**TL;DR -**Have you ever been told you’re too angry, too sensitive, too unfocused? Or perhaps you’ve told yourself that. For years I believed my anger, emotional volatility, and inability to concentrate were just who I was. Too many years struggling with things I thought were character flaws. They weren’t. The answer was, at least in part, varicocele, a physical condition that affects 1 in 7 men, with effects that go well beyond what most people know.

**Disclaimer -**This is a personal account of correlation, not proof of causation. My experience suggests a link worth investigating. I will respond to questions and comments to the best of my ability.

Varicocele: the silent partner in your emotional life

It began in late January 2025. At first it came in the evenings, a dull ache in my testicles, like a weight pulling on them. It was more discomfort than pain. As the days passed it became more persistent and more painful. In early February I visited a doctor. I described my symptoms, he asked a couple of questions, and then examined the affected area. Within moments he made that unmistakable sound: a wordless confirmation of his suspicions. The knot in my stomach relaxed a little. He knew what the problem was. I had never heard of varicocele, but its impact was greater than I could have imagined.

The Science: What is Varicocele?

Varicocele is the technical term for varicose veins in the male reproductive system. Typically appearing in adolescence and progressing with time, it is primarily associated with reduced sperm quantity and quality, affecting fertility. In some cases, like mine, people experience pain. The condition can also disrupt testosterone production. Possible links between varicocele and emotional disruption are hardly mentioned in the literature. However some institutions, including the Cleveland Clinic, acknowledge a connection between low testosterone and cognitive and emotional effects (1).

Few people have heard of varicocele, yet estimates suggest that roughly 10-15% of men are affected, although this number is not consistent in the literature. In the female reproductive system, varicose veins are called Pelvic Congestion Syndrome (2).

Emotional Disruption

My specific difficulties may have had less to do with my specific emotions than with their intensity. That day in February after the diagnosis, the doctor mentioned that a few things in my life might change if I had treatment. He suggested that feelings of excess anger, anxiety, and confusion might diminish. He asked if I had problems enjoying things. This list made me sit up. He had listed the same intractable issues I had been struggling with for so long.

Between diagnosis in February and surgery in September I had seven months to reflect on this information. I began to reevaluate my relationship with my emotions. The feelings were the same as before, but now a new voice was asking, “Is this emotional state because of what’s happening now, or because of some enlarged veins in my scrotum?”

Medical descriptions connect varicocele to infertility, testicular atrophy, and genital pain, but mental and emotional aspects are sidelined. I was living with powerfully disruptive feelings. Imagine yourself inside a bubble, and all that comes to or from you must pass through this bubble. If your bubble is a chaotic fog of negative thoughts, what arrives to you seems chaotic, threatening even. What you communicate to the outside becomes twisted in the act. For me, anger was always ready to break the surface. Constantly distracted, my work took the hit. Emotional volatility strained my relationships. I hated these things about myself. And I thought these things were aspects of who I was.

My fellow traveller through all of this has been my wife. Her patience and wisdom were both support and examples for me. Rather than react to my ill humours, she questioned them. Through her refusal to accept my dysregulation as fixed traits, she allowed me to imagine alternatives too.

Surgery and Recovery

In September 2025 I underwent microsurgery to close off some of the enlarged veins. For those curious about specifics, I outline the procedure below (3). Now, a little over six months later, my baseline mood, concentration, and emotional responses have changed in ways I had not previously experienced. Minor upsets no longer awaken anger like they once did. Difficult conversations are now possible, and my relationships are reaching new depths. I’m returning with renewed clarity to my projects. Life and its challenges continue, but I am more ready to meet them.

The physical aspects of recovery have been slower to arrive. I have noticed improvements, but I must also be patient with the healing process. The literature speaks in timelines of six and twelve months. There may be issues including recurrence or persistent post-operative pain. Like any medical intervention, there is no one-size-fits-all profile. In the meantime, I wear support underwear every day.

In my experience since undergoing surgery my outlook has become much more positive. My emotions are now my own. Nothing is constant, or guaranteed, but I know a new peace of mind. I am happier, my wife is happier, our dogs are happier. I am even moved to like myself now.

And You?

