Research reviewBody image and eating disorders amongst Japanese adolescents. A review of the literature
Introduction
This review will describe the prevalence of body image and eating behaviors amongst Japanese adolescents with a particular focus on prevalence in Japan, public health problems related to body image disturbance and possible factors influencing body image disturbance amongst adolescents living in Japanese society.
Eating disorders, including anorexia nervosa (AN), bulimia nervosa (BN), binge eating disorder (BED) and eating disorders otherwise not specified (EDNOS) are major and serious health problems related to body image disturbance amongst adolescents (Thompson & Smolak, 2002). In Western countries, the rates of AN and BN amongst young females are reported to be 0.3% and 1%, respectively, in the general population (Howk & van Hoken, 2003).
Although eating disorders have been previously regarded as peculiar to Western society, they are now considered a more global issue with some researchers recently confirming that non-Western countries including Japan, China, Taiwan, Hong Kong, the Republic of Korea and Singapore (Keel & Klump, 2003) have increasing rates of eating disorders (Mellor et al., 2009). As the aetiology of eating disorders is strongly related to societal norms, culture and ethnicity (Keel & Klump, 2003), their study requires an understanding of the issues around body image disturbance within different cultural contexts.
In the current review, we systematically searched the major databases in all languages to try to identify all articles reporting any relevant Japanese studies. The databases included in our search included psychARTICLES, psychoINFO, EBM Reviews, Medline, Pre Medline, Psych Info, Current Contents, ERIC and Web of Knowledge.
In order to search the Japanese databases we used CiNii (National Institute of Informatics Scholarly and Academic Information Navigator) to search for Japanese journals. Keywords in our searches included eating disorders, body image, body dissatisfaction, Japan or Japanese, and adolescents or children.
Section snippets
Early reports of eating disorders from Japan
Very early reports of eating disorders were clearly described in Japan in the medical literature dating as far back as the late-1600s (Kagawa, cited in Nogami, 1997) and these are nicely summarized in a review by Nogami (1997).
In Nogami's review, Shutoku Kagawa (1683–1755) describes patients with a “psychic illness” who would not eat regular rice, but only small amounts of food such as chestnuts or tofu for several days, months, or sometimes for more than a year. Kagawa wrote that ‘they would
Research in the late 20th century
Although considered less in number then in the West, Japan does have a well documented history of eating disorder research dating back to the 1980s. Following the research trends of Western countries the interest in and study of eating disorders in Japan increased during the 1980s (Nogami, 1997) as shown in Table 1. The prevalence of eating disorders in Japan based on reviews, epidemiological studies and clinical reports is shown in Table 1 with the range of rates for eating disorders ranging
Factors associated with body image disturbance and eating related problems amongst Japanese adolescents
There has been some research looking more closely at body image differences between Japan and other countries and the various factors influencing body image and all studies related to the topic have been summarized in Table 6. Kowner (2002) investigated Japanese body image from a cultural perspective, focusing on body esteem. He found that the Japanese identified similar characteristics of body esteem as these cited by Americans, which mainly consisted of physical and sexual attractiveness (
Implications for school-based education and policy
Following the changes of lifestyles in Japan towards a more Westernized pattern, there has been an increased concern from government about underweight and obesity, and imbalanced nutrient intake. In 1997, the Health and Physical Education Council indicated that instruction related to eating habits should be dealt with as an important part of health education in order to enrich and sustain a fulfilling life (Ministry of Education Science Sports and Culture, 1999). This report also stated that,
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2021, Body ImageCitation Excerpt :One of the principal themes to emerge in participants’ responses were the strong appearance pressures conveyed by both traditional and social media and the overwhelming focus on extreme slenderness. The focus on extreme thinness was perceived by participants as being particularly strong in Japanese media, in line with Japanese appearance ideals (Chisuwa & O’Dea, 2010). Interestingly, participants also identified the concurrent influence of trends from other geographic areas, highlighting the role of globalization in converging and increasingly unattainable beauty ideals (Widdows, 2018).
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