60% of us Americans are overweight. We even have lots of obese homeless people. Even among the poorest of the poor here in the U.S., I'd argue that obesity is a bigger problem for them than malnutrition.

Even in the U.S., Japanese products come much later than they do in Japan. Nintendo is getting its ass kicked by Microsoft everywhere except Japan so I wouldn't be surprised that they're focusing on Japan since they're not doing well anymore anywhere else.

U.S. and Canada (except Quebec, which I think requires French version games to be sold at the same time as English versions) have the same version so that's 1 version for 326 million people. Japanese actually save way more money than most that's why their economy is not doing well right now. However, they spend a lot on videogames and they also only require 1 version for 127 million people.

Europe is a different matter, though. France requires a French version that will be sold to 60 million people. Germany requires a sanitized, Saturday morning cartoon-like German version for 82 million people. The U.K. has 60 million people but needs their own English version. Many different European countries also need their own version. When a company thinks market, they consider each required version as a different market.