I recently went to a talk at Stanford by Kenneth Walsh of the Boston University School of Medicine, in which he spoke about his research on the molecular basis of obesity-linked cardiovascular disease. He did some fascinating experiments in which they took a genetically obese mouse (which many labs have shown have all the problems of obese humans) and turned on genes that build the fast-twitch muscles that we get from weight-lifting. These mice didn’t do much exercise and they still had the genes that caused them to become obese, but as they built up muscle tissue they lost excess fatty tissue and brought their insulin sensitivity, tissue regeneration and resistance to biological stress back to normal levels. Everyone in the room was thinking, “I want what they’re having.”
This got me thinking further. Exercise has been shown to have enormous and broad benefits. It reduces diabetes and insulin resistance. It builds stronger bones. It reduces atherosclerosis. It prompts the stem cells to create new brain cells. It lifts the mood, improves memory, makes one feel more confident and resilient. It extends life. It makes one more resistant to infection. There is strong evidence that exercise reduces the risk of cancer. I began to wonder—If someone could create a pill that you take every day and which does everything exercise can do, what would that be worth on the open market? More than $10 a pill—that’s what it costs for impotency drugs like Viagra, and that solves only one of the problems exercise addresses. Would people pay $30 a pill, which would be about $10,000 a year? Would they pay $20,000 a year? $50,000 a year? Many cancer drugs cost more and do less in terms of extending life. I don’t know exactly how much such a pill would be worth on the open market or how much I would be willing to pay for it, but I would probably be willing to devote a good chunk of my income to procuring it. I hate to think about how much I already spend on coffee annually.
But in the end my thinking comes back to one extraordinary fact: exercise is FREE. You can pay for equipment or join a gym to make exercise more fun or efficient, but the benefits of our imaginary exercise pill obtain, right now and for no cost, by going up and down stairs or lifting household objects.
We don’t need to develop such a pill because we already have the technology. And often, whenever we try to develop pharmaceuticals that mimic some of the effects of exercise, it messes up something else. Drugs developed to fight diabetes by activating PPAR receptors that are turned on during exercise have run into trouble because they increase the risk of heart failure. Exercise is like the conductor of a thousand-piece orchestra, perfectly tuned through evolution to get all the biological instruments in our body working together. When researchers learn about one biological mechanism and fiddle with it, the effect can be like giving the trumpets sheet music for the Star Spangled Banner while the rest of the orchestra plays a Viennese waltz.