Brad endured months of muscle and nerve testing and MRIs to rule out a spinal cord injury before visiting a clinic in his hometown of Phoenix, Arizona, that specialized in treating a very rare neurological disease. At the end of the appointment, the doctor offered him a hug, and then a diagnosis: amyotrophic lateral sclerosis, or ALS. It may as well have been a death sentence.

ALS, also known as Lou Gehrig’s disease, attacks the nerve cells that allow you to move your muscles, until you can no longer move, speak, swallow, or breathe. Doctors can manage symptoms and slow progression modestly with a handful of approved drugs, but there is no cure. The average life expectancy after diagnosis is two to five years, and there are more than 33,000 Americans living with the disease.

Brad walked to his car in a state of shock. On his drive back to work—he was a technology executive—he stopped at a parking lot, cried, and appealed to God. “I said the most desperate prayer in my life, asking Heavenly Father if this was really ALS,” Brad told me. “I remember getting a very clear answer: Everything is going to be all right.”

Within three years of being diagnosed with ALS, Brad had lost control of his entire body. When it came time to tell their three children—their oldest was in first grade at the time, their youngest was just 1—his wife, Tiffany, sat them down, had them put on oven mitts, and asked them to try to build something with Legos. It was nearly impossible. “That’s what Dad’s ALS is doing to him,” she told them.

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Early menopause did not help. In the last several years, I’ve put on about 20 pounds that I really don’t need. I also don’t seem to have the discipline, motivation, or time to lose them.

Still, that’s not why I went on a GLP-1. I went on a weight-loss drug because a doctor told me it might help ease symptoms I’ve struggled with for basically my entire adult life.

I was diagnosed with my first autoimmune condition—Graves’ disease—at the height of my health, when I was 23. My immune system forgot that my thyroid was a part of my body and attacked it, sending it into an overactive storm that made me very, very sick. My doctor prescribed strong medication and sent me on my merry way. In 1998, there was no discussion of diet or lifestyle or any of what we now know can influence autoimmune conditions. I probably did a lot of things that very slowly made my condition worse.

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Bartlett, whose biceps suggest he spends a lot of time at the gym and whose X profile describes him as an “entrepreneur” (such a beautifully elastic word; are we not all entrepreneurs?) climbed K2 ran an ultramarathon swam the English Channel had “a couple of glasses of wine.”

The results were horrific. As Bartlett explained to a fellow entrepreneur:

I got worse sleep that night, and then because I got worse sleep that night, I ate more poorly the next day. . . . I podcasted worse. I didn’t go to the gym that day or the day after because I felt really bad. . . . I could track all of this on my Whoop.

Hold on a second there, buddy.

Your what?

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She had assumed that when she was ready, her body would be too. No one in two decades of annual visits had ever explained that the most consequential decisions about her capacity to bear children were being made by her ovaries on a calendar she could not see, while her doctor took her blood pressure and refilled her birth control.

She is the patient I see several times a month. She is the most preventable tragedy in American medicine.

I am board certified in both obstetrics and gynecology, and reproductive endocrinology. There’s a fertility crisis happening right now in America—and a furious debate about who is to blame. The alleged culprits include housing, smartphones, and capitalism. One group is getting off lightly: ob-gyns.

In July, the Centers for Disease Control and Prevention (CDC) reported that the U.S. fertility rate had fallen to fewer than 1.6 children per woman—the lowest figure in our history—despite a 2025 survey of American Gen-Z women that found that nearly three-quarters intended to become mothers. American women are not opting out of building a family. They are running out of time.

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When Cissy, a former forensic nurse, asked Iris what else she could do for her before leaving for work, the answer never changed: “Can you put a pillow over my head so I can die? Please make my suffering stop.”

Depression was not new to the Dekkers. Omar has a history of it, as do other members of his family. But Iris’s was different. Her symptoms were psychological and physical—a condition called functional neurological disorder, associated with severe psychological distress and depression. It often presents with symptoms like paralysis, seizures, and chronic pain, and was once referred to in medical psychology as hysteria. Iris had spent more than two years in a wheelchair after a seizure left her unable to walk.

