Vaccine Shedding: Facts, Myths, & More

2025's Looking Like The Year Of Chronic Disease. Here Are 3 Issues To Watch

This time last year, we were eager to see how blockbuster obesity drugs would actually perform, and if they had staying power. We've gotten some answers. However, our crystal ball failed to predict the arrival of Robert F. Kennedy Jr. And his "Make America Healthy Again" entourage,   which materialized seemingly overnight in the summer. 

We knew the drugs were changing society, but we didn't know that Kennedy would hand a megaphone to critics of the drugs and the pharma industry, or that he'd become a conduit for a vast array of health concerns. Average people are talking about disease prevention, looking to modify their diets and lifestyle habits to ward off the leading causes of death and disability. (Primary care physicians rejoice!) That, along with the widespread health care dissatisfaction that became glaringly evident, has made chronic disease a top issue as we enter 2025. 

What comes next? Here are three things we're keeping an eye out for next year:

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Body Image And Chronic Illness

Source: Katie Willard Virant

We all have thoughts and feelings about our bodies. Sometimes, we catch a glimpse of ourselves in the mirror and like what we see; other times, we are disappointed by the gap between the idealized body and the one we actually inhabit. Illness intersects with body image in the many ways it can change the body. Illness-related body changes can include weight fluctuations, hair loss, skin changes, mobility, and gait alterations. How do people living with illness manage these changes?

Loss of identity

Our bodies are intimately ours. We know our face, our physique, our hair. We know this nose, this belly button; this particular way of walking. Furthermore, our bodies are the way we present to the world. We learn from an early age that people respond to our bodies, and we learn that some bodies are deemed more pleasing than others.

When bodies change due to illness, our relationship with ourselves and with the world at large is affected. We may feel like a stranger to ourselves; we also have to grapple with the new ways that other people see us. Shame, anger, and self-loathing are common responses to body changes imposed by illness. These are normal reactions to identity losses.

Working with body image

In the face of body image changes caused by illness, it's important to allow yourself time to grieve. Illness is a thief that steals so much, including how our bodies appear and function. It's understandable that you would feel sad and angry. Treat your feelings with self-compassion.

Resist appearance pressures that are arbitrary and harmful. Cultural norms advocate unrealistic appearance ideals that are designed to negatively affect body image. Media literacy—understanding how and why advertisers promote these unrealistic ideals—is a protective factor in combatting body image distress (Thornton and Lewis-Smith, 2023). We've been sold a body image ideal that is purposefully unattainable in order to keep us purchasing goods purporting to help us reach that ideal. Understanding this is a crucial prerequisite to intentionally rejecting that arbitrary ideal. If we can broaden our concept of beauty, we can make more room for acceptance of body changes caused by illness.

Seek connection with others. Shame and grief can cause us to disconnect at the very times we most need connection. Social support can counteract false beliefs that our appearance makes us unpalatable to other people.

Focus on what the body can do rather than how it looks. Body functionality describes everything the body can do across diverse domains, including physical activity, creative endeavors, communication, and the use of the senses (Alleva & Tylka, 2020). However, for people who live with illness, frustration over body appearance is often intertwined with frustration over body malfunctioning. Dissatisfaction with the body exists on two levels: appearance and functioning. Nevertheless, researchers stress that body functionality is not an able-bodies construct (Alleva & Tylka, 2020). Rather, functionality exists across many areas. Yes, there are ways in which your body does not work optimally. There are also ways in which it does.

Holding gratitude while holding pain

To live with illness is to suffer. It is painful, and no amount of gratitude practice can eliminate that pain. However, researchers have found that quality of life markers do rise with practices that emphasize acknowledgment and appreciation for the positive ways that one's body functions (Alleva & Tylka, 2020). Intentional and reflective movement modalities like yoga and stretching can provide attunement with the body. Similarly, exposure to nature has been shown to enhance appreciation for the body's ability to take in beauty and pleasure through sensory experience. Finally, writing practices that allow participants to reflect on positive body functionality can improve body image.

Source: Katie Willard Virant

Writing exercises to try at home

Dr. Jessica Alleva and her colleagues at Maastricht University in the Netherlands have developed a writing program designed to improve body image. The free, do-it-yourself program, is called "Expand Your Horizon." "Expand Your Horizon" offers a comprehensive list of body abilities—including some that we may not instinctively relate to body functionality. The exercises ask participants to reflect upon those functions, paying particular attention to the personal meaning of each function. The program broadens the notion of "body" and has been cited as currently the most effective writing technique for improving positive body image (Guest et al., 2019, cited in Alleva & Tylka, 2020).

Conclusion

It is not easy when illness causes our bodies to change. But we can take steps to improve acceptance of these changes and continue to live as fully as we are able.

