Medicalizing the Male Obesity through Metabolic Syndrome – Some Social Aspects of the Japanese National Chronic Disease Prevention Program

The Japanese mandatory National Chronic Disease Prevention Program started in 2008. Although some experts in public health and medicine have questioned the efficacy and feasibility of the program, it cannot be denied that it spread the term “metabolic syndrome” among the public and contributed much to the medicalization of obesity in Japan.

We interviewed scientists, experts, doctors and public health nurses about the intention of the program and the difficulties in its implementation. Currently we found the following points. 1) In spite of the fact that the program designates the whole population aged 40 to 74 as its target, the real target of the program is middle-aged men, especially working for small companies or self-employed. In that sense the medicalization of obesity is gender-biased. 2) The program used the newly developed diagnostic concept, “metabolic syndrome,” as its key concept to prevent cardiovascular diseases and type 2 diabetes. The concept played the central role in medicalizing obesity in Japan, where men’s obesity has always been the focus of health professionals. 3) The program faced with serious difficulties and resistance in its implementation. Some of the difficulties are viewed as originating from the masculine understandings of one’s health and its care. 4) There is also a marked contrast in the understanding of the program between public health nurses and general practitioners. Whether the reason for this lies in the professional interests of the two or in the gender biased concept of health for the two is not yet clear.

We like to place all of these issues in the context of medicalization of men’s health in the post-industrial society where several traditional masculinity-related behaviors are viewed as problems and medicalized.