Japan brings in compulsory fat checks for over-40s

Once the butt of jokes, the sight of men sucking in their bellies to hide expanding waistlines just got a lot more serious in Japan, where the government has introduced mandatory "fat checks" for the over-40s.

Aimed at trimming bulging annual health costs of more than $3bn (£1.5bn), the Health Ministry says from next month 56 million people must start keeping waistlines tucked in or be asked to change diet, see a doctor and possibly pay higher insurance costs.

But critics say the plan for the potbelly police, which sets a waist limit of 85cm (34in) for men and 90cm for women, will do more harm than good. "It's a comedy," Professor Yoichi Ogushi told The Japan Times. "If you follow the government's logic, you can do whatever you want as long as you have a slim waist."

Although mostly spared the obesity epidemic that plagues many Western nations, Japan is struggling with a recent rise in lifestyle illnesses, especially among the middle-aged.

This is being linked to a widespread shift from the traditional Japanese diet – based around fish, rice and vegetables, and including little red meat, dairy and processed foods – towards a more "modern", Western diet. Japanese men are faring worse than women: government statistics show that men are now 10 per cent heavier than they were 10 years ago, and the average woman's weight has increased by 6.4 per cent.

The Health Ministry says 27 million people now either suffer from, or are at risk of, high blood pressure, blood sugars and cholesterol, collectively known as metabolic syndrome, or "metabo" in the popular media.

Fear of the condition, and its associated diseases of strokes, heart attacks and diabetes, is behind a wave of new health fads and crash diets. With half of all men aged 40 to 74 sufferers, one estimate is that the market for "anti-metabo" services such as private health guidance and fat farms could soon reach 100 billion yen.

It seems appropriate that the country known for its love of cutting-edge technology should be seeking equally innovative,and expensive, ways to lose weight. Popular new fitness crazes include the Joba, a bucking-bronco style exercise machine that promises to lighten dieter's wallets by £700 a time, and the £20,000 Metabology Diet System, a space-age machine that subjects users to electric currents and steam.

The fight-the-flab campaign has already claimed at least one victim. Last year, a 74-year-old local government official in rural Mie Prefecture collapsed while jogging in an effort to cut his 100cm waist. He was in the government's weight-loss programme.

"We have to bring medical costs down," said Toshi-yuki Sato, a spokesman for the Ministry of Health, Labour and Welfare, who denied the plan would encourage crash-dieting and pill-popping. "Dieting badly will eventually cause medical costs to rise even more, so we hope the metabolic tests will be properly supervised."

Plans for a 25 per cent cut in metabo ranks by 2011 bothers some. "Fat people will be criticised by skinny people, old people by the young and companies will refuse to hire overweight people," said Katsura Sigiura, 37, a Tokyo construction engineer who says he is "borderline" tubby. "It makes me angry that the government has started this without consulting us."