“My stomach is eating itself.” On June 30, biohacker Bryan Johnson, known as the “blood-swap guy,” announced on X that he had been diagnosed with autoimmune gastritis. His immune system mistakenly attacks the cells in his stomach that secrete gastric acid, affecting iron and vitamin B12 absorption. There is no cure at present.
This diagnosis took many by surprise. Johnson is the most prominent figure in the U.S. longevity scene and follows the “Don’t Die” philosophy. He gained fame by swapping blood with his 17-year-old son in an attempt to extend life. He has a medical team of dozens; what he eats, how long he sleeps, and when he exercises are strictly scheduled, and he regularly undergoes hundreds of biomarker tests. He hopes to detect disease risks and any deviations from ideal states as early as possible.
What was also surprising, however, was that this time, unlike the past schadenfreude toward the bodily quirks of longevity elites, many ordinary netizens began earnestly pushing the question to themselves: if even Johnson, who invests nearly unlimited resources in longevity, cannot guarantee that every problem in his body will be caught in time, what should ordinary people who care about health management do?
Johnson’s diagnosis has drawn attention also because health has become an inescapable daily topic. Today, people pay more attention to exercise, sleep, and diet, and they know more about their own bodies. That is progress. But more knowledge and choices have not made being healthy simple. Social media loves to discuss what a person does for health, but the parts behind health that cannot be chosen by individuals rarely get the same airtime. Ordinary people do not have Johnson’s resources or professional medical teams. Compared with a billionaire chasing immortality, what health means for an ordinary person is far more complex than detecting a gastritis that is easy to miss.
1.Human Engineering
Billionaire Johnson’s body has had several problems before. He once injected extracellular matrix from donor fat into his face to fix facial hollowing caused by low body fat, only to suffer a severe allergic reaction that left his eyes swollen shut. He also took the anti-aging drug rapamycin for nearly five years, then stopped because of recurrent infections and deteriorating biomarkers. His experiments with growth hormone injections and young plasma were also ended, one due to adverse reactions and the other for lack of benefit. Johnson later made all of these public. In his view, these side effects are not failures but important experimental tests.
His newly diagnosed autoimmune gastritis is different; it is not simply a self-inflicted problem. For the past 11 years, Johnson’s ferritin levels have been consistently low. People suspected his plant-based diet, high-intensity training, and hyperbaric oxygen therapy: either they hindered iron absorption or increased the body’s demand for iron. But iron supplementation and dietary adjustments did not solve it. It was not until this year that a new medical team reexamined the clues. The definitive cause was identified by antibody testing and gastric mucosa tissue taken in advance. If no biopsy had been performed, the test would likely have ended with “no abnormality found.”
Johnson began his post by calling the illness “bad news,” then promptly announced it was also “good news”: he plans to try to conquer this disease and will make the whole process public. For him, “incurable” means he has a chance to solve an existing medical problem. He quickly laid out a new plan: continue tracking ferritin, vitamin B12, and gastrin; repeat biopsies; analyze cytokines and T cells; further ideas include regulatory T cells, engineered T cells, and AI-designed antibodies. Some of these approaches are still in early research stages, and some have not even been developed.
Although Johnson, with his no-death philosophy, is far from ordinary people, his diagnosis has also prompted some to re-examine their own bodies. On social media, people pulled out old lab reports and compared their chronic low iron, fatigue, and stomach discomfort with his experience. One netizen said his ferritin had been low for a long time, and this news prompted him to immediately book a gastroenterology appointment and arrange gastroscopy and colonoscopy. Another said she had been iron-deficient for years and doctors had found no cause, and asked whether she should also request antibody testing and gastric mucosal biopsy. The discussion quickly shifted from Johnson’s illness to an exchange of lab analyses. People could not help but think: if Johnson, with a medical team, took 11 years to find the cause, what might ordinary people be missing?
