
Can AI solve the loneliness epidemic? Here's what Aristotle would say
He cited statistics that the average American has fewer than 3 friends but yearns for as many as 15. He was close: According to a 2021 report from the Survey Center on American Life, about half of Americans have fewer than four close friends.
Zuckerberg then posited that AI could help bridge this gap by providing constant, personalized interactions.
'I would guess that over time we will find the vocabulary as a society to be able to articulate why that is valuable,' he added.
Loneliness and social disconnection are serious problems. But can AI really be a solution? Might relying on AI for emotional support create a false sense of connection and possibly exacerbate feelings of isolation? And while AI can simulate certain aspects of companionship, doesn't it lack the depth, empathy, and mutual understanding inherent to human friendship?
Researchers have started exploring these questions. But as a moral philosopher, I think it's worth turning to a different source: the ancient Greek philosopher Aristotle.
Though it might seem odd to consult someone who lived over 2,000 years ago on questions of modern technology, Aristotle offers enduring insights about friendships—and which ones are particularly valuable.
More important than spouses, kids, or money
In his philosophical text Nicomachean Ethics, Aristotle maintained that true friendship is essential for eudaimonia, a Greek word that is typically translated as 'flourishing' or 'well-being.'
For Aristotle, friends are not just nice to have—they're a central component of ethical living and essential for human happiness and fulfillment.
'Without friends, no one would choose to live,' he writes, 'though he had all other goods.'
A solitary existence, even one of contemplation and intellectual achievement, is less complete than a life with friends. Friendship contributes to happiness by providing emotional support and solidarity. It is through friendship that individuals can cultivate their virtues, feel a sense of security and share their accomplishments.
Empirical evidence seems to support the connection between friendship and eudaimonia. A 2023 Pew Center research report found that 61% of adults in the U.S. say having close friends is essential to living a fulfilling life—a higher proportion than those who cited marriage, children or money. A British study of 6,500 adults found that those who had regular interactions with a wide circle of friends were more likely to have better mental health and be happier.
And a meta-analysis of nearly 150 studies found that a lack of close friends can increase the risk of death as much as smoking, drinking, or obesity.
Different friends for different needs
But the benefit of friendship that Aristotle focuses on the most is the role that it plays in the development of virtue.
In Nicomachean Ethics, Aristotle identifies three tiers of friendship.
The first tier is what he calls 'friendships of utility,' or a friendship that is based on mutual benefit. Each party is primarily concerned with what they can gain from the other. These might be colleagues at work or neighbors who look after each other's pets when one of them is on vacation. The problem with these friendships is that they are often fleeting and dissolve once one person stops benefiting from the relationship.
The second is 'friendships of pleasure,' which are friendships based on shared interests. These friendships can also be transient, depending on how long the shared interests last. Passionate love affairs, people belonging to the same book club, and fishing buddies all fall into this category. This type of friendship is important, since you tend to enjoy your passions more when you can share them with another person. But this is still not the highest form of friendship.
According to Aristotle, the third and strongest form of friendship is a 'virtuous friendship.' This is based on mutual respect for each other's virtues and character.
Two people with this form of friendship value each other for who they truly are and share a deep commitment to the well-being and moral development of one another. These friendships are stable and enduring. In a virtuous friendship, each individual helps the other become better versions of themselves through encouragement, moral guidance, and support.
As Aristotle writes: 'Perfect friendship is the friendship of men who are good and alike in virtue. . . . Now those who wish well to their friends for their sake are most truly friends; for they do this by reason of their own nature and not incidentally; therefore their friendship lasts as long as they are good—and goodness is an enduring thing.'
In other words, friendships rooted in virtue not only bring happiness and fulfillment but also facilitate personal growth and moral development. And it happens naturally within the context of the relationship.
According to Aristotle, a virtuous friend provides a mirror in which one can reflect upon their own actions, thoughts, and decisions. When one friend demonstrates honesty, generosity, or compassion, the other can learn from these actions and be inspired to cultivate these virtues in themselves.
No nourishment for the soul
So, what does this mean for AI friends?
By Aristotle's standards, AI chatbots—however sophisticated—cannot be true friends.
They may be able to provide information that helps you at work, or engage in lighthearted conversation about your various interests. But they fundamentally lack qualities that define a virtuous friendship.
AI is incapable of mutual concern or genuine reciprocity. While it can be programmed to simulate empathy or encouragement, it does not truly care about the individual—nor does it ask anything of its human users.
