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The Cause to Turn a Cause into a “Medical Condition”

Posted Sep 19 2012 10:41am

Classifying common traits as mental illness or medical condition: It’s not just for the psychiatric profession anymore!

A physiologist has now suggested the possibility of doing just that for leading a sedentary lifestyle.

Yes, really.

In a Journal of Physiology commentary , Dr. Mark Joyner of the Mayo Clinic lays out the basic idea:

Physical inactivity and lack of exercise – deconditioning – is one of the most common preventable causes of morbidity and mortality known for an impressive array of diseases (Thyfault & Booth, 2011). It also appears to be a final common pathway for conditions like POTS [postural orthostatic tachycardia syndrome], fibromyalgia and chronic fatigue syndrome. If deconditioning were a recognized syndrome or diagnosis like hypertension, diabetes and POTS, it would be easier to educate the general public and medical community about the one universally effective treatment for it – exercise training.

As he told NPR ,

“The entire medical research industrial complex is oriented towards inactivity.” …Insurance companies will reimburse patients for pills for diseases related to inactivity, but rarely for gym memberships.

Yes, for better or worse, conventional treatment is often dictated by whether and how much insurance will pay. So why not work within the system and medicalize inactivity so you can prevent other illness and dysfunction?

Yet is inactivity alone really the issue or just one of an array of risk-elevating factors? Conversely, we might ask if exercise alone is a sufficient intervention.

And isn’t it kind of weird to label a cause of illness as a medical condition itself? It would be like calling rickets “lack of vitamin D” or scurvy “not enough vitamin C” or pellagra “too little niacin” (vitamin B3).

More, the proposed “condition” is really more of a behavior (or, if you’d rather, the lack of a behavior, i.e., physical activity), and in the words of Dr. Thomas Szasz (who just recently passed away ), “ No behavior or misbehavior is a disease or can be a disease. That’s not what diseases are.”

Of course, in Joyner’s scheme, you’d at least be treating a cause instead of symptoms. As he writes,

Physicians are presented with symptoms and use tools they are most familiar with (often drugs) to address them. Unfortunately, most physicians are simply unfamiliar with the complex physiological responses to both acute exercise and, more importantly, the adaptations associated with exercise training. Additionally, exercise training is ‘the hard way’ because as the Shibata paper shows, individuals in a severely deconditioned state essentially need supervised exercise training in a supportive environment. The Shibata paper also shows that when this environment is available the results can be remarkable and there is some evidence that with prolonged periods of training, even more dramatic improvement in the symptoms of these patients is possible….

Image by @alviseni , via Flickr


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