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'Age management' is a controversial new medical focus

Story Highlights

• Age management a fast-growing, controversial trend in American medicine
• American Medical Association does not recognize the field as a specialty
• U.S. anti-aging products market worth $45.5 billion annually and growing
By Caleb Hellerman
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Visit to read more on dietary supplements and human growth hormone.

ATLANTA, Georgia (CNN) -- Clothia Roussell draws inspiration from the prophets. "I've read in the Bible how we're supposed to live to see 120, and those prophets lived to be 400 or 500 years old," said the 49-year-old homemaker.

"My husband and I, we're both looking forward to living a long, healthy life," she said. Last fall, Roussell and her husband Michael, 47, who owns a commercial construction business in Fayetteville, Georgia, began seeing Dr. Ana Casas, who calls herself a specialist in "age management." It's one of the fastest-growing trends in American medicine.

The American Academy of Anti-Aging Medicine (A4M), which was founded in 1993 to support research on extending life and treating age-related disease, claims 19,000 members in 90 countries. Membership has nearly doubled in the past five years. The Business Communications Company Research firm says the U.S. market for anti-aging products is worth $45.5 billion and growing nearly 10 percent a year.

On its Web site, A4M refers to "the arcane, outmoded stance that aging is natural and inevitable" and says "the disablities associated with normal aging are caused by physiological dysfunction." That attitude is controversial.

The American Medical Association does not consider anti-aging an official specialty. Unlike Casas, who is board-certified in internal medicine and was an assistant professor at Dartmouth Medical School, many anti-aging practitioners are not certified in traditional fields. Robert Goldman and Ronald Klatz, the co-founders of A4M, are osteopathic physicians who in 2000 were ordered by the state of Illinois to stop identifying themselves as MDs. Last July, they did receive licenses to practice as MDs, although a spokesman for the state licensing authority said they are not allowed to write prescriptions.

Some observers say the whole field is an expensive hoax. "There is no such thing as anti-aging medicine," huffs Jay Olshansky, a sociologist at the University of Illinois who studies medicine and longevity. "As long as humans have existed, we have always desired to live longer. Every society, every religion, every culture. Of course, they all failed at dramatic life extension." Olshansky was slapped with a $120 million dollar defamation lawsuit by A4M after he accused the organization of promoting quackery. He countersued and both sides eventually agreed to drop their cases.

After meeting Dr. Casas, the Roussells started taking more than three dozen dietary supplements and began a serious diet based mostly on "good" carbohydrates and small helpings of fish, nuts, fruits and legumes. They also received an "exercise prescription" from Casas' business partner Lee Haney, an eight-time Mr. Olympia.

Casas' patients don't waste time in waiting rooms. She not only shares her cell phone number with them, but sits down every afternoon to answer e-mails. A medical technician makes house calls every three months to collect blood samples. The personalized attention isn't cheap. An initial consultation costs $2,250 and patients pay $995 every six months for unlimited consultations. Add anywhere from $200 to $500 a month for blood work and supplements, and it gets pricey. Most costs are not covered by insurance.

Another patient is John Smith, a blunt-talking former Marine. Smith says he considers most doctors to be "quacks," but praises Casas' boundless willingness to answer questions. "Our first meeting was scheduled for three hours, and we ended up talking for four and a half hours," says Smith, 64. "So many doctors are so rushed that you don't get any feeling of getting real attention. They throw you a pill, and run."

Casas herself is a refugee from what she disparagingly calls insurance-based medicine. "Your typical internist may have 4,000 patients. I've decided to limit myself to 400," she says. "Before, I would see a patient for maybe 10 minutes at a time. Now, I usually know as much about them as they know about themselves."

It's true that some anti-aging therapies fly in the face of traditional advice. Some doctors talk of measuring a physiological age -- as opposed to a chronological age -- even though the concept is dubious. "The only way I can tell your age is by looking at your birth certificate," says Dr. Nir Barzilai, director of the Institute of Aging at Albert Einstein Medical School in the Bronx. "There is no test I can give you which will tell me, with any precision, exactly how old you are." Besides that, many patients take dozens of supplements, even though published studies have found few benefits. And then there's the aggressive use of hormone therapy. Many anti-aging doctors use a liberal definition of "hormone deficiency" in order to prescribe human growth hormone, which mainstream physicians say should generally be reserved for children with growth problems.

Dr. Casas, who says she prescribes growth hormone for only a handful of patients, says the focus should be on more mainstream aspects of the practice. "Age management is preventive medicine," says Casas. "You want to live as long as you can, with the highest quality of life possible."

Clothia Roussell said the effects of the program were apparent right away. "It was not subtle. My son came to visit and said, 'wow, Mom, you're getting younger.' "We'll be seeing Dr. Casas for the next 75 years," she added with a gleaming smile. Why settle for less? A growing number of patients, at least those who can afford it, can't think of any reason not to.

Caleb Hellerman is a senior producer with CNN Medical News.

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Michael Rousell, 47, and his wife, Clothia Roussell, 49, see an age-management specialist, take supplements, watch their diet and exercise.


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