The Battle of the Bulge

[2triky]

[floatl][/floatl]New York Times

Japan, Seeking Trim Waists, Measures Millions
By NORIMITSU ONISHI
AMAGASAKI, Japan — Japan, a country not known for its overweight people, has undertaken one of the most ambitious campaigns ever by a nation to slim down its citizenry.

Summoned by the city of Amagasaki one recent morning, Minoru Nogiri, 45, a flower shop owner, found himself lining up to have his waistline measured. With no visible paunch, he seemed to run little risk of being classified as overweight, or metabo, the preferred word in Japan these days.

But because the new state-prescribed limit for male waistlines is a strict 33.5 inches, he had anxiously measured himself at home a couple of days earlier. “I’m on the border,” he said.

Under a national law that came into effect two months ago, companies and local governments must now measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual checkups. That represents more than 56 million waistlines, or about 44 percent of the entire population.

Those exceeding government limits...continued...

[Taro Toporific]

...continued...

...Those exceeding government limits—]The mayor of one town in Mie, a prefecture near here, became so wrapped up in the anti-metabo campaign that he and six other town officials formed a weight-loss group called “The Seven Metabo Samurai.” That campaign ended abruptly after a 47-year-old member with a 39-inch waistline died of a heart attack while jogging.[/i]

Still, at a city gym in Amagasaki recently, dozens of residents — few of whom appeared overweight — danced to the city’s anti-metabo song, which warned against trouser buttons popping and flying away, “pyun-pyun-pyun!”

“Goodbye, metabolic. Let’s get our checkups together. Go! Go! Go!

Goodbye, metabolic. Don’t wait till you get sick. No! No! No!”

The word metabo has made it easier for health care providers to urge their patients to lose weight, said Dr. Yoshikuni Sakamoto, a physician in the employee health insurance union at Matsushita, which makes Panasonic products.

“Before we had to broach the issue with the word obesity, which definitely has a negative image,” Dr. Sakamoto said. “But metabo sounds much more inclusive.”

Even before Tokyo’s directives, Matsushita had focused on its employees’ weight during annual checkups. Last summer, Akio Inoue, 30, an engineer carrying 238 pounds on a 5-foot-7 frame, was told by a company doctor to lose weight or take medication for his high blood pressure. After dieting, he was down to 182 pounds, but his waistline was still more than one inch over the state-approved limit.

With the new law, Matsushita has to measure the waistlines of not only its employees but also of their families and retirees. As part of its intensifying efforts, the company has started giving its employees “metabo check” towels that double as tape measures.

“Nobody will want to be singled out as metabo,” Kimiko Shigeno, a company nurse, said of the campaign. “It’ll have the same effect as non-smoking campaigns where smokers are now looked at disapprovingly.”

Companies like Matsushita must measure the waistlines of at least 80 percent of their employees. Furthermore, they must get 10 percent of those deemed metabolic to lose weight by 2012, and 25 percent of them to lose weight by 2015.

NEC, Japan’s largest maker of personal computers, said that if it failed to meet its targets, it could incur as much as $19 million in penalties. The company has decided to nip metabo in the bud by starting to measure the waistlines of all its employees over 30 years old and by sponsoring metabo education days for the employees’ families.

Some experts say the government’s guidelines on everything from waistlines to blood pressure are so strict that meeting, or exceeding, those targets will be impossible. They say that the government’s real goal is to shift health care costs onto the private sector.

Dr. Minoru Yamakado, an official at the Japan Society of Ningen Dock, an association of doctors who administer physical exams, said he endorsed the government’s campaign and its focus on preventive medicine.

But he said that the government’s real priority should be to reduce smoking rates, which remain among the highest among advanced nations, in large part because of Japan’s powerful tobacco lobby.

“Smoking is even one of the causes of metabolic syndrome,” he said. “So if you’re worried about metabo, stopping people from smoking should be your top priority.”

Despite misgivings, though, Japan is pushing ahead.

Kizashi Ohama, an official in Matsuyama, a city that has also acted aggressively against metabo, said he would leave the debate over the campaign’s merits to experts and health officials in Tokyo.

