Metricorexia: the illness is hyper-real, even if the disease is not.

The proliferation of consumer health technologies that allow individuals to measure and monitor biometrical parameters of uncertain clinical significance facilitates the decoupling of disease and illness. Drawing on Baudrillard's account of the successive phases of the image, this paper maps the migration of clinical signs through four stages: disease, predisease, statistical risk and self-referential. This final stage is described as metricorexia, a preoccupation with self-recorded biometrical data that has become dissociated from recognised disease. Using a hypothetical example alongside emerging and contested clinical entities, the paper explores the emergence of algorithmic authority and questions how clinicians can respond to this challenge. I propose a hyper-real medicine that acknowledges this separation from material reality and adopts narrative-based medicine to understand the meaning of these metrics for the patient.