The quest to live forever has fascinated humans for millennia. The Epic of Gilgamesh, composed about 4,000 years ago, follows a king who searches the world for a plant that can restore youth, only to lose the plant to a thieving snake. The (likely apocryphal) story of Juan Ponce de León, who is said to have embarked on a search for the Fountain of Youth in the early 16th century, refuses to die—unlike its protagonist, who was killed along his journey.
Today’s longevity-medicine movement is driven by the same aggressive desire for eternal youth as the mythic stories of old. But whereas in earlier times ideas about wellness could travel only as fast as the people who held them, today just about anyone with an internet connection can use social media and AI-generated graphics to sell medical advice in seconds. Despite a decided shortage of placebo-controlled trials in humans to support that advice, the business of longevity is booming, thanks in large part to sleek direct-to-consumer marketing delivered by health influencers with far more confidence than evidence. By 2030, $8 trillion might be spent annually on longevity-related products.
As a sports-medicine physician, I see the consequences of the modern longevity obsession up close. Patients arrive at my office convinced that the right peptides, cold plunges, or lab tests can meaningfully extend their lives. They’re almost certainly headed for disappointment—if not harm.
In many ways, the American people owe a debt of gratitude to the early champions of longevity medicine. Throughout the 20th century, Western physicians focused primarily on treating disease rather than preventing it. But over the past 15 years or so, a new generation of longevity-focused clinicians began emphasizing lifestyle changes such as sleep, exercise, and healthy diet as first-line strategies for disease prevention—not necessarily to extend life, but to improve health. More recently, private investment has poured into the field in pursuit of flashier claims about staving off death. Many longevity-focused clinics and influencers have drifted from prevention toward profit, selling an expanding menu of unvalidated treatments.
Some of the new advice is relatively harmless. Protein loading, for example, is unlikely to meaningfully extend one’s lifespan, but it is also unlikely to cause serious harm. Other trends are more concerning. I have seen patients experiment with drugs like rapamycin, an immunosuppressant medication prescribed for those who have undergone organ transplantation. Some health influencers claim, without convincing human-subject data to prove their point, that rapamycin slows cellular aging. Whether true or not, these claims have yet to be validated, but scientists do know that the side-effect profile of rapamycin includes an increased risk of infection and disease.
Other longevity enthusiasts are injecting or swallowing peptides, chains of amino acids that have been used in medicine for decades but are now becoming popular in their unregulated form. When prescribed by a physician, FDA-approved peptides such as insulin and GLP-1s can be remarkably effective. But no placebo-controlled human trials support the use of, say, “Wolverine” (scientific name BPC-157), a peptide that some influencers claim ramps up collagen production and aids tendon and ligament healing. Like many of the other non-FDA-approved peptides, anyone can order Wolverine online.
Along with supplements and drugs, excessive testing has become another pillar of the longevity movement. Apps, blood tests, and wearable devices purport to estimate customers’ “biological age” using metrics such as heart-rate variability, sleep scores, body composition, and biomarkers in blood. This type of “health score” does not predict how long a person will live, but it can provide a helpful snapshot of one’s current state of physiologic health and inspire healthy behaviors.
The bigger issue is more intensive screenings, especially full-body MRI scans, which many longevity clinics have marketed as tools to detect disease early and thereby extend life. Although this sounds like a good idea, the availability of screening has outpaced its clinical relevance. MRI scans routinely reveal anatomical changes that are a normal part of the aging process. Research suggests that the overwhelming majority of adults past middle age have tears or cartilage changes in their knees, or tendon injuries in their shoulders. Similarly, liver and kidney cysts are commonly seen on MRI scans, especially in people over 50, and most are of no clinical significance; they’re common enough that researchers have dubbed them incidentalomas. But when such findings show up on an MRI, the risk of unnecessary surgery or other treatment increases drastically. Once a liver lesion is seen on MRI, for example, the patient will likely be advised to get a liver biopsy, a procedure with a 2.4 percent risk of major medical complication.
Recently, I treated a 48-year-old man for a routine sports injury. Almost as an aside, he mentioned that he had undergone a full-body MRI as part of a longevity program. The scan revealed a small lesion in his prostate. His PSA, the validated screening test for prostate cancer, was normal. Still, he was referred to a urologist, who felt compelled to biopsy the lesion because it appeared on the scan. The biopsy was benign, but the procedure left my patient unable to sit comfortably for weeks. “I wish I’d never done the MRI,” he told me.
The irony is that modern medicine has already succeeded at what the modern-day longevity movement claims to offer. Over the past 150 years, human life expectancy around the world has more than doubled, to numbers that Ponce de León could hardly have dreamed of. Clean water, sanitation, antibiotics, and vaccines have done more to extend human life than any supplement stack ever could. Cold plunges and red lights may feel empowering, but there is little evidence that today’s biohacking tools meaningfully extend the maximum human lifespan.
A better—and more achievable—goal would be to extend healthy longevity, adding life to years instead of years to life. Scientists and doctors, for the most part, already know how to do this. Daily exercise and maintaining skeletal muscle volume as you age are among the most potent forms of preventive health care.
After decades of prescribing exercise as medicine to my patients, I tell them this: Move your body every day, and build muscles with weights or bodyweight exercises three times a week. Eat foods that you can recognize in nature. Prioritize sleep. Stay socially connected with community activities. Such a regimen may not enable you to cheat death. But it’s free. It’s evidence-backed. And it will help you live well right now.
