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While the health-care debate rages in the United States, Tokyo lawmakers have set a maximum waist size. Are you overweight for Japan?
TOKYO, Japan (AP) — Being thin isn't just a cost of fashion or social acceptance in Japan. It is required by law.
Miki Yabe, 39, a manager at a major transportation corporation, went on a crash diet last month to avoid being sent to pudgy purgatory by the fat police. Yabe ate 21 consecutive meals of vegetable soup and went to the gym for 30 minutes a day of running and swimming in the week leading up to her company's annual health check-up.
"It's terrifying," said Yabe, who stands 5 feet 3 inches tall and weighs 133 pounds. "This year, I gained 2 kilos [4.5 pounds]."
People in Japan, already the slimmest industrialized nation, are fighting fat in order to avoid the dreaded metabolic syndrome and meet a government-imposed waistline standard. Metabolic syndrome, abbreviated "metabo," is a group of health risks that includes stomach flab, high blood pressure, and high cholesterol and can lead to cardiovascular disease and diabetes.
Concerned about rising rates of both in a graying nation, Japanese lawmakers set a maximum waistline size of 85 centimeters (33.5 inches) for men and 90 centimeters (35.4 inches) for women last year.
The Senate and House health care reform bills in the United States have included the so-called "Safeway Amendment," which would offer lower insurance premiums to people who live healthier lifestyles. The Japanese experience teaches us how difficult it is to legislate good health.
Though Japan's "metabo law" aims to save money by reducing obesity-related health risks, there is no agreement that it will. The waistline limits, according to doctors and health experts, are in conflict with the International Diabetes Federation's recommended guidelines for Japan. Meanwhile, ordinary residents have been purchasing fitness equipment, joining gyms, and popping herbal pills in an attempt to lose weight, despite the fact that some doctors warn that they are already too thin.
According to Yoichi Ogushi, professor of medicine at Tokai University and one of the law's leading critics, the amount of "food calories which the Japanese intake is decreasing from ten years ago." "There is no obesity problem as there is in the United States." On the contrary, there is a leanness problem among young females."
One thing is certain: the majority of Japanese people will not take any chances.
Companies are providing employees with discounted gym memberships and special diet plans. Residents are purchasing new products marketed as combating metabo, such as the $1,400 Joba, which imitates a bucking bronco. Lawson, a convenience store chain, has opened Natural Lawson stores, which feature fresh fruits and vegetables.
Companies in Japan provide employees with annual health checks under the country's health-care system. Those who do not meet the waistline requirement are required to seek counseling. Companies may be required to pay more money into a health care program for the elderly if they do not reduce the number of overweight employees by 10% by 2012 and 25% by 2015. This year, an estimated 56 million Japanese will have their waists measured.
Despite having some of the world's lowest obesity rates — less than 5%, compared to nearly 35% in the United States — people in Japan have become heavier on average over the last three decades, according to government statistics. Worryingly, in a country that is aging faster than any other due to long life spans and low birth rates, the number of diabetics has increased from 6.9 million in 1997 to 8.9 million last year.
Health-care costs in the country are expected to double by 2020, accounting for 11.5 percent of GDP. That is why some health professionals support the metabo law.
"There is increased public awareness on the issue of obesity and metabolic syndrome as a result of the checkup," said James Kondo, president of the Health Policy Institute Japan, an independent think tank. "Because fighting obesity is a habit reinforced by increased awareness, this is a good thing." In addition, the program is groundbreaking in that it incentivizes [companies] to reduce obesity."
Though health exams for metabolic syndrome take into account blood pressure, cholesterol, blood sugar, weight, and smoking, waist size is the most important factor in Japanese law — and possibly the most humiliating.
Because some Japanese are hesitant to expose their bare stomachs to the tape measure, the government has allowed the tape measures to be administered to clothed patients. Those who choose not to strip down may deduct 1.5 centimeters from their results.
Some doctors have expressed concern about the system's crudeness. Satoru Yamada, a doctor at Tokyo's Kitasato Institute Hospital, published a study two years ago in which several doctors measured the same person's waist. Their measurements differed by up to 7.8 centimeters.
"I disagree that waist size is the most important factor," Yamada said.
Perhaps more astonishing, even before Japanese lawmakers imposed waistline restrictions last year, the International Diabetes Federation (IDF) revised its recommended Japanese guidelines. The new IDF standard for men is 90 centimeters (35.4 inches) and for women it is 80 centimeters (31.5 inches). However, the Japanese government has yet to modify its restrictions.
Yabe arrived at the clinic at 8:30 a.m. on the day of her exam. An hour was allotted for the battery of tests. As a result, her waist measured 84 centimeters, well below the limit. She had lost 6.5 pounds as a result of her diet and exercise.
Yabe, on the other hand, was back to eating pasta and other favorite foods a week later.
"I want to stay healthy now, but I'm not sure," she explained. "Perhaps I'll have a lot of bonenkai [year-end parties] in December." And I plan to drink beer almost every day next summer."
