‘Anti-Aging Medicine’ and the CulturalContext of Aging in Australia

Preliminary Findings from Ongoing Researchon Users and Providers of ‘Anti-AgingMedicine’ in Australia

BEATRIZ CARDONA

Centre for Cultural Research, University of Western Sydney, Penrith,New South Wales, Australia

ABSTRACT: This paper explores the management of the aging bodywithin the anti-aging discourse and its implications on notions of “suc-cessful” and “healthy” aging policies. By looking at some of the prelimi-nary findings of our current study of ‘anti-aging medicine’ in Australia,including interviews conducted with stakeholders in the anti-aging de-bate, this study explores some recurrent values and perceptions regard-ing ‘anti-aging medicine,’ the renegotiation of boundaries between illnessand health, and the social, cultural, and economic forces shaping under-standings and practices around aging and decisions to use anti-agingtechnologies.

KEYWORDS: ‘anti-aging medicine’; healthy aging; positive aging

BACKGROUND INFORMATION

“The war on anti-aging medicine,”1 with leading gerontologists and anti-aging practitioners and marketers fighting over the meaning of old age2 and thescientific validity and legitimacy of existing anti-aging therapies to alter theaging process3 and prolong life, has so far excluded the views and perceptionsfrom the consumers of these technologies. Despite evidence of a huge publicinterest in and willingness to pay for interventions that delay at least the appear-ance of aging,4 there is no current information available on the reasons whypeople pursue these practices. Common assumptions on why people use ‘anti-aging medicine,’ as pointed out by Lucke and Hall,4 include fears of disability

Address for correspondence: Beatriz Cardona, Centre for Cultural Research, University of WesternSydney, Locked bag 1797, Penrith South DC, NSW 1797 Australia. Voice: +61 2 9685 9600; fax: +612 9685 9610.

b.cardona@uws.edu.au

Ann. N.Y. Acad. Sci. 1114: 216–229 (2007). C© 2007 New York Academy of Sciences.doi: 10.1196/annals.1396.000

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and death and the pursuit of health in old age. The present study explores thesebeliefs along with the social discourse and structural transformations that giverise to the construction of the aging self using these narratives.

Definitions of what aging means in the 21st century, explains Katz,5 in-clude terms such as “positive aging,” “healthy aging,” and other terms froma new discourse promoting stereotypes of aging as a period of independence,choice, mobility, and autonomy. These new images of aging contrast sharplywith past perceptions of aging as a period of decline, decrepitude, and de-pendency. According to Katz this change in perception is the result of effortsby gerontologists in the 1960s to address an ageist discourse that fosteredinequality and victimized human differences.5 Notions of positive aging, how-ever, are closely linked to anti-aging values and the spread of an anti-agingculture, which, according to Katz, reinvents notions of maturity and growingolder without aging. The process of growing older unaffected by aging as-sumes the possibility that the physical and physiological signs of aging, suchas the wearing out of the body, reduction in mobility, and disability associ-ated with age can be treated to compress morbidity and improve the qual-ity of life. Part of the controversy surrounding this anti-aging discourse isnot generated by the potential of scientific intervention to achieve such com-pression of morbidity and improvement in the quality of life of elder people,but rather because it is characterized by an implicit ageism and a focus onconsumerism.

In Australia public health campaigns and health-promotion strategies, suchas the National Strategy for an Aging Australia, approach the issue of agingby promoting strategies that prioritize physical health and aim to enhance theability of aging individuals to manage their health needs. Campaigns promotingthe benefits of exercise and healthy dietary regimes have been part of thisstrategy. Less attention has been given to the physical, social, and economicenvironments in which elderly people live and the relevance of this environmentfor health outcomes.6 The cultural context informing some of these health-oriented discourses represents health outcomes as phenomena that lie in thehands of individuals, requiring appropriate lifestyle modifications.7 Age hasbecome a concern to a wider public and, as the inefficiencies of old age becomecostlier and costlier in the public mind, the body itself becomes a matter ofincreasing concern.8 Preventive medicine and aspirational sciences that seekto prevent age-related illnesses exist alongside governmental strategies thatdisinvest in long-term health care and financial support for an aging population,while directing aging individuals toward developing their own strategies for thegovernance of old age. Choosing ‘anti-aging medicine,’ this study will argue,represents one of many strategies that both constrain and facilitate identity inold age. Users of these controversial technologies seek, with varying degreesof success, to resolve the contradictions and challenges posed by aging incontemporary society.

