Skip to main content
Log in

The Rise of Eating Disorders in Japan: Issues of Culture and Limitations of the Model of “westernization”

Culture, Medicine and Psychiatry Aims and scope Submit manuscript

Abstract

As the first non-Western nation in contemporary history to become a major industrialized economic power, Japan is central to the debate on cultural relativism in psychiatric nosologies, and the study of eating disorders in Japan contributes to the complex discussion of the impact of culture and history on the experience, diagnosis and treatment of such disorders (R. Gordon 2001; Palmer 2001). Without question, the rise in eating disorders in Japan correlated with increasing industrialization, urbanization, and the fraying of traditional family forms following World War II. While the case of Japan confirms that the existence of eating disorders appears to be linked with these broader social transformations, it also points to the importance of specific cultural and historical factors in shaping the experience of eating disorders. In this article, we explore two particular dimensions of culture in contemporary Japan: (1) gender development and gender role expectations for females coming of age; and (2) beauty ideals and the role of weight and shape concerns in the etiology of eating disorders. Our analysis of these dimensions of culture, and the data accruing from empirical and qualitative research, reveal limitations to the model of “Westernization” and call for a more culturally sensitive search for meaning in both describing and explaining eating disorders in Japan today.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

References

  • Allison, Anne 1994 Nightwork: Sexuality, Pleasure, and Corporate Masculinity in a Tokyo Hostess Club. Chicago: The University of Chicago Press.

    Google Scholar 

  • American Psychiatric Association 1994 Diagnostic and Statistical Manual of Mental Disorders, 4th edn. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Bannai, C., N. Kuzuya, Y. Koide, T. Fujita, M. Itakura, K. Kawai, and K. Yamashita 1988 Assessment of the Relationship Between Serum Thyroid Hormone Levels and Peripheral Metabolism in Patients with Anorexia Nervosa. Endocrinologia Japonica 35: 455–462.

    Google Scholar 

  • Befu, Harumi 1966 Corporate Emphasis and Patterns of Descent in the Japanese Family. In Japanese Culture: Its Development and Characteristics. R.J. Smith and R.K. Beardsley, eds., pp. 34–41. Chicago: Aldine Publishing Co.

    Google Scholar 

  • Borovoy, Amy 2001a Not a Doll’s House: Public Uses of Domesticity in Japan. U.S. Japan Women’s Journal, English Supplement Nos. 20–21.

  • Borovoy, Amy 2001b Recovering From Codependence in Japan. American Ethnologist 28(1): 94–118.

    Google Scholar 

  • in press The Too Good Wife: Alcohol, Co-Dependency, and the Politics of Nurturance in Postwar Japan. Berkeley: University of California Press.

  • Brinton, Mary C. 1993 Women and the Economic Miracle. Berkeley: University of California Press.

    Google Scholar 

  • Bruch, Hilda 1973 Eating Disorders: Obesity, Anorexia and the Person Within. New York: Basic Books.

    Google Scholar 

  • Brumberg, Joan 1997 The Body Project: An Intimate History of American Girls. New York: Random House.

    Google Scholar 

  • Buckley, Sandra 1991 “Penguin in Bondage”: A Graphic Tale of Japanese Comic Books. In Technoculture. Constance Penley and Andrew Ross, eds., pp. 163–196. Minneapolis: University of Minnesota Press.

    Google Scholar 

  • Crisp, A. 1980 Anorexia Nervosa: Let me be. London: Plenum Press.

    Google Scholar 

  • D’Emilio, John, and Estelle B. Freedman 1997 Intimate Matters: A History of Sexuality in America. Chicago: University of Chicago Press.

    Google Scholar 

  • Efron, Sonni 1997 Eating Disorders go Global. Los Angeles Times, October 18, p. A1.

  • Finkelstein, Suzette 1987 Eating Disorders: Why Women and Why Now? In Women and Depression. Ruth Formanek and Anita Gurian, eds., pp. 161–181. New York: Springer.

    Google Scholar 

  • Furnham, A., and N. Alibhai 1983 Cross-Cultural Difference in the Perception of Female Body Shapes. Psychological Medicine 13: 829–837.

    Google Scholar 

  • Furukawa, T. 1994 Weight Changes and Eating Attitudes of Japanese Adolescents Under Acculturative Stresses: A Prospective Study. International Journal of Eating Disorders 15: 71–79.

    Google Scholar 

  • Garner, D.M. 1991 The Eating Disorders Inventory 2. Professional Manual. Odessa, FL: Psychological Assessment Resources.

