Communication, Society and Media ISSN 2576-5388 (Print) ISSN 2576-5396 (Online) Vol. 3, No. 4, 2020 www.scholink.org/ojs/index.php/csm 1 Original Paper Change Your Diet, Cure Your Illness: The Content and Consequences of Chronic Illness Food Blogs Gabrielle G. Gonzales1* 1 University of California Santa Barbara, Santa Barbara, United States * Gabrielle G. Gonzales, University of California Santa Barbara, Santa Barbara, United States Received: August 4, 2020 Accepted: August 20, 2020 Online Published: September 13, 2020 doi:10.22158/csm.v3n4p1 URL: http://dx.doi.org/10.22158/csm.v3n4p1 Abstract This year, the World Health Organization expects chronic disease to account for 75 percent of all deaths worldwide. The internet is an increasingly popular source of health information for those suffering from chronic illness. Online blogs, numbered at 152 million have become one of the most popular forms of web content. Specifically, healthy food blogs have emerged, enabling experts and non-experts alike to dispense health and diet information to large numbers of people. However, blogging in the social sciences remains an understudied phenomenon. This project studies the messaging of 65 popular chronic illness healthy food blogs and the potential consequences of the messages including the role of race, gender, and socioeconomic status. I find that two narratives persist on the blogs—the failure of western medicine to heal illness and the benefits of altering diet. These narratives result in empowerment through individual agency and community building for the bloggers. The messages on the blogs are also endangering in their individualization of health, side-stepping structural explanations for health. This research demonstrates chronic illness food blogs as sites for examining the dual effect of self-empowerment through health knowledge and the impact of surveillance and policing of their own and others’ bodies. Keywords healthism, illness, food, social media, agency, gender 1. Introduction As chronic illness is on the rise worldwide, experts and non-experts alike have stepped in to solve the health issues of millions. Besides medical doctors as a source for health information, the internet is now one of the most popular ways that people find information about health issues. In fact, 8 in 10 Americans turn to the internet for health information (PEW, 2011). A unique site to examine the dissemination of www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 2 Published by SCHOLINK INC. health information on the internet is through the healthy food blogs of women suffering from chronic illnesses. Women healthy food bloggers and the experiences they record in their online blogs illustrate the struggle to become well, as a woman, in today’s society and are writing en masse on the internet about how to cure, heal, and manage illness and health through food and diet. They are influential through the sphere of social media, especially Instagram. Instagram accounts connected to healthy food blogs have upwards of one million followers. Many of these bloggers go on to publish cookbooks and make a name for themselves in the world of food and health (Technorati, 2014). Food blogs are unique in their ability to allow individuals to be cited as experts and are relatively free of gatekeeping (Meyers, 2012; Ritzer& Jurgenson, 2010). Despite their enormous popularity, there has been little research done on food blogs across disciplines (Rodney et al., 2017; Dejmanee, 2015). With the rise in popularity of social media outlets like Instagram, Facebook, snapchat, and twitter these blogs have gained immense popularity as sources of information on health, wellness, and diet. Food blogs and concurrent messages about health and food are significant because of their sociological and broader significance. They are a publicly popular yet academically understudied phenomena. They are potentially influential as they attract hundreds of thousands of followers who buy the bloggers’ cookbooks, like their posts and comment on their Instagram pages (Johnston et al., 2013; Trivedi-Grenier, 2008). An exploration of health and wellness food blogs is a rich site to explore attitudes about health and diet in relation to food and morality. The research question addressed in this paper is: what cultural and moral frames about health and food emerge in chronic illness healthy food blogs? For this article, I examine frames from chronic illness focused healthy food blogs two narratives persist on the blogs—the failure of western medicine to heal the women and the benefits of altering diet and lifestyle. These narratives result in empowerment through individual agency and community building for the bloggers. Simultaneously, the messages on the blogs are endangering in the tendency individualize health, drawing upon healthism and side-stepping structural explanations for health. This research demonstrates chronic illness food blogs as sites for examining the dual effect of self-empowerment through health knowledge and the impact of surveillance and policing of their own and others’ bodies, especially bodies that are viewed as unacceptable in today’s society. Chronic Illness and Western Medicine Chronic illness is a major leading cause of death. Chronic illness or disease (Note 1) includes diabetes, obesity, cancer, high blood pressure or any other condition that “lasts a year or more and require ongoing medical attention and/or limit activities of daily living” (Warshaw, 2006). The World Health Organization estimates that three quarters of all deaths will be the result of chronic disease in 2020 (WHO). The health industry, fitness industry, health and food corporations, pharmaceutical companies, western medicine, and the government are attempting to address these perceived problems and all make up the “domain” (Figert, 1995) of chronic illness. Western medical doctors are often those who patients www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 3 Published by SCHOLINK INC. suffering from chronic illness come face to face with as a first line of defense in combatting their illness. However, many chronic conditions cannot be solved by traditional western medical approaches and/or little research has yet been performed on the many chronic illnesses that exist. An alternative approach taking hold is the belief by many that food and diet are a large part of the solution to a variety of chronic illnesses. This is especially