Every January, Americans reflect on the year behind them and draft a familiar list of resolutions. Eat better. Lose weight. Exercise more. Reduce stress. These intentions recur not because people lack discipline, but because the underlying health conditions driving them persist.

Despite unprecedented medical spending and pharmaceutical access, the United States remains chronically unhealthy. According to the Centers for Disease Control and Prevention, more than 76 percent of US adults live with at least one chronic condition, and over 51 percent live with two or more. The most prevalent conditions are well documented. Heart disease remains the leading cause of death, accounting for 680,981 deaths in 2023, while obesity affects more than 40 percent of US adults. Diabetes impacts 38.4 million Americans, and nearly half of adults have hypertension, a major contributor to stroke, kidney failure, and heart disease.

Treatment typically begins once disease is clinically apparent, and often relies on pharmaceuticals. Over time, this approach can lead to polypharmacy, the use of five or more medications. Patients with chronic illness frequently average two to four comorbidities, each managed independently, increasing the likelihood that side effects from one medication require another.

Something has gone wrong with our health. Each generation appears sicker than the one before, despite spending more on medicine than any society in history. At the same time, trust in once-authoritative sources of health guidance has eroded as pharmaceutical advertising increasingly blurs the line between reporting and recommendation. This piece examines how lifestyle, food, and institutional incentives reshaped our understanding of health—and why reclaiming it may require more courage than another prescription.

“What I think is really special about that place is that doing hard things is a way that we can become proud of ourselves,” said nursing student Vince Minutello, who has started exercising at the gym in Salt Lake City as a requirement for one of his courses.

Throughout most of my life, I used food to cope with chaos, depression, and pain I did not yet understand. By my early twenties, I weighed over 320 pounds and felt trapped in a body that limited every part of my life. This is the story of how learning about food, mental health, and habit-building helped me lose 120 pounds and rebuild stability.