THE WEEKLY HOWL IS A VERY FIT DOCTOR

Leading the Charge: One thing is that has almost been lost in the changes to the sport of CrossFit is that the genesis of these changes is a desire to focus on CrossFit Health. What is CrossFit Health? From Vox:

Since January, he’s hosted 340 doctors for weekends of networking, lectures, and a free two-day level-one CrossFit training course — the minimum requirement for anyone who wants to open a CrossFit gym. The next “MDL1” training will happen this weekend, at CrossFit’s headquarters in Scotts Valley, California. And Glassman has already expanded his offering beyond the US, to France and Brazil, in response to physician demand, he says.

The new endeavor — called “CrossFit Health” — is the future of his business, Glassman said. It might also be his legacy. By amassing and coaching an army of doctors, through CrossFit’s 15,000 affiliates around the world, he envisions nothing short of a global disruption of the health space. “[Doctors have] gone back [from the training weekends] a little bit militant. More eager to talk to one another and their colleagues; more likely to take a patient by the hand and bring her into the gym,” he said.

When asked what he hoped might come of the doctor trainings, Glassman was vague. “We thought it would just be nice to network [the doctors],” he said. When pressed, though, he articulated a big wish: While he wasn’t interested in drawing doctors away from medicine, he hoped they’d feel empowered to think about prescribing CrossFit to patients, incorporating it in their medical practices, maybe even opening up CrossFit affiliates.

In my years of medical reporting, I’ve come across hundreds of trainers, doctors, celebrities, and scientists who’ve promised permanent weight loss, longevity, and lasting health. As their fads have come and gone, the obesity and diabetes epidemics have only worsened, and, on average, Americans still aren’t exercising.

But Glassman’s view is distinct. Rather than focusing on patients’ frustrations with the limits of medicine — something celebrities Dr. Oz and Gwyneth Paltrow have exploited — he is now setting his sights on the dissatisfied deliverers of health care: the doctors.

Doctors, Glassman says, can see that CrossFit “fucking works.” And he’s become an unlikely advocate for solving an inconvenient problem: With the exception of bariatric surgery, doctors have few tools for treating, let alone preventing, obesity and other lifestyle-related diseases.

CrossFit is the only fitness company thinking about the big picture. It is starting to fulfill the role of an industry leader, something that the fitness industry has never had. This is how you grow the pie instead of just fighting competitors for market share and it raises the entire industry up. Creating a closer relationship between the medical establishment and the fitness industry is absolutely a good thing.

Other exercise scientists and obesity doctors I spoke to were much more skeptical of Glassman’s vision.

“We have a lot of [health problems] that could be addressed by better lifestyle, but the question is ‘how generalizable is [CrossFit].’ In my opinion — having taken care of thousands of patients — it’s not generalizable,” said Dr. Michael Jensen, an obesity and metabolism expert at the Mayo Clinic.

“[The people] who are in most need of correcting metabolic disorders — overweight, out of shape, busy, stressed — are very unlikely to be able to do what CrossFit wants them to do, physically, emotionally, lifestyle-wise.”

Jensen was getting at the question of whether CrossFit can truly help those most in need: the non-exercisers. “The biggest reduction in risk for every single known chronic disease when it comes to physical activity happens when you get somebody who does nothing to do something, and I mean anything — going for a walk,” said McMaster University’s Phillips.

There’s no substantive evidence — at least not yet — that CrossFit can transform these folks over the long term, he added, even with doctors prescribing the program.

“Exercise is truly a wondrous thing for health,” said obesity physician Yoni Freedhoff. “But suggesting there’s something unique to CrossFit probably isn’t evidence-based. And then there’s the fact that the percentage of the population sufficiently privileged to intentionally find consistent, multiple times per week exercise blocks is very, very small.”

 In response to this critique, Russ Greene, the CrossFit executive, said the company has always delivered workouts for free on its website.