true in the lives of food bloggers, when conventional western medicine may fail to address and cure these illnesses. Healthy food bloggers suffering from illnesses and broader health concerns are writing en masse on the internet about how to cure, heal, and manage illness and health through food and diet, reflecting a larger population also suffering from similar conditions. These food bloggers are also lay experts (Epstein 1995) whose personal, individual knowledge related to their own health journeys supersedes western medical advice. Cairns and Johnston (2015), in their research on gendered messages about food and body, claim that expert knowledge is essential to healthy eating discourses in the United States. While I agree, I also bring light to how non-expert, or lay knowledge is also essential to healthy eating discourse. Therefore, this project contributes knowledge on how lay people become experts in specialized fields outside of traditional expert knowledge. Healthism and Medicalization The current political and economic context of neoliberalism has fostered an individualized approach to health labeled “healthism” (Crawford, 1980). Healthism focuses on individual responsibility and moral imperatives, labeling certain foods as good and bad and ultimately certain bodies as good (thin, white) and bad (fat, of color). The underlying belief of healthism is that good health will lead to happiness (Contois, 2015; Bacon, 2015). In many ways, healthism parallels religion in the belief that following a certain set of rules or mandates will lead to salvation/happiness. Cairns and Johnston look at what they call the “do-diet”, a modern, gendered formation of healthy eating. They assert that the do-diet allows women to feel empowered in choosing to eat healthy in today’s neoliberal world. Women face the challenge of expressing agency through consumer choice while also constraining themselves through disciplining the body through diet. Both Cairn’s and Johnston’s sample and my own demonstrate alignment with the individualization of health, risk avoidance, and health as a moral duty (healthism). My sample is unique in that the chronic illness healthy food bloggers are a population who have not successfully avoided risk and are plagued by health problems as opposed to existing in a state of peak health. My research helps answer the broader sociological question of how individuals with chronic illness negotiate their identities in a context of healthism and more broadly, how any individual contends with the mandates of healthy eating in today’s neoliberal context. Food Blogs, Gender, and Self Help In the United States, self-help literature has been popular for decades among the masses, traditionally written by experts in the field and aimed to solve people’s problems on an individual level. Today, blogs www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 4 Published by SCHOLINK INC. have become a new avenue of self-help information written by everyday people. The purpose of self-help books is to provide people with individual solutions to their problems. Self-help literature throughout history reflects larger societal and cultural understandings of the time related to the concepts of self and self-identity (McGee, 2005; Merce Mur Effing, 2009). For example, McGee (2005) discusses the need for people today to maintain marriageability and employability in today’s social and political environment of insecurity and the resulting self-help literature that surfaced to advise people in securing employment and marriage (12). The themes of self-help literature related to healthy food blogs include the focus on individual transformation and the creation of the self. Blogs are contemporary representations of individual perspectives situated within a broader context and therefore provide valuable information about how lived experiences, however self-censored, are reflected within health discourse. These social media platforms serve as interactive public diaries. As J. Rak, an academic in the field of English and film studies, writes that, “blogging [...] is about the act of writing one’s self into existence for others to read and comment upon” (Rak, 2005, p. 176). Because of this, blogs are the perfect site to examine how individuals are discussing their “selves” in connection to food and health and a public conversation around these posts. The existing previous research on food blogs in the social sciences looks at their gendered content (McGaughey, 2010; Noren, 2011). Women dominate the blogosphere as both producers of food blogs and consumers (Cairns & Johnston, 2015; Matchar, 2013; Parsons, 2015). For this reason, scholars have approached food blogs from gendered and feminist perspectives (Rodney, Cappeliz, Oleschuk, & Johnston, 2017) Academics have also researched how blogs are representative of disordered eating behaviors (Boepple & Thompson, 2014; Lynch, 2010). My research extends the analysis of self-help into the internet and more specifically, blogosphere, demonstrating how self-help alters and adapts to changes in technology. 2. Method This paper examines the messages and framing of popular) chronic illness healthy food blogs (n=63)—defined by the presence of an illness, disease, or health condition negatively affecting the life of the blogger. Data for this project are collected from two main sources—personal health and wellness food blogs and personal Instagram accounts linked to these blogs. In order to determine which blogs qualified for consideration, a google search of “healthy food blogs” was conducted as a way of purposive homogenous sampling for those who identify as healthy food bloggers (Kemper, Stringfield, Teddlie, 2003). This approach was used by Lynch (2010), a public health scholar who researched perceptions of food and exercise in a community of food bloggers. I used this approach to assemble a list of 200 healthy food blogs. First I performed a google search of “healthy food blogs”. I clicked on every link that www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 5 Published by SCHOLINK INC. appeared. Usually, the results of the search yielded links to sites of lists of healthy food blogs that had been created by an outside source. I recorded the name of each of the blogs that showed up on each of the links. I did this until I reached a sample of 200+ blogs. Next, I went to each blog site’s “About” page. With the exception of one or two blogs, all blogs