The Brief

For the first time, internal TikTok communications have been made public that show a company unconcerned with the harms the app poses for American teenagers. This is despite its own research validating many child safety concerns.

The confidential material was part of a more than two-year investigation into TikTok by 14 attorneys general, including California, that led to state officials suing the company on Tuesday. The lawsuit alleges that TikTok was designed with the express intention of addicting young people to the app. The states argue the multi-billion-dollar company deceived the public about the risks.

In each of the separate lawsuits state regulators filed, dozens of internal communications, documents and research data were redacted — blacked-out from public view — since authorities entered into confidentiality agreements with TikTok.

But in one of the lawsuits, filed by the Kentucky Attorney General’s Office, the redactions were faulty. This was revealed when Kentucky Public Radio copied-and-pasted excerpts of the redacted material, bringing to light some 30 pages of documents that had been kept secret.

After Kentucky Public Radio published excerpts of the redacted material, a state judge sealed the entire complaint following a request from the attorney general’s office “to ensure that any settlement documents and related information, confidential commercial and trade secret information, and other protected information was not improperly disseminated,” according to an emergency motion to seal the complaint filed on Wednesday by Kentucky officials.

NPR reviewed all the portions of the suit that were redacted, which highlight TikTok executives speaking candidly about a host of dangers for children on the wildly popular video app. The material, mostly summaries of internal studies and communications, show some remedial measures — like time-management tools — would have a negligible reduction in screen time. The company went ahead and decided to release and tout the features.

Separately, under a new law, TikTok has until January to divest from its Chinese parent company, ByteDance, or face a nationwide ban. TikTok is fighting the looming crackdown. Meanwhile, the new lawsuits from state authorities have cast scrutiny on the app and its ability to counter content that harms minors. 

In a statement, TikTok spokesman Alex Haurek defended the company’s child safety record and condemned the disclosure of once-public material that has now been sealed.

"It is highly irresponsible of NPR to publish information that is under a court seal,” Haurek said. “Unfortunately, this complaint cherry-picks misleading quotes and takes outdated documents out of context to misrepresent our commitment to community safety.”

He continued: “We have robust safeguards, which include proactively removing suspected underage users, and we have voluntarily launched safety features such as default screentime limits, family pairing, and privacy by default for minors under 16.”

Kentucky AG: TikTok users can become ‘addicted’ in 35 minutes

As TikTok’s 170 million U.S. users can attest, the platform’s hyper-personalized algorithm can be so engaging it becomes difficult to close the app. TikTok determined the precise amount of viewing it takes for someone to form a habit: 260 videos. After that, according to state investigators, a user “is likely to become addicted to the platform.”

In the previously redacted portion of the suit, Kentucky authorities say: “While this may seem substantial, TikTok videos can be as short as 8 seconds and are played for viewers in rapid-fire succession, automatically,” the investigators wrote. “Thus, in under 35 minutes, an average user is likely to become addicted to the platform.”

Another internal document found that the company was aware its many features designed to keep young people on the app led to a constant and irresistible urge to keep opening the app.

TikTok’s own research states that “compulsive usage correlates with a slew of negative mental health effects like loss of analytical skills, memory formation, contextual thinking, conversational depth, empathy, and increased anxiety,” according to the suit.

In addition, the documents show that TikTok was aware that “compulsive usage also interferes with essential personal responsibilities like sufficient sleep, work/school responsibilities, and connecting with loved ones.”

TikTok: Time-limit tool aimed at ‘improving public trust,’ not limiting app use

The unredacted documents show that TikTok employees were aware that too much time spent by teens on social media can be harmful to their mental health. The consensus among academics is that they recommend one hour or less of social media usage per day.

The app lets parents place time limits on their kids’ usage that range from 40 minutes to two hours per day. TikTok created a tool that set the default time prompt at 60 minutes per day.

Internal documents show that TikTok measured the success of this tool by how it was “improving public trust in the TikTok platform via media coverage,” rather than how it reduced the time teens spent on the app.