    Google Scholar 

  • Garon, Sheldon 1993 Women’s Groups and the Japanese State: Contending Approaches to Political Integration, 1890–1945. Journal of Japanese Studies 19(1): 5–41.

    Google Scholar 

  • Garon, Sheldon 1994 Rethinking Modernization and Modernity in Japanese History: A Focus on State-Society Relations. The Journal of Asian Studies 53(2): 346–366.

    Google Scholar 

  • Garon, Sheldon 1997 Molding Japanese Minds: The State in Everyday Life. Princeton, NJ: Princeton University Press.

    Google Scholar 

  • Garon, Sheldon 1997 Molding Japanese Minds: The State in Everyday Life. Gender Equity Bureau, Cabinet Office of Japan

  • Garon, Sheldon 1998Annual Report. Tokyo: Cabinet Office

    Google Scholar 

  • Gordon, Andrew 1997 Managing the Japanese Household: The New Life Movement in Postwar Japan. Social Politics (Summer): 245–283.

  • Gordon, Andrew 2000 Society and Politics from Transwar through Postwar Japan. In Historical Perspectives on Contemporary East Asia. Merle Goldman and Andrew Gordon, eds., Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Gordon, Richard A. 2000 Anorexia and Bulimia: Anatomy of a Social Epidemic, 2nd edn. Oxford: Blackwell.

    Google Scholar 

  • Gordon, Richard A. 2001 Eating disorders East and West: A Culture-Bound Syndrome Unbound. In Eating Disorders and Cultures in Transition. Mervat Nasser, Melanie Katzman, and Richard Gordon, eds., pp. 1–16. New York: Taylor and Francis.

    Google Scholar 

  • Hochschild, Arlie Russell 1989 The Second Shift: Working Parents and the Revolution at Home. New York: Viking.

    Google Scholar 

  • Huon, G., and L. Brown 1984 Psychological Correlates of Weight Control Among Anorexia Nervosa Patients and Normal Girls. British Journal of Medical Psychology 57: 61–66.

    Google Scholar 

  • Hsu, L.K. George, and Sing Lee 1993 Is Weight Phobia Always Necessary for a Diagnosis of Anorexia Nervosa? American Journal of Psychiatry 150: 1466–1471.

    Google Scholar 

  • ILO Yearbook of Labor Statistics 1996 ILO Yearbook of Labor Statistics, Geneva, Switzerland.

  • Imamura, Anne 1987 Urban Japanese Housewives: At Home and in the Community. Honolulu: University of Hawaii Press.

    Google Scholar 

  • Inaba, S., and T. Takahashi 1989 Literature Review on Incidence and Prevalence of Anorexia Nervosa. In A Report on the Study of Anorexia Nervosa for the Fiscal Year 1988. S. Tsutsui, ed., pp. 1–25. Tokyo: Ministry of Health, Labor and Welfare.

    Google Scholar 

  • Inaba, Y., M. Takahashi, M. Nohara, and T. Fujita 1994 Gakkou Chosa Ni Yoru Shinkeisei Shokuyoku Fushinsho Oyobi Shinkeisei Taishokusho No Hindo. Kosheisho Tokutei Shikkan Shinkeisei Shokuyoku Fushinsho Tyosa Kenkyuhan Heisei 4 Nendo Houkokusho, pp. 41–45. [A school based study of the rate of anorexia nervosa and bulimia nervosa in 1994.] Tokyo: Ministry of Health, Labor and Welfare.

    Google Scholar 

  • Jack, Dana 1987 Silencing the Self: The Power of Social Imperatives in Female Depression. In Women and Depression. Ruth Formanek and Anita Gurian, eds., pp. 161–181. New York: Springer.

    Google Scholar 

  • Katzman, Melanie, and Sing Lee 1997 Beyond Body Image: The Integration of Feminist and Transcultural Theories in the Understanding of Self Starvation. International Journal of Eating Disorders 22: 385–394.

    Google Scholar 

  • Kelsky, Karen 2001 Women on the Verge: Japanese Women, Western Dreams. Durham, NC: Duke University Press.

    Google Scholar 

  • Kinsella, Sharon 1994 Cuties in Japan. In Women, Media, and Consumption in Japan. Brian Moeran and Lise Skov, eds., pp. 170–196. Honolulu: University of Hawaii Press.

