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Do the words “data center” make you want to drop everything and call your congressional representative? You’re not alone, if we judge the nation’s mood by the actions of politicians who poll-test what they eat for breakfast (and there are worse ways). 

This looks like the week that the data center backlash broke containment and became the defining issue of this political moment. 

In the Texas governor’s race, Democrat Gina Hinojosa went up with an ad against Republican Gov. Greg Abbott over data centers with the punchline: “Greg Abbott is selling you out.” In a critical toss-up House race, Rep. Marcy Kaptur (D-OH) launched an attack against her Republican challenger over his support for data centers. Pennsylvania Gov. Josh Shapiro, a likely contender for the 2028 Democratic presidential nomination who had previously touted data center investments, signed an executive order to limit their construction. He also bashed his opponent on data centers in a new campaign ad — a response to the Republican attacking him over those same facilities.

In my home state of Ohio, national Republicans are so worried about data centers damaging Sen. Jon Husted’s reelection chances that they sent a memo this week to top AI companies to warn that they could lose the seat because of the issue. And Mike Rogers, the Republican trying to win the Michigan Senate race for the GOP, went so far as to endorse a moratorium on data center building.

Go a little deeper

In one image, this is why politicians are screaming at anyone who will listen that they loathe these data centers just as much as you do and want to stop Big Tech from building any more. It is a stunning turnaround: The percentage of Americans who “strongly oppose” a data center being constructed in their area has more than doubled in a single year.

As Molly Taft documented in a recent feature story for Wired, the relationship between the ubiquitous data-center backlash and the fears about AI is becoming hard to ignore: Most people still say they oppose data centers even when they don’t live anywhere near one, and most people opposed to data centers are also more likely to be skeptical of AI. And those sentiments are clearly bipartisan, which is why you have a Democrat and a Republican in the Michigan Senate race striking the same tone on data centers.

The merits of both sides in the data-center debate are probably more nuanced than the political slogans popping up around it. But this phenomenon is clearly about something bigger than the brick-and-mortar buildings that have become these political boogeymen. As Marina Bolotnikova put it in a story for Vox earlier this summer: Americans don’t know how to fight AI. So they’re fighting data centers instead.

And now the politicians are following their lead.

One link for later

➨ Print your photos like it’s the 1990s. When everybody carries a camera in their pocket and snaps candids as casually as taking a sip of water, it’s easy to become jaded about all those pictures. Don’t be. The best way to appreciate them, Adam Clark-Estes argues in his latest piece on living in our tech-dominated world, is to print those images out like you did a few decades ago. Cherish your memories by holding them in your hands.

Before you go…

• Did you know…Cuba has more than twice as many doctors per capita as the United States? But that hasn’t stopped the island nation’s healthcare system from deteriorating to the point of crisis, as Ananya Rupanagunta writes for Vox.
• Today’s trivia: What’s the insect stage after larva? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in tomorrow’s edition.)
• Yesterday’s trivia: Yesterday we asked you for the name of the Survivor contestant who holds the franchise’s record for most appearances. That would be Cirie Fields, who appeared on six seasons between 2006 and 2026.

If you’re like me, and you grew up in a house where your mom refused to let you get a video game console, because she believed sitting and staring at a TV was bad for you, you might think of video games as antithetical to health. And there is plenty of research about the ways in which gaming too much can harm your physical and mental well-being. I don’t think anyone would argue that eight hours of Call of Duty every day is doing your body or your mind much good.

But the old caricature of video games as simple brain rot is increasingly out of date. Even some normal, non-educational games can help with brain function (as long as they are played in moderation — and some games are better than others). 

Beyond that, what if we could take something that is wildly popular (there are 3 billion gamers worldwide, 190 million in the United States) and reimagine it in a way that goes beyond just entertainment? Gaming tech has advanced to the point that we can put people into hyperrealistic virtual realities or use AI to create new personalized gaming apps with a brief voice prompt. These and other capabilities are unlocking new ideas from ambitious physicians and game developers that would have sounded like science fiction when I was a teen.

There’s increasing evidence that these platforms can be adapted to do genuinely incredible things to benefit our health. Here are just two ways in which video games are poised to change medicine — including one that allows any of us to game out in the name of advancing science. I can’t wait to tell my mom.

Video games could solve some big challenges in caring for kids

My perspective on video games in medicine started to change when I learned about one specific use: as an alternative to anesthesia for children and adolescents.

Here is a genuine clinical problem: For years, doctors have had few options beyond general anesthesia for kids who need to undergo imaging or minor surgeries. An MRI, for example, really only works when the patient is able to stay completely still and, as anyone who has spent a single minute around a child can attest, that’s hard for kids to do. So, children have been put under during routine MRIs or minor procedures that, when they’re performed on an adult, require only local anesthesia or no anesthesia at all.

But giving children general anesthesia comes with health risks. The FDA warns against repeated or lengthy use of general anesthesia for children 3 and younger because of the risks to their growing brains and future learning development. Other studies have suggested that general anesthesia also poses some risk to the development of older children, and its use should be minimized as much as realistically possible.

Enter virtual reality video games.

“Games and VR can be especially effective for reducing pain and anxiety during pediatric procedures, including burn care, needle procedures, and other medical treatments,” Dr. Kimberly Hieftje, co-director and co-founder of XR Pediatrics and the Yale Center for Immersive Technologies in Pediatrics, told me over email. “If we can help a child get through a procedure comfortably without sedation, that’s a significant benefit. Sedation and anesthesia carry risks, and minimizing unnecessary or repeated exposure is particularly important in children.”

Several small-scale studies have examined using virtual reality games as an alternative to general anesthesia for minor and routine surgeries and for MRI imaging — with promising results. In one 2024 experiment, more than 100 kids (average age of 11) wore a mobile VR headset during a minor procedure (most frequently a hormone implant) and played a relaxing game such as Pebbles the Penguin (in which players navigate a snowy world and collect pebbles) or Space Pups (in which they play as a canine soaring through outer space and eating treats) while doctors performed the operation.

The surgical team kept general anesthesia on hand in case it was needed, but none of the children involved in the experiment required it or any other kind of sedation. They were also able to follow simple directions from their physician during the procedure. Their post-surgery reports of pain were similar to patients who did receive anesthesia, and they had shorter recovery times.

Likewise, a study out of Canada published in December 2025 tested how younger patients responded to VR as an alternative to anesthesia when they needed an MRI. It was a small study of only 18 patients, but, once again, the results were encouraging. The kids (average age of 5) went into a VR game prior to the MRI scan, learning about the procedure while collecting magic fairy dust. Then, they went into the actual MRI. And all of the kids who had played the VR game prior to the procedure were able to complete the imaging scan without any additional sedation or anesthesia.

The foundational idea here is: Kids are not little adults. It’s harder for them to sit still. They get anxious about even imaging scans. “We create for adults and, then, put kids in it,” Hieftje said, “and we need to think backwards.”

Video games can help kids stay calm and stop moving — or, for kids with different medical needs, start moving. As any parent knows, children also aren’t very good at following directions or being self-motivated to exercise — even if it would be good for their health, like if they have Type 1 diabetes, for example. That’s why a group of researchers from Yale, as described in a study published earlier this year and which Hieftje co-authored, experimented with introducing kids with Type 1 diabetes to a virtual reality video game that coached them through exercises. 

It was a small group — 17 adolescents, an average age of 15 — but patients who participated were motivated to play the game, followed through with their routines, and even registered a small but detectable decrease in their blood sugar levels. The researchers are hoping that larger studies could demonstrate the program’s effectiveness and continue taking it mainstream.

The list goes on: Hieftje said their work uses games and immersive technologies to address everything from substance use and human trafficking prevention to mental health, child loss and grief, and infection prevention for infants in a natal intensive care unit.

But video games are doing more than changing clinical care for challenging patients. They are also unlocking the basic science that leads to new breakthroughs in treatment for everybody.

Video games could allow all of us to contribute to future scientific advances

When I think of massive multiplayer online games, I think of my friends and I camping out in somebody’s basement to play Halo against strangers for hours on end. But Attila Szantner, the co-founder and CEO of Massively Multiplayer Online Science, has found a more productive use for these remarkable platforms that can connect hundreds of people from all around the world.

What his company has done, in tandem with academic scientists, is integrate important but tedious basic research tasks into the gameplay of popular commercial multiplayer games like Borderlands 3. When I attended the Aspen Ideas: Health summit this summer, Szantner presented a demo of one of his company’s modules. What appeared to be players sorting colorful tiles in gameplay that would look familiar to anyone who’s played Tetris, he said, was actually players — normal people with no special training — helping to sequence DNA samples for people’s gut bacteria. Players in the game learn the task from a Borderlands character — including its ultimate scientific aim — and, then, complete the puzzles that the scientists have set up.

