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Saúde e Sociedade

Print version ISSN 0104-1290On-line version ISSN 1984-0470

Saude soc. vol.28 no.2 São Paulo Apr./June 2019  Epub July 01, 2019

http://dx.doi.org/10.1590/s0104-12902019180791 

ARTICLES

The problem of obesity in times of late capitalism: from neoliberal economics to collaborative public policies based on “good living”1

Ricardo Espinoza Lolasa 
http://orcid.org/0000-0002-4215-1419

Alberto Moreno Doñab 
http://orcid.org/0000-0002-4277-0535

Fernando Gómez-Gonzalvoc 
http://orcid.org/0000-0002-3877-1228

aPontificia Universidad Católica de Valparaíso. Valparaíso, Región de Valparaíso, Chile. E-mail: respinoz@ucv.cl

bUniversidad de Valparaíso. Valparaíso, Región de Valparaíso, Chile. E-mail: alberto.moreno@uv.cl

cUniversidad San Jorge. Zaragoza, Aragón, España. E-mail: fgomez@usj.es

Abstract

We study the problem of obesity based on current critical theory, which analyzes the problem posed by late capitalism as its cause. The study uses a critical perspective framed in the Hegelian studies, specifically in one of his central books, The Science of Logic, because in it “the immediate” allows us to visualize how the current ideology operates subjecting the human being and how “the immediate” is one of the principles that dominate capitalism, from which we analyze the issue. The capitalist logics are a reality that create social, political and cultural model in which the human being is trapped, assuming the productive and nutritional stance of this system that launches us to achieve high levels of production and a food policy based on the business benefit and consumption over the care ethic. We finish it by proposing the construction of public policies focused on what has been called “good living” in Latin America.

Keywords: Obesity; Good living; Late Capitalism; Neoliberalism

Introduction

This article is, in a very generic way, about how capitalist ideology - a topic currently studied by many authors both in philosophy and social sciences (Espinoza, 2016, Hardt; Negri, 2009; Harvey, 2015; Jameson, 2010; Zizek, 2006) - operates negatively in public policies related to health and, more specifically, to obesity. And to understand the problem, the method presented by Hegel in The Science of Logic (Wissenschaft der Logik, WdL) (Hegel, 2011) has the conceptual tools to visualize such ideology and, in addition, to realize how it happens and how it manifests itself in society, subjectivizing it.

Capitalism and immediacy in our subjectivization

The logical element of the Ideology, fundamental for our study on the “good-living”, is what Hegel calls in WdL “the immediate” (das Unmittelbare) (Espinoza, 2016). This is one of our fundamental theses in this article. And to fully understand it, with all that it means, we will have to study, briefly: what is “the immediate”? It will be necessary to see several edges that occur in the immediate and how they are logically expressed in different areas of the real, one of them being the practice of a healthy life. The immediate is always present, but in an apparently immediate way and, therefore, it usually passes the general before the unnoticed subject’s own vision. Hegel (2011) says: “Being is the immediate indeterminate.” That is why it is so difficult for us to see our own ideology, our own subjectification (it is part of our own being); on the contrary, it is naturalized for us and “it is what it is” - a “yes and amen”, Nietzsche (2000) would say - and it could neither be otherwise nor questioned. For this reason, it is always easier to analyze and criticize already extinct ideologies or geopolitical and different existential territories from ours. Something similar happens with obesity, but the other way around. As we are immersed in late capitalism, we can not see the problem of obesity at all, because we are part of its immediate character. We have been subjectivized to eat in a certain way, not to exercise, to consume a lot, etc., so that deep down we are part of the “obese” world.

