Japan, America, and The Right To Be Fat

After the presentation given on Japan and the quarantine period after birth and the very strict traditions regarding feeding and bathing, I was inspired to look further into Japanese health practices and found many other things were strict and different.

Firstly, due to the impetus of a significant other toward settling and having babies, rather than fewer women marrying, as you see in the U. S., there are much fewer young people in Japan dating or having sex (Haworth, 2013). The combination of conservative culture, preventing casual relationships, and marriage being, as they put it, the “death” of a woman’s career there, the population is gradually decreasing to the point that it concerns the government, and they are providing incentives. Personally, if I knew my mom would want to shut me indoors and tell me not to shower if I had a baby, I would be deterred too.

But speaking of incentives, it seems the Japanese government has no qualms about being involved in the health of its citizens and their life choices rather personally. 2008 heralded the institution of The Metabo Law to fight metabolic syndrome by regulating waistlines, with mandatory checks and counseling, treatment, therapy, and later monitoring for men with waistlines more than 33.5 inches and women more than 35.4 inches.

My first response to this was concern; it seems a bit totalitarian and unaccepting of various body types. However, recognizing the relative homogeneity of Japan in racial and ethnic backgrounds and thereby, likely, fewer deviations from the typical body structure, it made more sense than it would here. And additionally, isn’t our First Lady always telling us the American weight is out of control? As a healthcare provider, I have come to see this first hand. The estimated annual health care costs of obesity-related illness are a staggering $190.2 billion or nearly 21% of annual medical spending in the United States (Cawley & Meyerhoefer, 2012), so it makes sense for the government to be invested. With regard to birth, the complications of obesity in a pregnant woman present as subfertility, miscarriage, thrombo-embolism, hypertensive disorders, metabolic syndrome, preterm delivery and higher frequency of cesarean section, and complications for the baby include intrauterine death, congenital anomalies and macrosomia (Sirimi & Goulis, 2010). (For the non-nursing students, those are all very bad.)

Somehow, as an American, I just take for granted that it’s a right to be fat, just as it is a right to smoke, even if it is unhealthy and unwise. We talk a great deal in our culture about not fat-shaming and loving and accepting all bodies, though on top of the hypertension, diabetes, and other bone and organ problems caused by obesity, obese people are the most depressed and misdiagnosed in the country, so it’s not just moderately unwise but can actually be an immediate risk. How much excess weight goes past choice and aesthetic to health? People, especially fit people, debate the validity of BMIs. But by having a measured cut-off, it prevents rather than treats, and we know it is easier to not gain weight than to shed it; could this theoretically stop people before their weight is dangerous? Regardless, however successful this measure proved to be in Japan (and it was very successful), due to the different relationship with the government here, I think, however wise, it would clash culturally with Americans.

What are your thoughts? Is it moral, to save people from themselves, or immoral to take away choice? Is their government over-reaching? Is ours not fighting obesity hard enough? Let me know. (And good luck with finals.)

Cawley, J., & Meyerhoefer, C. (2012). The medical care costs of obesity: an instrumental variables approach. Journal of Health Economics, 31(1). 219-30.

Haworth, A. (20/10/2013). Why have young people in Japan stopped having sex? The Guardian.

Jayarajan, N. (25/5/2011). The Fat’s on Fire: Curbing Obesity in Japan. The Boston University School of Public Health, The Movement.

Sirimi, N., & Goulis, D. (2010). Obesity in pregnancy. Hormones, 9(4). 299-306.

2 thoughts on “Japan, America, and The Right To Be Fat

  1. Rand, I think this is a hard topic to talk about like female genital cutting is. Who are we to really say what works in someone else’s society and what doesn’t? At least, though, we aren’t all going to Japan and trying to “help” the Japanese from ruining themselves by staying slender and healthy.

    We report from our Western point of view and are still biased. The best thing that we can do is…do a study or some interviews! In Japan, there is obviously a largely homogenous opinion that obesity is not good for you. Let’s talk to the people and see what they think about this policy on their bodies. Then let’s introduce them to the concept of choice, options (maybe not bring up obesity in our country), and survey them again. This would at least give us some qualitative data on the topic from the people it affects.

    From my American point of view, I think it is taking away choices–of how I look, what I eat, what my activities are, how I spend my time and money. It also does not likely accommodate for the people who have secondary obesity, that is, obesity due to a different health issue. How do they deal with those people?

    No opinion on our government and obesity. I think it varies largely state-to-state and too many levels of politics and lobbying involved. Sad. That’s research for a PhD!

    • Chau, I have a hard time seeing FGM as anything but an obvious problem, but as a general rule, absolutely. (Yes, I am completely Western-biased.) I think this clearly worked in Japan, with numerous health benefits, and the culture has greater acceptance of authority intervening, so I doubt that it was extremely contentious. Great thoughts on secondary obesity; hopefully that problem would be noted and handled sooner, though, if there was more accurate tracking of weight gain. And yes, state-by-state variance wasn’t even something I considered.

      I don’t think, if this was proposed here, it would move an inch; we have such a strange and complicated relationship to fat in this country, and such resistance of the government in day-to-day living. Personally, though, I wouldn’t mind if it was, but I have the benefit of access to healthy options everyday. I think that should be our first priority, because you can weigh less and still be terribly unhealthy in a food desert.

      Thank you for your two cents!

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