Marie Claire article about anorexia in Japan branded “stupid journalism”

A post on the popular English language news site Japan Probe came to my attention today. The post highlights an article in the June edition of British women’s magazine Marie Claire entitled “Anorexia: The Epidemic Japan Refuses to Face Up To” and brands it “stupid journalism”. As a semi-regular reader of Marie Claire, I was curious to read it for myself.

Marie Claire, June 2012

The article, written by freelance journalist Georgia Hanias, featuring photographs by Kayo Yamawaki, focuses on the growing “epidemic” of eating disorders in Japan. Hanias features painfully thin 25-year-old Hachiko, quoting her as saying “My body shows what I’m going through. I don’t want to hide any more. In Japan, we don’t talk openly about our problems. We always pretend nothing is wrong. Silence is a virtue. It’s about time people faced up to what is really happening.”

Anorexia and bulimia are not topics I know much about, whether we’re talking about the UK or Japan.I’m not qualified to comment on the facts, but I can draw on my own experiences and encounters with people who have suffered from eating disorders. In the UK, I have known a couple of people who have fought eating disorders. In Japan I knew one woman who I suspecting might have an eating disorder, and a few people who suffered from depression which led to other problems including self-harm. I don’t recall ever having many conversations about eating disorders in either country, although I have had more conversations than I can count about dieting and healthy eating – a topic which seems popular for women all over the world. If I had read the article without the preconceptions given to me by Japan Probe’s branding of “stupid journalism”, I would probably have agreed with most of what Hanias says, although I do think her view of Japan as a country is a little narrow.

Let’s look at the points Japan Probe picks up on, all of which are based on a ‘review’ of the article found here. The red parts are quotes from the review of the Marie Claire article, and the blue parts are Japan Probe’s comments.

In Japanese there are no words for “I’m suffering” or “I’m sad”. I can’t share my feelings with anyone. Needing help is seen as failure, something to be ashamed of.’ 

Even though a Japanese person may have said this, it’s absolute bullshit. The Japanese language has words to express those feelings, just like every other language on the planet. It is astounding that the author took such a statement at face value and made it the opening line of an article about a serious subject.

Fortunately this isn’t the opening line of the actual Marie Claire article. The actual opening line is “A Krispy Kreme shop is the last place you’d expect to find an anorexic.” I do agree that it’s a silly comment to put much weight on, and of course there are words for “I’m suffering” or “I’m sad” in Japanese. However, as the article correctly points out, Japanese culture is such that people are discouraged from expressing their true feelings, especially if those feelings might make someone else feel uncomfortable or put someone out. If someone is overworked and exhausted and you ask them how they are, they will most likely tell you they are fine. If they are given more work to do, they will accept it without a grumble. This is a generalisation, of course, but I think it is fair to say that Japanese people are discouraged from expressing feelings of sadness or the fact that they need help.

The next point Japan Probe picks up on is to do with calories and Body mass Index (BMI)…

In fact, women in Japan are consuming fewer calories than they did in the Second World War. A third of the population of Japan has a Body Mass Index of less than 18.5, considered in Japan to be the lowest healthy weight.

Japan’s Health Ministry publishes annual reports on the nutrition of the Japanese people. The most recent report found that 11.0% of women and 4.6% of men have a Body Mass Index of less than 18.5 (underweight). It also found that 21.1% of women and 30.4% of men had a Body Mass Index of greater than 25 (overweight).

The statement about daily calories also does not present a fair picture of nutrition in Japan. As of 2008, the per capita amount was 1,867 calories per day, which is indeed quite low. Japanese wartime sources show that daily caloric intake declined from 1,971 calories a day in 1942 to 1,793 calories a day in 1945. The American military reported that by the summer of 1945 average caloric intake had dropped to 1,680 a day, with mining and heavy industry workers receiving greater amounts of food than others. Few women worked in the coal mines, so it is safe to assume that they were suffering badly during the war years. By 1945, many Japanese were starving, eating peanut shells, insects, and sawdust. Women in today’s Japan may not consume many calories, but the nutritiousness of their meals probably far exceeds that of the food available during the bleak war years.

I admit that I haven’t checked the facts, and I’m certainly not an expert on the topic of nutrition. If we assume Japan Probe have done their homework, it would seem Marie Claire‘s Georgia Hanias was misinformed. However, Hanias does make a valid point about the sale of “calorie-curbing products such as diet pills, slimming teas and laxatives, packaged in bright, candy-coloured boxes, lin[ing] the shelves of pharmacies on every street corner“. I’ve seen such products in Japan, and Hanias’ comment is a fairly accurate picture of the truth. If you can’t read Japanese, it might seem like there are a lot of different kinds of sweets available in the drug store. I don’t know what the rules are about the purchase of such products, but it certainly does seem like they would be easy to buy. I knew a lot of women in Japan who bought these kinds of products and consumed them regularly. Without studying the ingredients myself, and having a better knowledge of the products in question, I can’t really say how harmful they are. What I can say though, is that cough sweets are as readily available and as brightly packaged in Japan, and aren’t half as strong or as medicated as anything you can buy in the UK, which makes me wonder if a lot of these so-called diet products are actually just sweeties.