    Google Scholar 

  • Kiriike, N., T. Nagata, M. Tanaka, S. Nishiwaki, N. Takeuchi, and Y. Kawakita 1988 Prevalence of Binge-Eating and Bulimia Among Adolescent Women in Japan. Psychiatry Research 26: 163–169.

    Google Scholar 

  • Kok, I.P., and C.S. Tian 1994 Susceptibility of Singapore Chinese Schoolgirls to Anorexia Nervosa: Part 1 (Psychological Factors). Singapore Medical Journal 35: 481–485.

    Google Scholar 

  • LeBlanc, R. 1999 Bicycle Citizens: The Political World of the Japanese Housewife. Berkeley: University of California Press.

    Google Scholar 

  • Lebra, Takie Sugiyama 1984 Japanese Women: Constraint and Fulfillment. Honolulu: University of Hawaii Press.

    Google Scholar 

  • Lee, S. 2001 Fat Phobia in Anorexia Nervosa. In Eating Disorders and Cultures in Transition. M. Nasser, M. Katzman, and R. Gordon, eds., pp. 40–54. New York: Taylor and Francis.

    Google Scholar 

  • Lee, S., T.P. Ho, and L.K.G. Hsu 1993 Fat Phobic and Non-Fat Phobic Anorexia Nervosa—A Comparative Study of 70 Chinese Patients in Hong Kong. Psychological Medicine 23: 999–1017.

    Google Scholar 

  • LeTendre, Gerald 2000 Learning to be Adolescent: Growing up in U.S. and Japanese Middle Schools. New Haven, CT: Yale University Press.

    Google Scholar 

  • Lewis, Catherine 1978 Women in the Consumer Movement. In Proceedings of the Tokyo Symposium on Women, pp. 80–87. Tokyo: International Group for the Study of Women.

  • Littlewood, R. 1995 Psychopathology and Personal Agency: Modernity, Cultural Change and Eating Disorders in South Asian Societies. British Journal of Medical Psychology 68: 45–63.

    Google Scholar 

  • Maekawa, H. 2004 The Factors and Process of Weight and Shape Concerns in Japanese Female Adolescents. International Conference on Eating Disorders, April 30, Orlando, Florida.

  • Marcus, David, and Weiner, Morton 1989 Anorexia Nervosa Reconceptualized from a Psychosocial Transactional Perspective. American Journal of Orthopsychiatry 59(3): 346–354.

    Google Scholar 

  • McVeigh, Brian 1997 Life in a Japanese Women’s College: Learning to be Ladylike. New York: Routledge.

    Google Scholar 

  • Ministry of Health, Labor and Welfare 2001 National Nutrition Survey. Tokyo.

    Google Scholar 

  • Ministry of Health, Labor and Welfare 2002a National Welfare Survey. Tokyo.

    Google Scholar 

  • Ministry of Health, Labor and Welfare 2002b Statistical Handbook of Japan. Tokyo.

    Google Scholar 

  • Ministry of Public Management, Home Affairs, and Posts and Telecommunications 2000 National Census Data. Tokyo.

    Google Scholar 

  • Miura, Atsushi 2001 Mai Hoomuresu Chairudo (My Homeless Child). Tokyo: Clubhouse Press.

    Google Scholar 

  • Miyai, K., T. Yamamoto, M. Azukizawa, K. Ishibashi, and Y. Kumahara 1975 Serum Thyroid Hormones and Thyrotropin in Anorexia Nervosa. Journal of Clinical Endocrinology and Metabolism 40: 334–338.

    Google Scholar 

  • Miyamoto, Y. et al 1978 Triiodothyronine Immunoassay Using Polyethylene Glycol to Precipitate Antibody-Bound Hormone. Japanese Journal of Medicine 17: 15–21.

    Google Scholar 

  • Monbushô [Ministry of Education] 2001 Untitled Report. Tokyo: Ministry of Education.

    Google Scholar 

  • Mukai, T., A. Kambara, and Y. Sasaki 1998 Body Dissatisfaction, Need for Social Approval, and Eating Disturbances Among Japanese and American College Women. Sex Roles 39: 751–763.

    Google Scholar 

  • Nadaoka, T., A. Oiji, S. Takahashi, Y. Morioka, M. Kashiwakura, and S. Totsuka 1996 An Epidemiological Study of Eating Disorders in Northern Area of Japan. Acta Psychiatrica Scandinavica 93: 305–310.

    Google Scholar 

  • Nakai, Yoshikatsu 1997 Eating Disorder Inventory (EDI) Wa Mochiita Sesshoku Shogai Kanjya No Shinritokusei No Kentou. Seishinigaku 39(1): 47–50.

