A pill for exercise: Why it may be too good to be true

Recently, scientists at the University of Florida announced the development of a pill that could trick the body into weight loss. It works, they reported, by producing a response in mice skeletal muscle that mimics the response to exercise.

You’re probably familiar with the adage that “if something sounds too good to be true…,” and you know the rest. It became an adage because it’s true. Deeper investigation indicates that exercise-mimicking drugs are probably no exception.

Physical inactivity is the fourth leading cause of death around the world. One‐third of the earth’s population fails to get even the minimum amount of exercise recommended to experience health benefits. Globally, the adverse effects of inactivity are mounting. Lack of physical activity contributes to six to 10 percent of all deaths (other than deaths due to infectious disease.)

Knowledge about the significance of exercise is growing, while physical activity is declining. Enter scientific and big-business interests in the development of drugs that mimic exercise. The potential for profit is dizzying.

The quest for so-called “exercise pills,” however, is nothing new, as recent news seems to suggest. Scientific activity on developing such drugs was first reported in 2003. Multiple drugs have been developed but failed to earn the approval of the U.S. Food and Drug Administration (FDA).

What are exercise mimetics?

The term “exercise mimetic” is actually inaccurate and misleading. It is not too extravagant a statement to say that exercise affects, and is of benefit to, virtually every cell in the body. Many, if not most, of these effects and benefits of exercise are yet to be completely understood.

The Centers for Disease Control and Prevention (CDC) lists some of the benefits of physical activity. Specifically, exercise:

There are more benefits: fun, companionship, a sense of achievement, and spiritual well-being.

According to John A. Hawley, PhD, Director of the Mary MacKillop Institute for Health Research in Melbourne, Australia, the numbers, and complexity of these processes make it highly improbable that any single pharmacologic agent could ever mimic the wide‐ranging effects of exercise.

The term “exercise mimetic” should be used to refer to interventions that simulate the broad spectrum of health benefits of exercise, Hawley argues. The simplistic use of the term exercise mimetic creates unrealistic expectations. Misleading exaggerations of benefit, however, are highly marketable and favored by those with commercial interest.

Entrenamiento de fuerza es la clave de la longevidad
(Credit: Iren_Geo / Shutterstock)

The scientists searching for exercise-mimicking drugs have focused almost exclusively on substances that affect skeletal muscle function. Little scientific inquiry has been devoted to compounds that could affect other body systems. Hawley challenges the narrow focus. A single pill which increases skeletal muscle metabolism and endurance, improving muscle strength and function, ignores investigating the value of exercise and potential pharmacological influences on other tissues, such as the heart, lungs, and nervous system.

Atherosclerotic heart disease is the leading cause of death in the developed world. Tremendous progress has been made in the last few decades in understanding and treating atherosclerosis, such that between 2005 and 2015 there was a decrease in the occurrence of heart disease. Now, the incidence of heart disease is increasing, right along with the increase in overweight and obesity that is epidemic in the United States. Wouldn’t it make more sense to focus on the heart in the search for chemicals that mimic exercise and its benefits, rather than skeletal muscle?

There is also concern that health could suffer from a constant drug‐induced “metabolic overdrive”. Physical exercise consists of periods of metabolic overload followed by rest. The recovery period is essential for restoration of muscle’s natural metabolic components, as well as muscle repair and regeneration. No pharmacological compounds have been developed that mimic these phases, although it may be theoretically possible to do so.

It has been more than 20 years since work on so-called exercise mimetics was first reported in medical literature. The current compound of interest is associated with weight loss in overweight, inactive mice. Having such a drug for humans is speculative at best. You don’t have time to wait to get healthy until a pill that mimics exercise in humans is available.

Consider, also, that having the ability to create a drug, any drug, does not necessarily mean that it’s a good idea to use it.

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About the Author

Dr. Faith Coleman

Dr. Coleman is a graduate of the University of New Mexico School of Medicine and holds a BA in journalism from UNM. She completed her family practice residency at Wm. Beaumont Hospital, Troy and Royal Oak, MI, consistently ranked among the United States Top 100 Hospitals by US News and World Report. Dr. Coleman writes on health, medicine, family, and parenting for online information services and educational materials for health care providers.

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