Cissy described the look in her daughter’s eyes as “empty,” and her father called it a “black hole of depression.”

The symptoms began early in Iris’s adolescence. In 2019, at the age of 13, she began complaining of constant pain in her back, head, and stomach. At first, she pushed through it at school, during shifts at a bakery, while babysitting, and playing tennis, relying on a combination of painkillers and antidepressants, counseling at school, and cognitive behavioral therapy.

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Romano won’t be swimming in a sanctioned competition. Instead, she is racing in the very first Enhanced Games, created to reveal what more than 40 world-class athletes in swimming, track, and weightlifting can achieve if they are encouraged to use drugs that would otherwise destroy their reputations and end their careers.

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I’ve been covering women’s sexual health for 20-plus years, almost as long as pharma has been trying to create such a drug—one that triggers desire, arousal, and orgasm (or at least two out of the three). Now, a new documentary, The Pink Pill: Sex, Drugs & Who Has Control, streaming on Paramount+ (a division of our parent company), asserts there is a female answer to Viagra. It’s called Addyi, and the film treats the story of its bumpy road to approval by the U.S. Food and Drug Administration (FDA) in 2015 as a major front in the ongoing fight for female sexual pleasure and bodily autonomy.

You’ve heard of Viagra and its many spin-offs. So why have you never heard of Addyi? The film has an answer: sexism. “Just think to yourself: What if the pill had been blue?” Cindy Eckert, the co-founder and CEO of Sprout Pharmaceuticals, whose sole product is Addyi, tells viewers. Her point is both literal and metaphorical—Viagra has long been known as “the little blue pill.” And the film uncritically adopts this framing.

The story it tells is one of feminist triumph over sexist regulators who put unreasonable demands on the company because they took the sexual needs of women less seriously than those of men. Never mind the drug’s lackluster performance and concerning side effects. Bias was at the root, and Eckert was determined to expose it. “Not on my fucking watch,” she tells the camera.

Yet there is another narrative to the Addyi story that isn’t about sexism but about which drugs get approved and why. While Sprout did recognize a legitimate need, it also leveraged a public lobbying campaign to influence an agency that is supposed to be driven by science.

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Perhaps you’ve seen the headlines. “Perimenopause is having a millennial moment. Here are 7 ways to cope,” says The Washington Post. Or perhaps you’ve seen Apple TV’s glossy drama Your Friends & Neighbors, which is back for its second season; the female protagonist Mel is explicitly perimenopausal, and in the first season, she keyed a car for no apparent reason. She’s played by Amanda Peet, who talks about being perimenopausal in real life (“God knows I’ve wanted to key a lot of cars in the last three years,” she’s said.) In fact, it sometimes feels like every celebrity interview with a forty- or fiftysomething woman requires her to open up about what’s going on with her hormones. Drew Barrymore joked on CBS Mornings that when she found out how long perimenopause can last, she thought she’d “never make it 10 years like this.” Katherine Heigl told Business Insider that “whoever designed it so that women would be going through perimenopause while raising teenagers should be sent a strongly worded letter.”

At the same time, influencers who talk about perimenopause seem to have cropped up out of nowhere with something to sell you, causing people online to wonder where this all came from. It’s trickled down from Instagram to tchotchke shops, which sell fridge magnets that say “Perimenopause Is Hot.” You can buy a T-shirt that proclaims “Perimenopause Made Me Do It!” My mom, who is 48, started uncontrollably shaking her leg at night a few years ago. “It’s perimenopause,” she told me when I complained about how annoying it was.

But what exactly is perimenopause—and why are we all talking about it all of a sudden?

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This had been the case for most of my life. From childhood on, I struggled to make friends, which took a toll on my self-worth. By adolescence, my mental health had deteriorated, and I spent close to a year cycling through multiple psychiatric hospitalizations, outpatient programs, and group homes for depression and self-harm. At age 15, I was groomed online by a much older man, culminating in a traumatic sexual assault. Immediately afterward I tried to end my life, then spent a year in a youth residential treatment center in Utah.

