Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it's become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating--such as special taxes on sugary drinks and the banning of food deemed unhealthy--critics argue that these policies are paternalistic, (...) and that they limit individual autonomy over food choices. In Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Anne Barnhill and Matteo Bonotti show that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. The authors therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a 'farm to fork' approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a concrete tool for assessing policies that will be of interest to both scholars and policymakers. As well as offering a novel normative analysis of healthy eating policy, the authors offer a new theoretical framework that will be applicable to a wide range of public policy scenarios. (shrink)

States are increasingly implementing policies aimed at changing people's dietary habits, such as fat taxes, food bans, and nudges. In this article, we ask whether healthy eating policies are consistent with public reason, the view that state laws and policies should be justified on the basis of reasons that all citizens can accept at some level of idealisation despite their different conceptions of the good. What we intend to explore is an ‘if…, then…’ line of thought: if one (...) is committed to public reason, then may one consistently endorse healthy eating policies? First, we illustrate multiple ways in which contemporary societies are characterised by a reasonable pluralism concerning conceptions of health and values attached to eating practices. Second, we critically assess the implications of three main conceptions of the structure of public reason, i.e. ‘shareability’, ‘intelligibility’ and ‘accessibility’, for the public justifiability of healthy eating policies. We conclude that healthy eating policies are only consistent with public reason under the ‘accessibility’ conception, i.e. if they are based on reasons grounded in shared epistemic and moral evaluative standards, as long as such reasons reflect a reasonable balance of political values and do not overly prioritise or neglect any of these values. (shrink)

Who gets to decide what it means to live a healthy lifestyle, and how important a healthy lifestyle is to a good life? As more governments make preventing obesity and diet-related illness a priority, it has become more important to consider the ethics and acceptability of their efforts. When it comes to laws and policies that promote healthy eating—such as special taxes on sugary drinks or programs to encourage consumption of fruits and vegetables—critics argue that these (...) policies are paternalistic, and that they limit individual autonomy over food choices. In our book Healthy Eating Policy and Political Philosophy: A Public Reason Approach (Barnhill and Bonotti 2022), we argue that both paternalistic justifications for healthy eating efforts and anti-paternalistic arguments against them can be grounded in perfectionist views that overly prioritize some values over others. We therefore propose a more inclusive, public reason approach to healthy eating policy that will be appealing to those who take pluralism and cultural diversity seriously, by providing a framework through which different kinds of values, including but not limited to autonomy and health, can be factored into the public justification for healthy eating efforts. Additionally, the book adopts a ‘farm to fork’ approach to the ethics of healthy eating efforts: it engages with theories and debates in political philosophy, considers the implications of different theoretical positions for healthy eating efforts, and then develops a framework for assessing policies that can be used by researchers and policymakers. As well as offering a novel normative analysis of healthy eating policy, we also provide a theoretical framework that will be applicable beyond healthy eating policy to a wide range of public policy scenarios. We are extremely grateful to the contributors to this symposium for their thoughtful commentaries on our book. In this article, we provide a critical reflection on the issues they raise with regard to some key aspects of our analysis. (shrink)

The contribution of food and diet to health is much disputed in the background culture in the US. Many commercial or ideological advocates make claims, sometimes with health as a primary goal, but often accompanied by commercial or ideological interests. These compete culturally with authoritative recommendations made by publicly funded groups. For public policy concerning diet and health to be legitimate, not only should it not be inconsistent with the scientific evidence, but also it should not be inconsistent with the (...) political environment. Healthy Eating Policy and Political Philosophy (HEPPP), by Barnhill and Bonotti (2022), addresses how policy in this complex area might be justified. In the present essay I highlight some important strengths of their work and also make some points about how it might be clarified or enlarged in scope. The great strength of HEPPP is that it emphasizes the role of a political philosophy in evaluating the legitimacy of public policy. They presume a well-off liberal democratic state, and specifically they draw on Rawls’ political liberalism, as developed in Political Liberalism (PL). One of several interlocking technical concepts developed in this book, public reason speaks to the boundaries of what should be acceptable in public deliberation about constitutional essentials and basic justice. HEPPP explores the application of an extension of public reason to the justification of policies related to “healthy eating.“ Public reason has two components, both of which pertain to a common understanding among citizens: (1) a common understanding of the principles and ideals that are the foundation of the political society, and (2) a common understanding of the standards that govern reason and evidence, including common sense. HEPPP argues that even though for diet and health the complexity of the scientific evidence goes far beyond anything like common sense for a typical citizen, the technical idea of “accessibility” of the scientific evidence justifies reliance on it within the concept of public reason. I question this accessibility argument about scientific evidence and public reason because the nature of the population-level epidemiological evidence about diet and health is that it often includes judgments that are based on arguable interpretations, framing incidence in terms of risk and prevention; thus the issue is more than one of potential accessibility of scientific evidence. Nevertheless, evaluation and consideration of the scientific evidence is of obvious practical importance in policy deliberation concerning policy related to what Rawls call “ordinary legislation.“ Even though public reason applied to healthy eating policy may not be as pertinent as it is for constitutional essentials and basic justice, and even though it is unlikely to result in a “correct outcome,“ invoking reasons based on political values and principles held in common has important value even in these deliberations about more ordinary questions. That value applies not to the specifics of the particular issue, but to the larger context for the particular policy being deliberated, as a potential contribution to an overlapping consensus that is stable for the right reasons. If this vision of political liberalism were achieved, then contentious debate about health eating policy and its scientific basis could occur within that context and be resolved within the basic political structure. Because public health and political liberalism have a common concern for a good at the population level, they have an underlying affinity. Healthy eating policies could be evaluated in two not-unrelated ways: based on their instrumental contribution to the good of the public body of citizens as population-level health, and according to their stabilizing contribution to an overlapping consensus among citizens. In this latter way a policy would contribute to a conditional integral common good a la Sulmasy, one that has the prospect of conditioning a political system, and by doing so create the conditions of the possibility of a constitutive integral common good that is constituted on the right reasons for allegiance to an overlapping consensus. To conclude with reference to HEPPP, public reason may play an important function with respect to the political common good, even as debates about the weight and meaning of scientific evidence from epidemiology play out in deliberation of ordinary legislation concerning healthy eating. (shrink)

