Five years ago, Katsura Sugiura had the wiry physique of a sprinter, but marriage, good food and looming middle-age has softened him round the edges. Standing 172cm tall with an 87cm waist, he describes himself as a 'borderline' tubby. 'I don't have a problem with this weight,' says the 37-year-old construction engineer. 'My wife says I look good.' The Japanese government, however, has other ideas. Once the butt of jokes, the sight of men such as Sugiura sucking in their bellies to hide expanding waistlines has become a lot more serious with the introduction of mandatory 'fat checks' this month for all employees over the age of 39 - an estimated 56 million people. Aimed at trimming bulging health costs of more than US$3 billion a year, the government says employees with waistlines that exceed a set limit - 85cm for men and 90cm for women - will be asked to go on exercise and diet programmes and possibly pay higher insurance costs. And companies that fail to reduce their ranks of flabby workers by 10 per cent over the next eight years also face financial penalties. Sugiura has two years to get back in shape. 'It's causing me a lot of stress,' he says. 'I mean, men are supposed to put on a little weight when they get older, right?' But the campaign is being taken seriously by large corporations, which must pay millions of dollars in extra contributions to health care for the elderly unless they meet government targets. About 70 per cent of medical expenses for pensioners in Japan is covered by health insurance unions, funded by a mix of company and private premiums. Company contributions will be increased or reduced, depending on their success in getting employees into shape. 'We estimate our costs will be plus-or-minus 10 per cent, which is about 2 billion yen [HK$148 million],' says Hideyuki Nakajima, a spokesman for IT giant NEC. 'We're trying very hard to make sure we don't have to pay that penalty.' NEC has set tough internal targets, including a 25 per cent cut in the body mass index of overweight employees and a 30 per cent reduction in the number of male smokers at the company. Other businesses are also embracing the battle of the bulge. Nutrition seminars are growing in popularity along with exercise classes, subsidised gyms and calorie-counting. In some company cafeterias, employees can now read how many calories they have consumed on meal receipts. But many doctors have labelled the government plan flawed. 'It's silly to focus only on waist size because many people with bellies are perfectly healthy,' says Hiroo Hotta, a doctor who runs a clinic in a western Tokyo suburb. 'Some people are born with pear-shaped bodies, just like some have round faces. Putting high blood pressure, blood sugars and cholesterol in the same category isn't helpful.' Other critics have been harsher. 'It's a comedy,' dietary expert 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.' The flab fight 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 reduce his 100cm waistline. Critics fear more casualties as millions try to squeeze past the so-called fat police. 'People will die as a result of this plan, no question,' says Hotta. 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. More than 27 million people now either suffer from, or are at risk of, high blood pressure, blood sugars and cholesterol, which the health ministry has lumped together as metabolic syndrome, or 'metabo' in the popular media. The phenomenon is being linked to a shift from the traditional Japanese diet of fish, rice and vegetables towards 'modern' western fare featuring more red meat, dairy and processed foods. Japanese men are doing worse than women: government statistics show that men are now 10 per cent heavier than they were a decade ago, and the average woman's weight has increased by 6.4 per cent. 'We have to bring medical costs down,' says Toshiyuki Sato, a spokesman for the ministry, which predicts the health system will be swamped by the cost of caring for a nation of fatties unless it takes drastic action. At least the bureaucrats have put their metabo where their mouth is. Unappetising pictures of senior vice-health ministers Keizo Takemi and Noritoshi Ishida, shirts pulled up and paunches exposed for the tape measure, have been posted on the health ministry's website. Both fell victim to the syndrome and have starting blogging about their efforts to get their waists back under 85cm. 'I adore good food but I have to be strict with myself,' laments Takemi. Metabo has become one of this year's buzz words and fear of associated problems such as strokes, heart attacks and diabetes, is behind a wave of new health fads and crash diets. The Nikkei business newspaper estimates the market for 'anti-metabo' services such as private health guidance, weight-loss machines and fat farms could soon reach 100 billion yen. Companies have waded in with innovative, and expensive products. Once prosaic items such as bottled Oolong tea have been rebranded as metabo cures along with more exotic fare such as portable metabo-checkers and fat-burning pills. Wackier ideas abound in the Japanese press. Tabloid magazine Weekly Post reported that a Tokyo marine-products firm recently required its staff to eat at least one fish sausage daily after research suggested it could reduce fat. However, the health ministry denies its plan encourages fad-diets and pill-popping. 'Dieting badly will eventually cause medical costs to rise even more, so we hope the metabolic tests will be properly supervised,' says Sato. In an editorial criticising the flab test directive, Nikkei accused the ministry of overstepping the bounds of 'reasonable policy efforts' by 'uniformly imposing scientifically questionable criteria and threatening to slap penalties on the operators of health insurance societies that fail to improve the situation'. Even companies such as NEC question the efficacy of the policy. 'There are limits to the costs of what corporations and individuals can bear,' says Nakajima. Consumer electronics giant Matsushita Electric doesn't share its qualms. Company spokesman Akira Kadota says the national guidelines share the same aims as Matsushita's own campaign. 'We regard this plan positively,' he said. It introduced a health drive in 2001 and recently launched a low-fat cafeteria menu for middle-aged employees. This year it started issuing pedometers to workers along with prizes to those who clock up the most mileage. However, workers for All Nippon Airways have grumbled to the press about being corralled into 'lifestyle reform programmes', complete with gym training and diet-planning sessions. These include instructions to the wives of salary-men on how to make the all-important bento - or lunchbox - less fatty. Some firms have started running weekend seminars for tubby employees in the countryside. The popular press has dubbed them 'metabo boot camps'. Where will it all end? The government hopes to see a 25 per cent cut in the metabo ranks by 2015. Although many doctors think that's optimistic, they say the message is rapidly filtering down to younger people: get fit now or face pain later. NEC is one of several firms to have begun targeting the syndrome among employees in their early 30s. Sugiura says the result will be discrimination against people like him, especially in companies with group health programmes. 'Fat people will be criticised by skinny people, old people by the young and companies will refuse to hire overweight people,' he says. 'It makes me angry that the government has started this without consulting us.'