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The term “peptide” picks out a broad category. Peptides are small versions of proteins, or segments of proteins. Our bodies make a variety of peptides to send signals between cells, regulating everything from blood pressure to wound healing, and from sleep cycles to fat storage. Peptide drugs can interact directly with these signaling pathways. GLP-1s, the weight-loss drugs such as Ozempic, are peptides that alter hunger signaling. Insulin is a peptide drug that duplicates a natural peptide needed to extract energy from food. Both, of course, are regulated by the Food and Drug Administration (FDA). Other promising drugs are slowly making their way through the pipeline.

These are not controversial, nor are the powdered collagen peptides sold in Whole Foods and other health food stores. The latter are regulated by the FDA as supplements—a category they fall into because they are derived from cattle and fish and are considered a component of food. They may not necessarily do anything, but they’re considered safe enough, as are peptides sold in skin creams and approved as cosmetics.

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These questions are meant to tell us about a person’s risks. But no one taught me to ask a question that now seems embarrassingly obvious, given that we spend about 90 percent of our time indoors: What kind of environment are you living in?

We are trained to think of health as something that happens largely inside the body. Organs malfunction, hormones shift, and cells mutate. We search for pathology in blood and on scans. Sometimes that is exactly where the answer is, but not always.

What enters the lungs matters—hence the typical “Do you smoke?” question. But many of us spend almost all of our time breathing the air of homes, offices, schools, hospitals, barracks, dormitories, and apartment buildings. We assume these spaces are neutral backdrops to our lives, when in fact they are active participants.

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By the time she’s born, those 6 to 7 million eggs will have dropped to about 1 or 2 million. And by the time she’s 27.5—the average age an American woman has her first child—only 200,000 remain, if she’s lucky.

Most people, and especially most men, don’t think about those odds until they’re sitting in a fertility clinic.

That was the case for Travis Potter. In 2022, the then–40 year-old Wall Street hedge-fund manager and his wife, 37, had spent months in IVF clinics, and tens of thousands of dollars on hormonal treatment, trying to have a second kid.

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“My blood sugar was out of control. My weight was out of control,” she said. And yet, despite her worsening arthritis and type 2 diabetes, she still craved food.

She also craved alcohol, and was beginning to worry that her drinking habits were unhealthy.

And then, just like that: One shot took it all away. Her daily drink turned into one a month, her chronic joint pain vanished, she dropped 25 pounds. Ozempic didn’t just improve her health, it gave her choices—to do “things in life that I wasn’t doing before,” like going to the gym each day. She was finally sleeping through the night.

And yet when we spoke recently, she said she wasn’t sure Ozempic had made her life better. “My mind and my day-to-day is kind of gray,” Francis told me. In the first 48 hours after she injects herself—which is every week—the emotional impact is almost unbearable. “I just feel worthless,” she said.

This is the trade-off of weight loss for her: “You don’t want to be involved in life” for two days of every week.

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This is one of the greatest triumphs in the history of public health, and groups like the Campaign for Tobacco-Free Kids, the American Lung Association—and the FDA itself—should be celebrating. Instead, they are obsessing over whether flavored e-cigarettes should be allowed.

It's a complete waste of time. There are already plenty of vapes on the market in every conceivable flavor, illegally. Kids could buy them, but don’t. And the only thing really at stake in the fight over flavored vapes is whether adults should have easy access to what has proven to be one of the best ways to quit tobacco, which continues to kill people.

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In Ontario alone, 219 people were killed by the end of the next day following their request for “medical assistance in dying” (MAID) in 2023, according to a 2024 report by an advisory committee. About 30 percent of those deaths occurred on the same day that the person sought the government’s permission to die. The committee hasn’t published comparable numbers since then.

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But just how harmful are they, really?