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MATERIALS AND METHODS

This study proceeded using the following means:

(1) Twenty five in-depth qualitative interviews were held in Sydney, Mel-bourne, and Brisbane with both users and providers of ‘anti-agingmedicine’ as well as other key stakeholders in the anti-aging debates.

(2) A variety of texts relevant to the discourse, including anti-aging litera-ture, biogerontological research magazines, media channels, and popularmagazines, were critically analyzed.

(3) Social theories of globalization were used to understand the interplaybetween the global and local structures that shape the expansion of theanti-aging market.

PRELIMINARY ISSUES EMERGING FROM THE INTERVIEWS

This paper presents only a partial and summarized view of some of theemerging issues. A final report with a comprehensive analysis of ‘anti-agingmedicine’ in Australia through the views of consumers and providers and otherkey players in the anti-aging debate will be made available in future.

Preliminary issues emerging from the interviews showed:

• conflicting definitions and understandings of ‘anti-aging medicine’;• shifting interpretations of social discourses on aging: anti-aging and

“healthy aging”; and• deception, self-deception, or self-assertion by the anti-aging consumer.

Conflicting Definitions and Understandings of ‘Anti-Aging Medicine’

The providers of ‘anti-aging medicine’ in this study had a background inmedicine, having first worked as general practitioners before migrating to‘anti-aging medicine.’ The decision to specialize in this area was based onpositive personal experiences with ‘anti-aging medicine’ along with financialincentives. Different positions regarding the meaning and objectives of ‘anti-aging medicine’ were enunciated; some providers saw anti-aging as part ofcomplementary and alternative medicine (CAM), while others reinforced its“scientific” and mainstream biomedical character:

I work the natural way, stimulating the creation of hormones using naturalproducts. It is dangerous and I don’t recommend the use of synthetic hor-mones. [anti-aging practitioner]

I don’t consider ‘anti-aging medicine’ as alternative. I consider more thingslike naturopaths and homeopaths as alternatives. But ‘anti-aging medicine’

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is proper medicine. It is preventive medicine using products such as humangrowth hormone. [anti-aging practitioner]

The issue of what is “legitimate” ‘anti-aging medicine’ was evident, asvarious and conflicting positions were adopted by practitioners working indifferent fields. Although these physicians referred to themselves as “anti-aging doctors,” there was an absence of consensus as to what ‘anti-agingmedicine’ means, the risks and benefits associated with some products, andthe legalities of prescribing drugs such as human growth hormone (HGH) foroff-label uses.

Disparities in knowledge and source of information for the use and prescrip-tion of products such as hormone treatments for anti-aging purposes emerged,with some practitioners relying more heavily than others on pharmaceuticalcompanies’ guidelines to inform their practices, while others accessed re-sources and information from various medical journals and research. Personalexperiences with anti-aging treatments by practitioners themselves also pro-vided important clinical evidence used to inform their practices.9

My patients look at me and they can’t believe I am 74. I tell them my secret,hormones, human growth hormone. I have been using it for the last 10 yearsand as you can see I don’t look my age at all. When people see this they wantto try the same treatments for themselves.

Central to current debates on ‘anti-aging medicine’ by leading gerontolo-gists and anti-aging supporters concerns the issue of legitimacy as well as theperception of misuse, exaggeration, and/or extrapolation of biogerontologi-cal research for commercial interests. More importantly there is disagreementamong biogerontologists as to whether there are any anti-aging therapies cur-rently available to halt, slow, or reverse the aging process. From the pointof view advanced by Olshansky et al.,3 which supports a definition of agingbased on the biochemistry of cellular metabolism, ‘anti-aging medicine’ doesnot currently exist, as no interventions yet exist capable of modulating theaging process itself at the molecular level.

