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.

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.