The Exercise Pill
newyorker.com
newyorker.com
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.)
What if some of the commonly known positive effects of exercise, such as battling depression, are actually psychological effects of that discipline and motivation rather than physical fitness? I find it hard to argue this can't be the case.
There is virtue in working hard to achieve good outcomes, but not in working harder than actually necessary to achieve those same outcomes. (If you want to do things a harder way than strictly necessary because it's a fun pastime for you, that's fine too. Then the experience itself rather than the end state is what you are seeking.)
Although I do think the origin of "virtue" is because some things had good general effects, but nobody was able to explain why or how. Of course the concept has been abused since then.
I'm not sure we can come up with a principled way to distinguish the "good" kind of virtuous from the "bad" kind of virtuous without just deciding by ourselves what is virtuous and what isn't, at least to some degree.
It's pretty dang universal to feel "good" after putting in effort to achieve something.
That being said, the help with depression is not because you become physically fit. Exercise works even if you train in an ineffective way. It has more to do with chemistry (e.g. endorphins) in your brain then with overall result.
In terms of ways in which "discipline" and "motivation" might provide benefits such as battling depression... I could see arguments both for and against as plausible. Feeling that restrictions on your actions are entirely of your own choosing is tremendously helpful at reducing the negative consequences of harmful stimulus, that is supported by research. I am unaware of any research that says it can actually tip the needle the other direction and make a negative stimulus into a positive, but it could be possible. Then again, there are a billion other ways in which our volition is infringed upon on a daily basis by society flagrantly which probably contribute far more to depression and anxiety and similar problems than anything minor like what limits you might put on yourself, so taking away just that bit should probably not be a noticeable change.
The problem most people have with "virtue" arguments (and I share in this) is that if there is a REASON something should be avoided, then the reason suffices. If there is no reason, then you are inherently wrong to advocate that other people avoid it. And trying to paper over the situation with societal shame is just repugnant.
Whether the mood/psychological benefits come (or don't) with the pill as opposed to exercise, I think is germane to the discussion.
The second is very real and of course requires us to tread very carefully but shouldn't be a reason to stop investigating something.
Makes sense (not agreeing). The whole culture of modern society is all about not agreeing with such arguments.
That is, finding any idea of value in some authenticity that shouldn't be replicated technologically, silly.
"Let's do X just because we can" has often lead us to more trouble than merely not doing X.
Especially when we half-understand X and what it affects.
Case in point, as others mentioned, albeit positively, Soylent.
Yep. And yet you never see these people volunteering to make their livings as agricultural stoop labor peasants or (if female) volunteering to have 15 or 20 pregnancies over the course of their lives.
Someone wanting e.g. avoiding pregnancy to rely on "physical discipline" doesn't mean they are in favor of anybody having 15 or 20 pregnancies -- just that they are in favor of people having the discipline.
There are far better R&D approaches to maintaining health over the course of aging, but they get a tiny fraction of the effort lavished on exercise and calorie restriction mimetics, despite the continued absence of concrete therapeutic outcomes resulting from all of that investment.
The reason for this is probably that exercise and calorie restriction mimetic research dovetails well with the real underlying scientific goal of mapping metabolism, where as better approaches tend to bypass this need for mapping, focusing instead on well-known forms of damage that cause age-related decline.
That said, if you found a safe pill that would merely give the cardiovascular benefits of exercise, or help elderly patients maintain muscle mass, or move obese people to just being overweight, it would be worth tens or hundreds of billions of dollars.
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.
Sugar water and other high calorie stuff could see the same treatment tobacco got; cars could be banned from city centers to make room for bicycle lanes and lush pedestrian zones, parking lots could be required to be at least half a mile from offices and shopping malls, with nice walking paths between the two, etc.
"cars could be banned from city centers to make room for bicycle lanes and lush pedestrian zones, parking lots could be required to be at least half a mile from offices and shopping malls,"
Screw old people and the handicapped, eh?
Here's a better idea: live your life the way you want. Don't force others to live the way you want.
Because, you know, granting government that level of power that doesn't end up where you imagine that it ends up.
Those that still need it could safely use strollers and wheelchairs.
There also would likely be fewer handicapped. Allowing healthy people to drive huge four-wheel drive “wheelchairs” from the time they are 18 doesn’t make the population healthier.
I also doubt people currently live the way they want. If you ask a 40 year old with diabetes and a BMI of >30 whether they do, do they say so?
“Government of the people, by the people, FOR the people, shall not perish from the Earth.”.
Governments should shape society to make people happier. Just as with other tasks (product design, educating kids) that doesn’t mean giving them what they say they want.
Judging by things such as https://en.wikipedia.org/wiki/Human_Development_Index, some governments are better at providing what their people want then others. Call me an optimist, but I think the top ones have been granted “that level of power”.
For example, there is a difference between enabling (positive behaviors X, Y or Z) and enslavement (e.g., addiction, obesity, etc.)
I'd expect a drug that "mimicked exercise" would really do so in part by making you exercise more, without realizing you're doing so: i.e., by making you fidgety (and sweaty, and achier in your joints so you'd want to stretch more, etc.)
