On Chinese social media platforms, eating disorders are no longer only discussed as health conditions — they are increasingly reframed as disciplined lifestyles, aesthetic goals, and even sources of belonging.

I first encountered these communities almost by accident. Having grown up in an environment where body weight was constantly monitored and discussed, I was already familiar with the pressure surrounding thinness. In recent years, public discourse in China has further amplified concerns about weight and fitness. As a frequent user of Xiaohongshu (a Chinese social media platform similar to TikTok), where conversations about body image are highly visible, I became curious about how far these discussions extended.

One day, I searched for the term “ED,” which stands for eating disorder. What appeared was not health information, but an entry point into a hidden ecosystem — one that reframed illness as aspiration. A search on coded keywords, such as “ED woman” (ED 女), “CT” (Cui Tu or induced vomiting), leads users to semi-hidden networks where extreme thinness is normalized and even celebrated. Within this corner of the internet, members share daily routines, track calorie intake, and exchange strategies for suppressing hunger, often framed as self-improvement.

The population of Chinese teenagers suffering from eating disorders has almost doubled in the past three decades, according to a trend study based on national data. More recent research shows that more than 21 per cent of Chinese teenagers showed signs of eating disorders, and more than 11 per cent suffered from symptoms that carry clinical significance. The study also shows that the female population aged 15 to 19 from lower-income families and poor regions faces the highest risk. Researchers find that the interplay among pubertal development, increased social media exposure, and heightened body image concerns has contributed to the upward trend.

One widely circulated post describes a weekly eating routine from a user identifying herself as “160 cm/33 kg,” listing meals such as a single egg, small portions of rice, or low-calorie substitutes. Another post, entitled “160/29 kg daily intake,” documents a day’s intake that amounts to little more than a cucumber and minimal calories, presented not as alarming but as an aspirational routine.

A defining feature of these communities is the ritual of daily “check-ins.” Users document their weight, caloric intake, and perceived success or failure in maintaining restrictive eating habits. Typical posts read like personal logs: “Day 12: 500 kcal, no carbs, stayed strong,” or “Failed today, ate too much, starting over tomorrow.” These updates are not isolated expressions but part of a collective rhythm, where repetition reinforces commitment.

Comment sections function as spaces of mutual reinforcement. Users encourage one another to persist, with comments such as:

宝宝好美，感觉再瘦20斤会更漂亮

Baby, you are so beautiful, and would look even better if another 20 pounds were lost.

瘦成这样了腰还这么粗

She is already so skinny, yet her waist is still so thick.

These comments praise extreme restriction as evidence of willpower. Rather than being framed as harmful, these practices are aestheticized — presented as part of a desirable lifestyle associated with discipline, beauty, and control. In this context, suffering is not only normalized but reinterpreted as positive.

To evade content moderation and censorship, participants rely on a constantly evolving coded language. For example, users may refer to purging with emojis such as 🐰 (tù, meaning rabbit as well as vomiting) or use abbreviations like “ct” and “jc” (jieshi, meaning dietary restriction), creating a shared vocabulary that is difficult for outsiders to interpret. Over time, these evolving codes form subcultural systems that remain legible primarily to insiders.

Visual culture plays a central role in sustaining these communities. Images of extremely thin bodies — visible collarbones, fragile arms, protruding ribs, narrow waists — are circulated as aspirational references. Trends such as the “A4 waist challenge,” which emerged in 2016 and promoted an ideal waistline no wider than a sheet of A4 paper, reflect a longer history of thinness as a beauty standard. In curated posts, food itself is also aestheticized: a small, neatly plated portion becomes a symbol of restraint, transforming scarcity into visual desirability.

At the same time, many participants explicitly articulate the psychological grip of these practices. In one post, a user writes that she knows her weight has reached a dangerous level, yet still feels unable to stop: she describes standing on a scale each morning, unable to accept even minor increases, despite rationally understanding that the numbers “mean nothing.” She concludes that weight is the only thing she feels she can control. Such reflections reveal a tension between awareness and compulsion, where individuals recognize harm yet remain embedded in systems that reward it.

Particularly concerning is the presence of younger users in the ED networks, where they shared their strategies to conceal school and parental monitoring of their food intake and weight loss, such as using induced vomiting after family meals. In these exchanges, harmful behaviors are collectively celebrated and maintained.

Such trends have also alerted online Chinese media outlets. An article published on the WeChat account Her Magazine describes how eating disorders — including anorexia and bulimia — form an “ED subculture” among young women online in China:

这些女孩仿佛将减肥当成了运动员挑战极限记录一般，每天都在跟体重秤上的数字较劲，多一斤焦虑不安，少一斤成就感满满。[…] 为追求“网红身材”，ED这种心理疾病便成为了女孩们的“救命良药”，无数女孩开始追求ED，并成为ED妹。

与许多心理疾病一样，ED一旦患上，便会深深陷入其中且难以自拔。同时，它还自带“圈层文化”。[…] 这个所谓的圈子，其实是一座囚笼。这类圈子往往会切断人与真实世界的联系，只与“同类”抱团取暖。因此，在她们看来，脱离圈子，便意味着失去身份认同，失去那点仅存的“被理解”的感觉。

These girls seem to treat weight loss as if they were athletes attempting to break world records, constantly battling the numbers on the scale every day — an extra pound brings anxiety, while a pound lost fills them with a sense of accomplishment. […] In the pursuit of the “Social media-celebrity body,” eating disorders hasve become a “lifesaving remedy” for these girls, leading countless young women to embrace EDs and become part of the “ED community.”

Like many mental illnesses, once someone develops an ED, they become deeply entrenched in it and find it difficult to break free. At the same time, it comes with its own “subculture circle.” […] This social “circle” is, in reality, a prison. Such circles often sever one’s connection to the real world, leaving individuals to seek solace only among “like-minded” peers, and leaving the circle means losing their sense of identity and that last shred of feeling “understood.”

While Chinese platforms actively moderate certain types of content, eating disorder-related material continues to circulate through coded and community-driven channels. This reveals the limits of keyword-based moderation systems, particularly when users rapidly adapt their language and practices to avoid moderation.

Similar dynamics can be observed globally. On platforms such as Instagram and TikTok, users also employ coded hashtags and visual cues to share harmful content while avoiding detection. TikTok became a hotbed of ED promotion through its “SkinnyTok” subcommunity, which idealized the notion of thinness at all costs, until the hashtag and prominent SkinnyTok influencers were banned in June 2025, though the unhealthy content persists.

The Chinese case highlights how such communities evolve within a more tightly regulated digital environment, demonstrating both constraint and adaptation.

My initial search was driven by curiosity, but what it revealed was a system that quietly reshapes how young users understand self-control, beauty, and harm. As long as thinness remains a powerful cultural ideal, such coded networks are likely to persist.

Addressing this issue requires more than content removal. It demands a deeper understanding of how digital communities shape norms around the body, discipline, and belonging, as well as positive measures to empower teenagers who want greater autonomy and to take control of their lives by providing them with more opportunities at schools, within their families, and in society.