Skepticism and mockery were not lacking. Some snidely remarked that Johnson, who takes hundreds of supplements daily, “has finally discovered that his stomach is overwhelmed.” Others asked sharply why the so-called health guru always seems less than healthy. In some people’s view, Johnson’s problem is not that he does too little, but that he tinkers too much. Rather than living with such rigor every day, they would prefer to drink occasionally and eat an unhealthy fast-food meal. They may not live longer, but at least they can live more lightly. What these jokes truly touch on is what Johnson cannot eliminate no matter how much he spends: the contingency of the body. Johnson’s discussion did not stop within elite longevity circles, because it coincides with a broader shift: health has become a daily concern for more and more people.
2.Digital Life
Today, a person can access more bodily data than ever before. In gyms, people can measure BMI, body fat percentage, and muscle mass; smart devices can record heart rate, sleep, and blood glucose changes; medical tests can list levels of vitamins and minerals in the body. Deborah Lupton, an Australian digital society scholar, told Nanfengchuang that although tracking devices are novel, what people want from them is not new. For centuries or even millennia, people have wanted “a better life, a better self, a healthier body, and higher productivity.” Many do not take data from wristbands or smartwatches too seriously, yet still feel that having these numbers is better than not having them. Completing self-set step counts, weight-loss goals, or training targets brings a sense of satisfaction that “I am doing well.”
But numbers can always look better. Increasing muscle mass is particularly attractive, especially because its changes are visibly reflected in appearance. Clare Herrick, a global health scholar, has run for years, swims often, and goes to the gym. She told Nanfengchuang that when she visited Singapore seventeen or eighteen years ago, runners in the parks mostly jogged casually; on a recent return, she noticed runners’ gear was more professional, more women were doing strength training, and popular training programs were increasingly similar to those in the UK. In her view, social media makes fitness styles and body aesthetics across countries increasingly alike. She also observed that in the United States, foods increasingly emphasize “high protein,” and some restaurants allow customers to add extra protein to ordinary meals. People hope to build muscle, and muscle becomes the most visible proof of health management. But looking stronger does not necessarily mean the body functions better.
Similar changes appear in the supplement market. Supplements already have practical uses, such as supplementing necessary nutrients when deficient. Now they also carry broader expectations for energy, sleep quality, digestion, and immunity. The pandemic further boosted demand. Industry research firm Nutrition Business Journal tracked 22 countries and regions, and found global supplement sales grew 11% in 2020, a record; vitamin and mineral product sales rose 15.2% to $63.1 billion.
Social media’s trendy products and methods keep renewing. Juice cleanses claim that drinking vegetable and fruit juices for a few days can “reboot” the body; turmeric, originally used as a spice, is extracted and concentrated into curcumin supplements, marketed for anti-inflammation, joint protection, and immune enhancement. Although the actual effects vary from person to person, they are novel and interesting enough.
Here lies the complexity of the contemporary health landscape. It makes many people interested in exercise, sleep quality, and diet, and enables them to know more about their own bodies. Yet on social media and in consumer markets, the most easily disseminated parts are often those that seem fresher, cooler, and more convenient to buy. These parts include truly useful habits, but also mix in trends with limited evidence and risks that are easy to overlook. For example, taking multiple supplements at the same time may cause ingredient overlap, such as vitamin B6 being present in multivitamins, magnesium tablets, zinc tablets, and “anti-stress” formulas. Yet these limitations and risks cannot obscure the appeal of these popular methods. The pursuit of health becomes increasingly individualistic, but how these choices occur in life is often left out.
3.Sociality
“Health is a thorny issue,” Clare Herrick told Nanfengchuang. The difficulty is not whether individual actions work, but how much individual actions can actually determine.
