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).
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."