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Ozempic changed obesity treatment, but experts say the real revolution is next
The obesity treatment landscape is changing fast, with GLP-1 drugs opening the door to more effective care than ever before. Experts now envision a future where medications, minimally invasive procedures, surgery, and precision medicine work together to deliver better long-term results.
Samsung phones are getting a new feature for checking the health of your pets.
During the VivaTech 2026 conference in Paris, Samsung announced a new feature for its mobile devices created through a collaboration with the pet health management platform, Lifet. You’ll be able to snap a photo of your dog or cat which will be analyzed by AI to alert you to conditions like periodontal disease and obesity. [Image: https://platform.theverge.com/wp-content/uploads/sites/2/2026/06/samsung.jpg?quality=90&strip=all]
Optimize health to combat cardiovascular disease
The threat of heart disease and stroke is growing substantially among women and girls as rates climb for health factors such as high blood pressure, diabetes and obesity, with 6
Want obesity drugs covered by insurance? Telehealth companies have a big say
Telehealth companies offer lifestyle support so people taking obesity drugs can have the most success losing weight. But employers also want the telehealth providers to limit spending on the drugs.
Middle-aged adults taking GLP-1s for obesity can save over $192K on lifetime medical costs, higher if they don’t have college degrees, new study finds
The National Bureau of Economic Research paper's lead author hopes putting a dollar value on the benefits of GLP-1s will lead to better access
Trouble Ahead For GLP-1 Drugs As Health Plans Stop Paying
Half of U.S. employers and health plans are balking at paying for GLP-1 drugs like Ozempic, Zepbound and Wegovy for weight loss and obesity treatment, a new report shows.
Beyond BMI: New Score Stratifies Obesity Risk
BMI, while useful, is insufficient to identify patients at the highest risk for obesity-related complications. A new tool may help clinicians better stratify risk and target treatment.
Once-Weekly Drug Demonstrates Promising Dual Benefits in Obesity and Metabolic Health
/PRNewswire/ -- New data highlight the potential benefits of survodutide, a once-weekly injectable therapy targeting both the glucagon and glucagon-like...
An Avocado a Day May Keep Diabetes, Hypertension, and Obesity at Bay
Research suggests that eating more avocado may help reduce your risk of diabetes, lower blood pressure, and reduce your risk for obesity and other cardiometabolic risk factors.
E-bike safety; lung cancer treatment and prevention; keeping CMA Festival attendees safe; plus other stories with Vanderbilt Health sources
WKRN News 2 interviewed Jeffrey Upperman, MD, FACS, Professor and Chair of the Department of Pediatric Surgery and Surgeon-in-Chief of Monroe Carell Jr. Children’s Hospital at Vanderbilt, about e-bike related injuries following the recent death of a Brentwood High student and a proposal to require safety training before students could ride a bike on a school campus in Williamson County. Fabien Maldonado, MD, MSc,Professor of Medicine and Thoracic Surgery, was on WTVF News Channel 5‘s live studio show, “Openline,” with host Ben Hall, to discuss lung cancer, treatment and prevention. WSMV’s “Today In Nashville” program hosted Vanderbilt LifeFlight paramedic/flight nurse practitioner Tony Smith to talk about safety for the CMA Festival. The New York Times reporter Carl Zimmer interviewed James Crowe, MD, Director of the Vanderbilt Center for Antibody Therapeutics, for a story about the race to find vaccines and treatments as Ebola spreads. The Vanderbilt Health News release about the pilot clinical trial conducted by Vanderbilt Health and Cumberland Pharmaceuticals Inc., that confirms the safety of ifetroban and supports the further development of the drug to prevent cancer metastasis, was picked up by Reuters, Stock Titan,and others. Women We Admire has named Lee Ann Liska, President and Chief Operating Officer, to its list of top women leaders of Nashville for 2026. Radiology Business, Aunt Minnie, Bioengineer, and Imaging Technology News covered the study from Consuelo Wilkins, MD, MSCI, the Mildred Thornton Stahlman Professor in Rural Health and professor of Medicine in the Division of Geriatric Medicine, that found Black and Hispanic people, while known to be far more apt to have dementia, are significantly less apt than other racial and ethnic groups to show Alzheimer’s pathology on brain scans. STAT News interviewed Deva Sharma, MD, Transfusion Medicine & Hematology-Oncology, for a story about more patients requesting unvaccinated blood and what it means for the medical system at large. Yahoo! Health reporter Korin Miller interviewed Gitanjali Srivastava, MD, Director of Obesity Medicine, for a story about how semaglutide and tirzepatide compare. William Schaffner, MD, Professor of Preventive Medicine, was quoted by several news outlets about public health issues, including: NBC News (new COVID vaccinations); Medscape (pneumonia and sepsis); and CNN (protection from contagious viruses). Shelbyville Times-Gazette is repurposing Jessica Pasley’s July 2025 Vanderbilt Health News story on tick-borne illnesses as a front-page story.
