{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T08:29:52Z","timestamp":1793348992982,"version":"4.5.0"},"reference-count":96,"publisher":"Cambridge University Press (CUP)","issue":"4","license":[{"start":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T00:00:00Z","timestamp":1247097600000},"content-version":"unspecified","delay-in-days":5729,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Psychol. Med."],"published-print":{"date-parts":[[1993,11]]},"abstract":"<jats:title>Synopsis<\/jats:title><jats:p>A mixed retrospective\u2013prospective study of 70 Chinese anorexic patients in Hong Kong shows that although they were similar to Western anorexics in most other ways, 41 (58\u00b76%) of them did not exhibit any fear of fatness throughout their course of illness. Instead, these non-fat phobic patients used epigastric bloating (31\u00b74%), no appetite\/hunger (15\u00b77%) or simply eating less (12\u00b79%) as legitimating rationales for food refusal and emaciation. Compared to fat phobic anorexics, they were significantly slimmer pre-morbidly (<jats:italic>P<\/jats:italic>&lt; 0\u00b70001) and were less likely to exhibit bulimia (<jats:italic>P<\/jats:italic>= 0\u00b7001). The possible explanations for the absence of fat phobia and the interpretive dilemma this provokes are discussed from historical, pathoplastic and cultural anthropological perspectives. It is argued that anorexia nervosa may display phenomenological plurality in a Westernizing society, and its identity may be conceptualized without invoking the explanatory construct of fat phobia exclusively. As non-fat phobic anorexia nervosa displays no culturally peculiar features, it is not strictly speaking a Western culture-bound syndrome, but may evolve into its contemporary fat phobic vogue under the permeative impact of Westernization. Its careful evaluation may help clarify the aetiology and historical transformation of eating disorder, foster the development of a cross-culturally valid taxonomy of morbid states of self-starvation, and exemplify some of the crucial issues that need to be tackled in the cross-cultural study of mental disorders.<\/jats:p>","DOI":"10.1017\/s0033291700026465","type":"journal-article","created":{"date-parts":[[2009,7,9]],"date-time":"2009-07-09T14:03:06Z","timestamp":1247148186000},"page":"999-1017","source":"Crossref","is-referenced-by-count":208,"title":["Fat phobic and non-fat phobic anorexia nervosa: a comparative study of 70 Chinese patients in Hong Kong"],"prefix":"10.1017","volume":"23","author":[{"given":"S.","family":"Lee","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T. P.","family":"Ho","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"L. K. G.","family":"Hsu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2009,7,9]]},"reference":[{"key":"S0033291700026465_ref094","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.160.6.819"},{"key":"S0033291700026465_ref093","doi-asserted-by":"publisher","DOI":"10.1093\/jhmas\/46.1.3"},{"key":"S0033291700026465_ref092","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.157.6.902"},{"key":"S0033291700026465_ref091","first-page":"321","volume-title":"Bulimia Nervosa: Basic Research, Diagnosis and Therapy","author":"Vandereycken","year":"1990"},{"key":"S0033291700026465_ref090","doi-asserted-by":"publisher","DOI":"10.1016\/0010-440X(75)90050-4"},{"key":"S0033291700026465_ref089","first-page":"17","article-title":"A clinical study of Chinese patients with eating disorders","volume":"3","author":"Tseng","year":"1989","journal-title":"Chinese Psychiatry"},{"key":"S0033291700026465_ref088","doi-asserted-by":"publisher","DOI":"10.1016\/0277-9536(85)90062-0"},{"key":"S0033291700026465_ref087","doi-asserted-by":"publisher","DOI":"10.1159\/000287865"},{"key":"S0033291700026465_ref085","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.162.3.398"},{"key":"S0033291700026465_ref084","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199204)11:3<191::AID-EAT2260110302>3.0.CO;2-S"},{"key":"S0033291700026465_ref083","volume-title":"The