Exercise Pill? Yeah Right!

Don’t believe the hype around the news story about a revolutionary new exercise pill, because there is no exercise pill. There will be no exercise pill. There is just a 1 in 5,000 chance that the reported drug will make it to market by 2030. If and when that happens, it will not be marketed as an exercise pill.

Selling the dream

Researchers from Deakin University had one of their research papers published on an online science journal. Deakin must have a stellar PR team because by Wednesday all of the major network TV and news media were breathlessly reporting headlines like: “New ‘exercise pill’ could be a game changer in fight against obesity” (SBS) and “New ‘fat pill’ to help you lose weight without lifting a finger” (Ten Eyewitness News).

If one believes the gist of these reports, it will soon be possible to buy a pill which, when taken regularly, will instantly produce the same effects of a regular exercise workout routine. Sensational journalism? Yes. Useful information for people who want to control their weight? No. Here’s why:

The Research

The actual research paper, co-authored by Vidhi Gaur, Timothy Connor and others, is entitled “Disruption of the Class IIa HDAC Corepressor Complex Increases Energy Expenditure and Lipid Oxidation”. The fact that the title is not as catchy as “Exercise Pill a Reality: Aust Researchers” (Daily Telegraph) offers a hint that this paper is not about a miracle exercise pill.

The paper describes how, by injecting a type of chemical into the muscles of mice for 28 days (before killing them), they were able to record significant improvements in the metabolic health of the mice.

Tricking the Body

The mice which received the treatment were healthier than the ones which did not receive the treatment, because their bodies were tricked into “thinking” that they had been exercising (even though they had not been), because the drug interfered with their DNA in the same way that the effect of exercise does.

The researchers administered three different substances on the mice. The type of drug that was tested is a compound called an HDAC inhibitor. This type of compound has a long history of medical use mainly in the fields of psychiatry and neurology. HDACs were first used to treat epileptic fits in 1967. The family of compounds is also used in cancer treatment, inflammatory diseases, parasite diseases, HIV/AIDS, and now (apparently) metabolic diseases like heart disease and diabetes.

The primary purpose of the research appears to be an attempt to make the case that a specific HDAC inhibitor is an option for treating heart disease in people who are unable to exercise. Here, we are talking about people who are necessarily inactive because of old age, paralysis, or some other condition which makes it impractical to become active enough to effect metabolism in a meaningful way.

Why it is not an Exercise Pill

The term “exercise pill” has a meaning which is different to the properties and intended purpose of the drug being reported. An exercise pill would replace exercise by providing the same benefits of exercise, but this drug does not provide the same benefits of exercise (even if it indeed works exactly as reported in humans who are not killed after 28 days of intra-muscle injections).

Exercise causes a great many long and short-term changes to occur in the body’s structural, metabolic, hormonal, and psychological state. The HDAC inhibitor causes a much narrower set of metabolic changes in the short-term, and since they killed the mice after 4 weeks nobody can speak about the long-term effects.

Regular exercise has a profound and ongoing effect on a person’s muscle mass and basal metabolic rate, whereas it would appear that the effects of the drug being reported last for only as long as the compound is active in the bloodstream.

Why it may never appear on supermarket shelves

With just one single piece of research involving a few eight-week-old male mice from Western Australia, it is fair to say that this is a highly experimental drug. Even with maximum resource funding, it takes an average of 12 years for an experimental drug to move from laboratory trials to your bathroom cabinet, that is if it is able to pass all of the necessary tests and approvals including:

  1. Pre-clinical testing
  2. Investigational New Drug Application
  3. Phase 1 Clinical Trials
  4. Phase 2 Clinical Trials
  5. Phase 3 Clinical Trials
  6. New Drug Application
  7. Phase 4 Studies

The above steps are from the Federal Drug Administration (FDA) in the US but a similar process is followed in Australia.

Just five out of five thousand drugs which enter pre-clinical testing end up being tested on humans, and out of those five only one ever makes it to market. So, on the face of it, this new ‘exercise pill’ has a one in five thousand chance of making it into pharmacies, and even then it is likely to take upwards of a decade before it passes all of the tests.

Side Effects

All drugs have side effects, but at this stage it is not possible to speculate on what they might be for this “exercise pill”. Perhaps a good place to start would be the known side-effects of Belinostat, which is an HDAC inhibitor drug (same chemical family as the reported drug) currently available for the treatment of cancerous tumours:

  • Low blood pressure
  • Swelling of extremities
  • Rash
  • Fever
  • Itching
  • Vomiting
  • Diarrhoea
  • Chills
  • Cough
  • Anaemia
  • Dizziness

The list goes on but you get the idea – this drug is unlikely to be doled out to whomever wants it so that they can skip their daily walk around the block.

The conclusion is simple and obvious: there is no substitute, and there will be no substitute, for good old-fashioned exercise. So get those trainers on and get out amongst it!