Japan Probe’s final stab…

The author also attacks the Japanese concept of cuteness:

 The article explores the Japanese phenomenon of ‘kawaii’, meaning cute, a bizarre mix of highly sexualised, pre-pubescent imagery. Dolls, cartoons and pop stars all radiate the message that thin is beautiful. 

If the full article does devote significant space to complaining about the sexualization of pre-pubescent females, it is missing the point entirely. The idea that thin is beautiful goes beyond cuteness in Japan. Japanese women of all ages, including women who aren’t trying to look “kawaii” or pre-pubescent, feel pressure to be thin. The numerous television programs and bestselling books that promise weight loss to housewives almost never focus on cuteness.

This is where I would agree with Japan Probe 100%. Hanias’ view seems very narrow – taking the typical stance that “kawaii” = images like the one in the above picture of a manga-esque figurine and that this is what all Japanese women aspire to. She seems to be under the impression that “kawaii” = skinny, which I don’t think it does. Yes, a lot of Japanese women fall for marketing ploys that tell them that skinny = beautiful, but isn’t the same true for the UK, the US, and many other countries? Speaking from my own experience as a non-skinny woman in the UK, I feel that most magazines (Marie Claire included) don’t include many images of “real” women, and that all of the models and celebrities I see are slim and glossy and nothing like I could ever be. Clothes in “cool” shops stop at a size 12 (max) and don’t cater for women whose thighs weren’t designed for skinny jeans.

Some women see these unrealistic images in advertising and aspire to them, which can lead to eating disorders, but this is not something which is unique to Japan. Women are generally much slimmer in Japan (although I did meet quite a number of overweight women during my three years in Japan), and men are slimmer too. Japanese bodies are generally smaller than British bodies (sumo wrestlers aside!), so it’s natural that Japanese women would be slimmer, weigh less, and eat less.

As I said at the beginning, this isn’t a topic I know much about, but I think eating disorders need attention in the media and I am glad that this article has been published, even if there are some errors in it. British media is often disappointing when it comes to reporting the truth about Japan and Japanese culture, but at least they thought this topic interesting enough to warrant a feature article.

12 thoughts on “Marie Claire article about anorexia in Japan branded “stupid journalism”

  1. Interesting article. It seems the authors forget the unrealistic body shape of Barbie that girls in the UK and USA are given to aspire to at very young ages.

    I have studied anorexia and have actually spoken at at length to someone who suffered from it. His reasons were very complex and I suspect people in any community could fall victim to this condition.

    Good that eating disorders are discussed more in the media now if not a bit ironic as, in my opinion, the media has played a big part in making people want the “perfect” body. And that desire can lead to anorexia.

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    • Yes, with Barbie and other similar dolls (including Japan’s Licca-chan) there’s no wonder that young girls all over the world have an unrealistic idea of body image. The media also has a huge part to play in this, and I don’t think it’s fair to say that the situation is any better or worse in Japan that it is in the UK or America.

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  2. I’m also used to seeing poorly-researched articles on Japan/Japanese culture in the media here in the UK, so this comes as no surprise. I’m pretty sure that, as with most journalism, it’s a little sensationalised (for example, the photo of the “sweet-like” slimming supplements – I think the more colourful packages on the right that she’s talking about are actually health supplements like glucosamine and blueberry extract and such like you’d find in H&B. I don’t think they’re anything to do with dieting?).

    I think maybe she’s onto something with the photo of the anime figurine, though – in most anime that I’ve watched, the characters are freakishly thin, and there’s usually at least one female character who complains about her weight, or is on a diet (the one that springs to mind is Rihoko Sakurai from Amagami SS – the whole thing behind her character is that she’s supposedly fat and alternately loves eating and dieting. She’s actually the only normally-shaped girl in the whole cast). I think it’s not really healthy for girls to grow up seeing that all the time (but no, it isn’t much different in the West – just replace anime characters with pop stars or whatever).

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    • Thanks for your comment, Rhiannon. Yes, many anime characters are freakishly thin, and I didn’t know about Rihoko Sakurai from Amagami SS. But, as you said, it’s the same in the West – we just tend to draw our influences from pop stars and soap operas more than cartoons. I remember wanting to look like Kylie Minogue as Charlene in Neighbours when I was a kid, which is ridiculous given how petite Kylie is!