After tests, TikTok found the tool had little impact – accounting for about a 1.5-minute drop in usage, with teens spending around 108.5 minutes per day beforehand to roughly 107 minutes with the tool. According to the attorney general’s complaint, TikTok did not revisit this issue.

One document shows one TikTok project manager saying, “Our goal is not to reduce the time spent.” In a chat message echoing that sentiment, another employee said the goal is to “contribute to DAU [daily active users] and retention” of users.

TikTok has publicized its “break” videos, which are prompts to get users to stop endlessly scrolling and take a break. Internally, however, it appears the company didn’t think the videos amounted to much. One executive said that they are “useful in a good talking point” with policymakers, but “they’re not altogether effective.”

Document: TikTok demoted people it deemed unattractive on its feed

The multi-state litigation against TikTok highlighted the company’s beauty filters, which users can overlay on videos to make themselves look thinner and younger or to have fuller lips and bigger eyes.

One popular feature, known as the Bold Glamour filter, uses artificial intelligence to rework people’s faces to resemble models with high cheekbones and strong jawlines.

Internal documents show TikTok is aware of the harm that beauty filters, like Bold Glamour, can cause young users

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TikTok is aware of the harm these beauty filters can cause young users, the documents show.

Employees suggested internally the company “provide users with educational resources about image disorders” and create a campaign “to raise awareness on issues with low self esteem (caused by the excessive filter use and other issues).”

They also suggested adding a banner or video to the filters that included “an awareness statement about filters and the importance of positive body image/mental health.”

This comes as the documents showcase another hidden facet of TikTok’s algorithm: the app prioritizes beautiful people.

One internal report that analyzed TikTok’s main video feed saw “a high volume of … not attractive subjects” were filling everyone’s app. In response, Kentucky investigators found that TikTok retooled its algorithm to amplify users the company viewed as beautiful.

“By changing the TikTok algorithm to show fewer ‘not attractive subjects’ in the For You feed, [TikTok] took active steps to promote a narrow beauty norm even though it could negatively impact their Young Users,” the Kentucky authorities wrote.

TikTok exec: algorithm could deprive kids of opportunities like ‘looking at someone in the eyes’

Publicly, TikTok has stated that one of its “most important commitments is supporting the safety and well-being of teens.”

Yet internal documents paint a very different picture, citing statements from top company executives who appear well-aware of the harmful effects of the app without taking significant steps to address it.

One unnamed TikTok executive put it in stark terms, saying the reason kids watch TikTok is because of the power of the app’s algorithm, “but I think we need to be cognizant of what it might mean for other opportunities,” said the company executive. “And when I say other opportunities, I literally mean sleep, and eating, and moving around the room, and looking at someone in the eyes.”

TikTok’s internal estimate: 95% of smartphone users under 17 use TikTok

TikTok views itself as being in an “arms race for attention,” according to a 2021 internal presentation.

And teenagers have been key to the app’s early growth in the U.S., but another presentation shown to top company officials revealed that an estimated 95% of smartphone users under 17 use TikTok at least once a month. This lead a company staffer to state that it had “hit a ceiling among young users.”

TikTok’s own research concluded that kids were the most susceptible to being sucked into the app’s infinitely flowing feed of videos. “As expected, across most engagement metrics, the younger the user, the better the performance,” according to a 2019 TikTok document.

In response to growing national concern that excessive social media use can increase the risk of depression, anxiety and body-image issues among kids, TikTok has introduced time-management tools. These include notifications informing teens about how long they are spending on the app, parental oversight features and the ability to make the app inaccessible for some down time.

At the same time, however, TikTok knew how unlikely it was these tools would be effective, according to materials obtained by Kentucky investigators.

“Minors do not have executive function to control their screen time, while young adults do,” read a TikTok internal document.

TikTok pushes users into filter bubbles like ‘painhub’ and ‘sadnotes’

TikTok is well aware of “filter bubbles.” Internal documents show the company has defined them as when a user “encounters only information and opinions that conform to and reinforce their own beliefs, caused by algorithms that personalize an individual’s online experience.”

The company knows the dangers of filter bubbles. During one internal safety presentation in 2020, employees warned the app “can serve potentially harmful content expeditiously.” TikTok conducted internal experiments with test accounts to see how quickly they descend into negative filter bubbles.