Moreover, AI cannot engage in the shared pursuit of the good life. Aristotle's notion of friendship involves a shared journey on the path to eudaimonia, during which each person helps another live wisely and well. This requires the kind of moral development that only human beings, who face real ethical challenges and make real decisions, can undergo.
I think it is best to think of AI as a tool. Just like having a good shovel or rake can improve your quality of life, having the rake and the shovel do not mean you no longer need any friends—nor do they replace the friends whose shovels and rakes you used to borrow.
While AI may offer companionship in a limited and functional sense, it cannot meet the Aristotelian criteria for virtuous friendship. It may fill a temporary social void, but it cannot nourish the soul.
If anything, the rise of AI companions should serve as a reminder of the urgent need to foster real friendships in an increasingly disconnected world.
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OZ: Costs are going up, but there's been a 50 percent increase in the cost of Medicaid over the last five years. So I'm trying to save this beautiful program, this noble effort, to help folks giving them a hand up. And as you probably gather, if Medicaid isn't able to take care of the people for whom it was designed, the young children, the dawn of their life, those are the twilight of their life, the seniors and those who are disabled living in the shadows, as Hubert Humphrey said, then we're not satisfying the fundamental obligation of a moral government. And this President has said over and over that he believes that it is the wise thing and the noble thing to help those who are vulnerable and every great society does that, we're going to as well. So we're going to invest in Medicaid as is required, but we want an appropriate return on that investment. One thing that Medicaid patients should not face are drug prices they can't afford. MARGARET BRENNAN: Right, how do you enforce this? Pharmaceutical companies— DR. OZ: Well, the pharmaceutical companies, if you sit them down quietly, Margaret, and we've done that, and say you went into this business at some point, because you cared about people. I know there's many out there shaking their heads, but that is actually the truth. People go into health care, whether they're pharmaceutical companies or insurance companies or the PBMs or anybody in the space. Even at the CMS, the most impressive thing to me in my new task, and the President has appointed me to, is the remarkable quality of people within the organization, just unbelievably talented. They went into this job because they care about health care and about people. Somewhere along the lines, people forget. They put numbers ahead of patients. And when that happens, then you start running into problems. We went to the pharmaceutical companies and we said, you appreciate this is not a fair system. We should not be paying more in America, three times more, for your products than you charge in Europe. They get the joke. They understand the reality of this problem. They are engaging with us. We're in the middle of those negotiations. The President has a unique power to convene. We've done it with dealing with prior authorization, this heinous process where patients feel like they're trying to get care from a doctor. Everything's being done except all of a sudden the arm of insurance comes in and stops the whole process for unknown reasons for weeks, sometimes months. The insurance companies, representing 80 percent of the American public, got together and they said, because we pushed them, we're going to deal with this. We can do the same, I believe, with the pharmaceutical industry, with most favored nation pricing. MARGARET BRENNAN: Let me ask you about the changes that are coming because of this new law to Medicaid, which is jointly administered between the feds and the states. There are major reduction- reductions to federal health care spending here, one of the changes are these work requirements. It's about 20 hours a week, volunteer or work to qualify for health care. What is the guidance you are giving to states on how to implement this? Because in this economy, things are more complicated. Uber driver, independent contractor, how do they show they work their 20 hours a week? DR. OZ: Last weekend, I was at the National Governors Association with Secretary Kennedy, who has been a big advocate of work as well. Every Democratic president and Republican president has said that the foundation of a healthy welfare system of a social system of support is work. MARGARET BRENNAN: Right, but I'm asking how you actually implement that and register it so that people who are working do qualify, and they don't get caught up in paperwork because they didn't file something on time. DR. OZ: As long as we're okay that people should work and would want to work, and it's not just work, it's community engagement. They can go get educated, right? They can take care of family members. They can contribute in other ways, but work is a great way of doing and get you out of poverty if you can find jobs and elevate yourself. There have been efforts to do this in the past, but they haven't been able to achieve what we can achieve, because we have technologies now. And we've invested already, as soon as the bill was signed, began pilots to try to demonstrate that we can actually do this correctly. We have pilots now in Louisiana and in Arizona, in both cases, within seven minutes, you can click on where you're working. You mentioned Uber, you're an Uber driver. You click that button on your phone. It just takes you to your payroll provider. Let's say it's ADP. We then ask your permission, can we connect with this payroll provider to demonstrate what you've actually been able to work and earn over the