Governing obesity in Denmark

This chapter analyses predominant forms of political rationalities, expert knowledge, and governing technologies employed in the attempt to govern obesity in Denmark. If first examines how obesity became the object of biomedical and political concern through epidemiological studies. Moreover, it accounts for the key health promotion programmes employed to control obesity in Denmark. It points to the importance of a highly organized civil society, notably the gymnastics movement. Finally, by exploring two obesity control programmes targeting child obesity, the chapter examines the workings of health promotion.

Fighting obesity in England

This chapter analyses predominant forms of political rationalities, expert knowledge, and governing technologies employed in the attempt to govern obesity in England. First, we look into some of the historical antecedents to contemporary health promotion by briefly accounting for the preventive measures addressing obesity in the early twentieth century. We then turn to the re-casting of obesity as a question of lifestyle conduct during the 1980s. This is followed by an examination of the mobilisation of the community by the recent British governments and the attempt to apply behavioural knowledge and techniques (nudging) to governing obesity. Finally, we zoom in on the governing of child obesity and the role that the so-called fat camps play in obesity management.

Critical studies of the politics of public health promotion

The chapter provides an overview of existing critical social science studies of health promotion and outlines the analytical framework used in the remainder of the book. First, we review and discuss the merits and the limitations of the most influential political science, political economy, and sociological analyses, seeking to critically address contemporary politics of health. Second, we account for the Foucauldian-inspired analytical framework used in the empirical analyses. This implies accounting for the ways in which we adopt key analytical principles and concepts from Foucault’s work in order to analyse power-knowledge relations and unquestioned norms in the contemporary politics of health.

Promoting recovery in Denmark

This chapter examines political rationalities, expertise, and techniques of government involved in the emergence and implementation of recovery in Denmark. Our overall argument in this chapter is that recovery as a government technology unfolds right between the reciprocally depended practices of what Foucault refers to as government of others and government of the self. While the facilitator of recovery is the health professional, whose professionality comes down to being a coach, the expert of recovery is in fact the patient who is over and again urged to reflect upon herself and the possibilities of improving her current health and functions. The focus of mental recovery is on the lived life, experiences with mental illness, hopes, and dreams. It is in the merging of the expertise of individual transformation and the expertise of experience that recovery operates as a government technology.

Governing public health in England and Denmark

The chapter provides a solid understanding of the historical and political contexts of the obesity and recovery-oriented interventions analysed in the proceeding chapter. The wider purpose of this historical and political contextualisation is to provide an insight into the ways in which health promotion is unfolding in England and Denmark. We argue that three general strategies can be linked to the governing of health in both countries: prevention, cure, and promotion. These are distinct but nevertheless interrelated strategies. All three strategies are relevant today, but health promotion has come to play a hitherto unseen important role in Danish and English health policies since around 1990.

Conclusion

This chapter concludes that health promotion strategies and interventions have supplemented and partially recast earlier curative and preventive approaches in both England and Denmark. On the one hand, it is clear that curative approaches and physical prevention both continue to play a fundamental role in public health politics. On the other hand, it seems clear, at least in the areas of obesity control and mental recovery, that health promotion strategies seeking to augment the productivity and vigour of individuals and the population through a wide range of institutional, psychological, and socialising interventions have grown substantially since the 1980s. The chapter concludes that the terms biopower, constructivist neoliberalism and optimistic vitalism are useful concepts to grasp current modes of health politics.

Introduction

This chapter introduces the reader to the emerging political concern with health promotion in many OECD countries since the late 1980s. It outlines the aims and contributions of the book. Finally, it provides an overview of the remainder of the book.

Promoting recovery in England

This chapter examines the political rationalities, expertise, and techniques of government involved in the emergence of mental recovery in England as a field of more or – very often – less systematic political intervention. Like in many other liberal democracies, the treatment of the mentally ill in England has undergone a substantial transformation from an approach in which relatively narrow biomedical interventions were employed in large-scale mental institutions to so-called community-based care. Our overall argument in this chapter is that recovery is a power-laden practice that works above all through nurturing and structuring the self-steering capacities – the freedom – of the mentally ill. While we strongly sympathise with those that celebrate the emancipatory potential of the de-institutionalisation of the treatment of mental illness, we are also concerned with the new kind of power engrained in the recovery approach.