    Google Scholar 

  • Nakamura, H. 1976 Meiroku Zasshi. Tokyo: Meirokusha, Meiji 7–8 [1874–1875].

    Google Scholar 

  • Nakamura, K, Y. Hoshino, A. Watanabe, K. Honda, S. Niwa, and M. Yamamoto 1999 Eating Problems and Related Weight Control Behavior in Adult Japanese Women. Psychotherapy and Psychosomatics 68: 51–55.

    Google Scholar 

  • Nakane, Chie 1967 Kinship and Economic Organization in Rural Japan. New York: Athlone Press.

    Google Scholar 

  • Nasser, M., M. A. Katzman, and R. A. Gordon, eds. 2001 Eating Disorders and Cultures in Transition. London: Brunner-Routledge.

    Google Scholar 

  • Nogami, Y., and F. Yabana 1977 On Kibarashi-Qui (Binge Eating). Folia Psychiatrica Et Neurologica Japonica 31: 159–166.

    Google Scholar 

  • Nolte, Sharon H., and Sally Ann Hastings 1991 The Meiji State’s Policy Toward Women, 1890–1910. In Recreating Japanese Women, 1600–1945. G.L. Bernstein, ed., pp. 151–175. Berkeley: University of California Press.

    Google Scholar 

  • Ono, Hiromi 2003 Women’s Economic Standing, Marriage Timing, and Cross-National Contexts of Gender. Ann Arbor, MI: Institute for Social Research.

    Google Scholar 

  • Palmer, R. 2001 Commentary on Eating Disorders East and West: A Culture-Bound Syndrome Unbound. In Eating Disorders and Cultures in Transition. M. Nasser, M. Katzman and R. Gordon, eds., pp. 17–19. New York: Taylor and Francis.

    Google Scholar 

  • Patton, G.C., and G.I. Szmukler 1995 Epidemiology of Eating Disorders. In Epidemiological Psychiatry, Bailliere’s Clinical Psychiatry—International Practice and Research. Jablensky, ed., London: Bailliere Tindall.

    Google Scholar 

  • Pike, K.M. 1995 Bulimic Symptomatology in High School Girls: Toward a Model of Cumulative Risk. Psychology of Women Quarterly 19: 373–396.

    Google Scholar 

  • Pike, Kathleen 2003 Unpublished Data.

  • Pike, K.M., and H. Mizushima in press A Clinical Presentation of Japanese Women with Anorexia Nervosa and Bulimia Nervosa: A Study of the Eating Disorders Inventory-2. International Journal of Eating Disorders.

  • Pike, K.M., and Striegel-Moore, R. 1997 Disordered Eating and Eating Disorders. In Health Care for Women: Psychological, Social, and Behavioral Influences. S. Gallant, G. Puryear Keita, and R. Royak-Schaler, eds., pp. 97–114. Washington, DC: American Psychiatric Association.

    Google Scholar 

  • Renshaw, Jean R. 1998 Kimono in the Boardroom: The Invisible Evolution of Japanese Women Managers. New York: Oxford University Press.

    Google Scholar 

  • Roach, Mary 1999 What Can You Say About a High-Powered Exec with an Elmo Charm on his Cell Phone? He gets it. Wired 7(12). Electronic document. http://www.wired.com/wired/archive/7.12/cute_pr.html.

  • Robertson, Jennifer 1989 Takarazuka: Sexual Politics and Popular Culture in Modern Japan. Berkeley: University of California Press.

    Google Scholar 

  • Sasagawa, Ayumi 2002 The Social World of University-Educated Mothers in a Japanese Suburb. Paper Presented at the Anthropology of Japan in Japan Fall Workshop. November 2, Sophia University, Ichigaya Campus, Ichigaya, Japan.

    Google Scholar 

  • Sechiyama, Kaku 2000 Shufu Hogo Seisaku no Daitenkan o: Jidô Teate Giron o Kikkake ni Shite. Ronza 11: 134–145.

    Google Scholar 

  • Shorter, E. 1994 Youth and Psychosomatic Illness. From the Mind into the Body: The Cultural Origins of Psychosomatic Symptoms. New York: The Free Press.

    Google Scholar 

  • Smith, Stephen 1988 Drinking and Sobriety in Japan. Unpublished PhD dissertation, Department of Anthropology, Columbia University, New York.

    Google Scholar 

  • Statistics Sweden 2002 Statistical Yearbook of Sweden, 2002. Stockholm: Statistics Sweden.