The challenges to designing and implementing ethically and politically meaningful eating policies are many and complex. This article provides a brief overview of Anne Barnhill and Matteo Bonotti’s Healthy Eating Policy and Political Philosophy: A Public Reason Approach while also critically engaging with the place of racial justice, global interconnectedness, and debates over science in thinking about ethics and politics of public health nutrition and policy. I do not aim to burden Barnhill and Bonotti with the responsibility (...) to fully address these issues, but considering the interconnection of these issues and the ever pressing effects of climate change on local and global food systems, we collectively need to turn to these difficult and pressing questions about what a just food system looks like, what concerns are centred, and who is left out. I group these engagements with Barnhill and Bonotti under three headings: racial liberalism, global food system, and contested nutrition science. I conclude with some remarks about locality. (shrink)

As concerns about the negative health effects of unhealthy eating, overweight and obesity have increased, so too have policy efforts to promote healthy eating. Federal, state, and local governments have proposed and implemented a variety of healthy eating policies. Many of these policies are controversial, facing objections that range from the practical (e.g., the policy won’t succeed at improving people’s diets) to the ethical (e.g., the policy is paternalistic or inequitable). Especially controversial have been policies (...) limiting the options offered in the marketplace, limiting access to certain options, or providing disincentives for the purchase of certain options. Examples of such policies include proposed .. (shrink)

Peoples’ perceptions of healthy eating are influenced by the cultural context in which they occur. Despite this general acceptance by health practitioners and social scientists, studies suggest that there remains a relative homogeneity around peoples’ perceptions that informs a hegemonic discourse around healthy eating. People often describe healthy eating in terms of learned information from sources that reflect societies’ norms and values, such as the Canada Food Guide and the ubiquitous phrase “fruits and vegetables”. (...) Past research has examined how built environments shape people’s access to healthy living options, such as distribution of grocers versus convenience stores and fast food restaurants. Often overlooked is an in-depth understanding of how social contexts interact with built environments, molding peoples’ perceptions of healthy eating. This paper reports on perceptions of healthy eating in four communities across Alberta, Canada. A photovoice methodology was employed to elicit perceptions of healthy eating with 35 participants. This study illustrates how participants’ photographs and their stories convey multiple meanings about healthy eating within their own lives and communities. Findings suggest that a ‘local’ context is an important part of the discourse centered around the promotion of healthy eating practices in these and potential other communities. (shrink)

Healthy Eating Policy and Political Philosophy: A Public Reason Approach by Barnhill and Bonotti is a terrific effort to provide a systematic method for appraising the ethical aspects, broadly understood, of regulations and policies connected to food, diet, and eating. In this commentary I purport to highlight the originality and the merits of the volume by considering what it doesn’t accomplish in three of its parts. I first call attention to the specific construction of the subject matter, (...) namely on the question whether to be at stake are eating behaviors, dietary patterns, or certain food items; while Barnhill and Bonotti do not problematize it, this question is arguably pivotal to design effective policies and to adequately assess them. Second, I discuss the technical concept of “constitutive evaluative standards,” used by Barnhill and Bonotti to lay out their view, as this part of their work calls for an alignment with research on the philosophy of nutritional science and, more generally, philosophy of science. Finally, I take up the technical concept of “accessible reason,” which plays a central role in ascribing the public status to reasons, advocating for a more thorough determination of this concept based on recent work in epistemology. (shrink)

In their book Healthy Eating Policy and Political Philosophy: A Public Reason Approach, Matteo Bonotti and Anne Barnhill defend a conception of public reason centred on the notion of accessibility and advance an ethical toolkit public health policy makers can use to ensure they are reasoning publicly when designing healthy eating policies. Finally, they propose to institutionalise the process of public reasoning informed by their ethics framework by designing certain procedures of consultation and deliberation. This article (...) focuses on their institutionalisation and raises some doubts and concerns by arguing that the procedures designed by Bonotti and Barnhill may be counterproductive to some of their aims, in particular with respect to citizens’ control, epistemic injustice, and the conception of citizens as free and equal. (shrink)

Obesity continues to be a global issue. In recent years, researchers have started to question the role of our novel yet ubiquitous use of digital media in the development of obesity. With the recent COVID-19 outbreak affecting almost all aspects of society, many people have moved their social eating activities into the digital space, making the question as relevant as ever. The bombardment of appetizing food images and photography – colloquially referred to as “food porn” – has become a (...) significant aspect of the digital food experience. This review presents an overview of whether and how the viewing, creating, and online sharing of digital food photography can influence consumer eating behavior. Moreover, this review provides an outlook of future research opportunities, both to close the gaps in our scientific understanding of the physiological and psychological interaction between digital food photography and actual eating behavior, and, from a practical viewpoint, to optimize our digital food media habits to support an obesity-preventive lifestyle. We do not want to rest on the idea that food imagery’s current prevalence is a core negative influence per se. Instead, we offer the view that active participation in food photography, in conjunction with a selective use of food-related digital media, might contribute to healthy body weight management and enhanced meal pleasure. (shrink)

The social facilitation of eating plays a significant role in influencing individuals’ eating decisions. However, how social eating cues are processed in health promotion messages is unclear. This study examined individuals’ food craving in response to social cues in images and emotional experiences, perceived threat, perceived efficacy, behavioral intentions, and motivational coactivation elicited by social eating cues in obesity prevention fear appeals. Results suggested that the presence of a group of people eating in an image (...) facilitated food craving for the presented foods. Moreover, fear appeals that presented obesity and its consequences with more social eating cues, versus individual eating cues, generated greater positive emotional responses, perceived threat severity, response and self-efficacy, and motivational coactivation indicating more attention and threat vigilance. However, these cues also generated fewer self-reported intentions to change unhealthy eating behaviors. Implications and suggestions for future research are discussed. (shrink)

Healthy eating policies have become a hot and thorny domain of public concern because they affect people’s liberties, life prospects, and public expenditures. However, what policies state institutions may legitimately enforce is a controversial matter. Is state paternalism for the sake of public health permissible? Could people be incentivized to eat in a healthier manner? Barnhill and Bonotti’s recent book tackle these issues in a manner that seeks to combine the liberal values of state neutrality and antipaternalism, as (...) well as the effectiveness and legitimacy of food policies. To do so, they rely on the accessibility model of public reason. Although Barnhill and Bonotti’s proposal fills an important gap in the field and the accessibility model of public reason overcomes some strictures of the Rawlsian account, their account of public reason faces some practical challenges. Indeed, the institutionalization of their framework seems to need the figure of a moderator of a deliberative panel. However, this figure would create a tension between the public reason framework and the common requirements of deliberative accounts. (shrink)

