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Why Eating Disorders Are on the Rise in Japan
Eating disorders have been increasing in Japan since the 1980s—despite the country's historically low
obesity rates. A Japanologist explains the country's cultural obsession with being thin.
Japan has a rich visual culture, and one that embeds thinness as aspirational at the centre of many of its
storytelling tropes. Hansen identifies stories that code the act of not eating in a positive, even heroic light.
"Eating disorders are often embedded symbolically. One famous example would be Spirited Away. Chihiro's
parents become pigs because they eat a large amount of food, but that she herself refuses and therefore
does not become a pig. Her heroism begins with this act [of not eating]."
Become too thin in Japan, however, and you may encounter a backlash. "Someone will be celebrated for
being very beautiful and thin, but when they become too thin they run the risk of being described as 'sick' or
'crazy'." This was seen recently when Minami Takahashi, member of popular girl group AKB48, was
censured in the press for being too thin (addressing the criticism, Takahashi held up a sign during a
performance to deny she had a problem and professed her love for deep-fried katsudon).

Deviating from the skinny norm isn't always a bad thing. "There's a bit of a contradiction here. To be
beautiful, you need to be thin. But to be cute, it's not necessary to be thin. Especially in her teens, being a
slightly chubby girl can have positive connotations." And it turns out being funny excludes you from
oppressive body ideals the world over. "Comedians are celebrated in the public eye,
even when they're not thin."

Despite the challenges, Hansen is confident that the situation is improving. "When I started doing my
research in the late 1990s Japanese people didn't really know what eating disorders were. Now, I rarely
come across someone who doesn't know. My guess is that media stories and cultural products such as
novels, manga, anime and music has helped create this awareness, for good and for bad."


When you live in a society with one of the lowest obesity rates in the world; where the government can
punish you for being a little chunky around the mid-section, and where clothing brands favor a (literally) one-
size-fits-all approach, being overweight can be viewed as an unforgivable social crime. But is this what's
driving young women—and increasingly, men—across Japan to develop eating disorders?


Yesterday, Japanese doctors warned their health system is failing hundreds of thousands of eating
disorder sufferers—many of them teenage girls. Speaking to the BBC, Dr Toshio Ishikwa, president of the
Japan Society for Eating Disorders, said: "It's often too late by the time the patient is seen in a hospital.
Their condition is very severe. Sometimes they are even close to death." Dr Ishikwa singled out "the
cultural ideal that 'skinny is beautiful'" as particularly to blame: "that
[ideal] has gone too far and we need to address it."

Eating disorders are widely under-reported in Japan, making it difficult to get hold of reliable statistics.
According to a 2009 study, they've have been on the rise since the 1980s. However, getting accurate data
on eating disorders is complicated by the fact that Japanese sufferers are less likely to seek treatment,
and their healthcare system doesn't assess rates as systematically as other Western countries.

Although much of the world aspires towards a slender ideal of femininity, the pressure to be thin in Japan is
uniquely strong. Part of the cultural fetishization of thinness comes from the simple fact that Japanese
women are naturally slim. A diet geared towards small portions of vitamin-rich, low-calorie foods such as
oily fish and green vegetables has conspired to give Japan one of the lowest obesity rates in the world, at
3.6 percent of the population compared to around 30 percent in the US. And it's estimated that the
Japanese consume around 25 percent fewer calories a day then their corn-syrup-sweetened US cousins.
The pressure to remain slim is even government-mandated, with 2008's controversial "Metabo law"
requiring those aged 40–75 to stay within certain waist measurements, or see their employers slapped
with a fine. When you see posters slapped all over the subway reading
"Goodbye, metabo" (a word associated with being overweight in Japan),
and you're a civic-minded, slightly podgy citizen, what do you do? You go on a diet.

Despite this, Japan is beginning to wake up to the damaging implications of their body ideal (recently-
launched plus size magazine La Farfa has sold out every issue). Dr Gitte Marianne Hansen is a lecturer in
Japanese Studies at the University of Newcastle and the author of recent study Femininity, Self-harm and
Eating Disorders in Japan: Navigating contradiction in narrative and visual culture.
She explains why eating disorders are on the rise.

"One aspect of why eating disorders are attractive to some women is because the Japanese ideal for the
female body is very thin. But I don't think that's all of it. Women are confused about what it means to be
female in 21st century Japan. Increasingly, their bodies become the locus where this conflict is enacted.

"Interviews with women with eating disorders have found that whether housewives, young girls or women
in their early twenties, they're confused about what it means to be a woman. They're getting mixed
messages about norms related to femininity. Contemporary femininity in Japan is highly contradictive."
This is partly due to changing social norms. Eating disorders first took root in the Japan in the 1980s—
around the time women became more emancipated in the workplace. "Just like the contradiction that
women are expected to be full-time mothers/wives and at the same time full-time workers, by depriving
themselves of food women become both victims and victimisers. And so their body becomes the place
where these contradictions can be played out."

