Professional Documents
Culture Documents
Monaghan-2001-Sociology of Health & Illness
Monaghan-2001-Sociology of Health & Illness
Monaghan-2001-Sociology of Health & Illness
330±356
Introduction
Embodiment, emotions, consumption and risk are key themes within the
newer sociology of health and illness and, as stated by Williams et al. (2000:
4), they are as `central to health as they are to mainstream social theory'.
However, this important point about social theorising and `health' (rather
than illness) must be reiterated, emphasised and more widely acknowledged.
Discourses on health, while certainly identifiable within recent and not so
recent medical sociology and anthropology (e.g. Parsons 1951, Schulman
# Blackwell Publishers Ltd/Editorial Board 2001. Published by Blackwell Publishers, 108 Cowley Road,
Oxford OX4 1JF, UK and 350 Main Street, Malden MA 02148, USA.
Looking good, feeling good 331
and Smith 1963, Herzlich 1973, Crawford 1984, Frank 1991), need to be
extended and sustained in a thoroughly corporeal and empirically-grounded
light. That is, studying health necessarily entails incorporating and grappl-
ing with recent body theories in a manner that combines detailed ethno-
graphic understandings of bodies in everyday life (c.f. Nettleton and Watson
1998). Health, after all, is a social and thoroughly embodied construct that
takes a myriad of forms according to social context; it is far more than a
(peripheral) adjunct to social studies of illness and disease (Radley et al.
1997: 5).
Following recent body-centred sociological work and the rapidly expand-
ing social scientific literature on health (e.g. Glassner 1990, Saltonstall 1993,
van Hooft 1997a), this paper underscores the need for an explicit and
empirically informed attempt to bring `healthy' bodies `back in' to medical
sociology. This is necessary because, even among those medical sociologists
who stress the importance of theorising the body, primary emphasis is given
to sickness, disability and death as opposed to vibrant physicality and
associated embodied pleasures (see, for example, Williams et al. 2000: 8±11).
Such emphasis is common (Saltonstall 1993: 7), reflecting a more general
bias within medical sociology and public discussion of health issues. For
example, as stated by Hart and Carter: `Although lip service is made to the
notion of positive health status, and the need to avoid a pathologising bio-
medical perspective, much writing on ``health'' is in fact concerned only with
disease' (2000: 249).
Such negativity is understandable (Hart and Carter 2000). Following
Gadamer (1996), health could be described as an enigma. Similar to the
taken-for-granted body that disappears from (sociological) view (Leder
1990), health, for the most part, `is a state of being which is absent from
consciousness and experienced only in its negation by disease and injury'
(van Hooft 1997b: 245). Moreover, there are important moral and political
reasons for medical sociology's long-standing concern with illness or health
defined in negative terms. As evidenced by medical sociologists adopting a
collectivist approach, illness is not merely a disease of the body but a social
crime. However, and as will be argued below, concerns about illness, while
extremely important, should not obscure the sociology of positive health
and wellbeing. This is because the concrete corporeal manifestations of
`health' in everyday life ± components of and preconditions for embodied
social practice ± may, paradoxically, erode bodily capital while simul-
taneously contributing to it.
Using data generated during an ethnography of bodybuilding subculture,
this paper contributes to the growing sociological literature on health, well-
being and embodiment. It describes the representational and sensual pleasures
that muscle enthusiasts derive from their vibrant physicality. For individuals
embroiled in the positive moment of bodybuilding, such activity is beneficial
to mental, physical and/or social health. From a Foucauldian perspective,
gym culture consists of `practices' or `technologies of the self' which are
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332 Lee F. Monaghan
As stated by Frank (1990: 131) `bodies are in, in academia as well as popular
culture'. According to social theorists, the bodies valorised within popular
culture are overwhelmingly `lived' and active; they are young, sexually
attractive, fit and healthy-looking bodies (Featherstone 1991, Glassner 1990).
However, within recent empirically-grounded body discourses ± as formu-
lated within the sociology of health and illness ± the bodies that are `in'
are typically dis-eased and dys-functional (e.g. Lawton 1998, Twigg 1999,
Williams 1999). Empirically and theoretically, what is therefore needed is an
approach that brings socially inscribed and lived-bodies ± in all their various
states, guises and (dis)abled manifestations ± back into medical sociology.
