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Big in Japan? Fat chance for nation's young women, obsessed with being skinny

By Blaine Harden
Washington Post Foreign Service
Sunday, March 7, 2010; A10

TOKYO -- As women in the United States and across the industrialized world get fatter, most Japanese women are getting skinnier.

Still, many view themselves as overweight.

"I am quite fat, actually," said Michie Takagi, a 70-year-old grandmother and retired clothing store executive. She has a body mass index (BMI) of 19.9, which is at the thin end of normal. While the average American woman has gained about 25 pounds over the past 30 years, Takagi has gained 4.5 pounds, typical for her age cohort in Japan, according to U.S. and Japanese government figures.

Skinnier still are Japanese women younger than 60, who were thin by international standards three decades ago and who, taken as a group, have since been steadily losing weight.

The trend is most pronounced among women in their 20s. A quarter-century ago, they were twice as likely to be thin as overweight; now they are four times more likely to be thin. For U.S. women of all ages, obesity rates have about doubled since 1980, rising from 17 percent to 35 percent.

Social pressure -- women looking critically at other women -- is the most important reason female skinniness is ascendant in Japan, according to Hisako Watanabe, a child psychiatrist and assistant professor of pediatrics at the Keio University School of Medicine in Tokyo.

"Japanese women are outstandingly tense and critical of each other," said Watanabe, who has spent 34 years treating women with eating disorders. "There is a pervasive habit among women to monitor each other with a serious sharp eye to see what kind of slimness they have."

Public health experts say that younger Japanese women, as a group, have probably become too skinny for their own good. Restricted calorie consumption is slowing down their metabolisms, the average birth weight of their babies is declining, and their risk of death in case of serious illness is rising.

"I would advise these women to eat when they are hungry," said Satoshi Sasaki, a professor of preventive epidemiology at the University of Tokyo School of Public Health. "They should be satisfied with a normal body."

Fatter men and children

Japan has long been the slimmest industrialized nation, thanks, in part, to a diet that emphasizes fish, vegetables and small servings. But what makes people fat around the world -- sedentary workplaces, processed food and lack of exercise -- is also making many Japanese fat.

Adult men and children of both sexes are gaining weight at a pace that worries the government. A quarter-century ago, 20 percent of men in their 50s were overweight; now, 32 percent are.

Attempting to head off heart disease and other obesity-related illnesses, the government imposed waistline standards in 2007, requiring girth measurements at work-funded physical examinations and encouraging the rotund to diet and exercise.

Doctors say that for men, who are gaining weight in all age groups, the program makes considerable sense but that for adult women, it sends exactly the wrong signals. "The issue of skinny ladies is being overshadowed," said Sasaki. "Middle-aged women have the mistaken view that they are all getting fat."

Sakiko Ohno, a cosmetics wholesaler in Tokyo, is one of those worried women. She is 40 and has a BMI of 19.5 -- low, but still in the normal range.

"I think I am very fat," Ohno said repeatedly during an interview. "If I have a Starbucks muffin, that night I will skip rice and have vegetables."

'The critical eye'

Ohno, who is single, said women pay attention to their weight because Japanese men prefer petite women and because fashionable clothes are sized for thin women. "But the real reason why women want to be thin is so they can look at themselves in the mirror and compare themselves to other women," she said.

Researchers have found that Japanese women in urban areas are significantly thinner than those in rural areas. In their first year of college, the weight of young Japanese women falls, unlike that of American women, which increases.

"When population density is high, women are busy checking out body weight," Watanabe said. "They want other people to be fatter than themselves. It is complicated, competitive and so subtle. The critical eye is ubiquitous."

Japanese government data show that since 1984, all age categories of women from 20 to 59 have become more thin (BMI of less than 18.5). The percentage of those women who are overweight (BMI over 25) has declined, as well. Women in their 60s have neither gained nor lost weight. The only group of women that has become slightly more overweight is those 70 and older, and that increase is about 2 percent.

Studies in Japan have found little evidence that rates of serious eating disorders, such as bulimia and anorexia, are higher in Japan than in the United States or Europe. But government-funded research studies have shown that many women of child-bearing age have a misconception of what it means to be overweight, with up to 40 percent saying that a normal BMI measurement of 20 or 21 looked fat to them.

Those studies have also found that daily calorie consumption among young women was often two-thirds of the average adult's actual energy intake. Smoking rates among women in their 20s nearly doubled in the 1990s, jumping from 10 to 20 percent.

As in the United States and elsewhere, Japanese women are bombarded by media images of gorgeous, very thin women -- and public health experts say they believe those images have played a substantial role in increasing pressure on Japanese women to be skinny.

The American response to such media images puzzles many people in Japan.

"In the United States, you see all these beautiful skinny people on television, and yet Americans keep getting fatter anyway," said Sasaki, the public health expert at Tokyo University. "Why is that?"

Special correspondent Akiko Yamamoto contributed to this report.

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