That’s the central question in a new book by professors Jan Dutkiewicz and Gabriel N. Rosenberg, released Tuesday. Feed the People! Why Industrial Food Is Good and How to Make It Even Better doesn’t deny that the modern industrial food system has serious flaws. Still, the authors argue, it has dramatically improved food access and safety—reshaping public health in ways that would have once seemed unimaginable.

In the excerpt below, adapted from the book, they contend that processed foods—even ultra-processed ones—aren’t the dietary demons many make them out to be. And today’s calls to purge them entirely and “eat clean,” they suggest, offer no magic fix. In fact, such advice may even leave us worse off. —The Editors

In 1929, the canned-meat company Libby, McNeill & Libby printed a now-legendary pumpkin-pie recipe on the side of cans of its 100% Pure Pumpkin. It was an enormous hit, and pumpkin pie became a national superstar. But the can’s branding wasn’t quite accurate—and still isn’t. According to FDA regulations, the contents of a can of pumpkin can be made of a variety of squashes we don’t conventionally call pumpkins. And, in fact, most canned pumpkin you’ve ever eaten is probably something called a Dickinson squash.

Apologies if you’re a pumpkin purist. But if you are, and you’ve just found this out, what’s the alternative? Roasting and pureeing a pumpkin yourself? That’s a bad idea. Store-bought pumpkins don’t have the right starch or water content for the custard. Go to any bakery or grocery the week before Thanksgiving and ask them what they use for their pies. They’ll tell you the truth: It’s from the can.

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This disconnect has fueled a growing mistrust of the medical establishment—out of which has emerged the Make America Healthy Again movement (MAHA), led by Robert F. Kennedy Jr., a longtime critic of conventional public health wisdom. While some MAHA policies are controversial, few dispute the source of their appeal: Many parents no longer trust that the experts are acting in their children’s best interests.

Enter family physician and New York Times best-selling author Mark Hyman. His new book, Food Fix Uncensored, released today, argues that government malpractice and powerful corporate interests have rigged the medical and health systems against us. Watch Dr. Hyman’s interview with The Free Press’s Rafaela Siewert here. And read on for an exclusive excerpt from the book, in which Dr. Hyman takes aim at one of the primary culprits: the food industry. Big Food, he argues, is killing our children. And it won’t stop unless we stop it.
—The Editors

Kids today are fatter than ever.

Obesity rates in children have nearly quadrupled since the 1970s. Thirty-six percent are overweight or obese. One in four teenagers now has type 2 diabetes or prediabetes—a condition we used to call “adult-onset diabetes.”

Most of us know that the problem exists, and the Make America Healthy Again movement has made alleviating it one of its main goals. But why has it happened in the first place? The answer is tied to the powerful Big Food lobby—a collection of corporations that subjugate children’s health to the endless pursuit of profit—and to our political leaders who appease it.

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Our patients could sense that something was different, though. At 50 times the potency of heroin, how could they not? The high from the fentanyl component of what they had just snorted or injected came on more quickly and intensely than did heroin, thereby accelerating addiction to the drug. For dealers, this ensured an even more faithful customer base.

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For instance, there was a highly publicized study of cadaver brains in February 2025, using a new technique for finding plastic particles in the body, that concluded that in the most extreme cases, plastic shards made up 0.48 percent of the brain—enough to make a plastic spoon. Other studies, using the same technique, came to the same conclusion, leading to lots of shocking headlines and scary quotes from scientists. Matthew Campen, co-author of the plastic spoon study, even implied that plastic lodged in the brain might cause dementia.

Fast-forward to November, when another group of researchers published commentary in the journal Nature showing that the technique used to find all this plastic couldn’t distinguish the stuff from ordinary fat molecules. The Guardian, which had run some of the most alarmist headlines (“Microscopic Plastics Could Raise Risk of Stroke and Heart Attack, Study Says”), suddenly reversed course. Last week, it published a lengthy article slamming the research, with critics calling the original 2025 brain study a “joke.”

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