have “About” or “FAQ” pages. In order to be included in this research project, the blog author needed to mention any of these key words: “healthy”, “wholesome”, “whole foods”, “wellness”, “clean eating”, “food as medicine” and/or make a connection between food and health. These words denote, from the blogger’s perspective, a particular perspective and explicitly state the importance of the connection between food and health. If the blog’s “about” page connected food and health the next step was to go to their Instagram profiles. Once I reached 200 blogs I went through each blog to collect data on these variables: gender of blogger, age range of blogger, nationality, race/ethnicity, geographic location, start date of blog, level of expertise in food and health (if any), type of diet or food preference, description of health journey (if any). For about ¼ of the blogs, this was relatively easy information to find and figure out. The gender was easy to identify through traditional gender markers such as dress, makeup, and identification as a mom. I determined the relative age range of the blogger through their reference to their age as a “20-something” or “30-something”. If they did not explicitly mention age, I used pictures that they provided of themselves on the blog and the ages of their children (if mentioned) to estimate many of the women bloggers to be in their 30s. Statistically, data has also shown (Meyers, 2012) that most bloggers are women in their 30s. I determined geographic location usually by the explicit mention of where the blogger lived in their about page. If they did not provide this information, I went to their Instagram page. Some bloggers’ Instagram profile pages provide location information. If this information was absent I scrolled through the profile’s Instagram feed to look for any location tags. Location tags are available when posting on Instagram to identify your location. In terms of nationality, I used geographic location to clue me in to their nationality. I assumed the blogger was American if they lived in the United States, appeared white (the presence of light skin color), and did not mention being of another nationality, race, or ethnicity. For those bloggers who were not American, most of them discussed this in their “about” pages. They might say “I’m a Melbourne based food blogger, born and raised here” or “I’m one of the UK’s top food bloggers”, for example. I assumed the blogger was white if they had light/pale white skin unless they mentioned being mixed race or an ethnic last name. One white appearing woman mentioned that she kept her maiden name “Garcia” when she married because she was proud of her Latino heritage on her father’s side. I then categorized her as white/mixed ethnicity. If the blogger had dark skin and was American and lived in the United States and did not mention their race/ethnicity I categorized them as Black/African American in terms of race and ethnicity. Bloggers with Indian background, Middle East Background, or Asian background usually identified themselves as such. www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 6 Published by SCHOLINK INC. I recorded level of expertise if the blogger mentioned having education or expertise in the area of food, medicine, or nutrition. I assumed they had no expertise if they did not mention. To determine the start dates of the blogs I used a variety of techniques if it was not made immediately visible in the about section through the blogger saying something like “I’ve been blogging since 2010”. Because the layouts of blogs are all different I could only employ some techniques successfully on some blogs. On a simple blog layout, I was able to scroll to the bottom of the page where there was located a horizontal bar of numbers with arrows on either side. I was able to go the last page of posts and click on the very first post. The date was usually recorded at the top of the post and I was able to determine the date of the first blog post. Chosen blogs posts and Instagram posts (including image, caption, and comments) were coded using a grounded theory approach that combines deductive and inductive methods also known as abduction. The starting place for developing codes come from the initial research questions—informed by previous research and literature on this topic (Strauss & Corbin, 1990). The data are analyzed in relation to the research questions but theory is constructed from the data itself. The blogs posts and Instagram posts were uploaded into a data analysis software called MAXQDA. Through close reading of these posts, initial open coding took place, a process that allows for the description and categorization of portions of the blogs and Instagram posts based on their content. This entails identifying common words and themes and attaching a code to them and then writing initial memos about the data. Then another round of selective or “focused” coding occurred, which continued to identify important themes while eliminating others that no longer seem relevant. A codebook of relevant codes was created listing the codes and specific descriptions of the codes including examples and criteria for inclusion. Then focused coding took place, helping to refine the conceptual categories through the writing of advanced memos, turning codes into themes and concepts (Charmaz, 2006). When data saturation was reached, or no new data emerged the themes solidified and I wrote further memos about the data leading to potential answers to the research questions and further hypotheses (Bengtson, Endacott, Kang, Gonzales, & Silverstein, 2017; Kang et al., 2019). 