In our book, Marcia and I wrote about the “Western toxin effect,” in which developing countries begin to experience a rise in eating disorders, often spread through exposure to TV and the Western emphasis on appearance and physical beauty. Now, however, that phrase seems quaint. In Asia, for instance, pop culture has been completely co-opted by Western ideals of beauty, and the epidemic of eating disorders is full-blown.

I realized this when I came across a chapter in Euny Hong’s new book, The Birth of Korean Cool: How One Nation Is Conquering the World Through Pop Culture.

Hong tells the story of how South Korea, with head-spinning rapidity, rose from a poor, much-invaded nation to a pop culture supernova, dominating the world through its film, K-pop style of girl and boy bands, movies, electronic products, and video games. But along with the rise to prominence has come an obsession with appearance and plastic surgery.

South Korea is now the world’s plastic surgery capital, accounting for more procedures per capita than the U.S. or Brazil. The most popular procedures are double eyelid surgery (adding a crease in the eyelid to make it look larger, rounder, and more Western) and rhinoplasty, often to make the tip of the nose pointier.

The most disturbing part of this trend, though, writes Hong, is “the increase in the number of young children requesting surgery.” Plastic surgeon Dr. Sewhan Rhee says it’s common to see Seoul “middle-school children get plastic surgery during their winter school break. It’s not considered weird. It’s considered normal. “

Peer pressure and the desire to conform, those animating values of adolescent life, have resulted in “a surgical arms race,” Hong writes, “a one-upmanship among schoolchildren to look prettier.”

So it’s no big surprise to learn that South Korea has for some time now been seeing a rapid rise in eating disorders. Way back in 1997, in fact, Los Angeles Times reporter Sonni Efron reported this article on the rise in eating disorders in Asia. In 2012, Georgia Hanias, in a Marie Claire article, “Anorexia: The Epidemic Japan Refuses to Face Up To,” reported that eating disorders were increasing more rapidly in Japan than anywhere else in the world.

The “toxin effect” has spread to young women of all socio-economic levels in other parts of Asia, including South Korea, Singapore, and Hong Kong, even in countries where hunger is still an issue, such as India, Pakistan, and the Philippines.

In this YouTube video on eating disorders and thinness in South Korea, an American vlogger who covers the global invasion of Korean culture (or as it’s known in Korea, Hallyu), notes, “K-pop has been hugely influential in the whole diet scene because people want to look like their favorite K-pop stars.” Many of these stars are known for their extreme diets. Popular looks include “chopsticks legs” or “lollipop head,” a big head fronted with a cute face and Westernized eyes on top of stick-thin legs.

Korean culture is also one in which commenting and even bullying others about their size, shape, and appearance is not taboo. Japan is no different. During my time living there, I got used to seeing friends or relatives greet one another with the comment, “Oh, you got a little fat, didn’t you?”

Steph, the waif-like vlogger and host of the series “Hallyu Back,” recounts how she has been picked on by fellow teachers or students. “Any day I looked a little bloated,” she says, “comments would range from, ‘Oh, fat teacher,’ to ‘Are you having a baby?’”

The comments on her post are plaintive and alarming: A viewer, likely Japanese, whose handle is Taeyu95, writes, “I really want to go to Seoul next year, but my body is holding me back. I’m short and very fat: 159 cm (5’2.5?) and 49 kg (108 lbs). I want to drop to 39 kg… And K-pop is very influential to me starting dieting. I just don’t wanna be called fat in Korea.” Note how objectively normal-sized, even thin, this person is.

Another comment, from “Kpoping,” reads, “I’m 4’11″ and weigh 102 pounds. I would call myself fat. So I try to do the K-pop diets and ulzzang diets. I’m the biggest out of my friends, but I’m also the tallest. Also, my parents say that I’m big-boned. And I have been influenced so bad by Koreans and K-pop idols.” “Ulzzang,” by the way, describes the pale skin of certain K-pop stars; fans follow their diet tips (“Don’t eat too much meats! Meats turn u brown!”) in the hopes of turning as pale as their idols.

As you can see, the toxin has breached the hazmat suit. I wonder how soon it will be in our globalized world when even the farthest reaches of the globe are no longer immune?