For body theorists and medical sociologists (e.g. Crossley 1996, Watson
2000), analytic focus upon embodiment provides a useful way of studying
bodies in everyday life. Here bodies are socially constructed and experi-
enced, objective and subjective, specular and sentient. Viewed from this
perspective, the body, self and culture are intertwined: bodies have social
meanings conferred upon them and bodies confer meanings that are consti-
tutive of selfhood in post- or late modernity (Giddens 1991, Glassner 1990).
Various overlapping, conflated and complementary meanings such as
health, youth, social status and sexual attractiveness, may be ascribed to
both men's and women's exercised and dieted bodies. In discussing the
symbolism of the fit-looking body, Glassner (1990) claims exercise has
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Looking good, feeling good 333
(Klein 1993: 148). Importantly, the crucial point of overlap between `risk-
inducing' bodybuilders and `health conscious' fitness enthusiasts more
generally (e.g. weight trainers, joggers, participants in step aerobics) is a
shared attempt to embody and display a sense of empowerment and self-
mastery.
In constituting a postmodern pastiche, the various representational
features of muscle discussed below are conjoined, hybrid and ambiguous
(c.f. Glassner 1990: 230). From a postmodernist perspective, bodybuilders'
body configurations represent the polysemic nature of cultural texts, the
blending and blurring of various insignia (Bolin 1992: 87). As an organising
principle, however, representations of health and youth are discussed sep-
arately. This is heuristic since, in the semantics of postmodernity, `looking
healthy' is synonymous with `looking young' and, one may add, `looking
sexy' (Monaghan et al. 1998). Furthermore, in broaching the postmodern
imagery of muscle, as understood by reflexive body-subjects, the following
highlights some possible reasons for consuming bodybuilding technologies.
Different spatially, temporally and contextually located actors will give
different and sometimes mutually incompatible reasons for adorning their
bodies with muscle. From a postmodernist perspective, such complexity and
contradiction is accepted and expected (Glassner 1990: 225).
In reading the `normative' features of muscle the following analysis
transcends Cartesian dualism. Rather, an embodied understanding of the
external representation of the physical body is provided where the object-
ified body is one manner in which the lived-body shows itself (Turner 1992).
When referring to the social meanings of the sensible body (object of
perception), data pertaining to the sentient body (perceiving subject) are
frequently contained in members' accounts. Just as respondents in Watson's
(2000) study linked health as physical appearance to health as wellbeing,
my contacts often associated `looking good' with `feeling good'. However,
while the lived-meaning of muscle is central in understanding the ongoing
attraction of bodywork, teasing out the `objective' significance of exercised
and dieted bodies serves a useful analytic purpose. This facilitates critical
engagement with other constructivist studies that explain bodybuilding in
terms of gender inadequacy caused by a masculinity-in-crisis and a wish to
embody the physical trappings of hegemonic masculinity (e.g. Klein 1993).
Centrally, it will be argued that (a) hegemonic masculinity is not the only
meaning that may be ascribed to the muscular body's surface, and (b) taken
by themselves, particular meanings attached to muscle partially as opposed
to exhaustively account for the ongoing appeal of bodybuilding.
The partiality of constructivist analyses, which accord central significance
to the external, representational, socially inscribed masculine body, is under-
scored in the latter part of the paper. Here, explicit empirical attention is
given to the sensuous bodily experiences of anaerobic exercise and the per-
ceived benefits for everyday pragmatic embodiment. While such aspects
cannot be divorced from gender considerations, it is argued that theories
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Looking good, feeling good 335
The research
And the thing is about bodybuilding is that you can look fit even if you're
not. That's the thing about bodybuilders. They look tremendous
(Interview 12. Female bodybuilder).
