“This notion of ‘we’re getting old; it’s bound to happen’ doesn’t make any sense to me,” Bellizzi says. “I don’t think I’m so far out on the edge here that I’m gambling with my life. What I do know is I feel better.”

Image John Bellizi injects himself with with a hormone to forestall the aging process. Credit... Henry Leutwyler for The New York Times

It may be tempting to dismiss Bellizzi as a soccer fanatic afraid to age gracefully or to accuse Comite of squandering her talent by catering to affluent, youth-clinging patients. Nonetheless, their medical partnership could have broad, perhaps profound, implications. At root, this is a tale of empowerment, of humankind’s primordial urge to exert control over the aging process. That raises intriguing questions. What constitutes responsible cutting-edge science as opposed to a reckless pushing of the envelope? Where is the line separating a vanity fix from a genuine quality-of-life improvement? Imagine that a miracle drug is discovered that guarantees vigor far beyond retirement age, but shortens your life by, say, four years. Is it worth the trade-off?

The human body is a symphonic masterpiece of flesh and blood, but it wears out like any clanking machine on the factory floor. The ruthless tick, tick, tick of time strips gears, nibbles at bushings. On a submicroscopic level, damage is done by free radicals, unstable atoms that have a toxic effect on cell membranes and DNA. In addition, telomeres, the protective tips on chromosomes, fray from the stress of continual regeneration, much as serial photocopies of an image lose their crispness.

Some antiaging proponents make seductive promises about prolonging longevity. Comite steers clear of that camp. Her interest lies in extending the length of “health span,” as opposed to life span. Does the body have to slide inexorably downhill after 40? She says she is convinced that metabolism modulation can help stave off stroke, heart disease and diabetes; can flatten the trajectory of corporeal decline. Ideally, age-management-medicine patients will keep humming along nicely, then crash like a spent computer. As Comite puts it, “Can we maintain optimal health until one day when we just don’t wake up?”

Tantalizing though it is, Comite’s question is just philosophical conjecture. But the first hint that such a situation might be achievable came in a study that appeared in the July 5, 1990, issue of The New England Journal of Medicine. Dr. Daniel Rudman wanted to test the prevailing notion that older people lose muscle and gain fat because they produce less growth hormone. Twelve men, ages 61 to 81, were given small doses of synthetic human-growth hormone three times a week. After six months they showed a 9 percent increase in lean-muscle mass, a 14 percent decline in fat and a modest improvement in bone density. “The overall deterioration of the body that comes with growing old is not inevitable,” Rudman declared. “We now realize some aspects of it can be prevented or reversed.”

Rudman, who has since died, reportedly came to regret his choice of words and the fact that so many overlooked that this was a small test-group participating in a short-term study; it was not an experiment he intended to be conclusive. Still, a kind of growth-hormone and anabolic-steroid gold rush ensued — witness the fact that today you can buy hormones from China online and consult how-to books like “The Secrets of Mail Order Steroid Success.”

Within two years of Rudman’s study, the American Academy of Anti-Aging Medicine was established. It unabashedly presses the case for growth hormones, but there’s room in the tent for low-level light therapy, whole-body vibration machines and assorted New Age nostrums. The organization boasts of being “the first scientific nonprofit medical society to forecast the deliverance of human life spans in excess of 100 years.” A Chicago-area doctor and amateur bodybuilder named Alan Mintz also took keen interest in Rudman’s experiment. Mintz was soon augmenting his gym workouts with testosterone and growth hormone. He and his exercise partner, John Adams, owned a radiology-diagnostics company. They sold the business in 1994, pocketing millions. Rather than retire and work full time on their pecs, they started Cenegenics Medical Institute, a boutique age-management center, and relocated to Las Vegas.