3. Result Almost every chronic illness healthy food blogger engages with two narratives related to their healthy journey: the benefits of altering diet and lifestyle and the failure of traditional medicine to address their health concerns. In this section I document how these women food bloggers discuss these two narratives. I highlight the idea put forth by the bloggers that eating “real food” rather than engaging in modern medicine, is the path to a happier and healthier life, as well as the critical role of individual agency. In fact, it is the failure of western medicine that is the catalyst for the women to take their health into their own hands, utilizing their agency as individuals in a neoliberal world. My research positions these (mostly) www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 7 Published by SCHOLINK INC. white women food bloggers as subjects who both reinforce harmful individualizing ideology related to healthism while at the same time resist the imperatives of healthism and medicalization. They are complex subjects who exist at the intersection of race and class privilege while experiencing conflict with medical experts and the medical industry at large. The Failure of Western Medicine A major theme from the blogs is the failure of traditional western medicine to address the women’s health issues. From diagnosis to treatment, western medicine seems to fail these women at every step. Bloggers point to this failure as the reason for why they took their health into their own hands or took “control of their health” as many bloggers say. Bloggers experience misdiagnosis, a lack of resolution for their health problems, and feel they are overprescribed pharmaceuticals, none of which get to the root cause of their chronic illness. In terms of misdiagnosis and lack of resolution for their illness, bloggers say: “Doctors were useless at figuring out what was wrong. Spending almost 7 years going from specialist to specialist with no resolution. Not once was the diet or food allergies discussed.” “After multiple tests and visits to doctors I was still left with no concrete solutions or remedies for my restless nights of agonizing pain.” “I went to numerous doctors, who just didn’t have a clue what was going on with me. I became agitated and stopped seeking medical help because quite frankly I was frustrated!” These bloggers demonstrate the time spent, the multiple doctors consulted, with no real results or relief from chronic ailments. They mention that diet was never mentioned and that as a result of the lack of resolution, they became frustrated and remained in pain. Earthy Andy paints a vivid picture of her ailments and what it was like to live and suffer on a daily basis, Thousands of dollars have been spent on specialists and doctors, medications, and yet never have I achieved much of anything other than a short fix. The cycle of my problems always came back or did not leave at all. This included a long list of chronic stomach pains and digestive issues, celiac disease, fatigue, asthma, allergies, brain fog, leaky gut syndrome, IBS, mood swings, irregular menstrual cycles, candida overgrowth, hypothyroidism, and skin problems. Bloggers mention their doctors prescribing them medications and the bloggers’ refusal to treat their illnesses with these pharmaceuticals. For example, “After diagnosis, I saw conventional and unconventional doctors for years, each of them throwing prescription medications and bio-identical hormones at me, but I knew that wasn't the path I wanted to follow.” www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 8 Published by SCHOLINK INC. From another food blogger, “After two years of struggle my neurologist suggested adding yet another daily medication to my prescription regimen—a treatment plan that wasn’t working anyway. I kindly rejected her suggestion and drove home thinking, “There must be another way.” Pharmaceuticals often failed to get to the root cause of the health problems or address the health problems in a useful way. One of the most popular bloggers in my data (Deliciously Ella at 1.4 million Instagram followers) says,” I was prescribed a cocktail of medication, but unfortunately they had limited success in managing the condition and after about a year I hit rock bottom, both physically and mentally. At this point, I started looking into other ways of managing the condition and began researching diet and lifestyle.” As is evident in Deliciously Ella’s quote, the role of individual agency is critical in healing and finding solutions outside of western medicine. She points out that she began to educate herself on diet and lifestyle. Many bloggers have the same realization. There is a procession of events that occurs in most of the bloggers’ health journeys. First is the failure of western medicine and pharmaceuticals, then is the realization that something outside of the advice of western medicine must be done in order to heal. This translates into women educating themselves and taking their health into their own hands. “In this discovery and quest for natural healing, I realized that if I wanted to heal, I would need to be the key player in my wellness. Even doctors with the best intentions could not care for me on a molecular level, only I could do that.” The method of taking health into their own hands, or this “other way”/alternate solution is changing their diet and realizing the power of whole foods and a healthier diet, “At the age of 12, I was taking 96 pills a week. Not so much your ideal childhood. Unfortunately, back then I had no idea that the food I was consuming was literally killing me. My doctors never mentioned diet to me, so it wasn’t important, right? I was passed around from doctor to doctor, and unfortunately the most they could offer me were antibiotics, which basically worked like a short-term band-aid.” Once again, the solution is in eating differently. As this blogger writes, “After traditional medicine failed to get to the root cause and help me with migraines, autoimmune disease and more health challenges, I turned to whole foods, mindfulness, gratitude practice, natural remedies, self-care, acupuncture and Chinese medicine for healing and overall wellness.” Earthy Andy drives this point home in one of the last sentences on her about page as does Danielle Walker of against all Grain, www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 9 Published by SCHOLINK INC. The best thing I ever did for myself was to take the advice, that I should take my health into my own hands and “become an expert on you”. After a few years of suffering, multiple hospitalizations, and doctors telling me that what I ate wasn't a factor in my disease, I decided to take matters into my own hands and drastically change my diet. The failure of western medicine forced these women to find alternate solutions to their health problems. The following section continues with the themes of individual agency and benefits of changing diet and lifestyle as solutions to the failure of western medicine. The Benefits of Healthy Eating After modern westernized medicine fails to address the women’s health problems, the women take their healthy into their own hands. They do this through educating themselves on alternate forms of healthcare and