Hika | Eating Disorders in Asian Culture

My Eating Disorder Story

My eating disorder story is pretty complicated but what is different from the stories that probably many people here in the US have is that I did not go through the treatment for the most part. When my ED was the most powerful, there were no treatment facilities like the American ones, so I stayed at a psychiatry ward in a hospital and received “treatment” by a psychiatrist. No therapy, no nutrition counseling. I had been flirting with quasi-recovery for a while until I finally made my mind to commit to recovery. 

At that time, I was fortunate enough to find a HAES dietitian while I was studying abroad in Seattle. They were kind enough to see me on a sliding scale since I did not have insurance. They helped me a lot, while I was doing the work to unlearn diet culture and my fat phobia by myself, using the resources on social media (thanks to fat activists and recovery advocates as well as ED specialists). 

Recovery took a while and I was not able to receive emotional support from my immediate family but thanks to supporters from different area of my life, I was able to get to the point where I am now, and I do not think about food, body, and body movement in the way that I used to when I was struggling. It is very freeing. Not only did I gain weight, but I gained connection with others, healthy relationships with food and body movement, confidence and more! 

At the same time, I acknowledge my thin privilege that made me not “have to” deal with the oppression that people in larger bodies are exposed to daily and that makes their recovery even harder as well as my financial privilege to be able to access to the support that cost money though I am not coming from a high class family. I am still learning how to take better care of myself and become whole. Like many people, I am a work in progress and it is a damn amazing thing! Using my experience, I would like to keep empowering people who are in a rough chapter of their lives and be supportive of them. 

Shame, Stigma, and Linguistics

Shame plays a big role in preventing Asian people from seeking treatment. Like mental health stigma in many Western countries, having mental health issues is associated with being weak. Self-discipline and will-power are highly valued in many Asian countries (at least my country Japan), and having a hard time doing “normal simple things” that many people can do without actively trying because of the mental health struggle is, for many people, hard to fathom. Those who have mental health challenges are seen as weak and even though it is not verbalized, you get the sense of being judged as “less than …” Some people, like family members, even put them into words. My mother did. They say that out of “concern” not much for the individuals struggling but rather for themselves, thinking about what other people (neighbors etc.) see themselves having a person with mental health issues in the family.

Mental health is still a very taboo topic at least in Japan. Many people do not talk about “negative stuff” because it disrupts the “harmony” or the space for interpersonal connection, which is highly valued in many countries with relational culture. 

Many people in Asia still think of stereotypical “looks” when it comes to ED. There is no space for those who are not female and do not fit into the “categories” and are struggling with ED. 

There is also a lack of vocabulary that captures the mental experience is very hard for those who struggle to even understand and talk about what they are going through. For example, I do not find the same equivalent kind of translation for “overwhelming” in my first language. I remember when I did therapy for the first time in my life, I was so amazed and felt a sense of relief, being able to actually externalize my mental health struggle, and finding vocabulary to it.  

Different cultures, different foods

When I was in the US, I did not have a problem trying out the meal ideas written on the “meal plan”, although I remember I craved my cultural or Asian food in general and I did not know how I could apply it to my meal plan. Because there were no Asian food options in the meal ideas I received. Well, except for rice!

When I went back to my country, I had a hard time figuring out how to follow the meal plan and practice the plate-by-plate approach because Japanese meals are not plate based. Typical Japanese meals consist of: some sort of main dish, side dishes along with a bowl of rice and miso soup.

There were no meals like this in the book, so I almost panicked.  I did not have this kind of struggle when I was in the US because I was an adult. I was able to make a decision on what to eat and also I was living with a white host family. However, younger children who are struggling with an eating disorder and are still depending on their Asian American parents can experience this particular challenge.   

Representation

It is very important to see others who look like me and share my background. The eating disorder experience itself is very isolating. It is still nice to see other people who are in the recovery journey in general but there is something that only people from diverse cultural backgrounds get with each other. The struggle that is particular to BIPOC. I experience it each time I lead the BIPOC support group

Seeing people from your race and ethnicity in the eating disorder recovery space definitely makes people feel less alone and more hopeful. More recovery warriors of color and more clinicians of color please!!! 

Speaking of which, we also need to have more Asian folks in eating disorders studies and more Asian clinicians representations in the field. More education on Asian culture regarding mental health, value system, and food culture. Amplifying the voices of Asian recovery warriors and/or Asian people who went through ED.