Structured Clinical Interview for DSM-III-R","author":"Spitzer","year":"1988"},{"key":"S0033291700026465_ref079","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700005547"},{"key":"S0033291700026465_ref075","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(85)90005-6"},{"key":"S0033291700026465_ref074","first-page":"285","volume-title":"The Neuroses and Personality Disorders","author":"Russell","year":"1983"},{"key":"S0033291700026465_ref070","doi-asserted-by":"publisher","DOI":"10.1007\/BF00055003"},{"key":"S0033291700026465_ref069","doi-asserted-by":"publisher","DOI":"10.1177\/136346159202900201"},{"key":"S0033291700026465_ref067","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3956(85)90004-4"},{"key":"S0033291700026465_ref066","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700014616"},{"key":"S0033291700026465_ref065","first-page":"856","article-title":"Anorexia nervosa as a manifestation of compulsion neurosis","volume":"41","author":"Palmer","year":"1939","journal-title":"Archives of Neurological Psychiatry"},{"key":"S0033291700026465_ref063","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1177\/003591573903200313","article-title":"Prepsychotic anorexia","volume":"32","author":"Nicolle","year":"1939","journal-title":"Proceedings of the Royal Society of Medicine"},{"key":"S0033291700026465_ref061","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700004335"},{"key":"S0033291700026465_ref060","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.158.2.222"},{"key":"S0033291700026465_ref059","first-page":"311","article-title":"The epidemiology of anorexia nervosa in junior and senior high-school students in Ishikawa Prefecture","volume":"23","author":"Mizushima","year":"1983","journal-title":"Japanese Journal of Psychosomatic Medicine"},{"key":"S0033291700026465_ref058","doi-asserted-by":"publisher","DOI":"10.1037\/0021-843X.100.3.245"},{"key":"S0033291700026465_ref056","doi-asserted-by":"publisher","DOI":"10.1080\/00332747.1947.11022625"},{"key":"S0033291700026465_ref096","volume-title":"The ICD-10 Classification of Mental and Behavioural Disorders \u2013 Clinical Descriptions and Diagnostic Guidelines","year":"1992"},{"key":"S0033291700026465_ref055","first-page":"254","article-title":"Toward the understanding of anorexia nervosa as a disease entity","volume":"56","author":"Lucas","year":"1981","journal-title":"Mayo Clinic Proceedings"},{"key":"S0033291700026465_ref053","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.161.4.545"},{"key":"S0033291700026465_ref050","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700028531"},{"key":"S0033291700026465_ref049","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700022340"},{"key":"S0033291700026465_ref048","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.151.4.447"},{"key":"S0033291700026465_ref077","doi-asserted-by":"publisher","DOI":"10.1016\/0168-8227(90)90142-G"},{"key":"S0033291700026465_ref051","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.5.683"},{"key":"S0033291700026465_ref054","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.156.3.308"},{"key":"S0033291700026465_ref086","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700020559"},{"key":"S0033291700026465_ref039","doi-asserted-by":"publisher","DOI":"10.1037\/14090-000"},{"key":"S0033291700026465_ref010","doi-asserted-by":"publisher","DOI":"10.1007\/BF00116860"},{"key":"S0033291700026465_ref073","first-page":"131","volume-title":"Modern Trends in Psychological Medicine","volume":"2","author":"Russell","year":"1970"},{"key":"S0033291700026465_ref019","volume-title":"Anorexia Nervosa: Let Me Be","author":"Crisp","year":"1980"},{"key":"S0033291700026465_ref037","doi-asserted-by":"publisher","DOI":"10.1525\/aa.1971.73.1.02a00030"},{"key":"S0033291700026465_ref064","first-page":"255","article-title":"A clinical and psychosocial study of seven cases of anorexia nervosa in Singapore","volume":"23","author":"Ong","year":"1982","journal-title":"Singapore