    Google Scholar 

  • Striegel-Moore, R.H., L.R. Silberstein, and J. Rodin 1986 Toward an Understanding of Risk Factors for Bulimia. American Psychologist 41: 246–263.

    Article  Google Scholar 

  • Suematsu, H., H. Ishikawa, T. Kuboki, and T. Ito 1985 Statistical Studies on Anorexia Nervosa in Japan: Detailed Clinical Data on 1011 Patients. Psychotherapy and Psychosomatics 43: 96–103.

    Google Scholar 

  • Suzuki, Kazuko 1998 Pornography or Therapy? Japanese Girls Creating the Yaoi Phenomenon. In Millenium Girls: Today’s Girls Around the World. Sherrie A. Inness, ed., pp. 243–268. New York: Rowman and Littlefield Publishers, Inc.

    Google Scholar 

  • Szabo, C.P., and D. Le Grange 2001 Eating Disorders and the Politics of Identity: The South African Experience. In: Eating Disorders: The New Sociocultural Debate. M. Nasser, M. Katzman, and R. Gordon, eds., pp. 24–39. New York: Brunner-Routledge.

    Google Scholar 

  • Takeda, A., K. Suzuki, and S. Matsushita 1993 Prevalence of Bulimia Nervosa (DSM III-R) Among Male and Female High School students. Seishin Igaku 35: 1273–1278.

    Google Scholar 

  • Takeuchi, S., J. Hayano, T. Kamiya, R. Hori, S. Mukai, and T. Fujinami 1991 Body Image and Self Image in 712 Junior High School Students. Shinshin Igaku 31: 367–373.

    Google Scholar 

  • Treat, John Whittier 1996 Yoshimoto Banana Writes Home. In Contemporary Japan and Popular Culture. John Whittier Treat, ed., pp. 275–308. Richmond, UK: Curzon Press.

    Google Scholar 

  • Ueno, Chizuko 1988 The Japanese Women’s Movement: The Counter-Values to Industrialism. In The Japanese Trajectory: Modernization and Beyond. G. McCormick and Y. Sugimoto, eds., pp. 167–185. New York: Cambridge University Press.

    Google Scholar 

  • Ueno, Chizuko 1999 The Declining Birthrate: Whose Problem? Review of Population and Social Policy 7: 103–128.

    Google Scholar 

  • U.S. Bureau of Census 2001 Statistical Abstract of the United States: 2001. Rockville, MD: U.S. Government Printing Office.

    Google Scholar 

  • Van Wolferen, Karel 1990 The Enigma of Japanese Power: New York: Vantage Books.

    Google Scholar 

  • Vogel, Suzanne H. 1978 The professional Housewife. In Proceedings of the Tokyo Symposium on Women. Merry White and Barbara Moloney, eds., Tokyo: International Group for the Study of Women.

    Google Scholar 

  • Vogel, Suzanne H. 1988 Professional Housewife: The Career of Urban Middle Class Japanese Women. Cambridge, MA: Institute for Independent Study.

    Google Scholar 

  • White, Merry 1987 The Virtue of Japanese Mothers: Cultural Definitions in Women’s Lives. Daedalus 116(3): 149–163.

    Google Scholar 

  • White, Merry 2002 Perfectly Japanese: Making Families in an Era of Upheaval. Berkeley: University of California Press.

    Google Scholar 

  • Yamada, Masahiro 1999 Parasaito Shingeru no Jidai (The Age of the Parasite Single). Tokyo: Chikuma Shobô.

    Google Scholar 

  • Yamada, Masahiro 2001 The Housewife: A Dying Breed? Japan Echo 28(2): 54–58.

    Google Scholar 

  • Yates, Alayne, Jeanne Edman, and Mara Aruguete 2003 Ethnic Differences in BMI and Body/Self Dissatisfaction Among Caucasians, Asian Sub-Groups, Pacific Islanders and African Americans. Journal of Adolescent Health 33(4): 300–307.

    Google Scholar 

  • Zielenziger, Michael 2002 Young Japanese Prefer “Parasite Single” life to “Wedding Poverty.” Knight Ridder, December 18, 2002.

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kathleen M. Pike MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Pike, K.M., Borovoy, A. The Rise of Eating Disorders in Japan: Issues of Culture and Limitations of the Model of “westernization”. Cult Med Psychiatry 28, 493–531 (2004). https://doi.org/10.1007/s11013-004-1066-6

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11013-004-1066-6

Keywords

Navigation