      As for the diet pills/sweets, I can’t read all of the packages so I’m not certain what they are. It is true that chemist’s in Japan do sell a lot of health supplements and diet aids, but you may be right in saying that the products are no different to those we would find in Holland and Barrett.

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  3. Hello Haiku Girl and Readers:

    Thank you for your summary about the my piece in Marie Claire. Due to editorial word limits, I wasn’t able to add all of the details I had gathered in my interviews with specialists regarding the issue of eating disorders in Japan. I am very happy to get an opportunity to share them with you now!

    The feature story itself is a personal journey for a woman named Hachiko, who has spent many years trying to get adequate treatment for her eating disorder in Japan. The seven years to wait for treatment is for the highly trained specialist doctors who have consistently provided excellent care and results for their patients.

    The man that I interviewed, and who gave me this statistic is a very famous Doctor in Japan called Dr. Yamaoka. People can voluntarily go see him and wait years for a consultation, but they do not have to go to him. However, I have to point out that Dr. Yamaoka is regularly sent patients from national hospitals who have failed to provide support for ED suffers. Someone like Hachiko would fall into this category. She is a woman who has spent years trying to get the right treatment from specialists who are not adequately trained yet to deal with the complex psychological issues of Anorexia. Hachiko would eventually have to put on a waiting list to see someone like Dr. Yamaoka. She probably doesn’t have years to wait either.

    Here is further information that I want to add, which could not be included in the article.

    Japan doesn’t have a medical system like UKs; GPs refer you to a specialist

    and there is usually a long waiting list (as long as you stay in the NHS ‘national health service’)

    In Japan, self-referral is possible or it’s the standard. Although the
    Ministry of Health encourages ‘Let’s have a family doctor and then get referred to a university hospital if necessary’ policy, you can refer yourself to any hospital you like.(There is an extra charge for self-referal patients
    on the first consultation day). Traditionally, Japanese hospitals did not
    have appointment (booking) system for the first consultation. ‘Come anytime you need us’ sort of policy.

    Some hospitals and clinics still have the policy (especially the
    family doctors in communities) You may wait for 3 hours but you will be
    seen on the day.

    HOWEVER, big hospitals which attract a lot of patients cannot handle 20-30
    new patients a day and most of university hospitals have appointment policy now. Your appointement can be within a month can be 6 months.

    As mentioned before, there are some people who want to be seen by ‘famous’ doctors (like Dr. Yamaoka) or ‘famous’ hospitals. This trend was stronger in the past when there was less doctors for eating disorders and ED was a novel / media illness.

    Waiting to be seen by Dr. Yamaoka by referral from a hospital will take years. Hachiko would need treatment now from a doctor like him. Every other specialist has failed her on the NHS. I cannot stress how impressive Dr. Yamaoka’s is and his treatments are extraordinarily effective.

    So, just to summarise these statement/correction, I want to tell the readers:

    1. It is true that there is scarcity of highly qualified specialists and if you want to be seen by a particular doctor, you have to wait long but
    medical system does not force you to wait for seven years to see one particular specialist. You do have a choice. You can be seen by a local clinic/hospital much earlier (sometimes on the day) so the delay in consultation is partly the problem of treatment seekers. The treatment provided by the ED specialist will probably not be effective though- they are just not trained up to deal with the issues at hand.

    2. The government does now approve CBT as a treatment of depression and if the bulimic/anorexia is depressed the patient can get CBT.
    The problem is that CBT is approved ONLY when a psychiatrist (MD) gives it.
    Not a psychologist. This is because the qualification of
    ‘clinical psychologists’ is not recognized by the government. So, CBT lies
    in a wrong context. CBT is a psychological intervention
    given mainly by psychologists in the UK and US. (Psychiatrist can give CBT
    if they get training) Psychiatrists in Japan are usually not trained and too busy to give CBT so the availability of good quality CBT is very low. The government says there should be some qualification to guarantee the quality of CBT and the psychiatric qualification is the only one available in the field, which is true. Psychologists have been resisting to be controlled by the Ministry of Health (Doctors’ world) and choose to give independent qualification by themselves (Japanese Society of Clinical Psychologists). Very few psychologists are employed full time in a psychiatric/medical setting which is very different from the NHS situation. Lots of problems to be solved!

    3. Japan does need facilities and specialists which meet the need of chronically ill.

    4. Across all 80 medical schools in Japan, there is only one professor in
    psychiatry specialising in eating disorders.
    (there are some in the field of psychosomatic medicine)

    5. Anorexia Nervosa and other eating disorders has been around for a long time. In fact, Japan’s first reported case of Anorexia was in 1788- almost 100 years before the first case was identified in the UK. But there was an Anorexia and Bulimia boom in Europe and America during the 60’s and 70’s that Japan never experienced. According to the doctors I interviewed, like other developed countries, Japan has moved from a pre-feminism to post-feminism society, A woman’s role is no longer defined and she doesn’t have a clear idea of her place in society anymore. The nuclear family has disintegrated and more people are living alone, confined in private spaces. In isolation, sufferers can indulge their addiction. They can also be more susceptible to media influences, like skinny models or kawaii obsessions.

