The annual physical for the US president is often a humdrum affair to reassure Americans about the health of their commander-in-chief. But those occasions have rarely been routine with Donald Trump.

Trump on Friday undergoes his first check-up since retaking office, with a visit to Walter Reed National Military Medical Center — an event that puts the spotlight on the well-being of a 78-year-old president long reluctant about sharing details on his health.

The focus on presidential fitness intensified during the 2024 election, which initially pitted Trump against former President Joe Biden, the two oldest major-party candidates in US history. Mental acuity concerns amplified by a rocky debate performance eventually prompted Biden to drop out.

Trump seized on voter anxiety over his predecessor’s sharpness and vigor while the Republican’s team shared little about his own health, even after he survived an assassin’s bullet that grazed his ear.

Trump in January became the oldest president ever sworn into office — a record he previously held during his first term that Biden then took upon his inauguration in 2021.

The president is a fervent golfer, but he is not known to engage regularly in other forms of exercise. He is also a famed consumer of fast food, in particular McDonald’s and Diet Cokes. His health secretary, Robert F. Kennedy, Jr., is undertaking a massive overhaul of public health that has taken aim at soda, candy and ultraprocessed foods.

Trump’s had health scares in the past, including a coronavirus infection in Oct. 2020 that saw him flown to Walter Reed aboard Marine One for a hospital stay. He has embarked on a second stint in a notoriously stressful job, in which past officeholders often visibly age at the White House.

Friday’s visit caps a whirlwind week that saw Trump impose higher tariffs on select countries, delivering on one of his signature economic policy pledges, only to dramatically reverse course hours later following turmoil in equity and bond markets.

‘Never Felt Better’

While presidents are not required to undergo physical health exams or release the results publicly, it’s been standard practice for decades with the results published by the White House physician. Navy Capt. Sean Barbabella is serving as Trump’s personal doctor.

The president cast the exam in a social media post this week as routine and unnecessary, writing: “I have never felt better, but nevertheless, these things must be done!”

Trump stirred controversy with past physicals, dating back to his first campaign. In Dec. 2015, Trump released a note from then-personal doctor Harold Bornstein claiming he would be the “healthiest individual ever elected to the presidency.” Bornstein, who has since died, later said Trump dictated the letter.

The American public was able to glean more details about Trump’s health when he was in office. While then-physician Ronny Jackson gave Trump glowing reviews, exams revealed he had a common form of heart disease and was obese according to Centers for Disease Control and Prevention guidelines.

Jackson, now a House Republican from Texas, later became enmeshed in his own scandal over allegations he improperly dispensed prescription drugs and created a hostile work environment while White House physician — claims he denied. The allegations sunk Jackson’s nomination by Trump in 2018 to lead the Veterans Affairs Department.

During his last term, Trump waited more than a year after his inauguration for his first check-up. Another visit to Walter Reed in Nov. 2019, just months after a previous checkup, spurred speculation the president was unwell, though the White House cast it as a routine exam.

In 2020, then-White House physician Sean Conley reported no significant changes to the president’s health in a report that used “summarized data” from visits conducted between the Nov. 2019 visit and April 2020. There was no explanation for why Trump’s physical took six months to complete.

Cognitive Tests

Early in the first term, Trump’s critics questioned his fitness for office, particularly after a book by author Michael Wolff claimed that top staff believed he was mentally unwell.

Trump has touted his performance in cognitive tests, with Jackson saying in 2018 that he conducted such an exam at the president’s request and found “absolutely no concerns about his cognitive ability and neurological function.”

In 2020, Trump said he had undergone a cognitive test a year earlier and in an interview hailed his own performance by proclaiming “person, woman, man, camera, TV,” to explain how he repeated certain words to demonstrate his memory. The moment went viral.

Questions about how much health information those seeking the nation’s highest office should disclose became a flash point in the 2024 race.

Former South Carolina Governor Nikki Haley, who challenged Trump unsuccessfully for the GOP nomination, attacked both him and Biden by calling for mental competency tests for politicians older than 75.

Polls showed voters regularly worried about the fitness of Biden — at 82, the oldest person ever to hold the presidency. A series of recent news reports and books have detailed how those around him witnessed his decline in office.

The dynamic over age shifted after Vice President Kamala Harris, 60, entered the race. Her team often highlighted Trump’s propensity for verbal gaffes to question his fitness to serve.

Trump in 2023 released a letter from a personal physician that claimed he was in “excellent” physical and mental health, without providing any supporting data.