Tips & Resources

To fellow Asian folks out there struggling, it might be extremely challenging to have parents understand your experiences and mental health struggles. I remember once I stopped trying to make my parents understand mental health and what I was experiencing, not giving up but letting it go, allowing myself to be okay with it despite the sad feelings coming along with it, I felt some sort of sense of relief. Yes, it is totally valid that you want to be understood by family and it is not that they do not care about you, sometimes, mental health related anything is what takes a hot minute for them to understand because they grew up in an environment where mental health was very stigmatized. It is not possible for them to understand (I believe and I hope ) but it might not be a “right time” for them to expose themselves to change from a very stigmatizing place to a completely understanding place. You might want to, but you do not need to put your 100% into making your parents understand you.

Parents are not only people who are your support system. There might be other people who can understand you better and give you the support that you really need to get through the recovery process. Parents might eventually be more open to the mental health topic but maybe not. My mother was not able to when I was struggling the most. But she slowly became less allergic to the topic since she was exposed to more people fighting mental health challenges. It was like she peeled her mental health onion layers very very slowly. Though her mental health acceptance did not catch up with my recovery journey, and she is still not completely okay with the topic, She can hold mental health related conversations with me for a good minute. Letting go can be hard AND it can be very helpful. Know that parents are not the only people who can support you. 

Additional Resources

Hika Kukita

(she/her)

Hika (Hee-kah) Kukita is a Japanese cisgender straight female from a middle SES household. In addition to being an ANAD volunteer, she is finishing up her second Bachelor’s degree in Psychology at Linfield University in Oregon. After graduation, she will move on to a Masters of Social Work Program at Portland State University. Hika aspires to work with young folks in the minority groups in a mental health field as a social worker, and specifically in the community mental health setting to empower them, help them to find strength in themselves, and navigate their lives despite the systemic oppressions they face in their everyday lives. 

Yoga

  • Reconnect with one’s body
    • Promotes mind-body connection, awareness of self, and acceptance.
  • Stress and anxiety reduction
    • Yoga activates the parasympathetic nervous system, counteracting our body’s stress responses.
    • Deep, slow breathing can reduce cortisol  levels (stress hormone) and help calm our minds.
  • Intentional movement
    • Yoga provides a space to mindfully enjoy movement and explore a healthy form of exercise.
  • Long term healing
    • Provides a practice to safely and sustainably lean into.
  • A space for community and support
    • Oftentimes, yoga is done in a group setting, which can increase feelings of connection and lower feelings of loneliness.

After the completion of 7–12 yoga classes, a statistically significant decrease in anxiety, depression, and body image disturbance was seen (Hall et al., 2016).

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Some classes are targeted for rigorous exercise, such as “heated flow” or “power flow.” Please be mindful with what you practice, and look for “slow flow,” “yin,” “vinyasa,” and “restorative” yoga in non-heated rooms.

Music

  • Music can have a powerful effect on people’s mood

    • listening to uplifting or calming songs can help reduce stress and anxious feelings.
  • Music stimulates the limbic system, the part of our brain responsible for processing emotions
    • music triggers the release of serotonin and dopamine, which are associated with reducing feelings of anxiety, depression, and stress (which are often associated with eating disorders)
  • Slow tempo music has been shown to decrease cortisol, our stress hormone, as well as lower blood pressure and reduce heart rate.
  • Music increases the brains neuroplasticity, enhancing brain functions like mood regulation, decision making, and memory.

A study done by Mindlab International revealed that the song “Weightless” by Marconi Union resulted in a 65% reduction in participants’ overall anxiety (Dr. David Lewis-Hodgson).

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  • Ludovico Einaudi
  • Claude Debussy
  • Johann Sebastian Bach
  • José González
  • Laraaji
  • Bill Evans
  • Vance Joy
  • The Paper Kites
  • Moby
  • Tycho

Aromatherapy

  • Aromatherapy can be a helpful, low- cost (or free) tool for people managing eating disorders.
  • Aromatherapy involves using essential oils to help manage emotions and restore balance.
  • Scents can help ground people, encouraging mindfulness about physical and emotional sensations.
  • Can promote a tranquil environment and give a sense (& scent) of peace.
    • creates an atmosphere for individuals to feel safe in processing emotions

Lavender has been shown to reduce anxiety levels. It is seen as a “anxiolytic” solution to providing a coping method for those with anxiety disorders (Yoo & Park, 2023).

