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.