Approximately 14 million people live in Tokyo, so space is, understandably, at a premium. And if you look at the modern apartments in this bustling city, you’ll notice that most of them have a similar interior design—classic white walls, faux wood flooring and off-white bathrooms. Speaking of the latter, a Tokyo apartment bathroom is often compact, functional and (between us) a little monotonous. However, if you look closer, you will find beauty in monotony.

With a creative spirit, you can transform your small bathroom into a serene haven with these aesthetically pleasing products. Allow me to show you how!

Set The Vibe With Candles

Greetings from my Tokyo bathroom! As you can see, I’ve decorated the room with candles and artificial plants. I intended to create a space that would allow me to recharge and rejuvenate after a long day at work. The LED candles are from Ikea. I think they add a sense of coziness to the space. To create a spa-like experience at home, I often turn off my bathroom lights, play some lo-fi music and put these candles on while I indulge in a relaxing soak and sip on green tea.

• Price: ¥1,499 
• Buy: Ikea 

Add Sakura Petals To Your Bath

If you’re obsessed with Japanese cherry blossoms, then you will surely love this Sakura Bath Confetti from Loft. Sprinkle a handful into your bath and the water will slowly transform into a blissful shade of pink. It’s the perfect pick-me-up product when you’re feeling under the weather.

• Price: ¥350 
• Buy: Loft

Pamper Your Skin With Honey

This luxury body wash from Hacci is one of my favorites to use when I want to pamper myself. The mellow honey scent is soothing and it makes the skin feel smooth and smell delicious.

• Price: ¥4,950 
• Buy: Hacci

Mini Plants For The Win

I’m a big fan of artificial plants. They’re low maintenance and look like the real deal. I placed these cute succulents on my bathroom rack to add instant color to my plain white bathroom. It’s a minor detail that contributes to the overall low-key Zen aesthetic.

• Price: ¥299
• Buy: Ikea

Bathe With Yuzus

You don’t have to visit a sento (public bathhouse) to enjoy a yuzu bath. You can recreate the same experience at home! Yuzus are available throughout the year in Japan; you can buy them at supermarkets or order them online. Bathing with these aromatic citrus fruits will help melt away stress and elevate your mood.

Note: If you can’t find yuzu fruit at the supermarket, they also offer a bath salt versions.

• Price: ¥1,000 
• Buy: Amazon

Buff Away Those Dead Skin Cells

Most body scrubs in the market today are either too harsh or too fragrant. Some of them could even irritate your skin and cause it to flare up. This one from Sabon is the perfect product for sensitive skin. It is a cult favorite among Japanese women for its powerful scent. A bit pricey, but worth every yen! It contains almond and jojoba oil. Not only does it exfoliate your skin to perfection, but it also leaves your skin smelling divine.

• Price: ¥3,740 
• Buy: Sabon

Try Dry Brushing

Japanese washcloths are physical exfoliators made from nylon and polyester. You can use them with or without soap and water to cleanse your body. It is like dry brushing if you use them without water. Besides exfoliating the skin, dry brushing with this washcloth helps improve blood circulation, elevates your mood and makes your skin feel softer and smoother. Living in Tokyo, I’d recommend dry brushing once or twice a week.

• Price: ¥799 
• Buy: Amazon

Organize Your Bath Salts

Bath salts and tablets are readily available and affordable in Japan. I like to keep mine in this large bowl. You can also store them in baskets and mason jars. The idea is to spread them out to know how many are with you. Depending on the size of your bathroom, you can choose the container that is best suited to storing your bath products.

• Price: ¥1,430 
• Buy: Amazon

Invest In A Reed Diffuser

A reed diffuser in your bathroom will make the room smell fresh at all times. Unlike candles and electric diffusers, they don’t burn or require power to work. The one in the picture is from Daiso (yes, Daiso stores in Japan now sell reed diffusers as well!) If you’re looking for fresh scents in your bathroom, consider lavender, musk, eucalyptus, lemongrass, tea tree, citrus and rosemary. These scents will make you feel relaxed throughout the day.

• Price: ¥1,800
• Buy: Daiso

Bath Bombs For A Luxurious Soak

Lush is one of the best places to shop for bath bombs in Japan. While they offer a variety of them, keep an eye out for the ones exclusive to Japan. I recommend their Temple in the Sky bath bomb. It depicts a sparkly golden Japanese temple and has a fresh citrus scent. 

• Price: ¥920
• Buy: Lush (Japan Only)

I wrote this story to inspire you to transform your cozy Tokyo apartment bathroom space into a sanctuary. If you have more creative design ideas, please share them in the comments below. I’m excited to read yours!

Whether you celebrate Christmas, Hanukkah or Oshogatsu (Japanese New Year), this time of year is filled with holiday celebrations—and all the festive foods that go with it. In this Tokyo dietitian’s guide to festive feasting, I want to address a concern I hear every November and December from many of the patients who visit my office: how to balance meals in a way that allows them to enjoy their favorite holiday fare while still maintaining their health.

I completely understand their struggle, which is why I’m happy to share what I’ve learned through my work as a dietitian over the years. And before you start to worry that this will be another nutrition article suggesting you swap cauliflower into all your holiday recipes or warning about the dangers of sugar, let me reassure you that this is not that article.

Read on for tips on how to include balance and joy as you savor the season with these holiday eating dos and don’ts.

Healthy Holiday Eating Dos

Get Comfortable Living In The ‘Grey’

© Photo by iStock: AzmanJaka

Although many patients will tell me that they are an “all or nothing” kind of person and want to jump right in on a strict meal plan complete with lists of “good” and “bad” foods, the truth is that those types of diets or meal plans aren’t sustainable over long periods of time.

When I think of the patients who were most successful in making long-term dietary changes, they all shunned such rigid, “black and white” thinking and became adept at living in the space between severe restriction and complete abandonment of their nutritional goals. They didn’t live in fear of sweets and treats and were able to enjoy foods that were less nutrient dense—like dessert or alcohol—while still prioritizing ones that were.

This might look like having pizza with a large salad on the side or enjoying a lovely holiday lunch at a fancy restaurant, but planning a dinner filled with lots of vegetables, lean protein and whole grains that also taste delicious once back at home.

These types of patients never had to worry about “falling off the wagon” because they never got on it in the first place. They were patient with their progress and understood that the health or nutrition outcomes they wanted were only possible with time, consistency and making peace with food and eating.

Understand That Any One Meal, Snack Or Dessert Won’t Make Or Break Your Health

© Photo by iStock: PamelaJoeMcFarlane

Whenever a patient comes in panicking about an upcoming holiday meal or an outing like a bonenkai (end-of-year party), I find it’s often helpful to look at the bigger picture. Assuming you eat three meals a day, one meal is only 0.09% of your total food intake for the year.

So just like eating one salad won’t magically make all your health problems disappear, neither will enjoying one holiday meal. What you do consistently matters the most.

Offer To Bring Fruit Or Vegetable Dishes To Holiday Gatherings

© Photo by iStock: Elena_Fox

While I think you should enjoy your favorite holiday foods regardless of whether they’re nutritious or not (more on that later), you’d be surprised how appreciative people are if you bring a fruit or vegetable-filled side dish to a holiday party.

