Killing time at the hairdresser’s the other day, I started to flick through a Japanese women’s magazine. “Their world changed after they lost weight!” declared one article, depicting “before” and “after” pictures of six readers, along with each woman’s height and weight. I whipped out my cellphone and pulled up the website for BMI calculation.

BMI (body mass index) is one commonly used method to check whether adults have a healthy weight for their height. A figure of 18.5 to 25 is generally considered to be in the “healthy range.” Medical experts warn that BMI has its limitations — for example, those who have a lot of muscle may seem “overweight” since muscle weighs more than fat.

Among the women in the article, five had BMIs under 22.5 before they even began dieting, while their “after” BMIs ranged from 20 down to less than 17. Yet this was no magazine for image-conscious 20-somethings — it is aimed at the “around 40” age group. At a stage of life where their readers have had children and may be moving into perimenopause, why is a magazine advocating diets for women whose weight wasn’t a problem in the first place?

Mari Suzuki from the Japan Association for Eating Disorders (JAED) says that the percentage of underweight women in the 30-50 age range is rising.

“They see being thin as a desirable goal. Women are feeling pressure both from the media and from their peers to maintain a weight that may not be healthy,” Suzuki says.

So how do foreign women living in Japan cope in this environment? After doing some initial crowdsourcing for themes and issues, I created a basic survey and invited foreign women to share their thoughts and experiences via online groups and social media. The survey was in English.

I was overwhelmed with the response: A total of 583 women, ranging in age from their 20s to over 70, took the survey. By region, nearly half were from North America, 30 percent from Europe, 15 percent from Oceania and 6 from Asia. Respondents from South America and Africa together made up just one percent. Respondents in their 30s and 40s accounted for 70 percent of the total.

Skinny = healthy, larger = lazy

Half the women responded that their confidence in how they look has worsened since coming to Japan and that “living in Japan has been a major contributing factor to this situation.” On the other hand, 21 percent said the opposite was true, and that life here has contributed significantly to improving their body image.

When asked to respond to a number of statements to reflect their experiences and opinions, 85 percent agreed that Japanese media tends to promote the idea that “skinny is healthy”, and that heavier/curvier women are rarely seen. When they are, it is normally in a comedic or derogatory context.

“It disturbs me that overweight Japanese TV personalities are often made fun of and sometimes quite cruelly mocked for their weight. Just last night I watched a TV show where an overweight tarento (TV personality) had the chance to teach a kindergarten class. The kids made fun of her weight, pulled her skirt down and even punched her in the stomach, all in the name of ‘comedy,’ ” said a European woman in her 30s.

Katie from the United Kingdom knows firsthand about the rigors of the entertainment world. After a lucrative career in modeling, she moved into the tarento world of TV and advertising work. While the entertainment business is less demanding about weight than modeling, she says there is still pressure to conform.

“Women seen as overweight by managers will be ‘talked to.’ Larger bodies are seen as unhealthy and lazy,” said Katie, who is now in her 30s. “I find myself torn sometimes between not wanting to care so much about how I look, with doing my best for an agency which provides me with work and an income.”

Struggling to fit in

The narrow range of clothing sizes and lack of choice for larger or curvier women was cited as an issue by more than 80 percent of respondents, and many offered comments on their frustration with this problem. While ordering online has helped the situation, the narrow range of sizes makes even foreign women who were small in their home countries feel decidedly outsized in Japan.

“I deeply envy the sheer range of choice and availability of clothes for women who are M size or smaller. I have not been Japanese M size since I was 13 years old,” noted a North American woman in her 50s.

For some foreign women, Japan can seem like a paradise. Take Claire, who is in her 40s: “I’m already naturally tiny at 162 centimeters tall and 46 kilograms, so living in Japan was actually a godsend for me! I could get clothes to fit me well, unlike back home in the U.K., and I felt great for the most part,” she says.

Claire’s problem, however, was having large breasts for her slight frame, which drew unwanted attention and comments from both men and women.

“I tried to hide my shape with slouching but it caused a lot of neck, back and shoulder pain,” she recalled. The issue became so bad that she eventually took her physiotherapist’s advice and got a breast reduction. Claire reports that her self-confidence has soared as a result.

More than 75 percent of the women have put up with unsolicited comments from people they know about their body or weight.

Kiki, an American in her 50s, notes, “In my experience, while the Japanese comments (about my size) have been straightforward, the ones from foreigners have been more subtle — and those hurt just as much.”

A similar percentage agreed with the statement that “applying norms for typical Japanese body types to all people in Japan is potentially harmful for non-Japanese/bigger Japanese.” A woman in her 20s from Oceania expressed her frustration at annual company medicals.

“I work out almost daily, but because I have a lot of muscle and a larger frame, I get called out because my BMI is ‘too high’. Yet Japanese colleagues who never exercise slip through,” she says. Incidentally, according to the latest Japanese government statistics on health, only 10 percent of Japanese women in their 20s and 30s engage in regular exercise (at least twice a week for 30 minutes). This was the lowest among all age groups for women.

Body, food and diet fetishism

Among participants who said their body image had generally improved since coming to Japan, some women mentioned Japanese eating habits, including smaller portions, a wider range of vegetables and less fat, as one factor that may help in maintaining a healthy weight.

Malva, an American in her early 40s, found it hard to lose all the baby weight after her pregnancies and a busy full-time job exacerbated the problem. She has recently made a major effort to change her cooking and eating habits.

“After trying and failing at several diets throughout the years, I finally got hooked up with a female physician/nutritionist/physical therapist team who explained that preparing Japanese food is not as difficult as it looks. It takes some practice to discern between healthy Japanese food and not-so-healthy forms of it, but I am learning as I go,” she says.

