This morning I was scrolling through my Facebook feed and I ran across a link to an article that began “If there were a drug that treated and prevented the chronic diseases that afflict Americans and we didn’t give it to everyone, we’d be withholding a magic pill. If this drug was free, in a country that spends more than $350 billion annually on prescription drugs, where the average 80-year-old takes eight medications, we’d be foolish not to encourage this cheaper and safer alternative as first-line treatment. If every doctor in every country around the world didn’t prescribe this drug for every patient, it might almost be considered medical malpractice.”
My first thought in response to this was “if this drug is exercise I’m going to smack a bitch”. Alas, I opened the article, and the title “The Exercise Cure” glared back at me. The idea that exercise is necessary and easy for everyone is not only wrong, but also classist, ableist, and heavily neurotypical. Nobody can deny that exercise generally has a lot of benefits and that it can be great for improving overall health. However the idea that exercise is free, readily available, and should be something that everyone does ignores the fact that many people simply cannot exercise.
Let’s start with the claim that exercise is free. Well first and foremost exercise takes time and for those with the least amount of money, time is incredibly important. If you’re working multiple jobs, then taking time to exercise is a loss of money and shifts. In addition gyms aren’t free and simply going outside to run or walk is not always an option (as an example I am currently looking out on -2 degree temperatures. Also see: unsafe neighborhoods).
I’m also going to go out on a limb here and say that this author has never had a chronic disease. It’s one thing to suggest to a patient who is constantly in pain that exercise would make things all better. It’s another thing to be constantly in pain and then have someone tell you that you should probably get up and go move around a lot even though it hurts. Let’s also not forget that some people are simply not physically capable of exercise as traditionally imagined (those who are confined to wheelchairs or other similar situations) and that getting exercise then becomes far more expensive and difficult. Hello ableism, how’re you today?
Finally, as someone who often hears that their depression or anxiety would be improved if they just got out and exercised more, I’d like to offer a resounding “fuck you” to anyone who thinks that exercise cures chronic mental health problems, or that it is even possible when someone is severely depressed or has another difficult mental illness. Depression is debilitating, and suggesting that one can simply muscle past the lethargy, the lack of motivation, the anhedonia, and all the other elements of depression that actively make it difficult to exercise is both ridiculous and cruel. This is not to mention the intersection of eating disorders with all this, which the author casually blows past with a “There probably is such a thing as too much exercise, but I’m much more worried about inactivity”. Bully for you my friend, some of us don’t have that luxury.
I’m also not even going to touch on the fatphobia in this piece but let’s just leave this here: “Solving the obesity epidemic is the key to reducing health care costs”.
The overall suggestion of Metzl’s article is that we should offer financial incentives for movement. This might seem like a great idea, but it once again will set up a system in which those who already have the privilege to go to the gym, get a personal trainer, pay for exercise that they actually enjoy, have the time to exercise, and who are able-bodied and neurotypical will be rewarded. Not only will it reinforce those privileges, but it will financially disadvantage those who are already at great disadvantages (and let’s be honest: the overlap of class and race in this country would suggest that it will probably entrench the racial divide even further).
As a final note, we have a fair amount of evidence that weight relies heavily on genetic factors, and that many people will never fall into the “acceptable” category on the BMI scale. If we start creating official sanctions and rewards for exercise and health based on the assumption that everyone could lose weight with exercise, it could be an incredibly slippery slope to financial incentives for weight, which might mean penalizing people for something they have no control over whatsoever (once again, fatphobia). This is of course speculation, but the general attitude that everyone should be required to exercise, eat, and weigh a certain amount is incredibly damaging and incredibly dangerous.