At Matsuyama’s public health clinic, Kinichiro Ichikawa, 62, said the government-approved 33.5-inch male waistline was “severe.” He is 5-foot-4, weighs only 134 pounds and knows no one who is overweight.

“Japan shouldn’t be making such a fuss about this,” he said before going off to have his waistline measured.

But on a shopping strip here, Kenzo Nagata, 73, a toy store owner, said he had ignored a letter summoning him to a so-called special checkup. His waistline was no one’s business but his own, he said, though he volunteered that, at 32.7 inches, it fell safely below the limit. He planned to disregard the second notice that the city was scheduled to mail to the recalcitrant.

“I’m not going,” he said. “I don’t think that concerns me.”

http://www.nytimes.com/2008/06/13/world/asia/13fat.html?ex=1371096000&en=710f33a2ec431b91&ei=5124&partner=permalink&exprod=permalink

[Samurai_Jerk]

So, if you're tall and stocky are you supposed to have the same waistline as someone who's short and small boned?

[GomiGirl]

Bring on the J-version of "The Biggest Loser".. That would be funny.

[baka tono]

The word I hate most in Japan is metabo, I d rather people just say fat ass. Are they going to stop sumo next because they are all metabo and setting a bad example?

So if you smoke two packs a day but your gut meets the guidelines they dont give a damn? What bull!

[maraboutslim]

So, if you're tall and stocky are you supposed to have the same waistline as someone who's short and small boned?

I thought the "small boned, big boned" thing was pretty much a myth: there is much less variation that fat people want to believe. I think they say look at one's elbow or wrist since there isn't much fat there and it will show if they are big or small boned.

Regardless, percentage of body fat is a much better measure than waist size.

I'm absolutely shocked by those average waist size numbers for the USA (39" men, 36.5" women). I guess I shouldn't be since I see fat asses everywhere.

I think the Japanese waist size goals are reasonable, though the female one should be lower! What's up with allowing two extra inches for women? Their hips may be larger but there is absolutely no reason for their waists to be bigger. We have access to food at all times: there is no need to store up fat reserves.

[Kanchou]

I think it's bloody ridiculous that they're implementing state-sponsored invasions of privacy, especially ones based on such ridiculous standards.

I'd to tell them to f8ck off, and that my waist size is between me and my tailor (that I don't have).

If they're want a politically correct way to tell fatties to get into shape, use blood pressure.

[maraboutslim]

I'd to tell them to f8ck off, and that my waist size is between me and my tailor (that I don't have).

And I suspect they'd reply that in Japan it's actually between the fatty and all the people paying for his/her statistically higher costing healthcare. In other words, since everyone pays, it's everyone's business.

[DrP]

First off I despise the way Japanese take a word completely out of context, wack it, then enter it into their lexicon. No wonder their English skills overall basically suck.

Secondly, while I agree that it's generally a good idea to keep one's fat ratio on the lower side, they'd be far better off focusing on the real health issues in Japan which are MENTAL HEALTH. At least I'd have a far better chance of making it to work consistently on time rather than waiting for the near weekly Chuo clean ups.

I'd also suspect that their alcohol and tobacco use weighs in far heavier on the public health system troubles scale than obesity related disease.

[ttjereth]

[ttjereth]

And I suspect they'd reply that in Japan it's actually between the fatty and all the people paying for his/her statistically higher costing healthcare. In other words, since everyone pays, it's everyone's business.

Mandatory healthcare that doesn't cover half the increased costs that anyone with metabolic syndrome would be faced with.

[Kanchou]

And I suspect they'd reply that in Japan it's actually between the fatty and all the people paying for his/her statistically higher costing healthcare. In other words, since everyone pays, it's everyone's business.

What difference does measuring someone's waist size make in lowering health care costs? It only takes one glance for a doctor to be able to tell whether that person needs help with their weight, and to give them that help. Two things the doctor should be doing anyway.

There are much better ways of measuring someones health risk, namely their weight (which you already measure) versus height and body fat %, blood pressure (also measured at every checkup), and cholesterol.

