Transformations in the normative character of life and health: The case of lifestyle risk factors

A focus on prevention over treatment has emerged over the last 20 to 30 years as a reaction to the struggles of health services in the face of new and more complex patterns of disease that break with the medical idea that every disease includes a specific cause that can be diagnosed and cured. In preventive medicine, the goal is to avoid or reduce the risk of incidence of disease. Therefore, major international intervention studies aim to encourage patients at higher risk of disease to make prescribed lifestyle changes to reduce their risk. These practices, where a presymptomatic diagnosis is followed by intervention at the biological level to improve the suboptimal organism, are investigated through the lens of Canguilhem’s theories on the normal and the pathological. Interviews with health professionals and patients who participated in a diabetes prevention intervention, display how health professionals express the view that classification as ‘prediabetic’ through a blood sample was an effective technical manoeuvre given existing knowledge. The classified ‘prediabetics’, by contrast, who had not been sick nor experienced any symptoms before the general practitioner indicated that they were outside the normal range, reflect, through narratives, a new bodily awareness in the face of their biological condition; a vitalism as a meaningful ethical demand through measurements and numbers rather than through an orientation toward the body's own senses.