<figure id="attachment_307747" class="wp-caption alignnone" style="width: 1999px;" aria-describedby="caption-attachment-307747"><a href="#" data-ident_hash="7a799a65"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/pl-2013228956434-1.jpg" alt=""></a><figcaption id="caption-attachment-307747" class="wp-caption-text">Some women take laxatives every day to lose weight.</figcaption></figure>
 In recent years, &#8220;neurogenic emaciation,&#8221; an eating disorder also seen in elementary and junior high school students, is becoming more and more common. Let&#8217;s <a href="https://friday.kodansha.co.jp/article/307742">take a look at</a> this disease, which is said to have a 5% mortality rate among young women, <a href="https://friday.kodansha.co.jp/article/307742">following on from Part 1: The horrifying reality of the desire to lose weight, which has reduced elementary and junior high school students to skin and bones</a>.
 Neurogenic emaciation is a disease that is overwhelmingly common among women.
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 Thinking that thinness is a symbol of beauty, these women do things such as not eating, vomiting once they have eaten, and taking dangerous diet pills. This leads them to lose strength, develop secondary illnesses such as arrhythmia, and in the worst case scenario, die.
 Why are these women so obsessed with losing weight? Behind this is the mental problems they are facing. I would like to briefly introduce two cases that I interviewed.
<h2>Their limbs have become as thin as dead trees.</h2>
<figure id="attachment_307749" class="wp-caption alignnone" style="width: 1999px;" aria-describedby="caption-attachment-307749"><a href="#" data-ident_hash="478b25f7"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/pl-2013225426172.jpg" alt=""></a><figcaption id="caption-attachment-307749" class="wp-caption-text">The desire to lose weight seems to be particularly strong among women.</figcaption></figure>
 ● Former abused woman
 Ms. A was abused by her parents for a long time. Because of this, she had low self-esteem and was constantly worried that people would hate her.
 When she became a junior high school student, Ms. A started a social networking service and began posting pictures of herself to distract herself from her loneliness. At that time, her followers told her that she was thin and cute, and that they were envious of her small face.
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 She thought that if she lost weight, she would receive compliments, so she started posting pictures of herself on social networking sites after she lost weight. She wanted her followers to give her warm words of encouragement for losing weight because she had been mistreated by her parents. This behavior escalated each time she was beaten by her parents at home.
 Six months later, Ako&#8217;s limbs were as thin as dead branches due to her extreme dieting. To the untrained eye, she could have collapsed at any moment. Even so, her online followers continued to comment on how beautiful she looked, how enviable she was, and how they wished they could lose weight too.
<div data-friday-nextpage-lead="True story of a high school girl who could no longer even ride the train"></div>
<figure id="attachment_307784" class="wp-caption alignnone" style="width: 2000px;" aria-describedby="caption-attachment-307784"><a href="#" data-ident_hash="becb9af9"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/pl-2013229381149.jpg" alt=""></a><figcaption id="caption-attachment-307784" class="wp-caption-text">There are cases where being too thin can cause mental and physical abnormalities (photo is an image only)</figcaption></figure>
 Bullying at school
 B-mi was born with dark skin. In elementary school, she was bullied and called a &#8220;gaijin&#8221; because of it, and even stopped going to school. Since then, B-mi became very concerned about her body.
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 After entering high school, B-mi joined the volleyball club. Because the volleyball team at that high school was a strong one, her jump height was measured every week, and if it fell even slightly, the coach gave her a stern warning to keep her weight under control.
 In such an environment, the serious B-mi, who had been bullied in elementary school, became obsessed with the need to lose weight. She felt that if she did not lose weight, her coach would be angry with her, and her teammates would exclude her and hate her.
 She was not taught how to manage her weight in club activities. Impatient, B-mi searched the Internet and tried one wrong diet after another. She took laxatives every day, took hot baths for more than two hours, and ate only the whites of boiled eggs. &#8230;&#8230; Not only did B-Mi lose weight, but she also became constantly foggy from lack of nutrition and eventually couldn&#8217;t even ride the train to school.
<h2>Craving recognition from others</h2>
<figure id="attachment_307785" class="wp-caption alignnone" style="width: 3024px;" aria-describedby="caption-attachment-307785"><a href="#" data-ident_hash="e061d017"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/IMG_1135.jpg" alt=""></a><figcaption id="caption-attachment-307785" class="wp-caption-text">The &#8220;Hot Line&#8221; where numerous problems are reported (photo provided).</figcaption></figure>
 Among Japanese women, there is more or less a notion that &#8220;thin is beautiful.
 However, in many cases, those who are obsessed with this idea and even suffer from neurotic emaciation have other causes. As mentioned in the previous section, this is often due to emotional trauma such as abuse, bullying, or poor grades.
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 Every person has a desire to be accepted by others. However, most people achieve a certain level of self-esteem by gradually satisfying their need for approval in various areas such as study, sports, and hobbies.
 However, those who have been traumatized often crave recognition from others. Because of their low self-esteem, they escalate their dieting, thinking that the thinner they are, the more beautiful they will become and the more people will approve of them. When they lose control of their dieting, they become neurotic emaciatsis.
 Last year, Kohnodai Hospital of the National Center for Global Health and Medicine opened the &#8220;National Support Center for Eating Disorders: Consultation Hotline. The center receives consultations on eating disorders from all over Japan.
 Masako Nakano (a pseudonym), a nurse who works at the consultation desk, says, &#8220;The average number of consultations per person is about 1,000.