In the excitement over more decadent holiday dishes, fruits and vegetables often get overlooked. Yet in my experience, people are always happy to have them as part of their meal, and in many cases, it’s one of the first dishes to run out!

This time of year has amazing seasonal produce, such as mikan (orange), daikon, yuzu or komatsuna (Japanese spinach) that can be incorporated into dishes or salads that are sure to be a hit.

Appreciate Other Aspects Of The Holidays That Don’t Involve Food

© Photo by iStock: monzenmachi

Even though festive meals are a big part of the holidays, don’t let food and food anxiety overshadow the many other wonderful parts of the holiday season. From enjoying the holiday illuminations to visiting the shrine for hatsumode (first shrine visit of the year), the holidays aren’t just about eating—they are also about joy, connection and celebration.

Healthy Holiday Eating Don’ts

Don’t Skip Meals Before Holiday Gatherings Or Parties

© Photo by iStock: Prostock-Studio

“Saving up” calories before a big holiday meal or event almost always guarantees a binge. Plan to eat regular, nourishing meals instead.

Don’t Feel You Need To Make “Healthy” Versions Of Your Favorite Holiday Food

© Photo by iStock: JackF

There is nothing wrong with modifying a favorite holiday recipe to incorporate more nutrient-dense foods or to accommodate a dietary requirement, such as a dairy or gluten allergy. However, don’t feel like you must do that if what you really want is to enjoy the holiday meal or food as it is.

Research has shown that people who deprived themselves of their favorite foods—such as chocolate—not only experienced more cravings for the restricted food but also ended up eating more than those who didn’t restrict those foods in the first place.

So if what you really want is a piece of Christmas cake, don’t feel like you have to settle for some fruit or a sugar-free dessert instead—have the cake and enjoy it guilt-free!

Don’t Punish Yourself If You Overindulge In Food Or Drinks During The Holidays

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Avoid the temptation to restrict your food intake in response to overeating at a holiday event. Doing so only puts you in a binge and restrict cycle, since severe dietary restriction often results in overeating later due to feelings of deprivation and shame.

While it is okay to listen to your body and eat less food if you aren’t hungry at your next meal, punishing yourself by barely eating is counterproductive.

In the hustle and bustle of the holiday season, striking a balance between eating and celebrating can be challenging. Yet with the tips above and an extra serving of fruit and vegetables (sorry for the shameless fruit and veg plug but I am a dietitian after all!), you can start the new year healthy, happy and well nourished.

Republished for 2025.

There may be times in a person’s life when they need someone to talk to, and for many residents or expats seeking counseling in Tokyo, that moment can feel especially daunting. While friends, family and advice columns are all options, sometimes you need to hear an unbiased, professional opinion on a matter. Sometimes, the situation or emotions you’re experiencing are far too personal, too uncomfortable or perhaps even borderline illegal for anyone within your personal life to truly help with. It happens.

Talking to a professional is important. More people should do it, in fact. Individual counseling can help with a lot of different issues, be they stress, bereavement or seasonal issues. However, when you live in another country, language and cultural barriers can make it feel nearly impossible. And if you’re looking for couples counseling when you and your partner come from different cultural backgrounds and may not fully understand each other’s languages, that’s an even bigger hurdle.

Fortunately, in the Tokyo area, numerous professionals offer their services in English and other languages as well. If you search for clinics in Tokyo, you’ll find several that come up repeatedly—but whether or not these specialists are any good is the next question. You can’t always trust online reviews, nor should you, especially when it comes to your own mental health or the health of a relationship.

It can also be hard to ask others about counseling or therapists. There’s still a lot of stigma attached to mental health in both Japan and overseas, which can make it difficult even to approach the subject. With that said, if you are in need, you should reach out and get it for your own sake. You deserve to be your best self, regardless of what a partner, family or society says.

English Language Clinics

© Photo by iStock: Tero Vesalainen

While this is not a comprehensive list, these are the most widely approved and recommended counseling services in the Tokyo area as endorsed by individuals and mixed-ethnicity couples, Japanese couples and foreign couples living in Japan (about 80 people and 100 couples over 15 years).

Details of their services, fees and availability are found on their websites.

Tokyo Mental Health

• Location(s): Tokyo, Okinawa
• Online: Available
• Languages: English
• Couples counseling: Currently suspended

Bonds Tokyo Counseling Service

• Location(s): Setagaya Ward
• Online: Available
• Languages: English & Japanese
• Couples counseling: Available

Sky Counseling & Consultation Tokyo

• Location(s): Meguro Ward
• Online: Available
• Languages: English & Japanese
• Couples counseling: Available

Aoyama Bright Life Counseling Clinic

• Location(s): Minami Aoyama
• Online: Available
• Languages: English, Japanese, & Polish
• Couples counseling: Available

TELL Counseling

• Location(s): Tokyo and Okinawa
• Online: Available
• Languages: English, Japanese, Mandarin Chinese, Cantonese, Spanish; flyers available in Bahasa Indonesian & Spanish
• Couples counseling: Varies

Individual Specialists

If you would prefer to find your own specialist, there are two services available:

• International Mental Health Professionals Japan
• Japan Healthcare Info

English Only, Online Only Services

There are also many counseling options available online. Three of the most recommended services for couples counseling are Better Help, Talk Space and ReGain.  Details of their services, fees and availability can be found on their websites.

As these are overseas-based services, you may need to book appointments at late night or early morning Japan time to get the most out of them.

Japanese Language Only Clinics

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There are scores of Japanese language-only clinics to choose from, as well, for both individual and couples counseling. However, they do expect you to be able to communicate at a native or near-native level of Japanese. You may be required to prove proficiency in Japanese or bring a translator with you, otherwise. For individual counseling in Japanese, it is recommended that you consult with your primary healthcare professional for recommendations, as you may need a referral to schedule an appointment.

Some ward offices also offer individual and couples counseling services. Ask at your local ward office if they have any of these services or if there are any counseling services available in your ward as well—these may be covered by Japanese National Insurance.

In terms of couples counseling specifically, some Japanese clinics also offer services for international couples. That being said, you are expected to be a near native-level Japanese speaker in order to participate. If you are not but would be more comfortable with a Japanese counseling clinic, you may be required to hire your own translator first. You’ll need to discuss this with the clinics beforehand, as each has its own rules and requirements regarding translation services as well as any associated fees.

Mejiro Sola Clinic

• Location(s): Mejiro Station
• Online: Based on needs/circumstances
• Languages: Japanese, consult regarding translation services
• Couples counseling: Available

Hiroo Stress Clinic Psychiatry

• Location(s): Minato Ward
• Online: Available
• Languages: Japanese, consult regarding translation services
• Couples counseling: Available

Fufu Mondai Sodanshitsu Forte (Fufu Forte)

• Location(s): Shinjuku Ward
• Online: Available
• Languages: Japanese, consult regarding translation services
• Couples counseling: Only service provided

Domestic Violence & Other Helplines

© Photo by iStock: bymuratdeniz

Sometimes the kind of help people need requires professional, perhaps police, assistance. If you are the victim of domestic violence or aren’t sure and want to talk to someone to get a better understanding of your situation, there are also ways to get help.