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  • Lavender: calm, sleep, relax
  • Chamomile: calm
  • Rose: anxiety reduction
  • Lemon: energy, nausea reduction, concentration
  • Orange: brighten, uplift
  • Jasmine: anxiety reduce, sleep
  • Peppermint: alertness
  • Ylang ylang: calming, stress and anxiety reduction
  • Rosemary: focus

Art

  • Art can help provide a safe space for communication.
  • It can promote a sense of relaxation, and become a calming, meditative like experience (especially in “flow state”).
  • Gives an outlet and coping mechanism for managing difficult emotions.
  • Helps develop healthy habits and routines for self-management.
  • Increases an individuals sense of awareness and understanding of their emotions and thoughts.

Art can boost cognitive function, emotional resilience and self-confidence. It has also been shown to reduce stress and aid in conflict resolution (Hudson University, 2024).

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  • Coloring books
  • Digital coloring or drawing
  • Collaging
  • Sketchbook/journaling/ diary
  • Painting
  • Water coloring
  • Air dry clay (model magic) or traditional clay (ceramics)
  • Photography (use your phone!)
  • So much more!

Creative Journaling & Writing

  • Journaling allows space for self reflection, and emotional release.
  • Free writing can help you connect to your inner voice without judgment.
    • This can look like a steam on consciousness, a short story, or even poetry.
  • Both of these can give you space to problem solve, and look at a situation from a new angle.
  • Try out a prompt, or guided writing exercise if free writing isn’t your thing.
    • Examples & resources below!

Positive writing has been shown to promote positive emotions, as well as positive cognitive mechanisms in the general population (Lai et al., 2023).

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  • What are three things I’m grateful for today?
  • Write a letter to your future self. What do you want to tell them?
  • Write about a positive affirmation you want to start telling yourself.
  • How do you like to relax? Write about your favorite way to unwind.
  • What does “peace” look like to you? How can you bring more of it into your life?
  • What is something that always makes you laugh or brings you joy?

Self-Care / Self-Talk

Positive Self Talk

  • Positive affirmations are short, encouraging statements that can help build our self-esteem and challenge negative thoughts.
  • Repeating these statements daily can help foster a more loving relationship with yourself over time.
    • “Mirror-work” is when you look into the mirror and say kind, positive affirmations to yourself. It might feel awkward at first.
    • Try statements such as “I am enough,” “I am deserving of all the good things life has to offer,” or “I am strong, capable, and confident in everything I do.”
  • This can help build mental resilience, making it easier to cope with challenges and setbacks.
  • They can elevate your mood and promote a more optimistic view of life.
  • They help build confidence and self-worth by focusing on your strengths and capabilities.

Self Care

  • Self-care directly impacts emotional, psychological, and physical well-being.
  • Engaging in regular self care practices helps maintain balance and resilience, ensuring we can cope with life’s challenges.
  • Regular self-care allows the body and mind to recover, recharge, and maintain a sense of calm.
  • Taking care of yourself helps prevent burnout by ensuring you have the energy and mental capacity to meet the demands of life.
    • Without regular self care, you may become overwhelmed, leading to fatigue, frustration, and decreased productivity.
  • Giving yourself mental space helps clear your mind, improving focus, decision-making, and problem-solving.
  • Allows you to engage in activities that bring you joy, pleasure, and fulfillment. These experiences elevate mood and provide moments of peace and happiness.

Positive Self Talk

Affirming personal values has been linked to boosting ones happiness and meaning in life (Nelson et al., 2014). MRI’s show that self- affirmations affect brain activity! (Cascio et al., 2015).

Self Care

“Engaging in a self- care routine has been clinically proven to reduce or eliminate anxiety and depression, reduce stress, improve concentration, minimize frustration and anger, increase happiness, improve energy and more. From a physical health perspective, it has also been clinically proven to reduce heart disease, stroke and cancer” (Glowiak, 2024).

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POSITIVE SELF TALK

 

SELF CARE

  • Up to personal preference, ideas listed in the guide
  • Sleep: Make sure you get enough hours in
  • Making time for hobbies: painting, gardening, etc.
  • Doing chores: cleaning dishes, doing laundry, cleaning space, decluttering
  • Spending time outdoors: taking nature walks, sitting in a park
  • Being with people you love: friends, family, partners
  • Reading or learning: something of interest, and limiting technology/screen time
  • Personal care: shower, bath, deep breathing, meditation, massaging
  • Treating yourself: occasionally indulging yourself with something you love (ex: buying a new book, or a coffee from your favorite shop)
  • Mental care: attending peer support groups (for free with ANAD!), going to therapy (we can help connect you with someone)