The biological process in the human body that depend on upright motion include far more than just simple muscle stimulation and growth. The circular system is meant to work against gravity in concert with muscle contraction. It should be relatively obvious that there's indeed far more to exercise and basic bodily functions than this pill covers.
edit: link
There's some debate that stretching is actually a problem.
https://well.blogs.nytimes.com/2013/04/03/reasons-not-to-str...
In this case your point that such a pill wouldn’t help with your joints being limber or sweating is a cop-out. It’s not actually addressing the point of the discussion, instead focusing on details irrelevant to the point of the thought experiment.
[1]: http://lesswrong.com/lw/2k/the_least_convenient_possible_wor...
I exercise because I enjoy it and partly to look better. I really don't think it makes me more virtuous then, say, fat people who don't exercises, but are overall nicer or more helping to people around then I am. Or simply people who read more book then I am or people who teach kids in their free time or whatever.
If something is hard, takes a long time to do and makes you better you are right to feel virtuous.
I'm not saying I'm "against" the pill, but no pill is going to magically erase 1,000+ calories of over-eating or clear out all the awful things excess sugar and other carbs may do. It may certainly mitigate them, but like the person I know who got lapband surgery eventually found out, his eating just adapted to his new limitations (ice cream, sweets, etc dont take much room and are very high energy) and he gained weight after a while. We'll pop the pill, eat like pigs, and be at the same weight or higher after a while.
I imagine if this becomes a mass market medicine, its effective applications will be outside of weight control and more towards helping people achieve a certain level of fitness especially those with limited mobility or illness. Its not something you're going to buy able to buy over the counter for 'free' workouts. The same way you can't buy testosterone or steroids OTC.
If self-discipline were virtuous, would the "best" exercise pill be one that only enhances self-discipline (with no stimulant-like side-effects)—and thus makes it easy to be one of those people who just "decide to exercise and eat healthy" and end up doing so? Or would people likely still consider that "cheating" in some sense? And if so, do you think such people would be able to be convinced at that point that they're literally just measuring the "virtue" of people's genetics, rather than of their choices?
No one thinks working out should be illegal. So why should doing the same thing via other means be illegal?
Maybe it's the lingering Protestant-work-ethic-laced morality of the U.S., but we seem to be disproportionately likely to exaggerate the dangers of anything that seems like a drug, relative to things that don't seem like drugs (even when they clearly are -- i.e., alcohol).
It's not that I didn't care about paying attention, I really wanted to pay attention, it just wasn't happening. I think that's the difference - you wouldn't be forcing me to do something I didn't want to do, you'd be helping me do something I did want to do.
It's part of my life's work to make sure that kind of drugging of children becomes a thing of the past. It's criminal.
Can you imagine giving a child amphetamines to 'help' them in a non-coercive environment like a Sudbury School? https://ia801305.us.archive.org/19/items/TheSudburyValleySch...
In your post you talk about on and off and don't give us any insight whether you (always? most of the time?) made that decision yourself.
If one has to exercise to help build bone density anyways ( a concern for anyone who wants to have a healthy life after 40) the pill if it worked would only eliminate one component of an exercise regime.
I agree with the premise: "Self-discipline is virtuous per se."
I don't agree with the argument that follows: "We shouldn't develop alternates."
remember the horror stories from olestra's introduction, people shoving tons of chips because they were guilt free down their maws only to have digestive issues
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.
For example, a lot of fighters get caught taking drugs that decrease the estrogen production in the body, rather than actually getting caught taking steroids. Leagues ban steroids AND things that are used in coordination with steroids to increase the ability to enforce the steroid ban.
Now, I would argue that even if it does cause a long term dependency, it should be viewed, for the average person, the same way heart pressure medication is viewed. You have a medical condition, and this is a prescription you'll take for the rest of your life, but it will make you live a longer, healthier life.
If I were to change to, say, 5 reps at maximum weight just one time(heavy strength train), that would be a change in regimen.
Curls and crunches often give normal people better aesthetics than they had before. Some people want a 4/5/6 bench/squat/dead, other people want to look slightly better at the beach without utterly killing themselves in the gym. I know a couple order of magnitude more people with good aesthetics who control their diet and do a relatively candy-ass workout vs those rare powerlifting dudes who never do any ab work yet have abs visible through their squat suits.
It's lifting, it's a regimen, so it's a lifting regimen. And it's been very effective at quickly adding strength, endurance, and flexibility to my initially bad starting position.
Don't assume your way of doing things is the only way to do things.
Most of the people using this drug are using it with more serious exercise than I'm doing. In practice its being used as an exercise supplement, not replacement.
I'm 52, and recently started a strength/interval training regimen. In just a few weeks, I've increased my resistance loads 25-50%, and I'm losing a steady 1.5 pounds per week or so without a drastic diet change. It's a lot easier to control my eating now, too.
https://en.wikipedia.org/wiki/Dexter_Jackson_(bodybuilder)#C...
It's as if someone said that a car coasting to a stop slows by roughly 1% of speed every second and you tried to refute this by pointing out that if you hit the accelerator it goes faster.