“After following several ‘painhub’ and ‘sadnotes’ accounts, it took me 20 mins to drop into ‘negative’ filter bubble,” one employee wrote. “The intensive density of negative content makes me lower down mood and increase my sadness feelings though I am in a high spirit in my recent life.”

Another employee said, “there are a lot of videos mentioning suicide,” including one asking, “If you could kill yourself without hurting anybody would you?”

In another document, TikTok’s research found that content promoting eating disorders, often called “thinspiration,” is associated with issues such as body dissatisfaction, disordered eating, low self-esteem and depression

Despite these heedings, TikTok’s algorithm still puts users into filter bubbles. One internal document states that users are “placed into ‘filter bubbles’ after 30 minutes of use in one sitting.” The company wrote that having more human moderators to label content is possible, but “requires large human efforts.”

TikTok’s content moderation missing self-harm, eating disorder content

TikTok has several layers of content moderation to weed out videos that violate its Community Guidelines. Internal documents show that the first set of eyes aren’t always a person from the company’s Trust and Safety Team.

The first round typically uses artificial intelligence to flag pornographic, violent or political content. The following rounds use human moderators, but only if the video has a certain amount of views, according to the documents. These additional rounds often fail to take into account certain types of content or age specific rules.

According to TikTok’s own studies, the unredacted filing shows that some suicide and self-harm content escaped those first rounds of human moderation. The study points to self-harm videos that had more than 75,000 views before TikTok identified and removed them.

TikTok also has scattershot policies on content that includes disordered eating, drug use, dangerous driving, gore and violence. While TikTok’s Community Guidelines prohibit much of this content, internal policy documents say the company “allows” the content. Often, the content is findable on TikTok and just not “recommended,” meaning it doesn’t show up in users’ For You feeds or took a lower priority in the algorithm.

The company has talking points around its content moderation work. One example highlighted in the documents details a child sent to the emergency room after attempting a dangerous TikTok challenge. When dealing with the negative fallout from the press, TikTok told employees to use an internal list of talking points that said, “In line with our Community Guidelines, we do not allow content that depicts, promotes, normalizes, or glorifies [dangerous] behavior, including dangerous challenges.”

TikTok acknowledges internally that it has substantial “leakage” rates of violating content that’s not removed. Those leakage rates include: 35.71% of “Normalization of Pedophilia;” 33.33% of “Minor Sexual Solicitation;” 39.13% of “Minor Physical Abuse;” 30.36% of “leading minors off platform;” 50% of “Glorification of Minor Sexual Assault;” and “100% of “Fetishizing Minors.”

TikTok slow to remove users under 13, despite company policy

Kids under 13 cannot open a standard TikTok account, but there is a “TikTok for Younger Users” service that the company says includes strict content guardrails.

It is a vulnerable group of users, since federal law dictates that social media sites like TikTok cannot collect data on children under 13 unless parents are notified about the personal information collected. And even then, social media apps must first obtain verifiable consent from a parent.

In August, the Department of Justice sued TikTok for violating the federal law protecting the data of kids under 13, alleging that the app “knowingly and repeatedly violated kids’ privacy.”

In the internal documents, however, company officials instructed TikTok moderators to use caution before removing accounts of users suspected to be under 13.

An internal document about “younger users/U13” says TikTok instructs its moderators to not take action on reports of underage users unless their account identifies them as under 13.

The previously-redacted portions of the suit suggest the company is aware these young users have accounts – through complaints from parents and teachers — but does little to remove them.

TikTok in crisis mode after report on TikTok Live being ‘strip club filled with 15-year-olds’

After a 2022 report on Forbes about underage kids stripping on TikTok’s live feature, the company launched its own investigation.

That’s when TikTok officials realized there was “a high” number of underage streamers receiving digital currency on the app in the form of a “gift” or “coin” in exchange for stripping — real money converted into a digital currency often in the form of a plush toy or a flower.

TikTok discovered “a significant” number of adults direct messaging underage TikTokkers about stripping live on the platform.