DPH Hosts Fourth Annual Advancing Healthy Lifestyles Conference
DOVER, DEL. (June 4, 2026) — The Physical Activity, Nutrition, and Obesity Prevention Program (PANO) of the Delaware Division of Public Health (DPH) brought together hundreds of leaders, advocates, and practitioners for its fourth annual Advancing Healthy Lifestyles Conference, on June 4, at the Bally’s Dover Casino Resort. It was a full day focused on […]
Decoding the Complex Science of Obesity
GLP-1. GIP. Amylin. Incretins. Peptides. NuSH. It’s not hard to see why the language surrounding modern obesity research sometimes feels like an alphabet soup of scientific terms. But behind each is a growing understanding of how the body regulates hunger, metabolism, energy use, and weight. It’s shaping what we know about how those systems might contribute to obesity.
This new diabetes pill burns fat without the downsides of Ozempic
Scientists have developed an experimental diabetes and obesity pill that works in a completely different way from drugs like Ozempic. Rather than reducing hunger, it activates metabolism in skeletal muscle, helping lower blood sugar and increase fat burning while preserving muscle mass. Early clinical results suggest the treatment is safe and well tolerated.
Planetary Health Diet May Lower Obesity Risk at Menopause
The planetary health and low-insulinemic diets — rich in plants and whole grains and low in red and processed meats and fried foods — can aid weight management during menopause, a recent study shows.
Medicare’s mum on GLP-1s, and Massachusetts sues United
We've been asking Medicare for weeks about the cost of giving seniors $50 obesity drugs.
Vanderbilt Health study explores GLP-1 therapies to improve asthma outcomes in patients with obesity
The study is still recruiting participants. It will conclude in 2026 and provide insight for further investigations into the role GLP-1 agonists may offer in treating respiratory illnesses and overall immune responses.
Role of Physical Activity in Obesity Treatment and Cardiometabolic Health
Obesity affects 42% of adults in the United States and is strongly associated with major cardiovascular disease risk factors, including high blood pressure, abnormal cholesterol levels, and insulin resistance, making effective obesity treatment a critical public health priority.
Move more for your health, not just for the scale
Statement Highlights: Regular physical activity improves blood pressure, insulin sensitivity, cholesterol levels and cardiorespiratory fitness in adults with overweight or obesity, independent of weight loss, according to a new scientific statement...
Do anti-obesity medications affect bone health?
Learn about a new study to examine if GLP-1 weight loss medications have an effect on bone density.
Barcelona Institute for Global Health: Chronic liver disease in Europe: A preventable crisis going undetected
A new Lancet Regional Health – Europe Series calls for liver disease to be embedded in broader national and EU-level policies on diet, alcohol, obesity, public health and non-communicable diseases.
Watch Lilly Gets Back Into the Vaccine Business With New Deals
Eli Lilly & Co. is buying three clinical-stage vaccine developers for as much as $3.8 billion as it looks to become a leader in infectious diseases. The drugmaker has been using cash from its obesity drugs to expand into other disease areas. Bloomberg's Gerry Smith reports.
New AI body map reveals obesity’s hidden attack on facial nerves
Scientists have created an AI-powered system that can scan and map an entire mouse body in extraordinary detail — and it just uncovered a surprising new effect of obesity. Beyond disrupting metabolism, obesity appears to damage facial sensory nerves linked to touch and sensation, while also triggering widespread inflammation across the body.
Dietitian who never skips breakfast shares 3 high-fiber favorites
Skipping breakfast is linked to health problems including obesity, poor gut health, anxiety, and depression.
New obesity drug helped patients lose up to 85 pounds in trial
A new experimental obesity drug from Eli Lilly helped patients lose an average of about 85 pounds in a late-stage clinical trial. Duke Health expert Dr. Susan Spratt says the results are reaching levels typically only seen with gastric bypass surgery.