TOKYO, Japan (AP) — Being thin isn't just a cost of fashion or social acceptance in Japan. It is required by law.
Miki Yabe, 39, a manager at a major transportation corporation, went on a crash diet last month to avoid being sent to pudgy purgatory by the fat police. Yabe ate 21 consecutive meals of vegetable soup and went to the gym for 30 minutes a day of running and swimming in the week leading up to her company's annual health check-up.
"It's terrifying," said Yabe, who stands 5 feet 3 inches tall and weighs 133 pounds. "This year, I gained 2 kilos [4.5 pounds]."
People in Japan, already the slimmest industrialized nation, are fighting fat in order to avoid the dreaded metabolic syndrome and meet a government-imposed waistline standard. Metabolic syndrome, abbreviated "metabo," is a group of health risks that includes stomach flab, high blood pressure, and high cholesterol and can lead to cardiovascular disease and diabetes.
Concerned about rising rates of both in a graying nation, Japanese lawmakers set a maximum waistline size of 85 centimeters (33.5 inches) for men and 90 centimeters (35.4 inches) for women last year.
The Senate and House health care reform bills in the United States have included the so-called "Safeway Amendment," which would offer lower insurance premiums to people who live healthier lifestyles. The Japanese experience teaches us how difficult it is to legislate good health.
Though Japan's "metabo law" aims to save money by reducing obesity-related health risks, there is no agreement that it will. The waistline limits, according to doctors and health experts, are in conflict with the International Diabetes Federation's recommended guidelines for Japan. Meanwhile, ordinary residents have been purchasing fitness equipment, joining gyms, and popping herbal pills in an attempt to lose weight, despite the fact that some doctors warn that they are already too thin.
According to Yoichi Ogushi, professor of medicine at Tokai University and one of the law's leading critics, the amount of "food calories which the Japanese intake is decreasing from ten years ago." "There is no obesity problem as there is in the United States." On the contrary, there is a leanness problem among young females."
One thing is certain: the majority of Japanese people will not take any chances.
Companies are providing employees with discounted gym memberships and special diet plans. Residents are purchasing new products marketed as combating metabo, such as the $1,400 Joba, which imitates a bucking bronco. Lawson, a convenience store chain, has opened Natural Lawson stores, which feature fresh fruits and vegetables.
Companies in Japan provide employees with annual health checks under the country's health-care system. Those who do not meet the waistline requirement are required to seek counseling. Companies may be required to pay more money into a health care program for the elderly if they do not reduce the number of overweight employees by 10% by 2012 and 25% by 2015. This year, an estimated 56 million Japanese will have their waists measured.
Despite having some of the world's lowest obesity rates — less than 5%, compared to nearly 35% in the United States — people in Japan have become heavier on average over the last three decades, according to government statistics. Worryingly, in a country that is aging faster than any other due to long life spans and low birth rates, the number of diabetics has increased from 6.9 million in 1997 to 8.9 million last year.
Health-care costs in the country are expected to double by 2020, accounting for 11.5 percent of GDP. That is why some health professionals support the metabo law.
"There is increased public awareness on the issue of obesity and metabolic syndrome as a result of the checkup," said James Kondo, president of the Health Policy Institute Japan, an independent think tank. "Because fighting obesity is a habit reinforced by increased awareness, this is a good thing." In addition, the program is groundbreaking in that it incentivizes [companies] to reduce obesity."
Though health exams for metabolic syndrome take into account blood pressure, cholesterol, blood sugar, weight, and smoking, waist size is the most important factor in Japanese law — and possibly the most humiliating.
Because some Japanese are hesitant to expose their bare stomachs to the tape measure, the government has allowed the tape measures to be administered to clothed patients. Those who choose not to strip down may deduct 1.5 centimeters from their results.
Some doctors have expressed concern about the system's crudeness. Satoru Yamada, a doctor at Tokyo's Kitasato Institute Hospital, published a study two years ago in which several doctors measured the same person's waist. Their measurements differed by up to 7.8 centimeters.
"I disagree that waist size is the most important factor," Yamada said.
Perhaps more astonishing, even before Japanese lawmakers imposed waistline restrictions last year, the International Diabetes Federation (IDF) revised its recommended Japanese guidelines. The new IDF standard for men is 90 centimeters (35.4 inches) and for women it is 80 centimeters (31.5 inches). However, the Japanese government has yet to modify its restrictions.
Yabe arrived at the clinic at 8:30 a.m. on the day of her exam. An hour was allotted for the battery of tests. As a result, her waist measured 84 centimeters, well below the limit. She had lost 6.5 pounds as a result of her diet and exercise.
Yabe, on the other hand, was back to eating pasta and other favorite foods a week later.
"I want to stay healthy now, but I'm not sure," she explained. "Perhaps I'll have a lot of bonenkai [year-end parties] in December." And I plan to drink beer almost every day next summer."
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