The Domestic Violence Hotline Plus is a phone, email and live chat service that began in response to the shocking increase in reported domestic violence incidents during the pandemic lockdowns. The helplines are available 24 hours a day. Telephone and email consultations are Japanese only, but chats are available in English, Chinese, Korean, Indonesian, Spanish, Portuguese, Tagalog, Thai and Vietnamese. Select the language that you require at the top of their homepage and follow the instructions provided.

Victims of sexual violence should consult the Sexual Violence Relief Center Tokyo (SARC) as soon as possible, as they can help you with the police and any medical needs on a 24-hour basis. 

The Yorisoi Hotline is a service dedicated to Japan’s foreign community, offering assistance with a range of issues, including visa concerns, domestic violence and international trafficking. This service is available in Japanese, English, Tagalog, Korean, Chinese, Spanish, Portuguese, Thai, Vietnamese, Nepali, Indonesian and other languages, although availability varies.

And, of course, if you need someone to talk to, TELL Lifeline is also available.

Finding the right kind of help can be challenging when you live abroad, but hopefully, with this counseling in Tokyo guide, you have a better idea of where to start.

Japan has a reputation for being one of the loneliest countries in the world, and many newcomers search for advice on how to navigate feeling alone in Japan. With long working hours and social schedules that rarely overlap, it’s easy to understand why isolation is so common.

When I first lived here, I worked a contract playing piano and singing six nights a week at a Hakone resort. I met many kind and thoughtful people, yet my schedule and limited Japanese skills made it challenging to establish genuine day-to-day connections.

Loneliness is such a powerful and widespread emotion that several countries now treat it as a public health issue. The UK appointed a Minister of Loneliness back in 2018. Japan followed in 2021, naming its first Minister for Loneliness and Isolation, Tetsushi Sakamoto, in response to rising suicide rates and pandemic-related challenges. The position is currently held by Junko Mihara, who has served in the role for the past year.

Recent OECD data shows that around 10 percent of people in Japan have no social interaction outside their family. In other words, you’re truly not alone in feeling alone. The good news is that even small steps can make a meaningful difference.

Here are my personal tips for meeting new people, building community connections and experiencing all the incredible things Japan has to offer.

1. Invite Your Co-workers Out After Work

© Photo by iStock: AzmanJaka

The joy of being in Japan is that there are endless opportunities for fun—and for those in the city, everything is open late. Getting the chance to get to know your co-workers outside of work is undoubtedly a great way to create, strengthen and maintain new friendships.

The good news is that in Japan, post-work drinks or nomikai (drinking parties) are practically a part of the job, so you shouldn’t have much trouble persuading your colleagues to join you.

My Personal Recommendation

Music lovers in Tokyo should head to Shibuya’s Dogenzaka on a Tuesday night for Ruby Room’s famed open mic night, where a mixture of locals, ex-pats and travelers will entertain you. Given the intimate setting of the bar, it’s a golden opportunity to strike up a conversation with someone—if they don’t beat you to it!

You should also check out Savvy Tokyo’s food archives for more cool places to visit after dark with your (hopefully) new friends.

2. Discover New Passions Through Volunteering

Volunteering in Tokyo can be a great way to give back to the community, make new friends and appreciate the things you have to be grateful for. Working alongside other volunteer staff who are passionate about changing the world for the better will not only give you all the good feels, but you’ll be a part of a community where you’re all working towards one collective goal. And nothing brings people closer together than that.

My Personal Recommendation

For those who are slightly more introverted but love animals, the Animal Life Matters Association (ALMA) is accepting volunteers for both administrative tasks and caring for the cats and dogs, including cleaning cages, preparing meals and walking dogs. The website is in Japanese, but you can access the volunteering form here.

3. Endorphins Make You Happy—Exercise!

© Photo by iStock: joka2000

It’s all too easy to stay under the covers with a good Netflix drama, but if you dig deep and get up and at ‘em, your mind and body will thank you. If a standard gym session isn’t your cup of tea, I highly recommend a boxing class for an intense and not-your-everyday workout.

Other options include joining a local sports team or a running club, allowing you to make friends while exercising. You can easily find various English-speaking sports groups on platforms like Meetup.

My Personal Recommendation

I personally enjoy attending the B-Monster group-taught boxing classes, which are held in a dark room illuminated by colorful LED lights. The idea is to “refresh yourself both physically and mentally as if you were dancing in a club”—you’ll be having too much fun partying that you’ll forget you’re working out!

For a gentler workout, practice your namastes at one of these English-friendly yoga classes in Tokyo. Everyone, from beginners to super flexible yogis, is welcome.

4. Go To A Japanese Class

© Photo by iStock: izusek

Perhaps the most obvious point is the inability to speak Japanese—it is automatically isolating to a certain degree. Self-study is all well and good, but only another student studying the language can understand the arduous journey of learning Japanese.

The power of shared learning is not to be underestimated. I personally learned more Japanese in a single month of classes compared to months of self-study. And best of all, an environment like a classroom is the perfect place to meet others working hard toward the same goal.

My Personal Recommendation

If you’re like me and prefer flexible classes that don’t break the bank, I can recommend Coto Japanese Academy. Aside from the textbook material they provide, they teach Japanese words and phrases commonly heard in everyday situations, such as at convenience stores or train stations.

Simply being able to recognize a few sounds and kanji characters can go a long way; you’ll start feeling like you’re a part of the world around you. GaijinPot Study is also a valuable resource for finding a language school that offers courses tailored to your specific needs.

5. Take A Solo Trip 

© Photo by iStock: Oleh_Slobodeniuk

Being lonely isn’t always caused by the absence of interaction. Instead, it’s how you feel about those interactions. If you’ve ever gone out with a group of people, yet felt disconnected, you’ll know what I’m talking about.

One of the best aspects of Japan is its incredible safety and ease of travel. How is this possible? Enter Japan’s railway system. Hop on a train, throw on some earbuds and make the mental shift from “lonely” to “solo day-tripper”. With countless historical monuments, mountains, natural hot springs and an entire ocean only a hop and a skip away from most areas in Japan, there’s no better place to pursue your inner wanderlust.

My Personal Recommendation

There are a number of easy-to-get-to and totally #worthit spots in and around Tokyo that I love: Hakone for a dip in Japan’s famous onsens, Enoshima for those missing the beach or in search of a spa day, Kamakura to catch historical views of the massive Daibutsu or Ibaraki prefecture to catch the final colors of fall.

Feel proud of yourself for taking a chance on something—whether it’s a job, a relationship or your own desire to be in Japan—you took the leap and made it happen. You can get through this.

Further Resources

Loneliness can be debilitating and lead to other mental health issues. There are several places you can reach out to if you feel you need professional support.

• Tokyo Counseling Services offers counseling and therapy services in multiple languages to all residents of Tokyo.
• TELL (Tokyo English Lifeline) is a wonderful organization that provides 24-hour support for mental health.
• The Japan Helpline provides information and resources for areas across the country, covering a wide range of topics, including medical assistance and other emergencies.

Have you felt alone in Japan before? How did you deal with it? Let us know in the comments.

This article has been republished for 2025.