alter their diet and lifestyle leading to relief from chronic illness. It is evident from the blogs that these changes result in empowerment, health, and happiness for the bloggers, freeing them from lives previously spent ill. Bloggers note a critical point in their journey where they realize that changing their diet will change their lives. For example, one food blogger writes in her “About” section: Instead of feeling better after my diagnosis, I continued to suffer many months of deteriorating health until I made the transition to the Autoimmune Protocol, slowly reversing vitamin and mineral deficiencies and greatly improving my health. She makes it clear that it wasn’t until she changed her diet and lifestyle through the “Autoimmune protocol” that she started to feel better. Another woman points to real food as a way that her and her family began to heal, “Through good, natural, real food my family has overcome Hashimoto’s Disease, chronic migraines, IBS, severe asthma and eczema.” Another blogger says: “In the midst of dealing with a ton of health conditions, I realized I could help heal myself by eating REAL food, instead of the processed junk that makes people sick.” And: “Basically, I detoxed my life, one simple step at a time, and the change was profound. It literally changed my entire life. Yes, you read that right. Toxins were the trigger to it all, and living a life less toxic is what I needed to do to truly heal.” (bold type from blogger) Pervasive throughout my body of data is the role of the individual blogger as agent with the power to change their diet. The use of “I” statements throughout the blogs is striking. This agency to eat “real food” or less toxic food is the key in healing, connecting the ability of the individual person to change their diet. www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 10 Published by SCHOLINK INC. Bloggers point out that not only are they healed but they are happier and overall healthier as a result of changing their diet. An example of this from a blogger states, “I can happily report that since I changed my diet I have been free of all stomach pain. My knees & shoulders feel great, and are no longer inflamed. I now can be in the water surfing for hours without any pain. I was able to free my body from all the inflammation and today I am healthier and happier than ever before.” Another writes, “I began by cutting out the foods that I believed were causing me discomfort–> gluten, meat, dairy products, processed sugar and processed foods. I started incorporating more fibre from fruits, vegetables, nuts, seeds and gluten free whole grains. By making these changes to my diet and adjusting my lifestyle I noticed myself feeling more energised, happy and healthy.” And, “I KNOW, I know in my bones that real food is the key to health, and a healthy, thriving life is the key to happiness.” Not only will real food heal but it will make you a happier, healthier person. The link between health and happiness is made over and over again throughout the blogs. The connection between health and happiness is striking and is reminiscent of religion and the promise of salvation. The relationship between health and happiness is also well documented in research on advertising, demonstrating that in order to sell products to consumers, corporations inspire buying through appeals to happiness. Similarly, these women food bloggers are “selling” their approaches to diet through happiness. The two narratives presented above: the failure of western medicine and the benefits of changing diet and lifestyle illustrate a tension between what I term empowerment and endangerment. A focus on individual behavior and responsibility is a source of empowerment for the bloggers who find freedom in making their own decisions and choices about their health. Empowerment is also found in creating community and helping others in similar situations. At the same time, an individualized approach to health (as opposed to a structural approach) reinforces ideas that are harmful to disadvantaged populations without the privilege or access to take control of their health in the same way (for example, access to certain foods and grocery stores). Consequences of these narratives include the endangerment of the audience and the broader population. The individualizing of social problems ignores structural and institutional mechanisms for health issues and inequalities and potentially misinforms audiences on health issues. Empowerment The women bloggers frame individual agency through a lens of empowerment. They push back on modern medicine and resist medicalization by western doctors, asserting alternative routes to health. They take on the task of fixing their health problems themselves in order to help others in a similar www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 11 Published by SCHOLINK INC. situation, fostering community around their illnesses, providing accessible information, and empowering others in similar situation. This is often made clear in the mission statements of the blogs. For example, “Here at The Castaway Kitchen, our mission is to spread the word that food does heal. That you can embrace the dietary and lifestyle changes that will change your life.” There is an effort made to relate to those out there in the world suffering from similar symptoms and illnesses. In this way, not only are the bloggers empowering themselves, they are attempting to help others create community among those with similar issues. Deliciously Organic writes, “Chronic disease and health issues can leave you feeling helpless. With all of the conflicting advice about food and health, you need solid advice. You need someone who understands. My goal here at Deliciously Organic is to give you sound advice, vibrant recipes that your whole family will love and help you walk down the path towards better health Another woman says, “I am now living my best life through food freedom and I am so excited to encourage and support others who may be fighting the same battles. A few years ago, if you were to tell me that I’d one day be free from my mystery food allergies, energy deficits, and thyroid problems, I would have thought you were crazy. But I’m here to tell you, that there is hope! There is hope that you can turn your health struggles into a health success story.” The message and goal to help others who are suffering is clear in Deliciously Ella’s about page. She says, We