For example, it can be more evident if we look at the Eastern ideologies. We are easily aware of the Muslim world’s differences in general; we can even clearly distinguish a Sunni or Shiite variant of the same ideology; variant that has been in constant conflict for centuries and that allows us to understand enough of what is happening today, for example, in the Islamic State (Napoleoni, 2015). We “see” these ideologies in their immediate character for others, because for us such immediacy does not happen, that is why we can see it; such an ideology is not distanced and mediated. Some ideologies can be seen simply by practices (which obviously are foreign to ours). If we are in London, in a cosmopolitan capital, we are aware of a way of dressing of certain women who wear a veil. Literally we “see” the ideology and if we are finer in our look, we see up to different operating ideologies, as if they were blind forces that interact in front of us and generate a plot and force field, in different dresses of Muslim women from the simple veil of color used on the head, to the dresses, almost in the sadly famous style of the Afghan “burka,” all black, covering almost completely the woman’s body, from head to toe, leaving only the eyes visible; we are, literally, before the radical immediate character of the ideology. And that immediacy character will be present for us when we make visible what happens with obesity and the possibility of a “good living” in Chile (we can see the lack of public policies and the radical presence of capitalism). Therefore, we will have to show what disappears behind those phenomena. And by making it visible we will realize that it is the late capitalist ideology itself that is subjectivizing the current human being in general and the child in particular. This subjectivation of capitalism in our own body leads us to certain practices, making us “careless of ourselves”.

Obesity as a biological and individual problem? Orienting us towards the “good-living”

When we look closely and reflect on it, since it is the way in which the immediacy of capitalist ideology begins to crack, as the percentage data of North-American obese adults increased from 1985 to 2010, we can notice a truly surprising reality. Less than 10% of the population was considered obese in 1985, which contrasts drastically with a percentage higher than 30% in 2010 (CDC, 2015). The advance of capitalism is very fast and has disastrous consequences. In Chile, from 1987 to 2000, an increase greater than 10% of obese children was observed (Amigo, 2003). Such increase is “contagious”; people are becoming obese because their daily practices have been colonized by the capitalist industry. From 2007 to 2010, obesity in children under 6 years old increase, which reaches the worrying figure of 9.9% and of 22.4% for overweight infants (Chile, 2011).

If we analyze international and national public policies regarding what have directly caused and is causing this rapid percentage increase in obesity throughout the world, we find a three-headed Hydra - three major causes. A Hydra that is called late capitalism and that works in a precise, systemic way, with a decisive and inexorable step, truly hard to counteract. The three reasons are: (1) deterioration of the diet; (2) low levels of physical activity; and (3) lack of nutrition education (McAllister et al., 2009; WHO, 2010).

We could not disagree with these evidences to which the biomedical sciences, mainly, have been able to reach. But we do believe that focusing all the analysis on these causes with the subsequent construction of coherent public policies is limited and limiting. Logically, we agree with the individual responsibility regarding the increase of obesity. But we cannot forget - and there it is our philosophical-political analysis - that there is also a social and collective responsibility for the matter. This invitation to the non dichotomization of the obesity causes has been exposed in the interesting issue of The Lancet magazine of February 2015. The most current evidence allows us to see how these policies have not been successful in reducing these levels of obesity (Boyd et al., 2015; Christina, 2015).

If we defend the purely individualistic and biophysiological position that emerges from the three causes already described and that hide a linear analysis of the problem and a political and economic logic interested in this superficiality of analysis, the problem of obesity would have disappeared a long time ago, because all people would do the right thing to avoid having health problems related to the problem we are dealing with. This obviously does not or will happen, because it is something more radical that operates as a device for subjectivation of human beings. We advocate an analysis of the complex relational framework from which behaviors are constructed in human beings (Capra, 2002). In this sense, and following Kihn (2013) and Navarro (2013), we wonder when this progressive increase of overweight and obesity begins, and what was happening politically and economically in the world, and in Chile, in those moments. Therefore, it is evident that we must raise and make visible the ideological device from where we are, stand and move, and this device is seen in light of our situation and its historical evolution.

The late capitalist policies are installed with excessive force both in the USA and in England (Klein, 2009), and from there they begin to spread throughout the world. In Chile, the military dictatorship begins, specifically, in 1973, and the neoliberal laboratory, as it was called, starts to work (Foxley, 1988). During these years, a series of policies characterized by a certain social Darwinism, harsh attacks on the trade union logic, lack of labor protection, lower wages and deterioration of working conditions was initiated (Cárdenas, Correa, Prado, 2014, Harvey, 2015). It is no coincidence that in these years psychological illnesses such as stress and anxiety begin to emerge with force. In Chile, for example, the number of people served in the mental health device has increased dramatically in recent decades (Chile, 2014), with truly surprising changes in the suicide rate per 100,000 inhabitants (Valdés, Errázuriz, 2012).

