Nested Ecologies

A Multilayered Ethnography of Functional Medicine

By Rosalynn A. Vega

University of Texas Press

How functional medicine leverages systems biology and epigenetic science to treat the microbiome and reverse chronic disease.

Each body is a system within a system—an ecology within the larger context of social, political, economic, cultural, and environmental factors. This is one of the lessons of epigenetics, whereby structural inequalities are literally encoded in our genes. But our ecological embeddedness extends beyond DNA, for each body also teems with trillions of bacteria, yeast, and fungi, all of them imprints of our individual milieus. Nested Ecologies asks what it would mean to take seriously our microbial being, given that our internal ecologies are shaped by inequalities embedded in our physical and social environments.

Further, Rosalynn Vega argues that health practices focused on patients’ unique biology inadvertently reiterate systemic inequities. In particular, functional medicine—which attempts to heal chronic disease by leveraging epigenetic science and treating individual microbiomes—reduces illness to problems of “lifestyle,” principally diet, while neglecting the inability of poor people to access nutrition. Functional medicine thus undermines its own critique of the economics of health care. Drawing on novel digital ethnographies and reflecting on her own experience of chronic illness, Vega challenges us to rethink not only the determinants of well-being but also what it is to be human.

Nested Ecologies is an important read for functional medicine practitioners and advocates, along with other medical practitioners who are interested in learning more about functional medicine, structural competency, and the social and structural determinants of health. Additionally, medical anthropologists interested in alternative medicine, postgenomics, chronic illness, and the politics of access will ﬁnd rich material here, as will food studies scholars interested in clinical approaches to food systems, nutrition, and health. H-Net Reviews (H-Sci-Med-Tech)

Vega offers a much-needed critique of health care systems that normalize managing, rather than alleviating, chronic illness and disease, and that treat symptoms as individual and isolated rather than connected to and made possible by a person’s living conditions . . . Throughout [Nested Ecologies], Vega effectively merges science writing and medical anthropology and offers critical, timely, and vulnerable discussions of health and health care; food production and distribution; and social, medical, and environmental activism. CHOICE

This work is at the cutting edge of a critical, and integrative, medical anthropology. In addition, the auto-ethnography positions this book to be read broadly, across audiences interested in the social sciences and medicine as well as in classrooms. A fantastic and necessary book. Agustín Fuentes, Princeton University, author of Race, Monogamy, and Other Lies They Told You: Busting Myths about Human Nature

Rosalynn A. Vega is associate professor of medical anthropology at the University of Texas Rio Grande Valley. She is the author of No Alternative: Childbirth, Citizenship, and Indigenous Culture in Mexico.