Re-Engineering Fitness As Upstream Preventive Healthcare

Fitness is a failed business model in need of upgrades for an aging population.

Martin Pazzani
8 min readMay 6, 2014

The aging population is an unstoppable tectonic force that will reshape nearly every sector of the economy. In America alone, there are ninety-two million people above the age of 45 who have a habit of coaxing companies into changing products and services to fit their needs.

Now, they are starting to pay attention to the realities of aging and their search for solutions is creating a gargantuan new business opportunity: the Longevity Economy. An ineffective fitness industry — America has never been less fit — can either adapt to this fact, or continue to tread water using a business model that does not serve the people that need it the most.

It’s already clear that the baby boomer generation has no intention of aging the way their parents and grandparents aged. They are not going to retire at age 65 to a life of leisure or settle for bingo tournaments at the retirement home. No, they are on the hunt for the fountain of youth. Many fully expect to be snowboarding at age 85, but unfortunately there is a serious disconnect: they also happen to be the least fit group in history. So while they say they are looking to live forever, their behavior suggests just the opposite.

Far too many boomers are not active enough, either physically or mentally, and they eat too much of the wrong foods. Instead of being proactive about their health, many seem to be sitting on the couch, staring at a screen, and waiting for a magic youth pill that will never arrive. We’ve become far too accepting that aging means it’s time to slow down, and so we stop using our bodies and our brains decades before they are ready to retire.

However, there are signs of an awakening to the idea that the best solution is healthier living, particularly being active in both body and brain, and this creates the ideal opportunity for the fitness business to learn how to serve an older population.

Silicon Valley innovator Nilofer Merchant said, “Sitting is the smoking of our generation.”

That is indeed the painful truth. The obesity epidemic is already alarming, and it leads directly to exponential increases in diabetes, joint problems, heart problems, and dementia. In fact, the brain of an obese person actually shrinks, becoming up to 10% undersized because of the obesity.

Unless something changes, we are on a collision course for cultural and financial disaster. Yes, medical advances are effective at keeping fundamentally unhealthy people alive a lot longer than in the past, but by the time they need the healthcare system to survive, they have become an expensive problem. An overweight, inactive, and diabetic 65-year-old has an increased risk of dementia, and is on a lengthy and expensive downhill slide that can consume life savings and use a wildly disproportionate amount of healthcare resources.

“Most Americans spend somewhere around eight years at the end of their lives incapacitated either unable or severely limited in doing things such as getting up from a chair or walking,” said Colin Milner of the Int’l Council on Active Aging.

This decline is almost completely preventable. The sorry state of a whole generation is the result of numerous poor lifestyle choices, with too little help from a fitness business that is mired in its youth-focused origins and has failed to live up to the promise of creating a fitter nation. Ironically, a portion of the blame for our unfit nation can be placed on the fitness business itself, and since I know it from the inside out, I’m going to point to it’s shortcomings and offer some solutions.

As a former executive for Bally Total Fitness and Crunch, and an advisor to 24 Hour Fitness, I’ve done almost $1 million dollars in research over the last decade to understand why people don’t go to gyms and don’t exercise. Instead of asking the 50 million gym members how to make gyms better for them, I focus on creating solutions for 250 million people who would never consider joining a gym, or joined briefly and left. I believe it’s time we had a fitness industry that served more people.

The existing fitness business still uses a model developed in the 1970’s for a much younger population, and aside from cosmetic changes, has failed to adapt to the new marketplace. The numbers speak for themselves. Only about 30% of the population exercise at all, and only 20% belong to a gym. Perhaps half of them get no results at all because they exercise incorrectly or not enough. Then at age 45, when people need it the most, gym membership plummets to a mere 10%.

But change is coming. The aging population and the economic factors of the Longevity Economy are starting to demand it for a myriad of good reasons.

More and more scientific evidence is demonstrating that keeping brain and body active via exercise is as close as we can get to the fountain of youth. The most exciting part of this evidence is new knowledge that exercise with the right intensity, the right techniques, and the right variety of brain and body training can delay many of the effects of aging at worst, and at best create neurogenesis — the building of new brain cells — at any age.

I believe prevention is always preferable to medicinal cures and even more so when it comes to brain health. Instead of ignoring the aging population and leaving them to an uncertain future in the healthcare system, I propose that the fitness business transform itself into what it should be: upstream preventive healthcare, with a new emphasis on the needs of people above age 45.

It’s possible that within a generation, much of the trillions of dollars spent on insulin, dialysis, broken hips, congestive heart failure, depression, nursing homes, dementia, etc. could be saved. Sick, sedentary, senile 80-year olds in assisted care facilities could give way to legions of active, healthy great-grandparents still being productive and enjoying happier, healthier, longer lives in their own homes.

