Wednesday, November 9, 2011

Neoliberal healthist? Yes ma'am

I typically stay from politics but I can't keep clam about this one. Here's the deal:

Normally the word "neoliberalism" has negative connotations to me. Well, apparently I am guilty of being a NEOLIBERAL HEALTHIST and I'm owning it. Last week, my best friend was at the biggest conference in public health (American Public Health Association) and started texting me from a session entitled:

Introduction: The focus on obesity at the individual and health behavior level can mask the social and structural production of obesity. It has also proven to be largely ineffective, as the increasing levels of obesity in the U.S. have shown. Further, the focus on 'obesity reduction' may alienate women of larger sizes and actually result in their engaging in fewer health behaviors, such as exercise, due to issues of stigma. 

So take everything you read here with a grain of salt, I did not attend the session and this is clearly NOT my area of expertise BUT...I play a health expert in blogland.

I was so intrigued by my friend's texts (i.e., rants on the fact that health statistics show you can't be healthy at any size) that I had to do some internet searching on this new term for lack of any other route to learn more. I found masters theses, Ph.D. dissertations, blog articles, online mag articles, and articles from peer-reviewed literature on this topic. And they incensed me!

From what I can gather, neoliberal healthism is that idea that the individual is responsible for obesity and poor health and that good health can be achieved through one's own determination and actions. The neoliberal healthist believes that the individual is responsible for choosing a healthy lifestyle and even has a social obligation not to be obese, not be unhealthy, because of the high cost of disease to society (e.g., diabetes, cardiovascular disease, etc). According to some folks out there, including those who spoke during this session, this is BAD to put everything on the shoulders of the individual.

They believe that focusing on the individual masks the problems in society and culture that contribute to obesity. Oh, and don't use the words "obesity" and "obese" because it makes people feel bad and creates an intimidating environment.

I can see where they're coming from with using the term obesity. BUT I don't see any reason why individuals shouldn't take responsibility for their own health and when people don't take responsibility, I think it makes it MY problem, our problem. And that's not cool, yo.

I strongly feel that when they say we shouldn't focus on the individual, they are taking POWER AWAY FROM ME. They are telling me, "Sorry hon', but you're weak, you really cannot resist temptations out there, you aren't capable of taking care of yourself or making healthy lifestyle choices, you really can't change anything about your life. Just give up, we'll try to take care of this one for you by fixing all the problems with our media, marketing, food production and service, educational system..."

Sure we need to make larger changes at the societal and cultural level but in our free market system, I think we have to affect change from the bottom up. We have to make the change through our lifestyle choices, using our power as consumers. It's not happening from the top down. Unless you think the federal government can get away with a cap & trade system on sugar, fats, and preservatives in food?

This really struck a chord with me and was quite upsetting. It challenges my belief that I AM an individual, I am empowered to make smart choices. Also, I'm raising a toddler and I put a lot of effort into trying to teach him personal responsibility and consequences for his actions, so how can people say that making individuals responsible for their actions is WRONG?

What do YOU think? 

If you find this interesting, do you own searching and look into this then tell me what you find out.


  1. Apparently I'm a neoliberal healthist too! I agree that we need to take responsibility for our actions in all aspects of our lives. There will always be some external factors that we can't control, but we can minimize their effects and be the best person we can be.

  2. People who are obese didn’t get there over night. I enjoyed reading Tricia’s post at endurance isn’t only physical about this topic. I think that it is absolutel y our responsibility to make the right choices for ourselves. and it is possible-just look at the biggest loser. i agree with your bottom up mentality but i think that those who live with less income choose the “bad stuff” because eating right is so expensive. fruits and veggies are much more expensive than a box of mac and cheese or hamburger helper type meal (and sadly 1 pint of blueberries is more expensive than a happy meal). our society needs to demand a change but unfortunately i don’t think most of society can afford to do so.