New obesity treatment may help preserve muscle during weight loss
Gwyneth Paltrow and neuroscientist Andrew Huberman explore retatrutide, a new triple-agonist GLP-1 therapy said to reduce side effects and spare muscle.
Dartmouth Health study could point way to sustained weight loss for those who stop using GLP-1 drugs
GLP-1 drugs have transformed obesity treatment, but many patients regain weight after stopping the medication. A new study could point the way to a solution.
People who lost the most weight on Ozempic saw huge health benefits
People who lost significant weight while taking Ozempic, Wegovy, Mounjaro, or Saxenda had sharply lower risks of major obesity-related health problems, including sleep apnea and kidney disease. Those who gained weight instead faced higher risks — especially for heart failure — even though many patients discontinued the medications within a year.
Scientists Say a 40-Year-Old Childhood Obesity Warning May Be Completely Wrong
A long-accepted explanation of childhood growth patterns is now being challenged by new research that questions whether BMI changes in early life reflect fat accumulation at all.
Hantavirus Is Scary. Your Daily Habits Are More Dangerous.
Why rare diseases like hantavirus generate fear while heart disease, loneliness, obesity, and poor sleep quietly cause far greater harm.
Louisiana's youth obesity rate increased last year, so did it's national ranking. See the data.
Louisiana has gone from 5th-highest to the 4th-highest in the nation for youth obesity. See the national data.
Network topology of the gut microbiome associates with metabolic health in obesity
Nature Communications - Here, the authors show that microbiome network topology associates with metabolic health across obesity phenotypes, with reduced connectivity in metabolically unhealthy...
Healthy Returns: Novo Nordisk says high-dose Wegovy helped some patients lose nearly 28% of their weight
Novo Nordisk released new data that could help boost the case for the higher dose version of its blockbuster obesity injection Wegovy.
Obesity Drug Prices Undercut Healthcare Savings, CVS CEO Says
CVS Health Corp. Chief Executive Officer David Joyner said that drugmakers must significantly reduce the price of anti-obesity medicines before the drugs will save money for commercial health insurance plans.
The sugar intake – oral diseases nexus: Leveraging food environments for better population nutrition and health
Across the World Health Organization (WHO) Western Pacific Region, our diets are changing rapidly. Globalization has made processed foods, which often do not align with healthy diets, easier to find, more affordable, and more heavily marketed than ever before. Unfortunately, many of these products are often high in saturated fat, trans-fatty acids, salts and free sugars, contributing to the burden of all forms of malnutrition, including diet-related noncommunicable diseases (NCDs). The impact of these dietary changes is staggering. Sugars, in particular, are empty calories and are often hidden in processed foods and beverages. Over the last 20 years, the health burden linked to sugary drinks has nearly tripled, reaching 52.3 disability-adjusted life years per 100 000 in 2023. Excessive sugar is a leading cause of obesity, diabetes, and—most notably—oral diseases. Today, oral diseases affect over 960 million individuals in the Western Pacific Region. Tooth decay is the most common issue, especially for childre
Scientists say this common sweetener may be quietly rewiring your metabolism
Researchers say fructose is not just “empty calories” — it may actively push the body toward fat storage and metabolic disease. A new review found that fructose affects the body differently from glucose, disrupting normal energy regulation and promoting processes linked to obesity, insulin resistance, and cardiovascular problems.
Greater weight loss from GLP-1 drugs lowers health complication risk
New research to be presented at this year's European Congress on Obesity (ECO 2026, Istanbul, Turkey, 12-15 May) shows that, following treatment for obesity or diabetes or both using incretin-based drugs, losing more weight versus less weight, and losing a little weight versus gaining weight, both lead to relatively lower risk of obesity-related conditions.
Childhood obesity is at an all-time high — inviting a host of health complications
Every night before bed, Ashley Loboda walks by the family charging station and takes inventory. “I have four kids. It’s super annoying to walk...
New obesity discovery rewrites decades of fat science
Scientists have uncovered a surprising secret hidden inside fat cells that could reshape how we think about obesity and metabolic disease. A protein called HSL, long believed to simply release stored fat when the body needs energy, turns out to have a second job deep inside the nucleus of fat cells—helping keep those cells healthy and balanced. Even more surprising, people and mice missing this protein don’t become obese as expected; instead, they lose fat tissue in a dangerous condition called lipodystrophy.