Anti-aging researchers, such as Livesey and Raffaele,10 challenge this strictmolecular definition of aging and point to a clinical-organismal definitionto argue that there are many therapies scientifically proven to at least slow,and in some cases reverse, the changes in the function and structure of aginghuman bodies. Among therapies cited by these scientist–entrepreneurs arehormones, such as HGH, DHEA, melatonin, and nutritional supplements, thatcontain synthetic and natural anti-oxidants which are argued to slow down theaging process by preventing or delaying physiological decline and aiding lostfunctional abilities to be regained.

The use of these therapies in private clinics and for commercial interests,rather than in hospitals under the control and supervision of geriatriciansand for medically defined age-related illnesses, reflects tensions and power

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issues between institutions and individuals for the control and management ofknowledge about bodies, illness, and aging. Critics of ‘anti-aging medicine’point to the risks involved in poorly supervised practices, the financial costsfor consumers, and false expectations that the “fountain of youth” can befound in hormone treatments. This criticism is rebuked by both anti-agingpractitioners and consumers in this study by pointing to clinical evidence andby questioning the motives behind such attacks as well as challenging per-ceptions of consumers as vulnerable and unable to make informed decisionsabout the products they purchase to satisfy a need not yet met by orthodoxmedicine.

I think you could do yourself a lot of damage if you acted irresponsibly withwhat’s out there, no question. I think even in terms of a lot of medicine thatpreviously was on prescription is now over the counter. . .so, yes, it’s certainlya case of buyer beware. [Ronald, aged 51]

I get information in the internet before buying and so far nothing has made mesick or unwell. . . . on the contrary I feel better so how you feel is important,you can judge for yourself. [Galia, aged 49]

The expanding influence of ‘anti-aging medicine’ threatens the status andfunding of biogerontological research11 and challenges the dominance of insti-tutional discourses and management of knowledge about aging bodies. In hisanalysis of what is at stake in “the war on anti-aging medicine,” Vincent1 con-cludes that the field of gerontology is genuinely faced with a crisis provokedby unprecedented understanding of the biological mechanisms of aging.1 Heargues that it is a cultural crisis brought about by the belief in the infallibilityof science to cure aging and death.

Through this study it also becomes evident that this “crisis” gerontology isfacing resonates with the cultural construction of aging as decline. The dom-inant decline ideology promoted by science stigmatizes aging and old age,making it possible for society to create another type of crisis: the midlifecrisis, prompting aging individuals to seek remedies to halt the advent ofthis loss associated with later life. Positioning aging as a demographic, so-cial, and economic “crisis” in the 21st century has added further impetusto negative perceptions of the role and contribution of aging populationsto social and economic development. It has also prompted the adoption ofglobal and local political rationales which, along with new scientific conceptsof temporal biological processes, are all parts of the contingent social con-ditions that can produce anti-aging and enhancement technologies directedagainst aging.12 The extent to which gerontology engages with these cru-cial issues, including the impact of narratives of decline and loss in later lifeand the belief science has the answer to these challenges, will be an impor-tant factor in determining how ‘anti-aging medicine’ develops in the newcentury.

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Shifting Interpretations of Social Discourses on Aging: Anti-Agingand “Healthy Aging”

Crucial to an understanding of the motivations and forces behind the de-cisions to consume anti-aging technologies and therapies lie social, cultural,and economic narratives advanced by institutional agencies and disciplinesgoverning the lives of aging populations. Modern constructions of aging ad-vanced by medical institutions, Third Age advocates, global consumer markets,and national and international policies on aging position the aging process asone characterized by both risks and opportunities. The role of the state, asPhillipson points out,13 is crucial in the construction of old age, as evident inits allocation of resources for the aged and policies, such as enforced retire-ment and welfare entitlements. However in the 1970s the state began to retreatfrom its acquired obligations toward the elderly, including rationalization ofhealth and community care services to the more recent restructuring of wel-fare entitlements, personal financing of old age, and retirement age, leadingto what Phillipson calls a “collapse of consensus” about what to expect inold age.