Medical Journal"},{"key":"S0033291700026465_ref003","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1176\/ajp.147.12.1670","article-title":"Koro: proposed classification for DSM-IV","volume":"147","author":"Bernstein","year":"1990","journal-title":"American Journal of Psychiatry"},{"key":"S0033291700026465_ref018","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198701)6:1<1::AID-EAT2260060102>3.0.CO;2-9"},{"key":"S0033291700026465_ref044","doi-asserted-by":"publisher","DOI":"10.1017\/S0264180100000515"},{"key":"S0033291700026465_ref029","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.159.4.591"},{"key":"S0033291700026465_ref021","doi-asserted-by":"publisher","DOI":"10.1007\/BF00052156"},{"key":"S0033291700026465_ref046","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199101000-00005"},{"key":"S0033291700026465_ref071","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.154.3.400"},{"key":"S0033291700026465_ref082","first-page":"24","article-title":"A clinical report of 9 cases of anorexia nervosa","volume":"4","author":"Song","year":"1990","journal-title":"Chinese Mental Health Journal"},{"key":"S0033291700026465_ref095","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700011107"},{"key":"S0033291700026465_ref081","volume-title":"Build and Blood Pressure Study","year":"1979"},{"key":"S0033291700026465_ref052","doi-asserted-by":"publisher","DOI":"10.3109\/00048679109077729"},{"key":"S0033291700026465_ref062","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700010370"},{"key":"S0033291700026465_ref031","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700030762"},{"key":"S0033291700026465_ref078","doi-asserted-by":"crossref","first-page":"69","DOI":"10.1353\/jsh\/21.1.69","article-title":"The first great increase in anorexia nervosa","volume":"21","author":"Shorter","year":"1987","journal-title":"Journal of Social History"},{"key":"S0033291700026465_ref042","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700011016"},{"key":"S0033291700026465_ref015","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700024296"},{"key":"S0033291700026465_ref034","first-page":"22","article-title":"Anorexia nervosa (apepsia hysterica, anorexia hysterica)","volume":"7","author":"Gull","year":"1874","journal-title":"Transactions of the Clinical Society (London)"},{"key":"S0033291700026465_ref014","first-page":"26","article-title":"Behavioural therapy of seven cases of childhood anorexia nervosa","volume":"4","author":"Chen","year":"1990","journal-title":"Chinese Mental Health Journal"},{"key":"S0033291700026465_ref016","first-page":"85","article-title":"Standard weights for Chinese adults","volume":"3","author":"Chiu","year":"1978","journal-title":"Journal of the Chinese Nutrition Society (Taiwan)"},{"key":"S0033291700026465_ref076","first-page":"13","volume-title":"The Psychobiology of Human Eating Disorders: Preclinical and Clinical Perspectives","author":"Russell","year":"1989"},{"key":"S0033291700026465_ref002","doi-asserted-by":"publisher","DOI":"10.1192\/S0007125000107482"},{"key":"S0033291700026465_ref072","first-page":"190","volume-title":"Body Images: Development, Deviance and Change","author":"Rosen","year":"1990"},{"key":"S0033291700026465_ref080","first-page":"109","article-title":"Notes towards the history of anorexia nervosa","volume":"70","author":"Skrabanek","year":"1983","journal-title":"Janus"},{"key":"S0033291700026465_ref025","doi-asserted-by":"publisher","DOI":"10.1177\/000306515600400104"},{"key":"S0033291700026465_ref023","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199101)10:1<67::AID-EAT2260100108>3.0.CO;2-N"},{"key":"S0033291700026465_ref009","doi-asserted-by":"publisher","DOI":"10.3109\/00048678109159426"},{"key":"S0033291700026465_ref028","first-page":"589","volume-title":"Comparison to Psychiatric