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Chapter 4 asks how metabolism is diagnosable and treatable, through the sciences of diabetology, nutrition, and surgical amputation. It is concerned with absorption between persons and clinics. Ethnographically, it is anchored in the clinic and works through substances like calories, insulin, and blood sugars as sites of diagnosis and treatment. Morals of individual responsibility and addiction filter into ideas and practices surrounding obesity, and disease categories collapse weight gain into other pathologies along specific relational lines. For some clinicians, diets could shore up their patients’ sense of personal responsibility, with weight loss as a visceral reward for moral fortitude. There were limits to diets, however, as the chapter discusses in the case of prescribing drugs, and in the ultimate limiting factor of limb amputation for diabetics.

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