Key Problems Concerning Physical Activity, Health, and the Body

CONTEMPORARY CONSTRUCTIONS OF HEALTH AND PHYSICAL ACTIVITY
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1.0 Introduction
Digital health and fitness technologies are a growing trend in contemporary western societies, where there is a strong preoccupation with health, fitness, and weight. These technologies range from wearable devices like fitness trackers to weight loss apps and telemedicine platforms that are designed to provide users with real-time feedback on their physical activity levels and to motivate them to be more active (Becker et al. 2014). However, this trend also reflects the modern cultural and social environment that promotes weight gain and obesity, known as an 'obesogenic culture' (Campos 2004). Wearable technologies are often marketed with a strong emphasis on weight loss and on individual responsibility for one's health, perpetuating societal norms and expectations of the "ideal" body and physical activity levels. Moreover, these technologies also create inequalities in terms of accessibility and affordability, and they contribute to the medicalization of weight, which can lead to the stigmatization of people who are overweight or obese. Therefore, it's important to analyze the role of digital health and fitness technologies in the current obesogenic culture and to consider alternative frameworks for health that promote equity and accessibility.
One example of a digital health and fitness technology that reflects this preoccupation is the weight loss app. These apps typically offer a range of features such as tracking food intake, recording exercise, and providing feedback. They are often marketed with a focus on weight loss and individual responsibility for one's health. In this paper, weight loss apps shall be analyzed in the view of neoliberalism and Foucault's theory of surveillance and discipline to identify the problems associated with their presence in society. Alternative frameworks that should be used to replace the current obesogenic culture shall be proposed.
2.0 Neoliberalism and Proliferation of Obesogenic Culture
Neoliberalism is a social, political, and economic rationality that emphasizes the importance of free markets and individualism, and minimizes the role of the state in economic and social affairs (Andrew and Silk, 2018). This ideology has had a profound impact on the way that health and well-being are understood and addressed in contemporary Western societies, and is closely related to the obesogenic culture.
Notably, neoliberalism has advanced the proliferation of obesogenic culture in several ways. First, neoliberalism often involves cutting government spending on social programs, including programs designed to promote health and well-being. Reduced government spending results in reduced access to resources and opportunities that promote health and well-being, particularly for individuals from lower socio-economic backgrounds (Vallier 2021). Second, the advancement of neoliberal ideals results in the placement of responsibility for health and well-being on the individual, rather than the state or society (Ganti 2014). The shift can create an environment where individuals feel they are responsible for their health and are less likely to rely on government-funded programs or services. Individualized interventions are limited by the financial endowment of a given person as one does not rely on the government which results in unequal access to health programs.
Further, neoliberalism emphasizes free markets and economic growth. As a consequence, public healthcare facilities are privatized and a shift to the commodification of health is observed (George 1999). In a free market, health disparities are exacerbated as individuals have unequal access to a healthcare system characterized by high costs. Health services and products become commercial products that are marketed and sold as opposed to fundamental health rights that should be accessible to every citizen. In such an environment, the obesogenic culture thrives as various players in the healthcare industry places unjustified emphasis on weight loss and physical appearance at the expense of holistic health.
Overall, neoliberalism as a social, political, and economic rationality, is closely related to the obesogenic culture, by reducing government spending, emphasizing individual responsibility, privatizing healthcare, promoting the free market, and promoting the view of health as a commodity, leading to inequality of access and affordability (Guthman and DuPuis 2006). This can exacerbate health disparities and contribute to an unhealthy society. While products such as weight loss apps can be effective in promoting wellness in society, the commodification of health limits their applicability in the sense that they are designed and marketed in such a way that they generate maximum profit for healthcare providers (Millington 2014) as opposed to offering benefits to the consumers (LeBesco 2011). Access to such technology is also limited in a neoliberal environment where the individual’s ability to access is dependent on their financial well-being.
3.0 The Nature of Behavior Change Interventions in Obesogenic Culture
In an obesogenic culture, general "behavior change" interventions are often top-down and focused on an assumed knowledge deficit and healthism discourses. Such interventions are designed to change the behavior of individuals to improve their health, but they often fail to take into account the complexity of lived experiences and the social determinants of health as they are based on a top-down approach shaped by assumed knowledge deficits and healthism discourses. The interventions are often implemented by governments, organizations, or experts, rather than being developed and implemented in collaboration with the individuals or communities they are intended to serve (Fraser et al. 2006). A top-down approach can result in interventions that are not tailored to the specific needs and circumstances of the target population.
In most cases, the interventions often assume that individuals lack the knowledge or skills needed to make healthy choices, and they are designed to provide this information. However, this assumption can be problematic, as it can stigmatize individuals who are struggling with health problems and may have complex and multifaceted reasons for their behavior. Further, the interventions often promote the perspective that health is a personal responsibility and that individuals who are not healthy are not making the right choices (Wiest, Andrews and Giardina 2015), leading to the stigmatization of individuals struggling with health problems, and can discourage them from seeking help.
Behavior change interventions in obesogenic culture are largely unsustainable as they fail to take into account the need to adopt long-term behavioral changes that can lead to the maintenance of healthy behaviors. The one-size-fits-all nature of such interventions does not take into account the individual differences that may limit the applicability of the interventions.
3.0 Socio-cultural Perspectives of Health and the Body
From a socio-cultural perspective, health and the body are not just biological entities but are also shaped by cultural and social factors. Michel Foucault's theories of surveillance and discipline provide a useful framework for understanding how health and the body are regulated and controlled by societal norms and expectations.
