
The Exercise Pill - artsandsci
https://www.newyorker.com/magazine/2017/11/06/a-pill-to-make-exercise-obsolete
======
philipkglass
There seem to be basically two arguments against "exercise pills."

1) Self-discipline is virtuous in and of itself. We shouldn't develop
alternative ways to control weight and/or maintain muscle tone without
controlling food intake and exercise, because that undermines the tangible
rewards of virtue.

2) Biology is extremely complicated, and the drug that keeps you compact and
muscular in your 40s might end up promoting the growth of cancerous tumors all
over your body in your 60s. (As happened to the older mice who received high
doses of GW501516.)

I don't agree at all with the first argument. The second one is alarming
enough that I'm not going to be the first or even the millionth person in line
to obtain these compounds through grey-market channels and dose myself.
Similarly, I would _love_ a drug cocktail that prevents the unwanted physical
effects of aging, but I'll let other people blaze a trail with human trials
(clinical or self-experimentation.)

~~~
colordrops
3) There other benefits to exercise, including stretching and loosening joints
and ligaments, building coordination and body awareness, mental benefits, etc.
Sweating has benefits as well. I'd find it really hard to imagine that some
pill that mucks with metabolism or muscle growth or some other single
dimension would cover even a small portion of the benefits of exercise.

~~~
chiefalchemist
Yes and no.

Look around. When, as the article mentions, the option is no pill vs some pill
that helps in some way; for most people the pill makes sense.

As it is today, many people could alter their diets and improve their health.
Yet they do not.

In an ideal world this pill makes little sense. But our First World world of
today is far from ideal. Put another way, they say that worldwide more people
die from eating too much than not eating enough.

~~~
colordrops
Sure. I was just saying there are other arguments against these pills. I'm not
a luddite or a perfectionist and can see their use case though.

~~~
chiefalchemist
I hear ya. I do, in theory, agree with you. But the reality is most people
don't care to take care of themselves. And they wonder why healthcare costs
are so high.

------
imoldfella
"After the age of forty, all of us, even the athletic, lose about eight per
cent of our muscle mass each decade, with a further fifteen-per-cent decline
between the ages of seventy and eighty. "

This has not been my experience. I have added pretty substantial muscle mass
between the ages of 48 and 55 with fairly conventional weight lifting and diet
with no PED's. My back squat has gone from 185 to 385 (pounds)and my deadlift
from 265 to 465. 40 seems way too early to start packing it in.

~~~
aqme28
_Without_ changing your lifting regimen? I find that hard to believe.

~~~
mlevental
2x improvement in 7 years? there's nothing unbelievable about that?

~~~
berdon
2x improvement just depends on where you start in relation to where you have
been. If you haven't lifted legs heavily for a while you'll have to start
lower but you'll quickly regain that lost grown. Well, you'll regain the lost
ground faster than you'll go up past your old max.

------
xpaulbettsx
For anyone considering buying this (which was me until 5mins ago) read
[https://www.reddit.com/r/steroids/comments/6477mr/compound_e...](https://www.reddit.com/r/steroids/comments/6477mr/compound_experience_saturday_gw501516_cardarine/dg0sq37/)

The important bit:

> In animal trials, there are dose equivalence calculations you have to do
> first. Since rats were used in the study you have to divide their dosage by
> 6.2 for the human equivalence. So the 5 mg/kg/day for males and 3 mg/kg/day
> for females works out to 0.806 mg/kg/day and 0.484 mg/kg/day, respectively.
> For example, a 115 lb female would have an equivalent dosage of ~25 mg.
> That's a whole lot closer to the doses some of you are taking.

> In the study, cancer was seen even in rats on the lowest dosage. For all we
> know, they could have gotten cancer at lower doses too.

------
bbarn
My biggest barrier to staying healthy isn't motivation or willpower, it's
time. A lot of us waste a lot of time sitting in offices when more hours there
don't make us more effective or productive at what we do. Give me some of that
time back to go on 2-3 hour bike rides every day, and I suspect I'd be
happier, and find some way to be more productive.

~~~
mikekchar
I've had periods of my life where I'm very active and fit, and periods when
I'm not. To be honest, I have more time now than I ever have before (I work
from home), but I'm actually less active.

I think it's a fundamental misunderstanding that staying active is associated
greatly with free time or will power. In my experience it's more like a habit.
For example, most people would not leave the house without brushing their
teeth in the morning. It would just be disgusting. Most people will bathe once
a day. Most people will wear clean laundry. None of these things take
tremendous amounts of willpower because the aversion to _not_ doing them is so
strong.

