What Would the 'Exercise Pill' Mean?

The idea plays to our love of efficiency, spirit of entrepreneurship, and longing to install physicians and scientists as the new priests of the age.
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What if we could enjoy the benefits of exercise simply by swallowing a pill? Earlier this week in the journal Nature Medicine researchers at the Scripps Institute in Florida suggested that we are closer than ever to attaining this goal. They found that mice injected with a protein called REV-ERB underwent physiological changes usually associated with exercise, including increased metabolic rates and weight loss. Even obese, inactive mice experienced these changes.

The implications of this line of research could be huge. According to the U.S. Census Bureau's American Time Use Survey, Americans are exercising far more than we did 40 years ago - in fact, almost three times more. The average American now spends about two hours per week exercising -- or at least that's what we tell surveyors. Yet this is still only half the four hours per week recommended by many experts. And of course, we remain the second most obese nation in the world.

The exercise pill would help on multiple fronts. First, just think what we could do with an extra two hours per week. We would finally have the time to sit down and phone an old friend, take another shot at those scrapbooks, or get that bathroom repainted. Time really is money, and getting those two hours back would count for a lot.

Moreover, we would not need to shoulder the burden of guilt that many of us experience due to insufficient exercise levels. No longer would we feel compelled to avoid looking in the mirror in the morning or avert our eyes as we drive past a health club teeming with fit and trim exercise enthusiasts. Such guilt cannot be good for us, likely elevating the levels of stress hormones in our bloodstreams and undermining the self-confidence we depend on in so many other spheres of life.

Of course, we would recoup even more time than the two hours we actually spend on exercising. Think how many minutes we spend every week just talking ourselves into it, getting dressed for it, and driving to it. And what about all the after-exercise time - driving back home, showering, getting dressed again, and then sitting in the easy chair contemplating how tired and sore we feel or congratulating ourselves on what good care we take of ourselves.

This is especially true for schools. Despite No Child Left Behind and other federal legislation that sought to focus school curricula on reading, writing, and arithmetic, school children all over the country are still spending precious hours exercising during recess and gym, instead of hunkered down over their textbooks augmenting their vocabularies. Thanks to the exercise pill, our children will be able to devote all their time and attention to the part of the body that matters most, above the shoulders.

And what of the millions of exercise-related injuries that occur each year in the U.S.? According to the Centers for Disease Control, over 700,000 children are injured each year during exercise at school, while over 1.5 million Americans visit emergency departments for injuries suffered playing sports such as basketball, baseball, and football. Far fewer people choke on pills.

Of course, not everyone would see the exercise pill as good news. Consider the vast fitness industry. Health clubs alone generate nearly $25 billion per year in annual U.S. revenues. Likewise, companies that manufacture exercise equipment and apparel would also suffer. Nike alone, which generates another $25 billion in annual revenue, would need to develop new product lines beyond physical fitness and sports.

And even where such industries survived, they might be compelled to do a good bit of retooling. Over the past few decades, many clothing manufacturers have allowed their sizing criteria to expand with the US waistline, so that what was once an extra-large is now a large, and what was once a large is now a medium. With what would undoubtedly be widespread and immediate adoption of the exercise pill, the market for larger sizes would likely evaporate virtually overnight.

There might be additional collateral damage. For example, would the dramatic decline in personal engagement in exercise cause interest in professional sports to decline? Would fans who no longer played basketball, baseball, or football -- and especially potential fans who had never done so -- take as much interest in the exploits of once-favorite players and teams in the NBA, MLB, and NFL?

Some naysayers would resist the exercise pill for still other reasons. Some might argue that exercise has benefits that extend beyond mere slimmer waistlines, lower blood pressures, and improved serum lipid profiles. They might point, for example, to the self-discipline required to exercise on a regular basis and lament the fact that Americans need no longer make such a concerted and sustained effort to remain trim.

Moralists among the naysayers might go even farther, attempting to portray the able-bodied among those of us who rely on the exercise pill as somehow lazy or undedicated. The most extreme might even argue that working hard at working out is good not just for the body but for the character, helping us to develop habits of short-term self-denial for the sake of longer-term benefits that they regard as an important feature of the most virtuous among us.

They might also lament the loss of other ancillary benefits. For one, many American rely on team sports for much of our exercise. We elevate our heart rates on the basketball court or the soccer field. Others gather in groups for classes in yoga or aerobics. While we are together, we not only exercise but socialize. In some cases, we conduct business, in others we compare notes on personal and family life, and in still others we meet new people and form new friendships.

But many of these concerns can be readily addressed through the judicious application of a little good old American innovation. For example, sports stars can simply hawk their favorite brand of exercise pill, creating another basis for fan affinity. Americans who once developed self-discipline through exercise can start working crossword and Sudoku puzzles. We can make other sacrifices in life, such as getting to know our in-laws better. Pill-taking could easily be made into a group activity.

The idea plays to all of our strengths: our love of efficiency, spirit of entrepreneurship, and deep longing to install physicians and scientists as the new priests of the age.

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Richard Gunderman, MD, PhD, is a contributing writer for The Atlantic. He is a professor of radiology, pediatrics, medical education, philosophy, liberal arts, and philanthropy, and vice-chair of the Radiology Department, at Indiana University. Gunderman's most recent book is X-Ray Vision.

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