knew we wanted to bring what we were doing to a wider audience though, as we wanted make delicious plant-based food even more accessible. So shortly after opening the deli, we set about starting the larger, and most effective way of reaching the most people possible, which was to launch our food products business. We’re only getting started on our journey, but our core purpose has remained the same from when I wrote my first recipe, which is to share the joys and benefits of plant based living. It gave me my life and health back, and between us we can help millions of others too. Nutrition Stripped also discusses accessibility, We believe people should have access to the education they need to support their health in order to make small changes at a time—an ambitious goal, but one that’s a priority for us. While we’re a health and nutrition company and yes, a business, one that sells products, we’re also a company that shares our educational work and content largely for free. The empowerment felt by these women is similar to what is described by Alondra Nelson (2011) in her discussion of the People’s Free Health Clinics of the Black Panther Party in the 1970s. She looks at the concept of “self-health” in the clinics and writes, “Self-health was an important and transformative practice among feminist health radicals. ‘Know your body, know thyself’ Armour remembered. ‘Had I not been doing {self-examination], I might not even be here today’” (89). The PFHC were a structural www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 12 Published by SCHOLINK INC. challenge to medicalization while the food bloggers challenge the medical establishment on an individualized level. However, both foster community and in this way, are collective. As part of a larger collective, white women food bloggers are part of a community struggle to alter and change western medical knowledge structures, provide accessible information, and help others in similar situations. Although the context of white women chronic illness healthy food bloggers and women of color in the People’s Free Health Clinics is vastly different, there is a parallel between the resulting empowerment felt for both groups of women by taking their health into their own hands. However, the white women food bloggers focus on individualized approaches to self-health as opposed to the institutional and structural perspective adopted by the Black Panther Party. Empowerment is also found by these women through resisting medicalization. Women activists and organizers in Figert’s (1995) research resisted medicalization by a variety of interest groups involved in the domain of LLPDD and PMS as psychiatric disorders. The women with chronic illnesses in my sample (contested illness) are also resisting medicalization, or rather, their contested illnesses themselves cannot be medicalized. When offered medications, these women refuse medication in favor of taking control into their own hands and out of the hands of modern medicine and doctors. These chronic contested illnesses are yet to be medicalized in a traditional sense or cannot be medicalized because there is not medical research demonstrating the origin of these chronic illnesses and thus a treatment for them. A result of this issue in the lives of these women bloggers forcing women to have to advocate for themselves in the face of medical authority. The two main narratives of the blogs—the failure of western medicine and the impact of altering diet and lifestyle result in empowerment for the food bloggers. They are empowered as agents in control of their own health, finding solutions where western medicine could not. They also foster community and aim to provide accessible education and information for their audiences. Endangerment While the women food bloggers use their individual agency to feel empowered and foster community, the messages about food and lifestyle proposed by the food bloggers are not only empowering but also endangering. The bloggers potentially endanger audiences on three levels: by individualizing social problems, through a dogmatic policing of diet and lifestyle, and giving out possible misinformation. A source of endangerment is that the information on the blogs leads audiences to rely on individual level explanations and solutions for their health problems, sidestepping institutional and structural forces that shape health outcomes. Numerous quotes from “About” pages reveal messages such as this from Well Nourished, “Change begins with you as an individual but ultimately shapes your family, shapes your world. I believe that without good health there’s not much else.” www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 13 Published by SCHOLINK INC. Traditional neoliberal focuses on causes of health is largely individualized, “The focus on proximate risk factors, potentially controllable at the individual level, resonates with the values and belief systems of western culture that emphasize both the ability of the individual to control his or her personal fate and the importance of doing so (Becker, 1993)”. This approach is particularly seductive for a variety of interest groups, including white women food bloggers because it targets certain core values of American society. In addition, white women food bloggers possess the resources to achieve levels of health through individual intervention. Much of the food bloggers’ messages line up with ideas connected to healthism which places responsibility on the individuals turning food choices into moral imperatives (Connolly & Prothero, 2008; Cairns et al., 2013; Moore, 2010). Healthism does not challenge inequality on a structural level, individualizing the perceived problem. The belief that an individualized approach to health will solve health problems is misleading and endangering. In addition, the messages on these food blogs are somewhat dogmatic and result in potential policing of others’ lifestyles. There is a general lack of acknowledgment in the blogs that different populations have different and unequal access to healthy foods and services. In Foucault’s concept of “governmentality” (1991) individuals engage in self-surveillance and self-governance despite explicit or overt coercion. By regulating themselves through diet and lifestyle changes, these bloggers are to some extent engaging in self surveillance while also surveilling the lifestyle practices of outsiders. The assumption that lifestyles are