Two of my favorite pastimes: Japan watching and reading about culture-bound syndromes, merged wonderfully in April of 2008 when the Japanese government mandated maximum waist sizes for men and woman between 40 and 74 as part of their annual physical checkups. The limits are strict: 33.5 inches for men and 35.4 for women. As they say in Japan "jodan ja'nai" (you gotta be kidding me!)

The new law has teeth for companies. If a certain percentage of employees are over the waist limit the company can be fined with higher health care premiums. Those without full time jobs don't get off the hook. If you are over the limit and have any obesity related aliment you'll be given three months to lose weight. After three months of failure you'll be given dieting "guidance". Fail for six months and you'll get "re-education". If that sounds ominous it should. In Japan peer pressure is an art form. I have visions of pencil thin city workers installing tamperproof pig sound makers in the refrigerators of persistent offenders. I've read that Japanese who don't want to show bare skin can be measured with clothes on but they'll only get a small amount of credit for their clothes. Local governments who don't make weight loss quotas can be fined as well.

Japan watchers already know about the dangers of the dreaded "metabo" because it is constantly on pop culture shows and, increasingly, on government sponsored posters. The Japanese take foreign words and shorten them for their own use so "metabo" is short for "metabolism" but the Japanese meaning is any and all negative effects of obesity. Increasing rates of diabetes, heart disease, high blood pressure, you name it, if it is fat related and scary then it all gets lumped into the "metabo" syndrome. And the Japanese food supplement industry is there to help. Just search for "metabo supplements" and a vast list of diet and nutrition aids will show up.

Is Metabo a Culturally-Defined Syndrome?

IMetabo Anxiety Can Be Overwhelmingn my opinion, absolutely. In 2010 I flew from Tokyo to western Kentucky in America. I visit Kentucky several times a year and the contrast between Kentucky and Japan is breathtaking. Less than 5 percent of Japanese are obese but a whopping 31.5 percent of my fellow Kentuckians are. And this number has been going up in recent years which CDC statistics prove. The real health problems in Japan are well known: smoking, high salt intake and stomach cancer. So why the obsession with fat?

I believe metabo is a culturally-defined syndrome. Medical anthropologists define it as a medical condition, mental or physical, which does not exist outside a given culture. Mental diseases get most of the culturally-defined syndrome press. How can you NOT do research in witchcraft believing cultures where some men have panic attacks because they honestly believe witches will make one of their critical body parts disappear? Inquiring minds just have to know more about this but it is not just mental conditions, a culturally-defined syndrome can be physical. A heart attack is a heart attack in virtually all cultures but obesity…in Japan? I'm suspicious because of the presence in Japan of the wonderfully named culturally-defined syndrome called "taijin kyofusho".

Taijin Kyofusho, Only In Japan.

The index of culture-bound syndromes defines it as a Japan specific problem like this:

"taijin kyofusho: (Japan) a syndrome of intense fear that one's body, body parts, or bodily functions are displeasing, embarrassing, or offensive to other people in appearance, odor, facial expressions, or movements."

Is that just awesome or what? So I think metobo could be considered a subset of taijin kyofusho but in my research I found controversy! It seems gaijin (non-Japanese) like me are in the habit of lumping too much into the taijin kyufosho basket. In a July 2003 letter to the editor of the American Journal of Psychiatry several Japanese doctors took the magazine to task for such loose application of the label. They point out that in Japan there are four subtypes:

  • sekimen-kyofu(the phobia of blushing)
  • shubo-kyofu (the phobia of a deformedbody)
  • jikoshisen-kyofu (the phobia of eye-to-eye contact)
  • jikoshu-kyofu (the phobia of one's own foul body odor)

So all you gaijin generalizers out there take note and be specific!

A Serious Point In Closing.

Despite the somewhat snarky tone of this article I do appreciate that these are real problems to the suffers and they cause real pain. But things like government and media manipulation are often easier to see in another culture. By looking at instances of culturally-defined syndrome in other cultures you may find it easier to spot them in your own. The next time you see a TV advertisement telling you about a problem you never knew you had just ask yourself if what you are actually seeing is a real problem or does it seem more like a culturally-defined one.

Author's note – no self referring links, no affiliate links and no animals were used in the writing of this article.