Sunday, December 7, 2008

Youthfulness An American Obsession

It is a common sentiment in a society where many of us strive to look and feel decades younger - to prove to ourselves and the world that we are healthier and more vital than our parents were at our age. We've all heard it: 60 is the new 50, the new 40 and so on.

But often, we need a little help. Sometimes, a lot of help.

As the baby boomers march toward retirement, Botox, wrinkle fillers and hormones of various kinds have become big business. Medco's latest drug trend report shows, for instance, that human growth hormone use grew almost 6 percent in 2007.

The list for age-defying tactics is endless. Want six-pack abs? There's a surgical procedure to create fake ones. How about drastically cutting your calorie intake to slow the aging process? There's a group of die-hards that swears by it.

This search for eternal youthfulness certainly isn't new. "In 1,500 B.C. people were ingesting tiger gonads to rejuvenate them," says Dr. Gene Cohen, a George Washington University expert on aging. But for a generation of adults who've been weaned on the modern marketing message - that for a price, you can have it all - the quest is taking on a new urgency.

There is, of course, much to be said for taking good care of yourself. Eating healthy and exercising your body and your brain regularly are considered tried-and-true tactics for staying young. Protecting yourself from harmful sun rays is another. Even flossing teeth is a habit that, according to research on people who live to 100, might extend life.

But that's generally where the consensus ends.

Many in mainstream medicine and elsewhere worry that we're becoming too focused on treatments with short-term benefits that have potentially dangerous side effects and scant, if any, evidence that they'll help in the long run. In doing so, they wonder if some people are actually jeopardizing their chance at a long, healthy life, both physically and emotionally.

"The quest to live forever and the desire to avoid diseases and not suffer" is understandable, says S. Jay Olshansky, a public health professor and longevity researcher at the University of Illinois at Chicago.

But it can make people vulnerable to far-fetched and potentially dangerous scams, he said, with some of the more bizarre including fetal cell injections, inhaling radon gas, even cutting off testicles, an ancient practice meant to reduce overexposure to reproductive hormones.

"There's a large industry of people trying to sell to people what doesn't yet exist and they're making gobs of money doing it -- much to the dismay of those of us who are vigilant about protecting public health," he says.

There also are concerns that this obsession is sending the wrong message to younger generations. Surveys from cosmetic surgery trade groups suggest that sizable numbers of people, even in their 20s, are getting cosmetic procedures.

And a fall 2007 survey from TRU, a research firm that specializes in the teenage demographic, found that a quarter of young people, 12 to 19 - and a third of girls in that age group - are interested in having cosmetic surgery to improve their appearance.

Michael Wood, vice president and director of syndicated research at TRU, was a bit startled by the results.

"There's no doubt that the celebration of youth and looking younger has certainly accelerated in the last 10 years, five years even," Wood says. "And this is a generation that's growing up with that at a very young age."

The effect has been palpable, says Neil Howe, a respected generational expert who has written extensively about "millennials," young people who are coming of age in this century.

"I guess even young isn't enough anymore," Howe says. "It's got to be 'perfect' young."

Alex Sabbag, a 23-year-old Chicagoan, has felt the pressure, both self-imposed and societal.

"I'll age until I'm 25. Then I'm over it," she said to co-workers during a lunchroom conversation that turned to the topic of Botox.

She was only partly serious. But she says she's also accepted that we live in a society where being well put-together and youthful gives you status.

"We all buy into it," Sabbag says. And plastic surgery and other cosmetic procedures are part of it.

She's never had anything done, though wouldn't rule it out in the future. She also vividly recalls how her mother left home for several days, when Sabbag was in elementary school, and returned after having a facelift.

"I think it gives women and men alike worlds of confidence that ultimately makes them better people," Sabbag says. "Yes, it is a vain practice ... but I think there comes a point for people when hard work isn't enough to kick the last bit of belly fat or gravity has become entirely too unbeatable, and so a little nip-tuck of the forehead needs to happen."

For a group known as the Calorie Restriction Society, youthfulness isn't found in hormones. It's reducing food intake to, in some cases, near-starvation levels. But the claims are much the same -- "lots of energy" and feeling "sharp," says Brian Delaney, a 45-year-old California-born writer now living in Sweden. He's the president of the group that claims about 2,000 members worldwide and many more followers who use the method in hopes of markedly increasing their longevity.