BackgroundMediation analysis is important to test the theoretical framework underpinning an intervention. We therefore aimed to investigate if the healthy body image intervention’s effect on eating disorder symptomatology and use of muscle building supplements was mediated by the change in risk and protective factors for ED development and muscle building supplement use.MethodsThis study used data from the HBI intervention: a cluster randomized controlled universal intervention aiming to promote positive body image and embodiment and reduce the risk for ED (...) development including 30 schools in Norway. A total of 1,713 participants were included in the analyses. Conditional latent growth curve analyses were performed to test for indirect effects on ED symptomatology and weekly frequency of protein and creatine supplement use measured at the 12-month follow-up via change in the proposed mediators.ResultsIn girls, the reduction in ED symptomatology was mediated by positive changes in protective factors and reductions in risk factor scores. Comparable changes in protective and risk factors among boys played no mediating role.ConclusionInterventions aiming to reduce the risk of ED development in girls may benefit from aiming to enhance self-esteem and body image flexibility and reduce perceived media pressure and thin appearance internalization. Future studies should investigate the casual relationship between muscle building supplement use and risk and protective factors for ED development in both girls and boys. (shrink)

It is thought that just as hunger itself, the expectancy to eat impacts attention and cognitive control toward food stimuli, but this theory has not been extensively explored at a behavioral level. In order to study the effect of expectancy to eat on attentional and cognitive control mechanisms, 63 healthy fasting participants were presented with an affective priming spatial compatibility Simon task that included both food and object distracters. The participants were randomly assigned to two groups: an “immediate expectancy” (...) group made up of participants who expected to eat immediately after the task and a “delayed expectancy” cohort made up of individuals who expected to eat a few hours later. Slower reaction times toward the food and non-food distracters and a more pronounced effect on the RTs in the incompatible condition [i.e., the Simon effect ] were noted in both groups. The effect of the food and non-food distracters on the RTs was more pronounced in the immediate with respect to the delayed expectancy group. The magnitude of the SE for the food and the non-food distracters was also greater in the immediate with respect to the delayed expectancy group. These results seem to indicate that when the expectancy to eat is short, the RTs are delayed, and the SE is more pronounced when food and non-food distracters are presented. Instead, when the expectancy to eat is more distant, the distracters have less of an effect on the RTs and the correspondence effect is smaller. Our results suggest that the expectancy to eat can modulate both attention orienting and cognitive control mechanisms in healthy fasting individuals when distracting details are competing with information processing during goal directed behavior. (shrink)

In current society, eating is most definitely a gendered act: that is, what we eat and how we eat it factors in both the construction and the performance of gender. Furthermore, eating is a gendered act with consequences that go far beyond whether one orders a steak or a salad for dinner. In the first half of this paper, I identify the dominant myths surrounding both female and male eating, and I show that those myths contribute in (...) important ways to cultural constructions of male and female appetites more generally speaking. In the second half, I argue that the Christian church should share feminism’s perception of these current cultural myths as fundamentally disordered, and I claim that the Christian traditions of fasting and feasting present us with a concrete means to counter those damaging conceptions and reclaim a healthy attitude toward our hunger. (shrink)

Present study compared disturbed eating attitudes among male and female university students. For which it as postulated that female university students would have more disturbed eating attitudes as compare to male students. For that reason 200 males and 200 female university students from various universities of Karachi were incorporated in the study. Their age ranged from 19 to 25. Participants after verbal and written covenantfrom the heads of their institution were asked to fill the respondents’ profile form to (...) gather the participant’s demographic information, followed by Eating Attitude Test which was used to know ones disturbed eating ways. For statistical evaluation t-test was applied, which specified that male university students experience more disturbed eating attitudes compare to female learners. This clears that distressed eating attempts are not limited to females, but is now affecting males as well. Thus to avert its budding prevalence, teaching institutions should supervise its amassed risks in their students and stimulate them to healthy lines of eating. (shrink)

This paper argues that common social narratives about unhealthy eaters can cause significant damage to agency. I identify and analyze a narrative that combines a “control model” of eating agency with the healthist assumption that health is the ultimate end of eating. I argue that this narrative produces and enables four types of damage to the agency of those identified as unhealthy eaters. Due to uncertainty about what counts as healthy eating and various forms of prejudice, (...) the unhealthy eater label and its harms to agency are more likely to stick to some people than others and may reinforce patterns of oppression. I argue that fat people are especially vulnerable to this identification and the damage it can do. I then consider possible “counterstories” about unhealthy eaters, alternative narratives that might be less damaging to agency than the control narrative. I identify one promising counterstory but suggest that it may be limited when it comes to repairing damage to the agency of fat people. Overall, this paper illustrates some of the complex ways that healthism about eating affects agency, and emphasizes the ethical importance of the ways we think about and discuss eating and eaters. (shrink)

Orthorexia is a condition in which the subject becomes obsessed with identifying and maintaining the ideal diet, rigidly avoiding foods perceived as unhealthy or harmful. In this paper, I examine widespread cultural factors that provide particularly fertile ground for the development of orthorexia, drawing out social and historical connections between religion and orthorexia (which literally means “righteous eating”), and also addressing how ambiguities in the concept of “health” make it particularly prone to take on quasi-religious significance. I argue that (...) what makes this sort of disordered eating destructive to both men and women is ultimately a common urge to transcend rather than to embrace the realities of embodiment. In sum, I believe that orthorexia is best understood as a manifestation of age-old anxieties about human nitude and mortality—anxieties which current dominant sociocultural forces prime us to experi- ence and express in unhealthy attitudes toward healthy eating. (shrink)

Understanding the relationship between obesity and fast food consumption encompasses a broad range of individual level and environmental factors. One theoretical approach, the health capability framework, focuses on the complex set of conditions allowing individuals to be healthy. This qualitative study aimed to identify factors that influence individual level health agency with respect to healthy eating choices in uniformly constrained environments. We used an inductive qualitative research design to develop an interview guide, conduct open-ended interviews with a (...) purposive sample of 14 student fast food workers, and analyze the data. Data analysis was conducted iteratively during the study with multiple coders to identify themes. Emergent themes included environmental influences on eating behaviors and internal psychological factors. A localized, embedded approach to analyzing the factors driving the obesity epidemic is needed. Addressing contextual interactions between internal psychological and external environmental factors responds to social justice and public health concerns, and may yield more relevant and effective interventions for vulnerable communities. (shrink)

