President Donald Trump is set to undergo his first physical examination of his second term on Friday at the Walter Reed National Military Medical Center, reigniting a national conversation about presidential health, transparency, and age in leadership.

Trump, who at 78 is the oldest sitting U.S. president to begin a second term, announced the check-up in his signature nonchalant style on social media, stating, “I have never felt better, but nevertheless, these things must be done!”

Despite concerns about age dominating the 2024 presidential race, Trump has consistently been guarded about his health disclosures—even while he openly criticized his then-rival Joe Biden, labeling him “Sleepy Joe.” Both men made history as the oldest major-party candidates in a U.S. election. Biden eventually exited the race amid mounting concerns over his cognitive health, leaving Trump without a peer in the age-related political spotlight.

Questionable records and glowing claims

Trump’s approach to medical transparency has long been a subject of controversy. In 2015, during his first presidential campaign, his physician, Harold Bornstein, famously declared Trump’s lab results “astonishingly excellent” and predicted he would be the “healthiest individual ever elected to the presidency.” Bornstein later admitted that Trump had dictated the letter himself, according to NPR.

When Trump underwent his first White House physical in 2018, then-physician Dr. Ronny Jackson painted a glowing picture of the president’s health, praising his “great genes” and claiming he had scored a perfect 30 out of 30 on a cognitive exam.

“I told the president that if he had had a healthier diet over the last 20 years, he might live to be 200 years old,” Jackson famously said at the time.

Yet, the authenticity of such assessments continues to be debated, especially as the Trump administration has shown a pattern of releasing brief, data-less letters from doctors that offer sweeping but unsubstantiated claims about the president’s cognitive and physical fitness. In 2023, ahead of his re-election bid, Trump released another vague note, stating only that his “cognitive exams were exceptional.”

Golf, Diet Cokes, and a COVID scare

Trump’s lifestyle also adds complexity to the narrative surrounding his health. While he is known to be an avid golfer, he has not been observed engaging in other forms of regular exercise. His fondness for fast food—particularly McDonald’s—and Diet Coke is well-documented. In October 2020, Trump contracted COVID-19 and was briefly hospitalized at Walter Reed, raising further questions about the long-term effects of the virus on his health.

His current physician, Navy Capt. Sean Barbabella is expected to oversee Friday’s exam. While presidents are not legally required to disclose the results of their physicals, it has become a tradition in modern administrations to release some form of report to reassure the public.

A long history of secrecy in presidential health

Presidential health has historically been a closely guarded secret. John F. Kennedy publicly denied having Addison’s disease, despite clear evidence to the contrary. After Woodrow Wilson suffered a debilitating stroke, his wife and doctor covered up the extent of his incapacity, effectively allowing his wife to assume many presidential duties without public acknowledgment.

“They covered up for him for several months, and they were not truthful with the American people,” said Jeff Kuhlman, a physician who served under Presidents Clinton, Bush, and Obama.

In more recent years, Biden’s doctors opted not to conduct a cognitive exam during his term, prompting criticism from some quarters but defended by the White House as a reasonable medical judgment.

Will Trump’s full health picture be revealed?

Despite past promises of transparency, there remains widespread skepticism about whether Americans will receive a full and honest account of Trump’s health following this latest examination.

“The medical records are private. Presidents do not have to reveal their medical records,” said S. Jay Olshansky, a public health professor at the University of Illinois Chicago, in an interview with NPR.

And while there’s no current challenge to Trump’s mental sharpness—especially in light of the economic chaos stemming from his aggressive tariff policies—the larger issue remains: how much will the American public actually be told?

As Trump prepares for his Friday physical, one thing is certain—the results, whether released in full or not, will be dissected not just for their medical implications but for what they reveal about the future of presidential transparency.