As part of this internal probe, TikTok officials found that in just one month, 1 million “gifts” were sent to kids engaged in “transactional” behavior.

In an understated assessment, one TikTok official concluded: “[O]ne of our key discoveries during this project that has turned into a major challenge with Live business is that the content that gets the highest engagement may not be the content we want on our platform.”

Copyright 2024 NPR

SAULT STE. MARIE, Mich. — The idea came to Danielle Boyer in a toy store. The inspiration? It was Tickle Me Elmo.

"Whenever you'd press his belly, he would talk, and he would teach you things," she said. "There are toys that teach us in English, but there aren't toys that teach us Anishinaabemowin. And I wanted that to be different."

Anishinaabemowin includes the Potawatomi, Odawa and Ojibwe languages. Exact estimates vary, but there are fewer than 10,000 people in the U.S. who speak Anishinaabemowin. That number is around 25,000 in Canada. Some Native languages have just a few dozen fluent speakers, while others have none.

Boyer has seen how quickly language loss can happen. Her grandmother speaks Anishinaabemowin, but she is one of the last fluent speakers of their dialect.

"It is devastating to feel like your language could be lost," said Boyer, a member of the Sault Ste. Marie Tribe of Chippewa Indians. "You lose your culture, you lose a way to describe who you are."

U.S. Indian boarding schools played a major role in the loss of Indigenous languages. Children separated from their families were taught, sometimes violently, not to speak their native tongues, and many did not pass them on to their children.

Today, some Native youth are learning their languages in schools. But Boyer said many of them still aren't invested. "They see it as another homework assignment."

Boyer and Hoy work on some last-minute adjustments to his AI-powered SkoBot before presenting at his school's end-of-year showcase, called the STEAM Museum.

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That's why she invented the SkoBot. It's a customizable toy robot designed to get Indigenous children excited to learn their languages.

"I can say 'Hey SkoBot, what is bear?' And it will say, 'Bear is makwa, makwa,' and it'll repeat it, right? So I can say, 'What is crane?' It'll say, 'Crane is ajijaak, ajijaak.'"

SkoBots use a form of artificial intelligence to speak Indigenous languages, and they're small enough to mount on the user's shoulder. They sort of resemble mini R2-D2 droids, from Star Wars, except these robots are designed to look like woodland creatures and decorated in Native American florals.

Through a nonprofit she started when she was 18, Boyer, now 25, has mentored hundreds of Native American children across the country, teaching them to build SkoBots of their own. One of them is 12-year-old Holden Hoy in Michigan's Upper Peninsula.

"I was already a big fan of robotics and how they work, how you can bring inanimate objects to life," he said. "And I'm Ojibwe, and so I've always wanted to save the Ojibwe language."

Hoy, a rising seventh-grader, showed off his design at an end-of-the-year science fair at his school, JKL Bahweting Anishinaabe School in Sault Ste. Marie. Like Boyer, he is a member of the Sault Tribe.

He programmed his SkoBot to answer three questions ahead of his presentation. One of them was, "What's your name," to which the robot would respond in Hoy's voice: "Aaniin, Hello. Sabe indizhinikaaz, Bahweting indoonjibaa. I was built by Holden Hoy. I will not gain sentience and take over the world. Or will I?"

Hoy named his SkoBot Sabe, which means Bigfoot in Anishinaabemowin. In Ojibwe culture, Bigfoot represents honesty, one of seven sacred teachings.

His classmates and their parents stopped by his booth to see Sabe in action. Boyer was there too, helping Hoy with his presentation.

"I'm very happy that people are actually coming to this booth," Hoy said. "I'm happy that they are learning things, and I'm really happy that I'm part of the Ojibwe."

Sabe has one eye, a sensor that detects movement and lets it know to start listening.

Hoy's Sabe, or Bigfoot, SkoBot on display (right), alongside three other SkoBots that Boyer brought with her to show off at the STEAM Museum. Each represents a specific animal: a wolf, turtle and bear. Hoy's SkoBot is 3D printed in light gray, and its face is adorned with a footprint surrounded by floral designs.