By cutting daily calories to about 1,900, roughly half the recommended amount for someone his height and age, and exercising every day, Delaney has shrunk himself to about 140 pounds. He says his blood pressure, cholesterol and blood sugar levels have improved dramatically. At 5 foot 11, he admits he's "scrawny," which he calls the main drawback.

Hunger and wearing extra clothes to stay warm - because of little body fat or, he claims, an effect of slowed aging - are barely annoyances for Delaney. He says he eats sensibly, replacing junk food with lots of fruits and vegetables, no meat, and two meals daily - no lunch. Breakfast is often "a hearty bowl" of granola, with fruit, nuts and soy milk; while dinner could be fish, rice, beans, a large salad and red wine.

Other than "tons of fine wrinkles" he blames on too much sun as a kid, Delaney says in most respects, "I look much younger" than 45.

It is a bragging right many strive for.

"When we were younger, we'd talk about someone who was 60 and that was old. And now my gym is full of women over 60 and they look phenomenal," says Renee Young, a 48-year-old businesswoman in New Rochelle, N.Y. "They don't want to be categorized as old."

But there's more to it than that. Youthfulness, she says frankly, is also a means of survival in the business world, including in her line of work, public relations.

"It feels like you're put out to pasture. No one wants to feel that how they look means that their ability to do anything is decreased," Young says. "If you have a younger look, you feel healthier. You feel that you're still in the game."

In the back of her mind is the fact that her own mother died when she was only 56. So five or six mornings a week, even when she'd rather pull the covers over her head, Young gets up and puts in two hours at the gym.

That's more than double the hour or so a day generally recommended for optimal health. And still, for her, that wasn't enough. She recently spent nearly $20,000 on a tummy tuck because, as she puts it, no number of abdominal crunches was going to make her as trim as she wanted to be. The result has been a makeover for her entire sense of self, she says.

"I made a commitment this summer. If I was going to go through all this surgery, then it was going to have to be part of a complete program," says Young, who's also getting more rest and eating healthier.

"I can definitely see the result." She, too, says she has not felt this good in years.

Using a cosmetic procedure as a motivator is worthwhile, and lucrative, to say the least, says Dr. Jonathan Lippitz. He's an emergency room physician in suburban Chicago who does cosmetic procedures, such as Botox and skin fillers, in a separate practice.

But it's also a "very slippery slope," with patients sometimes willing to take more risk than they should and some doctors who'll accommodate.

"They'll always find somebody willing to do it," he says.

In his own practice, he says he finds himself continually walking a fine line in deciding which procedures he'll do - and which ones he won't.

"We all say, 'I want my hair different. I want my eyes different,' " Lippitz says. "This idea of being perfect is a problem, though, because it's not reality.

"I have people coming in and saying 'I want these lips.' I say, 'You can't have these lips.'

"I say, 'We'll work with what you have.' "

But what if what they have is just fine? These are the sorts of questions that trouble Dr. Michael Morgan, a dentist who does cosmetic work in another Chicago suburb.

He's been seeing more young, female clients walking through his doors. And even his own 13-year-old daughter asked if he would whiten her teeth, something he didn't think she needed. Nor did he consider it safe for her young teeth or "age appropriate."

"There's a consciousness about it. They are much more concerned with the appearance of their face. But there's also a social pressure," he says of the younger generation for whom he'll do the most conservative procedures, but no more.

He sounds a little sad when he talks about it.

"There's nothing wrong with wanting to look better. We want to look young. We want to look great," he says. "But part of that feeling has to come from within."

For those going to even greater lengths to try to keep aging - and ultimately death - at bay, there also are no guarantees. Calorie restriction guru Dr. Roy Walford succumbed to complications from Lou Gehrig's disease at age 79, closer to the average than the "extraordinarily long life" his followers talk about on their Web site.

Meanwhile, Dr. Alan Mintz, founder of Cenegenics, died at the relatively young age of 69 due to complications during a brain biopsy. Some research has suggested that human growth hormone injections can cause cancer. They've also been linked with nerve pain, elevated cholesterol and increased risks for diabetes.

Even so, Life, now the chief medical officer at Cenegenics, remains steadfast. Among other things, he points to studies that suggest that human growth hormone in low doses poses no cancer risk if there is no pre-existing cancer.

"Within the next 10 years, maybe less, this is going to be thought of as mainstream medicine - preventing disease, slowing the aging process down, preventing people from losing their ability to take care of themselves when they get older and ending up in nursing homes," Life says. "This is really the cutting edge of medicine."

Many are betting on that.


George Washington University, University of Illinois at Chicago, TRU, Calorie Restriction Society

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