Lack of time is a commonly reported barrier to healthy eating, but a literal lack of time is only one way that time may compromise eating well. This article explores how the first-personal lived experience of time shapes and is shaped by eating. I draw upon phenomenology and feminist theory to argue that the dynamic relationship between eating and temporality matters for food ethics. Specifically, temporalities and related ways of eating can be better or (...) worse vis-à-vis key ethical concerns. I highlight the possibility of altering temporalities through strategic eating and consider implications for individual food choice and structural change. (shrink)

In this paper I analyze Kant’s ideas about eating and drinking. First, I show that gluttony and drunkenness are considered ways to oppose to the duty to oneself as an animal being. Second, I claim that for Kant there is a healthy way of having meals, which consists in eating together with friends. Then I indicate that Kant accepts that one can drink at dinner parties but has to avoid drinks that lead to drunkenness and unsocial behavior. (...) In this sense, he draws a classification of the various kinds of alcoholic drinks, according to their potential harm. Afterwards, I illustrate how Kant’s own intimate life was a daily practice of his thoughts on dietetic conceptions and on what is better for digestion and health. To conclude, I mention the idea of a philosopher’s medicine of the body and why a strict diet should be avoided. (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female (...) student population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

In lieu of an abstract, here is a brief excerpt of the content:Eating Disorders and Mimetic Desire René Girard Stanford University Among younger women, eating disorders are reaching epidemic proportions. The most widespread and spectacular at this moment is the most recently identified, the so-called bulimia nervosa, characterized by binge eating followed by "purging," sometimes through laxatives or diuretics, more often through self-induced vomiting. Some researchers claim that, in American colleges, at least one third of the female (...) student population is involved to some degree. (Since nine out of ten sufferers are women I will use feminine pronouns in this paper but some undergraduates at Stanford tell me that the epidemic is spreading to male students.) G.M.F. Russell, the first researcher who focused on the specific aspects ofmodern bulimia, is usually presented as the discoverer of a new illness. The title ofhis 1979 publication contradicts this view: "Bulimia Nervosa: An Ominous Variant ofAnorexiaNervosa." And, indeed, all the symptoms he describes had been mentioned before in connection with anorexia (see Bruch). The insurance companies and the medical profession like only welldefined illnesses, and so does the public. We all try to distance ourselves from pathological contamination by giving it a name. Eating disorders are often discussed as ifthey were new varieties ofmeasles or oftyphoid fever. Why distrust the distinction between two illnesses with symptoms as radically opposed as those of anorexia and bulimia? Because we live in a world where eating too much and not eating enough are opposite but inseparable ways ofcoping with the slenderness imperative that dominates 2 René Girard our collective imaginations. Most of us oscillate all our lives between attenuated forms ofthese two pathologies. The man in the street understands perfectly a truth that most specialists prefer not to confront. Our eating disorders are caused by our compulsive desire to lose weight. Most books on the subject acknowledge the universal calorie phobia but somewhat absent-mindedly, as if it could not be the major cause ofa serious illness. How could a fundamentally healthy desire become the cause ofpathological behavior, even ofdeath? Many people would be healthier, no doubt, ifthey ate less. In view of this fact, it is not illogical to suppose that, in anorexia, there must be some motivation other than this healthy desire, some unconscious drive, no doubt, that generates abnormal behavior. By turning anorexia and bulimia into two separate pathologies, the classificators make it easier for us to lose sight of their common basis. The bankruptcy of modern theories The search for hidden motivations is the alpha and omega, ofcourse, of our modern culture. Our number one principle is that no human phenomenon is really what it seems to be. A satisfactory interpretation must rely on one of the hermeneutics of suspicion that have become popular in the nineteenth and twentieth century, or on several ofthese, on a cocktail of soupçon: psychoanalysis, Marxism, feminism, etc. We automatically assume that social phenomena have little if anything to do with what is obvious in them, in this case the rejection offood. In anorexia, psychoanalysts usually diagnose "a refusal of normal sexuality," due to the patient's excessive desire "to please her father," etc. These explanations are still invoked in books being written right now but the voice is growing fainter. Around this sort of thing the smell of mustiness is overpowering. Even in Lacan's own land, the old arrogance is gone. Early in my life, I had an opportunity to observe that the eating practices ofyoung women have nothing to do with a desire to please their fathers. Just before World War II, a pretty cousin of mine was dieting furiously and her father, my uncle, was storming about helplessly, trying to get her to eat more. Fathers, as a rule, are not pleased to see their daughters starve themselves. This particular father was also a physician, at a time when the medical profession had not yet caught the disease it was already trying to cure. Eating Disorders andMimetic Desire3 This uncle was our family doctor and, as such, had great prestige in my eyes, at least until that day. I had not yet read Freud but my later skepticism regarding his conception offatherhood may well originate in this incident. I immediately... (shrink)

Lifestyle-induced diseases are becoming a burden on healthcare, actualizing the discussion on health responsibilities. Using data from the National Association for Heart and Lung Diseases ’s 2015 Health Survey, this study examined the public’s attitudes towards personal and social health responsibility in a Norwegian population. The questionnaires covered self-reported health and lifestyle, attitudes towards personal responsibility and the authorities’ responsibility for promoting health, resource-prioritisation and socio-demographic characteristics. Block-wise multiple linear regression assessed the association between attitudes towards health responsibilities and individual (...) lifestyle, political orientation and health condition. We found a moderate support for social responsibility across political views. Respondents reporting unhealthier eating habits, smokers and physically inactive were less supportive of health promotion policies. The idea that individuals are responsible for taking care of their health was widely accepted as an abstract ideal. Yet, only a third of the respondents agreed with introducing higher co-payments for treatment of ‘self-inflicted’ conditions and levels of support were patterned by health-related behaviour and left-right political orientation. Our study suggests that a significant support for social responsibility does not exclude a strong support for personal health responsibility. However, conditional access to healthcare based on personal lifestyle is still controversial. (shrink)