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"Basically, when it hears that one trigger word, it then plays a prerecorded audio file. So there isn't synthetic speech, there isn't any generative AI," said Boyer. "It's simply listening to what you're saying, identifying it and playing [audio files] that already exist."

That means the SkoBots will never make things up, often called AI hallucinations. Hoy said it's important not to use generative AI. "AI tends to falsify things a lot, not get things from trustworthy sources."

Boyer's goal isn't to replace interactions with real language speakers. Instead, it's to get kids interested in not only their languages, but in subjects like science, math and engineering as well. That includes getting them to think about how to use AI ethically.

"Artificial intelligence, especially when it's not created by Indigenous people, stands to do a lot of harm to our communities," she said. "When you are putting accurate information into these models … you're giving away sacred information to companies that don't have our best interests at heart."

And as chatbots have become more popular, Boyer said some people have turned to them to help them learn their languages. She's even seen large language models like ChatGPT invent fake words in Anishinaabemowin, which she said is dangerous. "If we're not learning our language correctly, we shouldn't learn it at all."

Jocelyn Hoy is Holden's mom. She's excited that her son is not only exposed to their culture, but he's eager to know more. She said he's even been teaching her new things.

"As someone who, at a time in my life, did not want to be identified as Native American … now as an adult, I cannot wait to learn more, and I think the SkoBots are going to help me and so many kids — so many people in general — learn their heritage and who they are."

Holden Hoy said that heritage and the language are inseparable: "The language is the culture!"

He added, "It is important to protect it, because it's some people's way of life. Generation after generation is based around this culture."

Edited by: Steve Drummond and Lauren Migaki
Visual design and development by: LA Johnson
Copyright 2026 NPR

This story first appeared on The LA Local.

Murals depicting Korean drummers, dancers and historical figures were a large part of Dave Young Kim’s childhood in Koreatown.

At the time, the Korean American artist didn’t know what all of the imagery meant, but it left a lasting impression on him.

“We don’t learn culture via formal education. It’s all gleaned,” Kim said. “It’s just what we sense, and we feel a connection to it without actually knowing anything about it. It belongs to us, and it feels very familiar.”

Many of the murals Kim remembers from his childhood have since disappeared. With his latest mural at the Korean Resource Center, Kim hopes to bring some of that visual imagery back to the neighborhood.

Completed this summer, the mural is Kim’s first in Koreatown.

The mural shows a group of traditional Korean drummers moving beneath sweeping ribbons of color, with plum blossoms blooming across the bottom of the wall. Faint outlines of traditional Korean architecture appear in the background.

At the center of the mural is 풍물놀이 (pungmulnori), a traditional Korean folk performance that combines drumming, dance and acrobatics and has long been part of village festivals and celebrations.

A close-up view of artist Dave Young Kim’s mural at the Korean Resource Center in Koreatown. The work depicts traditional Korean drummers.

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For Kim, the project was a chance to reconnect the neighborhood with the kind of cultural imagery he says shaped his own understanding of identity growing up.

“It was important to me growing up, and for me to see myself through very purposeful art, very intentional art,” he said. “For my own formation and identity, I think it was very important. I’d like to do that for future generations.”

Kim, 46, who was born and raised in Koreatown, said the project felt different from his other murals because it was rooted in the community where he spent his childhood.

“The formative years of my life are here,” he said.

The project grew out of the Abbey Mural Prize, a national grant program that supports community-based public mural projects.

As part of the project, Kim partnered with the Koreatown Storytelling Program, which trains youth to interview community elders. Students interviewed residents at Durae Crenshaw House, an affordable senior housing complex and home to the Korean Resource Center, and shared transcripts with Kim as he developed the mural.

The architecture in the mural reflects the idea of home that emerged repeatedly in interviews with elders, Kim said.

“There were a lot of iterations of the mockups. The very initial ones were very, very, very rooted in the stories, the narratives from the elders,” Kim said.

The interviews also left an impression on Daisy Yeon, 17, one of the students who conducted them. She said participating in the project changed the way she thinks about Koreatown and its history.

Yeon said she believes traditional Korean imagery still has a place in a neighborhood that has changed rapidly in recent years.

