singapore, Taiwan and Korea. This is ironic, considering it is one of the smallest cities in Asia. According to the Taipei Times, 5% of Hong Kong’s population go to gyms, as compared to only 3% of the Taiwanese population.11 Another popular slimming centre, Marie France Bodyline, which is ranked as the sixth top spender on diet-related advertising in Hong Kong, has opened six outlets in six different districts.12 There are currently 1884 companies registered under beauty salons and weight-control services in the Yellow Pages Internet directory. 13 This shows the fast-growing expansion of these fitness clubs and slimming centres in Hong Kong. It should be noted that this figure does not take into account other unregistered companies. Clearly, there is a high demand for these services. In addition, a recent survey conducted by the Asia-Pacific Research Centre of the Chinese University of Hong Kong revealed that almost 70% of the clients were not happy with the service of slimming centres.14 Despite this, the number of women who invest in them is still increasing. Many of these slimming products and services are harmful to the body, and can have side effects, such as heart valve malfunction.15 More often than not, products and services are unsuccessful, or only work temporarily. Nevertheless, consumers are willing to spend their money on them, in an attempt to achieve the ideal body. Many have become so caught up with these slimming products and services they fail to remember that the most effective and safest way to slim down is regular exercise and a balanced diet.16 One of the reasons why the diet industry is so successful is because of effective advertising. Many market their product or service strategically, playing on people’s fears and obsessions of being overweight. However, these advertisements are often misleading and filled with myths. According to the Consumer Council, an increasing number of complaints have been filed against slimming centres in Hong Kong in the past three years.17 This suggests that the advertising techniques used to persuade potential customers are somewhat deceptive.
10
Tom Hilditch & Vivienne Chow (2002), “Slim Pickings”, South China Morning Post Online Edition, 28 June 2002, http://totallyhk.scmp.com/thkarts/ZZZDB75YG2D.html, 30 June 2002. 11 Annabel Lue (2001), “Fitness center to flex muscle in China”, Taipei Times Online Edition, 6 December 2001, http://taipeitimes.com/news/2001/12/06/story/0000114678, 28 June 2002. 12 See footnote 10. 13 Hong Kong Yellow Pages Internet Directory (2002), http://www.yp.com.hk/consumer/en/html/cat_browse_result2.asp?desc1=Medical%20Services%20%26%20Beauty &desc2=Beauty&groupid=1653&id=1647, 2 July 2002. 14 Hong Kong Baptist University Department of Journalism, “Wanna have a model figure? Think twice before slimming: medical expert”, The Young Reporter Online Edition, Vol. 34 Issue 1, http://www.hkbu.edu.hk/~tyrej/focus/focus0101.htm, 30 June 2002. 15 EatWell (2000), “Weight Reduction Methods – Myth and Truth”, http://www.eatwell.com.hk/weight/weightloss.m&t.e.html, 30 June 2002. 16 BUPA Health Care Organisation (2002), “How to lose weight safely and effectively”, http://www.bupa.co.uk/health_information/html/healthy_living/lifestyle/diet/diet2.html, 5 July 2002 17 See footnote 14. 3
Health Effects of Dieting Dieting can have many negative consequences on our health, especially when it reaches extremes. These include increased risks of heart disease and osteoporosis, which are diseases that show up later on in life. There is also growing concern about the use of slimming products and services, the effects of which may even be fatal. Recently, a woman in Singapore died from liver failure, caused by consumption of Slim 10, a diet pill manufactured in Guangdong. 18 It was seized from the Singaporean market in April for containing ingredients that were undeclared on the packaging. In 1999 and 2000, there were two recorded cases of women in Hong Kong who died because of diet pills. 19 This figure is probably much higher now, since the number of people taking diet pills has increased significantly over the past few years. One of the women who died took more than six kinds of weight-loss pills. Herbal teas are another type of slimming product, which can have negative effects on human health. They cause fluid and electrolyte imbalances, resulting in dehydration and irregular heart beat. 20 Drugs such as amphetamines, which are used to suppress appetite, may cause dizziness, hallucination, heart problems and even death.21 The Hong Kong Department of Health has banned drugs containing the amphetamine Phen-Fen from the market since 1998.22 Other similar drugs have also been banned.23 Aside the physical effects on our health, dieting can also have a psychological impact. Those who diet excessively often feel insecure and displeased with themselves. It may seem like their only goal in life is to lose weight. They often have a poor self-image and low self-esteem, which may lead to depression and obsessive behaviour such as an eating disorder. This may affect their daily life, including relationships, behaviour at work and academic performance. A study carried out by the Chinese University of Hong Kong revealed that almost 50% of women believed that their self-worthiness would enhance if they became thinner.24 As thinness is now regarded as culturally desirable, many women are dieting to seek the approval of society.
