OA offers help for people with eating disorders

By Karryn Miller

When 22-year-old model Luisel Ramos died at a Uruguay fashion show in 2006, her body mass index was 14.5. The World Health Organization classes a BMI of 16 as “starvation.” Later that, year 21-year-old Brazilian model Ana Carolina Reston died due to “complications” in her pursuit to be thin. Her weight — 40kg — was considered healthy for a 12-year-old.

The modeling industry has since taken measures to combat eating disorders, but the problem is still rife — and hardly restricted to those who make a living strolling down the catwalk.

In the developed world, anorexia is the third most common chronic illness suffered by young women; obesity is first. Although some men suffer from the problem, girls and young women are at highest risk.

According to Kathleen Pike, a professor of psychology at Temple University, Japan Campus, fully 3% of college students in Japan suffer from bulimia nervosa (vomiting after eating) and nearly 1 percent have anorexia nervosa (dangerously reducing one’s food intake).

Being a foreigner in Japan can act as a trigger. “Members of the foreign community are typically larger than the Japanese,” says Pike. When they come here, “they sometimes find they can’t buy clothes — going to a store only to find they are ‘too big.’”

However, one member of the Tokyo branch of Overeaters Anonymous (OA) — a 12-step help program similar to Alcoholics Anonymous — notes that if you’ve got an eating disorder, the problem’s roots normally lie deeper than the country you’re in.

“Eating disorders typically start from dieting due to body dissatisfaction,” says Pike. “No one ever thinks it will develop into a disorder… Over time, the behavioral component becomes fixed, the secrecy interferes with social functioning, and the disorder impacts on physical health and intellectual capacity.”

Other problems include menstrual dysfunction, dental problems such as rotting teeth, organ damage, infertility, vitamin and mineral deficiencies, and in extreme cases, like those of Ramos and Reston, death.

So what should you do if you have an eating problem or are concerned about a friend or family member? “Despite an increased awareness among health professionals, the resources are still limited here,” says Pike. “But there are treatments that work, and the sooner you get treatment the better your chances of recovery.”

For English support, contacting Tokyo English Life Line (TELL) is a good starting point. The NPO provides a free, anonymous hotline, and can put you in touch with one of its staff for professional face-to-face counseling in English, Japanese, German, Portuguese or Spanish.

OA, meanwhile, is open to people with all types of eating disorders, providing support through hour-long meetings twice a week, on Saturday and Sunday. Participants discuss the reasons behind their problem, a specific topic (such as “fear”), or one of the 12 steps. Each person is allocated a few minutes to speak without having to worry about anyone commenting on what they say. New members are allowed to just sit and listen, or join in if they like. As the group is entirely anonymous; members do not repeat what is said at a meeting, or even acknowledge each other if they meet in public.

Another option for those with eating disorders is to consult with a professional. Trained psychologists like Pike or local psychotherapist Hiroko Mizushima can provide valuable guidance through counseling.

Pike recommends that if you think someone close to you may have an eating disorder, you should “convey empathy and communicate that you care and are worried when approaching him or her about it. Don’t accuse them or make assumptions, and don’t be surprised if they are not immediately forthcoming about it; your caring may eventually be a critical component to mobilizing him/her to seek treatment in due time.”

Eating disorders — and the reasons behind them — may be complex but the illness is treatable, and with the right help and with time, patients can regain a healthy attitude towards food.

TELL Tel: 03-5774-0992. Free anonymous support by phone daily from 9 a.m.-11 p.m.

Overeaters Anonymous,

Other Resources

Academy for Eating Disorders

Eating Disorder and Referral Information Center

This story originally appeared in Metropolis magazine (

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female insecurity is the lifeblood of the fashion industry

1 ( +1 / -0 )

Being a foreigner in Japan can act as a trigger. “Members of the foreign community are typically larger than the Japanese,” says Pike. When they come here, “they sometimes find they can’t buy clothes — going to a store only to find they are ‘too big.’”

I can understand that. Women who shopped all their lives in regular clothes stores suddenly have to go to a plus-size store. An american friend of mine was nearly starving herself to fit in 'normal' clothes in Japan. It sounds ridiculous but even though she wasn't overweight, she suddenly felt very fat around all the petite women. But things are changing, the Japanese themselves are getting taller and bigger. There are more choices now and the bigger sizes also have nicer and more fashionable designs.