solely dependent upon individual choices as opposed to lifestyles as a result of institutional structures leads to the blame of populations that do not fall in line with acceptable ideas of health. This is especially apparent in populations whose bodies do not fit into the mold of what an acceptable woman’s body looks like in today’s society—white and thin. For example, within the context of the current “obesity epidemic”, bodies (especially fat bodies) face continued surveillance in the name of public health. Also, the bloggers guide audiences to question the medical establishment that could potentially be helpful depending on what illness they may be suffering from. For example, in the case of diabetes, if an audience member with diabetes refuses to see a doctor based upon the advice of a food blogger, their medical concerns will go unaddressed and may worsen. As most of these food bloggers are not medical experts with years of training, it is possible that their personal experiences with diet and lifestyle may not be right for everyone and in fact can be harmful, especially if the information provided by the blogger is incorrect. The empowerment of chronic illness food blogging is balanced out by the potential endangerment from the messages on these blogs. Food bloggers tend to individualize health, leading to the belief that everyone is responsible and in control of their own health, ignoring structural and institutional forces that shape the lifestyles of individuals. This can lead to surveillance and policing of their own and others’ bodies, especially bodies that are viewed as unacceptable in today’s society. And finally, misinformation www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 14 Published by SCHOLINK INC. about health that is transmitted through the blogs to large audiences is dangerous to those from treatable ailments. Table 1. Descriptive Variables of Blogs (n=63) # of followers (in thousands) Nationality Gender Race Eat Beautiful 10.5 USA Woman White The Curious Coconut 12.4 USA Woman White Real Food with Dana Yum Universe Low FODMAP Inspiration Salted Plains Grassfed Salsa The Healthy Hunter Clean Eating Kitchen She Likes Food Rubies and Radishes Living Healthy with Chocolate Meghan Telpner Feed me Phoebe Ascension Kitchen The Roasted Root Well Nourished Healthy little Vittles Thank Heavens Jessica in the 12.5 12.7 13 15 15.5 16.2 19.4 19.4 22.8 23.4 23.6 23.9 26.4 26.7 27.6 27.6 27.8 30.8 USA USA UK USA USA AUS USA USA USA BR CAN USA NZ USA AUS USA NOR USA Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman White White White White White White White White White White White White White White White White White Black www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 15 Published by SCHOLINK INC. Kitchen Deliciously Organic Veggie Balance Clean Eating Goddess With Food and Love The Garden Grazer Life of Goodness Unbound Wellness Sprinkle of Green Recipes to Nourish Root and Revel Real Simple Good Zen Belly Supercharged Food Gluten Free Cuppatea My Darling Lemon Thyme Downshiftology Cotter Crunch Predominantly Paleo Every Last Bite The Blender Girl Castaway Kitchen Healthy Little Peach Dolly and 31.5 32.9 33.4 39 40.6 41.4 41.8 45.4 46 49.2 51 53.8 60.2 61.8 68.4 71.9 74.4 82.8 83.2 88.2 95 97.2 104 USA USA CAN USA USA AUS USA UK USA USA USA USA AUS UK NZ USA USA USA CAN AUS CUB USA USA Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman White White White White White White White White White White White White White White White White White White White Unknown Latina White White www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 16 Published by SCHOLINK INC. Oatmeal Fed and Fit Living Loving Paleo Simply Quinoa Clean Food Dirty City Autoimmune Wellness Lexi’s Clean Kitchen Mariam Mind Body Health The Vegan 8 The Paleo Mom The Plant Riot Keto DietApp Inspiralized Kris Karr Madeline Shaw Low Carb Yum Lil Sipper Nutrition Stripped Against All Grain Earthy Andy Deliciously Ella 107 108 108 117 121 132 133 140 148 156 171 201 225 278 292 320 332 392 1.1 million 1.4 million USA USA USA USA USA USA USA USA USA AUS EUR USA USA UK USA USA USA USA USA UK Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman Woman White/Latina White White White White White White White White White White White White White White White White White White White 4. Discussion The reach and influence of social media outlets like blogs and Instagram have greatly expanded in recent years. At the same time, so have the rates of chronic disease. Chronic illness food bloggers bridge these two worlds. This article demonstrates the role of women chronic illness food bloggers in providing audiences with information about health, diet, and lifestyle. There are two consistent narratives appearing throughout the 65 blogs—the benefits of healthy eating and the failure of western medicine. The failure of western medicine to address these women’s health issues propels them to find alternate routes of healing. The main route they find is through changing their diets, which not only www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 17 Published by SCHOLINK INC. heals them but also allows them to find happiness. The two narratives on the blogs create both empowerment and endangerment. Empowerment is created through questioning the medical establishment, resisting medicalization, and creating community among other bloggers and audiences who face similar challenges. Endangerment results from individualization of health issues leading to the belief that each and every person is entirely in control of their own health and well-being. This is dangerous because it fails to acknowledge structural explanations for health differentials. The narratives of the blogs are also endangering because they result in the policing and surveillance of health behaviors. And lastly, endangering because of the possible misinformation on these blogs and the advice directing away from western medical practitioners with the potential to solve certain health ailments. References Bacon, H. (2015). Self-tracking in the Digital Era: Biopower, Patriarchy, and the New Biometric Body Projects. Body and Society, 4(2), 92-111. Becker, M. H. (1993). A Medical Sociologist Looks at Health Promotion. Journal of Health and Social Behavior, 34, 1-6. https://doi.org/10.2307/2137300 Bengtson, Kang, Endacott, Gonzales, & Silverstein. (2019). Emerging Developments in Spirituality, Religion, and Aging in New Dimensions