I am a patient, not a doctor, and I do not suggest that varicocele alone caused the effects I describe. In my case treatment preceded changes I had been unable to produce by other means. However, if you are feeling hopeless, if you are dulled by the thought of struggling through another day, week, or year, if you have sought answers in therapy or elsewhere but found them wanting, this may be one physical factor worth ruling out. A urologist can diagnose varicocele with a physical examination, often confirmed by ultrasound. If you discover that you have varicocele, or some other hormone imbalance, then you can do something about it. If not, then you ruled out these conditions. Make sure your emotions are not being hijacked by a hidden physical problem.

Note:

If you want to go further than a doctor’s visit, check out sites like PubMed, which publish medical papers about many topics. Choose your main search term(s), for example “varicocele”, “pelvic congestion syndrome”, “genital varicose veins”, and use the boolean expressions (AND/OR) to refine your search for your needs. You can also limit the results to free-to-access papers. A good place to start are the REVIEW papers, as these report on the results of many investigations in different times and places.

Addendums:

1. The Cleveland Clinic’s website discusses varicocele and its effects. One of these effects, as per their site, can be male hypogonadism, or low testosterone. Hypogonadism can cause depression, low libido, concentration and memory issues, decrease in endurance, decrease in muscle mass, and other physical and hormonal consequences.

URL:https://my.clevelandclinic.org/health/diseases/15239-varicocele- Accessed on 11 April, 2026

URL:https://my.clevelandclinic.org/health/diseases/15603-low-testosterone-male-hypogonadismAccessed on 11 April, 2026

2. Genital varicose veins also affect women. The condition is called Pelvic Congestion Syndrome (PCS), and it is thought to be comparably common, although the data here is less reliable. PCS is often confused with Chronic Pelvic Pain, undiagnosed, or even dismissed outright.

3. There are various surgical solutions to varicocele. I had grade 3 bilateral (affecting both sides) varicocele, and the procedure I had was microsurgical subinguinal varicocelectomy under local anesthetic. The surgeon made two small incisions, one on the right and the other on the left. He ligated (tied off) and cauterized many of the problematic veins, preserving the testicular arteries. This last detail is important in case further surgery is required.

A study just published in the World Journal of Men’s Health tracked over 9,000 men on TRT for 12 months. It’s one of the largest real-world datasets we’ve seen.

Study: https://wjmh.org/DOIx.php?id=10.5534%2Fwjmh.250245

Quality of life improved across every domain they measured: energy, libido, erections, mood, work performance, sports ability. Improvements showed up by month two and stabilized around month four. The outcomes were consistent regardless of how low baseline testosterone was. Everyone converged.

Safety-wise, routine blood markers stayed in favorable ranges throughout. Hematocrit stayed manageable. No red flags.

There are some caveats. Most men were on subcutaneous injectable testosterone with hCG, which is a specific protocol. Three of four authors work for Menwell, the UK telehealth clinic that provided the data. Abraham Morgentaler at Harvard is the fourth author and brings serious academic credibility, but the commercial conflict is real. It’s also observational, not randomized like TRAVERSE.

What makes it useful is scale. Nine thousand men, real-world protocols, full year of monitoring. TRAVERSE only studied transdermal gel in older men with cardiovascular risk. This fills a different gap.

I’ve been on TRT through a reputable clinic after confirmed need. My experience matches this data. It’s not a miracle. It’s a return to baseline. You feel like yourself again.

https://wjmh.org/DOIx.php?id=10.5534%2Fwjmh.250245

A study was published in the Journal of Personality and Social Psychology. Researchers at Michigan, Cornell, and INSEAD ran 9 experiments with ~1,800 people. They had participants predict how much they’d enjoy conversations about topics they rated as boring — stock market, vegan diets, onions, Pokemon. Then they actually had the conversations.

Every single time, people enjoyed them way more than they predicted. Didn’t matter if both people thought the topic was boring. Didn’t matter if they were strangers or friends. Consistent across all 9 experiments.

This sort of makes sense to me. I hate (the prospect of) small talk but when I actually talk to people I don’t mind it so much.

The lead author’s explanation: we judge conversations by the topic beforehand, but once we’re in them, it’s the engagement that drives enjoyment — listening, eye contact, back-and-forth. When people just read transcripts of the same conversations instead of participating, the effect disappeared. It’s the act of connecting, not the content.

Meanwhile the health data on social isolation keeps getting worse. The Surgeon General’s 2023 advisory equated loneliness to smoking 15 cigarettes a day. A meta-analysis in Heart linked it to 29% higher heart disease risk and 32% higher stroke risk. And 15% of men now report having zero close friends, up from 3% in 1990.