However, Japan’s “foodie culture” doesn’t win points with everyone.

“The hypocrisy of body obsession and food obsession in the media here is sickening,” said one North American in her 40s. “There are foods and supplements ads on TV to curb appetites, while there are variety shows promoting all-you-can-eat buffets, super-sized menus and eating contest winners.”

Violet commented on this obsession with diet and slimming aids. As an Asian-American, she had been on the small side back home and found it stressful to cope with being an L size here in Japan. When she had trouble shifting weight after giving birth, she consulted one of the ubiquitous esute (“esthetic”) weight-loss clinics.

“Most of the time was spent on sales talk and fixating on my insecurities, to bully me into buying a pricey package. I was put into a ‘sweat bag’, making me sweat a lot, and then I was measured. I was dying of thirst but the saleswoman insisted on measuring me before giving me water. ‘Look, you lost weight,’ she said. When I told her it was just water, she was not impressed!”

American Lizzie has struggled with body image since she was diagnosed with polycystic ovary syndrome (PCOS) as a youngster. PCOS is a condition where a woman’s hormones are out of balance, leading to other issues such as weight gain and ovarian cysts. After coming to Japan for a fresh start and meeting her husband, she found her condition was little understood by medical professionals, who blamed her struggle with weight on a lack of willpower.

Although her medical issues are now under control, Lizzie has been left psychologically scarred.

“To this day, I still feel like I’m ugly, disgusting and worthless. Yes, I’ve mostly recovered, though I feel I’ll always struggle, but I long for my home country, where I know I would be overwhelmingly average-sized instead of feeling like some big round monstrosity,” she said bluntly.

Gayle Olsen is a U.S.-licensed therapist with over 20 years’ experience working with both adolescents and adults in Tokyo. Olsen urges foreign women to reach out if they think they have an eating disorder (ED). “They do not have to go through this alone, and often need guidance as to how to stop the cycle and regain a healthy and emotional state. For teens, they also need support in working with their parents to form an environment for recovery, and for everyone, an understanding of the disease.”

Tokyo English Lifeline (TELL) also offers counseling and support for those in the international community who are struggling with body image issues. Kaori Ogiwara, TELL therapist and Eating Disorder Program coordinator, notes that moving to a new culture can trigger issues that might not have arisen if the person had stayed in their home country.

“A major upheaval, such as moving here for a job or to get married, may be a factor for developing an ED, as can looking ‘different’ in a culture where there is pressure to conform.” She adds that while EDs are still seen overwhelmingly as a women’s issue, more men are now coming in with problems.

While each woman has to make peace with her own body, the fact that close to 80 percent of respondents aged 60 or over said they are “happy” or “fairly happy” with their body image offers some hope. “While it may be more difficult for some women than others to lose weight, the ultimate responsibility for one’s body shape lies with the individual,” says a North American in her 60s.

As for those rail-thin Japanese women, JAED’s Suzuki predicts they may be paying the price down the line, with an increased risk of musculoskeletal disease known as “locomotive syndrome,” which may lead to osteoporosis and mobility issues in old age. “Along with metabolic syndrome and dementia, this will be a serious issue for elderly Japanese of the future,” she cautions.

Interviewees only referred to by first name asked to use pseudonyms due to privacy concerns. Your comments and story ideas: community@japantimes.co.jp

Pregnancy and motherhood bring new set of image issues

Seventy percent of the survey group were mothers, and these women responded to statements about raising children in Japan.

For many, issues start during pregnancy, when some medical professionals expect foreign mothers-to-be to adhere to strict guidelines on weight gain. These tend to be considerably less than the 10-14 kilograms that has been generally recommended in Western countries for a singleton pregnancy in recent decades.

This led to feelings of stress and shame for some during their pregnancies, when they were berated for their “lack of control” at Japanese clinics. The percentage of low-birth-weight babies (under 2.5 kg) in Japan has risen steeply over the last 30 years, and efforts by pregnant women to control their weight have been cited as a major factor.

Many foreign mothers have grown used to fielding unsolicited remarks on their child’s physical appearance, both from family and friends and strangers.

“My in-laws will comment on the size of my kids. Just the other day she asked my 3-year-old how many babies she has in her tummy!” says a mother in her 30s.

“I don’t condone the way some people talk about weight in front of children, but at the same time, the awareness of it isn’t a bad thing,” points out another mother in her 40s. “When I go home to the U.S. I notice how big a lot of children are getting, especially teenagers. No one tends to pull them up on it. It’s hard to find a balance.”

Georgina Rubenstein is a Melbourne-based specialist working with young people at the Butterfly Eating Disorder Day Program.

“Cultural, peer and parental attitudes towards weight, size and shape have a significant influence on body image,” she says. “I think it’s particularly important to educate parents about ways in which they can promote healthy body image in their children. I think parents often underestimate how influential they are in this respect.”

Japanese children study practical information about nutrition and exercise as part of their health classes, but the topic of body image isn’t generally touched upon. Researcher Naomi Chisuwa-Hayami from the Faculty of Human Life Sciences at Osaka City University is hoping to change this. She is working with the Osaka Board of Education to study the eating habits and body image of adolescent girls, with a view to eventually incorporating findings into the health curriculum.

“Even girls who don’t have any hang-ups about their bodies will start talking about themselves critically in front of their friends, because it isn’t cool to be satisfied with how you look,” Chisuwa-Hayami explains. “Just telling teenage girls ‘It isn’t good to diet’ isn’t enough. Educators need to offer support in terms of mental care, too.”