These challenges to personal and collective identity have been further ex-acerbated by the dramatic expansion and global influence of biomedicine andits attempts to fill in the vacuum left by the retreat of the state in guaran-teeing consensus about old-age rights, expectations, and possibilities. The“biomedicalization of aging,” as first referred by Estes and Binney,14 at-tempts to construct aging as a medical problem to be alleviated in part bymedical intervention. Despite the array of evidence of the importance of so-cial, economic, and behavioral factors in explaining the experiences of oldage, the biomedical model is becoming the “institutionalized thought struc-ture,” influencing research, policymaking, and views about aging and scienceitself.7

The most important implications of a biomedical model of old age are theconstruction of old age as pathological and undesirable and biomedicine as aform of social control of the elderly through medical definition, management,and treatment.7 The following extracts provide example of how consumers of‘anti-aging medicine’ have incorporated mainstream discourses about agingpromoted by medical knowledge and social policy directions to justify theirdecisions to consume anti-aging products and therapies.

What’s the good of living in your 80s if you’re going to be in a nursing home?‘Anti-aging medicine’s’ really the insurance policy. [John, aged 53]

I just don’t want to end up sick and debilitated and being looked after by peo-ple. Plus, I’ve got a very strong sense of responsibility and being personallyresponsible for what I do and not wanting to impose on other people. [Sharon,aged 43]

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The power of official discourses on aging as illness and decay, and newdisciplines of self-care and self-funding produce new identities and behaviorsfor individuals, as evidenced in the respondents’ concerns with ‘anti-agingmedicine’ as an insurance against the risks of financial or care “burden” onothers. Significant also in this analysis is the understanding of the respondents’life-long experiences structured around social class, economic opportunities,and cultural preferences. Health-related behaviors are influenced by socialdeterminants such as education, income, occupation, life events, and socialnetworks,15 calling for a more nuanced social and structural analysis of theinformants’ life-course.

Most of the users of ‘anti-aging medicine’ in this study identified themselvesas financially well off and belonging to upper-middle-class backgrounds. Theyall had tertiary education and 90% were employed in business and professionalsectors. Their perceptions of what health and healthy means coincide withprevious research in Australia, including the Health Status of Older People(HSOP) project, conducted in 1996,16 showing that older people place greatimportance on keeping physically and socially active. However, in contrast tothe HSOP study, anti-aging consumers do not see “absence of disease” as anunlikely ideal, but, on the contrary, a real possibility to be achieved throughlyfestyle and consumption choices. This higher expectation also contrastedsharply with an East Sydney Area Health Service study of elderly people fromeconomic and socially disadvantaged backgrounds in the Eastern Sydney areawhich found that elderly people were more willing to endorse a view of agingas an unremitting decremental process with expectable stages of decline.17

This perception of an inevitable aging-related decline along with a belief thatgood health can largely be attributed to “good fortune” positions them in sharpcontrast with anti-aging consumers in this study. Such contrast in views andexpectations is a clear indication that the social and economic conditions ofpeople’s lives significantly influence the nature and meaning of their practices.The structured dependency model of age-related inequality,18 if applied to anti-aging consumers in their privileged social and economic position, suggests thatthe material forces and access to resources and consumer-culture informationinform their attitudes, beliefs, and expectations and consumer choices aboutwhat is possible in old age. An important analysis, which is beyond the scope ofthis paper, concerns thus the tendency to homogenize the experiences of agingindividuals under health-promotion narratives and Third Age ideologies, oftenoblivious to enduring socioeconomic differentials in the life-course19,20 andthe response-ability7 to achieve “successful” and healthy aging.

Active, healthy and productive aging, as pointed out by Biggs, has takenon a “moral significance that mediates our everyday understanding of whatit is to age well” (p. 96).21 The opportunities for identity-building offered bysocial phenomena including consumer lifestyles, plastic surgery, and retire-ment communities offers an almost inexhaustible array of identity alternatives

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that exist, however, within the very specific and limited confinements of theyouthful body. Some of the main concerns of gerontologists5,22 with ‘anti-aging medicine’ and values lie therefore in the fact they are market-driven,and they are becoming the dominant discourse shaping the views of old age.Part of this increasing dominance in shaping current ageist culture, arguesHaber, is the result of a current global concern with the increase in the num-bers of older people and the impact that this increase has on the local andglobal economy.

