Obesity surgery : an ethnography of metabolic im/balance

• Main Author: Porras, Jordi Sanz
• Published: Lancaster University 2011
• Subjects: 616.3
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.662193

Several intemet sites sucp as 'Live Well' run by the National Health Service of the United Kingdom promote a 'healthy lifestyle' among citizens by providing information on how to avoid weight gain. A common recommendation to achieve and maintain a 'healthy' body weight is to balance body metabolism. That is, the energy we put in our body (calories we eat) must be the same as the energy we spend (physical activity). This thesis questions the universality of this recommendation and explores the complexity of balancing metabolism in daily life. In order to tackle this issue, this dissertation is premised by posthuman Science, Technology and Society studies (STS). This implies understanding metabolic balance as a set of practices that involve the association of human and non-humans actors. An attention to everyday practices is the guiding principle as this dissertation locates a study of metabolic balance in a case study of how people who suffer from morbid obesity live with bariatric surgery. Empirically this thesis demonstrates that in practice metabolism needs to be continuously re-balanced in daily life to avoid weight (re )gain. I suggest that the process of balancing metabolism may include sets of practices which are beyond the decision making of an informed individual. Metabolic balance, in the case of bariatric surgery, is shared work, an effect of collaborative work by the collective of cure (' healthy' lifestyle recommendations) and secondary care practices (coping with aspects of embodied living such as eating, masticating, drinking, buying, digesting or exercising). Theoretically, it argues that when metabolic balance after a gastric bypass is achieved, it is an effect of tinkering with secondary care practices of body metabolism. Thus, instead of putting big efforts into patient's adherence to a set of general healthy lifestyle recommendations, more attention should be given to care practices which (im)balance metabolism.