“Games are the absolute masters of engagement. They found the magic formula to make repetitive tasks feel fun,” he said. “In citizen science, people have intrinsic motivation to help, but standard tasks get monotonous and people drop off. Games solve that completely.”

They’ve turned the boring but vital work of number crunching and sequencing into gameplay — and convinced millions of their fellow citizens to help. In a paper published in October 2024 in Nature Biotechnology, Szantner and his co-authors described a project that involved more than 4 million individuals completing more than 135 million science puzzles in order to align a million human microbiome sequences. They found that the players’ collective contributions led to better sequencing than the current state-of-the-art computational methods. In another project, they turned some basic cellular analysis tasks into gameplay on the multiplayer game EVE Online that, once again, performed better than what is now the standard.

We have only scratched the surface of gaming’s awesome potential. Clinicians are also optimistic about gaming’s ability to preserve the cognitive health of aging adults and coach them through exercise routines (much like the kids in that Yale experiment), especially as the native gamer generations get older. Video games could revolutionize trauma care by placing burn victims inside of a cold VR environment — and what if you could reduce PTSD by playing Tetris? In 2020, the FDA approved the first video game for ADHD treatment: EndeavorRx. Experts confronting a male loneliness epidemic believe they can use video games to bring young men together. These programs could also transform medical training and allow surgeons to preplan and practice surgeries using their patient’s unique data to produce a bespoke virtual reality practice module.

The point is: The caricature of video games as a gateway to couch potato-itis is a relic of the past. Gaming could help all of us stay healthy — seriously.

Over the weekend, Rep. Alexandria Ocasio-Cortez (D-NY) announced on Instagram that she had joined the thousands of American women who freeze their eggs every year, a number that has been steadily growing for the past decade.

“This is a choice that I am making to feel more in control of my life,” Ocasio-Cortez said in her Instagram story sharing her decision. 

As politicians in the public eye often do, Ocasio-Cortez turned her personal choice into a statement:

Usually I keep my private life quite private, but I have made the decision to start freezing my eggs, and I want to share this because I was weighing it for a very long time. I was saving for it for a very long time, and there just isn’t a ton out there, I feel, and sometimes it can feel very daunting. As women in general, we are not taught about our own bodies. We are not prepared for our own lives. … We need to show more depictions of women having full lives.

At the same time, she acknowledged being “in a very privileged position” to be able to take advantage of egg freezing. The process still typically costs $10,000 or more — and most insurance still doesn’t cover it. Not even AOC’s federal health plan. Egg freezing is a luxury afforded only to the people who can pay for it and take on the significant burden of the treatment and all of the uncertainty that comes with it.

Ocasio-Cortez’s announcement underscores the awkward place that egg freezing still occupies in the landscape of fertility access — at a moment when Republicans in power are lamenting falling birth rates and searching for ways to encourage more people to start families. In theory, egg freezing gives women the flexibility to take more control of their decisions about having kids and preserve that possibility for themselves in the future. But in reality, the promises of this important procedure have often been unfulfilled. 

Beyond the intimidating price tag, as AOC alluded to, many young women don’t know some of the basics about age-related fertility decline and how to maximize their chances that egg freezing will lead to an actual pregnancy. There are some “significant gaps in fertility knowledge amongst Gen Z women in particular,” said Danielle Melfi, CEO of Resolve, a fertility treatment advocacy group. 

“That points to why someone like AOC who has such broad awareness and broad reach across her channels,” Melfi told me, “specifically younger people who aren’t tuned into any politician but would be tuned into her. Her sharing her story and journey matters.”

Egg freezing is not a panacea, and it never will be. But it can give individuals options and a sense of empowerment. And right now, as AOC acknowledged in her video, those are privileges reserved for the people who are in the know and have the means to take advantage of it. For everyone else, significant barriers still remain.

Freezing time doesn’t come cheap — or easily

On average, the cost of egg freezing averages between $10,000 and $20,000. And, for most people, including AOC, who makes $174,000 a year on her congressional salary alone, health insurance coverage is not an option. According to a 2024 KFF employer survey, just 12 percent of large employers who offer health insurance provide egg or sperm freezing.

That’s not for lack of trying.

As of now, 21 states have mandates requiring health insurers to provide some level of coverage for “fertility preservation” when it is deemed medically necessary — for a younger cancer patient who is about to undergo chemotherapy, for example, a more and more common scenario these days. But coverage for what is viewed as elective freezing, as AOC is doing, is still generally not included in those requirements.

But even the state-level mandates come with a huge carveout. Under America’s Frankenstein healthcare system, there is a very important type of health insurance plan that is exempt from such state laws: self-funded employer plans, meaning those that fully cover their workers’ medical expenses without relying on an outside insurance company. They are governed only by a federal law known as the Employee Retirement Income Security Act, and that law provides no guarantees for egg freezing or other reproductive care. 

About half of Americans get their insurance through their work, and of those employer plans, more than 60 percent are self-funded. That is a lot of people who have no guarantees for this kind of service, even when a serious medical reason is motivating them to freeze their eggs. The select few who can get egg freezing covered are typically higher-income, too, adding to the disparity between the US healthcare system’s haves and have-nots.

Support for IVF among the American public has been rising, with 70 percent saying in 2024 that access to IVF was a good thing. And fertility coverage is having a political moment, too: the HOPE With Fertility Services Act, which would require insurers to cover some basic fertility treatment when it is deemed medically necessary, was introduced this year with a bipartisan slate of more than 20 sponsors, though it remains stuck at the committee level for now. The Trump administration has fixated on dropping fertility rates, but, beyond a limited IVF executive order, they have not seriously pursued plans to expand access to egg freezing. A national mandate to cover egg freezing, even only when medically necessary, could end up being opposed by both health insurers (which have fought all kinds of benefit requirements in the past) and the religious right (which has specifically challenged mandates for reproductive healthcare, like the Affordable Care Act’s contraceptive mandate).

It will likely take a variety of policy changes to give people more financial support for this important but expensive service. So what now? Unfortunately, I think we are stuck with patchy coverage and can expect only incremental improvements for the foreseeable future. On the plus side, Melfi said, more employers may increasingly offer these benefits as a competitive advantage.

But access isn’t the only problem.

Egg freezing works best when people actually know how to take advantage of it

Even if a person is able to access egg freezing, it doesn’t always pay off. 

A study published in the American Journal of Obstetrics and Gynecology in February found that fewer than 6 percent of people who froze their eggs electively had come back to thaw them within five to seven years. Of those people, 79 percent had a usable embryo after warming and 29 percent had a pregnancy that resulted in a live birth.

Of course, just because some people haven’t warmed their eggs within seven years doesn’t mean they won’t come back in nine: The point of this service is you could freeze your eggs at 30 even if you’re not ready for kids until you are 40. Those numbers will likely grow with time. And some of those people might end up successfully getting pregnant on their own the old-fashioned way, which means they won’t need their frozen eggs at all. 

“Typically, people who are coming in to freeze their eggs haven’t actually tried to conceive yet. When they are ready to start conceiving, a lot of people may not have any issues conceiving,” said Dr. Mabel Lee, a reproductive endocrinologist and infertility specialist at HRC Fertility in Pasadena, California who led the published study. 

What is true is that getting pregnant is difficult no matter how you go about it — even conceiving through intercourse only results in a 20 to 25 percent success rate on a given try, Lee said — and success with frozen eggs depends on how young the person was when their eggs were preserved: The younger they are, the higher the chances of success. That makes it all the more important that people — particularly younger people — know about the realities of egg freezing and how to make the most of it, whether they are spending thousands of dollars of their own money or whether they are using insurance to pay for it. Awareness among young people of the basic relationship between age and fertility remains discouragingly low. Lee said she has patients come in all the time who say they wish they had known more about egg freezing sooner.

The likelihood of a live birth may go up if the eggs were younger, but is that enough to convince someone in their mid-20s to pay out of pocket to freeze their eggs? In the midst of an affordability crisis, is that even an option? It might not be; in the meantime, Lee said women could get a blood test to measure their ovarian reserves, which estimates a person’s egg count, and use that to make an informed decision about egg freezing in consultation with their doctor.

Once you have decided to freeze your eggs, using a high-quality clinic is a must: That’s the other major variable in success, Lee told me. The Society for Assisted Reproductive Technology maintains a national database covering clinics across the country and tracking birth success rates and other metrics. It’s like a report card of sorts, so you can hopefully choose the best provider for you.