The first years of life mark a time of rapid development and dietary change, as children transition from an exclusive milk diet to a modified adult diet. During these early years, children's learning about food and eating plays a central role in shaping subsequent food choices, diet quality, and weight status. Parents play a powerful role in children's eating behavior, providing both genes and environment for children. For example, they influence children's developing preferences and eating behaviors by (...) making some foods available rather than others, and by acting as models of eating behavior. In addition, parents use feeding practices, which have evolved over thousands of years, to promote patterns of food intake necessary for children's growth and health. However in current eating environments, characterized by too much inexpensive palatable, energy dense food, these traditional feeding practices can promote overeating and weight gain. To meet the challenge of promoting healthy weight in children in the current eating environment, parents need guidance regarding alternatives to traditional feeding practices. (shrink)

How to Eat is the second in a Parallax's series of how-to titles by Zen Master Thich Nhat Hanh that introduce beginners to and remind seasoned practitioners of the essentials of mindfulness practice. Pocket-sized, with bold black-and-white illustrations by Jason DeAntonis, How to Eat explains what it means to eat as a meditative practice and why eating mindfully is important. Specific instructions are followed by a collection of verses written for secular practitioners that help set a mindful intention for (...) each activity connected with preparing, serving, eating, and cleaning up after meals. The results of mindful eating are both global and personal. Eating a meal in mindfulness shows practitioners that the whole universe is supporting them. This awareness helps develop compassion and understanding, reminding practitioners that there are things they can do to help nourish people who are hungry and lonely. Encouraging moderation, mindful eating can lead to optimum health and body weight, while diminishing waste, and contributing to a more healthy society. Scientific studies indicate that meditation contributes tremendously to well-being, general health, and longevity. How to Eat is perfect for those who want a comprehensive yet simple guide to eating as a meditative practice. (shrink)

As Brillant-Savarin remarked in 1825 in his classic text Physiologie du Goût, “Tell me what you eat, and I will tell you who you are.” Philosophers and political theorists have only recently begun to pay attention to food as a critical domain of human activity and social justice. Too often these discussions treat food as a commodity and eating as a matter of individual choice. Policies that address the global obesity crisis by focusing on individual responsibility and medical interventions (...) ignore the dependency of human agency on a culture of possibilities. -/- The essays collected here address this lack in philosophy and political theory by appreciating food as an origin of human culture and a network of social relations. They show how an approach to the current global obesity epidemic through individual choice deflects the structural change that is necessary to create a culture of healthy eating. Analyzing the contemporary food crises of obesity, malnutrition, environmental degradation, and cultural displacement as global issues of public policy and social justice, these essays display the essential interconnections among issues of social inequity, animal rights, environmental ethics, and cultural identity. They call for new solidarities and new public policies to ensure the sustainable practices necessary to the production and distribution of wholesome and satisfying food. -/- Lévi-Strauss located the origin of ethics in table manners. By learning what and how to eat, humans learned respect for others, for the earth, and for the other forms of life that sustain human existence. Lévi-Strauss fears that in our time this “lesson in humility” coursing throughout the mythologies of “savage peoples” may have been forgotten, so that the world is treated as a thing to be appropriated and the extinction of species and cultures as an inevitable result of the ascendancy of global capital. This volume makes clear the need to change the way we eat, if we are to live on the earth together with what Lévi-Strauss calls “decency and discretion.”. (shrink)

The HealthyFood program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled trial, we tested the efficacy of financial incentives combined with text messages in increasing healthy food purchases among HF members. Members receiving the lowest cash back level were randomized to one of six arms: Arm 1 : 10% cash back, no weekly text, standard monthly text; Arm 2: 10% cash back, generic weekly text, standard monthly text; Arm 3: 10% (...) cash back, personalized weekly text, standard monthly text; Arm 4: 25% cash back, personalized weekly text, standard monthly text; Arm 5: 10 + 15%NET cash back, personalized weekly text, standard monthly text; and, Arm 6: 10 + 15%NET cash back, personalized weekly text, unbundled monthly text. In the 10 + 15%NET cash back, the cash back amount was the baseline 10% plus 15% of the net difference between healthy and unhealthy spending. The generic text included information on HF and healthy eating, while the personalized text had individualized feedback on purchases. The standard monthly text contained the cash back amount. The unbundled monthly text included the amount lost due to unhealthy purchases. The primary outcome was the average monthly percent healthy food spending. Secondary outcomes were the percent unhealthy food spending, and the percent healthy and unhealthy food items. Of the members contacted, 20 opted out, and 2841 met all inclusion criteria. There were no between-arm differences in the examined outcomes. The largest mean difference in percent healthy spending was between Arm 1 and Arm 2, and the largest mean difference in percent unhealthy spending was also between Arm 1 and Arm 2, but no differences were statistically significant after correction for multiple comparisons. None of the tested financial incentive structures or text strategies differentially affected food purchasing. Notably, more than doubling the cash back amount and introducing a financial disincentive for unhealthy purchases did not affect purchasing. These findings speak to the difficulty of changing shopping habits and to the need for innovative strategies to shift complex health behaviors. NCT02486588 Increasing Engagement with a Healthy Food Benefit. The trial was prospectively registered on July 1, 2015. (shrink)

The prevalence of overweight and obesity in young adults has increased dramatically in recent decades. The unhealthy eating habits that develop at this time can often lead to negative health consequences in the future. It is therefore important to learn about self-regulation and self-control strategies and help young adults to have healthy eating behaviours. This study aims to present an Italian version of the Tempest Self-Regulation Questionnaire for Eating adapted for young adults. The instrument assesses self-regulation (...) and self-control strategies to counteract the desire and temptation to eat unhealthy food and to choose healthy foods. A total of 645 students took part in the study. The results of the confirmatory factor analysis supported the six first-order factors model concerning specific self-regulation strategies and a higher-order structure of the TESQ-E [χ2 = 336.480, p < 0.001; CFI = 0.95; RMSEA = 0.04; SRMR = 0.04]: three correlated second-order factors and one-third-order factor. The results also confirmed the strong measurement invariance of the TESQ-E across gender. To have reliable comparisons across males and females, the latent mean differences tests were performed on the six specific self-regulation strategies. The analysis showed that females appear to prefer strategies that directly address the goal by expressing explicit intentions or plans to eat in a healthy way. Convergence validity was tested through correlations with Eating-Self-Efficacy Brief Scale, Emotional Eating Scale, Scale of Attitudes towards Healthy Eating, and Body Mass Index. In conclusion, the TESQ-E appears to be a psychometrically sound questionnaire that can be effectively used with young adults to measure self-regulation strategies in eating in order to plan personalised interventions for the prevention and control of the metabolic syndrome, and to reduce a wide range of diet-related diseases. (shrink)