This new type of aging govermentality,23 based on complex and contradic-tory models positioning aging as both decline but also opportunity, shifts theburden of the state’s responsibility toward its aging populations to individualsthrough narratives of personal empowerment, thus reconceptualizing individ-uals as autonomous actors who can choose behaviors, practices, and mostimportantly, products.12 Aging individuals are being encouraged, through co-ercive as well as persuasive global and local policies and campaigns, such ashealthy aging, to become self-managing and to internalize the values of in-dependence, productivity, and self-care in later life. In turn, commercial anti-aging narratives and ideologies are part of an array of strategies available tomainly affluent aging individuals to maximize these individual self-managingregimes and chances to accomplish and exceed.

What I am doing now is about “healthy aging”. . .using anti-aging, eating theright food, exercising and doing everything I can to remain healthy for aslong as I can. [Galia, aged 49]

I try to medicate every day, and I do a lot of metaphysical work aroundstuff—listening to my body. If my body says something’s going wrong, I getit checked out fairly quickly. Lots of testing, but testing for specific things,like specific markers to do with cardiovascular disease and cancer. Like, yourhormone levels, for example—your estrogen and progesterone. [Sharon, aged43]

Anti-aging discourses and consumer markets seek to provide a particularversion of the self-managing techniques individuals require in order to achieve‘successful aging’ and the dangers and consequences of failing to implementthis type of care. Websites, such as those of the American Academy of ‘anti-aging medicine’, capitalize on global discourses on a demographic aging pop-ulation crisis, the risk of disability, burden, dependency and loss of mobility.Alongside this marketing of fear, anti-aging markets offer hope and the pos-sibility not only of growing old unaffected by illness, but also of reverting toa younger self or no aging at all. Consumers of ‘anti-aging medicine’ in thisstudy believed their anti-aging products was allowing them to control theiraging process and avert all the dangers associated with old age, including lossof vitality, look, and symbolic power. The tendency to explain their youthfulappearance and vitality as evidence that ‘anti-aging medicine’ works, revealed

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a lack of awareness and uderstanding of the complex interplay of factors deter-mining how a person ages, including genetic, environmental, socio-economic,and cultural factors.

You look at one person who is 60 on anti-aging [therapy] versus someonewho is not, there’s like ten years difference between the two. . . .I’ve got onefriend and she’s 55 and she looks 35 and another friend who’s 73 and shelooks 53. They have the energy that normally you wouldn’t have at that age.[Diane, aged 63]

In fact, people were quite surprised at my age. They’re quite shocked whenthey find how old I am, because I can do things that men of 45 are actuallystopping doing. I look younger than them and my energy levels are higher insome ways. [Edward, aged 59]

The goal of reverting to a younger self, expressed in the above comments,seeks more than the attainment of health in later life—it also proposes newbenchmarks of what a person should look and act like at certain age and thedesirability of subjecting the body to technoscience and anti-aging treatmentsin order to alter the “normal” to new values that then position the person tohave an advantage over others the same age. This type of enhancement—onethat creates a “cultural complicity”24 by which the choices to adopt certain en-hancement technologies are created by cultural forces and commercial interestsand consumer cultures—ignores the long-term consequences for society: newstandards of normality, success, and moral virtue around the body’s ability toremain ageless.

