Try This – Try This – 3 Wild Steps Japan Took to Tackle Obesity (and It’s Not Weight-Loss Drugs)

Last week I shared that Japan has a 4% obesity rate, compared to our 42.5% obesity rate. 

Today I want to share THREE reasons why they have lower obesity rates and a longer lifespan and healthspan than we do.

And just a heads up, one of them is super controversial.

But first… 

Did you know a whopping 70% of Americans are either overweight or obese? 

These days, it seems like many people think the solution to our obesity crisis is weight loss drugs. 

Many Americans are looking for a quick fix to lose weight, but this approach can have serious consequences. The known consequences include lifetime drug dependency, gastrointestinal issues, an increased risk of thyroid cancer, and of course, there are the unknown effects that will come up in the future.

But we also know that the cost of obesity is high: an increased risk of type 2 diabetes, dementia, cancer, heart disease, and much, much more. 

What is it about the landscape of our food and culture that makes it hard for our nation’s citizens to effectively and healthily lose weight, and what can we learn from other countries who have curbed any sign of obesity? 

Last week I listened to a fascinating conversation between Bari Weiss, host of Honestly and founder of The Free Press, and writer Johann Hari about Johann’s experience with Ozempic and his research on weight loss, weight-loss drugs, and how the Western world handles weight loss compared to places like Japan. 

In this interview, he highlighted the stark differences between the food and diet cultures of Japan and the United States and why the Japanese have been so effective at keeping their obesity rates low. 

Today I want to share three steps Japan took to prevent an obesity crisis in their country and why weight-loss drugs might not be the best solution to our obesity problem.  

Let’s get into it…

Reason 1: A Reverence for (Real) Food from an Early Age

Getting out of the grips of ultra-processed food is really hard. Unfortunately, Americans start to become addicted to ultra-processed food at a really young age; these foods account for two-thirds of children’s and teens’ diets in the United States.

In Japan, kids eat a more traditional diet from a very early age. Johann Hari explains that many Japanese kids prefer vegetables, rarely snack, and are offered school lunches with plenty of real-food options. 

In 1954, Japan passed the “School Lunch Act", which ensures that kids receive healthy school meals. Later, in 2009, this program was revised to include a curriculum that teaches kids about the benefits of healthy foods and involves them in both food preparation and cleanup. Unfortunately, access to healthy foods and education about food is not part of the American school system, and it’s leading to more and more children becoming sicker and overweight. 

Here’s an example of school lunches in Japan from Japan Educational Travel.

It’s clear that being introduced to healthy foods from an early age, without the interference of an abundance of ultra-processed food, not only makes Japanese children healthier but also gives them a deep appreciation for food. 

In his interview, Johann also shares the story of Professor Kenny, who performed an experiment on rats to see the effects of an American diet on their eating habits. At first he gave the rats plenty of fresh, unprocessed food and noticed the rats would eat when they were hungry and stop when they were full. He then gave the rats an American diet, and the rats became obese and addicted to the food. He tried to reintroduce the fresh, whole-food diet, and the rats would simply not eat it.

This is astonishing. The American diet is hijacking our brains, making it really hard to enjoy fresh, unprocessed, whole foods. Not only do ultra-processed foods change our taste preferences, but they are also very addictive, making it harder to stop eating, even when we’re full. Unfortunately, this is why many Americans turn to weight-loss drugs, even for children, so that they can eat less processed food. But as Johann mentions in this interview, these drugs don’t help us eat better; they just help us eat less. Unless we actively work on crowding out ultra-processed foods, especially for children, we’re going to be stuck with a lifelong problem. 

Reason 2: The Elderly Prioritize Movement in Daily Life 

In 2013, Japan’s Minister of Health, Labour, and Welfare implemented Health Japan 21 (the second term), designed to promote overall health, including nutrition, exercise, rest, and more. Part of this plan included citizens being given a recommendation of daily steps to achieve. Johann also explained that Japan, which has one of the highest life expectancy rates, promotes daily movement, especially among the elderly. 

Older populations are given access to clubs, team sports, and hobbies that encourage both movement throughout the day and community. Not only does this lead to a longer life span but also a longer healthspan. Japanese people experience health until late in life, whereas Americans often spend the last 20–30 years of their lives in poor health. 

In Japan, there is a concept called meiwaku (“being a nuisance”). Elderly Japanese people (for better or worse) do not want to be a burden to their families and take a lot of pride in being independent and active citizens. According to one report, 70% of Japanese people surveyed between ages 60 and 69 were working, volunteering, or active members of community activities. 

As many Americans get older, not only do they struggle with multiple chronic conditions, but they become more isolated and less active members of society. If we put more focus on making daily activity accessible and enjoyable, the way that many older Japanese people have, we would have less sedentary behavior later in life. 

Reason 3: The Metabo Law

Perhaps the most controversial action taken in Japan (that actually worked) is the Metabo Law.

When Japan saw a 0.4% increase in obesity in 2008, they introduced a law that aimed to shed light on the dietary and exercise patterns of citizens. As part of this law, every company had to weigh its entire staff over a period of time, and if the weight of the company went up as a whole, they were fined by the government. 

Not only that, workplaces tracked steps and meals and publicly outed workers who were not taking their health seriously. All adults between ages 40 and 74 were required to have their waist circumferences measured and undergo annual checkups where they received blood work and X-rays. This was all in an effort to prevent metabolic syndrome, a cluster of conditions such as high blood pressure, abnormal lipids, and increased belly fat that can lead to an increased risk of type 2 diabetes, heart disease, and other chronic diseases. The six-month plan led to improvements in four of the five characteristics of metabolic syndrome, which is huge. 

When Johann asked a few of the people he met in Japan what they thought of this law, they said they actually liked it because it held them accountable and without it, they might have let bad habits take over. 

And this was all put into place because of a 0.4% increase in obesity! 

While this might seem extreme, is it more extreme than lifetime dependency on a weight-loss drug that could have some serious consequences? I don’t think so. 

Concluding Thoughts 

The problem with obesity is not so simple. Our food landscape and culture is not one in which physical activity and access to healthy food are weaved into day-to-day life. It’s no wonder that many Americans are turning to “simple” solutions like weight-loss drugs. 

But as Johann says, “It shouldn’t be that half the population of the US wants to inject itself with a risky drug to prevent an even riskier medical condition.”

We have to ask ourselves how we got to the point where we believe that a weight-loss drug is our only solution.

A combination of policy, health education and promotion, and reducing access to ultra-processed food could be just what we need to tackle our obesity crisis. 

Here’s to your health,
Dhru Purohit