Most people in India struggle to get enough to eat - one estimate is that 60% of India's women are clinically malnourished.
In a country where many go hungry, anorexia is unknown to most
But psychiatrists in urban areas are reporting cases of anorexia nervosa, the so-called slimming disease that can cause sufferers to starve themselves to death.
Most people in India have still not heard of the condition but Delhi psychiatrist Sanjay Chugh says he has seen an explosion in anorexia cases over the past few years.
He says a typical case could be a 17-year-old girl of around five feet six (1.68m) weighing just 4st 10lbs (30kg) who is convinced she is overweight.
"You can actually see her bones sticking out of her body," Dr Chugh says.
For [the public], a person who's starving herself to death must be stupid
The arrival of cable television and Western fashions and films has given today's teenagers the idea that thin is beautiful.
Western fast foods have arrived too but as the young girls at Delhi's pizza and burger bars tuck in, they also say they want to lose weight.
"I would like to be thinner than I am of course," says one girl.
"When you see other people so perfectly in shape, you want to do it yourself. I'm not happy with whatever I am right now. I'm trying to reduce it."
The irony is that India's traditional idea of beauty is of healthy, well-fed women with rounded figures.
Aditi Gowitrikar was a catwalk model until she started making films.
As a model she was under pressure to be stick thin.
But as a film actress, performing not for India's elite but for the masses, she was suddenly required to change shape and develop curves.
Model Aditi Gowitrikar needed to fatten up for film roles
"They tried to feed me - they used to send a little bit extra so that I managed to eat more and gain a little weight," Ms Gowitrikar says.
"Maybe I added a couple of kilos, I don't know. They tried a little bit and then they just used to send padding to me with every costume."
Some middle class women are starting to desire a slim silhouette but many Indian men have not caught up.
They still see big as beautiful.
If women do succumb to pressure to be ultra thin and develop anorexia, says Dr Chugh, the public has little sympathy.
He says everyone is aware that hundreds of millions of people do not get enough food every day.
"For them, a person who's starving herself to death must be stupid," he says.
But a climate of hostility will certainly not stop the disease.
What it may stop is the growing number of sufferers seeking the help that they need.