This is an on-going series exploring ethical-decision making practices around public health initiatives in the library. This series focuses on libraries effort to combat the so-called obesity epidemic with fitness initiatives. Part One introduces the scope of the series (including pointing to some exemplar programs at libraries). Part Two explores how libraries use the Kantian perspective of duty to describe fitness programming as a response to the opioid epidemic and an ethical act.

A note on terminology: Throughout this series, I use the term obesity and obesity epidemic. Many individuals prefer to describe themselves as fat and reject the medicalization of body types. I occasionally switch to using the term fat.

Kantian Ethics, Redux

Kantian ethics believes in universal duties and ask us to divorce our ethical-decision making from the context of a situation. Before we dismiss context as irrelevant to ethical decision-making, we should take a look at what it is.

We can begin with a question: Why are fitness initiatives (some) libraries’ chosen response to the so-called obesity epidemic? The answer, I think, is neoliberalism. Neoliberalism is characterized by problem-solving the issues of our time through focusing on the actions of individuals and private entities.

As a response to a public health crisis, fitness initiatives are an exemplar of neoliberal thinking in three ways: (1) they de-politicizes health by focusing on individual action (lose weight through exercise) rather than systemic change (extend access to healthcare to all), (2) they reinforce the notion that self-improvement is a moral exercise and should be an individual’s main focus, and (3) they value some bodies as the ideal and other bodies as “unnatural.”

De-politicizing Health: What Neoliberalism and the Opioid Epidemic Can Tell Us about the Obesity Epidemic

In the 2020 paper Humanitarian reason and the movement for overdose prevention sites: The NGOization of the Opioid “Crisis.” Thomas Foth argued that the opioid crisis has been transformed from a complex, ongoing situation with political and systemic implications to a medical emergency. In a similar fashion, the “obesity epidemic” is presented urgent health crisis. Foth (2020) described this as a transformation of political action into moral action creating an “apolitical movement that only aims to save lives in the name of humanitarianism.” 

Foth (2020) argued that there are three primary impacts. First, when we focus on a medical emergency, whether that’s combatting the opioid epidemic one overdose at a time or addressing obesity through “reforming” fat bodies via fitness, we neglect systemic issues such as economic inequality, food desserts, or adequate healthcare for all bodies. Second, a medical emergency creates the conditions where one party views the other as an object of “pity” or reform rather than a true ally in a political fight against policies, regulations, and laws. Third, the medical emergency erase the government as either the cause or possible response to the crisis and reduces it down to individuals caring for other individuals (or their own bodies).

Self-Improvement Masquerading as Morality

In her 2018 book Numbered Lives: Life and Death in Quantum Media, Jacqueline Wernimont documents self-tracking, often featured in fitness initiatives, as a morality project, with origins in Christian diarists, such as St. Augustine’s Confessions. St. Augustine and other spiritual diarist sought to document their habits as a means to control themselves (p. 102). Although, as Wernimont documents, self-tracking as a means to manage the “unruly human body” is an ancient practice, it holds particular purchase over individuals in a neoliberal landscape (p. 102).  

Like Foth, in her 2016 book The Quantified Self, Deborah Lupton described how political action is redirected into individual action. While Foth focused on the transformation of the crisis itself an apolitical movement, Lupton described how individuals are primed to view the societal issue of health as an individual projects. Neoliberalism, she argued, positions “care of the self…as an ethical project” (p. 45). This emphasis on “care of the self” results in citizens focused on optimizing their own well-being over organizing politically.

By this point, the problem itself isn’t political and even if it were, we are not political actors.

Shock Me, Shock Me, Shock Me with that Deviant Behavior

Neoliberalism push us towards the idea of, if not a neutral body, an idealized body. The best way to explore this concept is to consider the ways to be “deviant” with regard to fitness in the neoliberal viewpoint.

You aren’t striving to be healthy or fit

If neoliberalism sees self-improvement, such as fitness tracking, as a moral action it follows that people/bodies who are not constantly striving to bring their bodies back under control are consider “unnatural”/immoral. Although being fit takes considerable effort and therefore could not be considered a person’s “natural” state, under the viewpoint of neoliberalism, desiring and striving towards fitness is our natural state. (Or to put it more simply, think about some of the things people assume about the moral rectitude of fat people.)

Your body doesn’t fit in the rules of the fitness initiative

Alongside the assumption that we are want to be more fit, fitness initiatives often prioritize certain body types over others. Consider fitness tracking devices. Both Lupton (2016) and Wernimont (2018)’s work pointed out the ways in which fitness tracking technology has failed to account for the differences in our bodies, from health applications failing to track menstrual cycles to being unable to account for steps taking while pushing a stroller. Aside from having a body with a period or one that needs to push a baby, there are other “unruly” bodies out there. Ones that walk differently or don’t walk at all.

Obesity Ouroboros

I began this section with the question: Why are fitness initiatives (some) libraries’ chosen response to the so-called obesity epidemic? But we could equally ask: Of all the issues impacting our health, why are libraries focusing on the obesity epidemic? Could it be that neoliberalism has primed us to focus on obesity over racism as a public health crisis (for example)? Obesity, this thing we have created, is seen as an individual moral failing best addressed through hyper-focus on individual behavior (such as “calories in/calories out”). Could it be that neoliberalism created both the problem and the solution? If the context is so key to both the problem and the potential solutions we see, then Kantian ethics will not help us.

What Now?

I have argued that Kantian ethics are an inadequate ethical framework to address this question and to evaluate libraries responses to these crises. Neoliberalism shaped our perception of both the crises and our possible responses. The ethics of care and intersectional justice ethics offer alternative perspectives.  

In the next post in this series, I will argue that libraries may be able to create programming to address both the opioid crisis and the obesity epidemic using intersectional justice ethics and/or the ethics of care.