There are still no guarantees. Fertility is too fickle. But by improving access and raising awareness, there are clear steps we can take to try to maximize egg freezing’s potential.

GLP-1 drugs promised to usher in a new era of treating obesity as a disease. We could leave behind the anti-fat biases of the past, which blamed obesity on moral failing or personal weakness. Instead, these drugs would allow us to approach it as a medical condition, a complex matrix of genetics and other forces which could be changed with the right dose of these powerful new medicines. 

Or so the thinking went. 

While the clinical potential of these drugs remains immense, they have yet to change how the broader US culture perceives and engages with weight and weight loss. Even as millions of Americans shed pounds in bulk for the first time, they are also contending with fierce stigma and shaming from others — instead of being criticized for being fat, they are being criticized for using GLP-1s. 

The social media communities that have blossomed around GLP-1s are filled with tales of awkward conversations and much worse. Partners who berate a significant other who wants to go on Wegovy or Zepbound. Coworkers who blame the drugs for their rising insurance costs. Even dismissive and unsympathetic doctors and nurses. 

Some people who take GLP-1s must contend with an uneasy sense of living behind enemy lines: Many people describe being at work or out in public and overhearing people talking about GLP-1s and passing judgment on people who they think are taking a “shortcut” to lose weight.

“It’s like you’re being stigmatized without the person who’s [saying] it even realizing it, necessarily,” said Adriana, a 33-year-old GLP-1 user who lives in the Chicago area. (Vox agreed to identify the people we spoke to by their first name, to protect their privacy when discussing stigma.)

“There’s a lot of internalized stigma and judgment we have from the culture about our bodies and ourselves.”

Erin Standen, psychology professor who studies health and behavior change at Rice University

This is not just evident from anecdotes. Researchers have put the question to the test. And they have found that Americans not only feel more negative stigma toward somebody who lost weight with a GLP-1 than somebody who lost weight through diet and exercise — they also feel more negatively about the GLP-1 user than somebody who never lost weight at all.

“It seems like people are really reacting negatively to the idea that somebody who has lost weight with a GLP-1 might be, quote-unquote, ‘taking the easy way out’ or cheating the system,” said Erin Standen, a psychology professor who studies health and behavior change at Rice University and led one such study. “There’s a lot of internalized stigma and judgment we have from the culture about our bodies and ourselves.”

Americans have internalized the message that being overweight is a personal failure so thoroughly that, now that the kind of extraordinarily powerful weight-loss shots and pills long hoped for are here, many people struggle to see it as good news. They see it as cheating.

GLP-users feel damned if they do, damned if they don’t 

GLP-1 users have found themselves in a trap. They’ve felt judged for years for their bodies: Studies have found that up to 42 percent of adults with obesity have experienced some kind of weight discrimination; and between 40 and 50 percent have internalized weight bias. One survey from this year found that 81 percent of people taking GLP-1s said that they had felt social pressure to be thin, and more than half said that those attitudes influenced their decision to take one of the new weight-loss drugs.

And yet, now that they’re cutting weight, they’re being judged for how they lose it. In the same survey, 69 percent of GLP-1 users said other people saw the drugs as a cheat code, 23 percent said that it was hard to handle other people’s feelings about the meds, and 43 percent said that they didn’t like talking about their GLP-1 use for fear of judgment.

“Culturally we have a widespread belief that weight isn’t complex — it’s simply energy in versus energy out,” Susan Persky, a behavioral scientist at the National Institutes of Health who has studied GLP-1 stigma, told me in an email. “If everyone ‘should’ be able to manage their weight through diet and exercise, engaging willpower and hard work, using GLP-1s is seen as a cheat or a hack. So someone with higher weight who uses a GLP-1 is not only seen as lazy or weak, they’re also seen as cheating to achieve weight loss that other people have ‘earned’.”

Perhaps the most extensive study on GLP-1 stigma so far is from scholars at Rice University, UCLA, and the Mayo Clinic, published in the International Journal of Obesity in April. It followed an earlier paper, published in April 2024 in the same journal, that suggested people had more negative views of a woman who lost weight with a GLP-1 versus somebody who lost weight with diet and exercise.

The new experiment sought to replicate those findings and extend them. How did people feel about somebody who took a GLP-1 versus somebody who never lost weight at all? How would people feel about somebody who regained weight? They gave more than 600 participants short profiles of hypothetical patients who were all alike except for one thing: One had lost weight with diet and exercise, one had lost weight using a GLP-1, one didn’t lose weight. They were asked to rate the person on various positive and negative metrics, to measure how they perceived the person and whether they’d want to associate with them socially.

What they found revealed how deep the bias against GLP-1 users seems to run.

When comparing the two hypothetical people who lost weight, study participants offered far more negative traits and far fewer positive ones to the people who had used a GLP-1, Standen told me. “That really stuck out,” she said. They also ranked the GLP-1 user as more unhealthy. 

But even beyond that, people actually rated the person who didn’t lose weight at all more positively than the GLP-1 user. “People were more likely to say they were willing to connect socially with the person who hadn’t lost weight as compared to the person who was a GLP-1 user,” Standen said.

The study didn’t ask the participants to explain in detail why they felt the way they did about GLP-1 users. But Standen and other experts attributed the attitude to those cultural norms around body weight that have turned obesity in the minds of many into a matter of personal morality rather than the medical and socioeconomic issue that most clinicians view it as.

“Stigma toward GLP-1 use reflects deeply rooted cultural beliefs about effort, discipline, and personal responsibility for weight and health,” Stacy Post, a postdoctoral scholar at Georgetown University who authored the 2024 study on GLP-1 stigma with Persky, told me over email. “In this context, it is not surprising that GLP-1s are often viewed as a ‘quick fix’ for a problem that many believe should be solved through willpower and lifestyle changes alone.” 

And the consequences of stigma go beyond straining someone’s personal relationships. People can feel shame and stress when they think they’re being judged, and that in turn can have direct physical effects that are bad for their health. 

“These small little moments where people feel discriminated against do accumulate in the body,” Standen said. “Experiencing stigma or feeling judged for having used or not used a GLP-1 is directly harmful to your overall physical and mental health.”

Feeling judgment “also might lead you to either avoid health care or be less open when seeking healthcare in ways that could long-term harm your health as well,” Standen said. We know how much GLP-1s can improve the health prospects of somebody who is obese, so if somebody decides not to take a weight-loss med for fear of being judged, that is a net loss to their health. 

What it’s like to be a GLP-1 user when society shames GLP-1 users

The Rice study affirms something GLP-1 users have been saying in online communities since these drugs hit the market a few years ago. I have spent the past few months reading these stories on the various Reddit communities dedicated to GLP-1 drugs and weight loss, and the frustration that users experience in being judged for medications they feel are approaching a miracle drug is palpable.

One poster described her boyfriend becoming “extremely upset” when she said she was considering going on a weight-loss medication; another person also detailed their fight with an unsupportive partner. Others have contended with rude comments from coworkers. People have faced judgmental questions when they were visiting a hospital’s emergency room for something unrelated. One person even encountered the stigma at their cross-stitch club.

I spoke with two people, Adriana and Mike, who had shared their experiences of GLP-1 stigma on Reddit.

Mike, 50, and living near Boston, says he had been big his entire life, but after seeing an unflattering vacation photo a couple years ago, he decided he wanted to get serious about losing weight and thought a GLP-1 could help him. After losing some weight through Weight Watchers, he went on Zepbound; all told, he’s shed about 170 pounds.

He and others have encountered judgment for his weight loss in surprising places. Mike told me the story of going to visit an old friend from college, after he had started taking Zepbound. 

His friend’s mother was there and she inquired about his evident weight loss. He told her he was taking a GLP-1 medication. And for the rest of the weekend, she badgered him about whether whatever he was eating fit with his “diet.”

“It was eye-opening because when I first went on it, I’m like, ‘I don’t understand why people don’t want to tell anybody. This is a good thing. The world should know,’” he told me. “And then you realize, ‘Oh, God, this is affecting my ability to enjoy myself this weekend because I have to answer for it every two seconds.’ That’s when you’re like, ‘Okay, I understand why people don’t want to tell.’” (He added that the incident has, fortunately, become a running joke between him and his friend.)

Adriana from Chicago had been naturally thin for most of her life, never developing particularly good diet or exercise habits. But a couple of years ago, she had a bad mental health episode and started to cope by overeating, she says; she gained 50 pounds in a year. She had a family history of diabetes, and her doctor told her she was prediabetic. She felt an urgency to do something, she told me: “I just need to go on this medication before I do irreversible damage to my health.”