Bullying in Japanese schools, or ijime, is an entrenched problem. To the degree that modern bullying attacks not just the odd ones out, the pressure on foreign or part-foreign children in Japan may have decreased compared to previous generations, but the odds are not in their favor, nor in anyone else’s. Every child is a potential victim of modern bullying.

A recent scandal involving a senior high school baseball team that withdrew from Japan’s national tournament after alleged abuse of a junior member has brought renewed attention to this issue. Recent increased efforts by educational institutions to resolve and eradicate the harassment offer some hope.

What’s Considered Bullying in Japan?

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Japan’s Ministry of Education (MEXT) has monitored ijime cases since 1985, gradually broadening definitions to reflect modern realities—including bullying outside school grounds and online harassment.

MEXT defines bullying as:

An act by a student or students toward another student that causes physical or psychological suffering, as judged from the standpoint of the child who feels bullied.

Whether suffering has been caused or not is judged based on the standpoint of the child who has been bullied. It’s a broad definition aimed at encompassing the diverse nature of today’s cruel tactics.

A Persistent Issue

Bullying in Japanese schools has been deeply ingrained for generations. A 2013 study by the Tokyo Metropolitan School Personnel Training Center found that 66.2% of children surveyed had been bullied, and 46.9% had both been bullied and bullied.

Though awareness and policies have improved since then, the landscape has evolved rather than disappeared, and reported bullying cases continue to climb.

Latest National Figures (FY2024, Reported in 2025)

Although these numbers reflect reported cases, experts note that substantial underreporting may still exist.

Types Of Bullying in Japan

© Photo by iStock: Kayoko Hayashi

In recent years, bullying has shifted to target children over minor misunderstandings, group conflicts or online rumors. While diversity visibility has increased, children of mixed cultural backgrounds or newly arrived foreign families can still face exclusion or misunderstanding.

Most forms of modern bullying leave no visible signs, and some camouflage it in ambiguity. It includes actions that might otherwise be regarded as just fooling around, such as hiding a person’s bags or shoes or scribbling on their books.

In many cases, the rest of a group or class bullies a single child and may even band together to deny those actions if questioned by a parent or teacher. For bullies, being part of a group of people doing the same thing diminishes their sense of responsibility for their actions.

The internet has also provided new and anonymous forms of ijime, further advancing the bullies’ sense of it being a game. Victims may find slanderous comments about them on social media platforms, or have photos or their address posted online, or repeatedly receive insulting messages.

MEXT data shows:

• Teasing, insults, repeated negative comments: Still the most common
• Group exclusion and silent treatment: A uniquely persistent form in Japan
• “Play-acting” violence: Poking, hitting, kicking disguised as “jokes”
• Online harassment and social media exclusion: Rapidly increasing, often happening in private chat groups or group LINE messages among classmates
• Forced acts, humiliation: This includes coerced “apologies” or dares

Bullying Peaks Around Middle School

© Photo by iStock: urbancow

An examination of when bullying occurs reveals one key reason as to why it occurs. MEXT research shows that cases rapidly increase from grade five of elementary school through to junior high school, with the majority of reported incidents emerging in the first grade of junior high school.

That period—around 13 years of age—coincides with adolescence and the physical and emotional growth of children, particularly the formulation of self-identity. Kids’ growth on the physical and emotional levels at this time can cause them stress and dissatisfaction, and bullying acts as an outlet for those feelings.

For bullies, experts note that many have issues at home or at school that are causing them stress, worry or a sense of inferiority, and they release those frustrations via their attempts to control others or attack them.

The Onlooker Issue

The dynamics of ijime include not only the bully—or bullies—and the victim, but also those nearby: onlookers who fall into two categories, the audience and the bystanders. The audience enjoys the show that the bullies put on. Bullies interpret that enjoyment as support for their actions, and that intensifies their actions.

Bystanders pretend they haven’t seen what is going on, most often because they fear that voicing an objection to it will make them a target. The bullies interpret this as implicit support. Many experts believe that the actions of onlookers can alter the direction of ijime.

If students could see that, in the long run, verbally objecting to the bullies helps their own situation because it weakens the bully and his actions, a key mechanism of ijime would wind down—but that’s a hard ask for a young child.

The social view of ijime has been a dark one: inhumane actions shrouded in silence and impossible to resolve. If there is no prospect of a solution, there is little incentive to report it to a teacher or parent.

Government Action & Policy Progress

© Photo by iStock: ferrantraite

In 2013, Japan passed the Ijime Prevention Methods Promotion Law, which requires schools to:

• Investigate bullying regularly (student surveys)
• Report suspected cases immediately
• Develop structured response systems
• Train educators and monitor cases closely

The law was passed after public outcry over the handling by a junior high school in Otsu City, Shiga Prefecture, and the board of education there, of the 2011 suicide of a second-grade student who was being bullied intensely.

The school initially denied that such actions had occurred. However, questionnaires among their students returned numerous accounts of bullying of the boy, verifying that the school tried to keep the information secret. When such accounts eventually emerged in news reports, the board of education downplayed the answers as being only hearsay.

A number of students also stated in the questionnaires that the boy’s homeroom teacher was aware of the bullying, had even witnessed it and laughed about it. Numerous other accounts said the boy had been repeatedly punched and kicked, told to die and forced to “practice” committing suicide almost daily.

It was widely considered that both the school and the local board of education had attempted to cover up the bullying, its connection to the child’s death—which occurred at home—and their responsibility for the events.

Does The Ijime Prevention Law Actually Work?

The law aims to prevent the recurrence of the structural problems that allowed the Otsu City boy’s case to go unchecked. It places responsibility for bullying on national and local authorities, as well as schools.

Although other cases of bullying have come to light even after its introduction, the ijime prevention law is at least a step in the right direction. It helps bring the problem out of the shadows so that we can see what is going on.

Under MEXT’s instruction, teachers are taking the stance—and teaching students—that ijime is unconscionable. The history of it so far has taught us that even though students may downplay it as just a little slap or joke, just like all the other kids are doing, every act of bullying causes pain.

To uphold our own sense of morality against an opposing wave—during adolescence of all times—may be one of life’s most challenging tasks, but in the end, it is the only way forward.

Supporting Your Child

© Photo by iStock: takasuu

Our children need our support. Make it a habit to talk with your child about their day and things that have happened at school, so that they feel comfortable coming to you if they have a problem. To prevent raising a bully, help your child experience compassion and caring for others from an early age.

If you suspect your child is being bullied but isn’t saying so, ask them how they spend their school recess periods and with whom, and inquire about how their good friends are doing lately.

Signs Of Bullying

• Silence
• Reluctance to attend school
• End of contact with good friends
• Talks less about school and friends
• Stealing money from home
• Unexplained bruises
• Damaged school supplies
• Excessive concern about their phone

If your child encounters bullying, listen carefully to what they say and how they want to approach the problem. Discuss the issue with their homeroom teacher and ensure that the principal is also informed. You will need to work closely with the school to overcome the problem.