Iterative Health banks $77m to level up AI-driven clinical research tech
Google Ventures-backed Iterative will now expand its platform into burgeoning therapeutic areas like cardiology and obesity.
Surprising obesity discovery rewrites decades of fat metabolism science
A key protein involved in fat metabolism has been found to do more than scientists once thought. Instead of just releasing fat, it helps maintain healthy fat tissue and balance in the body. When it’s missing or disrupted, the results can be surprisingly harmful. This finding reshapes how researchers think about obesity and metabolic disease.
New obesity tool aims to predict risk of 18 serious complications
A new tool, OBSCORE, is meant to better define who's at risk for obesity complications, going beyond BMI to include family history, diet, and more.
Scientists restore memory by blocking a single Alzheimer’s protein
Researchers have identified a new potential weapon against Alzheimer’s: blocking a protein called PTP1B. In mice, this approach boosted memory and helped brain immune cells clear harmful plaque buildup. Since PTP1B is also linked to diabetes and obesity—both risk factors for Alzheimer’s—it could offer a broader treatment strategy.
Thanks to GLP-1s, Obesity Experts Are Trying to Understand ‘Food Noise’
Before the rise of GLP-1s, obesity experts didn’t study the internal buzz that compels people to eat. Now that food noise is being switched off, they want to understand it.
Inside the endoscopic revolution in weight loss
Article explains how bariatric endoscopy — including endoscopic sleeve gastroplasty and transoral outlet reduction — combined with metabolic therapies and GLP-1 receptor agonists is expanding nonsurgical obesity treatment options and reframing obesity as a chronic, multifactorial disease.
Healthy life expectancy gap between rich and poor has widened
Poor housing, obesity and the effects of deprivation have been suggested as underlying causes of the fall.
As heart, kidney and metabolic health worsen, cancer risk may rise
Research Highlights: Researchers studied the link between cardiovascular-kidney-metabolic syndrome (CKM syndrome) and risk of cancer. CKM syndrome refers to several connected health conditions, including heart disease, stroke, kidney disease, obesity...
Science & Medicine: Weight loss surgery without the scalpel
Obesity rates in South Texas exceed the national average, but many patients hesitate to pursue bariatric surgery due to the risks involved. UT Health San Antonio now offers endoscopic alternatives that achieve comparable weight loss results with no incisions, shorter recovery times, and lower risk.
A Simple Sugar in Ultra-Processed Foods May Drive Obesity, Metabolic Disease
Recent research shows that fructose in ultra-processed foods may drive disease, like metabolic syndrome, which includes obesity. Reducing your intake of this type of simple sugar could help lower the associated health risks.
Restrictions on obesity drug coverage force patients to pivot
Twelve million people lost coverage for Zepbound over the last year. The same number of people lost coverage for Wegovy, according to an analysis by GoodRx, a drug discount website.
Amazon One Medical introduces weight management program with upfront GLP-1 medication costs
The new program combines primary care, pharmacy, and virtual options to treat obesity as a chronic condition—all in one place.
Is stevia actually healthy? What to know when cutting back on sugar
Research has shown diets high in added sugar can be linked to several health issues, including obesity, Type 2 diabetes and fatty liver disease.
Scientists discover natural hormone that reverses obesity
A hormone called FGF21 can reverse obesity in mice by activating a newly identified brain circuit tied to metabolism. Surprisingly, it works in the hindbrain—the same region targeted by GLP-1 drugs like Ozempic and Wegovy—but through a completely different mechanism. Instead of suppressing appetite, FGF21 ramps up the body’s energy burning. This insight could pave the way for more targeted weight-loss and liver disease treatments.
Advancing Metabolic Health Through Coordinated Care
The Metabolic Health Institute is a first-of-its-kind model unifying endocrinology, obesity medicine and bariatric surgery under non-surgical leadership.
US states drop Medicaid coverage of GLP-1 weight-loss drugs as demand rises
Experts say any short-term financial benefit will be outweighed by long-term health costs related to obesity
New Mexico childhood obesity up as Trump administration cuts erode healthy food programs
By third grade, New Mexico childhood obesity rates outpace the national average — which hovers around 20% for those 2 to 19.
