IN THE land of the Sumo wrestler, where the prowess of sportsmen is regularly judged by their massive girth, one of the world's most ambitious anti-obesity campaign is under way.
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, t
he preferred word in Japan these days.
But because the new limit for male waistlines was a strict 33.5 inches, he had anxiously measured himself at home a couple of days earlier. "I'm on the borderline," he said.
Under a national law that came into effect two months ago, companies and local governments must measure the waistlines of Japanese people between the ages of 40 and 74 as part of their annual check-ups. That represents more than 56 million waistlines, or about 44% of the entire population.
Those exceeding government limits and suffering from a weight-related ailment will be given dieting guidance if, after three months, they do not lose weight. If necessary, those people will be steered towards further re-education after six more months.
The limits of 33.5 inches for men and 35.4 inches for women are identical to thresholds established in 2005 for Japan by the International Diabetes Federation as an easy guideline for identifying health risks.
To reach its goals of shrinking the overweight population by 10% over the next four years and 25% over the next seven years, the government will impose financial penalties on companies and local governments that fail to meet specific targets. The country's Ministry of Health argues that the campaign will keep the spread of diseases like diabetes and strokes in check.
The ministry also says that curbing widening waistlines will rein in a rapidly ageing society's ballooning health care costs, one of the most serious and politically delicate problems facing Japan today. Most Japanese are covered under public health care or through their work. Anger over a plan that would make those aged 75 and older pay more for health care recently brought a parliamentary censure motion against Prime Minister Yasuo Fukuda, the first against a prime minister in the country's post-war history.
But critics say that the government guidelines are simply too strict, and that more than half of all men will be considered overweight. The effect, they say, will be to encourage over-medication and ultimately raise health care costs.
In Amagasaki, a city in western Japan, officials have moved aggressively to measure waistlines in what the government calls special check-ups. They aimed to measure at least 65% of the 40 to 74-year-olds covered by public health insurance, an "extremely difficult" goal, acknowledged Midori Noguchi, a city official.
When his turn came, Nogiri, the flower-shop owner, entered a booth where he bared his midriff, exposing a flat stomach with barely discernible love handles. A nurse wrapped a tape measure around his waist across his belly button: 33.6 inches, or 0.1 inch over the limit.
"Strikeout," he said, defeat spreading across his face.
The campaign started a couple of years ago when the health ministry began beating the drums for a medical condition that few Japanese had ever heard of – metabolic syndrome – a collection of factors that heighten the risk of developing vascular disease and diabetes. Those include abdominal obesity, high blood pressure and high levels of blood glucose and cholesterol. In no time, the condition was popularly shortened to the funny-sounding metabo, and it has become the nation's shorthand for obesity.
The mayor of one town in Mie, a region near Amagasaki, 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.
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 check-ups 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," he said. "But metabo sounds much more inclusive."
Even before Tokyo's directives, Matsushita had focused on its employees' weight during their annual check-ups. Last summer, Akio Inoue, 30, an engineer carrying 17 stone on a 5ft 7in frame, was told by a company physician 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 their families and pensioners. As part of its intensifying efforts, the company has started giving its employees "metabo check" towels that double as tape measures.
Companies like Matsushita must measure the waistlines of at least 80% of their employees and get 10% of those deemed metabolic to lose weight by 2012.
NEC, Japan's largest maker of PCs, said that if it failed to meet its targets, it could incur £9.7m in penalties.
Trim tacticsThe Japanese government has imposed stringent waist size limits: 33.5in for men, 35.4in for women.
• More than 56 million waistlines, 44% of the population will be measured.
• The government says the number of overweight people has to drop by 25% in seven years.
• Major companies such as NEC fear they will be fined millions of pounds if their employees do not reach that goal.
The full article contains 1025 words and appears in Scotland On Sunday newspaper.