In the active times of my life, that's _exactly_ how I've felt about exercise.
It's just feels _awful_ not to do it. Just like you find time to brush your
teeth, bathe, do your laundry, etc, etc -- you find time to exercise. You have
a routine in your life and deviating from it makes you feel bad. It seems
almost morally wrong to deviate from that routine.

Somewhat ironically, having more free time (and more options), I actually have
a harder time doing all of these things now. I work from home and my wife goes
out first thing in the morning. I'm alone. Do I need to eat breakfast? Do I
need to brush my teeth? Do I need to bathe? Do I need to change my clothes?
It's a running joke that remote contractors don't do these things, but there
is some truth to it. Where I _never_ needed willpower to do these things
before, now I do!

Luckily the fix is simple (because even if you aren't motivated to do those
things, you still feel _awful_ not doing them). You make a routine and you
stick to it. You _remove_ options. Although you might reasonably think that
sticking to a routine requires willpower, it's actually the opposite. Allowing
yourself an option and _still_ doing it is what requires will power.

So just like you would never leave for work without brushing your teeth and
having a shower, now you must never leave without doing your exercise. And
just like having a 3 hour bath is _awesome_ (I live in Japan and go to the hot
springs to do that every time I can!), it's not reasonable in most people's
lives. You've got 20 minutes to take a shower. Well, you've got 20 minutes to
exercise too (I recommend doing it just before you take a shower). Sure it
limits your options about what you can do, but that's not necessarily bad.

If you can't find 20 minutes in your day -- then you have some big problems
that you need to sort out. Sort them out because not having even 20 minutes to
call your own will burn you out pretty darn quickly.

~~~
pault
Confessions of a long time remote worker: once I didn't bathe for two months
(I was really depressed). The funny thing is, after a week or so my skin and
hair seemed to dry up and stop producing oils/smells (confirmed by a neutral
third party). When I started bathing again I got really bad acne for weeks.
I'm better about it now, but I'm still working at home and still hate taking
showers and brushing my teeth. Try not to think about this the next time
you're on a conference call with one of your remote coworkers. :)

~~~
mikekchar
Remote working is a _lot_ harder on the psyche than most people think (before
they do it ;-) ). Especially if you've done 1 or 2 days a week remote for a
while (which IMHO is an optimal way to work), you start to think that working
remote full time is going to be all sorts of amazing with no drawbacks. This
is my second stint (first one I did for about 18 months, this one is 3 years
this week). I'm definitely happier doing the remote thing now, but there are
days/weeks/months where I would kill to go into the office (too bad it would
cost me about $5K to get there...)

BTW, I've heard that there are bacteria that live on your skin that keep it
relatively in good shape if you don't wash. It lives on the oils and urea that
you excrete. When you wash frequently, the bacteria doesn't have a chance to
sustain a healthy colony, so you end up greasy/stinky. Apparently still better
to wash, but not nearly as horrible not washing as people assume (eventually).

------
ravenstine
I have a feeling such a pill would go the way of testosterone which, even
though it could be safely administered to people who don't necessarily have
"Low T" to positive ends, is still only a treatment for those who desperately
need it. People on the low end of whatever arbitrary, non-standard serum
testosterone scale often don't get treatment because they are technically
"normal", which completely disregards the benefit someone can see from being
brought to the high-end of the scale. Likewise, an exercise pill might only be
given to those who are morbidly obese rather than mostly sedentary office
workers who would rather get more work done than dedicate another hour every
day towards mindless exercise.

~~~
JamesBarney
One of the reasons for this is testosterone treatment is associated with
higher rates or cardiovascular disease.

~~~
icelancer
While true, this is not the reason testosterone was banned. The AMA argued
vociferously against banning it, in fact.

~~~
JamesBarney
You're 100 percent right. I was just explaining why some doctors are reluctant
to prescribe it.

The fact it's banned is total bullshit. There are no testosterone addicts in
the same way there are cocaine or heroin addicts. It doesn't have any societal
harm, and it's risks aren't any worse than maintaining a poor diet.

------
thomascgalvin
> Mice that had been given large doses of the drug over the course of two
> years (a lifetime for a lab rodent) developed cancer at a higher rate than
> their dope-free peers. Tumors appeared all over their bodies, from the
> tongue to the testes.

> ...

> Since then, he has developed a less potent version that he hopes will also
> be less toxic.

So yeah, this isn't exactly ready for mass consumption.