Men and women with obesity face very different hidden health risks
New research reveals that obesity affects men and women in surprisingly different ways. Men are more likely to develop harmful abdominal fat and signs of liver stress, while women show higher inflammation and cholesterol levels. These differences could help explain why health risks vary between sexes. Scientists say this could lead to more tailored treatments for obesity.
Health Issues Linked to Obesity Differ Between Men and Women
Women and men with obesity have different health issues, which should be taken into account when suggesting treatments or interventions.
Early weight gain is linked to lifelong health consequences
Putting on weight earlier in life may be more dangerous than previously thought. Researchers found that early adulthood obesity significantly raises the risk of premature death, especially from major diseases like heart disease and diabetes. The longer the body carries excess weight, the greater the damage appears to be. Interestingly, cancer risk in women didn’t follow this pattern, suggesting other biological factors are at play.
Early weight gain is linked to lifelong health consequences
Putting on weight earlier in life may be more dangerous than previously thought. Researchers found that early adulthood obesity significantly raises the risk of premature death, especially from major diseases like heart disease and diabetes. The longer the body carries excess weight, the greater the damage appears to be. Interestingly, cancer risk in women didn’t follow this pattern, suggesting other biological factors are at play.
Scientists discover hidden brain switch that tells you to stop eating
Your brain’s “stop eating” signal may come from an unexpected source. Researchers found that astrocytes—once thought to just support neurons—actually play a key role in controlling appetite. After a meal, glucose triggers tanycytes, which send signals to astrocytes that then activate fullness neurons. This newly discovered pathway could lead to innovative treatments for obesity and eating disorders.
Iterative Health, US Heart & Vascular Partner to Advance Community-Based Cardiovascular Research
April 2, 2026 — Iterative Health and US Heart & Vascular (USHV) have announced a strategic partnership to advance research through community-based innovation in cardiovascular care. "Clinical research is one of the most powerful ways we expand access, improve patient outcomes, and shape the future of cardiovascular care," said Robbie Allen, chief executive officer of US Heart & Vascular. "By partnering with Iterative Health, we are strengthening our ability to bring innovative therapies directly into the communities we serve. This collaboration ensures our physicians and patients have access to leading-edge trials while allowing US Heart & Vascular to remain focused on delivering exceptional, physician-led care." Under the agreement, USHV research sites will join Iterative Health’s global site network, which now spans over 100 sites across three continents. The companies share a commitment to advancing clinical research as a driver of care innovation, and this collaboration represents a major milestone for both organizations, strengthening USHV's leadership in community-based cardiovascular research and expanding Iterative Health's multispecialty focus beyond GI, hepatology, and obesity into cardiology. USHV clinical research sites will gain access to Iterative Health's centralized operational backbone, providing end-to-end support across clinical research operations, services, business development, technology innovation, and corporate functions. The strategic partnership reduces operational complexity and unlocks growth potential for USHV research sites while enabling all USHV physicians to expand access to cutting-edge therapies to the thousands of patients they serve annually. "Innovation in cardiovascular medicine shouldn't be limited to a few academic centers," said Thomas Waggoner, DO, MD, RPVI, FACC, FSCAI, FSVM, RPVI, Structural Cardiologist and Medical Director for Clinical Research at Pima Heart & Vascular, and USHV Physician Champion for Clinical Research. "By expanding community-based research across USHV, we're ensuring more patients have access to clinical trials and breakthrough therapies close to home, where trusted relationships with their physicians already exist." This alliance reinforces Iterative Health's standing as the definitive research partner across specialized therapeutic areas, now spanning GI, hepatology, obesity, and cardiovascular care. Trusted by many of the nation's leading provider organizations and biopharma sponsors, Iterative Health's global site network delivers industry-leading trial performance, accelerating life-changing therapies to market at scale. "Entering cardiology through our strategic partnership with US Heart & Vascular is a defining moment for Iterative Health and reflects the strength of our site-serving model," said Jonathan Ng, founder and CEO of Iterative Health. "Together, we are ensuring that thousands of patients have access to the newest available therapies, and that sponsors have a credible, high-performing partner to accelerate cardiovascular trial success." For more information, visit www.iterative.health and https://usheartandvascular.com/.
Demand for GLP-1 pills and shots surges, and not just for weight loss
Use of blockbuster anti-obesity drugs like Wegovy and Zepbound is growing, with about 1 in 8 adults in the U.S. saying they currently take the medications.
As demand for GLP-1 pills and shots surges, healthy habits are still key
Whether they’re using weekly shots or daily pills, more Americans than ever are turning to anti-obesity drugs to lose weight and boost health.
