Hsiao-chen (not her real name) began dieting when she was 12. Without her realizing it, her weight had climbed to 60 kilograms, making her rather pudgy for her 158 centimeter height. When her classmates teased her and gave her rude nicknames, she decided to lose weight. At first, she ate only meat and veggies and cut out rice, but did not thereby slim down. Hsiao-chen then had to adopt more extreme methods to lose weight. She skipped breakfast, and ate only bread or a few cookies for lunch. She would avoid dinner by lying and saying that she had eaten with classmates after school.
This form of compulsive dieting did, as expected, enable her to steadily lose weight. In order to slim down faster, each day she also exercised vigorously such as by performing more than 100 sit-ups and running around an athletic field. On many nights, Hsiao-Chen was roused from slumber by her hunger, and the pangs would keep her from returning to sleep. However, when she saw the numbers drop a little on the weight scale, all the suffering she had endured seemed as nothing.
Three years of continual dieting and Hsiao-chen was down to 40 kilograms. But she did not feel tired, but only that her body was light and full of energy, while her classmates expressed their envy. Hsiao-chen still thought this was not enough, hoping she could keep her weight below 40 kilos. She therefore went further and only chewed but did not swallow her food. After two years, when her height was 161 centimeters, she weighed only 30 kilograms, and was suffering from severe depression. On several occasions, she tried to harm herself by slitting her wrists or swallowing pills. These behaviors alerted Hsiao-chen's mother that something was wrong, and she had no choice but to forcibly take her to a hospital for treatment.
When Hsiao-chen came to Chen Kuan-yu's clinic, he was shocked to see an emaciated body like that of a terminal cancer patient. He discovered that the level of potassium ions in Hsiao-chen's blood was even lower than that of severely ill patients in intensive care, putting her at risk of dying from shock at any time. After several consultations, Chen discovered that Hsiao-chen was growing up in a single-parent home, and lived in close quarters with a mother with whom she was in constant conflict. This severe emotional bind combined with her desire to lose weight had finally mutated into anorexia. Fortunately, Hsiao-chen likes food very much, and only stopped ingesting food because she feared getting fat-so that dealing with her condition did not prove to be overly problematic.
Chen first used family counseling to make Hsiao-chen's mother face her daughter's dislike of eating, while attempting to improve the rigid way the two interacted. Because Hsiao-chen often ignored her hunger too long, overate, and vomited what she ate, the very feelings of hunger and satiation had become confused. Finding it difficult to deal with food on a table, she preferred hiding out and eating alone, disliking having to dine together with other people. So Chen invited Hsiao-chen's family to share meals with other anorexics and their families, allowing Hsiao-chen to once again experience the feeling of people eating communally.
After several courses of therapy, although Hsiao-chen has stopped coming to Chen's clinic for treatment, she seems to have brought her anorexia under control, as well as gradually overcome the discord between herself and her mother and developed partial autonomy. Currently, her weight has risen to about 46 kilograms.