Here are some options if you want to seek advice from other sources, too:

• The Tokyo Metropolitan Education Consultation Center: Holds English phone consultations on the Friday of each month, from 1 p.m. to 5 p.m. (Tel: 03-3360-4175). This free service can also arrange an in-person consultation. It is closed on public holidays.
• TELL Lifeline: Offers assistance in English to both children and parents from 9 a.m. to 11 p.m. (Tel: 0800-300-8355).
• 24-Hour Children’s SOS Hotline: Nationwide toll-free line for students facing bullying or school-related stress. Available 24 hours. (Tel: 0120-0-78310) (Japanese)
• Childline Japan: Anonymous support for children under 18, every day from 4 p.m. to 9 p.m. (Tel: 0120-99-7777) (Japanese; website available in English)
• Children’s Rights Hotline (Ministry of Justice): For human-rights issues, including bullying. Weekdays 8:30 a.m. to 5:15 p.m. (Tel: 0120-007-110) (Japanese)
• SNS Educational Counseling (Tokyo Metropolitan Board of Education): Consultation via LINE for school-related issues. (Japanese)

Bullying may never disappear entirely, but with increasing awareness, dedicated resources and open dialogue among educators, parents and students, continued progress is possible.

This article has been republished with the latest information.

At precisely noon each day, a small carton of milk, a steaming bowl of rice and a perfectly portioned side of fish arrive on every desk in my kids’ classroom. There’s no packed lunch from home, no chatter and no choice. This is kyushoku (Japan’s beloved school lunch system), and for many foreign families, it’s a cultural experience that takes some getting used to. When my Kiwi-born child started second grade in Japan, this daily ritual quickly became one of our biggest challenges as we learned to adjust to Japan’s school lunches.

I’d expected the language barrier to be hard. I didn’t expect lunch to be harder.

From Lunchboxes To Kyushoku

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In Japan, kyushoku is not just a meal. It is considered part of the curriculum, teaching children about nutrition, teamwork, etiquette and respect for food. Students take turns serving their classmates, eat the same dishes together and clean up afterward in the name of equality and community. It is a beautiful concept in theory and in practice, but for newcomers, it can be overwhelming.

Back home in New Zealand, lunchtime was a relaxed and social affair. We would take our lunchboxes outside, sit in groups and talk during the break. Teachers encouraged healthy food choices with rules against lollies and chips, but every child brought something different and the occasional quiet sandwich-for-home-baking trade was practically a rite of passage. If you did not finish all your lunch, that was your choice and your lesson to learn later.

Lunchtime in a Japanese classroom could not have been more different. Every student eats the same meal at their desk. There is no talking, a rule introduced during COVID-19 that still lingers in many schools. The result is a quiet, almost ritualistic meal where the only sounds are thirty-five children chewing, slurping and sipping milk in unison. For a child with sensory sensitivities, this was overwhelming. The combination of silence and the sounds of eating was difficult enough, but the food itself posed its own challenges.

Japanese school lunches are wonderfully balanced, often including rice, miso soup, a salad and a meat or fish dish, all carefully planned by a licensed dietitian. Yet for a child unaccustomed to these flavors or textures, it was a steep learning curve. The fish-heavy menus were the hardest. Tiny fried fish (shishamo) with their eyes still staring up were particularly confronting. Most days, my kid stuck to rice, bread and milk, sometimes facing a tray of food that had cooled by the time it reached the desk.

Cultural Expectations Meet Individual Needs

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In Japan, finishing everything on your plate is not only polite but also a sign of respect. It is still considered a moral value. The concept of mottainai, meaning “waste nothing,” is deeply ingrained. Teachers encourage children to eat every bite, both to teach gratitude and to help them experience a wide variety of foods. It is an admirable approach, but for children who cannot finish their meals because of sensory issues or appetite loss, it can also be distressing.

During my kid’s first year, the classroom teacher was strict and followed every rule closely. Every student was expected to clear their plate with no exceptions. The pressure around lunch built up day after day and soon my kid began to dread school altogether.

The following year brought a very different experience. The new teacher was patient, kind and understanding. He encouraged tasting new foods without pressure and allowed small accommodations, such as wearing noise-canceling earmuffs to reduce sensory overload. That simple change transformed lunchtime from something stressful into something manageable.

Helping Your Kids Adjust To Japan’s School Lunch System

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The biggest lesson I learned was that communication matters and the sooner the better. Speaking up respectfully about your child’s needs can make a world of difference. Each teacher handles lunchtime differently. Some are flexible, while others are more traditional, but most respond well when parents communicate calmly and show appreciation for the system, explaining individual challenges.

Here are a few things that helped our family:

• Wearing Noise-canceling headphones: We discussed this with the school in advance and the teachers approved it. It allowed my kid to focus on eating instead of the sensory chaos around them.
• A doctor’s note: If your child struggles to finish meals due to medical reasons, such as a reduced appetite caused by ADHD medication, a note from a doctor can help teachers understand that it is not a matter of defiance.
• Big breakfasts and after-school snacks: For a while, my kid barely ate at school. We compensated with hearty breakfasts and snacks later in the day. Japanese schools do not have a morning tea break like in New Zealand, so this helped bridge the long gap until lunchtime.
• Preparation at home: Talking about upcoming meals, explaining ingredients, or trying similar foods in a low-pressure setting helped reduce anxiety and made new dishes seem less intimidating.

Finding Balance At The Lunch Table

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I have come to respect Japan’s school lunch system, not just for the nutritious and affordable meals, but also for the relief of not having to prepare lunches every morning. Although it can be difficult to adapt to at first, especially for children used to a freer and more casual eating environment, kyushoku has encouraged my child to try foods they might never have been brave enough to taste before.

It takes time, support and a great deal of understanding. If your child comes home hungry or upset about lunch, it does not mean they are ungrateful or failing to fit in. It simply means they are human and adjusting to a new rhythm. Over time, they will adapt, build resilience and even begin to enjoy parts of the experience. Mine still does not love the cold soup days, but now eats happily with the rest of the class and celebrates their favorite meals.

Every foreign parent raising children in Japan will eventually find themselves walking the line between honoring local culture and protecting their child’s well-being. So if you are sending your child off to school and worrying about lunchtime, here is my reassurance:

They will not starve, they will not fall behind and they will learn at their own pace to navigate this unique part of Japanese school life.

How did your child adjust to Japan’s school lunches? Let us know if you have any advice or experience!

Hey Hilary—He’s On The Phone Again

I never thought I would be writing to anyone for advice, but I’m starting to feel like I’m losing my mind. My Japanese boyfriend and I have been dating for two years. I used to think we had a great relationship, but now I’m not so sure. He started out being so attentive and caring, but things have really gone wrong.

He’s constantly on his phone. He looks at it while we’re at restaurants, he takes it to the bathroom with him, and even takes it into the shower too. He still looks at it even when we’re holding hands and walking together, too. I have to make sure he doesn’t walk out into traffic because he would otherwise.

I don’t know if he’s just doomscrolling social media, either. He types sometimes, other times he smiles at the screen, and a couple of times I caught him making short videos of himself. He won’t share what he’s looking at even if I ask, and if I try to sneak a peek, he shuts the screen off and tells me it’s personal. I know phone addiction is a thing, but is it that, or is he cheating? How should I confront him about this?