Not only is it possible, but we know how to do it, and here’s how to start:

1. Improve and evolve the gym experience for people above age 45.

Junior-high locker rooms, symmetrical rows of outdated equipment, pounding rap music, lack of privacy, glaring lights, rude members, unsanitary conditions, high-pressure sales tricks, and predatory personal trainers all contribute in varying degrees to create an intimidation factor that drives many away from the gym experience and keeps even more from considering it in the first place. These factors are deal-breakers for the vast majority of the aging population, who reject the traditional fitness club model. Every one of these issues can be diminished or eliminated with more insightful design principals, modernized equipment, and a better understanding of how to design for and manage the human element. Essentially, the current fitness business is an old Radio Shack. I want to build the Apple Store of fitness.

2. Build a new fitness meme.

The current fitness meme contains DNA from Arnold/Pumping Iron, Baywatch Hardbodies, and X-Games. There is nothing particularly wrong with that, except that this imagery alienates the demographic that needs fitness the most. It is outdated, too young, too male, and frankly scares off the mass market that doesn’t aspire to look like Mr. Universe or Pamela Anderson. More realistic and far more approachable is a growing new fitness meme that emphasizes a more realistic fitness lifestyle, and embraces a 64-year-old Diana Nyad, who swam from Cuba to Florida, a group called Skydivers Over Sixty, the aspiring 70-year old marathoners, and the army of empty-nesters who now have the time to travel and hike the Alps if they want. This new meme needs to shift away from what you look like on the outside, or how fast you can run a 10K, or how much you can bench-press. Instead it needs to be about living longer, spending less on healthcare, not being an expensive burden to your family or the system, and having a much higher quality of life during those extended years. It also needs to emphasize that it’s essential that your brain lasts as long as your body.

3. Embrace The Quantified Self movement.

The advent of wearable fitness trackers and apps is only a starting point in what is certain to become commonplace: measuring and tracking a wide range of biometric and cognitive data. The current technology has definite shortcomings, but in the near future, it will be accepted, if not expected, that you will use some form of bio-tracker to keep your family, your trainer, your doctor, and quite probably your insurance company informed of your biometrics and your progress during a workout program. This will enable and encourage an easier-to-sustain fitness lifestyle. Better drivers pay less for auto insurance because they are better risks to insure. People who maintain a higher level of fitness and are willing to prove it through Quantified Self technology, will pay less for health insurance by the same actuarial logic. The fitness business can do themselves a lot of good by understanding this dynamic, how to use the data it generates, and use it to improve the effectiveness of their programs.

4. Put the brain first.

Every movement, every muscle, every physical activity is controlled by the brain. There is no such thing as ‘muscle memory’ in sports. It’s the brain that is guiding those complex motor skills and coordinating hundreds of muscles. So wouldn’t it make sense for the fitness business to embrace the latest techniques for maximizing brain function? The brain uses about 20%-30% of the nutrients you ingest and the oxygen you breath despite weighing only four pounds. Face it, the brain is the most needy of all organs, and it must come first. Starting with the brain becomes especially important when you consider the needs and the motivations of the aging population.

Fear of dementia is on everyone’s mind, and we are about to see a large uptick in people whose bodies last longer than their brains (this scenario is the most expensive of all). However, exciting new research is making it clear that the right kind of integrated brain and body exercise can have significant anti-aging effects, and also perhaps even build new brain cells.

We’ve discovered in our trial programs that when you make brain health the priority, the benefits to your physical health follow in tandem, and are both numerous and significant. This is potentially life changing stuff we’re talking about here, and if enough people catch on, it will be culture changing.

The idea of focusing on brain fitness is in an embryonic stage. There needs to be much more research in this area. There needs to be more investment in better fitness options for the age 45+ market, and more application of motivational, design, and technology insights that can create a more inclusive and non-intimidating fitness business for an older population.

The Longevity Economy is here and it’s demanding solutions. One of those solutions is to re-engineer fitness as upstream preventive healthcare. It looks to be an exciting and rewarding path to travel.

Martin Pazzani is CEO and Founder of Act!vate Brain & Body Inc. a startup in the process of building a fitness company dedicated to the brain and body fitness of people above age 45. Their mission is to radically improve the trajectory of aging. Act!vate Brain & Body is on Facebook and Twitter at @ActivateBrains.

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Martin Pazzani

Corporate CEO / CMO turned Serial Entrepreneur. Founder (brain fitness, longevity, bourbon, tequila). Strategist. Marketer. Mountaineer. TED Speaker. Author.