past month? This also, by the way, confirms your eligibility. But there's a bigger benefit here. Once you do that, you're in, you're done. However, what if we take one step further, Margaret? What if we go beyond just proving that you tried the work to actually say, You know what, you didn't work enough, but we can actually help you by connecting you through an employment office? MARGARET BRENNAN: So you're still figuring out the technology, but isn't there an end-of-December deadline for a lot of these things to be figured out? And how do you make sure that people don't get kicked off? Because in the state of Georgia, which already had work requirements, they have really struggled to make this work. DR. OZ: Well, a couple of things. It's not the end of December, it's end of December a year from now, and Georgia is apples and oranges. Georgia had a program only for people under the poverty level, and for those people, if they wanted, they could elect to come into a system to help them get jobs. There have been 50,000 reduction in head count of uninsured people in the overall program in the last five years. Overall, Georgia, 2 million less uninsured people. So Georgia is using a lot of tactics, and they're going in the right direction. I would argue that if you have confidence in the American people and their desire to take to offer to try to get a job, if we challenge you to that. And remember, if you're an able-bodied person on Medicaid, you're spending 6.1 hours watching television or leisure time, so you don't want that— MARGARET BRENNAN: —Well, KFF Health Policy found 92 percent of adult Medicaid recipients already are working. Or they have the carve out because they have to have caregivers, or they have to do other things. DR. OZ: They're fine. All they have to do is there'll be a simple app. If you've already carved out, that's super simple. If you're supposed to be if you're able-bodied and supposed to be working, we want to help connect you to the job market and get you into work. We have twice as many jobs available in America as people who seem to want them. The foundation of work is not just about fulfilling eligibility. The goal of health care insurance is to catalyze action in the right direction, to get you healthier, to give you agency over your future, so you recognize you matter, and you should have a job, therefore to go out and change the world. MARGARET BRENNAN: So there's a drug addiction problem in this country. How are those changes going to impact people who are on Medicaid in states like Kentucky, in states like West Virginia? DR. OZ: In many instances, there are carve outs for folks who have substance use disorder problems. There are programs-- MARGARET BRENNAN: —How do they prove that? ADMINISTRATOR OZ: Well, they can— MARGARET BRENNAN: Is this in the app? DR. OZ: Yes, it will be in the app. The app, again, this is being developed by the United States Digital Service, led by Amy Gleason, who is a wonderful technologist. She and I were with the President and Secretary Kennedy and the head of the czar for AI in this country on Wednesday, talking about overall how we're going to change the use of health technology in America. We've got to get into 2025 with health technology, as is true in every other sector. If you're watching the show right now, you could also be streaming media. You could take an Uber somewhere, the rideshare. You could do an Airbnb. Technology should make the system more efficient. We should have confidence that it will also allow us to do what we all agree is possible. If the whole challenge to a work requirement is that you don't have confidence in our ability to accomplish it, that's a separate question, because I do have confidence in the American people, and we have confidence we can pull this off. Look at the passport system, Margaret. Right now, you can go and get a passport in two weeks without having to go to the post office, send pictures, and all that's gone. It's fixable. Let's use technology. MARGARET BRENNAN: I'm still confused on how someone who is in the throes of substance abuse is going to use an app to say, I'm in the throes of substance abuse every week, to file on online— DR. OZ: —When they go in to get their help for their substance abuse treatment, assuming they're going for help on that, they can also get enrolled in, in those requirements, can be fulfilled. We want to talk to them in as many ways as possible. It's not going to happen just because we put an app out there, you, you have social workers and other folk elements who care a lot about this population, who are coming together, but they have to have some mechanism to report back. That just has not been done well. MARGARET BRENNAN: Well, and this is incredibly detailed, and that's why we wanted to have you on. I have so many more questions for you on rural hospitals and some of the other criticisms. I have to leave it there for now. But thank you, Dr. Oz-- DR. OZ: Can I give you 30 seconds on rural hospitals, because this is important. You have 7 percent of Medicaid money going to rural hospitals. We're putting 50 billion dollars the president wants us to, Congress wants to— MARGARET BRENNAN: There are a lot questions on how you're going to duel that out, and whether you have already made promises. Do you have any specifics for us? DR. OZ: Yes. Wait, wait, it's going to be, they'll get the applications in early September. The money is designed to help you with workforce development, right sizing the system and using technology to provide things like telehealth that can change the world. Imagine if we can change the way we think about the delivery of health and make it more about getting people healthy so they can thrive and flourish and be fully present in their own lives and as Americans. MARGARET BRENNAN: Dr Oz, we'll leave it there. We'll be back in a moment.