A Pill Called Exercise


Imagine a pill that confers the proven health benefits of exercise. Would you take it?Physicians would widely prescribe it, and healthcare systems would see to it that every patient had access to this wonder drug. Patients clearly need a prescription of exercise, but little has been done in an organized fashion to help them get it. Instead, we keep overemphasizing and expanding an array of high-priced and often marginally effective pills and procedures.


Nations around the world have a lot at stake in getting citizens more active. The World Health Organization recently recognized physical inactivity as the fourth leading risk factor for global morbidity and premature mortality (WHO 2009). The cost of medical care for inactive patients dwarfs the cost of caring for active ones (Anderson et al. 2005). Further, we may be looking at a generation of children who are so sedentary they could be the first generation to live shorter lives than their parents. Where will we get our next generation of police officers, firefighters and soldiers with the fitness and strength needed for these demanding jobs? The public health threat of physical inactivity will only get worse if organized medicine does not act.


Physicians must become more ardent advocates for exercise. They should ask about it at every patient visit, and every patient’s activity level should be seen as a vital sign. After all, it is arguably the single best indicator of health and longevity.


Furthermore, we need a melding of the fitness and healthcare industries. Physicians should be able to refer patients to a fitness professional who can help them achieve their exercise goals. The benefits are just too great to ignore.  (I am a Certified Medical Exercise Specialist which means I can personal train you safely even if you have health challenges such as heart disease, diabetes and musculoskeletal issues just to name a few).


The association between a physically active lifestyle and good health cannot be denied. The active and fit live longer, healthier lives, while the sedentary and unfit tend to suffer prematurely from chronic disease and die at a younger age.


Public health experts worldwide have been sounding the alarm about the risks of obesity, yet evidence suggests inactivity is an even bigger risk factor. In fact, if exercise were a drug, it would be the most powerful ever prescribed. Hence the creation of the Exercise is Medicine® (EIM) Global Health initiative, which urges physicians worldwide to use an “exercise vital sign” to assess people’s fitness and to offer a proper exercise prescription—typically walking at a moderate pace for 30 minutes on 5 or more days each week.


This simple prescription has the potential to prevent and treat more diseases than any other therapy. Furthermore, strength and flexibility training can also be powerful medication to help with the aging process and to improve quality of life. While physicians often recommend exercise to patients, we acknowledge that fitness professionals have the training and skills to help people adhere to these recommendations. Doctors and fitness pros joining forces to improve public health needs to become the new normal—and EIM is working to make that happen.


Research suggests a linear relationship between physical activity and health status, and an association between disease and inactivity in every subgroup of the population (Lancet 2012). Yet mainstream U.S. medicine has mostly ignored this research and failed to integrate exercise into standard disease treatment and prevention paradigms. This has to change, because the Affordable Care Act is ensuring that more and more Americans have access to health care and we are quickly realizing that our current healthcare system with its focus on pills and procedures is not financially sustainable. We must shift the focus to keeping people healthy, and we know the best way to do it:


Avoid tobacco, eat a healthy diet and exercise daily!


While smoking rates have plunged over the past 50 years, the results on healthy diets have been a massive failure: Americans have grown even fatter, and we can’t find five nutrition experts who can agree on the best diet; with diet books and weight loss programs of their own to promote, most have conflicting interests.


Mainstream medicine, meanwhile, has not embraced exercise because there is no clear way to profit from patients becoming more active. The people who actually pay for health care, however, have an incentive to notice the ample evidence proving that fit, healthy people cost us less to care for, miss less work and stay more productive.

The time has come for physicians to strongly advise patients to engage in regular physical activity, particularly patients facing chronic diseases such as diabetes, heart disease and high blood pressure. Moreover, fitness professionals and health clubs can play a pivotal role in helping to ensure that people heed their doctors’ prescriptions to exercise.


For more information on exercise, contact Maurie Cofman, CMES, CES, TBMM-CES, Personal Trainer, Certified Medical Exercise Specialist, Health Coach and Corrective Exercise Specialist in the St. Louis, Brentwood, and Clayton, MO area.