There has been widespread interest in fitness since the early 1980s (Glassner
1990, Klein 1993). Exercise, or more specifically aerobic/cardiovascular
exercise such as running, cycling, and swimming, is often touted as healthful
where `health' and `fitness' have become synonymous in everyday usage
(Glassner 1990: 216). It would appear that a crucial factor in the increasing
public acceptance of bodybuilding in recent years is its connection to the
contemporary health movement (Klein 1993: 147). No doubt, the rising
popularity of nutrition and exercise render bodybuilding attractive to many
health conscious people. A male bodybuilder, who also reported experi-
menting with steroids, remarked: `It's a healthy lifestyle, working out
regularly as opposed to sitting in front of the telly eating bags of crisps and
drinking cans of beer all the time' (Interview 16).
Although bodybuilders have been touted as proponents of a healthy life-
style (Klein 1993: 147), many participants know lifting weights is primarily
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Looking good, feeling good 337
R31: It's all to do with looks, and I would rather look good on the
outside. That's what bodybuilding is. It's not for fitness reasons,
it's all visual.
LM: I suppose it is easy to associate [bodybuilding with fitness] because
you eat low-fat foods to get a good physique.
R31: I don't eat low-fat food because it's good for you. You're eating
them because you know it's what you have to eat to look like
you want to look. It's not the health.
LM: [. . .] If you could eat chips and were guaranteed to put on muscle,
would you?
R31: Yes, I would be in my element, I would love it. I'd be round the
fish shop every night (Interview. Male Bodybuilder).
For most bodybuilders the health of the `inner body', derived from exercise
and eating a nutritious diet, is secondary to the healthy look of the `outer
body', and is considered an `added bonus'. Indeed, the look of the outer
body is so central that during contest preparation possible adverse effects to
health are accepted in order to improve the appearance of the body (as
judged by ethnophysiological or subcultural aesthetic criteria). For instance,
body-fat is depleted to extremely low levels to enhance muscle visibility:
Alan: When I was competing I got down to 2.6 percent body-fat. It's
not healthy but it's good. It feels good to look like that. My fat
got so low though. Ha, I've got this leather sofa at home. It's
normally quite comfortable but when I was ripped [displayed no
body-fat] I had to put a cushion under my backside if I wanted to
sit down. It was so painful if I didn't as I had no fat there to act as
a natural cushion.
Jack: When [professional bodybuilder] competed I heard his body-fat
was so low he got blisters on the soles of his feet when he was
walking on and off stage. He didn't have any fat on his feet to
cushion them (Field Diary, 21st January 1995: Al's Gym).
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338 Lee F. Monaghan
I know guys who were in school with me and we were the same
[physically] when we left school, and I've gone this way [taken up
bodybuilding] and you ought to see the state they're in now. And
they've got high blood pressure and their cheeks are flushed and things
like that, pot bellied as well. I think, well, you know, I wouldn't want to
look like it. I think I take too much pride in myself because you have to.
I think you have to take pride in yourself, in your appearance and that
sort of thing. And, I couldn't look like it [old school friends]. I'd hate it.
I'd hate myself for looking like that full stop. So I think that's what
keeps me going [to the gym] as well (Interview 16. Male bodybuilder).
And:
You look fit. People always remark how fit I look even when I'm tired.
They always say `you look really fit and healthy' and they used to say
that to me when I was dieting [for a bodybuilding competition]: `you look
great, your eyes are shining, your skin is clear' (Interview 11. Female
bodybuilder).
There is the sense in which bodybuilding dissolves dualities where the inner
and outer body become conjoined: enhancing the appearance of the outer
body helps maintain the inner body and vice versa (Glassner 1990: 233).
Except for those occasions when bodybuilders strictly adhere to pre-contest
diets, or when physique-enhancing drugs are taken `incorrectly' (Monaghan
2001), bodybuilders (similar to fitness enthusiasts) claim looking healthy
(muscular, low-fat) equals feeling and therefore being healthy. As stated by
interviewees in response to the question: `which is more important to you,
looking or being healthy?'
They're both important, but looking healthy I think is the key rather
than being healthy [. . .] But one complements the other. Because if you
look healthy you're going to feel healthy. You're going to feel healthier
anyway aren't you? (Interview 30. Female bodybuilder)
I would always like to think that people always come up to me and say:
`well, fair play, you look fit sort of thing'. And going to my doctor, he
says: `well you're fit' [. . .] But you know, like I say, it [looking and being
healthy] is combined. It's a mixture of the two (Interview 18).
