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Controlling population weight gain is a major concern for industrialized nations because of associated health risks. Although Japan is experiencing rising prevalence of obesity and overweight, historically they have had and continue to maintain a low prevalence relative to other developed countries. Therefore, Japan provides an interesting case study of strategies to curb population weight gain. In this paper we explore Japanese approaches to obesity and diet through observational and ethnographic interviews conducted between June 2009 and September 2013. Nineteen interviews were conducted at four companies and three schools in Tokyo, as well as at a central Tokyo community health care center and school lunch distribution center. Interviewees included physicians, a Ministry of Health bureaucrat, human resources managers, welfare nurses employed by health insurance organizations, school nurses (also government employees), school nutritionists, and a school counselor. We highlight the role of culture and social norms in encouraging healthful behavior in Japan, focusing on the Ministry of Health, Labor, and Welfare's metabolic syndrome screening program (implemented in 2005) and the Japanese national school lunch program. The Japanese government prescribes optimal body metrics for all Japanese citizens and relies on institutions such as schools and health insurance organizations that are in some instances closely affiliated with the workplace to carry out education. Japan's socio-cultural approach leads us reflect on the cultural and social conditions that make different policy prescriptions more politically feasible and potentially effective. It also provokes us to question whether limited behavioral modifications and “nudging” can lead to broader change in an environment like the United States where there are fewer broadly shared socio-cultural norms regarding acceptable health behavior. [ABSTRACT FROM AUTHOR]

Japan and the United States are both post-industrial societies, characterized by distinct trajectories of dying. Both contain multiple "cultural scripts" of the good death. Seale (Constructing Death: the Sociology of Dying and Bereavement, Cambridge University Press, Cambridge, 1998) has identified at least four "cultural scripts", or ways to die well, that are found in contemporary anglophone countries: modern medicine, revivalism, an anti-revivalist script and a religious script. Although these scripts can also be found in Japan, different historical experiences and religious traditions provide a context in which their content and interpretation sometimes differ from those of the anglophone countries. To understand ordinary people's ideas about dying well and dying poorly, we must recognize not only that post-industrial society offers multiple scripts and varying interpretive frameworks, but also that people actively select from among them in making decisions and explaining their views. Moreover, ideas and metaphors may be based on multiple scripts simultaneously or may offer different interpretations for different social contexts. Based on ethnographic fieldwork in both countries, this paper explores the metaphors that ordinary patients and caregivers draw upon as they use, modify, combine or ignore these cultural scripts of dying. Ideas about choice, time, place and personhood, elements of a good death that were derived inductively from interviews, are described. These Japanese and American data suggest somewhat different concerns and assumptions about human life and the relation of the person to the wider social world, but indicate similar concerns about the process of medicalised dying and the creation of meaning for those involved. [ABSTRACT FROM AUTHOR]