The medicine has revitalized her she said. She hasn’t experienced serious side effects and the food temptations that led her to binge-eat have been quieted. She says she’s seeing a therapist and a dietitian and feels as good as she has in years.

But she’s experienced stigma at every stage of her journey too. Adriana said that growing up, she was often praised by her family for being thin. Then when she gained weight, her family nagged her about it and friends started cutting her out of more physical activities.

Since she started taking Zepbound, she hasn’t told a lot of people — but she has still felt the prejudice toward GLP-1 users in unexpected ways. Many people in her life just assume that she is reverting back to her previous body type and compliment her for looking slim, then turn around and judge somebody else who’s on a weight-loss drug.

“My coworkers will say, ‘Oh, you look so good,’ and then they’ll mention some other person who was maybe always bigger, and they’ll say, ‘But she’s on the shot,’” Adriana said.

And online spaces, where so many of our health and wellness conversations take place these days, are filled with people expressing hurtful opinions about GLP-1 users, often fixating on reports — both credible and not so credible — of dangerous side effects. That was what prompted Adriana to post her frustrations on Reddit.

“What really bothers me is the fake concern for our health, which is the thing that always comes along when people are policing other people’s bodies,” she said. “When people are overweight, people say, ‘Well, I’m just concerned for their health.’” she said. But “now that there is this medication that’s helping, the stigma is: ‘Well, what about the side effects?’”

Will the GLP-1 stigma ever go away?

As GLP-1 use continues to rapidly expand across the country, there are signs that this stigma could eventually be broken down.

It starts with sheer numbers: The more people who take a GLP-1 or know somebody who has, the more likely they might have a more charitable view of GLP-1 users. About 12 percent of Americans said in an August 2025 survey that they had taken a GLP-1 drug. As of May 2026, one in five US households had at least one GLP-1 user, according to data from PricewaterhouseCoopers. This growth may be the best hope for breaking the stigma that is a nasty asterisk on what is otherwise a remarkable moment in medicine. 

“As these medications become more prevalent and more people have either used them themselves or have a close loved one who has used them, it is possible that that will help to reduce the stigma and increase acceptance,” Standen said. “We know that in general, one of the more robust findings in social psychology is that as people have more contact with folks who have identities or situations that might be unfamiliar to them, bias tends to go down over time.”

It is expected to be one of the largest prescription drug rollouts ever.

Mike said he has confronted acquaintances who spoke badly of GLP-1s, explaining how they have worked for him and the hard work he has put into the process. “Your perspective always changes when you suddenly know someone,” he said. 

The number of GLP-1 users is probably as low as it will ever be. Medicare launched its $50 GLP-1 prescription program in July, and millions of Americans will be eligible to receive these medications cheaper. It is expected to be one of the largest prescription drug rollouts ever.

And access should continue to expand. Pharmaceutical executives say they are making inroads with the private employer-based insurance plans that cover about half of the US population; at a health conference — Aspen Ideas: Health — in late June, Laura Steele, group vice president of US cardiometabolic health at Eli Lilly, said the company has seen large employer coverage increase significantly, from about 20 percent covering the medications in 2025 to 67 percent. 

In a decade, 50 percent or more adults in the US may be taking one of these drugs, Alison Furman, partner and US consumer markets industry leader at PwC, said at the Aspen panel. 

As bad as things might still feel to people taking GLP-1s right now, social attitudes do seem to be evolving. According to PricewaterhouseCoopers data shared with Vox, 23 percent of current GLP-1 users openly share that they are on the drugs, compared to the 2 percent who say they haven’t told anyone. People who are considering going on a GLP-1 are even more open-minded. More than half of those considering the drugs (53 percent) say they would share their use with their immediate family members, versus 42 percent of current users.

“The stigma is subsiding,” Furman said. “You see an increase in just openness around this drug. All those signs we believe point to increased adoption over time.”

Adriana has even seen hints of it herself. She has opened up to a few friends who had asked about her weight loss. “Once you start that conversation,” she said, “it’s kind of shocking how many people are like, ‘You know what? I’ve been thinking about going on.’”

AI is the hottest thing in medical care right now — but many of us feel trepidation about it. Just one illustrative public survey sample: An October 2025 KFF poll found just 8 percent of Americans reported feeling a “great deal” of trust in AI managing their appointments or analyzing their health records, and only 32 percent said they would trust an online health tool that uses AI to access their medical records to provide personalized health information.

But many clinicians and healthcare administrators see AI as a powerful new tool that offers myriad opportunities to streamline and improve treatment. A 2026 survey found that more than 80 percent of US doctors use AI professionally — doubling the share from 2023. Physicians are excited by AI’s potential to keep more accurate notes of interactions with patients, to act as a second pair of eyes for human doctors, and to monitor people at risk of deteriorating and ending up in a dangerous situation.

The disconnect between what people and their providers want from AI could create more distrust, at a time when faith in the healthcare system and the medical profession have slid. Patients today want to feel empowered and in control. How can that be possible when these seemingly godlike machines are becoming more and more entrenched in our hospitals and doctors offices?

The answer comes in four words: “human in the loop.” It’s the principle upon which the ethical integration of AI depends and it could help to bridge the gap between lay people and the professionals on AI in medicine. In surveys, people are much more comfortable with the idea of their doctor using AI as an assistant than with AI acting on its own. And most clinicians want to use AI in that way, as a second opinion or passive monitor, not as a replacement for their judgment. There are real fears among the healthcare workforce about that possibility: A group of NYC nurses who were recently laid off claim it’s because their labor was going to be replaced by AI. “Human in the loop” appears to be a point of agreement between doctors and patients at this pivotal moment.

“Doctors…and nurses and staff always have been interested in primarily making the best decision for the people under their care — and these tools can help with that,” Alison Callahan, a research scientist at Stanford University who works on AI programs used in the university’s health system, told me. “The interest in making sure those tools are accurate is high.”

But what does “human in the loop” really mean in practice? How can you know when and how your doctor is using AI? And what is the best way to talk to your provider about the sudden influx of artificial intelligence in healthcare before a robot starts taking appointment notes or analyzing your MRI? I called some leading experts to find out. 

How AI is currently being used in medicine

Patients and providers alike are incorporating AI into healthcare. Individuals are using commercial AI chatbots to ask about their symptoms or the health metrics tracked by their Apple Watch, while large academic medical centers are developing sophisticated programs and protocols to try to improve medical care at the population level.

It starts with ChatGPT, Claude, etc. — the large language models that are available to the public. People are increasingly turning to them to try to understand what’s going on with their own bodies. Individual physicians are also consulting with large language models to answer questions or get up-to-date on the latest research as they figure out how to best care for their patients. 

Then there are ways in which hospitals and doctors offices are adopting AI at the institutional level. Many facilities are using AI as a way to take, collate, and summarize notes on a patient; in theory, it’s a more organized way to keep track of the informal interactions and observations that doctors have when checking on their own patients. Hospitals are also using AI to handle some administrative tasks, like scheduling follow-up appointments; some health systems have even started to use AI to help patients get ready for appointments — to send reminders about colonoscopy prep, for example.

And finally, you have maybe the most ambitious use of AI by health systems right now: as a diagnostic and risk prediction tool. In these cases, AI might offer a second opinion when, for example, a doctor is triaging a patient in the emergency room. It might help the ER staff figure out how to prioritize patients. Or these programs could monitor people either during a hospital stay or out in the real world (by drawing data from the person’s wearable) and make predictions about who may be at higher risk of complications and require further care. AI could recommend that somebody would benefit from seeing certain specialists or receiving a specific medicine or lab test, and generally offer proactive advice about the patient’s medical care.

But at this point, AI adoption is still “highly localized,” said Jennifer Goldsack, CEO of the Digital Medicine Society, a nonprofit that works with healthcare providers, drug makers, and government agencies on how to incorporate new tech (including AI) into clinical care. It depends on the individual doctor or health system. A lot of them are setting up their own programs and their own protocols for how to use these tools.

That is a big reason why it is so important for patients to be proactive about understanding how AI is being used for their health care. You can’t make assumptions; the only way you’re going to know for sure is to ask.

The questions you should ask your doctor about AI

By and large, experts say, patients should feel confident: Doctors and nurses want to keep a human in the loop, even as they integrate AI into their workflows.

“It will be a doctor who is going to be reading that summary or a nurse who is going to be reading that summary and then taking an action to order a lab or put a recommendation in for a follow-up appointment,” Callahan said. “There is high interest in making sure that that is the right decision for that person. That hasn’t changed.” 