In sum, while health and fitness are not necessarily central reasons for
bodybuilding, in achieving an image of healthiness many participants are
able to interpret this as a sign that they are also healthy. No doubt, this
contributes to the ongoing appeal of bodywork, independent of antecedent
insecurities and inadequacies caused by a masculinity-in-crisis (Klein 1993).
Postmodernity entails creating what Glassner (1990) terms a `post-dualistic
selfhood' where there is a merger of such oppositions as inner and outer:
service of the outer body confers benefits on the inner body and vice versa.
Even if bodybuilders accept that (some of) their activities are physically
harmful, contrary to Klein (1993) this does not mean they are dissimilar to
fitness enthusiasts. As noted, bodybuilders are akin to other fitness trainers
because both achieve positive health conceived in representational rather
than instrumental terms. Certainly, bodybuilders' `healthy-looking' bodies
may digress from normative images of embodiment given their size, pro-
portions, muscle mass and leanness. However, bodybuilders' physiques are
not radically dissimilar from athletically muscular bodies; the former are
an exaggeration and extension of the latter (Monaghan 2001: 84). Body-
builders, similar to weight trainers, may therefore account for their activities
on health grounds given the gender-wide symbolic meanings attached to
lean, strong, athletic bodies.
Youthful bodies
Well, there's a saying isn't there? `You don't stop training because you
grow old, you grow old because you stop training' (Interview 38. Male
bodybuilder).
The ageing individual, who experiences severe bodily decline through dis-
ability, to the extent that the body imprisons and masks the inner self, is one
representation of ageing. This contrasts with images of `the ``heroes of
ageing'', those who adopt a positive attitude towards the ageing process and
seem to remain ``forever youthful'' ' (Featherstone 2000: 609). Bodybuilding
is an activity clearly aligned with positive representations of ageing.
The concept of `muscle maturity' is familiar to most bodybuilders. This
refers to the quality and condition of muscle following years of continuous
exercise and diet. Similar to vintage wine, the trained body reportedly im-
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Looking good, feeling good 341
proves with age. In noting this aspect of the subculture, Klein (1993: 147)
quotes an excerpt from an indigenous magazine: `bodybuilding is one of the
few sports ± and possibly the only sport ± where athletes can honestly say
they are finally reaching their peaks in middle age'. A male bodybuilder
aged 37 remarked:
I've spent all my life with what I consider to be a good physique and as
I'm getting older I find it even harder to fade away to obscurity. And
I'd like to surpass what I've done in the past. I'd like to be better than
what I've been (Interview 24).
The postponement of ageing by sport, the body beautiful and the main-
tenance of a youthful appearance are major societal concerns for both men
and women and are themes addressed in the sociology of the body literature
(c.f. Featherstone 1991, Turner 1991). Importantly, since self-mastery and
the ability to hold onto youth are dominant societal concerns, bodybuilding
is well placed to take advantage of this interest in the body (Klein 1993:
147). Below a female bodybuilder talks about her wish to improve her body
over time:
R30: In like five years' time I'll be 34 and if I can achieve something like
that [looking at a photograph of a competitor's physique] I'll be
happy [. . .]
LM: So as you get older you're body's going to be getting better in
your view because that's what you want to achieve. And a lot of
women when they're sort of approaching 30 and they think it's
pretty much downhill from there on but . . .
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342 Lee F. Monaghan
R30: Well, when I got to 29 I stopped and thought: `my God, I'm
going to be 30 next year and I want something to aim for'.
Because as you say, a lot of people think `30, oh my God'! You
know? `It's downhill'! I wanted just to get, I wanted to better
myself (Interview 30).