Obesity report sets out vision for healthy future in Peterborough
A new obesity charter for Peterborough says authorities should look beyond individual behaviour.
Your Thymus and Your Healthspan
Our thymus gland plays a central role in the development or our immune system, specifically for supporting T cell development (how these cells got their name, maturation and differentiation in the thymus) and discriminating between self and foreign, non-self antigen proteins with production of dendritic cells. As we age, our thymus gland shrinks—the process known as involution—with progressive change from spongy to fatty tissue, with loss of functionality. But this process, with respect to timeline and extent, markedly varies from one person to the next. And to make things even more complicated, our thymus gland anatomy and precise location in the chest also is highly variable. So the famous Frank Netter diagrams from the 1960s (such as at left below) don’t capture the remarkable heterogeneity that a random set of 12 chest CT scans (below at right). What I consider as 2 landmark papers in Nature this week (here and here) used AI to quantify health of the thymus in 2 large cohorts, and then correlate the metric to a broad array of health outcomes. In this edition of Ground Truths, I’m going to cover three questions: (1) How was thymus health determined by AI?; (2) How is thymus health linked to key clinical outcomes? and (3) Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? Subscribe 1. How was thymus health determined by AI? This was accomplished by extensive work developing and validating an AI pipeline for 2 stages, the first for localization and segmentation of the thymus bed, and the second to quantify a digital marker, termed the thymic health score. There’s a lot to this algorithmic development, so I won’t go into all the details, but just provide a rudimentary outline of what was done. The 1st stage used supervised learning with 2 radiologists reviewing 2,461 chest CT scans. That work trained a 3D U-Net model to automatically identify the thymic bed’s 3D cropped region using center of mass coordinates, which reached 99.8% accuracy. The 2nd stage used a foundation model that was pre-trained with SwAV (which stands for Swapping Assignment between multiple Views), a self-supervised model, that generated a high-dimensional thymus representation of 4,096 features. That compares to the radiology reductionist and subjective scoring of 0 to 3 where 0 means the thymus is fully degenerated and fatty, and 3 is considered dense, intact glandular soft tissue. Notably, the self-supervised learning (SSL) performance was superior to supervised (AUC ~0.75 vs 0.55, respectively) reflecting the shallowness of the 0-3 classifier vs SSL’s holistic, self-taught AI. The thymic health score ranged from 0 to 100, with the highest number indexed to fully preserved thymic health. The algorithmic work extended to explainability with both Shapely value distribution, meaning the model was holistic not relying on any “magic” pixel, and occlusion sensitivity, demonstrating the model’s performance was not affected by ribs, sternum, lung tissue, but rather focused on the thymic bed directly. Below are a few saliency maps from the occlusion sensitivity that indicate the thymic bed focus, not affected by neighboring structures, using the jet color scale. Now the AI was ready for processing ~25,000 CT scans, each over 30 MB files, from the 2 large participant cohorts to provide a thymic health score, it did so in less than 14 hours, which is less than 2 seconds per scan! Share 2. How is thymus health linked to key clinical outcomes? The two cohorts were the National Lung Screening Trial, NLST (N=25,031) and the Framingham Heart Study, FHS (N=2,581) each with baseline demographics and long term follow up of >12 years for health outcomes. From the NSLT, you can see below that increased age and body-mass index were correlated to reduced thymic health. And, overall, men had reduced thymic health scores compared with women. There are a lot of graphs in the paper for outcomes, for both the NLST and FHS cohorts. To simplify the major outcomes, below is a composite Figure with striking reduction of all-cause mortality and for the different causes of death. The results were consistent between the 2 cohorts. For example, the cardiovascular mortality hazard ratio average was 0.57 in NLST and 0.38 in FHS (weighted to be 0.53 for the aggregate). The reduction of mortality also extended to digestive diseases and pulmonary disease (data not shown below). Lung cancer incidence was reduced by 36% for high vs low thymic health (Figure below, with a panel -incidence and b panel-mortality, adjusted for age, sex, BMI, smoking status). Notably, there was a smoker’s paradox: lower incidence and improved survival for lung cancer in smokers who had a high thymus health score. Smoking was associated with lower thymic scores whereas alcohol was not. Higher thymic health was linked to higher HDL cholesterol, lower triglycerides, lower fasting blood glucose, and lower systolic and diastolic blood pressure. Inflammation biomarkers, such as C-reactive protein and interleukin-6, were