Working across two different countries and cultures has taught Japanese-born Masae that eating disorders speak the same language, regardless of a person’s mother tongue or environment. Based in the USA, Masae has an ambitious vision to ease suffering in her home country. Read her story. _________________________________________________________________________ Providing hope and healing for people with an eating disorder in Japan By Masae Yasuda Eating disorders don’t discriminate. They affect people of all genders, ages, races, ethnicities, body shapes and weight, sexual orientations and socioeconomic statuses. In Japan, eating disorders were not even recognised by Japanese psychiatry for many years. In my view, the treatment environment for eating disorders in Japan is 30 years behind the United States. As a psychiatric nurse who has worked in both the United States and Japan, and who has lived with an eating disorder in both countries as well, I’ve experienced this harsh truth firsthand. It’s been a long time since I first suffered from an eating disorder. I was living in Japan at the time and, despite working in the medical field, I was unable to access helpful treatment. Here is a snapshot of the messages I received and thoughts I told myself over and over again during this difficult period: “I just need to stop!” “Nobody cares.” “I need to deal with this problem myself and without any help.” An eating disorder is the same everywhere but the levels of care differ Not until I began working in an adolescent eating disorder unit in the US did I gain an understanding of how behind Japan was, and still is, in this treatment space. The US was offering patient-centred treatment and people were actually willing to help patients and their family. At the same time, medical staff were supportive and kind. This was a far cry from what I had experienced and observed in Japan. My work across two very different countries and cultures has taught me that eating disorders speak the same language, regardless of a person’s mother tongue or environment. Having embarked successfully on my own healing journey, I now want to offer a specialized eating disorder treatment program in Japan so that people who develop these vicious illnesses are no longer forced to suffer alone or in silence. In recent years, I have invited Japanese medical professionals (MDs, RNs, psychologists, dieticians, school nurses, students) to the US to conduct study tours. Additionally, I have helped to translate a number of books into Japanese that explore eating disorders including Life Without Ed by Jenni Schaefer, 8 Keys to Recovery from an Eating Disorder by Carolyn Costin and Bulimia: A Guide to Recovery by Lindsay Hall. However, I realise more is needed and that is why I need your support in publishing my first book (more on the book below). People with eating disorders need to feel supported and cared for This work is part of my mission to improve the eating disorder treatment environment in Japan. I want people with eating disorders and their loved ones to feel supported and cared for. We know that eating disorders have the HIGHEST MORTALITY RATE OF ANY OTHER MENTAL ILLNESS. From what I have seen and experienced, mental health and psychiatric illness are still rarely recognized in Japan. Unlike other illnesses and health challenges, eating disorders are not cured with medication. Recovery from an eating disorder requires a more integrated approach involving internists, psychiatrists, pediatricians, psychologists, nutritionists, nurses, caseworkers, occupational therapists, physical therapists, teachers, parents, family members and the patients themselves.   The prevalence of eating disorders in Japan is said to be about the same as in the US, with the latest statistics released by the Japanese government in 1998. However, the real number of patients with eating disorders in Japan is unknown due to various reasons such as unclear diagnostic criteria, lack of treatment facilities and the use of different names for diagnosis and prescription purposes.  In Japan, many medical professionals have told me that people living with eating disorders can never fully recover and that people are destined for a life-long struggle, similar to an addiction. I strongly believe this is not the case. I speak from experience when I say eating disorder recovery involves a lot more than simply eating. Recovering from this illness is not as easy as the general public may think. For most people without the illness, ‘eating’, ‘not eating’, ‘weight’ and ‘body shape’ may be simple concepts. However, for those living with an eating disorder, their self values and beliefs and thoughts, can cause many uncomfortable negative emotions. These emotions can be intricately intertwined. As a result, fighting this illness alone is almost too difficult. Most people need a support team comprising a range of medical experts. How you can help to make a difference to those living with an eating disorder in Japan Click here to go to Masae’s crowdfunding campaign where you can donate however much you can afford. Remember, every dollar counts. I’m writing a book to raise awareness in Japan As part of my mission to raise public awareness about eating disorders in Japan, I wish to highlight that healing from an eating disorder is very possible. Creating a treatment program specializing in eating disorders in Japan is the first phase of my project. You can help to generate traction by supporting the publication of my first book where I write about my experiences with an eating disorder as both a nurse and patient in Japan and the US. I am beginning to promote the book already and am aiming for a publication date of May 2020. My hope is that this book will be available widely in bookstores in towns throughout Japan. Instead of me personally educating people on a one-to-one basis, my intent is for this book to be a platform for educating Japanese society about eating disorders. This will lead to an increase in awareness for eating disorders, a deeper understanding and recognition that this is a disease that needs medical treatment in the national insurance system. I want people to understand there are many ways eating disorders can be treated. With the support and cooperation from everyone, I believe that we will be able to provide a supportive and accessible environment where patients and their families can receive treatment for eating disorders in Japan. To read the Japanese version of this post, click here. How you can help to make a difference to those living with an eating disorder in Japan Click here to go to Masae’s crowdfunding campaign where you can donate however much you can afford. Remember, every dollar counts. About Masae  Masae is a registered nurse in Japan and the United States. She has worked in the psychiatric settings including with eating disorder patients in both countries. She founded Eating Disorder Hope Japan in 2014 to improve treatment for people with an eating disorder. She translated fourED related books. When Masae goes back to Japan every summer, she visits different hospitals, nursing colleges, family/clients support group to share her professional and personal American experience to Japanese professionals, clients and families. She has organized study tours for Japanese professionals to learn and visit various treatment facilities in Los Angeles and Hawaii. Her goal is to build the first eating disorder specialized program/unit/center in Japan by 2022. Now Masae is offering free podcasts in Japanese, online discussion board, online self–learning course in Japanese, and an individual support service for clients and family members. Contact: www.edrecoveryjapan.com (Japanese) Email: info@edrecoveryjapan.com FB: EatingDisorderLosAngeles (Japanese) Twitter: @edhopejapan (Japanese) References Schaefer J (2003). Life Without Ed. Costin C & Grabb G S (2011). 8 Keys to Recovery from an Eating Disorder: Effective Strategies from Therapeutic Practice and Personal Experience (8 Keys to Mental Health) Hall L (1992). Bulimia: A Guide to Recovery. Japanese Ministry of Health, Labour and Welfare  About World Eating Disorders Action Day 2019 This year grassroots activists, volunteers, and over 250 organizations in 40+ countries are calling for caregivers to receive support, health care workers to be properly trained, and access to immediate, evidence-based treatment. Why We Can’t Afford to Wait Worldwide over 70 million people are estimated to be affected by an eating disorder, Eating disorders have the HIGHEST MORTALITY RATE of any psychiatric illness   Eating disorders affect people of all genders, sexual orientations, ages, socioeconomic class, abilities, races, and ethnic backgrounds. It is time to take action. Good news! When treated EARLY and correctly, eating disorders have the highest and fastest recovery rate!    How to support World Eating Disorders Action Day, June 2, 2019 Join the movement, show your purple on social media! Use hashtag #ShowUsYourPurple Follow conversation on social media. Use hashtags #ShowUsYourPurple #WeDoActNow Host or attend an event. See  http://www.worldeatingdisordersday.org/2019-events-2/ Donate. To support the work see http://www.worldeatingdisordersday.org/get-involved/participating-organisations/. Discuss eating disorders. Through open, supportive dialogue, we can create change.