While at an analytical level the study of the body may demand a trans-
cendence of dualistic thinking, at the experiential level dualistic thinking
may be perpetuated (Bendelow and Williams 1995: 88). Indeed, since body-
subjects are able to conceive of themselves as objects, it is possible for
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Looking good, feeling good 343
For Klein (1993: 147), bodybuilding contradicts the health movement which
is supposedly geared towards longevity. The use of drugs in bodybuilding is
considered anomalous; it seemingly counters the sport's public declaration
of holding onto youth and the desire for physical immortality. However,
given the foregoing discussion one may appreciate why bodybuilding regimens
and the use of physique-enhancing drugs often prove attractive. Training and
diet, as well as carefully planned steroid use (see Monaghan 2001: 95±128),
enable participants to look and feel younger, fitter and more healthy over
longer periods of time. The potentially health-damaging practice of drug-
taking for purposes of looking healthy takes on dimensions of rationality
within postmodernity. By blurring certain dualities (e.g. old and young,
mortality and immortality, inner and outer body) it reflects the contempor-
ary human dream to control corporeal existence (Glassner 1990, Wachter
1984). Fitness in its postmodern guise, which is attainable through body-
building, offers an intimate and holistic marriage between self and body:
`the twin victims of Cartesian culture reconcile their differences at long last.
The self ``in touch with'', ``caring for'', ``in control of'' the body, no longer
need experience the body as but another object out in the world (Mead 1934:
164)' (Glassner 1990: 221).
A final point should be made concerning the use of bodybuilding drugs in
countering the ageing process. It is reasoned that for all the benefits exercise
and nutrition may confer on physical appearance, this aspect of ageing can
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344 Lee F. Monaghan
LM: But do you think now, as you get older, your muscles do go, even if
you carry on training?
R29: Of course they do. You've seen Freddy training [in his 50s] and
a lot of guys my age. Now, unless you're banging in, you know,
testosterone replacement [i.e. steroids]. You know, your hormone
levels drop don't they? Drastically.
LM: They're supposed to drop after 20 aren't they, after 20 they start
going down?
R29: And after I think after 30, 35 they really take a nosedive
(Interview 29).
Old age! Well, you're fighting a losing battle really. But you are putting it
off. Well, even if you look at guys about 40, you know, they take their
shirts off in the swimming pool and you think: `fucking hell, I don't
want to be like that!' You don't do you! And that's what you'd be like
without the weights. So the weights do you a favour (Interview 29).
The greatest feeling you can get in the gym or the most satisfying
feeling you can get in the gym is the Pump. Let's say you train your biceps:
blood is rushing into your muscles and that's what we call `the Pump'.
Your muscles get a really tight feeling, like your skin is going to explode
any minute. You know it's really tight like somebody is blowing air into
your muscles. It just blows up and it feels different, it feels fantastic.
(pause) It's as satisfying to me as coming is, you know, as having sex with
a woman and coming. So you can believe how much I am in heaven?
(Arnold Schwarzenegger, cited by Wacquant 1995a: 176)
constructive of both the specular and the sentient body and is grasped
retrospectively as a worthwhile experience:
LM: Talking about the workout and the pain involved in training. . .
R24: Yeah, I suppose in one way the end justifies the means, you know,
that the pain is something that has to be endured to get the end
[a muscular body]. But I enjoy, I enjoy pushing myself through
that threshold of pain. I find it gives me ± maybe it strengthens the
character. Maybe you feel that you can then take on lots of things
in the world. If you can just do this to yourself without anybody
really making you do it, then I think it gives you great depth of
character [Yeah?] Enables you to take on other problems ± I know
that when I'm training 100 per cent other problems they pale
compared to if I'm not training and I feel able to take on things
and to sort out things much better when I'm in top shape
(Interview 24. Male bodybuilder).
For this bodybuilder, the emotions associated with physical and experiential
embodiment directly impact upon what Watson (2000: 118-19) terms
`pragmatic embodiment': a functional rather than representational mode
of bodily construction. This point is concordant with a gender analysis
of bodybuilding. For example, pragmatic embodiment (the immediate
everyday social body) is implicated in the construction of masculinity in the
public world of formal employment. (Similarly, see Lyons and Willot 1999:
295±6, regarding the significance of the `health as productivity discourse'
vis-aÁ-vis masculine identity, power and class.) Of course, the performance of
gender may be independent of biological sex. Women bodybuilders may also
embody competence and force i.e. traditional masculine attributes (Connell
1983), which has perceived benefits for the pragmatic and experiential body:
When I go down to the gym, I go there with a goal in mind, and when
I come out of there I nearly always feel that I've had a brilliant
workout. `God, that was brilliant'! I feel powerful, I feel strong, I feel
energetic. It's just a nice feeling. But I don't know any other sport that
you can get that sort of rush every workout almost (Interview 33. Male
bodybuilder).
