The State of Longevity

Make sure to also check out the companion podcast to this piece with Andrew Huberman here.The longevity movement is here to stay (no pun intended).Not long ago, taking care of our health largely meant following our doctor’s advice and sticking to what our insurance covered. There has always been a fringe movement of biohackers and crunchy people taking a more hands-on approach, but that mindset has only recently moved into the mainstream.Two things accelerated this shift. The first was the COVID-19 pandemic, which made us acutely aware of our mortality and the fragility of our health. It exposed the limits of our medical system and reminded us that a yearly physical doesn’t necessarily mean we’re healthy.The second was ChatGPT. Suddenly everyone could ask questions about their health and make sense of complex medical information in simple English. Today, Americans are taking their health into their own hands, spending more time, money, and energy on health and longevity.So what is coming next? To understand how people are taking charge of their health – and what they want – we surveyed 500 randomly selected consumers in the U.S. on their views about everything from peptides to toxins to brain-computer interfaces.We’re also talking to people at the cutting edge of health and technology. Our upcoming podcast conversations will explore how they approach their own health and what the rest of us might learn from them. First up, Andrew Huberman walks us through a day in his life, from food and exercise to supplements and sleep.For founders, this newfound consumer interest in health creates an opening. We think some of the biggest opportunities in longevity will go to companies that help people take action and manage their health over time.Below, we combine our observations on the longevity market with our recent survey results to explore where the next great companies might be built.Today, there is no single place to manage your healthcare. Your records are scattered across doctors’ offices, and getting care means navigating a mix of phone calls, patient portals, pharmacies, and labs.Companies are racing to build the ultimate healthcare home – an app that knows your medical history and records, prescribes your annual labs and imaging, connects to your wearable, and uses AI to help you understand what’s going on. And when you need care, it connects you with virtual or in-person clinicians who can prescribe treatment or perform procedures as needed.The leading contenders in this race have different head starts. Function Health has lab and imaging results that show how our health changes over time. Oura and WHOOP already have a place in our daily routines. General Medicine and Counsel start with the ability to deliver care. Ferry Health understands the fragmented landscape of where to get insurance-covered care. OpenAI, Anthropic, Amazon, and Apple are building on large audiences and products we already use.The race is to become the first place a consumer turns to when they need something done for their health. Asking AI a question about your health is useful, but arranging the next test, booking the appointment, and making sure the patient gets follow-up care and prescriptions is harder. As AI makes answers and interpretation cheaper, value will migrate to the companies that can figure out the action layer.If this sounds like “Muse for healthcare,” that’s the idea. There is room to build very large companies around the healthcare needs that generalist AI assistants are unlikely to prioritize. The complexity of our healthcare system today makes this harder to build, but could also make it harder to replace.We expect room for multiple winners. Almost everyone could use this kind of help.The MAHA movement has brought the toxins in our food, water, and everyday products to light, and consumer willingness to spend on “clean” non-toxic products has grown massively. Just a few years ago, the word “microplastics” was not in our lexicon; now our survey revealed that 63% of consumers are aware of the plastic particles building up in our bodies, 35% are concerned about them, and the biggest biohackers are trying plasma exchange to remove microplastics from their blood.For consumers looking to reduce everyday exposures, the shopping list goes way beyond buying organic food into a broader focus on what we ingest. Our survey of Americans revealed lots of consumer change in this respect. 24% of respondents are swapping to nontoxic cookware, 39% are subbing out plastic for glass, and 70% are filtering their water.That mindset extends beyond the kitchen and into the broader home. Healthmaxxers are buying air purifiers (37%), testing their homes for mold (18%), switching to organic-cotton clothing or bedding (17.5%), and even buying new natural or organic mattresses (11%). Even EMF emitted by wifi, cell phones, and microwaves is on consumers’ radar: 14% said they are trying to reduce it.Consumer spending is moving faster than the evidence.

In our survey, 62% of respondents said they would pay more for products labeled as “non-toxic.” That creates opportunities across food, home goods, and personal care.GLP-1 receptor agonist medicines (e.g., semaglutide, tirzepatide, orforglipron, and others) have revolutionized health more than any drug in our lifetimes, transforming care for diabetes, obesity, and cardiovascular health – and the promise of their benefits keeps growing.The runaway success of this class of approved GLP-1s, growing comfort with at-home self-injection, and loosening regulation have also fueled a surge of interest in other unregulated peptides. Consumers are now experimenting with compounds not approved by the FDA that are marketed for recovery, performance, and appearance, including the pursuit of “looksmaxxing.” For example, BPC-157 is promoted for tissue repair; melanotan II for tanning.But the market’s enthusiasm to date has outpaced the actual evidence. Many of these compounds are still missing strong human data that demonstrates safety and efficacy, and buying from unregulated suppliers raises questions regarding what is actually in the vial. And while HHS’s most recent policy eases enforcement against licensed pharmacies compounding six peptides under specified conditions, these peptides remain unapproved by the FDA, with unresolved questions about safety and efficacy. Despite the buzz, the single-digit billion compounded peptide market is dwarfed by even a single FDA-approved peptide: Eli Lilly’s tirzepatide, which generated nearly $44 billion in sales under the Mounjaro and Zepbound brands in the first nine months of 2026 alone.We see the peptide trend unfolding along two distinct paths across biotech and healthcare. From the biotech side, we predict growth in the pipeline of rigorous, FDA-regulated peptide drugs – and growing enthusiasm from investors seeking to underwrite medicines that not only meet the traditional safety and efficacy bars, but could also have vast consumer appeal. This is an unnatural trend for the biotech sector: drugs are indicated based on clinical need, and historically the market has actually struggled to identify and treat patients efficiently. Peptide medicines with robust consumer pull can create an unusually efficient path to patients, and we suspect this dynamic could extend to other disease areas, including sleep, bone health, and cardiovascular health.On the care delivery side, we could see a repeat of the GLP-1 cycle if additional peptide drugs demonstrate safety and efficacy and gain mainstream adoption. GLP-1s helped many care delivery companies grow, but most of the enterprise value accrued to pharma. Other peptides could follow a similar pattern in care delivery: first, dedicated prescribing companies may emerge, following the model of Calibrate, Found, and Weekend Health from the GLP-1 wave. Then, existing healthcare companies could add peptide prescriptions to attract new patients. But as more companies offer the same drugs, prescribing them could become less of a competitive advantage and more of a service patients expect. At that point, offering peptides may matter more for keeping existing patients from leaving than for attracting new ones.Cholesterol could become dinner-table conversation for a surprising reason: while heart disease is still America’s biggest silent killer, there’s rapidly growing evidence that we can understand risk, detect disease at early stages, and intervene with medications to not only prevent but actually reverse some of the plaque already in our arteries. This is giving consumers a compelling reason to take their heart health seriously before a cardiac event.For LDL – the “bad” cholesterol – the evidence increasingly supports “lower is better,” especially for people at higher risk. A study published this October found that intensive treatment shrank plaque in the heart’s arteries by about a fifth over 18 months in people with heart disease.

Getting cholesterol into the “normal” range may not be enough for your personal risk, and medication could provide additional protection.New treatments could bring cholesterol management to a wider audience.

PCSK9 inhibitors like Repatha help the liver clear LDL from the blood, but injections, cost, and insurance restrictions have limited their use. Only 21% of our survey respondents knew about these drugs. We expect that to change and for these drugs to enter the consumer zeitgeist as miracle drugs that lower cholesterol with few side effects: Lipfendra, the first PCSK9 inhibitor available as a daily pill, received FDA approval in July 2026.Evidence also supports treating high-risk patients before their first heart attack or stroke.