References to interventions to improve the self and alter the mood also makea biological reductionist assumption that all behavior, interactions, and phys-iological functions are related to neuronal structures. This perspective erasesthe social, creating a subjectivity reliant on assistance—psychopharmaceuticaldrugs to make a person happier, or more “authentic” or less depressed—andignores the social, economic, and cultural forces that may be at play. As Roseexplains,

This certainly raises important questions about how we configure the bound-aries of the normal and the pathological, the treatable and the acceptable. Itdoes indeed raise questions about the kinds of humans we want to be and therole of the market in this reshaping of ourselves as “neurochemical selves”(p. 3).25

Terms such as “health promotion,” “healthy living,” and “healthy aging”highlight the mandate for work and attention toward attaining and maintaininghealth. The shift in cultural expectations of constant self-discipline risk abate-ment and surveillance as personal responsibility produces a paradox in health:health is both more biomedicalized through surveillance and risk technologiesdone by the individual at home and less medicalized as the key responsibilityshifts from the professional physician to reliance upon collaboration with the

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individual patient/user/consumer.26 As the following extract indicates, con-sumers of ‘anti-aging medicine’ extend their surveillance mechanisms to in-clude risk containment of anti-aging products which could paradoxically makethem seriously ill while promising to make them “better than well.”

I’m concerned, for example, that DHEA might increase prostate cancer, thepotential, and testosterone might do the same, so I vigorously check my PSA.I’ve had a biopsy on my prostate, for any slight indication of trouble, it wasa very painful biopsy, and it proved negative. [Edward, aged 59]

I have a blood test every three months, just to make sure there are no sideeffects from the hormone treatment and I see X. . . probably every three weeksand let him know anything that I feel. But apart from that, I guess it’s likeany medical research. Someone says that Lipitor is very good for cholesterol.I haven’t got time to get the knowledge of those people who say Lipitor isgood, to actually take it. So it’s like . . . I take Panadol if I have a severe pain.I don’t go on the internet and study every research document on Panadol andwhat might be the side effects, or cough syrups. . .or coffee! And the otherthing is, life is full of all these things that aren’t properly explained anyway.[John, aged 53]

Deception, Self-Deception, or Self-Assertion:The Anti-Aging Consumer

Aged populations are constructed differently, empowered at times and dis-empowered at others, to reinforce specific ideologies and practices by variousinstitutions and governing bodies. A recent report from the United States Gen-eral Accounting Office (GAO) on anti-aging health products27 highlighted thepotential physical and economic harm to senior citizens from these products.The GAO report argues that it is senior citizens who are most at risk fromanti-aging “cure all” claims.27 The report claims that 4 of 10 senior citizensuse herbal dietary supplements, arguing that these older persons are suscep-tible to claims of cures for chronic diseases and conditions, such as cancer,memory loss, arthritis, and atherosclerosis. The portrayal of senior citizens byregulatory bodies as vulnerable to fraud and quackery contrasts sharply withimages of silver surfers and bay boomers, actively pursuing lifestyle and healthopportunities, advanced by media and market aging research.28 In these poli-tics of representation ageism manifests itself under the guise of either negativeor positive images, obscuring the material and cultural realities—both positiveand negative—that shape the health choices and experiences in later life.

Representations of anti-aging consumers as vulnerable and in need of inneed of protection can sometimes be contrasted with anti-aging users in thisstudy who, while acknowledging the possibility of therapies not working, alsoreaffirmed their critical judgment, awareness of possible side effects from thetreatments, and willingness to take risks in the hope of maximizing healthoutcomes and enhancing specific physical and personality traits in accordance

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with cultural and consumer expectations. This finding, however, does not ex-clude the possibility that users are being misled and/or misinformed regardingthe actual benefits of the products being consumed. Moreover this is a warningon how the problem of illness and health bears on the constitution of the selfas an ethical subject, the sense of what we do with our freedom, and the extentto which we engage with attributions of self responsibility.29

I saw something on the internet which I thought was going to help me. Iread all about it and I thought this is it and I asked the doctor to give it tome. Well the doctor gave it to me and it was all right, but the thing is what Ididn’t realize was that when I researched that product I thought I had all ofthe answers but there were other products were better which I wasn’t awareof. [Harold, aged 66]

The positioning of many anti-aging consumers in this study as in “part-nerships” with health providers and in a more democratic power relationshipis indicative of how new consumer ideologies in health provision are con-textualized in the anti-aging doctor/consumer relationship as well as howthe self is asserting itself against mainstream medical indifference.30 Thenew framework of providing consumer-oriented and individualized medi-cal treatment in contexts dealing with healthy, relatively well-informed ag-ing individuals, opens up new interactions and power dynamics as wellas new avenues to “problematize” health and exercise control over agingindividuals.