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I bought a sewing machine. I simply could not find fitting skirts and pants with my waist/hip ratio. Japanese women have a smaller ratio, making garments too tight at the hips while too big at the waist, not to mention the oddly short length of long sleeves. Another thing: Japanese women are NOT petite. Petite means a back length of 15inches or less. Japanese women have long torso and shorter leg (just check out the long torso needed to wear a kimono). I am lucky I can still find things because I am short (well, here in Japan I am almost tall) and I find shoes within Japanese average sizes. After much despair trying to find fitting brassieres in Japan, I resorted to ask my family to send me some pairs.

I did go to plus size store once... but the 'plus' was a long jump from Japanese L size (a Western Medium to Small) to some quite large garments I just couldn't wear. Which is why I resorted to getting a sewing machine (I'm good at sewing, actually).

The Japanese eat way too much. The amount of carbohydrates and starch in their diet is high, and the portions are also large (if you sum up all the small dishes). Trying to eat all your hosts offer can add several pounds through the first months. Corporate parties, school department gatherings and eating out during research trips (every night at the hotel in the case of university field trips that may last up to two weeks) puts a serious strain on the body metabolism - and yet the social pressure to eat is very high.

All the above I mention only to illustrate a few of the reasons why foreign women could easily fall prey to eating disorders in Japan. Men can also fall prey of the food binges, plus excessive amounts of beer that may develop into an early beer belly. Social gatherings at scholar level or at corporations are MANDATORY. You may only refuse a few after you have established yourself into the group (and after the HATEFUL newbie year, which is HELL in Japan unless you have a thick skin - which I do). I met once a Muslim professor and despite all the "polite" pressure, there was no way on Earth they could coerce him into drinking. I followed his example. Some of my kohai were encouraged and began refusing alcohol after they saw I was doing it (social coercion or peer pressure, whichever name you call it is a social ill in Japan). Slowly, I also learned how to refuse excess of food. Thankfully though, I never resorted to vomiting or starving myself between social gatherings. I am much lighter now, I must say. One curious thing is, even when I felt the bigger lady in the room, I received admiring compliments from friends at the onsen e___e;. The lack of privacy is... a cultural shock.

Unfortunately, eating disorder sufferers find themselves powerless against some of the circumstances described above. I think it's great there is help available now for foreigners as well.

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if you want to lose weight, don't eat so much and exercise. it's simple.

however, i do agree that eating disorders are a huge problem (not just with women). it is a psychological problem in a country that is traditionally not so great at identifying psychological disorders. any step towards helping people is a helpful one.

i disagree with the article's subtle attempt to portray fat americans who come to japan as the victim, though. the truth is that most ARE fat, and could stand to lose some weight (if nothing else, for their health...)

-2 ( +0 / -2 )

my wife was the opposite: she is very thin, which is normal in Japan, and she had a huge complex when we lived in US. but she was smart enough to start going to gym instead of pigging out for me stress is a problem, and I struggle to quit that snack that goes so well with the late night beer. don't dare telling me to quit the beer though

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always a lot of talk on this subject, thin simply looks good in models, thin looks good in male models also people also die from over-eating, so we need to keep a balanced view here, both ends are extreme

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People are also dying of obesity, and the cliche industry to blame is fast food even when that's barely a factor.

In Japan and Europe, normal people can actually find normal clothes to wear. In the US XXL and XXXL outnumber Medium, occupy greater shelf space, and some stores barely stock Medium or Small if at all. If any demographic is skewing society, it's fat people.

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@timeon"my wife was the opposite: she is very thin, which is normal in Japan, and she had a huge complex when we lived in US. but she was smart enough to start going to gym instead of pigging out for me stress is a problem"

This sort of ignorance is exactly why women continue to have eating disorders and do not seek help. This assertion reflects judgment of women who having eating disorders.

Intelligence has nothing to do with eating disorders. People who overeat, starve themselves or binge and purge have a mental health problem. It's a psychological issue which is independent of intellect. Being "smart" does not save one from developing such problems.

The solutions are not simple because emotional or psychological problems are not easy to solve. The "eat less, exercise more" reply to obesity only makes people feel less capable of dealing with their problems which drives them to have an even worse problem. When you oversimplify the solution, you do so in order to diminish the magnitude of the problem in an effort to elevate the fact that you personally do not suffer form such issues. It's about emotions, not about habits or character flaws.

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The Beauty Industry are you killers. Only hiring gals who fit stereotypes and unhealthy weight limits.

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