Tokyo Weekender - November 2017

several prefectures are working toward
creating treatment and support programs.
Unfortunately, there is yet to be a medical
facility specializing in eating disorder treatment
founded in Tokyo.
Before JAED was established, its preceding
organization conducted a signaturecollecting
campaign between 2011 and 2013
to try and show the need for such treatment
facilities. However, even if such facilities are
established, there might be a new problem.
“If people with all levels of symptoms
rush to a new facility, it might create a long
waiting list and patients with more serious
symptoms cannot be prioritized. What Japan
needs right now is to increase more medical
professionals who can take on primary care,
whether it be physicians or pediatricians or
psychiatrists. Japanese psychiatric care does
not fully integrate a clinical psychological
point of view; the care is more medicinecentered.
Education needs to change first,”
says Nishizono-Maher.
One of JAED’s aims is to create awareness
around eating disorders, and to host
educational seminars for medical professionals.
This year, JAED’s seminars are open to
clinical psychologists, registered dietitians,
dental hygienists, and sports trainers.
For foreigners who suffer from eating
disorders in Japan, Nishizono-Maher advises
that it’s important to look for help from
somebody you trust. “It might be difficult to
skin, and inspire people around the world to
shift their perspective away from “the thinner
the better,” a similar movement is happening
in Japan. In 2013, the first magazine
for pocchari (plus-size) girls was established
in Japan (pocchari is a word used to describe
overweight in a cute way), and in September
this year, the first fashion show for plus-size
figures, Tokyo Glamorous Pocchari Collection
2017 A/W, was held. Several brands
sponsored the event and are launching their
own plus-size lines.
As with all big changes that need to
happen, it’s these small movements that will
ultimately lead to a culture shift as Japan
edges towards acceptance of a more physically
diverse society, and support of those
who are suffering.
If you or someone you know needs help,
find out more about TELL's eating disorders
treatment program at telljp.com/counseling/
eating-disorders
ALTHOUGH THE ROYAL FAMILY DESCRIBED PRINCESS
AIKO AS SIMPLY BEING “TEMPORARILY ILL,” THE
MEDIA AGGRESSIVELY REPORTED HER TO BE
SERIOUSLY ANOREXIC
Dr. Aya Nishizono-Maher, a founding
member of the Japan Association for Eating
Disorders (JAED), which was established in
2016, elaborates: “The cause of eating disorders
does not simply come from the desire to
be thinner and prettier. This tends to often
get misunderstood. Many cases happen in
situations like this: A so-called ‘good girl’
and a hard worker experiences a setback in
her academic or sports performance. She
keeps on making an effort to do better but
sacrifices her time for eating in the process.
Then people around her start to admire her
for getting thinner and ‘prettier.’ That accelerates
her habit of not eating. No matter how
much effort she makes, she may not achieve
number one in her academic record if other
people continue to excel more; but losing
weight fulfills her desire to achieve a result.”
Is anorexia more common in Japan
specifically, as opposed to other countries?
The answer is hard to find. Nishizono-Maher
explains: “The prevalence rate of eating disorders
is difficult to assess because in both
anorexic and bulimic cases, the percentage
of people that actually visit doctors is very
low. Also, the prevalence rate depends on
whether to include the increasing grey zone
of people with lighter symptoms. If we only
include patients that meet all the diagnostic
criteria, the prevalence rate of anorexia nervosa
in young females in Japan is considered
to be slightly less than 1%, and 2% for bulimia
nervosa, as in other developed countries.
Currently, the average number of new onset
anorexic sufferers in developed countries
is five to seven in every 100,000, and it is
evaluated to be the same for Japan. It might
seem like a small number, but this means
Tokyo alone has 600 to 800 new anorexic
patients every year. And this does not count
potentially anorexic people who do not see
doctors.”
Regardless of the statistics, one of the
biggest problems is lack of support. According
to Nishizono-Maher, most developed
countries have dedicated treatment facilities
for eating disorders, yet there are none in
Japan, aside from a few independent support
groups such as TELL and community
forums. In 2014, a division was established
in the National Institute of Mental Health
(NCNP) called the Center for Eating Disorder
Research and Information (CEDRI), which
allowed some studies and educational
activities to be carried out. Under this center,
find a professional who speaks English, but
one cannot break the distorted pattern of
eating while keeping the problem to oneself.
I often hear foreigners complain that when
they moved to Japan their clothing size went
up from medium to large due to the smaller
sizing of Japanese clothing, or that there are
too many places to eat out. But at the same
time, there are beneficial aspects in Japan
when it comes to living a healthier life – ease
of finding healthy foods, smaller portion
sizes, and safer streets for walking outside.”
To try and help educate her patients
about the importance of better eating habits,
Mami Suzuki hosts regular cooking classes.
“As a dietitian, I cannot cure patients’ conditions,
but I share my experiences in the hope
that it might help them recover. Their own
will to overcome their condition is the most
important thing.”
As Western plus-size models, such as
Ashley Graham, continue to advocate the
importance of being comfortable in our own
TOKYO WEEKENDER | NOVEMBER 2017 | 37