in Spirituality, Religion, and Aging by Bengtson and Silverstein. Routledge: New York. https://doi.org/10.4324/9780429463891 Bernell, & Howard. (2016). Use your words carefully: What is a chronic disease? Frontiers in Public Health, 4(159). https://doi.org/10.3389/fpubh.2016.00159 Boepple, & Thompson. (2014). A Content analysis of healthy living blogs: Evidence of content thematically consistent with dysfunctional eating attitudes and behaviors. International Journal of Eating Disorders, 47(4), 362-367. https://doi.org/10.1002/eat.22244 Johnston, C., K, J., & MacKendrick, N. (2013). Feeding the “organic child”: Mothering through ethical consumption. Journal of Consumer Culture, 13(2), 96-117. https://doi.org/10.1177/1469540513480162 Cairns, & Johnston. (2015). Choosing health: Embodied neoliberalism, postfeminism, and the “do-diet”. Theory and Society, 44(2), 153-175. https://doi.org/10.1007/s11186-015-9242-y Charmaz. (2006). Constructing Grounded Theory. Sage Publications: London. Connolly, & Prothero. (2008). Green Consumption: Life-politics, risks and contradictions. Journal of Consumer Culture, 8(1), 117-145. https://doi.org/10.1177/1469540507086422 Contois. (2015). Guilt-Free and Sinfully Delicious: A Contemporary Theology of Weight Loss Dieting. Fat Studies, 4(2), 112-126. https://doi.org/10.1080/21604851.2015.1015925 www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 18 Published by SCHOLINK INC. Crawford, R. (1980). Healthism and the medicalization of everyday life. International Journal of Health Services, 10, 365-388. https://doi.org/10.2190/3H2H-3XJN-3KAY-G9NY Dejmanee, T. (2015). Food Porn as Postfeminist Play: Digital Femininity and the Female Body on Food Blogs. Television and New Media. https://doi.org/10.1080/21604851.2015.1015925 Epstein, S. (1995). The Construction of Lay Expertise: AIDS Activism and the Forging of Credibility in the Reform of Clinical Trials. Science, Technology, and Human Values, 20(4). https://doi.org/10.1177/016224399502000402 Figert. (1995). The Three Faces of PMS: The Professional, Gendered, and Scientific Structuring of a Psychiatric disorder. Social Problems, 42(1), 56-73. https://doi.org/10.1177/016224399502000402 Foucault, M. (1991). Governmentality. In G. Burchell, C. Gordon, & P. Miller (Eds.), The Foucault effect: Studies in governmentality (pp. 87-104). Chicago: The University of Chicago Press. Fox, S. (2011). Health information is a popular pursuit online. PEW. Retrieved from https://www.pewresearch.org/internet/2011/02/01/health-information-is-a-popular-pursuit-online/ Hegde, R. S. (2014). Food Blogs and the Digital Reimagination of South Asian Diasporan Publics. South Asian Diaspora, 6(1), 89-103. https://doi.org/10.1080/19438192.2014.876172 Hopkins, K. (2007). Food Blogs, Unplugged. Where Did They All Come from? Culinate, January 24. Retrieved from http://legacy.culinate.com/content/2053/index.html Johnston, J., Rodney, A., & Chong, P. (2014). Making Change in the Kitchen? A Study of Celebrity Cookbooks, Culinary Personas, and Inequality. Poetics, 47, 1-22. https://doi.org/10.1016/j.poetic.2014.10.001 Kang, Endacott, Gonzales, & Bengtson. (2019). Capitalizing and Compensating: Older Adults’ Religious and Spiritual Uses of Technology. Journal of Anthropology and Aging, 40(1). https://doi.org/10.5195/aa.2019.194 Kemper, E. A., Stringfield, S., & Teddlie, C. (2003) Mixed Methods Sampling Strategies in Social Science Research. In A. Tashakkori, & C. Teddlie (Eds.), Handbook of Mixed Methods in Social and Behavioral Research (pp. 273-296). Sage: Thousand Oaks. Lynch, M. (2010). Healthy Habits or Damaging Diets: An Exploratory Study of a Food Blogging Community. Journal of Ecology of Food and Nutrition, 49(4), 316-335. https://doi.org/10.1080/03670244.2010.491054 MacKendrick, N. A. (2014). More work for mother: chemical body burdens as a maternal responsibility. Gender and Society, 28(5), 705-728. https://doi.org/10.1177/0891243214529842 Matchar, E. (2013). Homeward Bound: Why Women Are Embracing the New Domesticity. New York: Simon and Schuster. McGee, M. (2005). Self Help Inc. Oxford University Press: New York. https://doi.org/10.1093/acprof:oso/9780195171242.001.0001 www.scholink.org/ojs/index.php/csm Communication, Society and Media Vol. 3, No. 4, 2020 19 Published by SCHOLINK INC. McGaughey. (2010). Food in Binary: Identity and Interaction in Two German Food Blogs. Cultural Analysis, 9, 69-98. Meyers, E. A. (2012). “Blogs Give Regular People the Chance to Talk Back”: Rethinking “Professional” Media Hierarchies in New Media. New Media & Society, 14(6), 022-1038. https://doi.org/10.1177/1461444812439052 Moore, S. (2010). Is the Healthy Body Gendered? Toward a Feminist Critique of the New Paradigm of Health. Body and Society, 16(2), 95-118. https://doi.org/10.1177/1357034X10364765 Mur Effing, M. (2009). The original and development of self-help literature in the United States: The Concept of Success and Happiness, an Overview. Atlantis, 31(2), 125-141. Nelson, A. (2011). Body and Soul: The Black Panther Party and the Fight against Medical Discrimination. University of Minnesota Press. Norén, L. (2011). Food Blog Study Descriptive Statistics, Part 1. Graphic Sociology. https://doi.org/10.5749/minnesota/9780816676484.001.0001 Parsons, J. M. (2015). Gender, Class and Food. New York: Palgrave Macmillan. https://doi.org/10.1057/9781137476418 Rak, J. (2005). The Digital Queer: Weblogs and International Identity. Biography, 28(2), 166-182. https://doi.org/10.1353/bio.2005.0037 Ritzer, G., & Nathan, J. (2010). Prosumption: The Nature of Capitalism in the Age of the Digital “Prosumer”. Journal of Consumer Culture, 10(1), 13-36. https://doi.org/10.1177/1469540509354673 Rodney, Cappeliz, Oleschuk, & Johnston. (2017). The Online Domestic Goddess. Journal of Food, Culture, and Society, 20(4). https://doi.org/10.1080/15528014.2017.1357954 Strauss, & Corbin. (1990). Basics of Qualitative Research: Grounded Theory Procedures and Techniques. Sage Publications, Inc. Technorati. (2014). Food Blogs. San Francisco. Trivedi-Grenier, L. (2008). Digital Cameras and Degustations: How Food Blogs Are Redefining Food Journalism in the United States. Unpublished Masters thesis, University of Adelaide. Warshaw, G. (2006). Introduction: advances and challenges in care of older people with chronic illness. Generations, 30(3), 5-10. Note Note 1. Chronic disease and chronic illness will be used interchangeable in this article (Bernell and Howard 2016).