The term “healthism” can be traced back to sociologist Irving Zola. In 1980, American scholar Robert Crawford gave it an influential elaboration in “Healthism and the Medicalization of Everyday Life.” At the time, new health consciousness and self-care movements were emerging in the United States. Health no longer merely meant the absence of disease; it also became evidence of happiness, an ideal life, and a better self. At the same time, the responsibility for improving health increasingly fell on individuals and their lifestyles. Crawford worried that when health problems and solutions were placed on individuals, the working conditions, living environments, and social resources behind illness would recede from view. Health, originally a complex issue, gradually became a question of personal choice: whether one made the right decisions and was sufficiently disciplined.
More than forty years later, new technologies and health trends have further refined this personal responsibility. They appear to add points to health, but for some people they may merely compensate for gaps left by work and life.
Wang Fuqin, a professor at Tongji University who studies health inequality, told Nanfengchuang that contemporary young people’s lives are themselves a bundle of contradictions. On the one hand, they value health more than before; on the other, work and social life force them to work overtime, stay up late, sit for long hours, eat irregularly, and rely on caffeine to keep going. This contradiction is not just due to lack of self-discipline. Wang Fuqin said that before smartphones were widespread, many people had relatively stable off-work times; even when overtime was needed, they might know in advance. After communication tools became ubiquitous, many non-manual workers remain on call even after leaving the office. What is truly exhausting is not just longer working hours but also unpredictable schedules.
In the first half of 2025, the national average weekly working time for enterprise employees in China was 48.5 hours. The World Health Organization and the International Labour Organization estimated that in 2016, about 745,000 people worldwide died from ischemic heart disease and stroke linked to extremely long working hours. Compared with those working 35–40 hours per week, those working at least 55 hours per week had a 35% higher risk of stroke and a 17% higher risk of dying from ischemic heart disease. Work not only takes time away from sleep, exercise, and cooking; it itself can become a health risk.
In Wang Fuqin’s view, maintaining regular exercise, adequate sleep, and a balanced diet requires health awareness, stable income, free time, and a relatively predictable life. For many workers, these conditions are hard to satisfy simultaneously. Therefore, when people cannot fundamentally change the rhythm of work and life, supplements, personal trainers, and health tests may become a form of compensation.
This raises another question: when health knowledge and technologies are already available, who is better positioned to translate them into action? In 1995, American sociologists Bruce Link and Jo Phelan proposed the “fundamental cause theory.” They noted that medicine had identified more and more direct risks related to disease, such as diet, cholesterol, and exercise, but they asked: what causes some people to be more exposed to these risks? In their view, income, knowledge, power, and social relationships are resources that can protect health. Diseases change, and medical knowledge and health technologies update, but people with more resources often obtain information earlier and are more likely to act on it.
The fundamental difference is that different social groups may not be pursuing the same “health.” Wang Fuqin said that for advantaged groups, health means not only avoiding illness but also longevity and “high-quality longevity” with fewer years of living in poor health. For those in disadvantaged positions, health often means getting treatment as quickly as possible after falling ill, not missing work because of illness, and minimizing medical expenses. In more extreme cases, they fear that one illness may lead to impoverishment or returning to poverty.
A study tracking 8,184 elderly Chinese people found that at age 65, the life expectancy gap between higher and lower socioeconomic groups was about two years, and the gap in disability-free life expectancy was also significant. When different people enter the discussion of longevity, they start from different places.
Wang Fuqin divides health determinants into layers. Closest to the individual are health behaviors such as diet and exercise; further outward are work environment, housing conditions, and family structure; still further are medical insurance systems and public health services. In this sense, “everyone is the first person responsible for their own health” is not wrong. In fact, Healthy China Action (2019–2030), while advancing that slogan, also emphasizes the joint participation of government, society, family, and individuals. Individuals need to develop healthy habits; the state needs to provide fair medical insurance and public health services; communities need to create environments compatible with healthy lifestyles; and workplaces affect how much time a person has for sleep, exercise, and rest. Only when all these conditions coexist can health awareness more likely become a sustainable way of life. Today, it is good that individuals learn various methods for health and longevity. This responsibility can begin with the individual, but it cannot end there.