Is it self-serving for CrossFit to want doctors to prescribe CrossFit to their patients? Of course, it is. They’re a for profit company, what do you expect? CrossFit is not for everyone but this will end up driving a lot of people to gyms and workout programs that are not CrossFit. The key is to change the relationship between medicine and fitness. Modern medicine was designed to treat patients who have contracted diseases not to take a holistic approach and try to prevent disease. But right now, the biggest health problem is that people are overweight which leads to a host of diseases. We need a more holistic and preventative model. This is a huge step in the right direction even if everyone doesn’t end up cranking out WOD’s.

Love the pop-up: Maintaining a decent fitness routine on the road has historically been a struggle. Your hotel gym, if you’re fortunate enough to have one, was probably a joke. Buying day passes at the neighborhood gym was prohibitively expensive and if you tried to run outside, you would probably get lost. That has been slowly changing as hotels have trying to accommodate fitness-conscious guests. Now Orangetheory is launching a series of pop-up gyms inside hotels. From Digiday:

High-end gym chain Orangetheory is testing out pop-ups for the first time. The company, which operates 1,000 gyms in 16 countries, is launching them to reach a new customer segment — travelers.

Orangetheory launched its first pop-up location last week at the Boca Raton Resort and Club, a Hilton-owned Waldorf Astoria hotel, and in 2019, plans on launching about a dozen more in hotels across the U.S., according to Kevin Keith, chief brand officer at Orangetheory.

At the first location, any guest at the resort can purchase a group interval training class for $30 or, if they are already members of the gym, join a class for $20. Keith said the company is also working on merging fitness with wellness by designing packages that would pair an Orangetheory class with other amenities at the hotel such as spa services. The pop-up will last six months.

Hotels are very interested in fitness these days and we’re going to see more collaborations over the next few years. I wonder who looks to get more aggressive. Equinox is building a hotel but I wonder if we’ll see more consolidation coming from the other side: hotels buying gyms. It’s also important to note that Equinox is owned by The Related Companies, a massive real estate firm. Both hotels and gyms are real estate businesses and fitness is becoming more important to the type of guest that hotels want. Gyms could offer a path to growth as well as a way to differentiate from competitors. And a lot of the big hotel chains are already franchisors so they’re no stranger to that business model.

Owning the wrist: Wearables are going to be a thing, whether you like it or not. Smartphone growth is over so tech companies have to figure out a way to put some kind of device on the wrist of every man, woman, and child. How they’re going to do that is still up in the air because the value proposition of wearable devices is still debatable when we all carry computers in our pockets. From Inc.:

Wearable biometric devices are quickly entering the mainstream. A new forecast from eMarketer says the number of U.S. adults who wear a smartwatch will cross 10 percent in 2019, while one in five internet users will own some kind of wearable.

Yet the category has long suffered a "so what?" problem. The standard knock is wearable trackers give you data that's mildly interesting but ultimately irrelevant. After a few weeks or months, the novelty of knowing your step totals or resting heart rate wears off--even faster if you know much about how inaccurate those numbers can be. That's why user churn has been such a persistent problem for companies in this space, or so the theory goes.

I see it somewhat differently. The value proposition of fitness trackers is real; it's just awfully front-loaded. When I started wearing a Fitbit, I was shocked to find out how few steps I took on low-activity days. I noticed how much better my energy was on days when I broke up long periods of sitting with walks and altered my habits accordingly.

The Oura was even more of a wake-up call. While it lacks the multifunctionality of a smartwatch, it makes up for it with smartly presented biometric insights and suggestions. The device combines data from its various sensors to generate a daily sleep score and a "readiness" score that's a measure of fatigue versus freshness. Looking at the breakdowns, you can see things like how much deep sleep versus REM sleep you got the night before, how that compares with your weekly or monthly average, and what each means to your overall well-being. (Deep sleep, I learned, is crucial for muscle rejuvenation and repair, while REM sleep is more important for creative thinking.) The Oura also tracks heart rate variability, a measure of how responsive your heart's rhythms are to stimuli; high HRV indicates a well-rested central nervous system.

Just a few days of wearing the Oura made me realize I should be thinking less about how many hours I spend sleeping and more about sleep quality. Tinkering with my nighttime habits in response to its suggestions, I quickly noticed how much more restorative sleep I got, particularly in the first half of the night, if I ate dinner earlier and limited alcohol consumption to one drink. Other changes I've made include an earlier bedtime and setting my devices to switch to "night mode," which filters out blue light, after 8 p.m.