My Oral Cancer Shows The Deep Connections Between Chronic And Infectious Disease

By Larry Schlesinger

Dec. 16, 2024

Schlesinger is a physician-scientist and professor, president, and CEO of Texas Biomedical Research Institute, a nonprofit research organization in San Antonio, Texas.

The connection between infection and chronic disease is one I know personally. A few years ago, I was diagnosed with oral cancer. My doctors tracked the cause to a human papillomavirus (HPV) infection I'd had many decades earlier.  

I am 69, and when I was growing up, there was no HPV vaccine like there is today — a vaccine developed thanks to infectious disease research. It's estimated to prevent 90% of HPV-related cancers. If I had been born in a different time, I would have received the vaccine and likely would have been spared from this cancer.

Thankfully, I've been successfully treated and am in remission. But my experience of a viral-induced cancer — one shared by millions — raises a point that's missing in the current, post-election debate about what type of health research our country should prioritize.

Robert F. Kennedy Jr., whom President-elect Donald Trump plans to nominate for Health and Human Services secretary, has publicly called for U.S. Government-funded medical research to focus on chronic illnesses like diabetes, heart disease, obesity, and cancer, while taking "a break" on infectious disease research.

It is not an either/or situation.

New data show the HPV vaccine prevents cancer in men, too. Why don't more people get it?

Prioritizing chronic conditions, defined as those lasting longer than three months, actually means prioritizing infectious diseases, which are caused by infectious organisms like viruses, bacteria, and parasites. Infection, we are appreciating more and more, plays an important role in these chronic conditions.

Limiting the study of infectious diseases would worsen the chronic disease epidemic. Research into the interconnections between the two is integral, not optional, to solving the crisis. 

We are only just recently beginning to unravel the role that bacteria and viruses have in chronic conditions. For example, we know that they cause an estimated 13% of cancers worldwide, according to the American Association for Cancer Research — and this is likely a very conservative percentage. Not everyone who gets an infection will develop cancer — far from it. But millions do. What makes some more likely to develop a chronic condition like cancer? This is a question that researchers are working to answer.

Before the 1980s, stomach ulcers were thought to be caused by stress and lifestyle. Then two Australian scientists discovered a bacterium, Helicobacter pylori, is the cause of stomach inflammation (gastritis), and the widespread inflammation can predispose individuals to stomach ulcers and cancer. The finding was so novel at that time, it was awarded the Nobel Prize in 2005 and inspired others to search for microbial causes for other common chronic inflammatory conditions.

The list goes on: Epstein-Barr virus, one of the nine herpesviruses known to infect humans, is associated with several diseases, including mononucleosis, a form of cancer (lymphoma), and autoimmune diseases like systemic lupus erythematosus (also known as lupus) and multiple sclerosis (MS). Chagas disease, which is caused by a parasite spread by infected triatomine bugs (also known as kissing bugs), can cause chronic heart problems and even heart failure.

Evidence is growing that infections from herpes, pneumonia, syphilis, Lyme disease, and gum disease contribute to development of neurodegenerative diseases such as Alzheimer's. Enteroviruses are linked with the development of type 1 diabetes. More research is needed to understand these associations and then find ways to intervene.

A key link between infectious disease and chronic disease is inflammation. When we get sick or scrape a knee, our bodies mount an immune response to fight the invading infection — redness, swelling, heat, and pain are all signs of inflammation. A little bit of inflammation helps us heal. But if inflammation continues for too long or begins to attack healthy tissues, it becomes chronic and harmful. This state of chronic inflammation can trigger chronic diseases.

Long Covid is a new name for an old syndrome

Long Covid is a recent example. The virus SARS-CoV-2, which causes Covid-19, leads to short-term inflammation in many people. But 17 million adults in the U.S. Continue to experience a range of ongoing, long-term health issues, including extreme fatigue and impaired cognitive function.

Many of America's overall health issues are related to chronic conditions — which in total account for 90% of the $4.5 trillion health care expenditures — and should be studied and addressed, including infection.

While research has intensified into the complex interactions between infection and chronic disease over the past 15 years, there is much we still do not understand. How do genetics, environment, and other health conditions influence these interactions? What is the impact of aging on immunity, response to infection and chronic diseases?

One thing is for sure — we all get infections throughout our lives. It is imperative we continue investing as a nation into how infectious diseases contribute to inflammation and chronic conditions.  

We must tackle both to truly improve America's health.

Larry Schlesinger, M.D., an internationally recognized authority in infectious diseases, is a physician-scientist with more than 30 years researching lung immunology and diseases like tuberculosis. He is professor, president, and CEO of Texas Biomedical Research Institute, a nonprofit research organization in San Antonio, Texas.

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