Human beings now have more options for exercise than at any other time in history. Getting fit is no longer a drab activity accomplished through monotonous jogs around the park; it’s commodified and hawked in increasingly bizarre and unforeseen ways.
Fitness trends abound in the modern landscape: There’re regimens like Soul Cycle, hot yoga, CrossFit, Pilates, and aerial fitness, along with a plethora of health food cleanses that promise to throttle and rejuvenate the body in more dynamic ways than a treadmill was ever capable.
In spite of undeniably addicting fads that get us to the gym before dawn or during happy hour, and hanging upside-down from ceilings, and pumping pedals in the dark surrounded by luminescent candles, the physical effects that exercise has on the body have not changed.
But the fitness scene might find itself subjected to a massive disruption, where the microscopic effects of working out — the molecular reactions that occur in fat cells and muscle tissue — aren’t honed through trendy memberships at fitness clubs, but are replicated by a pill.
At the molecular level, researchers note, exercise is still exercise.
Ismail Laher, a professor of pharmacology at the University of British Columbia, is hopeful for a future where skeletal muscle might be stimulated by a tablet, he says it’s no replacement for actual exercise — if that’s an option.
Laher and other researchers believe such a drug could have profound effects for people with physical disabilities. According to a recent paper co-authored by Laher and published in Trends in Pharmacological Sciences, new research points toward a future where individuals with Type 2 diabetes, cardiovascular disease, severe spinal problems, and obesity, might be able afforded nourishment similar to actual exercise, all through a few drugs that are currently being tested.
But just how would such a pill work?
“With the development of molecular techniques, we can pinpoint specific molecular changes taking place inside cells,” Laher says, adding that these developments on the molecular level can be simulated in the human body through the ingestion of a pill.
“If you have a target, you can create drugs to interact with those targets,” he says.
Laher’s words invoke the methods of another recent study, authored jointly by researchers at the University of Sydney and the University of Denmark in Copenhagen. Published in Cell Metabolism in October, the study represented something of a windfall in the realm of exercise science: Researchers analyzed human skeletal muscle biopsies from four untrained, healthy males following 10 minutes of high-intensity exercise. Using a technique known as mass spectrometry to study a process called protein phosphorylation, co-author Dr. Benjamin Parker discovered that short, intensive exercise triggers more than 1,000 molecular changes in the human body.
While the Cell Metabolism study might represent kind of a harbinger, Laher’s work provides the next logical step: a massive roadmap of these molecular changes, all teeming within the human body during a bout of vigorous exercise. Laher then advances a theoretical outline of how a pill might one day interact with these targets to simulate the effects exercise.
Laher’s study, titled “Exercise Pills: at the Starting Line,” discusses different candidate pills with names like AICAR and GW501516, and he thinks they might prompt “muscles [to] grow more efficiently,” and allow people with conditions like muscular dystrophy to attain “bigger, stronger and faster muscles,” regardless of their sedentary state.
The idea of tumefied biceps and superhumans walking the streets is an easy fantasy to conjure after listening to Laher describe the possible effects of AICAR and GW501516, but the drugs aren’t like steroids at all.
Steroids “have effects in many parts of the body, that’s why you get the moon phase, rage, diabetes, and cardiac effects,” he says.
“These pills don’t act anything like steroids, they act immediately, and they’re specifically attacking skeletal muscle.”
Such a product would certainly spark the intrigue of venture capitalists, not to mention cause concern for sports doping and black market activity, but Laher warns against futurist visions of a big name drug usurping the very notion of fitness as we know it.
“Just because you can activate [a muscle] with a drug, doesn’t mean it’s equivalent to the natural stimulus,” Laher says.
Besides, “these drugs will not get Homer Simpson off the couch. They will not motivate you to exercise more.”
The findings outlined by Laher’s study, which essentially advance the most exhaustive blueprint to date for how to bring exercise pills to provenance, is not without its numerous detractors.
In fact, some researchers believe that bringing the kind of drugs to market that Laher outlines in his paper is the stuff of sheer fantasy.
“Although the concept of taking a pill to obtain the benefits of exercise without actually expending any energy has mass appeal for a large majority of sedentary individuals, such an approach is likely to fail,” Juleen Zierath, professor of integrative biology at the University of Copenhagen, tells Inverse.
Zierath justifies her logic by citing the myriad chemical effects that take place in the human body — all generated by exercise — and how complicated it will be to target nearly 1,000 different chemicals reactions with a single pill.
In effect, she sees the same University of Sydney breakthrough as evidence of an insurmountable task: “Exercise training provokes widespread perturbations in numerous cells, tissues, and organs. It is the multiplicity and complexity of these responses and adaptations that make it highly improbable that any single pharmacological approach could ever mimic such wide-ranging effects.”
Or in other words, a pill is too simple of a concept to match the complex chemical phenomena created by physical exercise, much of which has eluded researchers for decades.
Laher’s “blueprint” isn’t the first time researchers have been convinced of a significant advancement in the development of exercise pills either. In 2012, a Harvard researcher named Bruce Spiegelman generated headlines and sparked the attention of the pharmaceutical industry after he discovered a purportedly magical protein.
Called “Irisin,” after the Greek messenger goddess Iris, Spiegelman’s protein was believed to turn dangerous white fat cells into productive, healthy brown fat cells.
Billed as revolutionary, Irisin was summarily disproven almost as fast as the maelstrom of media coverage and investment that buffeted its rise.
One of Spiegelman’s biggest critics is Harold Erickson, a professor at Duke University medical school. Erickson’s critique of Irisin is indicative of his views on the greater concept of an eventual exercise pill, of which he says smacks of “very wishful thinking.”
“The evidence that [an exercise pill] might exist, is still very defective,” he says.
Laher isn’t unaware of the multiple caveats undergirding his own research. “It is unlikely that there is a single medical switch to be turned on to reap all the rewards of regular exercise,” he says.
In the future, Laher will test the viability of his candidate pills, and attempt to answer some very important questions.
“The next steps revolve around efficacy and safety issues — are these pills really doing what they claim to do, are they as good or superior to regular exercise, just what exactly are the benefits?”
In other words, issues pertaining to dosage, the effects of the drugs on pregnant women, the disabled, and possible side-effects, haven’t even been addressed yet, which are all very big, important questions.
“There is still a lot that we don’t know,” Laher says.