From here, Drewnowski’s (Director Nutritional Sciences Program - University of Washington, Seattle) statement is completely understandable, pointing out that obesity will not decrease, since the current levels are the result of a deteriorating economic context (Drewnowski, Rehm; Arterburn, 2014; Drewnowski et al., 2014). Like the work of Ionesco (2004), The rhinoceros, it will generate a rapid advance by practices contagion, and soon most people will be obese.

Despite the great efforts made to see and understand the psychological, social, economic, political and philosophical aspect of obesity (this is its ideology), we are still reproducing the version supported, almost exclusively, in the biophysiological dimension of such problem (Moreno, Álvarez, 2010).

That is why, in an effort to get away from this limited and limiting perspective, we propose to start going towards a concept of health and well-being arising from the theories of decoloniality in Latin America (Marañón, 2014) that invites us to look at population’s health problems from an anti-capitalist historical imaginary, characterized by the capacity to attend and rescue a subjectivity based on reciprocity and on a liberating rationality of exploitation and domination; solidarity between people and nature and expressed in each personal and collective action. It is the only way to overcome the immediate nature of late capitalism. This is being called “Good living” (Marañón, 2014), and it is already starting to spread the logic from which certain public policies are being built in some Latin American countries.

It is complex to define “Good living”, because we assume, following Acosta (2016), that it is not a thesis, nor a concept. Constructing a manual of what is or should be good living would be as incoherent as it is unreal. It is, more than a concept, an contextualized experience to each of the ways of being of America’s original peoples.

Huanacuni (2010) suggests that, according to the dominant ideology, people want to enjoy a better quality of life, understanding that it depends almost exclusively on the Gross Domestic Product of each country. Good Living, from the American peoples, assumes that the economy cannot be the only answer to the well being of people, but that living in fullness is determined by a relationship with oneself, with others and with the existence in general.

It is from this general perspective that we see as necessary the decolonization of the concept of health. This decolonization leads us to value and rescue the knowledge of Abya Yala regarding well-being, and it means understanding that in late capitalism health is unavoidably associated with consumption. Capitalism is not genuinely concerned about obesity, but its main concern revolves around the existence of consumption. That is, on the one hand, we are offering (“selling”) obesity, while being offered (“being sold”) health.

From the budgetary capitalist logics, the quality of life is associated with the possibility of remaining valid in the consumption. In our case, it would be the possibility of continuing to consume those foods that capitalism itself indicates as being of a legitimate consumption. Herbalife, for example, is not a way of feeding, but is defined as a multilevel marketing corporation from which we are told what would be the way or ways to feed ourselves better. This would be related to trying to determine which products are seductive to the palate and associate them with the consumption, also, of images, colors, sounds, prizes and gifts. This is an appliance that preserves the high level of consumption.

From the knowledge produced by cultures as complex and dynamic as the Mapuche, Guarani or Aymara, among others, it would be about eating and living justly, because health is not only thought individually (what happens to me), but rather to think about health in terms of reciprocity, which is thought and felt in human and non-human terms.

This conceptualization, from the current critical theory, opens us the possibility of a pedagogical work towards the transformation of this unjust and inequitable society that does not allow us to “live well”. In common terms for all of us, it does not allow us a “living/being/occurring” (Wild, 2002), despite our efforts to achieve it. Inequality in Chile (Mayol, 2012) and in the world (Milanovic, 2011) has perpetuated and still perpetuates a not very collaborative relationship between countries and people. A network of competitive relations, of denial and that does not generate human well-being, that we long for. As Althusser says2, all practice seeks to perpetuate itself, and this is, in reality, the ideological apparatus of the State.

Philosophical analysis of our problem: obesity in times of late capitalism and its implications for the construction of public policies based on “good living”

From the same Greeks, the philosophical task was fully political. And we do not refer only to the two great classical philosophers: Plato and Aristotle (which the work on the political, the body and the contingency of their time is totally evident), but for the pre-Socratics it is quite clear that the question of the Polis was central in their research, ideas and practical life (theorizing philosophy is something very late). The polis is thought as something incorporated, and from it, it is designed for all. And this is what is forgotten today; apparently there are certain public policies that are not designed for people, but for other interests, subjecting ourselves to precariousness. And it is the task of both philosophers and educators to make this problem visible and to think what should be done to correct it as soon as possible.