Michel Foucault's theory of surveillance is rooted in his understanding of power as a pervasive and productive force in society. In his view, power operates through a range of social institutions and practices that regulate and control individuals' behaviors and beliefs (Foucault 1991). One of the key mechanisms through which power operates is surveillance, which is the process of monitoring, observing, and controlling individuals (Foucault 1975; Focault 1977; Foucault 1991; Foucault 2007). Foucault (2007) argued that surveillance is not just an overt, repressive form of control, but it is also an integral part of everyday life. He identified several types of surveillance, including physical surveillance, such as the use of CCTV cameras, and psychological surveillance, such as self-monitoring (Focault and Blasius 1993). He also identified several forms of surveillance, including discipline, which is the process of training individuals to conform to societal norms and expectations, and panopticism, which refers to the idea of being under constant surveillance, even when no one is watching (Foucault 1975; Focault 1977; Foucault 1991; Foucault 2007). Foucault's theory of surveillance is most famously associated with the concept of the panopticon. The “Panopticon” is a type of prison design, in which a central observation tower is surrounded by prison cells (De Moya and Pallud 2020). The prisoners can be observed at all times, but they cannot see the observer (Focault, Dreyfus, and Rabinow 1982), which creates an environment where the prisoners are constantly aware that they are being watched.
In the context of health and the body, surveillance operates through a range of social institutions and practices, such as the healthcare system, medical professionals, and digital health technologies that monitor, observe, and control individuals' health status and behaviors. The use of these technologies, such as weight loss apps, for example, creates a sense of constant monitoring and self-regulation (Christl and Spiekerman 2016; Wolf 2009), where individuals are expected to track and monitor their health status, as well as conform to societal norms and expectations of health and fitness levels.
On the other hand, Michel Foucault's theory of discipline refers to the process of training and regulating individuals' behaviors and beliefs through a range of social institutions and practices. Foucault argues that discipline is a key mechanism through which power operates, and it is an integral part of everyday life. According to Foucault (1991), discipline is characterized by the use of techniques that are aimed at creating obedience and conformity in individuals. These techniques include the use of rules and regulations, the imposition of penalties, and the manipulation of rewards and incentives. The form of discipline as detailed by Foucault includes punitive discipline as used to regulate individual behaviors among the deviant, normalizing discipline as used to establish societal norms and expectations, and self-discipline as used for self-regulation and self-control (Foucault 1975; Focault 1977; Foucault 1991; Foucault 2007). In the context of health and the body, discipline operates through institutions such as hospitals, gyms, and schools, as well as through societal norms and expectations about the "ideal" body.
Thus, the combination of these two theories highlights how the process of surveillance and discipline work together in shaping and controlling individuals' health behaviors and the way they see their bodies. The constant monitoring of one's health status, the self-regulation of one's health behaviors, and the internalization of societal norms and expectations work together in creating a society in which individuals conform to what is perceived as the "normal" or "ideal" health and body status.
4.0 Analysis of the Weight Loss Apps
Weight loss apps, to a certain extent, create some problems in the contemporary constructions of health and physical activity by perpetuating a societal view that there is an “ideal” body. The apps promote unrealistic standards of beauty and body shape, using language that creates negative associations with being overweight. In most cases, weight loss apps use images of thin, toned bodies in their marketing materials to promote their products. Weight loss apps also perpetuate societal ideals of the "ideal" body by depicting models in their advertisements, who are typically white and able-bodied, with a specific body type, which can create an unrealistic representation of beauty and body shape and can also create pressure for individuals to conform to these specific ideal images (Fox 2012). Most of the language used in the apps suggests that there is an “ideal” body shape that one should strive to attain. The use of terms like “lose weight” or “shed pounds,” in the weight loss apps create a negative association with being overweight and a positive association with being thin, which can lead to negative body image. Further, the weight loss apps encourage most of their owners to set goals that are based on taking action to reduce one’s weight. Weight loss apps encourage users to set weight loss goals, which can create the idea that health is only achievable through a specific weight (Foucault et al. 1988). This can create unrealistic expectations and an over-reliance on technology for weight loss, while also ignoring the fact that sustainable weight loss requires long-term lifestyle changes.
Notably, weight loss apps perpetuate societal norms and the prevailing expectation of the ideal body through the use of “before and after” images. Weight loss apps use "before and after" images in their advertisements, which can create an unrealistic expectation that one can achieve a specific body shape within a short period (Penny and Kirk 2015). These images can create pressure for users to conform to societal norms and expectations of the "ideal" body shape. In addition, the apps use stigmatizing language that contributes to the further stigmatization of people who are overweight or obese and discourages them from seeking help.
In addition to perpetuating the pursuit of the “ideal body,” weight loss apps have a problem in contemporary society as they generate inequality regarding the affordability and accessibility of weight loss apps. Not everyone has access to smartphones or the internet, which is required to use weight loss apps. The apps also require users to incur financial costs in terms of subscriptions and in-app purchases. Differences in affordability create inequalities in terms of accessibility, making it harder for people who are most in need of healthcare to access it (Rich and Miah 2017). People who are unable to access these apps might be at a disadvantage compared to others when it comes to improving their health status (Levin and Smolak 2010). It is also important to consider that some individuals may lack the digital literacy skills to effectively use and navigate the app creating additional barriers for those who are not familiar with the app or lack access to information to help them understand how to use the app effectively (Markula 2008). The marketing approach to weight loss apps creates targeted advertisements to a specific group that they deem to have better access and the financial power to use the apps (Hardey 2019). As a consequence, the marketing decisions lead to additional inequalities that harm the people who may be in most need of the weight loss apps.
Notably, weight loss apps can contribute to the medicalization of weight in many ways. The apps present obesity as a disease through the use of medical-sounding information to explain the physical activity levels and health of the app users. A review of weight loss apps reveals a dis...