Still, many patients say they’d be more comfortable with AI use if their doctor fully explained it in advance. And health systems may have their own priorities that push their facilities toward more rapid AI adoption and delegating more tasks to these AI tools, as seen in the recent NYC nurse layoffs.

So if you want to be informed on exactly where this technology is present and have the ability to consent to its use, you have every right to ask your doctor, experts say. 

“AI is new, but the trust that serves as the foundation of the physician-patient relationship is not,” Timothy Keyes, a machine learning scientist at Stanford Health Care, told me over email. “To that end, I think that conversations about medical AI use should be open, honest, and transparent — just like any other conversations about shared decision-making in the clinical environment should be.”

For some things, your doctor should be asking you proactively if you consent to AI use — note-taking, for example. At my most recent primary care appointment, my doctor asked me if it’d be okay for him to use AI to take and summarize notes from our conversation; Goldstack told me she’d experienced the same at recent physician visits. (This is probably the most common AI use that you will encounter, and Keyes said it’s worth considering giving your consent: “There is growing evidence that they reduce physician burnout and save them at least a bit of time each day writing notes.”)

There are also a number of direct questions that you can ask:

• Will AI be used in my care and how?
• How is my data being protected?
• Can I opt out of any AI services that I do not feel comfortable with? (Keyes noted that patients should be allowed to opt out of any care, AI-related or not; if opting out is not an option, ask how a human provider will be involved.)
• How is the health system or clinic making sure that any AI system they use is working as intended?

And the transparency goes both ways. If you’re asking a question because you consulted ChatGPT before your appointment, tell your doctor. If you’ve talked with a chatbot because of mental health struggles, tell your doctor. And at the same time, feel free to ask your physician how you yourself could actually use AI in a responsible and productive way to improve your health.

“This opens up the opportunity for both the physician and the patient to be humans-in-the-loop,” Keyes said, “in different parts of the loop, with different perspectives, using an AI system to better understand the bigger picture.”

In a way, the novelty of AI and its rapid adoption is an opportunity for all of us to be nosier and more inquisitive patients. What all of these questions really come down to, Callahan said, is how your doctor is making decisions about your health care. That is relevant to all of us, no matter how AI is involved or even if there is no AI being used at all. 

Callahan said she always has a list of questions for her doctor when they recommend a course of treatment: “What are the factors in my health that are informing this recommendation that you have? Would you be making this recommendation for other patients who are similar to me? What can you tell me about the outcomes that I might expect to experience if I say yes to this?”

“I actually think if they can point to the part of your health that is connected to the decision, whether or not an AI tool helped to make that connection is secondary to their ability to communicate effectively to me about it, and help me to feel engaged in making a decision about my own care,” she said.

AI is changing medicine quickly, for both patients and their doctors. The best way to stay ahead is to talk about it.

What caused the ongoing outbreak of cyclospora, the diarrhea-causing parasite currently spreading across the United States? Michigan officials have been saying for weeks that they believed the outbreak may be linked to bagged salad or salad kits. What we were waiting to learn was the specific brands and specific products in question. 

And late last week, it looked like we finally had the answer — but then things quickly got cloudy. 

On July 16, the Washington Post reported, citing anonymous sources, that the outbreak had been linked to shredded iceberg lettuce supplied to Taco Bell by Taylor Farms. A day later, Taylor Farms said it was withdrawing products from US stores and restaurants based on information from the FDA.

But then on July 19, per NBC News, the FDA said that there had been a false positive for cyclospora when testing a sample of Taylor Farms iceberg lettuce; Taylor Farms said in its own statement that the FDA had “apologized” for the mix-up. The next day, the company and the federal government were stuck in a semantic argument: Per NOTUS, the FDA insisted it did not “officially apologize” to Taylor Farms but “explain[ed] factually the issues” with the false positive. 

So where does that leave us right now? Officials still believe that Taylor Farms iceberg lettuce was the source of the Michigan outbreak. But whether those are the only products driving the outbreak remains unclear, with almost every state now reporting at least one cyclospora case in 2026. And on Thursday afternoon, the FDA announced that it was tracking a second outbreak linked to other unspecific products, though details were otherwise scarce.

Any outbreak of food-borne illness requires careful public communication. Officials need to tell people how to avoid contaminated food without scaring them away from eating fresh fruits and vegetables altogether.

But instead, many Americans have been left wondering what, exactly, they’re supposed to do. As one frustrated Reddit user put it: “So is the damn lettuce bad or not????” (If you need some advice on what foods are safe and what foods to be cautious about, we have a story for you.)

It may sound like a funny question, but it’s a profoundly serious one. The problem isn’t just that people are confused about their lettuce. The Trump administration’s handling of the cyclospora outbreak — from its conflicting public messages to accusations of political favoritism — has left many Americans even more confused about whether they can trust anything they’re hearing from the government. That’s a dangerous place to be during any public health emergency.

The cyclospora outbreak has become a communications nightmare

We are approaching 10,000 cyclosporiasis cases across the US this year: Michigan alone has recorded 7,664 as of this morning, Ohio has seen more than 1,200, and more than 40 states have now reported at least one case in 2026. The country usually sees a few hundred cases at most in a given year. Cyclosporiasis, the disease caused by the cyclospora parasite, leads to what public health experts describe as “watery” and “frequently explosive” diarrhea. While it isn’t typically life-threatening, it can cause serious complications: 160 people have been hospitalized in Michigan since the outbreak began.

And so for those of us who very much hope to eat fresh produce but do not want diarrhea, there’s a bit of urgency to figure out where the cyclospora is coming from. Food-borne illness investigations are already inherently difficult because of how globalized our food supply has become: Produce can travel all over the country and the world before it comes to your grocery shelf, and the process of government health workers interviewing the people who get sick and cross-checking to identify the shared foods that they might have in common is laborious.

Once investigators find a source, the information has to be shared clearly and responsibly. That is where the Trump administration has tripped up this week. 

Trump — and Health Secretary Robert F. Kennedy Jr. in particular — came into office criticizing the public health establishment. They accused officials of misleading the public about the novel coronavirus and the vaccines developed to fight it, while failing to convey the nuances of the pandemic. But now, as they grapple with the incomplete picture of the cyclospora emergency, they are making many of the same mistakes.

“They’re very similar problems, even if on the outside, they don’t look quite the same,” said Michael Mackert, director of the Center for Health Communication at the University of Texas at Austin. “The underlying commonality is very much that we are dealing with imperfect information all the time.”

In any outbreak, some uncertainty is to be expected. Investigators have struggled to identify the source of earlier cyclosporiasis outbreaks too. And the FDA maintains that the likely source of the outbreak is Taylor Farms iceberg lettuce, based on the information they have gathered from sick patients and other sources, no matter the false positive result that has sparked so much confusion.

“The epidemiological evidence is so strong that the lack of a positive test is almost meaningless,” said Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia. 

But the mistake that the Trump administration made was in sharing preliminary results and then having to issue a seemingly contradictory statement shortly afterward.

“FDA should have waited for confirmation of the presumptive results before going public,” Diez-Gonzalez said.

The larger stakes of the Trump administration’s poor communication

Investigations like these are hard enough — but when you add in the public health funding cuts of the past 18 months and the casual and widespread corruption characteristic of the Trump administration, trust in the government’s public health apparatus has sunk even lower.

It’s created just the conditions for conspiracies to bloom. “Unfortunately our FDA is compromised,” wrote one top commenter on Reddit. “I would not trust what comes out of it during this administration.” 

Several news outlets and influential social media accounts noted that Taylor Farms had donated $1 million to Trump’s MAGA super PAC and, in the middle of the controversy, received a private White House meeting. According to the New York Times, Taylor Farm officials used that meeting to dispute the findings that their products were responsible for the outbreak — and shortly thereafter, the FDA made its “false positive” announcement.

The administration insists that their decision-making is being guided by science, but even the appearance of impropriety has become a common theme in the press coverage. The broader uncertainty and distrust may help to explain why it’s not only Taco Bell and Taylor Farms taking a hit right now: According to Market Watch, Chipotle and the fast-casual salad chain Chopt have also seen a decline in traffic in recent weeks.

Public health requires public confidence. Perceived influence from special interests is a problem, even if the interactions didn’t alter the FDA or CDC’s actions.

Kennedy, who helms our government’s health department, should understand this well: His Make America Healthy Again movement made restoring public trust a central part of its message while accusing the existing public health establishment as being in league with special interests. 

The cyclospora outbreak has revealed how difficult that is to do in practice. 