Japan has a rich visual culture, and one that embeds thinness as aspirational at the centre of many of its
storytelling tropes. Hansen identifies stories that code the act of not eating in a positive, even heroic light.
"Eating disorders are often embedded symbolically. One famous example would be Spirited Away. Chihiro's
parents become pigs because they eat a large amount of food, but that she herself refuses and therefore
does not become a pig. Her heroism begins with this act [of not eating]."
Become too thin in Japan, however, and you may encounter a backlash. "Someone will be celebrated for
being very beautiful and thin, but when they become too thin they run the risk of being described as 'sick' or
'crazy'." This was seen recently when Minami Takahashi, member of popular girl group AKB48, was
censured in the press for being too thin (addressing the criticism, Takahashi held up a sign during a
performance to deny she had a problem and professed her love for deep-fried katsudon).
READ MORE BELOW....
ABOVE CLOTHING STORE CHAINS IN JAPAN FOR SUPER SKINNY....
CALLED "STARVATIONS" MANY SAY THIS WOULD NEVER FIT INTO THE NYC SHOPPING..
Most people suffering with eating disorders in Japan are not receiving any
medical or psychological support, according to doctors.
The Japan Society for Eating Disorders claims the health system is failing
hundreds of thousands of sufferers.
It also says the pressure on girls, in particular, to be thin has "gone too far".
The government says it's trying to set up more services and has tried to
discover the extent of the problem.
"I hated being chubby when I was a kid," says Motoko - who is using a different
name to hide her identity.
"The other kids bullied me so I always wanted to change."
Motoko was 16 years old when her eating disorder started. She would severely
limit how much she ate and then started exercising excessively.
By the time she was 19, Motoko was dangerously underweight. She says her
parents didn't know how to help her.
"They were negative about my illness," she says. "When I tried to see my
doctor, they told me not to.
"My mother felt responsible, perhaps my father blamed her too."
Fear of 'wasting food'
Motoko's story is a familiar one. Stigma around eating disorders - for both
sufferers and their families - prevent many people from coming forward.
"They see actions such as binging on food and then vomiting (bulimia) as
shameful," says clinical psychiatrist Dr Aya Nishizono-Maher, a member of The
Japan Society for Eating Disorders.
"They feel they have to hide it. Parents may think they are wasting food so that
might stop them seeking help."
After more than 10 years, Motoko finally started getting the help she needed
and she now attends one of the few eating disorder community support groups
which receives money from the government.
She is now married and has a young son and says her life is much better since
she started treatment.
But her experience as a teenager was very different.
"The school nurse saw me when I was so thin (but there still wasn't any help).
Maybe it's something you cannot do anything about, but I wish I could have got
the help I needed sooner."
Eating disorders
The Japanese government said it was difficult to get an accurate picture of
how many people are suffering with eating disorders because so few come
forward for treatment.
Doctors say the prevalence in Japan is "comparable with that of the UK".
However, in 2014 only 10,000 people were getting treatment for eating
disorders according to Japan's Ministry of Health, Labour and Welfare. That's
compared to 725,000 people in the UK, a country with almost half the
population of Japan.
There is no family doctor referral system, so it's largely up to sufferers and
their families to understand what's happening and to find psychiatric support
themselves.
Doctors say that is a big ask for people desperately trying to hide their illness,
or not even recognising they are unwell.
"The medical system is failing people with eating disorders," says Dr
Nishizono-Maher.
"Hundreds of thousands of people are suffering in silence. There are very few
services available to help people."
'Close to death'
The president of the Japan Society for Eating Disorders, Dr. Toshio Ishikwa,
said: "It's often too late by the time the patient is seen in a hospital.
"Their condition is very severe. Sometimes they are even close to death."
The government acknowledges it has a huge challenge on its hands.
It set up a project in 2014 to try and establish the extent of the problem and
how best to deal with it.
Takanobu Matsuzaki, Deputy Director of the Ministry of Health, Labour and
Welfare, said: "We want to achieve
widespread public recognition of eating disorders.
"We hold symposiums for the public and we publish information on our website
to tell people about the programmes we offer."
The government partly funds only a handful of community support groups. Mr
Matsuzaki says he wants more of these services to be made available.
"We want to set up local systems of support where their illness can be picked
up early so people can be helped sooner," he explains.
Unhealthy aspirations
Another major concern is the immense pressure women and girls in particular
face to be very slim. Eating disorders are complex and rarely down to one
thing, but there are concerns as to whether that pressure is having an impact.
Dr Ishikwa said: "Although the causes of eating disorders are unknown, there
is the predominant cultural ideal that 'skinny is beautiful'. That has gone too far
and we need to address it."
Japan's first and only magazine aimed at so called "plus-size" girls is trying to
encourage people to acknowledge and celebrate different shapes and sizes,
not just the "skinny ideal" portrayed in the mass media.
arumi Kon, editor-in-chief of La Farfa magazine, started the publication two
years ago after her own battles with accepting her body.
She said: "When I was a teenager I was so embarrassed and ashamed of
myself... Because I was big.
"Now it's been 15-20 years but girls still feel like this. It's just not right. I want to
tell girls 'just be yourself, be happy, be healthy'."
http://www.bbc.com/news/health-36095287