Bruno Gualano
He is a Full Professor in the Department of Internal Medicine at the University of São Paulo Medical School (FMUSP) and President of the FMUSP Lifestyle Medicine Center. He holds a degree in Physical Education from the USP School of Physical Education and Sport (2006); is pursuing a degree in Philosophy at PUC-SP; holds a PhD in Sciences from the USP School of Physical Education and Sport (2010); completed a postdoctoral fellowship in Internal Medicine at FMUSP (2010–2011); completed a postdoctoral fellowship in Philosophy (Theory of Knowledge) at PUC-SP (2024–2025); and is currently completing a postdoctoral fellowship in Philosophy (Ethics and Political Philosophy) at PUCSP. He obtained...
Exercise as Therapy: Yesterday, Today, and Tomorrow
The idea that movement heals is one of medicine’s oldest intuitions. As early as Hippocrates, exercise—in the right dosage—was seen as a remedy against illness; it later took on a mechanistic dimension with Descartes, whose "animal spirits" (1649) traveled along the nerves to set the body-machine in motion. It was not until 1953, with Jerry Morris’s study of London bus workers, that this age-old perception was transformed into epidemiological evidence. What Descartes had conjectured was finally measured: exercise operates through a systemic molecular repertoire, likely inherited from an evolutionary history that shaped us for movement. Today, there is robust evidence of the therapeutic effects of exercise on conditions as diverse as obesity, cardiovascular disease, autoimmune disorders, and COVID-19. From clinical practice to public health, the contemporary challenge has shifted from the “efficacy” of exercise—which has been amply demonstrated—to its “effectiveness,” a matter that remains open to question. Answering what makes someone physically active requires viewing movement not merely as an individual behavior to be corrected through counseling and awareness-raising, but as a health practice shaped by embodied dispositions, unequally distributed resources, and the social fields in which bodies live and work. This shift in perspective has profound implications: the question "how do we convince this person to change?" is joined by another, equally decisive one—what conditions make such a change possible for them? It is this question that should drive the field forward.