Eating Disorders The incidence of eating disorders in Hong Kong has been increasing over the past few years. Previously, eating disorders were more of a Western phenomenon, as plumpness was considered attractive and a sign of prosperity and good-fortune in non-Western societies such as Hong Kong. However, anorexia and bulimia are now extremely common in Hong Kong. According to the Department of Health, the number of adolescent females with eating disorders in 2001 was 10%.25 This figure has increased by 50 times in 18
Yahoo!Asia News (2002), “Singapore woman dies after taking diet pill”, 2 June 2002, http://asia.news.yahoo.com/020602/reuters/asia-108098.html, 30 June 2002. 19 EatWell (2000), “Improper Dieting May Be Life Threatening”, http://www.eatwell.com.hk/weight/inproper.e.html, 2 July 2002. 20 EatWell (2000), “Weight Reduction Methods – Myth and Truth”, http://www.eatwell.com.hk/weight/weightloss.m&t.e.html, 30 June 2002. 21 Ibid. 22 Ibid. 23 Consumer Council (2001), “DH instructs recall of “slimming health food””, 30 March 2001, http://www.consumer.org.hk/danger/gia/20010330/010330e.htm, 3 July 2002. 24 The Chinese University of Hong Kong (2002), “CUHK Study Reveals: Every 5 in 100 Female Nurses in Hong Kong Has Anorexia or Bulimia Nervosa Before”, 7 June 2002, http://www.cuhk.edu.hk/ipro/020607e.htm, 27 June 2002. 25 Hong Kong Government Department of Health (2002), “Health Status of Women in Hong Kong”, January 2002, http://www.women.gov.hk/women/download/health_status_of_women.pdf, 26 June 2002. 4
the last decade, with victims as young as 10 years old.26 It is alarming that young girls, who have not even reached puberty, are dieting at such extremes. Anorexia nervosa sufferers have an intense fear of gaining weight, and as a result they become obsessed with dieting. They perceive themselves as fat, even when dangerously thin. Often, they eat so little that they end up starving themselves, causing malnutrition. Other effects of anorexia include osteoporosis, heart problems and kidney failure.27 In extreme cases, this illness may even lead to death. Studies have shown that anorexia sufferers have a mortality rate 10 times higher than that of non-anorexics of the same age.28 However, anorexia in Hong Kong seems to be slightly different than in Western cultures. Victims lack a fear of fatness, or the “fat phobia” which is the fundamental characteristic of anorexia. Instead, their weight-obsessive behaviour is due to reasons such as low self-esteem and social pressures. 29 According to Dr. Sing Lee, a senior lecturer in psychiatry at the Chinese University of Hong Kong and Director of the Hong Kong Eating Disorders Centre, the root causes of eating disorders include sexual abuse, academic failure and family problems.30 Bulimia nervosa sufferers, like anorexia sufferers, are again obsessed with their weight. However, unlike anorexia victims, they often eat in huge amounts uncontrollably. Afterwards, they feel guilty for doing so, and in order to lose weight, often resort to destructive methods of purging the food, such as by using laxatives or self-induced vomiting. It may seem that eating disorders are common only amongst adolescent girls. This is not the case, as anorexia and bulimia may occur at all ages and in both genders. A recent study carried out by the Chinese University of Hong Kong revealed that three quarters of nurses surveyed were dissatisfied with a part of their body, and more than 90% were concerned about body weight and shape.31 The nurses, aged between 20 and 55, were from 12 hospitals in Hong Kong. Two-thirds of them believed that having a slim body was important.32 Almost 40% had tried dieting previously and 5% of nurses had suffered from an eating disorder before.33 This is particularly disturbing, as if even health professionals, who should be more informed about the risks of dieting, suffer from eating disorders, this may suggest to the general public that there is nothing wrong with obsessive dieting.
Conclusion Perhaps the key prevention to the harmful effects of dieting is awareness. If the public and media are educated about the low long-term success rates and negative health effects of dieting, the number of people going on fad diets can be reduced significantly. Last year, the Save the Children Fund conducted a
26
Ibid. The KELY Support Group (2001), “Naming the Causes of Disordered Dieting”, http://www.kely.org/kely_diseating.htm, 2 July 2002. 28 Patsy Moy (2001), “Girl, 10, among victims as young hit by anorexia”, Association for the Advancement of Feminism, 8 November 2001, http://www.aaf.org.hk/hotnews/20011108.htm, 2 July 2002. 29 SK Leung & S Lee (1997), “The variable presentation and early recognition of anorexia nervosa in Hong Kong”, Hong Kong Medical Journal 1997; 3:433-5, http://www.hkam.org.hk/publications/hkmj/article_pdfs/hkm9712p433.pdf, 2 July 2002. 30 Sonni Efron (1997), “Women’s Eating Disorders go Global”, The Los Angeles Times, 18 October 1997, http://www.hartford-hwp.com/archives/50/103.html, 2 July 2002. 31 The Chinese University of Hong Kong (2002), “CUHK Study Reveals: Every 5 in 100 Female Nurses in Hong Kong Has Anorexia or Bulimia Nervosa Before”, 7 June 2002, http://www.cuhk.edu.hk/ipro/020607e.htm, 27 June 2002. 32 Ibid. 33 Yahoo!Asia News (2002), “Hong Kong Nurses Obsessed with Losing Weight”, 7 June 2002, http://asia.news.yahoo.com/020607/reuters/asia-109133.html, 30 June 2002. 27
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“Treasure your Body” education programme on healthy eating and eating disorders. 34 This involved exhibitions, workshops and competitions, and was successful in promoting a healthy body image amongst teenagers in Hong Kong. Campaigns like this can bring about a positive effect on society, and the government should perhaps consider funding more projects to promote awareness on the many consequences of dieting. As thinness is now regarded as the norm, this may have an impact on not only overweight people, but also those who are at their healthy weight. These people may be discriminated against because of their size, and this could create barriers in employment and other opportunities in society. The public need to recognise that people are of all different shapes and sizes. We should not be prejudiced against those who we think are different. Legislation on the advertising techniques slimming product and service companies could also be reinforced, alerting consumers on the fraudulent nature of these advertisements. For example, a health warning on the dangers of extreme dieting could be issued on slimming advertisements, similar to the warnings on cigarette advertisements.
34
The Save the Children Fund Hong Kong (2001), “'Treasure your Body' - School Education Programme 20002001”, http://www.scfhk.org.hk/program/anorexia.htm, 2 July 2002. 6