Philosophy goes hand in hand with politics, and this today has returned to be something fundamental, considering that what is happening at social level and what is to come is at stake. It is not the same to have a high levels of obese youth and not to have it, what is happening is that there are different models of society and, above all, different ways of operating the world: one points towards a consumerism economy and the other towards a collaborative economy, for example. But it is about understanding the “hand in hand” between public policy and philosophy. Everything is about that. That “hand” indicates a certain articulation between both, and that articulation is the “method we are proposing” to investigate the “good living”, from the subjectivity to society, from the prevailing ideology: late capitalism.

In the method we can realize and express the thing. Somehow, this or that thing is left to be modeled, and sometimes its “existence” depends on it. And to speak today about the political, it is necessary that we use a method. The Hegelian method allows us to study what happens with public policy, what has characterized it and how it can be designed in the near future in order to generate a “good living” and stop the advance of obesity.

How is it possible to “read” obesity today? Why does Hegel allow us to see and interpret the complex phenomenon of subject, society, politics and business? (Vitiello, 2012) Why does Hegel allow us to investigate, in this article, about public policy? In times of savage capitalism, business models, parameters of scientific quantification and exacerbated success, why Hegel? How is Hegel key to understanding where the company should go today, not only in Chile, but in the world? Basically, when looking at the data we have indicated, what happens in Chile is nothing more than subjective atomism3 (Hegel, 2011, Marx, Engels, 2000), as Hegel would say, that is, narcissism and every man for himself! Times of wolves devouring other wolves (Espinoza, 2012); why Hegel in the current Leviathan empire of late capitalism? What is most proper when everything has become a measuring instrument and we are trapped to something that rules us and tells us what to do and what to expect when science, sometimes, no longer thinks, does not create, but simply calculates within an established rule, within a given ideology? That is the problem of ideology that structures us in all areas of reality and, therefore, also in business; and the feeding company for children and school-age adolescents is a very appropriate area to generate large profits quickly. What is needed is that they eat junk food (rich in sugar and salt) and, therefore, that they do less physical exercise. But we have forgotten that the same rule has been created by people and their technical expertise and that, therefore, it is not “in itself” something fallen from heaven or donated by some God but produced by the public policies themselves. For example, the same business model in Chile has been produced as such from the Treasury onwards. It is not a “company in itself” - that was always like that; no, in other places the food company works together with society - that has always been that way and moves in an a-historical way. This is absolutely false and we have to make it clear in this article. Nowadays, apparently, we have no “time” to live but simply “outlast” in the violent matrix of total consumerism that surrounds us, anchored to the point of this “now” that is presented simply as everything that gives meaning to people (caught up in the “vulgar” time of the clock, as Heidegger would say in the final pages of Sein und Zeit of 1927) (Heidegger, 1977); times of mere “presenteeism”, what Jameson sometimes calls “fragmentation” or “perpetual present”: “What we call ‘fragmentation’ refers… to this perpetual present” (Jameson, 2010, p. 55). This is precariousness.

Apparently, for some interested parties who believe in a simple-minded Francis Fukuyama and The End of History and the Last Man, of 19924 (Fukuyama, 2010, p. 11), in that the neoliberal model is reality itself, with its overall significance (the horizon of the “capitalist presence” that gives meaning to all things), and there is nothing that can wait or reconcile (because there are neither past nor future, but a simple immediate, eternal and necessary present of wild consumerism), or in a more literary version to the Cormac McCarthy and his remarkable The Road”, 20065 (Cormac, 2009, p. 13), in that the extreme radical consumerism cannibalism gets to what is typical of the human being; in which cultural production gives space simply to “cannibalism” against each other to survive (and this begins from childhood and precarious power), then when it happens, it is no longer possible to get out of the “period” of the present horizon, in which we are and live tide on: to be in its indeterminate immediacy, as Hegel would say in his Wissenschaft der Logik (Science of Logic)6, which works naturalizing it as a rule that measures us, constitutes us and ideologizes us7 (Espinoza, 2016). That is why many believe that nothing can be done with capitalism and, in the end, with the problem that concerns us, the obesity. It is like that and it will always be like that; and that children and young people will continue to eat what they eat, and the company will continue to profit from all this before the eyes of society, because it is legally allowed, but this is not the case. It is necessary to legislate from another understanding of the human being. Well, if not, the young man has been lost forever; from this moment, he seeks to be simply “animal” or, said in an old way, a production force. Nietzsche writes this idea brilliantly in his youth and shows how the subjects long to be animals, being always tied to the mere present of their being:

