Anti-aging can be a difficult topic to address: a war is currently fought over the meaning of the term in research and medicine, and as a brand for products in an energetic and often fraudulent marketplace. Even mentioning anti-aging medicine is likely to prejudice many readers, but I will try to put this all into context.
Anti-aging now has a number of quite different common meanings and connotations, each of which is championed by a particular group or loose coalition of interests. Advocates for these groups have a way of diving into the fray without defining their terms, and this tends to make reading about the surrounding debates somewhat confusing for a newcomer.
In the scientific community anti-aging research refers exclusively to slowing, preventing, or reversing the aging process. While the future is looking very promising, there is presently no proven and available medical technology that slows or reverses aging in humans. (Although the jury is still out on the practice of calorie restriction and regular exercise). Nor is there any currently available method short of waiting for people to die to accurately measure the effects of an alleged anti-aging therapy.
In the medical and reputable business community, anti-aging medicine means the early detection, prevention, and treatment of age-related diseases. This is quite different from tackling the aging process itself, and a wide array of strategies and therapies are currently available. Calorie restriction, for example, lowers the risk of suffering a wide range of age-related conditions.
In the wider business community - which includes a great many fraudulent or frivolous ventures - anti-aging is a valuable brand and a demonstrated way to increase sales. At the worse end of the scale, this leads to snake oil salesmen, "anti-aging" potions that may or may not make your skin look younger, and infomercials that tout the "anti-aging" benefits of various foods. Broadly, and very charitably, we can look at these varied definitions of anti-aging as meaning "to look and feel younger in some way." This has no bearing on how long you live or how healthy you actually are, and many of these products simple do not achieve the results claimed.
The confusion of greatest interest here is between the first two definitions above: treating the disease of aging versus treating aging itself. Many interventions can lengthen an individual's life span by preventing or curing specific age-related diseases that would otherwise prove fatal. For example, ask yourself whether a method of preventing heart disease or type 2 diabetes is anti-aging medicine. The therapy in question might have no effect on the underlying aging process, but it would nonetheless help many people to live comparatively longer, healthier lives. Is this anti-aging research? Scientists say no, some medical and business groups say yes.
Why Can't They All Just Get Along?
Scientists are appalled at what is going on in the anti-aging marketplace. The more reputable businesses in that marketplace are appalled by the hucksters and pervasive fraud. Anti-aging is a valuable brand in science and business, and all of these groups are attempting to control or profit from the brand: the war over the meaning of "anti-aging" is thus fought for money, but more importantly for the perception of legitimacy.
Perception of legitimacy goes a long way towards determining funding for scientific research and revenues for a business. Scientists feel, quite rightly, that the noise and nonsense coming from the anti-aging marketplace damages the prospects for serious anti-aging research. If the public believes that anti-aging means high-priced cosmetics marketed to the gullible, then no scientist is going to obtain funding for a serious proposal in longevity science that uses the word "anti-aging" no matter how accurate it might be. Worse than that, people start to assume that real efforts to reverse aging must be impossible - and science at the large scale requires public support and understanding to thrive.
Businesses in the "anti-aging" marketplace make money from the aura of legitimacy whether or not their products perform as advertised, and so a lot of effort is expended to create and maintain this perception. Businesspeople with working, accurately marketed products carry out their own fight against opportunists and frauds who damage the market and the brand.
A common objection to the way in which anti-aging businesses establish legitimacy is that they cherry-pick supportive studies in areas in which the facts are still unsure and scientists are still working towards a conclusion. A few positive studies are not enough to settle any question or recommend any course of action in the complex world of medicine. Many business don't even go that far, and settle for a cargo-cult patchwork assembly of disconnected research results, nonsense or irrelevant when taken together as a whole. Sadly this usually works to sell products, even as it promotes scientific illiteracy and misunderstanding.
The vast amount of money spent on products that claim to turn back the clock or at least hide the progression of aging demonstrates that people want real anti-aging medicines. The issue is that these real anti-aging therapies don't exist yet: an entire industry of business and manufacture has come into existence in advance of the products it should be selling, and somehow is still thriving.
We Are Not There Yet
The concept of optimizing natural longevity is useful when trying to draw a distinct line between what you can do now to lead a longer, healthier life, and what will be possible in the future. We can presume that there exists, for each person, some maximum life expectancy that can be reached using modern medicine and appropriate lifestyle and diet choices. You might adopt calorie restriction, exercise regularly, keep up a good relationship with a physician, and spend an appropriate amount on preventative healthcare. You will have access to modern clinics to treat age-related disease when it strikes. Each of these items will help raise the odds of living longer and in better health than you would otherwise have done. Does this make them anti-aging strategies, preventative medicine, or merely adequate maintenance for an aging body?
If we possessed medical technologies that could extend the healthy human life span to 150 years or more then it is a fair bet that no-one would be arguing about the semantics of anti-aging research and medicine. In large part, these battles over meaning and legitimacy stem from the present absence of anti-aging therapies capable of greatly extend healthy life span. A year here and a year there are better than nothing, but far more effective medical technologies are possible in the near future.
Thus a focus on medical research and funding is vital and central to any efforts made to live longer healthy lives. We are simply not there yet! People always want a silver bullet right now, and focus on tiny short term gains at the expense of long term development. If a tenth of the effort spent on redefining anti-aging, selling junk and lies, or trying to optimize natural longevity was spent on developing the medicine of the future - ways to actually reverse aging such as repair of mitochondria and restoration of aged stem cell populations - then we would be well underway towards that goal.
The modern medicine and lifestyle choices like calorie restriction that are all we have access to in the here and now are largely ineffective in the grand scheme of what is possible when it comes to human aging and longevity. They are poor first steps on a very long road. Medical science can do far, far better in the future, but getting there will require work, activism, and support for longevity research rather than the present grubbing around in the "anti-aging" marketplace.
Last updated: May 5th 2013.