elevated in the people with lower thymic health scores. In their second paper, the same team looked at the relationship between thymic score and outcomes for 3,476 patients receiving cancer immunotherapy. The non-small cell lung cancer progression-free survival was reduced in patients with low thymic health score. A parallel relationship for survival was seen for other types of cancer including melanoma, breast, and kidney with a 44% lower risk among high thymic scores (Figure). A similar pattern was seen with different immune checkpoint inhibitors. The thymus health score outperformed programmed death ligand-1 (PD-L1)and tumor mutation burden (TMB) assay of the tumor and was an independent prognostic marker of progression-free survival. In this dataset, a direct connect with thymus score and adaptive immune function was noted with a correlation before cancer treatment for both T-cell diversity and thymus T-cell production (a metric known as T cell receptor excision circles). Thymus Removal Study There is a highly relevant citation about thymus function before moving onto ways to rejuvenate it. In 2023, a very important study of thymus removal during cardiothoracic surgery was published, with 1146 patients undergoing thymus removal vs 1146 matched controls (mean age 55 years). The adverse outcomes for thymus removal were striking, with a 2.9 higher risk of all-cause mortality and doubling of cancer incidence, 1.5 fold increase in cancer mortality, and 1.5-fold increase in autoimmune diseases. The immune function showed marked compromise after thymus removal, as reflected by CD4+ and CD8+ T cells (Figure below) Share Ground Truths 3. Are there ways we can promote a healthy (aka rejuvenate) thymus gland in our later years? In recent months we’ve learned a lot about the process of thymus involution and the pathways by which this may be modulated. Thymus involution is primarily due to loss to thymus epithelial cells (TECs) and there are 2 subtypes with different functions: the cortical, responsible for positive selection of T cells, and the medullary, for negative selection. When adipose tissue infiltrates the thymus, thymic adipocytes are pro-inflammatory, knocking out T-cell output. Likewise, systemic inflammation, or “inflammaging,” from smoking, obesity, and chronic stress promote thymic adipocytes. Now, from preclinical studies, we know about key pathways that account for these processes. Historically, back in 2014, FOXN1 was recognized as a single master transcription factor essential for TEC function, with studies in mice with forced FOXN1 upregulation leading to thymus regeneration. That laid the foundation for potential regrowth of quiescent thymus cells. It took awhile to find pathways to accomplish this goal and to even refute its role as the master regulator. The Liver-Thymus Axis Feng Zhang and his team recently showed that injection of an mRNA vaccine to the liver encoding DLL1, IL-7 and FLT3-L in combination, factors known to support thymopoiesis (Figure), successfully enhanced immune function in aged mice. However, the effect was transient. The FGF21 Story Two reports in 2025 addressed the thymus gland’s production of FGF21, a growth factor (fibroblast growth factor 21) and its control of thymus involution. This growth factor is also produced by the liver, but it doesn’t have impact on the thymus in aged rodent models. In contrast, The liver’s hepatocyte growth factor (HGF) has been shown to reverse senescent TEC structural changes. Growth hormone stimulates production of insulin growth factor-1 (IGF-1) in the liver and the thymus. Two small studies in human participants (TRIIM, for Thymus Regeneration, Immunorestoration, and Insulin Mitigation) of 6 and 50 people, respectively, treated with combined human growth hormone, metformin and DHEA, suggested the potential of slowing epigenetic aging and improving thymus mass and function. But the combination of drugs, small sample, and lack of controls make conclusions murky. Increased thymus FGF21 led to increased CD8 T cells in old mice and extended healthspan and improved physical performance. Building on the previous FOXN1 data, ablation of β-klotho, the obligatory co-receptor for FOXN1, accelerated thymic aging. The benefit to FGF21 was confirmed in a companion paper using an FGF21 knock-in mouse model showing thymus enlargement and increased TECs throughout the lifespan. (schematic Figure below). The accompanying editorial for these 2 papers speculated: “The proposed link between age-associated thymus involution and organismal aging is intriguing, and suggests we might seek to achieve systemic rejuvenation by counteracting thymic involution.” Other Factors Lessons from the Axolotl (Mexican Salamander) In an elegant set of experiments of the axolotl (Figure), known for its complete thymus regeneration after total surgical removal, mediators were identified. Surprisingly FOXN1 was dispensable. But midkine, a growth factor, appeared to be the driver, the initiator of thymus cell growth, survival, and repair. Other components that contributed were Postn+ (periostin-expressing mesenchymal niches) and Ccl19, a chemokine protein from the bloodstream. RANK