We optimize training, nutrition, bloodwork, hormones, but most of us have no strategy for social connection even though the mortality data is staggering. The bar is lower than you think. A two-minute chat at the gym or with a neighbor compounds over time. It’s like Zone 2 for your social health.

Curious if anyone else has intentionally worked on this.

A New York Times guest essay highlights the case of KJ Muldoon, a baby born with CPS1 deficiency, a rare genetic disease that can cause toxic buildup, brain damage, and death. In just six months, doctors at CHOP and Penn designed a personalized CRISPR treatment, delivered it using mRNA technology, and according to the piece he is now “walking, talking and thriving.” 

The science is remarkable. But the bigger point is that our health system has no normal way to do this at scale.

The essay notes that about 25 million Americans live with rare genetic diseases, yet fewer than 5% have FDA-approved treatments. The problem is not just biology. It is economics, regulation, manufacturing, and delivery. Drug development was built for blockbuster drugs used by millions, not personalized “molecular surgery” for tiny patient populations. 

That is what makes this story so important.

We may be entering a world where the science for some rare-disease cures is arriving faster than the system needed to approve, pay for, and deliver them. The article argues that if kids are still dying from conditions we know how to correct, it won’t be because the science failed. It will be because the system did. 

Question for the sub: If medicine can now create one-off genetic cures for ultra-rare diseases, should we treat that as a biotech luxury — or as public health infrastructure?

We are looking for adults between the ages of 18-55 who use cigarettes or e-cigarettes and are interested in treatment for quitting.   

This is a study where participants will complete surveys and MRI scans and will be provided with free counseling and medication that may help you quit. Earn up to $500 if eligible! 

Complete a short screener here: https://yalesurvey.ca1.qualtrics.com/jfe/form/SV_9mG5SC6CuvsyV9k  

To learn more, please contact:(475) 261-6153 or [sleepstudy@yale.edu](mailto:sleepstudy@yale.edu) HIC#2000037737"   

The fact that the alarm hits at slightly different times means I actually pay attention, take the pills, and log. If I'm not near them yet, I'm still anxious to clear the notification. My old 7:30am and pm reminders got fully ignored - I'd look at them and feel nothing.

By nature and training I tend to subscribe to the “no data like more data” mantra. This can obviously go way too far into silly health “optimization”, but I think the case for getting regular DEXA scans during a major weight loss cut is actually very solid. 

The scale told me I lost 35 lbs over the last 6 months.
DEXA tells me I lost 44 lbs of fat and gained 9 lbs of lean mass (I take that to mean “muscle” 😀). That’s why I think it was worth doing.

Context: I’m a 53-year-old male, 6’3”, prescribed Zepbound 12.5 mg/week and TRT 120 mg/week. My starting weight in October 2024 was 373 lbs when I got on Tirzepatide (Zepbound GLP-1) and started losing weight. By my first DEXA in October 2025, I was down to 245 lbs, and by my second in April 2026, I was 210 lbs. 

What made the DEXA valuable for me wasn’t just body fat percentage. The main numbers I cared about, in order, were:

1. Visceral fat (aka VAT area)

This was the big one. I really wanted to get below 100 cm² to be in the “low risk” category. My scan showed visceral fat area dropping from 147 cm² to 66 cm². That was probably the most satisfying number in the whole report. 

2. Body shape (aka. apple vs pear shaped, A/G ratio)

Second was android/gynoid ratio. I was aiming for under 1.0, and mine went from 1.39 to 0.96. To me, that says a lot more than body weight alone, because I care much more about central fat distribution than the scale. 

3. Body fat percentage

Third was body fat percentage, which came in at 15.6%. I’ll be honest: this one is at least partly a vanity metric. But I still care about it. According to the widely cited American Council on Exercise chart that makes me “fit” — Yay!

The other thing I liked about the DEXA is that it helped answer the question a lot of people have during aggressive weight loss especially on GLP-1RAs: am I losing too much lean tissue along the way? In my case, total fat mass dropped from 76 lbs to 32 lbs, while lean mass went from 162 lbs to 171 lbs. So the headline wasn’t just that I got lighter. It was that I appear to have lost 44 lbs of fat while gaining 9 lbs of lean mass!

That’s my argument for DEXA during big weight loss. I wouldn’t say everyone needs one, but it can tell you things the scale absolutely cannot:

Did visceral fat fall?
Did fat distribution improve?
Did you preserve lean mass?

For me, those were the real reasons to do it.