  3. I completely agree with you. I don't know why so many people shy away from owning their own life. I also like to have the power and ability to change my own life and am willing to take responsibility for my own actions and the results that come with them. The commercial on tv that really drives me nuts is for a weight loss clinic whose slogan is "it's not you, it's your metabolism." Okay, so great if this clinic is helping people lose weight, but what a load of crap that slogan is. It might be your metabolism that is a problem, but it is you making the decision to make a change, call the weight loss clinic and follow their plan.

    Oh... and on another note, I've not been commenting much and blogging not at all but I'm still reading & enjoying your blog!! I just passed your name along to a friend I run with who is moving with her husband & two young girls to the Seattle area so she might look you up. :)

  4. I agree with you! Virtue is needed not excuses, or government programs etc. etc.! I made myself fat and now I am running and eating better and losing weight! Cause and effect. There are healthier low cost choices such as bananas,apples, beans, peanut butter. I find that when you eat healthier, low glycemic foods you eat less, because they nourish and fill you unlike high sugar processed foods. Besides, I can spend extra on good food or pay for medicine and doctor bills.

  5. I guess I'm a neoliberal healthist too. I agree that a person should be fully responsible for their actions that make them fat and they shouldn't be able to blame something else. However, I think our society does tempt people with too large of portions, McDonalds saying their food is healthy and healthy food being more expensive than crap food. But all in all, it is a decision that rests in each one of our hands whether or not to pick the crap food up and put it in our mouths or finish off that huge plate of mexican food.

    Thanks for shedding light onto this, Alma!

  6. Thanks for this post, Alma. This ties in with so many thoughts I've been having lately. I'm incensed that anyone would promote the idea that personal responsibility is a BAD thing.

  7. I can see your point, Alma, empowerment is very important. However, consider this: obesity rates are highly correlated with income. Of course, that doesn't mean that poor people have no control over their health but there is absolutely no doubt that the odds are stacked against them. There are a myriad of reasons for this - of which I am sure most of us are at least somewhat aware of.

    This issue strikes close to home for me because I've been learning about the "achievement gap" in higher education - that is, white students whose parents went to college are much more likely to do well in college that students of color and white students who are first generation college-attendees. Studies have shown that universities can reduce that achievement gap if they provide resources to help disadvantaged students (tutoring centers, extra TA support, etc.). These programs are essentially teaching smart, capable students how to succeed in college - skills which most children of college graduates learned at home. Unfortunately with budget cuts, many of those extra resources are disappearing and the achievement gap is reappearing. Studies that address the achievement gap have shown that disadvantaged students can do just as well as other students if given appropriate resources. Ignoring them only perpetuates the problem; the disadvantaged continue to be disadvantaged.

    I believe that the same applies to living a healthy lifestyle. If we put all the responsibility for health on individuals, we are ignoring all the factors that lead to a higher risk of obesity in people from low-income backgrounds. I think that is unfair and I think it does not address those larger societal-level problems that put certain groups of people at risk.

  8. I agree with you a hundred billion percent.

    That's all.

  9. This is a very interesting post that I agree with for the most part.

    I agree that no one can make anyone decide to live a healthy life,and that it is the responsibility of the individual to make good choices in their own health. No government program can make someone decide to lose weight and be active.
    However, I think that everyone needs to be educated on how to do so. And right now in this country there are people who do not know the facts on healthy eating and exercise.

    Healthy food can be expensive, BUT it is actually less expensive than the dollar menu everyday. What is truly expensive is the time it takes to make healthy meals.
    When people are impoverished, under-educated and have to work more than 1 job to support themselves, something is going to go by the wayside, it will almost always be their health because the immediate problem is that they can't pay the bills, not that what they're putting in their body is slowly killing them.

    Somethings need to change socially, but a lot of it should rely on the individual. That is why I support incentive programs for the lower income regarding health, do something get something.

    I definitely think that this "[the individual] has a social obligation not to be obese, not be unhealthy, because of the high cost of disease to society." is something important to focus on. Health costs are driven up by folks who do not take care of themselves, if we all made the decision to live healthier lives, but also gave back and helped others live this way, then everyone would benefit.