Individual agency in the form of product knowledge and consumer-orientedanti-aging practices, along with proactive engagement in body managementand surveillance against a background of constrained possibilities of growingold outside the framework of agelessness, are illustrative of a Foucaldian modelof how the identities of older people are both facilitated and constrained bybiotechnologies. In this paradox the self is caught between “an ontological bat-tle of learning about the self and health needs and having their ‘needs’ decidedby others” (p. 3).29 The following comments are illustrative of this paradox,particularly in relation to the manner in which users of anti-aging therapiesinterpret their “choices” as a transgression of normative decline ideologies anda self-assertion against mainstream medical indifference.

[It would be good] if doctors were given long enough time to work with peoplerather than treating their diseases [and doing] something more interesting thanwhat they’re doing now, like creating incentives. People are not “incentivized”by their clinical condition, they are “incentivized” by other things, like weight,image and body appearance. [Sharon, aged 43]

Well, I am not silly, I know they [anti-aging products] don’t do everythingthey say. . . .I know some drugs are lifesaving and some others cause greatharm, but you can also look at the medical profession and be very critical ofsome of the drugs they prescribe to people. So my main concern is with thevalidity of conventional medicine to give answers to the problems we face

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today and to provide a plan of action that looks at preventing the diseases thatsooner or later will confront us. [Leslie, aged 61]

Cultural reductionist models of senior citizens as either “vulnerable” or“empowered” render complex human experience and interactions into cari-catures and exclude the likelihood of these traits mutually co-existing, alongwith a myriad of other traits, experiences, and possibilities. As it currentlystands, such constructions tell us more about how disciplinary apparatuses andsites of domination construct the self to produce reductive social and histor-ical analyses23 with vested interests in promoting particular versions of whatlater life is or should be about. Protecting consumers against fraudulent claimsand potentially dangerous practices is an important task. However, given theperspectival nature of knowledge, a multifaceted approach is needed that is ca-pable of incorporating existing tensions between competing institutions tellingdifferent versions or “truths” about aging, health, and illness and the skepticismof an increasing number of aging individuals about the ability of governmentsand mainstream medical practices to address the challenges of growing old inmodern Western societies.

CONCLUSION

On one level I think it is a problem that as a society we feel the need to haveto do these [anti-aging] procedures. It’s all about our currency of people, youknow. “Am I worthwhile, am I worthy?”—all that sort of crap. “As I get older,I need to be looking good each day in my job. . .” I think it’s tragic that wehave those attitudes, but they are alive and well and prevalent, and see, I aman opportunist, and I’m a chameleon, so I do it because I think, well, it helpsme get what I want out of my life because I live in a society. I haven’t yetopted out. [Sharon, aged 43]

I find this quote from one of our anti-aging consumers to encompass someof the anxieties and tensions confronted as their aging self is recreated within aparticular social discourse. Sharon’s comments also point to the need to look atanti-aging technologies and products through an examination of the relationsamong individuals, technologies, consumer markets, political ideologies tocontrol aging populations, and scientific concepts of what is natural and whatcan be “cured” or enhanced.

Attacks on ‘anti-aging medicine’ because of its pseudoscientific characterand unregulated practices, I believe, is not going to resonate with many dis-illusioned and anxious consumers who view mainstream medical practice aspoorly equipped to deal with the cultural context of aging in modern Westernsocieties.

The point is therefore not about the increasing success of ‘anti-agingmedicine’ and pseudoscience in enticing consumers into their practices,but rather the urgent need for social gerontologists, researchers, and

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philosophers “to determine the conditions and contexts in which an in-dividual’s adaptation to aging is either facilitated or limited.”31 This as-sessment should take into account the role of consumer cultures andanti-aging ideologies in an era of aggressive global capitalism and reducedgovernmental commitment towards the financial and health provision of itsaging populations.

ACKNOWLEDGMENTS

I thank Dr. Brett Neilson, chief supervisor for my Ph.D. thesis, for his adviceand support in the writing of this paper.

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