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.
To be fair, if you had more willpower, you'd be more willing to exercise in what limited time you do have. So it's fundamentally a willpower limitation.
they don't have the "willpower" to commit the remaining time they have left to yet another chore.
Wouldn't them having remaining time, and spending it in another way, imply that it is a matter of will?
It is a willpower issue for the majority of us on this forum who have it well off compared to most people.
You have to make time for it just like you have to make time to budget vegetables into your diet when it's more convenient to eat fast food on the way home. It's your health.
That you think it's insensitive for me to point this out just shows that there are some health issues, like obesity, that are taboo subjects. But we're not at the dinner table.
It's not taboo, you're just assuming too much here and instead of asking for a clarification you went right to "nope, it's your willpower". "Willpower" is a hotly contested idea in the psychological community as is, so, yeah, it's more than just "an inconvenience".
Here's an article I found on this site that was kind of eye opening on that subject: http://nautil.us/issue/45/power/against-willpower
If he says it's time why not just give him the benefit of the doubt. He has a very large information advantage over you and me.
We're all prioritising time. If you can't fit in 1-3 hours of riding a bike, fit in 10 minutes of something else.
(We built https://streaksworkout.com/ to help this. People choose the exercises that suit them and then start a 6-30 minute workout based on how much time they have.)
It takes literally 3 minutes, and I've gone from 85kg overweight nerd, to 72kg fit nerd in a few months.
If you look at my sibling comment, you'll see how controversial it is when I point out that this is possible. People are always like "but you don't know me nor how much time I have" but the vast majority of people can sneak in some exercise if we really wanted to. It's just inconvenient.
Or people will say "won't others look at me funny if I do pushups in the office?" Who cares? I can certainly imagine offices where this is impractical, but we of all people are most likely to be able to pull it off.
Meanwhile at the last two places I worked, a few people ended up doing mini-workouts after a week or two of watching me. We ended up using one of the spare meeting rooms as the quick pushup room. It's a comical sight for visitors and new hires. But really, it shouldn't be such an oddity to do some light exercise in life. It just shows how backwards our social norms are, and how they work against us.
But what's also inconvenient are the health issues that arise from sedentary lifestyles.
Not your main point but many people care what things while understanding that they shouldn't and saying "but you shouldn't!" won't change that, so it's a completely useless sentence which just serves to hand wave a valid problem of your strategy.
For example, some men never approach women our of fear of rejection or lukewarm reception. Any man that wants success with women and dating will have to challenge his self-limiting beliefs.
So what if they are reminded of it in an HN comment? Whether that's useless to them only indicates how unwilling they are to change. But it's a prerequisite for the advice in my post.
You know, one of the biggest parts of the warmup of an improv class I once took was to stand up and make noise. Like pretend you are a dinosaur. Embarrass yourself. Without fail, it would snap you right into the headspace of what it took to do improv -- being able to look past yourself and perform.
I was flabergasted as well, its crazy to think that we need so little excersise. Maybe the problem is that people think they have to hit the gym once a week for a few hours, while a few minutes every day is much more effective.
I mean you wouldn't learn an instrument or a language that way, why should your physical response be any different.
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.
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).
If you can find a way to manage your time more effectively, barbell work is even better. Rippetoe's Starting Strength and a Starting Strength coach in your area would be your best introduction.
Not that I think you were being literal, but you don't have to ride your bike 2-3 hours per day to get the benefits of exercise. The biggest problem most people face is not knowing what to do and how to do it. The above suggestions should be sufficient to overcome that IMO.
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.
> ...
> 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.
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.
> The combination of effects made 516 seem like a promising treatment for what’s known as “metabolic syndrome,” a cluster of symptoms—including obesity, high blood pressure, and high blood sugar—that is a precursor to heart disease and diabetes. More than a third of adult Americans are estimated to have metabolic syndrome, which made 516’s potential profits seem rather attractive.
The dangers of rampant heart disease and type-2 diabetes can't be understated either in this context.
Also the next paragraph notes it only caused cancer in later stages of the mouses life which may translate to 60-70yrs in humans. It's possible there are potential trade offs still at lower doses for people in their 50s at a high risk of dying from heart failure.
Not to mention tweaking the drug itself.
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!
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 :)
Anyone who would tout taking this as some kind of supplement is insane. Soylent arguably more healthy.
That's a little over the top. Proper dosing- TRT levels- and regular blood work can keep some of the issues at bay.
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."
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.
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.
Additionally, they are stacking anabolic steroids with amphetamines and derivatives of such, as well as compounds like clenbuterol, liothyronine sodium, and even dinitrophenol.
[1] https://en.wikipedia.org/wiki/Enobosarm
[2] https://blog.bulletproof.com/sarms-increase-muscle-growth-20... (best link I could find without getting lit up by the work firewall for hitting a steroid site)
I think you will find the self-reported side effects and gains of GW50156 to be.... much different than stories like this one portray.
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.
Er, not for a long while. It's all Oyster cards now. Bus conductors went ages ago.
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.