Observe the herd that grazes before you. You does not know what yesterday or today is; You run everywhere, eat, rest and run again, and so, from morning to night, from one day to another, immediately linked to your pleasures and pains, nailed to the present moment, without showing neither melancholy nor boredom. The man observes with sadness such spectacle, because he considers himself superior to the beast, and, nevertheless, envies its happiness. This is what he would want: not to feel, like the beast, neither disgust nor suffering, and yet he wants it differently, because he cannot want it like the beast. (Nietzsche, 1932, p. 73)

This is what the “late capitalist institution,” that gives meaning and presence to the subjects (and that “territorializes” even their unconscious) (Deleuze, Guattari, 2000), knows, that the human being wants to be a mere animal and that this is why one ties it to the present of work, exploitation and consumerism; binds it to his immediacy, to that immediate present of eating “garbage” in an i-reflexive way or, in other words, ties it eternally to not stop enjoying that “crap”. So one is always consuming and, at the same time, working to have the means to consume. Its order is: Enjoy! - Slavoj Žižek has worked this in detail throughout his work - and we would say: Eat! The subject consumes oneself, from a very young age, as a simple beast, so one does not feel, among other things, oneself in all the historical-vital-productive dimensionality; that is, in his/her free being. So as not to feel nor to suspect a new “eco-nomic” conception, so as not to feel a new “house” to inhabit that is no longer merely one-sided and exploitative of one another, sometimes contemporary sciences are part of this impoverished model: of this neoliberal “ideology” that always seeks to reproduce itself. An ontologized ideology that articulates the one with the same reality. Very rightly, Jameson says:

The same happens with the attempt to separate ideology and reality: the ideology of the market is not, unfortunately, a luxury or additional adornment, ideational or representative, that can be extracted from the economic problem and then sent to a cultural or superstructural morgue so that specialists dissect it. (Jameson apud Zizek, 2003, p. 309)

Another form of articulation is needed that complexly expresses reality in and by itself in its multiple folds, but expresses it from a certain development that is liberating the whole system from this ideological slavery to the needs trapped in the immediacy of time and of the real result. The idea is to realize a certain emancipation “from” the empirical “in” the empirical itself in the development of everything. This is the company we want for Chile. Mediation is needed, that is, the “cultural formation” (Bildung) so that the human being can gradually rise above oneself, over the empirical, animal character, of mere immediate present to which one is subject. Chile needs public policies from a social, collaborative and humanistic model to stop childhood obesity, source of multiple evils in the immediate future of an alienated society. That is why Hegel, since The Phenomenology of the Spirit, and even before, always knew that Bildung, the mediation par excellence, was fundamental to open the human being to something better, above the immediate and empirical in what it is trapped:

The cultural formation, that work to be taken away from the immediacy of substantial life, will always acquire knowledge about universal principles and points of view, only to laboriously rise up to the thought of the Thing as such, besides sustaining or refuting it with fundamentals, grasping the rich and concrete fullness by its determinants and knowing how to provide appropriate information and a serious judgment about it. (Hegel, 1971, p. 59)

Final considerations

The article has addressed, in its radical, the crisis of the company as it has been by the perspective of capitalist ideology and how it has legislated, then taking care of children in schools and study centers. We see a profound damage by which they have been subjectified. Cannot we think that the company, for example in Chile, is not structured from the capitalist ideology? It is its being; it is its “yes and amen”. How to rethink another company in another policy for young people and their nutrition? How to undertake the adventure of the business in a collaborative way with the other located in the middle of the polis? Is it possible for a company in Chile, which, being private, is not voracious and works articulated with society and with goals at the country level?