Also, what are they going to do if someone is a health risk? Stop covering them? Sorry, that's not how universal healthcare works, so you're going to be paying your share regardless of how fit or unfit you are, and there are always going to be people who cost the system many times the average over their lifetimes than others. That said, there will be many people who put a lot in and never have to get anything out of the system. But that still doesn't justify forcing people to submit to a size check by law.

Women with large breasts tend to develop back problems, does that mean they should have to tell their physicians their three sizes?

Either way, implementing arbitrary standards isn't going to change the cost of medicine if those people don't make the efforts to become healthier.

[maraboutslim]

I still want to know why they are allowing women an extra 5cm of waist?

[2triky]

I still want to know why they are allowing women an extra 5cm of waist?

Biologically, woman have a higher percentage of body fat than men.

[maraboutslim]

Yes, but if that smaller boned thing has any truth at all, it's clear women have smaller frames. They may have wider hips, and we'd all love that, but there is still no reason in the modern world for anyone to carry any excess fat around their waist.

Even in the land of the fatty, USA, the stats quoted on page 1 show the women at several inches smaller than the men.

[gomichild]

First off I despise the way Japanese take a word completely out of context, wack it, then enter it into their lexicon. No wonder their English skills overall basically suck.

Secondly, while I agree that it's generally a good idea to keep one's fat ratio on the lower side, they'd be far better off focusing on the real health issues in Japan which are MENTAL HEALTH. At least I'd have a far better chance of making it to work consistently on time rather than waiting for the near weekly Chuo clean ups.

I'd also suspect that their alcohol and tobacco use weighs in far heavier on the public health system troubles scale than obesity related disease.

I agree with all of the above. AND I'm currently sober.

[Mulboyne]

Yomiuri: Metabolic syndrome 'groundless' - Domestically used abdominal girth standards have no scientific basis

Abdominal circumference does not serve as a measurement of a person's risk of suffering heart attack or stroke, according to a health ministry survey, the Yomiuri Shimbun has learned. The ministry's latest survey discredits the basis of ministry's current numerical standards for judging whether a person has metabolic syndrome, that is, a man whose abdominal circumference exceeds 85 centimeters and a woman whose girth exceeds 90 centimeters. In addition to abdominal girth considerations, a person currently is diagnosed as having metabolic syndrome--and offered pertinent advice--when he or she registers two or more abnormal readings in the three areas of blood pressure, blood sugar and blood fat. However, these criteria have been criticized for being stricter for men and laxer for women when compared with other developed countries. The research group, led by Tokyo University Prof. Takashi Kadowaki, surveyed the connection between abdominal girth and heart attack and stroke in about 31,000 people aged between 40 and 74 at 12 locations across the nation.

The group found that a person's risk of developing such symptoms does not suddenly increase when a certain round-the-belly measurement is exceeded. However, it was proven that an oversize waistline brings with it a higher risk of certain ailments. The currently used criteria are based on data gathered from small-scale research projects undertaken by academic groups or other entities. Until now, it was assumed that a person's likelihood of suffering certain health problems sharply increased when their accumulated visceral fat stretched the tape measure past a preordained point. Last year, the research group found that abdominal girths greater than 85 centimeters and 80 centimeters for men and women, respectively, correlated to rises in blood sugar, blood fat and other factors. However, the latest research shows that the measurements currently used do not properly indicate the connection between abdominal girth measurements and a sharp increase in the risk of developing certain illnesses.

Other countries do not necessarily take abdominal girth measurements into account when checking for metabolic syndrome, relying instead on a battery of other tests. For example in the United States, the "standard" abdominal girth measurements for men and women are 102 centimeters or more for men, and 88 centimeters or more for women, but these measurements are only part of five criteria that also include neutral fat, high-density lipoprotein (HDL) cholesterol, blood pressure and blood sugar.

