Youth Trends in Japan: Part Four –
Anorexia and other Teenage Eating Disorders on the Rise

J. Sean Curtin (Fellow, GLOCOM)

A full list of articles in this series can be found here.

A newly released government survey on the eating disorder Anorexia Nervosa shows that it now afflicts about 2% of female high school students with roughly another 10% at potential risk of developing it. The first cases of eating disorders, which can be fatal, were documented in Japan during the late sixties and early seventies. Over the last decade various regional surveys have shown that the number of recorded cases has been steadily rising. Although Japanese rates are not as high as those in Europe and the United States, the new survey indicates that the problem is rapidly growing.

The latest survey was conducted in fiscal 2002 for the Ministry of Health, Labour and Welfare by Hisako Watanabe, an expert in pediatric psychiatry at Keio University, School of Medicine. Watanabe has previously conducted earlier surveys on eating disorders in 1987, 1992, 1997 and 2002. According to the new survey, 5.5% of those interviewed were underweight when they were in their first year of high school, with the figure rising to 13.2% by the time the girls reached their final year. This situation could easily lead to the girls developing either Anorexia Nervosa or Bulimia Nervosa.

Of those in the study thought to have the disorder, only 0.6% had been diagnosed as anorexic by a physician. An additional 1.7% were believed to be suffering from anorexia because they exhibited various symptoms associated with the ailment such as drastic weight loss, abnormal eating habits, the ceasing of menstruation, etc. The survey covered 1,409 female junior and senior high school students at 15 different schools. The long-term project measured the subjects' height and weight from the first year in elementary school to the second and third years of high school.

Professor Watanabe's previous research in conjunction with other studies conducted by medical researchers in various regions such as Niigata (published 2000), clearly indicate that the prevalence of the eating disorders Anorexia Nervosa and Bulimia Nervosa has been on the rise. However prevalence rates in Japan are believed to be lower than those of the European Union and the United States, but the Japanese numbers are rapidly rising.

According to the Ministry of Health, Labour and Welfare, the total number of people suffering from eating disorders in 1980 stood at just 3,200 people. By 1998 this had leapt to 23,200 and this figure has most certainly increased over the past five years. Many Japanese medical institutions have found themselves unable to effectively treat patients suffering from eating disorders due to the increase in the number of cases.

It is estimated that somewhere in the region of 10% of anorexic and bulimic patients die from starvation-related problems such as heart failure, or from suicide, which arises from self-destructive tendencies caused by the eating disorder. Various kinds of eating disorders are also found in other Asian countries such as South Korea, Singapore, Hong Kong and China, but the most extensive research on the problem has been conducted in Japan. In comparison with many European Union countries, Anorexia and other eating disorders have not been given so much coverage in the Japanese media. Perhaps the first time the problem received nationwide attention was in 1996 when the popular TV idol Rie Miyazawa acknowledged she had a problem with anorexia and went to Los Angles for treatment. Since then there have been one or two other high-profile cases, but the Miyazawa case remains the most notable.

Research indicates that the average age at which Anorexia has been afflicting young Japanese girls has been steadily dropping over the past decade. Currently, there is no national data available on the number of elementary school students diagnosed with eating disorders, but regional studies clearly show that over the last ten years victims have been getting progressively younger. One mother, whose daughter suffered from Anorexia since the age of 12 and tragically died from the disorder at age 17, wrote a book to highlight the issue in elementary schools. The book was published in 1999 and entitled "Kyoshokusho no Shogakusei - Musume Aya no Baai" [Anorexic Elementary School Students - My Daughter Aya's Case].

The latest government survey results clearly show that Anorexia and Bulimia have now become quite common diseases in Japan. Many experts think that the increase is linked to the spread of Western eating habits, fashions, trends and the so called "slim is beautiful" concept. The state has established national networks to help better coordinate treatment and expertise, but there is still a long way to go before a satisfactory level of care can be attained. The new survey and earlier research clearly demonstrate that eating disorders are now a serious national problem afflicting many young girls and women. All the evidence indicates that the number of cases is certain to increase as more young Japanese women succumb to Anorexia and Bulimia. This makes it vital for the government to draft effective policy measures for combating this growing problem.

Other articles in the Youth Trends in Japan Series

Youth Trends in Japan: Part Three – Increasing Unemployment and Poor Work Opportunities
J. Sean Curtin, Social Trends: Series #40, GLOCOM Platform, 4 June 2003

Youth Trends in Japan: Part Two – "Parasite Singles" in Europe and Japan
J. Sean Curtin & Michael Kavanagh, Social Trends: Series #39, GLOCOM Platform, 26 May 2003

Youth Trends in Japan: Part One – "Parasite Singles" in the International Context
Social Trends: Series #38, GLOCOM Platform, 26 May 2003

Useful On-line References

Anorexia afflicts 2% of students
Japan Times, June 20, 2003

Clinical Characteristics in Patients with Anorexia Nervosa and Obsessive-compulsive Disorder
Matsunaga H, Kiriike N, Iwasaki Y, Miyata A, Yamagami S, Kaye WH. Psychological Medicine, March 1999;29(2):407-14.

Eating Disorders on the Increase in Asia
Sonni Efron, Los Angeles Times, Saturday 18 October 1997

Nationwide network eyed to combat eating disorders
Japan Times, 20 December 2000

Prevalence of anorexia nervosa and bulimia nervosa in a geographically defined area in Japan
Nakamura K, Yamamoto M, Yamazaki O, Kawashima Y, Muto K, Someya T, Sakurai K, Nozoe S, International Journal of Eating Disorders, September 2000;28(2):173-80

Teen eating disorders increasing
Japan Times, 14 April 2002

Other GLOCOM References Related to Youth Trends

The Declining Birthrate in Japan: Part Three – Italy-Japan Comparisons
J. Sean Curtin, Richard J. Samuels and William T. Stonehill, Social Trends: Series #19, GLOCOM Platform, 11 December 2002

Comment: A Fuller Understanding of "Parasite Singles"
Daniel P. Dolan, Debates, GLOCOM Platform, 2 June 2003

Changing Attitudes towards Gender Roles in Japan: 2002 Snapshot
Social Trends: Series #8, GLOCOM Platform, 24 September 2002

Teenage Sexual Trends Create Health Concerns
Social Trends: Series #2, GLOCOM Platform, 13 August 2002