~~~
kolbe
Whereas the link between anabolic steroids and cancer is pretty weak. If
someone is interested in getting fit (or fit looking) with pills, we already
have some pretty good stuff out there.

[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827559/](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3827559/)

~~~
icelancer
Pretty much. For anyone interested in how anabolic-androgenic steroids got
banned in the USA, check out _Bigger, Faster, Stronger - The Side Effects of
Being American_ for a much fairer viewpoint than your high school counselor
shoved on to you. tl;dr: Steroids were banned due to non-scientific scares
equivalent to "poison in candy" arguments around Halloween.

The inconvenient truth is that we already have the fountain of youth [0] -
it's injectable long-ester testosterone, which is cheap, easily obtainable,
and safe [1].

EDIT: I see you said "pills." While safe-ish, they're much more dangerous due
to liver toxicity. Injectable testosterone is much more effective, cheaper,
and safer.

[0]: For men. For women, the results are different and comes with worse side
effects.

[1]: Safe is a relative term. But exogenous test use done correctly is very,
very safe. And compared to the alternatives that are sold, like prohormones,
they're orders of magnitude safer.

------
ineedasername
The TL;DR:

1) Causes cancer. Of, like, everything. TFA put it more eloquently: "From the
tongue to the testes"

2) So, shelved.

3) Less toxic versions under research; color me interested! (you know,
everything causes cancer anyway)

4) Social implications!

------
chiefalchemist
"...There are a handful of other contexts where a short course of an exercise
pill could be extremely useful..."

Missing from the list that followed has: people wearing VR goggles (e.g.,
Oculus Rift) and never leaving their bed or sofa.

The Matrix isn't as far fetched as it used to be :)

------
kolbe
Steroids have been known to do this for decades (if not centuries)

[http://www.nejm.org/doi/full/10.1056/NEJM199607043350101](http://www.nejm.org/doi/full/10.1056/NEJM199607043350101)

------
corpMaverick
Can we at least have a pill that makes you want to exercise?

~~~
comicjk
"Preworkout" (sugar and caffeine) products are basically this, as long as your
caffeine tolerance is not too high.

~~~
cgh
And beta-alanine. The tingly feeling is like a signal to get moving.

[https://examine.com/supplements/beta-
alanine/](https://examine.com/supplements/beta-alanine/)

------
scottlocklin
Whenever numskull journalists write the phrase "exercise pill" they're talking
about growth hormone secretagogues or anabolics. This one is an anabolic SARM;
a particularly nasty one that seems to be pretty carcinogenic. Note that
people who take SARMs or regular anabolic steroids look pretty good, but
they're certainly not achieving any real health benefits. Long term use nets
you cardiovascular problems and eventual chemical castration.

Anyone who would tout taking this as some kind of supplement is insane.
Soylent arguably more healthy.

~~~
totallynotcool
>and eventual chemical castration.

That's a little over the top. Proper dosing- TRT levels- and regular blood
work can keep some of the issues at bay.

------
AElsinore77
There's a lot of discussion here about "virtue" and "self-discipline" \- I'd
like to offer an interesting possibility that "discipline" is not about
motivation or willpower, but is actually an intellectual exercise of avoiding
motivated reasoning in the mind.

The simplest example: I resolve to wake up in the morning to run before work.
However, when I wake, I feel exhausted. "You need more rest; you can always
make it up tomorrow," I might think to myself. If I accept this as a reason to
stay in bed, I am falling to motivated reasoning; I am believing as fact an
excuse made by my mind looking for a way out of discomfort. I can rest easy
when I believe my excuse. I can rest easy when I can say "I have plenty of
discipline, I just needed to rest today."

Exercise is merely one of many ways to illuminate your logical fallacies to
yourself. The fallacy of motivated reasoning is what causes alternative facts
- the mind can always come up with a reason to avoid the discomfort of getting
out of bed, just like it can come up with reasons to avoid the discomfort of
saying "I was wrong."

------
zeveb
I imagine that, if successful, this could make more money than Viagra. I'd
happily pay several hundred dollars a month to have a fit body without ever
exercising.

~~~
kolbe
It's existed for a very long time, but still hasn't fully taken off.

[http://www.nejm.org/doi/full/10.1056/NEJM199607043350101](http://www.nejm.org/doi/full/10.1056/NEJM199607043350101)

~~~
zerr
Does it also have the same health benefits as exercises?

~~~
bagacrap
It (supraphysiological doses of testosterone, meaning more than any human
produces naturally) causes cancer, hair loss, interferes with endogenous
hormonal function, and entails many other deleterious side effects that
exercise does not. It will increase aerobic capacity by increasing red blood
cell count but too much added viscosity of the blood also poses a health risk.
So this is rather different from "exercise in a pill".