In trying to communicate nuanced information during an active outbreak — while consulting interested parties like Taylor Farms itself — the administration has instead fueled doubts about the credibility of its messaging

Even before cyclospora turned eating salad into a leap of faith, Trump had a poor track record: His administration has slashed CDC staff, brought on vaccine skeptics to set vaccine policy, and clashed with the scientific establishment on a number of high-profile issues, like the time Trump held a televised press conference to argue a disproven theory that Tylenol can cause autism.

“Unfortunately, this is another example of a missed opportunity to establish credible and trusted communications to prepare the public to understand the real risks from the pathogen and confidence in the food safety and information from the FDA,” Scott Ratzan, editor-in-chief of the Journal of Health Communication: International Perspectives, told me. “Faith in our institutions continues to erode. We could do better.”

We are lucky cyclospora is not a deadly disease. Next time, the stakes for these miscues could be much higher.

This story appeared in Today, Explained, a daily newsletter that helps you understand the most compelling news and stories of the day. Subscribe here.

Defense Secretary Pete Hegseth announced this week that the Pentagon would begin testing the testosterone levels of all military members over the age of 30 as part of their regular, annual physical exams. And — if their levels are low — service members could choose to receive testosterone replacement therapy.

“It’s not about artificial enhancement,” Hegseth said. “It’s about restoring and optimizing your natural capabilities, protecting your longevity, and ensuring you have the biological foundation required to sustain the fight.”

The High-T Department of War. pic.twitter.com/hlAUq3j2cD

— Secretary of War Pete Hegseth (@SecWar) July 15, 2026

It’s another example of the performative masculinity that has defined Hegseth’s time atop the US military. He has sought to rebrand the Department of Defense as the Department of “War,” preached a “warrior” ethos, rolled back DEI initiatives while blocking promotions for women, and taken an unusual interest in the beard-grooming standards of service members.

The testosterone obsession is just one of several ways that the military is having a Make America Healthy Again movement. Hegseth announced over the spring that service members would no longer be required to get an annual flu vaccine. (The military later reinstated the mandate for new recruits, after a major flu outbreak at a boot camp.) And also this week, he launched a new investigation into the Defense Department’s decision in 2021 to mandate the Covid-19 vaccine — shades of the efforts being made by Robert F. Kennedy Jr. at the US Department of Health and Human Services.

Go a little deeper

The “T” trend is not just a fixation of Kennedy’s, who has said that he takes testosterone supplements, and Hegseth. More Americans of every age group are taking testosterone. By one count, prescriptions grew from 7.3 million in 2019 to more than 11 million in 2024.

So, is getting more people to take supplemental testosterone actually a good idea? Should everybody be screened, as Hegseth is suggesting for service members over 30?

The Endocrine Society said in a statement after Hegseth’s announcement that there was “insufficient evidence” to support testosterone-level screening for asymptomatic Americans. Previous research suggests that, if anything, testosterone is already overprescribed in the US; only 12 percent of men receiving a prescription had received appropriate diagnostic testing.

Testosterone levels indeed fall as men age, and there has been a general decline in testosterone among men today compared to men of the past. But what’s not clear is whether widespread testosterone testing and supplementation is the solution. 

For one, distinguishing between a natural decline in testosterone and a decline that warrants clinical intervention is the subject of ongoing debate among doctors. Low T can also be a sign of other chronic health conditions that it would be better to treat. If your T is dropping because of obesity, for example, it would be better to lose weight (or take a GLP-1 drug instead of a testosterone supplement). The evidence is mixed on how much taking T actually improves things like mood, energy, sexual performance — or military effectiveness — and taking too much testosterone could come with its own health risks.

The dialogue around T supplements is still evolving. Doctors used to worry that extra testosterone could cause cardiovascular problems, but more recent research has allayed those fears, leading  proponents in the Trump administration to call for more prescribing. But the evidence right now does not appear to support the widespread T testing and supplementation that the military’s new program would suggest.

One link for later

How to keep your cool on a bad day: As a parent of three children, I’m always on the lookout for better ways to manage my stress — and took heart in the four strategies suggested by Vox’s Allie Volpe in her piece this week. If we can take the time to acknowledge how we’re feeling and really reflect on what has led us to feel that way, we might be able to avoid a full-blown meltdown. That’s news you can really use.

Before you go…

• Did you know: Prediction markets correctly guess the winner of reality TV shows upward of 90 percent of the time? It’s a trend that raises questions about insiders using insider knowledge to make a buck — and risks ruining the fun of following these shows.
• Today’s trivia: What is a Russian name meaning “holy”? (You can find this and other brain puzzles in Vox’s daily crossword. Look for the answer in Monday’s edition.)
• Yesterday’s trivia: Yesterday, we asked you what animal can be as narrow as a few millimeters or as wide as 13 feet. That would be crabs, the various species of which can range from tiny and adorable to monstrously terrifying.

Update, July 20, 2026, 2 pm ET: This story, first published July 17, has been updated with the current case numbers and developments in the search for the source of the outbreak.

Have you been looking at the lettuce aisle at your grocery store with a wary eye since the diarrhea outbreak began? You’re not alone. This is the summer, which should be high time for fresh produce. But the ongoing emergency has even doctors asking themselves unthinkable questions: Should I stop eating salad? Are any fruits and vegetables safe?

The disease in question, cyclosporiasis, is caused by the parasite cyclospora, which can infect people when it is attached to fresh produce and then consumed. Watery diarrhea — described by public health authorities as “frequent” and “sometimes explosive” — is the most common symptom.

Michigan health officials said last week that they suspect lettuce or bagged salad to be the culprit for the parasite-driven outbreak in the state that has sickened more than 6,100 people. But identifying the specific products to blame has been a challenge. On Thursday, the Washington Post, citing anonymous federal officials, reported the outbreak may trace back to Taylor Farms products that were used by Taco Bell. But then, on Sunday, the FDA said that the tests showing the Taylor Farms product contained cyclospora had been false positives. As of Monday afternoon, the source of the outbreak is still unclear, although Taylor Farms has continued a voluntary recall of its iceberg lettuce products.

I live in Ohio, where there have been nearly 1,200 cases, and I love salad kits. The current outbreak is a major cramp on my lunch plans — and I know I’m not alone. 

So, what do we do? I’ve consulted with a food safety expert and a dietitian to get the answers. The topline message is: Don’t stop eating your fruits and vegetables. They’re good for you. But be smart with your food hygiene.

“I don’t think we’re at that point of shying away from eating your green vegetables,” Francisco Diez-Gonzalez, director of the Center for Food Safety at the University of Georgia, told me. “The benefits overall still outweigh the risks.”

How can we still enjoy our summer produce in this time of cyclospora? Here’s a guide.

Here are the “red light” foods linked to prior outbreaks

While we don’t know for certain the cause of the current outbreak, cyclosporiasis has been linked with specific foods in the past. Let’s start with that list:

• Basil
• Bagged salads and salad mixes
• Cilantro
• Mesclun lettuce
• Parsley
• Raspberries
• Snow peas
• Sweet peas

These foods — either because of where they’re grown or their texture or both — have historically had a higher risk of carrying cyclospora. It might be wise to steer clear entirely for the time being — especially the prepackaged salad products.

The Michigan health department, for example, is urging people to avoid bagged lettuce and salad kits and to purchase whole heads of lettuce instead. And since the outbreak is impacting most states now, it’s advice we’d all be wise to heed.

Then there are “yellow light” foods that need careful cleaning

But for a lot of fruits and vegetables, including whole lettuce, you should still wash them thoroughly — because that’s always a good idea. If you need tips for washing your produce, we’ve got them. For heads of lettuce, for example, cut away the outer layers and wash in between each leaf as best you can. 

“Fresh produce is still generally safe, delicious and nutrient-dense,” Rosemary Trout, a food scientist at Drexel University, told me over email. 

But she gave a yellow light for any leafy greens or fruits and veggies that have textured edible skins. The more texture there is, the more of a risk there is because the parasite can stay attached more easily — even if it’s been diligently washed. Raspberries carry a higher risk than blueberries, for example, and those have been associated with earlier cyclosporiasis outbreaks.

Another point of emphasis: Several doctors have told me that, even if an item says it is prewashed, you should wash it again. And again.

But there are lots of “green light” foods you probably don’t need to worry about

Trout gave a green light to any canned fruits and vegetables, any produce that you cook — importantly, at high heat — at home, and any frozen fruits and veggies.

In general, these are Trout’s safety tips for prepping fruits and vegetables at this uncertain time:

• Be consistent and thorough — at least 20 seconds — when washing your hands and always use hot, soapy water. 
• Peel or remove the outside layer of the fruit or veggies — the rind of a watermelon or cantaloupe, for example, or the outer layer of a head of lettuce.  
• Don’t consume damaged, bruised produce. 
• Keep produce cold in storage, ideally for a relatively short amount of time. 

