Japan is currently undertaking the world’s most ambitious anti-obesity campaign. A national law came into effect a couple of months ago that requires companies and local governments to measure the waistlines of their employees that are between the ages of 40 and 75. This in itself is a huge undertaking given that that represents 56 million waistlines. Those that exceed the state-prescribed limits of 33.5 inches (85cm) for men and 35.4 inches (90cm) for women- as defined by the International Diabetes Federation- and have weight-related issues, will be told to lose weight. If they don’t succeed in 3 months, they will be given dietary guidelines. If unsuccessful after 6 months, they will have to have addition education.
These efforts have been put in place to curb the growth of metabolic syndrome in Japan, to reduce the overweight population by 10% in the next 4 years and by 25% in the next 7 years, and, of course, to cut health care costs.
Metabolic syndrome is a term used to describe a collection of risk factors for heart disease including abdominal obesity, diabetes, high blood pressure and high cholesterol. The term ‘metabo’ has become widely used in Japan and has become synonymous with ‘overweight’.
Companies must get 10% of those deemed metabo to lose weight by 2012 and 25% to lose weight by 2015. If these targets aren’t met, the government will impose financial penalties. And the penalty isn’t trivial. NEC, Japan’s largest maker of personal computers, could incur a penalty of up to $19 million. As a result, the company is taking action, measuring the waists of all employees over the age of 30 and sponsoring metabo education days for employees and their families.
Opponents to the new government crackdown claim the criteria is too strict, the results will result in overmedication and therefore increase healthcare costs.
For a while now, health professionals have been saying that waist circumference is a better predictor of long-term health than the scale. Fat around the waist is linked with an increased risk of heart disease, type 2 diabetes, stroke, high blood pressure, as well as back pain, some cancers, breathing problems and even death.
Perhaps the Canadian and American governments should start a similar campaign? The waist circumference criteria for North Americans is less than 40 inches (102cm) for men and less than 35 inches (88cm) for women- higher than in Asian. American health surveys show that over the past forty years, the average waist size for men has grown from 35 inches to 39 inches; for women, from 30 inches to 37 
inches.
39% of men and 60% of women have waist circumferences above target.
According to a 2002 study, people with 41-inch waists pay about $2,600 more per year in annual medical expenses than do those with 32-inch waists.
The National Institutes of Health recommends that men with waists measuring 37 inches or greater and women with waists larger than 31.5 inches modify their lifestyles to reduce their waists and resulting health risks.
Sources:
http://www.nytimes.com/2008/06/13/world/asia/13fat.html?pagewanted=2&_r=2&ref=health
http://www.idf.org/webdata/docs/MetSyndrome_FINAL.pdf
http://www.healthnews.com/family-health/aging-getter-older/japanese-government-declares-war-fat-1221.html