However, the present research shows that one thing has not changed: the fatter people become, the more likely it is that they will suffer a heart attack or stroke. Men and women diagnosed as having metabolic syndrome under the current criteria have a 1.44 times and 1.53 times higher risk, respectively, of experiencing such problems compared to their healthy counterparts. "Both men and women have a higher risk of suffering heart attack or stroke when they're large around the waist, but it was difficult to determine a baseline," Kadowaki said. "Based on the result of this latest survey, we need to further discuss proper abdominal girth standards."

===

Obesity still brings risk

With a recent study finding no clear correlation between set abdominal girth measurements and a sharp increase in the risk of developing such diseases, the government's diagnostic standards and checkup procedures will inevitably have to be reviewed. However, this does not mean that bodily circumference is unconnected to lifestyle-related diseases.

It is important to bear in mind that abdominal girth measurements are not a mere matter of joy and despair. Rather, it is crucial that people--even slim individuals positively brimming with health--give due consideration to lifestyle-related diseases and, where necessary, take appropriate measures to prevent them.

[Greji]

Yomiuri: Metabolic syndrome 'groundless' - Domestically used abdominal girth standards have no scientific basis

This is interesting, but how far has it propagated? Yesterday, I took my annual company physical (the required insurance jobbie) and the first thing done was take down my height, weight and waist circumference. Hello metabolic. I can already guess what is going to be written on the report.

At least standing there in my knickers, I was able to dazzle the nurse with all the measurements. She did like my pouch jockeys and immediately asked for my keitai number. Since she was fat and ugly, I did the only proper thing and gave her Ikemen Tommy's number.

[Dragonette]

I'd also suspect that their alcohol and tobacco use weighs in far heavier on the public health system troubles scale than obesity related disease.

Agreed! When I see a guy, especially a j-guy, with a big belly, my first thought is "a fucked-up liver". and that's not even counting the ones who die of stomach or esophageal hemorrhaging. They should be giving more attention to their crap drink-til-you-barf culture and then to the horrendous suicide rate.

And yeah, J-woman are a bit less hour-glass than us gaijin goyls, but I still can't believe they have bigger middles than J-men. Neither myself nor my guy is overweight at all, and although my oshiri can't fit into his jeans too well, he can't borrow my belts, either.

And really, we Manhattan-dwellers usually aren't fat, although I can't say the same for my Brooklyn or SI neighbors. The theory is that because we don't own cars we tend to walk a lot. I couldn't deal with government enforcing my body size, though - I'd probably blow up like a balloon just to spite them!

[IkemenTommy]

She did like my pouch jockeys and immediately asked for my keitai number. Since she was fat and ugly, I did the only proper thing and gave her Ikemen Tommy's number.

Oh so now that makes sense. I got a weird suspicious call at lunch by a female and said we just met the other day. I thought it was another one of my drunken moments so I played along and I agreed on a date.

Thanks Greji, I owe you one.

[Russell]

[matsuki]

the acceptable "Metabo" limit appears to depend on race

What about mixed fucks like me?

[Coligny]

more...

Though the acceptable "Metabo" limit appears to depend on race, this is not taken into account in those measurements. It kind of sounds ridiculous that I am "diagnosed" every year as being "at risk of metabolic syndrome" even with a BMI in the normal range and blood pressure in the low values. Well, one more reason to just ignore them.

I think that in post Fukushima fallout... the metabo bullshit can eat shit and die...

[Samurai_Jerk]

more...

Though the acceptable "Metabo" limit appears to depend on race, this is not taken into account in those measurements. It kind of sounds ridiculous that I am "diagnosed" every year as being "at risk of metabolic syndrome" even with a BMI in the normal range and blood pressure in the low values. Well, one more reason to just ignore them.

Has anyone yet come up with an explanation why Japan sets such a strict standard for men but such a loose standard for women?

[matsuki]

[Russell]

What about mixed fucks like me?

You are free to take the best from both worlds!

[Russell]

I think that in post Fukushima fallout... the metabo bullshit can eat shit and die...

...if it weren't such a serious matter.

[Russell]

[matsuki]

He is just saying that he likes them slender.

...and loose!

[legion]

...and loose!

and sloppy?