Get creative with your recipes

If you want to steer clear of any questionable produce or take the safest preparation route that you can, you might want to get a little creative with your recipes. With your lunch salad, for instance, “peeled, shredded carrots, thinly sliced radish, or thinly sliced cooked beets might be a nice substitute for leafy greens,” Trout said.

Heat remains the most surefire way to eliminate any cyclospora parasite that might be lingering on your produce. So look through your cookbooks for any dishes that feature grilled vegetables. Vox Even Better editor Rachel Miller (a more accomplished cook than I) suggested a few recent New York Times Cooking recipes, which you can check out via these gift links:

• Grilled halloumi and vegetables
• One-pan orzo with spinach and feta
• Orzo salad with peppers and feta

Peppers, eggplant, squash, and zucchini are your friends. They respond well to heat, and they are easy to clean. And even some leafy greens — like spinach — hold up nicely to sautéing. 

Support your local farmer’s market

Right now is also a great time to check out your local farmer’s market for produce. 

Dr. Kathleen Linder, who is the hospital epidemiologist at the Veterans Affairs hospital in Ann Arbor, Michigan, told me that she has been buying locally since the outbreak began. Prior outbreaks have been linked to produce that was grown elsewhere — whether in the US or internationally — and shipped long distances before it arrived on our grocery shelves. Summer is a crucial season for small farms and farmers’ markets; they shouldn’t be penalized for a health emergency that they had nothing to do with.

Buying locally could reduce the risk that your produce has been exposed to the parasite. Trout said you can ask your local growers about their water supply to make sure that what you are buying is safe.

“Single-source produce from a local farm with good manufacturing/farming practices in place, with a safe water supply, are good,” Trout told me. “Commercially processed, pre-packaged foods are likely combining produce from various farms, which may increase risk, despite good manufacturing practices in place.”

So while cyclosporiasis is an unwelcome concern as we plan our summer cookouts, it doesn’t need to stop you from enjoying fresh fruits and vegetables. Be a little more diligent about your food hygiene, get a little creative with what you’re preparing, maybe stop by a farmer’s market — and you’ll be fine.

As if we needed one more thing to worry about so soon after the hantavirus scare, there is a new public health threat for Americans to contend with: a rapidly escalating outbreak of, of all things, diarrhea.

It’s a parasite-borne illness called cyclosporiasis. It can cause explosive and watery bowel movements — and it is wreaking havoc across the United States this summer.

How bad exactly? As of July 15, Michigan’s health department is reporting 3,762 cyclosporiasis cases, up from 1,500 late last week. Forty-four people have been hospitalized as of July 9. To put that number in context, the state normally sees about 50 cases in a year. To the south, at least 364 people have been infected in Ohio. According to a USA Today compilation of state health department data, almost every state has reported at least one cyclosporiasis case this year. 

This is not our first bout with a cyclosporiasis outbreak. In 2013, the US saw more than 600 cases, and more than 500 people were sickened across the country by contaminated McDonald’s salad meals in 2018. Cyclosporiasis is caused by the parasite cyclospora, which can infect people when it is attached to fresh produce and then consumed. It does not, fortunately, spread from person to person. We do know some likely culprits: Bagged salads, basil, cilantro, peas, and berries have been linked to prior outbreaks. 

Watery diarrhea — described by public health authorities as “frequent” and “sometimes explosive” — is the most common symptom. People can also experience cramping, bloating, nausea, and vomiting. Symptoms can start anywhere between two days and two weeks after a person eats tainted food. No one has died, and thankfully, cyclosporiasis is rarely fatal. But it is an extremely unpleasant experience that could last for up to a month without treatment, and certain people, such as folks who are immunocompromised, are at higher risk of more serious complications.

There are steps that everyone can take to protect themselves from cyclosporiasis (more on that in a moment). But the current situation is challenging, because, right now, officials don’t actually know which products are causing the outbreak. “At this time, no specific produce grower, supplier, or type of produce has been identified as the source,” Laina Stebbins, a spokesperson for the Michigan Department of Health and Human Services, said in a statement to Vox on Friday. On Monday, Michigan officials said they believed lettuce or bagged salad products were to blame, but still had not identified specific brands or items that could be linked to the growing outbreak.

It’s a public health mystery, one that results from both the sneaky nature of the parasite itself and our increasingly globalized food supply. It could be a while before we learn the answer. But, in the meantime, if you’ve found yourself spooked by some of the recent headlines, here’s what you actually need to know.

Why cyclosporiasis outbreaks are so hard to trace

Cyclosporiasis makes itself hard to find. Scientists don’t know exactly how much of the parasite a person needs to be exposed to to become infected — one of many unknowns about the basic features of the bug. The foods carrying this pathogen may not be contaminated with much of it at all, which makes any preemptive testing a challenge.

And, on top of that, there can be a long gap between the parasite being introduced to the food supply and when a person actually gets sick, which further complicates any efforts to trace the outbreak’s origins. A fruit or vegetable could be contaminated in one of the various tropical or subtropical regions of the world where cyclosporiasis is more common, well before it lands in your grocery store in the United States. 

“Oftentimes when we see these outbreaks, what happens is that somewhere in the world, a contamination event occurs, and then that produce is then shipped throughout the area and it could go anywhere in the world,” Dr. Kathleen Linder, the hospital epidemiologist at the Veterans Affairs hospital in Ann Arbor, Michigan, told Vox. 

Sometimes, the source can be closer to home: A 2020 outbreak appeared to be linked to produce grown in Florida and shipped to a plant in Illinois that produced bagged salad kits. But, as if to demonstrate the difficulty of doing this work, the FDA said it could not conclusively prove those farms were the source of the outbreak.

The point is: We have a food production supply chain that sources produce and combines ingredients from all over the country and the globe — providing more opportunities for a parasite like this to find its way in.

“We’re relying more and more on produce coming from other countries so that we can have raspberries all year round,” Joseph Eisenberg, a professor of epidemiology and global public health at the University of Michigan, told Vox. “That kind of luxury only happens when we centralize our food distribution system.”

Even once an outbreak is underway, it can be hard to pinpoint the source. Symptoms may not occur for up to two weeks after a person eats contaminated food. 

“I can barely remember what I had for dinner a couple nights ago; there’s no way I’m going to be able to remember a week ago,” Linder told me. “It takes a lot of time and a lot of manpower to get all that information collected.”

As with any outbreak under the Trump administration, the Centers for Disease Control and Prevention is responding with significantly fewer workers and resources than it used to have. To be clear: This cyclosporiasis outbreak could have happened either way. This parasite has sparked widespread infections before. But Linder said that because the CDC has rolled back some of its national reporting programs, it’s been left to the states to take the lead — and that has made it harder to pull together a complete picture of the outbreak.

“It has been very hard to get updated information,” Linder said. “The information is lagging a little bit behind because it’s being done at the state level.”

What you can do to reduce your risk of cyclosporiasis

For scientists, the work ahead involves better understanding the properties of the pathogen itself and developing surveillance tools and techniques that allow us to catch contaminated food before it reaches people. But what can the rest of us do right now, during an active outbreak?

According to various public health authorities, the short version is to cook the produce that you can — heat is the absolute best option for eliminating cyclosporiasis — and to clean your raw fruits, vegetables and herbs as thoroughly as possible. 

Wash everything with running water before eating or preparing it. Scrub the firmer fruits, like melons and cucumbers, with a produce brush if you have one. If you see damaged or bruised areas on your fruit or lettuce, cut them away. Even if a food’s package says it’s prewashed, Linder said she advises people to rewash it just to be sure.

Previous outbreaks have specifically been linked to bagged lettuce and salads, so you might consider buying whole heads of lettuce instead. If you do that, cut away the outer layers and then separate the inner leaves to wash them. For green onions, you should cut away the bulby root and the outer layer and then wash them thoroughly. Raspberries were associated with one of the first US outbreaks in the 1990s, and they are particularly tricky to clean given their bumpy surfaces; you may want to consider eating them only after cooking (to prepare a jam or compote, for example) or opt for frozen raspberries for the time being. (Freezing is believed to reduce, if not completely eliminate, the parasite.) And be careful with leftovers: You should refrigerate any unused foods that you plan to eat later within two hours. 

You could also consider buying locally sourced foods, Linder said, because cyclosporiasis is more common in food sourced from other parts of the world.

If you do start to experience extreme diarrhea, make sure to hydrate very well to avoid dehydration. Linder told me that if somebody experiences dizziness, they can’t keep fluids down, or they have very dark urine, then they should seek immediate medical attention. And anybody experiencing those symptoms should get in touch with their health care providers and their local health department. 