This study explored Christians’ view that living a healthy lifestyle by eating right and exercising was essential to what being a Christian meant to them, theoretically representing internalization of these health behaviors into one’s religious values and identity. Using a secondary data analysis of Pew Research Center survey data, we found that a minority of Christians (16%) internalized a healthy lifestyle; who also tended to be more religious, as expressed by believing in God, reading scripture, praying, and (...) volunteering at church. The results provide preliminary support for the theorized disconnect in religious internalization of certain health behaviors, but not others. However, further exploratory analysis suggests that individuals who are a part of denominations that more recognizably express the importance of a healthy lifestyle as a part of their religious beliefs, and internalize this belief, might subsequently participate in and self-report healthier behavior. (shrink)

Over the past several decades, urban community gardens have arisen in diverse and economically compromised neighborhoods across the U.S. as part of multiple environmental justice efforts. Urban community gardens have enabled users to mitigate the effects of many environmental injustices such as the impact of food deserts, nutrient poor food found at convenience stores, and pesticide laden grocery items. While these benefits have promulgated across the U.S., community gardens are also well known to be located in historically contaminated locations in (...) urban landscapes. These landscapes include former brownfield sites, superfund sites, and other abandoned spaces of contamination. Although environmental justice efforts to reclaim healthy food in urban community gardens are commendable, the presence and effects of potentially harmful contaminants is often overlooked as gardens are established. Further, governmental organizations tasked with protecting human health, such as the Environmental Protection Agency, have not established any health standards for urban community gardens. This creates many challenges in determining what is safe in community gardens, and garden mangers and users are often unaware of how severe the impacts of contamination may be or how to mitigate its effects. In this study, I highlight the prevalence of harmful concentrations of contaminants in urban community gardens in and near Seattle, Washington that are managed with organic practices. I then present the challenges and barriers to gardening in contaminated spaces. Finally, I make recommendations to address contamination in gardens spaces, and call for better regulatory standards and other forms of support to mitigate risk to users. (shrink)

The aim of this study was to analyze the association between physical activity and eating habits during the COVID-19 pandemic among Brazilian adults. A sample of 1,929 participants answered an online survey, however 1,874 were included in the analysis. The impact of the COVID-19 pandemic on eating habits was assessed inquiring about participants' intake of fruits, vegetables, fried foods, and sweets during the pandemic. Physical activity was assessed by asking participants about their weekly frequency, intensity and number of (...) minutes/hours engaging in structured physical activities per week. Participants were then stratified into categories based on moderate-to-vigorous intensity and into active or inactive. Increased sweets consumption was the most commonly reported change to eating habits, followed by an increase in the consumption of vegetables, fruits, and fried foods. Physical activity practice was related to lower consumption of fried foods and sweets. A cluster analysis revealed subjects with higher the level of physical activity was more likely to follow a healthy diet. Thus, physical activity was positively associated with healthier eating habits. Health authorities must recommend regular physical as a strategy to improve overall health during the COVID-19 pandemic. Future studies should address the physical activity interventions to improve health status during a pandemic. (shrink)

Qualitative inquiry into eating disorders is burgeoning, offering valuable and innovative insights into various aspects of the condition. This study used life‐history interviews with 20 women who had recovered from anorexia nervosa, bulimia nervosa or both and who had remained healthy. The interviews focused on the women's narratives and experience rather than a diagnostic therapeutic model. Three themes of control, connectedness and conflict emerged as significant in the development, experience of, and recovery from an eating disorder. The (...) development of the condition was attributed to a lack of control, a sense of non‐connectedness to family and peers and extreme conflict with significant others. Recovery occurred when the women re‐engaged with life, developed skills necessary for conflict resolution and rediscovered their sense of self. Rather than viewing the development of, and recovery from an eating disorder as separate and discrete events, the data from the life‐history interviews suggest they are better viewed as one entity — that is, the journey of an individual attempting to discover and develop their sense of self. This perspective challenges some current constructs of eating disorders; it is not a condition in and of itself but a symptom of deeper issues that if addressed, when the individual is ‘ready’ to make that choice, will lead to recovery. (shrink)

ObjectiveBulimia nervosa and binge eating disorder are eating disorders characterized by recurrent binge eating episodes. Overlap exists between ED diagnostic groups, with BE episodes presenting one clinical feature that occurs transdiagnostically. Neuroimaging of the responses of those with BN and BED to disorder-specific stimuli, such as food, is not extensively investigated. Furthermore, to our knowledge, there have been no previous published studies examining the neural response of individuals currently experiencing binge eating, to low energy foods. Our (...) objective was to examine the neural responses to both low energy and high energy food images in three emotive categories in BN and BED participants.MethodsNineteen females with BN or BED, comprising the binge eating group, and 19 age-matched healthy control ’s completed thorough clinical assessment prior to functional MRI. Neural response to low energy and high energy foods and non-food images was compared between groups using whole-brain exploratory analyses, from which six regions of interest were then selected: frontal, occipital, temporal, and parietal lobes; insula and cingulate.ResultsIn response to low energy food images, the BEG demonstrated differential neural responses to all three low energy foods categories compared to HCs. Correlational analyses found a significant association between frequency of binge episodes and diminished temporal lobe and greater occipital lobe response. In response to high energy food images, compared to HC’s, the BEG demonstrated significantly decreased neural activity in response to all high energy food images. The HC’s had significantly greater neural activity in the limbic system, occipital lobe, temporal lobe, frontal lobe, and limbic system in response to high energy food images.ConclusionResults in the low energy food condition indicate that binge frequency may be related to increased aberrant neural responding. Furthermore, differences were found between groups in all ROI’s except the insula. The neural response seen in the BEG to disgust food images may indicate disengagement with this particular stimuli. In the high energy food condition, results demonstrate that neural activity in BN and BED patients may decrease in response to high energy foods, suggesting disengagement with foods that may be more consistent with those consumed during a binge eating episode. (shrink)