“Personally, the way Koreatown has evolved in these few last years from the pandemic and the shift where people move into other Korean enclaves like Buena Park and Torrance, Koreatown is partly becoming a place of pop-up matcha spots, for example,” she said. “So I think it’s important for tradition to still be here.”

Seeing the finished mural was “a full-circle moment,” she said, after spending months interviewing elders whose stories became part of the artwork.

While researching Koreatown’s public art history, Kim learned many of the murals he saw as a kid grew out of cultural initiatives and public funding that no longer exist. He also discovered an earlier generation of Korean American muralists whose work once covered parts of Koreatown.

In 1993, artist Dong-In Park completed a mural of traditional Korean farmers’ dance in the Korean Community Center at 981 S. Western Ave.

He told the Los Angeles Times he hoped “the 1.5- and second-generation Korean kids” would not forget their language and history. Park, along with artists including Sonia Hahn and Kuk Chol Han, helped establish a tradition of public art celebrating Korean culture during the late 1980s and early 1990s.

An undated photo of Dong-In Park’s mural depicting a farmers band playing music and dancing to provide entertainment for Korea’s largely agricultural population. The mural was previously located at 981 Western Avenue in Koreatown.

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Kim wants his mural to carry that tradition forward while also reflecting the history of the community it was created for.

The Korean Resource Center, founded by South Korean democracy activist Yoon Han-bong, has long organized around immigrant rights, workers’ rights and civic engagement. During the project, Kim learned that traditional Korean drumming has long played a role in the organization’s activism.

In the mural, an older drummer who immigrated from Korea leads the group, followed by a middle-aged performer who learned from him and younger drummers wearing sneakers, modeled after college students who continue the tradition today.

“Where we landed was very much to the core of what KRC is,” Kim said. “They are very activist and progressive.”

The Koreatown of today is filled with Korean-owned businesses and Korean-language signs, Kim said, but far fewer public murals reflecting Korean culture.

His latest mural isn’t about recreating the past so much as restoring something he believes has faded from the neighborhood.

As an artist, Kim said, public art has the power to shape how people experience a place.

“There’s something about the everyday landscape that you kind of are forced to take in,” he said, “and then as an artist, having the ability to shape what that might be.”

Lineage Logistics, the company that operates the burned cold-storage warehouse in Boyle Heights, announced yesterday it's removed “nearly half” of the food waste there.

The waste, the company said, has been sealed in deodorized containers and is being transported off-site.

Lineage estimated that demolition and cleanup of the rest of the burned structure should be largely completed in the “coming days.”

Before the weeklong fire that began on June 17, the warehouse stored approximately 44,000 tons, or 88 million pounds, of food.

The company said it has started removing the wall separating the burned and unburned sections of the building this weekend to speed up the cleaning of the unburned structure.

The process includes installing plastic sheeting where the wall used to be to help tamp down odors

That part could take up to three days and may temporarily increase odors. To mitigate the smell, the company said three carbon filters will be added on the Union Pacific side of the warehouse.

The company is trying to meet a 45-day deadline set by L.A. Mayor Karen Bass to complete the cleanup. Lineage has faced citations and warnings from L.A. County and the South Coast Air Quality Management District for "an ongoing odor nuisance" and “unsanitary and nuisance conditions.”

A slate of popular peptide therapies has won the backing of a key advisory panel to the federal government — a step that could eventually open up broader access to the experimental drugs.

In a marathon two-day meeting last week, the panel of doctors, academics and pharmacists recommended the Food and Drug Administration reclassify almost all of the compounds under consideration so that specialized pharmacies in the U.S. could begin offering them.

Seven different peptide therapies — none of which are FDA-approved drugs — were under consideration.

Currently, these peptides can't be made in the U.S., except for research purposes, leading many peptide users to buy unvetted substances sold online, with disclaimers such as "for research use only" and "not for human consumption."

By narrow margins, the panel voted in favor of all but one. The FDA isn't required to follow advisory committee recommendations but typically does.

The outcome represents a win for Health Secretary Robert F. Kennedy Jr., who has publicly supported peptide therapies, and the broader wellness and longevity industry, which stands to profit substantially.

