The quest to live forever has fascinated humans for thousands of years. the The Epic of Gilgameshwritten about 4,000 years ago, follows a king who searches the world for a plant that can restore youth, but loses the plant to a stealing snake. The (possibly apocryphal) story of Juan Ponce de León, who is said to have set out in search of the Fountain of Youth in the early 16th century, refuses to die—unlike the protagonist, who is killed during his journey.
Today’s longevity medicine movement is driven by the same aggressive desire for eternal youth as the ancient mythological stories. But whereas in earlier times ideas about health and wellness could only travel as fast as the people carrying them, today anyone with an internet connection can use social media and AI-generated graphics to sell medical advice in seconds. Despite the apparent lack of placebo-controlled human trials to support this advice, the longevity business is booming, thanks in large part to sleek direct-to-consumer marketing delivered by health influencers with much greater confidence than evidence. By 2030, $8 trillion may be spent annually on products linked to longevity.
As a sports medicine physician, I see firsthand the consequences of the modern obsession with longevity. Patients arrive at my clinic convinced that the right peptides, cold plunges, or laboratory tests can beneficially prolong their lives. They are certainly headed toward disappointment, if not hurt.
In many ways, the American people owe a debt of gratitude to the early champions of longevity medicine. Throughout the twentieth century, Western doctors focused primarily on treating diseases rather than preventing them. But over the past 15 years or so, a new generation of longevity-focused doctors has begun to emphasize lifestyle changes such as sleep, exercise, and a healthy diet as first-line strategies for preventing disease — not necessarily to prolong life, but to improve health. More recently, private investment has poured into this area in pursuit of more lurid claims about avoiding death. Many longevity-focused clinics and influencers have drifted from prevention to profit, selling an expanding menu of unverified treatments.
Some of the new advice is relatively harmless. For example, protein loading is unlikely to significantly extend a person’s life, but it is also unlikely to cause serious harm. There are other trends that are more worrying. I have seen patients try medications like rapamycin, an immunosuppressive drug prescribed to those who have undergone organ transplants. Some health influencers claim, without convincing human data to prove their point, that rapamycin slows cell aging. Whether or not these claims are true has not yet been verified, but scientists do know that side effects of rapamycin include an increased risk of infection and disease.
Read: America has entered a late stage of protein
Other longevity enthusiasts inject or ingest peptides, chains of amino acids that have been used in medicine for decades but are now common in their unregulated form. When prescribed by a doctor, FDA-approved peptides such as insulin and GLP-1s can be remarkably effective. But there are no placebo-controlled human trials to support the use of wolverine (scientific name BPC-157), for example, a peptide that some influencers claim increases collagen production and helps heal tendons and ligaments. Like many other non-FDA-approved peptides, anyone can order Wolverine online.
Along with supplements and medications, over-testing has become another pillar of the longevity movement. Apps, blood tests, and wearable devices aim to estimate customers’ “biological age” using metrics such as heart rate variability, sleep scores, body composition, and blood biomarkers. This type of “health score” does not predict how long a person will live, but it can provide a useful glimpse into an individual’s current state of physiological health and inspire healthy behaviors.
The bigger issue is more extensive screening, especially whole-body MRI scans, which many longevity clinics have marketed as tools to detect disease earlier and thus prolong life. Although this seems like a good idea, the availability of the test has outstripped its clinical importance. MRI scans routinely reveal anatomical changes that are a normal part of the aging process. Research indicates that the vast majority of adults over middle age suffer from tears or changes in the cartilage in their knees, or injuries to the tendons in their shoulders. Likewise, liver and kidney cysts are commonly seen on MRI scans, especially in people over 50 years of age, and most are of no clinical significance; They’re common enough that researchers have called them incidental tumors. But when such findings appear on an MRI, the risk of unnecessary surgery or other treatment increases dramatically. Once a liver lesion is seen on an MRI, for example, a patient will likely be advised to have a liver biopsy, a procedure that carries a 2.4 percent risk of major medical complications.
Read: GLP-1 envy was just the beginning
I recently treated a 48-year-old man for a routine sports injury. Almost as an aside, he mentioned that he underwent a full-body MRI as part of a longevity program. The examination revealed a small lesion in the prostate. His PSA test, an approved screening test for prostate cancer, was normal. However, he was referred to a urologist, who felt compelled to perform a biopsy of the lesion because it had appeared on scan. The biopsy was benign, but the procedure left my patient unable to sit comfortably for weeks. “I wish I had never had an MRI,” he told me.
The irony here is that modern medicine has actually succeeded in what the contemporary longevity movement claims to provide. Over the past 150 years, human life expectancy has doubled around the world, numbers that Ponce de León could not have dreamed of. Clean water, sanitation, antibiotics, and vaccines have done more to extend human life than any combination of nutritional supplements ever did. Cold plunges and red lights may seem encouraging, but there is little evidence that current biohacking tools meaningfully extend maximum human lifespan.
A better – and more achievable – goal is to extend healthy lifespan, adding life to years rather than years to life. Most scientists and doctors already know how to do this. Daily exercise and maintaining skeletal muscle volume as you age are two of the most powerful forms of preventative health care.
From the January 2025 issue: America needs to radically rethink what it means to be old
After decades of prescribing exercise as medicine to my patients, I tell them this: Move your body every day, and build muscle using weights or body-weight exercises three times a week. Eat foods that you can recognize in nature. Prioritize sleep. Stay socially connected with community activities. Such a system may not enable you to cheat death. But it’s free. It’s backed by evidence. It will help you live well now.