Um, it's probably like a drug addict. It's, they say it's a needle going in
which, you know, they're addicted to. With me, it's, I get addicted to
the resistance I'm pushing against. And when I overcome it, it gives me,
you know, a lot of satisfaction (Interview 29. Male bodybuilder).
Another man claimed the feelings experienced in the gym surpass those
associated with psychotropic drugs: `I feel high as a kite when I come out
of the gym [. . .] It's better than drugs. It's better than a drug and that's the
truth' (Interview 36).
The comparison with drug addiction, however, may also carry negative
connotations, possibly undermining selfhood. It would appear that the
similarity between bodybuilding and drug dependency, for those embroiled
in bodybuilding, is not a literal comparison. Although competition body-
building entails health risks, some participants maintain that bodybuilding
is less dangerous than chronic drug addiction. A male junior competition
bodybuilder and steroid user said: `I suppose training is [like a drug]. It gives
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348 Lee F. Monaghan
R43: I got into heavy drugs and things [heroin] so I used bodybuilding
to change the people I was hanging around with. Anything,
because like, if you're a junkie [and you want to give up the drug]
you've got to understand [. . .] you've got to change your whole
lifestyle. So I thought I'd go from one extreme to the other. Go
from abusing my body to rebuilding and putting something back
into my body and that's what I did. I cut everybody out and
just went to the gym and trained and trained and trained until
I was . . . Now I could stand in a room with these people [heroin
injectors], I can watch them do what the hell they like and it
wouldn't affect me, whereas a few years ago, I couldn't have. I'd
have been tempted [. . .] it's taken me five years to get here you
know so, that was my first reason for doing it, to swap my
addiction from being a junkie into a bodybuilder basically.
LM: So when you say addiction, do you think bodybuilding's almost
like a drug?
R43: Of course! [. . .] Bodybuilding, running, anything. If you take it
on strong enough it will be such a big part of your life that you
won't be able to do without it, so that to me is an addiction.
LM: To you it's better than being addicted to heroin?
R43: Oh definitely. I'd rather go in the gym and press weights than go
into my house and press needles in my arm at the end of the day.
problematic for the health professional because it is here that the social
and physical boundaries of bodies touch (Watson 2000: 119). However,
describing the experience and wider impact of emotion and hidden visceral
processes, which are associated with intense physical exercise, does much to
explain the sustainability of `risky' bodywork. Here the often chemically
enhanced `healthy' bodies actively participating in gym life experience a
positive sense of wellbeing. Bodybuilders, similar to weight trainers and
others engaged in regular vigorous exercise, are able to state that they not
only `look good' but also `feel good'.
Conclusion
Shilling (1993) observes that the body has had an `absent presence' within
sociology. The burgeoning social science literature on the body since the
1980s partly counters this neglect but it does not go far enough. Wacquant
(1995b), for example, complains that one rarely encounters actual living
bodies of flesh and blood within recent social studies of the body. Similarly,
Watson (2000: 51±60) bemoans the fact that the sociology of the body
is theoretically driven and empirically lacking. It is also hamstrung by
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352 Lee F. Monaghan
Acknowledgements
Notes
1 Following a recent paper on the normalisation of drug use among those attend-
ing the Sydney Gay and Lesbian Mardi Gras, such readings are also necessary.
As stated by Southgate and Hopwood (1999: 303): `. . . cultural and subcultural
constructions of pleasure, lifestyle and health need to be considered if the
demand for illicit substances is to be adequately accounted for'.
2 Of course, what actually constitutes an aesthetically pleasing body, and thus what
serves as a source of personal satisfaction, varies between and among types of
gym member (Monaghan 1999b). Such variation, it should be added, is only
analytically relevant relative to one's particular research questions. Elsewhere such
heterogeneity has been of central analytic concern (Monaghan forthcoming).
However, in this paper, I have different aims; namely, to explore what is actually
a basis of commonality within popular gym culture.
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