Fitness as Medicine for Body, Mind & Soul

My newsfeed is inundated, veritably assaulted, with tips and tricks on fitness. The protein elixirs, the clothing, the trainers, the imperative. And I am all in. 

I have often mused that the key to my present state is a healthy dose of Vitamin V—V for vanity. But what if we were to trade vanity with urgency? Would this resonate better? The urgency that lies before us is the realization that health and longevity—the drivers of the medical industry—is to capture them in time and with intention before it becomes difficult and expensive. The $600 billion price tag on fixing health must be replaced with a systematic campaign to fuel health before the crisis sets in. 

So, I say to athleisure and workout pundits and protein supplement innovators alike: bring it. 

I used to tell my patients that exercise is a resolve that begins at bedtime. If you sleep in your workout attire and place your shoes at the foot of your bed, you are one step in on the process. If your 16-ounce water bottle is poised and ready to go, you are an additional step forward on the path. If there is gas in your car and your gym membership is paid for, you need only resolve to get there. And if you have a trainer or a friend and familiar faces cheering you on when you enter the door, your success is almost guaranteed. Resolving to proactively address these steps and hurdles is the de facto line where success and failure are determined. The initiative to resolve them today, as in right now, is the essential vitamin “you/U” for Urgency that we simply must prioritize. 

The Horsemen of Health: What’s at Stake? 

In Outlive: The Science and Art of Longevity, Dr. Peter Attia highlights the “horsemen” we are confronted with which are the drivers of health maladies. They include cardiovascular diseases (stroke, heart disease, and hypertension), metabolic (diabetes, as an example), neurological (dementia and Alzheimer’s) and cancer. When we examine the aspects of health that are within our grasp and control in the context of these horsemen, we begin with our behaviors: the choices we make in our daily lives that must be negotiated in the spirit of healthcare agency.

A negotiation is an agreement you make based on gains and gives—what you are willing to give and what you hope to gain in return. Healthcare agency is the ability to derive, comprehend, and make medical decisions with informed consent. When contemplating our lives in the context of health and longevity, we are in control of a large percentage of what happens to us. Fitness is a fundamental variable in the context of health and wellness and can be regarded as a negotiation made with our health agency. 

In this video, Dr. Peter Attia delves deeper into the four horsemen of chronic disease, emphasizing the critical role our lifestyle choices play in combating these major health threats. 

Fitness as Your Prescription 

So, let us go back to the original conversation on fitness with Peter Attia’s horsemen as to the why. If we are to look at hypertension, diabetes, dementia, and cancer, we can find a unifying risk factor for all of them: obesity. When weight exceeds the parameters that constitute healthy living for any given demographic, the risk for burdensome illnesses rises. Such diseases can be treated with pharmacotherapy and adjusted with additional drugs to achieve control. 

However, the goal cannot simply be achievement of health through medications if one is to consider internal approaches. With behavioral modifications undertaken and probably enjoyed, you endeavor to avoid disease altogether or use fitness as your treatment upon diagnosis. Imagine: fitness as your Rx. If we can see both purpose and measurable outcome in exercise, we might be able to stave off diseases before they manifest and control outcomes like stroke, heart attack, diabetes, decline in memory, and cancer. 

Peter Attia emphasizes that insulin resistance, often linked to obesity, increases the risk of cancer up to 12-fold. By maintaining a healthy weight and preventing insulin resistance, we can reduce the likelihood of developing metabolic dysfunction, which is a precursor to many chronic conditions, including cancer. This underscores the importance of fitness as both prevention and treatment— imagine flipping the script, where your workout is your prescription. Fitness as medicine. Isn’t that what we’re really after? Moving away from relying on pills and procedures, and instead getting ahead of it all with a proactive approach to health. 

The Cost of Disease vs. The Cost of Prevention 

Healthcare burden refers to the immense costs of treating diseases and the expenses tied to debilitating outcomes, such as stroke or even amputations resulting from poor disease management. As of 2022, the annual cost of treating diabetes alone in the U.S. equals $413 billion. Stroke adds an additional $40.1 billion. In 2024, the cost of treating heart disease, including catheter-based interventions and bypass grafts, is projected to reach $252.2 billion. To put this into perspective, the United States is expected to spend over $5 trillion on healthcare in 2024—an unprecedented figure. 

Now, compare that to the cost of a gym membership, access to nutritious food, and a good night’s sleep—pennies in comparison. 

You Are the ‘U’ in Urgency 

Your health outcome does not need to pattern that of your forebears. Do not believe that you are destined for hypertension or diabetes when recounting your family’s history. You can change your course if you are willing to recognize your role in health outcomes and place urgency before excess.

We in healthcare must engage in conversations that speak to longevity and wellness in the context of the greatest prescription with the best side effect. Your vanity is a redemptive catalyst when you are driven by behaviors that are neither destructive, nor punitive. Fitness is among the greatest prescriptions we can offer our patients. 

Mandating physical education not merely for our children, but for all of us, lifelong, makes sense. A life lived well lends to lower costs of healthcare, prolonged healthspan, and lifespans that are spent enjoying the things we love with fewer burdens physically and economically.