Disordered eating and the contradictions of neoliberal governance

Abstract

The last decade has seen the development of an important literature on the contradictions between neoliberal norms of corporal citizenship and the forms of consumption that market-based food systems promote. This paper seeks to contribute to the literature by exploring the relationship between these contradictions and the increased prevalence of particular eating disorders (binge eating disorder (BED) and bulimia nervosa). Within contemporary neoliberal food systems bingeing is increasingly normalised and consumption temporally disorganised. At the same time, neoliberal public health policy, and the wider 'health' entertainment media it legitimates, focuses on the promotion of 'correct' forms of consumer agency. Individuals who fail to manage consumption 'appropriately' are stigmatised. The growth of bulimia and BED can be related to the contradictory pressures that the food system and regime of corporal governance place on individuals. The paper also seeks to explore how the increased medicalisation and biomedicalisation of eating since the 1980s fits within a broader neoliberal governance strategy. By medicalising key social problems the neoliberal state depoliticises these issues. Medicalisation and biomedicalisation obscure the role of capitalism in generating these problems and encourage a focus on individual dysfunction.

21st-century capitalism: structural challenges for universal health care

“…“Income and its distribution, income inequality, economic insecurity, and unhealthy lifestyles link trade policy to social determinants of health” ([42], p. S15). As Pirie points out, “the growth of income inequality has had a far more direct role in shaping the development of the fast food industry” ([46], p.846). Two mutually reinforcing dynamics propel the global spread of the fast-food industry: it depends upon an ample supply of low-wage flexible labor, and these poorly paid workers create additional demand for cheap, filling food [46].…”

“…As Pirie points out, “the growth of income inequality has had a far more direct role in shaping the development of the fast food industry” ([46], p.846). Two mutually reinforcing dynamics propel the global spread of the fast-food industry: it depends upon an ample supply of low-wage flexible labor, and these poorly paid workers create additional demand for cheap, filling food [46]. The association between “increases in obesity, reductions in time spent in food preparation and a shift toward consumption of processed foodstuffs” is well-documented in both developed and developing countries ([47], p.112).…”

“…Biomedical public-health discourses and industry narratives around individual responsibility and choice-centric conceptions about consumption obscure these structural dimensions. As Pirie notes, “medicalization and biomedicalization obscure the role of capitalism in generating these problems [eating disorders] and encourage a focus on individual dysfunction” ([46], p.839). These approaches “reduce the pressure on the state to intervene in the market” ([46], p.841).…”

Activity‐based analysis of sociotechnical change

“…The promotion of the nutricentric health‐conscious food consumer coincided with the neoliberal public health regime that demanded individuals/subjects to take responsibility for the management of their health (Pirie, ; Siedlock, Smart, & Gupta, ). At the same time, epidemiological studies by national and international organizations stressed the importance of food in the causes of illness, and nutritional scandals and other publicized events (e.g., mad cow disease) highlighted the risks associated with the consumption of mass‐produced food (Dixon, ).…”

“…Health care organizations and insurance companies have been experiencing additional pressure because of the increase in life expectancy and in the percentage of aged population, which usually is not in good state of health (Stone, ; Papachristos and Adamides, 2016). These issues introduced “self‐care” and “prevention” in the strategies of the pharmaceuticals industry (Pirie, ; Siedlock et al, ). At the same time, in the supply side, increased regulation of clinical trials and production processes resulted in longer development times and higher costs and exposed large firms to competition from generic drugs (Malerba & Orsenigo, ).…”