~~~
lossolo
> causes cancer

Source? Because 200 mg of Testosterone E a week is already more than human
organism can produce. In study linked above they gave them 600 mg a week.

Most professional bodybuilders are doing minimum of 1g of test a week for
years. Most of them have heart problems if any from test. Most problems they
have are from different compounds like Trenbolone, GH etc. but not
testosterone.

I don't know any study that links testosterone to be a main reason of
developing cancer, that's why I ask for source.

~~~
cgh
Just to add to this, tren (and all other steroids) are essentially
testosterone derivatives. "GH" is growth hormone, which is not a steroid.

Taking massive amounts of steroids can be a health risk for sure. But as the
parent implied, trt-levels of test (200-300 mg/week) are well-tolerated.

------
icelancer
I knew this was about GW50156. A version of this article has been published
every six months or so in various outlets. GW50156 is widely available via
research chemical sites and various underground
bodybuilders/powerlifters/athletes are using it + peptides + various other
drugs to skirt AAS testing.

I think you will find the self-reported side effects and gains of GW50156 to
be.... much different than stories like this one portray.

~~~
gadders
It is amazing the chemicals and hormones that bodybuilders will put into their
body to build muscle or cut body fat. They really are the original body
hackers.

------
Mz
One of the things that exercise does for you is it helps your body take out
the trash. I see no means for a pill to replicate that function. Without that,
it seems pretty obvious that there will be negative long term consequences to
getting your "exercise" in pill form.

This is how this works:

Lymph is basically the clear part of the blood with stuff like red blood cells
removed. One piece of the lymphatic system is powered by the heart. But lymph
is also called interstitial fluid. It exists throughout the body. It
circulates, moving back and forth between tissues and your blood.

When it moves back to your blood, it takes waste products with it, leaving
behind cleaner, healthier tissue. These wastes mostly get removed when you
urinate.

Physical activity dramatically increases the rate at which lymph gets moved
back to the blood. I have seen figures anywhere from 3 to 8 times as fast as
when you are sedentary.

Walking a whole lot, sometimes hours a day, has played a big role in my
healing journey. I believe this increased cleansing process is a key detail as
to why that has helped.

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0xbear
Before the exercise pill, it’d be good to have a pill which helps with
exercise. For instance strengthens the ligaments without destroying
flexibility too much. Or boosts endurance without having horrible side
effects, stuff like that. Seems like an easier problem than an all
encompassing “exercise pill”.

~~~
maaaats
Yeah, I don't care much for a pill replacing exercise. A pill giving me the
ability to exercise without all my ails though...

------
lend000
Fascinating -- as much as I enjoy to be active and stretch out, I imagine the
benefits of sustained exertion could be entirely replaced by an artificial
mechanism. This would be a nice time saver, and if it provides the same good
feelings that you get after a good workout, then health in an active person
could even be improved by preventing the need for heavy exertion and focusing
on stretching and movement. This could reduce joint stresses and put more
hours in the day. Very excited to see the effects of this drugs in humans.

------
gadders
>>“If you’ve been to London, then you know,” Bill Hayes, a writer and
photographer who is at work on a history of exercise, told me. “The driver
sits at the front and drives the bus, and the conductor hops on and off the
bus and climbs up and down the stairs taking tickets and getting people to
their seats.”

Er, not for a long while. It's all Oyster cards now. Bus conductors went ages
ago.

------
jax711
I actually used to take GW50156. Since it's a research drug companies in the
US can sell it for "research" purposes.

Yes I know it gives cancer, but the doses that were used in the study for mice
were astronomical. It's the equivalent of doing the ld50 of a drug.

------
KKKKkkkk1
Well, that kind of reminds me how in the 90s the media published articles
saying that Prozac is about to make sadness disappear, and our society is
about to turn into a Brave New World. Turns out it was just stealth marketing.

------
Steko
Another interesting report about a drug that 'melts away fat in arteries':

[https://www.abdn.ac.uk/news/11280/](https://www.abdn.ac.uk/news/11280/)

------
deepnotderp
Also, fwiw, (iirc) they observed huge benefits to exercising even when GW and
AICAR were taken in tandem, so it's probably most useful as an exercise
amplifier.

