I really enjoyed this. I gave it a 4/5 though it may rate higher than that at some later date. I must ponder. I was skeptical when I started but the story kept me going. The world building was efficient and readers are brought in without needing to understand the world's entire history. The information flow was natural for me.

Though the story is Japanese, it shines a light on the sort of "health is a virtue" social more we're experiencing in Western culture. In the story, if you smoke or drink or overeat you're worthy of scorn and forced to undergo psychological treatment. 

It also reflects the nascent "kindness culture," where one must display favorable views towards all, regardless of one's own personal feelings. It's a society whose citizens are legally and morally compelled to act in a healthy manner for the benefit of the state - no matter the human cost. Japanese culture is much more homogeneous than US culture and those who are different are that much more obvious. The sort of social pressure in the book carries more weight if seen in that light. All aspects of life are controlled to facilitate physical and mental well-being or, at least the outward appearance thereof. Almost the entire planet lives in a gilded cage. And almost everyone wants it that way. They dare not want it any other way. Society chose safety over freedom and found itself deserving of neither. Conflicts internal to one's psyche arise when one's own desires do not align with those of the state. Most simply blame themselves for not living up to the standards. That's when some people take drastic action against themselves.

I liked the somewhat controversial "emotional markup language." Some readers don't. Some like the story if they ignore it. I found it interesting and it mostly avoided long stretches of otherwise cumbersome exposition. It was refreshing to get an info dump essentially marked up and formatted as one - like a Wikipedia article. I found it novel and a clever evolutionary adaptation in storytelling - a modern aside or chorus, as it were. I did not find it distracting or overdone. I got used to it quickly.

The story moves. I knocked it out in a few sessions over a couple days. The prose is approachable and readable. And it takes you places. There's a bit of international intrigue in there. Altogether it was an interesting story with flawed characters attempting to live flawed lives in a state where flawlessness is mandatory. The execution was a bit pulpy but it was well written and I must remember what I read was translated from Japanese. So, on balance I found it rather well done.

Some areas explored in the book are very dark. Sexual exploitation, while not the central focus of the story, is described. This may upset some readers. It is not gratuitous. Its presence does explain certain aspects of the story. The author does not linger in this area. But it is present. I found it distasteful and unnerving but otherwise necessary to the story. And it stood in stark contrast to the sanitized media consumed by the denizens of the story. It was effective.

If I had to nitpick I would say the epilogue was wholly redundant. I felt it diluted the story, which I found rather sad and horrible in a good way. I was tearing up at what was clearly the end. I got it. But then there was more tacked on to explain what I had just read and understood. I felt the book was obvious enough without further explanation and would have preferred an abrupt end. Your mileage may vary. Nevertheless I came away from the book profoundly depressed.  It worked. I felt something, which I believe was Itoh's point.