—Phone Sick

Dear Phone Sick,

I can understand the frustration you must be feeling. No one wants to spend time with someone who ignores their very existence, especially not if you become their de facto guide so they can pay more attention to their phone.

Phubbing VS Phone Addiction

Phubbing is the term used to describe ignoring one’s partner or friends and focusing on phone use instead. This can happen among groups of friends or between couples on dates. While the person on their phone might not see anything wrong with this, the ignored partner is often left feeling an emotional disconnect and lower overall satisfaction with the relationship.

Phone addiction, on the other hand, is a behavioral addiction centered on the obsessive use of a smartphone. While people’s lives do tend to be oriented around their phones, the boundary between “normal use” and addiction isn’t based on the amount of time or usage, but their behavior when denied access to their phone.

Symptoms of phone addiction include lying about how much they use it, not being able to be alone without it, reaching for it immediately when bored, and anger or irritation if their phone use is interrupted.

Another warning sign is an inability to walk or do other activities without having their phone on in some capacity. The Japanese term  “○○ながら” (‘something’ nagara) means “while doing [something]” and has become shorthand to refer to people doing an activity while on their phones. You mentioned having to act as his guide because of his phone use. 

From my perspective, it does sound more like a phone addiction than him phubbing you. Not that that’s very reassuring, I’m sure. What is more concerning, however, is the fact that he’s hiding the phone from you.

Adultery

Shutting off your screen and telling people something is personal in and of itself isn’t necessarily a bad thing. However, repeatedly doing so, keeping your phone constantly with you, smiling at the screen, and typing at odd hours or more than usual are all classic red flags of adultery.

Ask yourself these questions: 

• Has he always been secretive about his phone? 
• Have you ever been allowed to look at it before? 
• Does he get angry or defensive when you ask to see his phone? 
• Is your partner spending less time with you, or does he suddenly seem busier than usual with friends or work? 
• What is your gut telling you?

The last question may be the hardest of all, as it means facing the possibility that he has been cheating on you for some time and hiding it in plain sight. There are several ways to handle this, of course, and the option you choose is entirely up to you.

First, you can ghost him. 

Not in the traditional sense, but rather you withdraw from the relationship, essentially. He’s been ignoring you and your presence in favor of his phone and whatever he’s doing on there, so why give him access to you any longer? Avoid texting or calling him as often, and refrain from sharing your news with him. Instead, make plans to do other things or spend time with friends rather than him. Make making yourself happy the priority, and you’ll start to see positive changes in yourself.

Whether he’s addicted to his phone or cheating or both, he will either not notice or notice too late. You’ll have your answer: you weren’t a priority to him, and that’s his loss, not yours.

Your second option is to confront him directly. 

If you choose this route, you must be prepared for what a direct confrontation can entail. I don’t know you or your partner, but doing this in a public place tends to keep people from reacting with the level of vehemence they might in private.

I would start by asking him to put his phone down, then telling him how you feel, and that you suspect him of cheating on you. How he reacts is entirely up to him, but how you perceive his response will tell you everything you need to know. Whether he comes clean about cheating, tries to gaslight you into thinking you’re wrong, or gives you his phone and/or proves his innocence, he has still been guilty of ignoring you in favor of his phone.

I think you yourself already know what you would like to do, but understandably, you would want outside validation of your feelings as well. Just remember, you don’t deserve to be ignored or cheated on, and you should never have to beg for attention from someone who claims to be your partner—best of luck!

Got a question you’d like to ask Hilary? Email it to askhilary@savvytokyo.com with the subject “Ask Hilary.”

You’re walking home late at night. Someone is following you. You squirt pepper spray in the person’s face. You’re just defending yourself, right? Not quite. According to the laws on self-defense in Japan, you can quickly morph from the victim into the aggressor if the court deems it necessary.

Recently, Japan has been reeling from disturbing stories of stalking and the murder of women in particular. In Kobe, Megumi Katayama was stabbed to death in her building’s elevator by a stalker. In Kanagawa, Asahi Okazaki was stalked and allegedly murdered by her ex. These stories have led to a spike in the sale of pepper spray as women prepare to defend themselves. But legal experts warn that the law may not be on their side.

What Is Self-Defense?

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Legal self-defense, or 正当防衛 (seitou bouei), is a tricky concept. What is considered self-defense in other countries may not fly in Japan. Article 36 of the Japanese Penal Code lays out the law. To use self-defense, you need to prove that:

1. Your attacker broke the law, i.e., the attack was illegal.
2. The attack was “imminent,” putting you in immediate danger. In other words, you had to defend yourself on the spot.
3. Your defensive actions were proportionate to the attack. You did not counterattack with excessive force. Also, you did not defend yourself before or after the threat had passed.

What Is Not Self-Defense?

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Article 36 also states that if you defend yourself “excessively” (かじょうぼうえい/kajoubouei),  the judge may reduce or exempt you from punishment, depending on the circumstances. 

Let’s give an example. A man gropes you on the train and swiftly exits at the next stop. You chase him down and beat the crap out of him. He deserves it, right? Maybe, but the court may see things differently. Why?

The court may judge that when your attacker escaped, the threat from the groping expired. You were no longer under “imminent” attack and your defensive actions appear vengeful. Your attacker may even press injury charges because you over-defended yourself.

What About Using “Weapons”?

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Let’s go back to the pepper spray example. If you carry pepper spray in public, you could be charged under the Misdemeanor Act. It’s illegal to hide and carry, without a valid reason, a knife, iron rod or any device that can be used to harm a person’s life or body. In this context, pepper spray can be considered a “device” that could hurt someone.

As mentioned in the first paragraph, if you spray your stalker even though he hasn’t touched you, he could press charges because you injured him without a good reason.

In the same way, if you were carrying a household item like a pair of scissors or an umbrella and you used it to over-defend yourself, you could be charged with injury. If convicted of injury under Article 204 of the Japanese Penal Code, you could face a fine of ¥500,000 or go to prison for up to 15 years. Talk about being on the wrong side of the law!

Domestic Violence: An Iffy Situation

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Let’s look at another scenario. Your significant other has grown increasingly abusive and violent towards you. One day, when he threatens you as he usually does, you counterattack with such force that you kill him. 

This happened in a 2014 domestic violence (DV) case. The Sapporo District Court acquitted the defendant on the grounds of self-defense. During a heated argument at home, the defendant stabbed her partner in the shoulder and he died. The court found that the attack was immediate. The victim kept hitting the defendant and she could not escape without defending herself. They also found that the stabbing was proportionate to the victim’s repeated violence.

However, in another DV case, in 2019, the Nagoya District Court did not allow the defendant to plead self-defense. Here, the defendant suffered years of abuse. One day, her husband proceeded to attack and threaten her as usual. She strangled him to death. The court judged her actions as “excessive” and that she should have tried to escape. However, she received a lesser sentence because of the history of violence.

These two cases clearly show that, even if parties have a long history of abuse,  the court will always pay attention to the “imminence”  and “proportionality” of the defendant’s actions.

What Can I Do To Defend Myself Legally?

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Back to that old pickle. Now that you’re clued up about self-defense laws in Japan, what is legally permitted to protect yourself, others and your property from would-be attackers?