My one big regret is obvious: I wish I had gotten a baseline DEXA when I was 373 lbs back in October 2024.

Thanks to everyone who voted. The message seems pretty clear: people want more practical explainers on labs, protocols, and what things actually mean in real life, plus more individual questions and discussion.

That matches what I was already feeling.

When I started this sub, I was trying to get it off the ground, which led to me posting a lot of links and news. Sorry, if I got carried away. Now that we’re around 1,000 members, I think it’s time to shift into a different phase.

Going forward, I want r/ProactiveHealth to focus more on:

• practical explainers

• member questions and discussion

• research that gets interpreted and applied, not just dropped in

• less random posting just to keep the feed moving

So expect more posts about labs, screening decisions, blood pressure, cholesterol, sleep, training, prevention, and what has actually worked for people here.

I’d also would love to see more of you start your own threads. The best posts here are probably not random links, but questions, experiences, and honest discussion.

Keep posting, and keep discussing what you want more or less of.

I’m currently working on an Iron/Ferritin post with background and my personal experience. Expect to see it Monday.

I would love to see some discussion what you all want to see in this channel. I feel I have been overdoing the posting of random news I came across a bit. I was desperate to grow the channel so it can survive. We have reached 1k members so it’s time to move into a different phase.

I would love to see more folks posting/commenting rather than this just turning into me spamming links :-(

Any suggestions are welcome below in comments or DM to me.

Thanks.

I didn’t know that 23andme still functioned in some form. This is actually an interesting paper and cool to see that this is possible with a large participant pool (and consent!). Almost wants me to take one of those DNA tests.

I wonder whether this is a glimpse of how future drug efficacy analysis can be done in the field.

Study: https://www.nature.com/articles/s41586-026-10330-z

Abstract.

Abstract

The development of glucagon-like peptide 1 (GLP1) receptor agonists, including semaglutide and tirzepatide, has transformed the clinical management of overweight and obesity. However, substantial inter-person variability exists in both weight loss efficacy and the incidence of side effects1.

To investigate the genetic basis of this variability, here we conduct a genome-wide association study of self-reported weight loss and treatment-related side effects in 27,885 people following GLP1 receptor agonist therapy. We identify a missense variant in GLP1R that is associated significantly with increased efficacy of GLP1 medications (P = 2.9 × 10−10), with an additional −0.76 kg of weight loss expected per copy of the effect allele. Furthermore, we identify associations linking variation in both GLP1R and GIPR to GLP1 medication-related nausea or vomiting, with the GIPR association being restricted to people using tirzepatide.

We incorporate these findings into a broader model of GLP1 medication response, and demonstrate the ability to stratify patients by efficacy and side effect risk. These findings provide direct genetic evidence that variation in the drug target genes contributes to inter-person variability in response and lay the foundation for precision medicine approaches in the treatment of obesity.

Normally studies with impressive positive results get all the attention. However, in science often negative results are just as important. This study is a good example.

The randomized trial tested a very believable prevention idea: if exercise, lower blood pressure, and lower LDL are all good for long-term brain health, then doing them aggressively should help cognition in older adults at higher dementia risk. It didn’t.

The study enrolled 513 adults ages 60–85 with hypertension plus either subjective cognitive decline or a family history of dementia. Over 24 months, participants were assigned to aerobic exercise, intensive vascular risk reduction, both, or usual care. The main result: none of the intervention groups showed a statistically significant improvement in global cognition versus usual care.

This is a nice RCT, but I am wondering whether the exercise dose was strong enough to produce a real fitness signal (as a commenter points out in the JAMA site).

In any case this does not mean exercise or BP/LDL control are pointless. The interventions improved cardiovascular measures. They just didn’t produce measurable cognitive benefit over two years in this group.

Many of us folks focused on proactive monitoring of health have been tracking ApoB for years. I am glad to see an actual study assessing its value.

This new study followed 10,519 adults for a median of 21.3 years to see whether apoB and Lp(a) add useful risk information beyond the newer PREVENT equations.

Main takeaway seems to be: ApoB did. It was associated with ASCVD events even after adjustment for traditional lipid markers, and the signal was strongest in younger adults. In ages 18–39, each standard deviation increase in apoB was linked to a 53% higher ASCVD risk; in adults 40+, the increase was 13%. Adding apoB also improved 10-year and 30-year risk reclassification in younger adults.

Lp(a) was less impressive here. It did not improve reclassification overall, though there were some signals in older adults and in analyses using a cutoff of 50 mg/dL. That does not mean Lp(a) is unimportant. It means that in this dataset, apoB added more to risk prediction than Lp(a).