 &#8220;On average, we receive 20 ～to 40 minutes per consultation. I listen to them for about 20 to 40 minutes on average. We try to find out not only the current situation, but also the underlying concerns of the patient. First of all, it is important for the patient to recover physically, but if the patient&#8217;s problems are not properly taken care of, there is a possibility that he/she will develop an eating disorder again.
 If a client is unable to lead his/her daily life due to the neurotic emaciation, we first inform the client that his/her life is in danger and recommend that he/she go to an appropriate medical institution to regain weight.
<div data-friday-nextpage-lead="The Consultant's Contradictory Desires"></div>
<figure id="attachment_307780" class="wp-caption alignnone" style="width: 890px;" aria-describedby="caption-attachment-307780"><a href="#" data-ident_hash="86267a4e"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/IMG_7091m23.4.jpg" alt=""></a><figcaption id="caption-attachment-307780" class="wp-caption-text">Dr. Kawai warns against excessive dieting (courtesy photo).</figcaption></figure>
 However, this is only a superficial care, and the root cause of the nervous emaciation must be corrected. In the case of Child A, it is a family problem, and in the case of B-mi, it is the trauma of being bullied.
 This is not easily handled by psychiatry or psychosomatic medicine alone, so it is sometimes necessary to entrust schools, child guidance centers, or counseling services to deal with the problem. This is where the difficulty of treating neurotic emaciation lies.
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 Dr. Keisuke Kawai of the same hospital says, &#8220;There are many patients with eating disorders in Japan.
 There are many patients with eating disorders in Japan, but there are very few specialized medical institutions. There are two reasons. One is that there are few doctors who can treat both the physical and mental aspects of this disease, and the other is that there is not yet a cooperative environment among multiple medical departments. We would like to spend more time on medical treatment, but under the current system, we cannot get the reimbursement that is commensurate with that. Moreover, if medical treatment is too difficult, it is difficult to find people who are willing to work on it.
 Second, patients themselves do not feel threatened by the fact that they are thin and tend to refuse treatment. Their real intention is, &#8220;I don&#8217;t want to gain weight because I have lost weight. Therefore, even if doctors try their best to treat them, they do not cooperate. I want to focus not only on the thinness, but also on the patient&#8217;s painful mind, but it takes time to get there.&#8221;
<h2>I can&#8217;t walk, but they say, &#8220;I&#8217;m fine, aren&#8217;t I?</h2>
<figure id="attachment_307781" class="wp-caption alignnone" style="width: 4032px;" aria-describedby="caption-attachment-307781"><a href="#" data-ident_hash="ecba9d7c"><img src="https://res.cloudinary.com/fridaydigital/image/private/t_article_image/wpmedia/2023/04/IMG_1140.jpg" alt=""></a><figcaption id="caption-attachment-307781" class="wp-caption-text">The &#8220;Hot Line,&#8221; a consultation service (photo provided).</figcaption></figure>
 It is no mean feat to spare time and effort to deal with patients who refuse treatment. This is even more so for general practitioners, who are expected to make a profit in order to run their hospitals.
 Therefore, the Consultation Hotline listens to the patient&#8217;s story to the end and not only introduces specialized medical institutions nationwide, but also provides correct information on what to do if the patient is not doing well there, who to consult, and how the family or school should handle the patient&#8217;s situation. Provide the correct information on what to do if things don&#8217;t go well, who to consult, and how the family and school should respond.
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 Even so, Nakano says, in reality, there are many difficulties. Nakano says, &#8220;The counselor&#8217;s desire to lose weight is a big problem.
 The desire to lose weight is very strong,&#8221; says Nakano. Even when I tell them that if they don&#8217;t lose weight, their lives may be in danger, they say, &#8216;I don&#8217;t want to gain weight, so please stay thin and regain my strength. I am not sick enough to go to a psychiatrist.
 Some people can&#8217;t even walk, but they say, &#8216;I&#8217;m fine, aren&#8217;t I? Or sometimes parents are more evasive and say, &#8220;My child is still fine. In order for these people to receive proper medical care, the institution has to be that solid.
 As we saw in Part I, the Internet is filled with various postings and information that overly glorify thinness. In addition, the parents of today&#8217;s generation, who spent their youth in the 1980s, the era of the diet boom, have a longing to be thin, and they may demand the same of their children.
 It is sad to say, but it may be a necessary phenomenon for young women who are having a hard time living in such an environment to engage in excessive dieting out of concern for the eyes of others.
 In Japan 200,000 More than 200,000 people in Japan suffer from eating disorders. Among them is neurogenic emaciation, which has a mortality rate of 5%. If society as a whole does not take this seriously and change its mindset, even if only gradually, it will unintentionally drive the sufferers further into a downward spiral.
 ■ National Support Center for Eating Disorders: Consultation Hotline
 Phone 047-710-8869
 Hours: Tuesday through Friday 9:00 a.m. to 5:00 p.m. 9:00 a.m. &#8211; 3:00 p.m. 3:00 p.m. Hours: Tuesday through Friday 9:00 a.m. to 3:00 p.m. (except holidays, year-end and New Year holidays, and Bon holidays)

 Born in Tokyo in 1977. Nonfiction writer. He has reported and written about culture, history, and medicine in Japan and abroad. His books include "Absolute Poverty," "The Body," "The House of 'Demons'," "43 Killing Intent," "Let's Talk about Real Poverty," "Social Map of Disparity and Division," and "Reporto: Who Kills Japanese Language Ability?

 Kota Ishii

 The "desire to be thin" is widespread, especially among women. The trend is spreading to younger and younger age groups, and even elementary and junior high school students are seriously affected. In the worst case, it can even lead to death. Nonfiction writer Kota Ishii reports on the horrifying reality that even medical specialists are alarmed by!

Taking laxatives every day and taking hot baths for 2 hours…5% mortality rate! The Fabulous True Story of a Woman Who Wanted to Lose Weight

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