If attacked, you should:

1. Block, push away or otherwise escape your attacker.
2. Defend yourself only to the extent of stopping the attack.
3. Scream, yell out or use a rape alarm/security buzzer to alert others around you.
4. Report the attack at the nearest police station or koban (police box).

To minimize the risk of being followed and attacked:

1. Be aware of your surroundings. Ditch the screen and earbuds. 
2. Walk in well-lit areas or areas with surveillance cameras. If the area looks dodgy, take a taxi.
3. Live in an apartment higher than the second floor.
4. Hang out men’s underwear/clothing on your washing line outside to showcase a male presence.

Other things to try for ease of mind:

1. Learn aikido. Unlike other martial arts, in aikido, you do not attack but rather “redirect” the actions of your attacker to defend yourself.
2. Keep pepper spray at home for emergencies. Although it is illegal to carry around as a self-defense weapon, it is completely legal to have it stored in your home.
3. If you have any suspicions, inform your local police immediately. They may not be able to take immediate action without evidence, but they can increase patrols in your area.

Of course, it’s easy for things to get iffy in the heat of the moment because life is life. Whatever happens, keep your head on and protect yourself. Just don’t overdo it.

Have you or a friend ever experienced a situation like this? How did you defend yourself? Read more about groping in Japan and how you can deal with the dreaded chikan.

Disclaimer: This is not legal advice but for information purposes only. Please consult a qualified attorney if necessary.

Everyone knows that death is inevitable. If you are married to a Japanese national and living in Japan, then there may come a time when you lose your spouse. Losing a partner in Japan can happen after a long illness, old age, or something very sudden and unexpected. Calling it an unpleasant experience is putting it extremely mildly. Grief takes a novel rather than an article to describe adequately.

I’ve lost a partner, and I’ve known several people, Japanese and foreign, who have lost a spouse/partner as well, both in Japan and while living abroad. How was the experience? Well, in short:

“It sucks. You lose everything in no time at all, and nothing is ever going to be the same again. Does it get better? I mean, it gets less bad with time, but that’s not really encouraging” (Sarah, 59).

The Emotional & Physical Toll

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Grief is a total body experience. Emotionally, you may be numb, sad, lonely or struggle with feelings of guilt, anger and fear. Or any combination of the above at the same time.

Physically, grief causes sleep disturbances (too much or too little), a weakened immune system and an increased risk of heart problems (Broken heart syndrome). The stress of a loss, especially of a partner, can lead to unhealthy coping mechanisms, which can increase or worsen your health as well.

Many people have experienced loss while living overseas away from their families. Grieving as an expat has its own layers of isolation, to say nothing of the logistical challenges or impact that cultural differences can have.

What about grieving the loss of a partner while living in another culture?

“There are so many rules you have to follow with funerals in Japan that it helped me grieve in the short term. People could tell me what to do, what I had to wear and that made it easier. Until it didn’t, then I was a train wreck. It hasn’t been easy, but I found talking about it [in a support group] has made it more tolerable” (Jean, 43).

As unimaginable as it might sound, there will come a time when grief doesn’t hit you as hard as it once did. The complicated mix of feelings eases, and eventually, you may feel like your old self again. However, this isn’t always the case.

Complicated grief, also known as persistent complex bereavement disorder, essentially means that the painful emotions of grief are so severe and long-lasting that you struggle to recover and resume your own life.

“My mother [Japanese] couldn’t function after my father [American] died. She tried to take her own life, and I had to put her in a hospital to get treatment. She’s still struggling, but doing a little better. I started going to counseling after she was hospitalized, too” (Maya, 33).

If you are still in intense grief and unable to move forward even in the slightest, a year after your loss, please seek help. There are always places to turn to for help with your mental health. For more information, please see this article on counseling in Japan.

Death & Work

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Japanese employers must provide their full-time employees with bereavement leave, or ‘condolence leave’ kibiki kyuka (忌引休暇). That being said, they are not required to provide said leave to anyone working part-time, on a short-term contract or as a dispatch or temp worker.

The amount of leave you’ll be given depends on your relationship to the deceased. If you are a partner, you will be given five days. You can get an additional two days if you are in charge of organizing the funeral. Any other leave will either have to be negotiated or used as paid/unpaid time off.

Five days. A business week. That doesn’t sound like much, and it isn’t for most people.

“When my wife died, I powered through and went back to work, but I didn’t care anymore. I was already old enough to retire, and so I did. I had to—I wanted to do what we couldn’t instead. Our kids were glad to have more time with me. I think it helped us all to grieve” (Keith, 68).

The Practical Aspects Of Loss

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They say that “nothing is certain except death and taxes,” and both involve more than their fair share of paperwork.

“I had no idea what to do when my wife died. She handled everything in terms of paperwork for us for so many years. I didn’t know where anything was or what kind of Buddhist my wife was until her older brother explained where their parents’ grave was” (Alan, 71).

There are a number of steps involved when reporting the death of a partner, which have been covered more in depth here. What bears repeating, however, is that any foreigner married to a Japanese partner will have extra requirements to meet. Failure to do so can and will lead to many more complications that no one should have to deal with while grieving such a deep loss.

Contacting & Reporting

You have to contact your local immigration office within two weeks of the death if your partner is a Japanese national. For most foreigners married to Japanese nationals, your status in Japan is a  ‘Spouse or Child of Japanese National’ visa, and, as cruel as it sounds, their death effectively cancels your visa status. 

When reporting to the immigration office, you will need to submit a 配偶者に関する届出 (haigusha ni kansuru todoku; “Notification of Spouse”), your passport, your residence card, your spouse’s death certificate, proof of your spouse’s Japanese nationality and your marriage certificate.

Upon their death, you have two options: to remain in Japan or to move back to your country of origin. If you wish to leave, you have up to six months to stay in Japan and take care of the inheritance process, etc.

Staying in Japan After Loss

If you intend to remain in Japan, however, you will need to submit a 在留資格の変更 (zairyushikaku no henko; “Change of Status of Residence”) form as well as the documents mentioned above.

Failure to submit this document can mean your visa is revoked or denied. If, for any reason, your visa status change isn’t granted, you might be given a ‘Designated Activities’ temporary visa (特定活動ビザ; tokuteikatsudo biza) so that you can deal with the estate and prepare to move overseas.

Hopefully, you will not experience losing a partner in Japan and the struggles that accompany it for many, many years to come.

Over the past two years, drugs like Ozempic and Mounjaro have gone from quiet prescriptions for Type 2 diabetes to global household names. Thanks to celebrity testimonials, viral TikToks and endless headlines, these GLP-1 medications (short for glucagon-like peptide-1 receptor agonists) are now strongly associated with rapid weight loss. Japan hasn’t escaped the buzz. English-language ads for Ozempic and similar drugs are now common across social media, often targeting foreign residents. If the constant media push has you wondering about Ozempic in Japan, here is your Savvy Guide to these medications.