These peptides are promoted for a wide range of uses and are often taken together, including for injury recovery, muscle growth and fat loss, improving athletic performance, enhancing metabolism and more.

If the agency takes the panel's recommendations, clinicians could have the ability to prescribe six peptide therapies: BPC-157, MOTS-c, KPV, TB-500, Epitalon and Semax.

A compound called Emideltide, sometimes used for insomnia, was the only one to receive a down vote.

The panel's endorsement of peptides was a striking rejection of the FDA's stance against them.

While the level of evidence for each compound varies, all of them lack the kind of large, well-controlled trials in humans that are necessary to establish safety and effectiveness, which is required for drug approvals. Peptides are strings of amino acids — smaller than a protein — that often act as signaling molecules in our bodies and carry out many critical functions.

They can be synthesized and delivered as drugs, often by injection. Some of those, like insulin, are naturally occurring in the body. Others are modified versions, as with the blockbuster GLP-1 obesity drugs.

Scientists for the agency spoke extensively about the lack of reliable data for any of the seven peptides before the committee. They advised the panel to vote no.

In some cases, they couldn't find any published clinical studies in humans — and there were safety concerns like the potential to encourage cancer growth or to trigger a massive immune response.

A "foundational challenge" was simply defining the substances, because the chemical composition for peptides labeled with the same name varied considerably, explained FDA official Russell Wesdyk.

"You will see many, many different forms," he said. "We can't create quality standards until we actually know what it is."

The divide among the experts on the panel was a study in contrasts.

Ahead of the meeting, eight new members were appointed. Most have ties to the peptide industry and include physicians who work for medical practices and companies that promote them.

In almost all cases, they voted in favor of lifting restrictions.

A spokesperson for the Department of Health and Human Services pushed back on criticism about potential conflicts of interest and said all underwent the standard ethics and vetting process.

"I think it's about patient access," said Dr. Asare Christian, one of the panel members who runs a Pennsylvania-based clinic that advertises peptide protocols and hormone optimization.

That sentiment was echoed throughout the many hours of public comment.

Compounding pharmacies, large telehealth providers and others from the industry underscored the perils of the unregulated marketplace, with some offering anecdotes of patients obtaining unmarked vials from sketchy suppliers.

"What we are advocating for is not the Wild West," said Brigham Buhler, who runs a telehealth company that offers hormone optimization and peptides and is an ally of Secretary Kennedy.

"What we are advocating for is to slow down or shut down the gray and black market and to allow patients to have a safe and effective manufacturing process," he told the panel.

But some panelists were skeptical of that argument.

"I'm concerned that we are responding to market-induced demand rather than a decision based in solid science," Dr. Elizabeth Rebello, an anaesthesiologist at the University of Texas MD Anderson Cancer Center, commented after casting a no vote.

The FDA committee was tasked with reviewing data that supports using these peptides to treat a variety of specific conditions, such as BPC-157 for treating ulcerative colitis, an inflammatory bowel disease.

However, if the FDA ultimately reclassifies them and they are produced by compounding pharmacies in the U.S., clinicians would have discretion to write prescriptions outside of those narrow indications.

During the meeting, industry groups — and some on the panel — repeatedly criticized the FDA presentations for not reflecting more recent scientific data on the substances, including results from other human studies that had been submitted ahead of time.

FDA staff said they had considered everything submitted by the meeting deadline and would still take new information into account as they weigh next steps.

The decision to place the products on the FDA's official list for compounding doesn't come close to the standards for drug approval, but some worry that nuance will not be clear to the public, which may not be aware of the limited data for humans.

"I think this endorsement can be potentially harmful and I cannot in good conscience vote yes," said Dr. Brian Lee, a member of the panel and an associate professor at the Keck School of Medicine of USC.

If the FDA moves to reclassify the peptides so that compounding pharmacies can make them, it will be through a formal rulemaking process that could stretch into next year or 2028. There is a possibility that Kennedy could invoke special authority to make them available sooner.

The panel is scheduled to meet again in February to consider additional peptide therapies.
Copyright 2026 NPR