Menopause is the one stage of a woman's life when the standard advice does the most damage, because every instruction is aimed at a body she no longer has. Her oestrogen falls and takes her carbohydrate tolerance with it. She is told to eat more wholegrains. The advice makes it worse. Her muscle starts going, a few hundred grams a year. She is told to cut the red meat and do more cardio. The advice makes it worse. Her cortisol climbs and parks the fat on her middle. She is told to count calories and walk it off, which raises it further. The advice makes it worse. Her cholesterol rises, because the body is trying to make hormones out of it. She is offered a statin. The advice makes it worse. Her sleep breaks into pieces. She is told to try camomile and go easy on the cheese. The advice makes it worse. Her head fogs and her mood drops. She is offered an antidepressant in the same ten minutes. The advice makes it worse. Her joints ache. She is told it is her weight, and handed the diet that put it there. The advice makes it worse. Then the numbers get worse, and that is called ageing. Every one of those symptoms is the same body asking for the same three things: protein to hold the muscle, fat and cholesterol to build the hormones, and an end to the sugar spikes it can no longer absorb. That is a plate of beef, eggs and butter. It has been that plate for two million years. The women who switch in their late forties say the same thing in the same order. The weight goes without a fight. The sleep comes back. The fog lifts. The joints go quiet. The flushes ease. They gave her a statin for the cholesterol her body was trying to turn into oestrogen. Then they told her to eat less of the only food that could have replaced it.

Nobody in America got sicker on the morning of 4 June 1998. Twenty-nine million of them went to bed a healthy weight and woke up overweight, because the NIH had moved the BMI line from 27.8 to 25 overnight. That is the whole business model. Here is the headcount. 1994: a WHO panel invents osteopenia. Bone thinner than a young woman's, nowhere near thin enough to break. Half of all postmenopausal women qualify on the spot. 1998: the overweight threshold drops to 25. Twenty-nine million new patients. Not one of them gained a pound. 2001: the cholesterol panel publishes ATP III. Americans recommended a statin go from 13 million to 36 million. Twenty-three million new customers in one afternoon. 2003: the blood pressure committee invents prehypertension. A diagnosis for people whose blood pressure is normal. Forty-five million qualify on day one. 2013: the statin guideline is rewritten. Another 12.8 million eligible, almost all over sixty, none with heart disease. Eight of the nine men who wrote it were on the payroll of statin manufacturers, disclosed only when they were forced to. 2017: hypertension moves from 140 over 90 to 130 over 80. The share of American adults labelled hypertensive jumps from 32 per cent to 46. Thirty-one million people, before lunch. 2026: the new cholesterol guideline lands in March. Another 21.5 million eligible, total now 87.5 million. The people it just added carry an average ten-year risk of 3.1 per cent. Which is to say, almost none. Not one of those was a discovery about the human body. Every one was a decision about where to draw a line on a chart, taken in a room, by a show of hands. And note the direction. Thirty years, four organ systems, and the line has never once moved back. No panel has ever sat down, reviewed the last panel's work, and handed several million people their health back. Over 140 million reclassifications in a single country. A woman of sixty-eight can sit on four of those lines at once and be four kinds of ill without a single symptom, on five tablets, for a body that is doing exactly what a sixty-eight-year-old body does. A cure is capped by the number of people who have the disease. A threshold is capped by the population.