Studies","author":"Fairburn","year":"1988"},{"key":"S0033291700026465_ref012","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(198321)2:3<3::AID-EAT2260020302>3.0.CO;2-D"},{"key":"S0033291700026465_ref020","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.161.1.104"},{"key":"S0033291700026465_ref068","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700017700"},{"key":"S0033291700026465_ref032","doi-asserted-by":"publisher","DOI":"10.2190\/R55Q-2U6T-LAM7-RQR7"},{"key":"S0033291700026465_ref006","volume-title":"Eating Disorders: Obesity, Anorexia Nervosa, and the Person Within","author":"Bruch","year":"1973"},{"key":"S0033291700026465_ref047","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199111000-00001"},{"key":"S0033291700026465_ref007","doi-asserted-by":"publisher","DOI":"10.1007\/BF01254810"},{"key":"S0033291700026465_ref001","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM-III-R)","year":"1987"},{"key":"S0033291700026465_ref004","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.145.3.331"},{"key":"S0033291700026465_ref005","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.156.4.565"},{"key":"S0033291700026465_ref008","volume-title":"Fasting Girls: The Emergence of Anorexia Nervosa as a Modern Disease","author":"Brumberg","year":"1988"},{"key":"S0033291700026465_ref011","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1977.01770210101009"},{"key":"S0033291700026465_ref013","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1993.01820140051005"},{"key":"S0033291700026465_ref017","doi-asserted-by":"publisher","DOI":"10.1177\/070674378903400223"},{"key":"S0033291700026465_ref022","doi-asserted-by":"publisher","DOI":"10.1177\/136346159002700401"},{"key":"S0033291700026465_ref024","doi-asserted-by":"publisher","DOI":"10.1016\/0022-3999(87)90009-2"},{"key":"S0033291700026465_ref057","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199201000-00002"},{"key":"S0033291700026465_ref026","doi-asserted-by":"publisher","DOI":"10.1097\/00005053-199201000-00003"},{"key":"S0033291700026465_ref027","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.153.3.385"},{"key":"S0033291700026465_ref030","volume-title":"Anorexia Nervosa: A Multidimensional Perspective","author":"Garfinkel","year":"1982"},{"key":"S0033291700026465_ref033","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.162.2.276b"},{"key":"S0033291700026465_ref036","volume-title":"Fish's Clinical Psychopathology","author":"Hamilton","year":"1985"},{"key":"S0033291700026465_ref035","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1002\/1098-108X(198905)8:3<259::AID-EAT2260080302>3.0.CO;2-#","article-title":"The psychiatric history of anorexia nervosa and bulimia nervosa: weight concerns and bulimic symptoms in early case reports","volume":"8","author":"Habermas","year":"1989","journal-title":"International Journal of Eating Disorders"},{"key":"S0033291700026465_ref038","doi-asserted-by":"publisher","DOI":"10.1002\/1098-108X(199101)10:1<15::AID-EAT2260100103>3.0.CO;2-I"},{"key":"S0033291700026465_ref040","volume-title":"Chinese Medicine \u2013 The Web that has no Weaver","author":"Kaptchuk","year":"1983"},{"key":"S0033291700026465_ref041","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.100.419.411"},{"key":"S0033291700026465_ref043","doi-asserted-by":"publisher","DOI":"10.1192\/S0007125000047061"},{"key":"S0033291700026465_ref045","doi-asserted-by":"publisher","DOI":"10.1016\/0165-1781(88)90071-6"}],"container-title":["Psychological Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0033291700026465","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,15]],"date-time":"2024-03-15T04:12:03Z","timestamp":1710475923000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0033291700026465\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1993,11]]},"references-count":96,"journal-issue":{"issue":"4","published-print":{"date-parts":[[1993,11]]}},"alternative-id":["S0033291700026465"],"URL":"https:\/\/doi.org\/10.1017\/s0033291700026465","relation":{},"ISSN":["0033-2917","1469-8978"],"issn-type":[{"value":"0033-2917","type":"print"},{"value":"1469-8978","type":"electronic"}],"subject":[],"published":{"date-parts":[[1993,11]]}}}