Friday, June 13, 2008

Big Brother has arrived . . . in Japan


This article made my jaw drop over my morning tea. I don't know why--this kind of government intrusion into private lives is the logical consequence of all the anti-obesity hype we're hearing. It's coming here too, I fear, under the guise of a national health plan that ties "wellness" to "consequences."

But here's the thing: In Japan, talk about eating disorders is very hard to come by. I sit on a committee at the Academy of Eating Disorders with international representation, and the member from Japan has talked repeatedly about how hard it is to get any of the media there to write about eating disorders. And how difficult it is to discuss e.d.s in Japan.

And yet the Japanese government is imposing sanctions on those whose waists exceed a randomly set number?

Once again, the connection between the war on obesity and eating disorders scares the hell out of me. For good reason.

16 comments:

Shinobi42 said...

That's sick. ANd what's worse, people who are at a normal weight with a large waistline will be dieting themselves to Underweight which actually carries higher risks of death! I hope people don't have to die before the japanese realize their mistake.

Harriet said...

Shinobi, are you from Japan by any chance? I'd love to hear more about how eating disorders are discussed, or not, there.

Shinobi said...

No I'm not, I'm just a boring old American with an interest in video games. Alas.

kbassler said...

I agree that this is an irrational intrusion into individual lives, but the waist size measurement was actually set by the International Diabetes Foundation, not randomly.

Harriet said...

That makes it no less random to my mind. There is a correlation--mind you, not a causation--with waist sizes over 35 inches and heart disease. But there's nothing that I'm aware of that even correlates, let alone establishes causation, for waist sizes of 33 and a half inches.

kbassler said...

Here's a quote from the IDF website, the scientific veracity of which I am not equipped to assess: "Obesity, particularly abdominal obesity, is not only a major risk factor for type 2 diabetes but also for other non-communicable diseases such as cardiovascular disease (heart attack and stroke)."

So measuring waistlines, while not something government should be doing, is a way of identifying at-risk populations. I think that's what medicine tries to do - identify people more likely to succumb to a disease or condition and work to prevent that from happening. If waist size is an indicator, it's worth measuring.

But what the Japanese government is proposing to do AFTER the measurements are taken is what is frightening, not the actual measuring.

I remember being taken aback by having my pregnant belly measured at each midwife visit - could something so seemingly simple have any effect on the positive outcome of my pregnancy? But they convinced me that decades of such measurements allowed them statistics to identify potential problems and head them off.

Anonymous said...

I keep thinking that losing weight for health is the equivalent of dying red hair black to stave off skin cancer....

luv said...

How ironic that I just found this on www.time.com... Time Magazines website.. it was in their quotes section:

The Japanese are so slender that they can't afford to lose weight.
Professor YOICHI OGUSHI,
on a national law that requires companies and local governments to measure waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups

-- This reminds me of all those normal weight and even underweight women I hear in the ladie's room now and then who are obsessing on their latest diet.

ricki said...

They don't even index it for height! Taller people will - proportionally - have larger waists.

So while it might be comparatively easy for a 5' 2" tall man to make the 33.5 inch designation, what about a 6' tall man? I realize that many ethnic Japanese are shorter than Westerners, but still...what about the Ainu, who are an ethnic group within Japan (who are already somewhat discriminated against) who are just naturally bigger?

I hate this kind of thing. And you know there will be calls for it to come to the U.S. The day they make us line up in public for our "metabo check" is the day I become a hermit living in a cabin back in the hills. I might even buy a rifle to point at anyone coming at me with a tape measure.


(And I'm within what's considered the "OK" range for females in Japan!)

Anonymous said...

I'm an American living in Japan, and the diet culture here is really terribly pervasive. My job forced me to see a Japanese doctor and she was awful (fortunately I went to see my American doctor later). The booklet that came with my government-run health-insurance card is mostly about weight loss. It's one of the aspects of Japan that makes me want to go back home sometimes.

vesta44 said...

I've been following a few posts at JunkfoodScience, and if the US government has its way (and big pharma and the medical community) this type of thing is exactly what's going to be happening here in good old US of A. And if it does, I'll quit going to the doctor for any reason, and die at home, rather than be forced to diet/have WLS just to get thin, even though my being fat isn't costing my insurance company any more money than my being thin would (I probably use maybe $800 a year of my insurance coverage, and that's basically for routine check-ups). And there were years when I didn't use any of my insurance coverage at all (no check-ups, no emergency room visits, no illnesses). All this is going to do is create more problems and cost more money for consumers (whose money is going to end up in the pockets of doctors and big pharma, just where it doesn't need to be).

Harriet said...

Anon (the second one),
How are eating disorders like anorexia and bulimia discussed/perceived in Japan? (if at all)

Lillian said...

My father, 72 years old and very thin, probably wouldn't be close to that measurement if not over. BMI of 22.4. I can imagine many very thin or even underweight men not meeting that guideline.

ricki said...

And what about people on long-term Prednisone therapy? Or other meds that make you gain weight/"puff up"?

On the NYT "Health" blog, as predicted, everyone is like, "Oh, this is SUCH a great idea, we should have it in the U.S. except those fatty fatty Americans are afraid of facing the TRUTH!" Bleaugh. I guess THEY can't face the truth that some people just are bigger and are still healthy...

Meowser said...

My boyfriend is pencil thin and his waist is 32 inches -- just barely within the "acceptable" range. Meanwhile, mine is 36 inches, just outside the "acceptable" range, and I'm a giant fatass. (And it should be noted that my waist measurement went down about 5 inches after discontinuing Effexor, even though I did not lose a large amount of weight. How many people have had a significant increase in waist size due to antidepressant usage, I wonder?)

If it's adult-onset diabetes they're freaked out about, do they even recognize the fact that there's almost always a genetic component, especially when it's developed before about age 70? And that dieters get it a lot more frequently than nondieters?

I agree with you, Harriet, too many people believe EDs (other than binge eating, which all fatasses are presumed to be doing) are "no big deal" compared to the "obesity crisis." It's just a "necessary sacrifice to look beautiful." Gack.

Erin @ The Skinny Gourmet said...

Wow, that is truly amazing. Particularly in light of a recent post I just read (very well researched) on junkfoodscience about research disproving any correlation between waist circumference and health outcomes.