    Much of this invaluable information was provided to me by Dr. Aya Nishizono-Maher, a psychiatrist specialising in eating disorders at the Tokyo Metropolitan Institute of Medical Science and Department of Clinical Child Psychiatry. She is quoted in my article in June and is an amazing contact for anyone who would like to learn more about ED in Japan.

    I hope this clarifies matters!
    Georgia 🙂

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  4. I also want to state that we have also reconfirmed with Dr. Yamaoka that there is a seven year waiting list in his hospital for treating ED patients. The point is that his clinic only take reservations from people who are already seen in other hospitals for several years, and have a recommendation letter from that hospital so that they don’t die while they are waiting. Even at these hospitals if the patients want to get a ED specialist to see them it takes 2-3months.

    Most patients with potential ED symptoms first visit gynecologist, internal medicine, or department of psychosomatic medicine, and most hospitals are accessible in Japan, and of course if someone wants to see “a” doctor he/she CAN do that the next day, but that’s just a doctor and not ED specialists, because compare to the number of ED patients that stats reveal (twenty-thirty thousand or more) the number of ED specialists are only two-three hundred, and ED is not something that can be fixed in a week or so, it takes years so the number of patients build up and since there’s not enough financial support from the gov. not many hospitals want to/can see ED patients. Some hospitals even tell the patients that they have to go somewhere else to see the specialists.
    Also unlike other developed countries there’s no National Center for ED, so just few days ago Dr.Yamaoka took a request to some politician to make ED national center in each prefectures so they can train specialists, as the number of patients are growing. They are working on collecting signatures for that too. He also requested Health, Labour and Welfare Ministry to fix the medical insurance policy for seeing ED patients.

    Regards,
    Georgia

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    • Thank you, Georgia, for your lengthy and informative comments. It’s a shame there wasn’t room in Marie Claire for more on this topic. Clearly this is a big subject and one that needs much more attention in Japan. Let’s hope the Japanese government is able to train more specialists.

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  5. That’s a very interesting article. I must admit I’ve seen far fewer obviously anorexic women here in Japan than I did at home, but perhaps they remain hidden. The main tragedy seems to be the lack of access to medical help, not just for anorexia, but a lot of mental health problems.
    There are a number of female talents and comedians like Naomi Watanabe who are overweight, but their attitude is “so what?” And they’re not shamed into dieting. When they interview guys on TV about what they’re looking for in a girlfriend, the first answers are usually “someone who is kind” or “a girl with a nice smile”, not “she’s gotta be hot”. I don’t think they’re being politically correct; skinny b*tches are not popular! I feel less exposed to “lose weight” messages here than I did back home. Japan’s far from perfect, but I don’t think it’s any worse than any other country when it comes to weight issues.

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    • That’s an interesting comment, Kiki, thanks. In my case, I actually did feel pressure to lose weight when I lived in Japan, but I know it was all in my head. I felt like I was giant sized most of the time, and not being able to buy trousers or jeans made me quite depressed. In England I’m a little overweight but about average compared to most women my age. In Japan I felt too fat all the time. I had also assumed that when I moved to Japan I would lose weight because my image of Japanese women was that they were all so skinny. In reality, I found that I loved the food too much and didn’t lose weight at all. I also met quite a number of non-skinny Japanese women.

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  6. Pingback: Dying to be skinny – a privilege? « Laugh Lots, Travel Often

  7. I have to agree with you on the Japanese, both men and women, being generally slimmer, although of course there are exceptions to every rule. I do feel like I’m a big girl in Japan for sure. There also isn’t a great variety in Japanese clothes sizes, I find. I went dress shopping once, a few years ago, and the dress I loved was available only in M or L (and it was a small L!) and got so depressed about it I never shopped at a Japanese clothing store again! I don’t often buy clothes in Japan, but Zara, H&M, and Uniqlo are my staples.

    I also dislike those “weird Japan” articles. You’d think wherever you went here you’d see kids licking each other’s eyeballs and people sporting doughnut heads, and I have never seen either (though perhaps I’m not hanging out in the right places 😉 )

    Either way, props to you for tackling a thorny issue 😀

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    • Thanks for your thoughts on this. I wonder if clothing sizes in Japan will change as people (generally) get bigger and more foreigners live in Japan? I read an article recently that said that it’s becoming fashionable to to a ‘marshmallow girl’ (i.e. a bit plump) in Japan, but like all these other ‘weird Japan’ articles, I don’t know if that’s true.

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