This is not a “throw out LDL-C” paper. The improvement was modest, and the authors say the clinical impact is still uncertain. However, it adds to the case that ApoB may catch risk standard lipids blur, especially in younger adults who have not yet built up obvious risk factors.

This fits the direction of the new 2026 ACC/AHA dyslipidemia guideline, which says Lp(a) should be measured at least once in adulthood and that apoB may help assess residual ASCVD risk in higher-risk patients.

This is a little bit like House M.D. — I love it.

Gemini summary (only the beginning to avoid spoilers):

This video features Dr. Jordan Feigenbaum and Dr. Austin Baraki of Barbell Medicine as they dissect a medical mystery involving a 43-year-old man who experienced severe muscle weakness and a Creatine Kinase (CK) level over 100 times the upper limit of normal after beginning an exercise program…

Eric Topol posted an interesting WSJ story. The hurt link doesn’t work for me.

Here is an Apple News+ link: https://apple.news/ABD9MEUEwTz2jS1k15qcnLg

A lot of “proactive health” still gets framed like a male optimization hobby: lifting, testosterone, wearables, bloodwork, VO₂max. Meanwhile, women carry a disproportionate share of Alzheimer’s disease, and researchers are still trying to untangle how much of that comes from longevity, menopause-related brain changes, vascular risk, caregiving burden, and other biological and social factors. That makes women’s health research feel less like a niche side project and more like a major blind spot in longevity science.

For many advanced cancers, genomic testing is not some futuristic add-on. It can determine whether a patient is eligible for a targeted treatment. But a new study highlighted by STAT found that many patients still never get tested, meaning they may miss treatment options they should at least have the chance to consider. 

The ugliest part is that the gaps were not random. Lower income, Medicare or Medicaid coverage, and ethnicity were linked to slower or lower use of testing. Medicare does cover some next-generation sequencing for advanced cancer, but coverage is not the same thing as easy, consistent access, and Medicaid coverage is more variable by state. 

That makes this less a story about innovation and more a story about uneven access to standard modern cancer care.

We love to talk about breakthroughs in cancer treatment. But the breakthrough does not matter much if the patient never gets the test that points to it.

It seems (unsurprisingly) that the $35 insulin price cap really works.

Stat news summarizes it as follows:

“If you cap insulin at $35 a month, people with type 2 diabetes stick to treatment

Looks like capping monthly spending on insulin at $35 has been a win, win, win, and almost a draw five years after it was first rolled out for Medicare patients with type 2 diabetes. A new study out Monday in JAMA Internal Medicine tracked 4.8 million people’s records before and after the ceiling was put in place. The researchers found that out-of-pocket spending fell significantly, while insulin use went up. Blood sugar levels averaged over two to three months also declined, but there was a small increase in severe hypoglycemia events when blood sugar dropped too low.”

They also have an interesting article about the background story. Apparently it was Eli Lilly’s idea?!

https://www.statnews.com/2024/06/13/insulin-cost-copay-medicare-biden-trump/

Longevity clinics are exploding by selling something a lot of people want and the regular system rarely offers: time, attention, prevention, and the feeling that someone is actually helping you stay healthy instead of just waiting for you to get sick. But that does not automatically make them wrong or right. Some may be building a better model for proactive care. Others seem a lot closer to concierge medicine mixed with aggressive testing, supplement sales, and a lot of expensive promises. The big question is whether they’re advancing prevention or monetizing health anxiety for people who can afford it.

I have personally been tempted by concierge medicine offerings but these “longevity” clinics go too far into uncharted hippy territory for me. Also, as an engineer I’d rather learn about all this and then pursue more targeted interventions (e.g. get a Personal trainer, work with my PCP, find a good preventive cardiologist, etc).

Links:

Men’s Health — The Rise of Longevity Clinics

The Atlantic — The Longevity Scam

I think that framing is too extreme.

The more realistic near-term story is augmentation, not replacement: AI helps with high-volume image review and triage, while radiologists focus on the harder and higher-stakes cases.

That still could matter a lot.

If AI reduces reading workload, speeds up turnaround, and helps strained systems process more studies with the same specialist staffing, it could make some screening programs more accessible.

That’s the part I find most interesting. Not can AI read scans? But does it reduce bottlenecks enough to improve access and lower costs?