GLP-1 Drugs Approved in Japan

© Photo by iStock: Munro

Can you actually get Ozempic or similar “weight loss injections” in Japan? The answer is yes, but only under strict medical criteria. The three most common medications available are:

• Ozempic (Semaglutide): Approved in Japan in 2020, Ozempic is officially prescribed for type 2 diabetes management. Some doctors may provide it off-label for weight loss, but this is not common practice.
• Mounjaro (Tirzepatide): This newer GLP-1 medication was approved in 2022, also for type 2 diabetes treatment. Like in the case of Ozempic, its recognized role in Japan is blood sugar control, not weight loss.
• Wegovy (Semaglutide): Wegovy is the only injectable medication approved for obesity management and has been available since 2023. It’s covered under Japan’s National Health Insurance (NHI) if you meet the criteria (BMI ≥35, or ≥27 with related health conditions such as hypertension or diabetes).

Several other GLP-1 medications are also now available in Japan, including Rybelsus (oral semaglutide), Saxenda (liraglutide), Trulicity (dulaglutide) and Byetta/Bydureon (exenatide). These are usually prescribed for managing type 2 diabetes rather than weight loss.

The Cost: What You’ll Pay With & Without National Health Insurance

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Whether these drugs are covered by National Health Insurance (NHI) or not makes a huge difference to your monthly costs. Japan’s NHI usually covers 70% of drug costs, leaving patients to pay about 30% out of pocket.

Here are the official 2025 prices and typical copays for the three most common medications available (monthly estimates are based on four weekly doses at the lowest available dose and exclude clinic visits or test fees):

The Marketing Push To Foreigners

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If you live in Japan and spend any time on social media, you’ve probably noticed the rise in ads for “weight loss injections.” Even if your feed has nothing to do with dieting, it’s now common to see English-language promotions for Ozempic, Mounjaro or similar drugs.

These marketing campaigns target foreign residents because access through Japan’s public health system is limited. Strict NHI criteria and a lack of English-language support often make it harder for foreign residents to get GLP-1 medications. Private clinics are well aware of this gap, and so they have begun to market aggressively to international residents, often charging significantly higher, out-of-pocket prices.

Private English-Speaking Clinics Offering GLP-1 Treatments

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If you don’t qualify for coverage under Japan’s National Health Insurance (NHI), or if your doctor isn’t supportive, several private English-speaking clinics do offer GLP-1 medications. These clinics can be convenient, especially with bilingual staff and telemedicine delivery, but they can cost two to three times more than NHI-covered prescriptions.

It’s worth checking the fine print before signing up so you know exactly what you’re paying for. Some clinics bundle everything (consultations, follow-ups, needles, alcohol swabs, even travel letters) into one package. Others only list the medication price upfront and bill separately for extras like blood tests.

These are a few well-known clinics offering GLP-1 weight loss treatments in Japan:

• Hada no Clinic (Tokyo): Bilingual clinic advertising weight-loss programs that include check-ups and counseling.
• Bianca Clinic (Tokyo): Provides Mounjaro and other GLP-1 injections for weight loss, marketed as weekly treatments.
• Tokyo Medical and Surgical Clinic (Tokyo): Longstanding international clinic in Tokyo offering weight loss treatment programs, including GLP-1s, with English-speaking doctors.
• Juniper: Telemedicine platform with English consultations, nationwide delivery and travel letters for medication.
• E-Life Clinic: Offers online consultations and pricing packages for Ozempic, Mounjaro and Saxenda.

Important Factors to Consider

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If you’re thinking about trying a GLP-1 medication like Ozempic, Mounjaro or Wegovy, it’s worth looking beyond the hype. These drugs can be effective, but they also come with real risks that shouldn’t be overlooked.

How GLP-1 Medications Work (& What to Expect)

One of the main ways GLP-1 medications like Ozempic work is by slowing gastric emptying. Put simply, food takes longer to leave your stomach and move into your intestines. This makes you feel full sooner and stay full for longer, reducing your appetite. The exact mechanism, however, is also what causes many of the most common side effects: nausea, bloating, a constant feeling of fullness, stomach pain and sometimes vomiting.

Studies show that in some cases, GLP-1 drugs can cause gastroparesis, a condition where the stomach doesn’t empty properly, leading to severely delayed digestion and awful side effects. Having lived with gastroparesis myself, I can say it’s more than an occasional upset stomach and will drastically impact your quality of life.

Don’t just take my word for it. In clinical trials, nausea was reported in about 44% of people taking higher doses of semaglutide, while vomiting affected roughly 25%—making these two of the most common side effects. That’s also why you need to factor in the ongoing cost of additional medications, like anti-nausea tablets, which are often needed to manage these symptoms.

Other side effects frequently reported with GLP-1 drugs include diarrhea, constipation, acid reflux and abdominal pain. These symptoms are often worse at higher doses or when the dose is increased too quickly. Because of these risks, it’s essential to carefully weigh the benefits of these medications against the possibility of long-term side effects.

These medications can be useful tools, but they’re not quick fixes and carry real risks. If you’re considering them in Japan, always start by speaking to your doctor and making sure you understand both the benefits and the downsides.

As you rush around the city to make it in time for your next appointment, how do you find the time to simply be still? It is far easier to meditate in the surroundings of a lush and serene temple in rural Japan than in the heart of Tokyo, but if you can do it here, then you can do it anywhere! Bring inner peace into your daily life with these five meditation tips to help improve your life in Tokyo.

1. Give Yourself Permission

We all deserve a little ‘me’ time, and a few minutes spent in meditation will make you a calmer and more productive person. People often make excuses about their obligations to their family or their colleagues as reasons why they can’t find the time to begin a meditation practice.

There is absolutely no need to feel guilty about taking the time to meditate.

2. Schedule A Time

No matter how busy you are, you can always find five or 10 minutes to sit and meditate. In the beginning, a few minutes before you go to bed or as part of your evening ritual works well.

Another option would be to spend a few minutes meditating at the end of your lunch break. If you have to miss a meditation session one day, don’t be too hard on yourself. This is an activity that you want to do, not another thing that has to be done!

3. Meditation Can Be Done Anywhere

Meditation does not have to be done on a special cushion in an incense-infused room. You can do it on a park bench, on the subway, or even while walking along the street. If you become too rigid about the “right” way to meditate, then you will miss the opportunity to include it in your day.

If you turn up early to an appointment or find yourself waiting for someone who is running late, use the opportunity to simply sit for a few minutes. Don’t switch on your phone!

4. Observe Your Thoughts

Many people get frustrated with meditation because they can’t control the myriad thoughts racing through their minds. This is perfectly normal in the beginning, and it shows that you are human! When this happens, choose not to get frustrated but instead just observe the thoughts. If you start attaching to the thoughts, then one will lead to another, and you will find yourself getting caught up in a spiral of drama.

It takes some practice, but when the thoughts come in, make a conscious choice to let them go.

5. Make Your Daily Activities A Moving Meditation

It is not necessary to sit still to meditate. There are many forms of moving meditation that you may not be aware of, such as painting, dance and tai chi. You can even make your daily chores a moving meditation. Washing the dishes or ironing can become a meditation if you choose to allow yourself to be mindful of what you are doing.

Once you begin a meditation practice, you will see many opportunities throughout the day to include some form of meditation. It is all about personal choice and how you react to your environment.

The more you do it, the more you will want to do it, and before you know it, you will be that serene person gliding through the streets of Tokyo!

Let us know your meditation tips for those in Tokyo via the comments below!