We use Marya Schechtman’s Narrative Self-Constitution View to support the widespread idea that food can contribute to the construction and expression of our identities and be used to understand others. What foods we consume can be one such way to construct our identities as food itself can have different values: ethically sourced, healthy, culturally significant, etc. However, the ability to constitute one’s own identity in this way depends on the ability to autonomously choose what we consume. We argue that (...) most consumers have much less control over their own consumption habits than is typically assumed (indeed, much of the literature on food and identity relies on the assumption) and thus consumers have diminished autonomy with respect to identity-constitution. We focus on the effects of three such autonomy compromising practices: food impositions, which are social pressures on food choice; manipulative marketing; and impediments to access. Together these practices diminish second-order endorsement of food-related values, generate false beliefs about what one is eating, and create social, economic, or physical barriers which limit access to desired foods. There are, however, spaces where consumers are fighting back against cultural norms and agribusiness and changing their own relationship(s) with consumption, thereby exercising increased autonomy over their food and their identity. (shrink)

Food images are useful stimuli for the study of cognitive processes as well as eating behavior. To enhance rigor and reproducibility in task-based research, it is advantageous to have stimulus sets that are publicly available and well characterized. Food Folio by Columbia Center for Eating Disorders is a publicly available set of 138 images of Western food items. The set was developed for the study of eating disorders, particularly for use in tasks that capture eating behavior (...) characteristic of these illnesses. It contains foods that are typically eaten, as well as those typically avoided, by individuals with eating disorders. Each image has now been rated across 17 different attributes by a large general United States population sample via Amazon’s Mechanical Turk. Ratings included subjective attributes as well as estimates of nutrient content. Each participant rated a subset of stimulus set food items on all 17 dimensions. Additional description of the image set is provided in terms of physical image information and accurate nutritional information. Correlations between subjective ratings were calculated and an exploratory factor analysis and exploratory cluster analysis completed. Outcomes of the factor analysis suggested foods may be described along three latent factors of healthiness, tastiness, and umami taste; the cluster analysis highlighted five distinct clusters of foods varying on these same dimensions. Descriptive outcomes indicated that the stimulus set includes a range of foods that vary along multiple dimensions and thus is likely to be useful in addressing various research questions surrounding eating behavior and cognition in healthy populations, as well as in those with eating disorders. The provision of comprehensive descriptive information allows for stimulus selection that is optimized for a given research question and promotes strong inference. (shrink)

The COVID-19 pandemic is negatively impacting people’s mental health worldwide. The current study examined the effects of COVID-19 lockdown on adult women’s eating, body image, and social media habits. Furthermore, we compared individuals with and without signs of orthorexia nervosa, a proposed eating disorder. Participants were 143 women, aged 17–73 years, recruited during a COVID-19 lockdown in Canada from May-June 2020. Participants completed self-report questionnaires on their eating, body image, and social media habits during the pandemic. The (...) Eating Habits Questionnaire assessed symptoms of orthorexia nervosa. Compared to the period prior to lockdown, women with higher total orthorexia nervosa scores reported eating a lot more than usual, feeling greater pressure to diet and lose weight, thinking about food more often than usual, experiencing greater weight gain, and perceiving more pressure from social media specifically to lose weight and to exercise, compared to their healthy counterparts. We examined associations between individual EHQ subscales and perceived changes to eating and weight. Women who scored high on EHQ-Problems reported seeing more weight loss content on their social media than those who reported fewer orthorexia nervosa symptoms. Conversely, those who scored low on EHQ-Feelings reported feeling a lot less pressure to lose weight, somewhat less or a lot less pressure to lose weight or to exercise from social media specifically, and trended toward less laxative use during lockdown, compared to those who scored higher on orthorexia nervosa. And those who scored low on EHQ-Knowledge reported feeling somewhat less or a lot less pressure to lose weight than those who reported more orthorexia nervosa symptoms. Together, the findings suggest that women with symptoms of orthorexia nervosa are experiencing an exacerbation of disordered eating thoughts and behaviors during COVID-19, and that social media may be a contributing factor. (shrink)

Childhood obesity, linked to a sedentary lifestyle and an unbalanced diet, is one of the main problems in today’s Western societies. In this sense, the aim of the study was to analyze students’ perceived satisfaction in physical education classes with learning strategies and engagement in learning and critical thinking as determinants of healthy lifestyle habits. The study involved 2,439 high school students aged 12–18 years (M= 14.66,SD= 1.78). Structural equation modeling was conducted to analyze the predictive relationships between the (...) study variables. The results showed that teaching, teaching mastery, and cognitive development are precursors to deep thinking on the part of students, indicators of the adoption of healthy lifestyle habits. These results reflect the importance of the methodology adopted by the teacher in order to positively influence the students’ habits. (shrink)

Background: Greater vulnerability to negative emotions appears associated with the development and maintenance of eating disorders. A systematic review of psychophysiological studies using emotion-eliciting film clips reveals that there are no studies examining the effect of standardized validated film clips on psychophysiological response across a range of EDs.Methods: Using standardized validated film clips without ED-specific content, the present study examined self-reported emotions and psychophysiological responses of women with Binge-Eating Disorder, Anorexia Nervosa, Bulimia Nervosa, and Healthy Controls at (...) Baseline, during Neutral, Sad, Happy, and Fear-inducing film clips, and at Recovery.Results: Throughout the protocol, the ED groups reported significantly greater sadness and anxiety than HCs. Additionally, the AN group reported more fear, the BED group more frustration, and the BED and BN groups more tension than HCs. Compared to HCs, the BED group reported stronger urges to binge throughout the protocol, whereas BN group reported stronger urges to binge relative to the HC group only at Baseline and Recovery. The BN and BED groups experienced decreased urges to binge during all film clips compared to Baseline. Respiratory Sinus Arrhythmia levels were significantly lower in the BED group compared to HCs and the BN group throughout the protocol.Discussion: Standardized validated film clips can be used to elicit expected self-reported emotion and skin conductance responses in ED groups, although individuals with EDs compared HCs report greater negative emotions. Interestingly, film clips appeared to reduce urges to binge in binge-eating groups. (shrink)

Calorie labeling on menus is one of the more recent public health responses to calls for increased access to nutrition information. The goal is to encourage consumers to make more healthy food choices. In this commentary on ‘Equity in Public Health Ethics: The Case of Menu Labelling Policy at the Local Level’, I focus first on research supporting health equity-directed goals for menu labeling policies; then I turn to the issue of challenges and opportunities for menu labeling as a (...) part of local food policy and food activism. I argue that, while there is some evidence that changes in menu labeling may help to promote health equity, other moves are needed at all levels of political organization. In particular, effecting shifts in attitudes and consumption will require changing our relationships with the food sources in our neighborhoods, and changing those food sources themselves. Leveraging our knowledge of behavioral economics and social marketing, using social networks and developing programs to transform eating patterns; all of these require participation and coordination among many stakeholders. Menu labeling is one tool, but many others are needed to effect change in communities. (shrink)

