One of the western diagnostic criteria for anorexia nervosa is a 'morbid or intense fear of fatness', which is absent in some Chinese anorexic patients in Hong Kong. As a result, patients often visit non-psychiatric doctors and have extensive investigations performed. By the time they are referred to psychiatrists, some may already have reached an advanced stage of illness. In this report of two patients with anorexia nervosa, we attempt to illustrate the variable presentation of anorexic patients in Hong Kong, and to alert health professionals to the early recognition and treatment of this potentially lethal disorder.