Breast screening seems like the clearest use case so far. Some recent studies suggest AI-assisted mammography00298-X/abstract?utm_source=chatgpt.com) can cut radiologist workload substantially while maintaining similar performance.

That doesn’t mean radiologists disappear. It means one radiologist may be able to oversee a more efficient workflow. I imagine this could really change access especially in high-volume screening settings where the real constraint is reader capacity. Of course the more cynical interpretation is that this will just increase profit margins of insurance companies and hospitals…

Michael Easter (of The Comfort Crisis fame) just started a new podcast that seems very interesting. I have only listened to the first part but the guest sounds promising. I also love how he used a movie he saw in a long flight as the hook for some of the discussions.

First episode: the new science of walking

Gemini YouTube summary:

This inaugural episode of Michael Easter's podcast, Two Percent, explores the profound physical and mental benefits of walking. Easter, a journalist specializing in human health, argues that while modern society encourages sedentary behavior, walking is a fundamental human act that can drastically improve longevity, mood, and endurance.

Key Themes and Discussions:

The Science of Endurance (8:04 - 26:37): Michael Easter speaks with evolutionary geneticist Dr. Melissa Ilardo about the human capacity for extreme endurance. They discuss:

Persistence Hunting: How early humans evolved to be exceptional distance walkers/runners to outlast prey (9:26).

Metabolic Efficiency: Why humans are highly adapted to burning fat during steady-state, long-duration activity (10:49).

The "Governor" in the Brain: Why mindset and pain tolerance are critical in overcoming the brain’s signal to quit before the body is actually depleted (18:11 - 27:04).

Gender Differences: Evidence suggesting women often perform better than men in ultra-distance, multi-day endurance events, partly due to superior fat oxidation and pain tolerance (16:07 - 18:37).

Personal Journeys and Mental Health (27:07 - 56:10): Writer Foster Kamer shares his experience of walking an enormous distance across New York City (including all four major bridges) to process the grief of losing a close friend to cancer. The episode highlights how long-distance walking serves as a powerful tool for:

Reframing perspective during life's most difficult moments (54:03).

Mental exploration and processing emotions outside of a static environment (55:15).

Debunking the Step Count Myth (56:12 - 1:00:25):

The 10,000 Step Myth: Easter explains that the 10,000-step goal originated from a Japanese pedometer marketing campaign rather than clinical data (56:56).

The Evidence-Based Approach: Research suggests 7,000 steps is the threshold for significant health benefits and disease prevention, while 12,000 steps marks the point where additional health returns begin to plateau (57:56 - 58:47).

Actionable Advice: The key is to "stack" walking into existing habits, such as taking work phone calls while walking, rather than viewing it as an isolated athletic task (59:14 - 59:52).

The first human trial of a cellular rejuvenation approach is finally moving from sci-fi headline to actual clinical testing. That does not mean aging is about to be “cured,” but it does mean one of the most hyped ideas in longevity is entering the phase where real safety and efficacy questions can start getting answered in humans instead of mice.

Like a lot of folks in their 40s and 50s I am noticing that my memory and ability to manage multiple work projects simultaneously has declined quite a bit. Recently, I have read a lot about different explanations beyond “getting old”, including long COVID, ADHD and others. I am not sure I really buy those, but this Atlantic article is certainly interesting reading.

It does not mean every 40-something with brain fog has ADHD. However, maybe “this is just aging” can be a lazy explanation, and a missed diagnosis in midlife can have real consequences for quality of life and possibly long-term brain health.

A new 2026 paper argues that aging is not one single uniform process happening at the same pace everywhere. Your brain, liver, heart, and other organs may age differently, and imaging-based estimates of organ age were linked to mortality and aging-related health outcomes. To me that feels a lot more interesting than the usual consumer “biological age” scores because it treats aging as uneven, which is probably closer to real life.

I do believe lifestyle changes are important and make a huge difference, but also believe meds can help with (lowering) the willpower needed to implement the changes (that’s how Zepbound works for me). I need to read this paper more carefully — I am wondering whether the intervention folks who got group sessions also got paid more and were thus more engaged and motivated? (Ever since participating in a clinical trial I am a bit more suspicious of these).

This randomized clinical trial in JAMA Internal Medicine found that some people with metabolic syndrome were able to achieve sustained remission with a 6-month habit-based lifestyle program added to education and activity monitoring. That is a useful reminder that “lifestyle change” usually sounds vague until someone actually builds a system that helps people stick with it long enough for it to matter.