All this took me a few weeks to figure out. Once my new habits were in place, though, there wasn't much more for the Oura to do. I continued checking my stats every morning, but that, too, was just a new habit. Now that I knew what internal signals to pay attention to, I didn't need an app to let me know when I'd slept deeply or awakened feeling especially fresh.

This is the best articulation of the problem with fitness trackers that I have seen. It’s not that they don’t do anything, it’s just that it doesn’t seem necessary to keep wearing them forever. They’re good for establishing behavior but after a while, they’re not that essential. This is why smartwatches are taking over. If you’re going to buy a device to wear on your wrist, it may as well do a bunch of things. It’s also why smartwatches are shifting from a focus on fitness to broader emphasis on wellness and health because fitness tracking is not going to be enough by itself.

So where does this end up? Does the smartwatch replace the smartphone? Probably not. How are you going to take a picture with a smartwatch? Will wearables find their killer app? I don’t know but I do know that the tech companies are going to keep going until they find one.

Innoventing: Re-inventing fitness is really hard. We may live in a time in which science fiction is becoming science reality but it is very difficult to improve on the most low-tech forms of fitness. If you want to get strong, lift heavy things. If you want to get fit, get out and move. That doesn’t mean that there isn’t any room for innovation. From Men’s Health:

For now, Tonal’s ability to mimic various resistance-training strategies is its selling point. Its electromagnetic resistance can be altered in an instant, and its programming allows it to simulate more than merely lifting weights. You can use advanced techniques that normally require extra equipment—for example, curling as if you had chains attached to your weights (with the resistance progressively increasing as you lift)—or even employ eccentric loading techniques, with the resistance increasing as you lower the weight.

I bang out a set of lat pulldowns, then a set of biceps curls with simulated chain resistance, and start getting a solid burn. Next I experiment with more bench presses, this time using the unit’s automated spotter system to push out a few extra reps. This doesn’t feel quite right; essentially, the “spot” is a programmed weight reduction that I can’t change. I tell Tonal’s representatives that a human spotter would force me to keep working for my rep. They mention that issues like this can be fixed quickly with a software update. “You can wake up one morning,” says David Azaria, Tonal’s head of software, “and just find new functionality.”

Because the hardware is modeled after a cable machine, it’s ideal for muscle-building exercises like curls and shoulder presses, but not cleans, snatches, and other functional movements that have grown so popular.

Over the past two years, trainers have started favoring total-body moves; even budget-priced big-box gyms like Blink Fitness now have battle ropes and medicine balls. Tonal’s movement tracking and resistance may seem right out of The Jetsons, but to forward-thinking trainers it’s Flintstonian. “In the fitness world, we are clearly going away from machines,” says Mike Boyle, a veteran Boston-based trainer. “You can get an awful lot of stuff done with dumbbells and a bench.”

Tonal founder and CEO Aly Orady counters that I can find other ways to perform the moves that the unit doesn’t accommodate. No power cleans? I can tweak my workouts to do deadlifts and jump squats. But given its price tag, should I need to do that?

Tonal does present something interesting. I am intrigued by its ability to adjust resistance through the range of motion; that is something new. Innovation often arrives as a result of some kind of limitation. The problem Tonal was looking to solve was a space issue: how do you deliver a gym experience at home without taking up a whole lot of space? Because heavy things take up a lot of space and don’t look great in the middle of your living room. That constraint led Tonal to come up with electromagnetic resistance. And changing the source of resistance away from gravity gives it some new properties. But even for all of Tonal’s innovation, it is still lacking some crucial exercises. Some people might not miss them but when something is that expensive, you don’t expect to have to make compromises. Re-inventing fitness is hard.

Tidbits:

-DNA tests can psyche you out

-World Gym is getting into the studio game

-The CrossFit prodigy

-Mat Fraser, Samantha Briggs, and Team Invictus won the Dubai CrossFit Championship and are the 1st qualifiers for the 2019 CrossFit Games

-How should a doctor talk to their patients about obesity