Sooner or later, experts will probably figure out what caused the current outbreak, whether it’s one source or several. But cyclosporiasis will still be a concern in the future; it’s a byproduct of the food system we have built. It serves as a potent reminder about the importance of good food hygiene. A little extra effort to wash your food before you eat it could save you a lot of pain later.

Update, July 15, 2026, 11:45 am ET: This story, first published July 10, has been updated with current case numbers and products linked to the outbreak.

As I am typing this, a device rests on my wrist that purports to unlock a trove of real-time information about my body’s performance. I can click a button and check my heart rate and review how much it’s varied over the course of the day. It can tell me how many steps I’ve taken, how many minutes I’ve been “active” throughout the day, and — if I wore it while I slept — just how well I rested, according to the data its sensors can pick up from my arm.

The Apple Watch is a remarkable piece of technology, when you stop and really think about what it does. It’s no surprise, perhaps, then, that we have collectively become obsessed with these things. One 2023 government survey found that one in three Americans wear a smartwatch or wristband to track their health and fitness. More recent industry surveys put that figure even higher: More than half of the US population owns a wearable or connected device and tracks at least one health metric with it.

That’s a lot of people who are swimming in the ocean of information that our Apple Watches, and FitBits, and Oura Rings, and Whoops report back to us. Dr. Michael Joyner, who studies the physiology of exercise at the Mayo Clinic, said he has a three-pronged criteria for thinking about the usefulness of these metrics: Is it measurable? Is what you’re measuring actually meaningful? And is the information that you’re receiving actually actionable? 

“If one or two are missing, the thing may be the most interesting thing in the world. It may be cool,” he said. “But it’s not going to make a difference in long-term outcomes.”

Across medicine, we are developing remarkable tools for detecting things in the human body, outpacing our ability to interpret what we are finding. We are getting closer to a future where these devices could offer invaluable insights into how our body is performing outside of the doctor’s office or hospital, but here in the present, we should keep our expectations in check.

Here’s what you should know about some of the most common metrics that wearables track.

Do we really understand what our wearables are telling us?

These devices claim to track both old-fashioned and new-fangled measures of your body’s performance. You’ve got your heart rate — something humans have been able to pick up from the wrist before anybody had dreamed of smart devices — and your step count. My Apple Watch estimates how many calories I have burned throughout the day. The Oura Ring takes your temperature, which can help predict ovulation or offer an early sign that you’re coming down with something.

But as the technology has gotten better, new measures for things many of us have never heard of have emerged. Heart rate variability, or HRV, has gained a lot of recent interest. It assesses the tiny variations, measured in milliseconds, in the rhythm of your heartbeat; the Economist dubbed it “the most useful indicator” of your overall health. Some devices then use HRV to deliver “recovery” scores that judge how well your body bounces back from your workout or “stress” scores that attempt to quantify how much strain you are under.

HRV demonstrates the conundrum that wearables can present to us, Joyner said. The metric itself has a scientific basis: Researchers have, in fact, found that the amount your heart rate varies over time is associated with your overall health. In general, a higher HRV is better than low, because it suggests your body is more adaptable and better regulated.

But that doesn’t necessarily mean that tracking your HRV from minute to minute with a smartwatch will translate to better health. For starters, we don’t have specific interventions for improving HRV, Joyner said. We don’t even have universally accepted definitions of what high or low HRV is.

In any case, the best strategies are the same heart health guidelines we’ve known about for decades: don’t smoke, don’t drink to excess, eat a healthy diet, exercise. You didn’t need a smartwatch to tell you that’s the best way to take care of your heart, Joyner pointed out. So what good was really derived from closely monitoring your HRV?

“As an individual metric that you can track and do something about, it’s interesting, but there’s no definitive data that you’re going to get better,” Joyner, who was speaking for himself and not the Mayo Clinic, said. “Follow the guidelines. People who follow the guidelines are going to do better on these metrics. But whether you can intervene specifically to make the metrics better or should pay much attention to them, who knows?”

Dr. Ami Bhatt, chief innovation officer at the American College of Cardiology, told me that the bedrocks of evaluating your heart health are still the old mainstays like your blood pressure and your cholesterol, along with newer metrics checked via blood test such as ApoB and lipoprotein. Are you a smoker? What’s your family history?

The value from wearables is less about the specific numbers they are reporting — especially with something like HRV, for which there are not universal guidelines — and more about the long-term trends they can track. By collecting your personal data over time, they can help you figure out what’s normal for you and help you notice if something changes. So don’t freak out if your HRV is different from somebody else’s, or you see one abhorrent reading in your daily report. But if you notice a change in your resting heart rate or HRV that persists over time, then it might be worth going to see a doctor about it.

“We don’t want to overreact to just one abnormal reading,” Bhatt said. “If you just know your baseline when you’re relatively healthy, you can catch the trends.”

It’s all about having realistic expectations about what your wearable can deliver — and recognizing that, for some things, the old ways are still better. When it comes to those metrics that incorporate HRV to determine your stress and “recovery,” Joyner said that self-reported data (literally, how do you feel?) remains the more accurate way to evaluate a person. 

And at a certain point, your wearable can straight-up make your health worse. Fixating too much on your sleep problems, for example, can paradoxically cause more sleep problem. An American Society of Sleep Medicine survey this year found that 76 percent of US reported losing sleep because they were worrying about their sleep. It’s a problem — dubbed “orthosominia” — that scientists have been warning about for nearly a decade: the possibility that our obsession with better sleep, and doing things like wearing a device to track our sleep, could actually give us insomnia.

Bhatt said she’d like to see these devices develop the capability to detect when a user may be checking their data a little too compulsively. Joyner, for his part, said he worried that the culture around health and wellness could, ironically, create a lot of stress for the people who get deeply invested in tracking their activity. 

“I actually worry we’re entering a too-much-information world,” he said. “It’s going to be anxiety-provoking.”

How to have a healthier relationship with your wearables

Even as we recognize the limitations of wearables, that doesn’t mean they can’t be useful — and they’re going to keep getting better.

Right now, there are obvious situations where a wearable can be helpful. As Bhatt suggested, they can help you understand your personal baseline and notice any changes. Certain patients, such as those with congenital heart failure, can clearly benefit from ongoing monitoring of their heart’s performance, per the American Heart Association. Anybody can use a wearable to make sure their heart rate doesn’t reach dangerous levels during a workout. And these devices could ultimately prove effective in catching underlying heart problems — but there is still work to do. A 2019 study on wearables and atrial fibrillation is telling: At the time, only a tiny percentage of wearers received a notification of an irregular heartbeat, suggesting that there were others that the devices were missing. But, for those who did get an alert, the majority of them did in fact have A-fib. (The FDA has since said that several smartwatches are capable of A-fib detection.) Some patients who have had a serious cardiac event are being asked to put on a wearable, so their doctors can remotely monitor their heart, utilizing an AI assistant that checks the incoming data for any signs of a pending emergency.

And these are the worst wearables we’ll ever have. The future iterations of these devices are going to become more precise and more integrated with AI, which could allow them to ultimately provide more value to the people wearing them. The hypothetical potential for integrating wearables with health care delivery more broadly is immense. 

“None of these things will exist in a silo,” Bhatt said. “Your health records, how you’re doing, your wearables, your lab data, people are going to be pulling those together…and trying to give you insights.”

But for now, for the average person, it’s more of a personal choice. Joyner, whose work is all about maximizing human performance, does not wear a smartwatch. Bhatt likes to experiment with different devices with a certain goal in mind, like trying to improve her sleep over the course of a few months.

As Bhatt put it to me, if a wearable motivates you to take your health more seriously, then it’s already doing your body some good. “The best health metric is the one that changes what you do in a way that improves your health,” she said. “For you and I, that may be different things. For your grandmother, it’s something else. For the woman down the road, it’s something else.”

At the most fundamental level, people who use wearables tend to move more when they do — up to 40 more minutes of walking per day, according to a 2022 Lancet study. That is a gain for their health; recent research has shown that even a little bit of movement can have life-saving benefits. The more wearables encourage people to move, the more they can deliver real health benefits. 

So if you like wearing one, that’s fine. I’m not dropping my Apple Watch’s step tracker any time soon, because it pushes me to get moving. But be mindful of how your use affects you and how preoccupied you are with certain metrics. Stress is one of the worst things for your health. So is a lack of sleep. If you find your sleep metrics are keeping you up at night, or that your sleep seems to have gotten worse since you started using it, it’s okay to take it off.