Pillar 3 Exercise

This is post 3 of 6 focused on exploring my 'six pillars of health'. 

Coming at longevity medicine without a mental model leads me to fall down a dizzying rabbit hole of options which are overwhelming and exhausting. Thus, I created a six pillar model of health that allows me to sort, triage, and critically assess all the information I obtain in my never ending journey to optimize health. 

My six pillars are Life Philosophy, Sleep, Exercise, Nutrition, Social, and Sex. Is there something sacred about these 6 pillars? No, these pillars were not divine revelation delivered to me on tablets of stone. However, I have found that designing specific and actionable interventions to improve health works well in the 6 pillar paradigm. It’s broad enough to cover the most important bases but not so broad as to be directionless and unhelpful; they are useful guide-rails that are not overly ridged. 

With that being said, let's take a look at our third pillar, 'Exercise'.

Perhaps nothing is more potent to improving the length of time you are alive AND improving the quality of that time as exercise. I can easily list off all the scientific mumbo-jumbo about exactly how and why exercise is so good for you, but at a fundamental level I think everyone intuitively gets it. Just like people instinctively know smoking and doing methamphetamine are bad for you, people have a sense that exercise is good for health.

So I think the interesting question is why doesn't the typical American exercise?, and more specifically why don't you exercise? (I'm using the 'impersonal you' here as I don't know if you the reader this is an avid exerciser or not.) I think I have found the key determining factor... it comes down to identity and your default state. Thus, in my practice I start my approach to exercise, not by listing all the zone 2 metrics, VO2 max cut offs, or strength training routines, but by digging into the unique life philosophy of the patient in front of me. I need to know their 'WHY' before I can really do much else of value with their exercise. What I am specifically looking for is to see if the patient in front of me identifies as an, "I am an exerciser" or an "I am not an exerciser".

I have come to find that this identification makes all the difference. If you are in the "I am not an exerciser" category, then all exercise endeavors are going to be by necessity enacted by will power. Spoiler alert... will power doesn't work... at least not in the medium or long term. Ever wonder why every time you get into a bit of an exercise trend, and then you miss a day, it throws the whole thing off and you can't seem to get back on track? It's likely because your identity is that of a "non-exerciser."

When you identify as a 'non-exerciser' and the life bumps come along, you inevitably get off track and 'default' back to the unhealthy habits of the 'I am not an exerciser' identity. Instead, when "I am an exerciser" is part of your identity, no matter what the shitshow of life throws your way, you can't help but come back to exercise. Any disruption of your exercise routine is viewed as a blip in an otherwise inevitable process of continuing to exercise, because that is your identify, that is your 'default' state. 

Just to really double down on this point, exercise has this daunting initial start up effort that needs to be overcome before it becomes enjoyable and addicting. If you are white knuckling it through, fighting against your identity as a 'non exerciser' with sheer will power, your likelihood of success when it comes to establishing a sustainable exercise program is very very low. If you are instead flowing with the current and following your identity as 'an exerciser', then you are simply doing what is inline with how you view yourself and it will more likely than not fall into place, making your likelihood of success when it comes to establishing a sustainable exerciser program very very high. Seems like some kind of 'mind-fuckery' but it works.  

Wait... did I just catch you saying that exercise should be addicting in that previous paragraph? That's right, I am specifically using the word 'addicting'. By the time I'm done with you I want you on the path to where you have several of the the classic hallmarks of addiction when it comes to exercise. I want you to crave exercise, I want you to feel great when you do exercise, I want you to prioritize it above other competing behaviors, I want you to build up tolerance to exercise and indulge in more and more to 'get your fix', and I want you to feel withdraw when you don't get exercise.

Of course the 'addiction' terminology starts breaking down after this. I don't want you to exhibit some of the other hallmarks of addiction, like distress or impairment from exercise, preforming risky behavior to get your exercise in, or destroying other parts of your life like your job or important social relationships to the fanatic pursuit of of exercise. Interestingly, getting addicted to exercise will use some of the same neural pathways that addictive drugs highjack, so there is more than just abstract analogy in my terminology. All that being said, I definitely

want you more 'addicted' to exercise than you are now. 

After nailing your 'WHY' everything gets way easier. It's really only after we go down this life philosophy route, establish your 'WHY', and find the vein that leads to exercise becoming inline with your identity, that I start going down the zone 2 metrics, VO2 max cut offs, or strength training routines. We start digging into what your specific needs are for exercise based on your current health, labs, genetics, preferences, body composition, current cardiorespiratory fitness, resources, accountability system, and time constraints to make a program specific to you. We check back in at multiple points and retest using objective metrics to make sure the program we are developing is actually working.

We follow the data and we make sure you are enjoying it. If either of those criteria aren't met, then we rework it until it does.

Exercise should be rewarding and non-negotiable in your life. We will dive past the trendy bullshit fads and look at what gets us the most gains for the least effort.