Marvin is a contract hog farmer in Iowa. He owns his land, his barn, his tractor, and his animal crates. He has seen profits drop steadily for the last twenty years and feels trapped. Josh is a dairy farmer on a cooperative in Massachusetts. He doesn’t own his cows, his land, his seed, or even all of his equipment. Josh has a healthy income and feels like he’s made it. In The Food Sharing Revolution, Michael Carolan tells the stories (...) of traditional producers like Marvin, who are being squeezed by big agribusiness, and entrepreneurs like Josh, who are bucking the corporate food system. The difference is Josh has eschewed the burdens of individual ownership and is tapping into the sharing economy. Josh and many others are sharing tractors, seeds, kitchen space, their homes, and their cultures. They are business owners like Dorothy, who opened her bakery with the help of a no-interest, crowd-sourced loan. They are chefs like Camilla, who introduces diners to her native Colombian cuisine through peer-to-peer meal sharing. Their success is not only good for aspiring producers, but for everyone who wants an alternative to monocrops and processed foods. The key to successful sharing, Carolan shows, is actually sharing. He warns that food, just like taxis or hotels, can be co-opted by moneyed interests. But when collaboration is genuine, the sharing economy can offer both producers and eaters freedom, even sovereignty. The result is a healthier, more sustainable, and more ethical way to eat. (shrink)

ABSTRACT Riding on the rising concern of public health and the growing neoliberal self-care agenda, the food market has witnessed a surge in ‘healthy’ food despite the criticism of this food does not help consumers eat more healthily. A growing interest in Critical Discourse Studies is how food marketers colonise not only the food discourse but also the broader ideas and values such as health, politics, and environment. Contributing to this growing body of research, we look at one of (...) the fastest-growing food trends, ‘functional drinks’, which claim to target physiological and psychological processes in the body, so that consumers can manage their health and performance. Company websites rely on forms of infographics to communicate how the products work. Adopting the notion of ‘integrated design’ from multimodal CDS, we show how these infographics, drawing on their affordances, are particularly useful in symbolising classifications and causalities which could not be accounted for in running texts. The paper argues that this is a way health and science converge with a neoliberal discourse of self-management and enterprise culture. Given the increased use of forms of integrated design in communication, more critical discursive work is needed in this area. (shrink)

ObjectivesThis pilot study sought to develop and evaluate a novel online group-based intervention to help breast cancer survivors make healthy lifestyle changes intended to yield not only beneficial physical outcomes but also greater behavioral, and psychosocial well-being.MethodsAn exploratory single-arm, mixed-method triangulation design was employed to evaluate the feasibility and preliminary effectiveness of the HLM-ABC intervention for overweight BCSs. Fourteen women participated in the 10-week intervention and completed quantitative measures of the above-mentioned outcomes at baseline, post-treatment, 6-month, and 12-month follow-up (...) time points. Qualitative data were obtained post-treatment via semi-structured interviews and a treatment satisfaction questionnaire.ResultsParticipants lost an average of 2.83% of their baseline weight by 1-year follow-up, equal to a small effect size. Despite achieving only modest weight loss, participants achieved meaningful gains in the form of increased physical activity, discovery of gratifying movement, more intuitive eating habits, greater bodily and emotional awareness, and positive shifts in beliefs about being able to make healthy choices regarding food and physical activity. Furthermore, they demonstrated a slight improvement in body image and described feeling more self-compassionate, empowered, and acknowledging of variables beyond control that can present barriers to change.ConclusionAfter completing a 10-week online program, participants achieved meaningful and lasting changes on a number of healthful indicators, even when this did not correspond with a significant reduction in weight. Findings highlight the complex, multifaceted nature of “health” and lend support for promotion of healthier lifestyle following cancer treatment that encompasses not only physical weight, but also behavior, psychosocial well-being, and circumstances such as life-preserving hormonal treatments. (shrink)

This article explores how older adults negotiate and partially counter normative expectations of “health citizenship” that stress individual responsibility for maintaining health and preventing health problems. Based on interviews with 55 participants in Canada and the U.K. about what healthy living means to them in their everyday lives, we examine how the dominant discourse of personal responsibility in participants’ responses is counterpointed by a more muted, yet significant, alternative critical perspective on the relative roles and responsibilities of government and (...) citizens in making healthy living possible. Drawing on Hauser’s (1999) concept of vernacular rhetoric along with recent theories of environmental citizenship, we analyze how participants exercise their civic-political judgment by using a logic of dissociation to argue that what government says about the importance of healthy living is incompatible with what government does to support citizens’ abilities to eat healthily and live actively. By deploying this technique of argumentation to address structural-political-economic dimensions of healthy living, participants enact, in modest ways, an alternative, critical-collective mode of health citizenship that complicates and, at least partially, disrupts neoliberal constructions of the individually responsible, “good” health citizen. (shrink)

Previous research has shown that short-term fasting in healthy individuals is associated with changes in risky decision-making. The current experiment was designed to examine the influence of short-term fasting in healthy individuals on four types of impulsivity: reflection impulsivity, risky decision-making, delay aversion, and action inhibition. Participants were tested twice, once when fasted for 20 hours, and once when satiated. Participants demonstrated impaired action inhibition when fasted; committing significantly more errors of commission during a food-related Affective Shifting Task. (...) Participants also displayed decreased reflection impulsivity when fasted, opening significantly more boxes during the Information Sampling Task (IST). There were no significant differences in performance between fasted and satiated sessions for risky decision-making or delay aversion. These findings may have implications for understanding eating disorders such as Bulimia Nervosa (BN). Although BN has been characterised as a disorder of poor impulse control, inconsistent findings when comparing individuals with BN and healthy individuals on behavioural measures of impulsivity question this characterisation. Since individuals with BN undergo periods of short-term fasting, the inconsistent findings could be due to differences in the levels of satiation of participants. The current results indicate that fasting can affect performance on the IST, a measure of impulsivity previously studied in BN, whilst performance on other impulsivity measures were unaffected. However, the results from the IST were contrary to the original hypothesis and should be replicated before specific conclusions can be made. (shrink)