What is clear, as the data show, is that the concrete problem of obesity will continue to increase if serious measures are not taken, but not merely technocratic measures, but those that allow us to see the ideology in which we are immediately subjectified by late capitalism. Only by analyzing the concepts at stake, by showing the historical evolution of certain decisions in public policies, by pointing out and generating a reflective awareness of how a model operates in our daily practices, for example, food, by treating the problem not as something individual, but rather as a problem of the country, by denouncing the actors that are behind these initiatives, that we will achieve significant changes in the problem of obesity, and we believe that this will be able to stop its progress.

Today it is necessary, more than ever, to work in interdisciplinary teams, problems that are inherently complex and have multiple edges, such as obesity. Faced with such problems, we need teams capable of working in a coordinated manner, from data to concepts collection, allowing us to effectively reach real solutions. But all this can be lost in the desert of indifference if we fail to commit to the problem, because in this way we will see ourselves as “obese”, so we need to say no to public policies anchored in capitalist motivations of certain holdings that have captured democracy in recent decades, not only in Chile, but throughout the world.

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1This article is the producto of the investigations financed by Conicyt/Regular no. 1170454 (entitled “Realidad y arte en Zubiri”) and Conicyt/Regular no. 1170019 (entitled “El mapa escolar como ‘epistemicidio’ de los educativo: comprensión de la escuela desde los márgenes”).

2Marx said that even a child knows that a social formation that does not reproduce the conditions of production while producing, will not survive even a year. Therefore, the final condition of the production is the reproduction of the conditions of production (Althusser apud Zizek 2003, p 115).

3The “independence” of reality occurs with the intrusion of subjectivity in that ethical world, in this action apparently moved by particular ends. Not in vain in the Encyclopedia when referring to civil society, it will speak of the “atomism system”. See, Hegel, G.W.F. Enciclopedia de las ciencias filosóficas. Madrid: Alianza, 2000, § 523. Critique present in the words found at the beginning of the Communist Manifesto, when the action of the bourgeoisie in history is described: “Everything that is stratum and stable evaporates, everything sacred is desecrated and human beings are finally forced to contemplate their position in life, their mutual relations, with cold eyes” (Marx; Engels, 2000, p. 51).

4“What we might be witnessing is not only the end of the cold war, or the culmination of a specific post-war period, but the end of history as such: that is, the end point of the ideological evolution of humanity and the universalization of Western liberal democracy as the final form of human government” (Fukuyama, 2010, p. 11).

5“He got up with the first gray light and left the boy sleeping and walked to the road, and squatting he studied the region that extended to the south. Arid, silent, infamous. It must have been October, but I was not sure. I had not used a calendar for years. They would go south. Here it was impossible to survive another winter “(Cormac, 2009, p. 13).

6Das Sein ist das unbestimmte Unmitelbare. Hegel, G.W.F., Wissenschaft der Logik, Erster Teil, Die Objetive Logik. Ersted Band. Die Lehre vom Sein (1832), Felix Meiner, Hamburg, 1985, p. 68. “Being is the immediate indeterminate.” Hegel, G.W.F. La ciencia de la lógica I. La lógica objetiva: 1 El ser (1812) / 2. The Doctrine of Essence (1813). Madrid: Abada, 2012.

7Hegel treated this brilliantly in the third section of WdL’s “The Doctrine of Being.” In the bottom, the being as the immediate thing lies an appearance that measures and, in its measurement, constitutes everything real in said appearing. “The measure, then, is the respectivity of relations, that is, a determination (Bestimmung) and not any determination, because it determines, puts terms, closes, excludes, defines, delimits both outwards and inwards” (Espinoza, 2016, p. 95).

Received: December 19, 2018; Accepted: February 28, 2019

Correspondence Alberto Moreno Doña Av. Angamos, 655, Reñaca. Viña del Mar, Chile. Cp 2520000.

Authors’ contributions Espinoza was responsible for the philosophical analysis. Moreno was in charge of the analysis focused on the philosophical elements and their relationship with good living and obesity. Gómez was responsible for the final revision of the article and the reworking of those passage, when required. Espinoza, Moreno and Gómez contributed to the writing of the article.

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