https://astralcodexten.substack.com/p/book-review-crazy-like-us

We talk a lot about falling biodiversity. Sometimes we apply the same metaphor to the human world, eg “falling linguistic biodiversity" when minority languages get replaced by English or whatever. In Crazy Like Us, Ethan Watters sounds the alarm about falling psychiatric biodiversity. Along with all the usual effects of globalization, everyone is starting to have the same mental illnesses, and to understand them in the same way. This is bad insofar as greater diversity of mental illness could teach us something about the process that generates them, and greater diversity of frameworks and responses could teach us something about how to treat them.

He makes his point through four case studies, starting with:

I. Anorexia In Hong Kong

Until the 1990s, there was almost no anorexia in Hong Kong. There were lots of patriarchal beauty standards, everyone was very obsessed with being thin, but anorexia as a disease was basically unknown.

At least this is the claim of Sing Lee, a Hong Kong psychiatrist who studied in the West. He learned about anorexia during his training in Britain, then went back to Hong Kong prepared to treat it. He couldn't find anybody. He tried really hard! He put out feelers, asking if anyone knew anybody who was having some kind of psychiatric problem where they were starving themselves. With apologies for the unintended offensive pun - nobody bit.