and RANKL RANK (receptor activator of nuclear factor κB its ligand (RANKL) have been considered key regulators of medullary TECs. In a study of both aged mice and human thymus cell cultures, their key role was confirmed, with multiple benefits of resorting TEC function, recruitment of progenitor cells, and T cell development. Subscribe Summing Up This body of work strongly supports the health of the thymus gland as a critical regulator of human healthspan, not just a correlate or link. The new landmark studies are reinforced by the regenerative biology experimental models that have shown, via an array of mediators, that healthspan of aged mice is at least in part dependent on thymus gland function and its critical role for maintaining adaptive immunity. It sure seems that we’d be better off having an immune reservoir of naive T cells instead of a profile in older adults of exhausted, low quality, memory T cells, with a senescent phenotype. It is striking that we ignored the importance of the thymus gland for many decades. A wake-up call was the results of the thymectomy matched control study reviewed here, with the opposite of high thymic health score improved health outcomes. The convergence of AI and healthspan here is notable. The exceptional and laborious work for developing and validating (no less explaining) the AI to quantify thymus health set the foundation for probing the connect the major health outcomes in two cohorts with extensive follow-up. We’ve never had a way to meaningfully quantify the thymus gland before, so this represents important leverage of supervised, self-supervised, and transformer models. The study wouldn’t have been possible without AI. And it begs the question as to whether there are ways we can maintain our thymus at a high health score. But it’s not so simple to rejuvenate our thymus. There are multiple risks including the induction of autoimmunity, increasing the risk of cancer, and inducing a pro-inflammatory state. For example, factors that increase TEC proliferation could compromise the medulllary negative selection process and leak out auto-reactive (self-attacking) T cells. Thymic cells could be induced to proliferate, but we know, for example, that growth hormone and IGF-1 are associated with an increase risk of cancer. If thymus rejuvenation doesn’t clear out the accumulated senescent cells in older adults, then inflammation within the gland could block the production of TECs. Keeping these risks in mind, we now have identified many ways to keep our thymus healthy as we age that undoubtedly will be tested in clinical trials going forward. Ultimately, the benefit-to-risk tradeoffs will be defined. In the meantime, we have desperately needed an immunome. As I’ve stressed in multiple prior Ground Truths, we have no test in the clinic to assess a patient’s immune status! It was very encouraging for me to get an email from Hugo Aerts, the senior author of the landmark papers in the days after they were published: “I also wanted to say that your Substack on “Why We Need an Immunome” was inspiring for this work. We found it a very compelling perspective and greatly enjoyed reading it.” Just having an assessment of a person’s immune status via a chest CT scan, with millions of these performed per year, might help in guiding the right immunotherapy for cancer (e.g. more intensive, combinations for those with low thymic health scores) and help define people who are increased risk for age-related diseases of cancer, cardiovascular, and neurodegenerative. The main theme of Super Agers is that we now have many layers of data (genetics, proteins, biomarkers, organ clocks that can be integrated via multimodal AI) for us to define a person’s specific risk decades before one of these age-related diseases leads to symptoms, enabling prevention. From the new studies this week, we can add thymus health score as yet another way to understand a person’s risk, a window into their adaptive immune system and healthspan. And perhaps someday we will be able to safely rejuvenate the thymus, or maintain its health through one’s life, and use the thymus health score to monitor. NB: I wrote this post (No A.I.) A Quick Poll Loading... ********************************************************************* Thanks to Ground Truths subscribers (now > 200,000) from every US state and 212 countries. Your subscription to these free essays and podcasts makes my work in putting them together worthwhile. Please join! If you found this interesting PLEASE share it! Share Ground Truths Paid subscriptions are voluntary and all proceeds from them go to support Scripps Research. They do allow for posting comments and questions, which I do my best to respond to. Please don’t hesitate to post comments and give me feedback. Let me know topics that you would like to see covered. Leave a comment Many thanks to those who have contributed—they have greatly helped fund our summer internship programs for the past two years. It enabled us to accept and support 47 summer interns in 2025! We aim to accept even more of the several thousand who will apply for summer 2026.
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