The Anti-Obesity Doctor: If You Don't Exercise, This Is What's Happening To You! - Gabrielle Lyon

to this day everybody focuses on Obesity but obesity is not our problem if you are in the lower one-third of strength you have a 50% greater risk of dying from nearly anything you have to prioritize skeletal muscle what is that this is the organ of longevity the only organ system that you have voluntary control over and there's only two ways to stimulate skeletal muscle number one Dr Gabrielle lion is a pioneer of muscle science and the board certified physician for athletes CEOs and Navy Seals transforming the way we think about muscle and how it can

prevent disease optim your body and completely reshape how we age when it comes down to your health it shouldn't be about how you look it should be about how you perform and there's known replacement for resistance training and skeletal muscle mass but only 6 to 8% of people are meeting the resistance training guidelines and the majority of individuals are sedentary can you describe to me what my life will look like as a 61-year-old if I just sit in this chair and do zero resistance training for the next 30 years are you ready you're 30 so

right now Alzheimer's disease and cardiovascular disease is likely throughout your lifespan your testosterone is probably low and your sperm quality isn't as good as it could have been so there's a link between my fertility for men and women and my muscle mass yes and then you're probably going to be extremely winded walking upstairs likely have obesity and sleep apnea which means you're deteriorating your brain and metabolic health and it's all going to come down to choices our present choices will determine our outcomes so run me through your day cuz I'm just going to copy whatever

you do great okay so what time do you wake up what do you eat how long do you train for are you calorie counting at this point and what time is that last meal typically well question if you could sit at a table with any four guests from the d a CEO who would you choose here's a challenge for the entire D CEO Community if we hit 10 million subscribers by the end of 2024 you will get to pick four guests for your dream conversation and you can make it weird or you can make it

wonderful and here is the best part 3,000 of you that subscribe will be invited to join this conversation live in person and for free subscribe now and let's make this happen together Dr Gabrielle lion what is it that you do for people I believe that I take away any physical restrictions and I certainly feel privileged to take care of people that change the world and when you say physical restrictions give me some flavor and color at what you know when we think about the way in which humans are sometimes they have low energy or hormonal

problems or gastrointestinal problems you name it but those things limit their ability to show up in the world no matter how high performing or how high achieving the common denominator is their health and nobody will ever go higher than their own personal health it is the great equalizer that and age and who did you do it for give me a flavor of the people you've worked with and the walks of life they come from and what they do yes well I've been a physician for 20 years and there has been a number of patients and

kinds from geriatrics I did my fellowship in geriatrics in aging and when I finished that I started a coner medical practice and I take care of right now many of the guests who have been on this podcast like um Evie pomus and um a woman named Dan Patrick I don't know if you know who that is she's a race car driver extraordinary and many tier one operators like Navy Seals and CEOs individuals that are out there that are Mavericks really trying to change the world and one of the things that happens is individuals have this

capacity to push through any way that they are feeling but the cost of that is very predictable and in my clinical practice and part of what I believe that I was put on this Earth to do is to help people who help change the world so when people come to you and you practice what is it that they typically say what is it the the most typical thing that they're searching for and how do they articulate that that is a wonderful question and one of the things that they say is they feel like they know

they could feel better that they could have more energy better sleep you name it that they just have this sense that something is still on the table and we figure it out we go through whether it's Environmental Testing again hormones blood work a lot of my patients have been deployed overseas they come back they've been to Mayo Clinic and all these other places but they still don't get better and I think wellness and health is very holistic in the approach and I am telling you once that is taken care of these people are already making

such an impact but then they can go on because they're not encumbered by inflammation or not feeling well or let's say their body composition is off let's say they are someone who's always been a high achiever and high performer and I don't know they hit midlife and all of a sudden things have changed it's my job to help remove any of those physiological restrictions so that they can do what they do best and not worry about the other things is it complicated what you propose are your Solutions complicated or are they simple another great question

it really depends on what it is that we're looking at the most complicated of all of it is actually not the physical it is definitely the mental because you have to understand that I think a physician needs to be very good at being able to recognize patterns and diagnose patterns of disease but in effect effective physician is able to recognize patterns of people because people are extraordinarily predictable in their nature I'm going to give you an example you're looking at me there's an eyebrow rais I had I'll tell you about one one patient in particular

and every year he put on this massive event this massive event in Vegas made millions of dollars did well and every year I would wait for the phone call I'm feeling depressed I just did so well I don't know what's wrong with me I'm off my diet I don't work out I all the Litany of things and what he failed to recognize was as high as he was going was as low as he was going to fall and I see that with all my type A individuals I wouldn't say that there's a particular demographic of

patient whether they're SEALS or CEOs or moms but it is definitely a mindset and the individuals that I see they want the best out of themselves and at the other side of that and I'm sure you know many of these high performers they drive really hard but they fail to recognize that as high as they go after a book launch and maybe you experienced this with your own book you worked so hard you launched this book into the world or maybe your first massively successful episode which now may be a little bit less because they're

all massively successful but right after after that there is this dip and you don't go back to a baseline it's not like any other Tuesday it's a very big high and a very big low and one has to recognize that nothing will take someone off any kind of Health and Wellness Journey faster than those Lowes and is that psychology or is that physiology I is that my mind and my thoughts or is that my biology and what's going on in my head my perspective is that it's physiology there is an internal recognition or interpretation of

the stress but from my perspective there is a physiological response and from what I can tell and what I believe and what I've seen is this dopamine drive it's and of course this is a simplistic way of talking about it but there's this drive and they are so excited they're amped up they've spent a ton of time in preparation getting ready to do this thing and they've deployed so much importance on this one thing that when that thing is over they're constantly grasping for the next thing and we all talk about burnout as this thing

and burnout happens that way and it's this drive of more and once you can recalibrate that drive and understand that you have to have a very neutral mindset going into things then people are able to mitigate and manage their own physiology mhm the the mindset component is probably the most important because I could give you the perfect plan but if you are unable to to execute that then it doesn't matter there must be so many millions of people that listen to my podcast that have heard all of this advice in terms of how to better

themselves their cognition their performance in various aspects and they still haven't put any of it into motion for whatever reason and you must experience that too in your practice where someone comes to you you tell them what to do but the how part is sort of contingent on them having some kind of motivation or discipline or whatever it is um from my perspective it's worthiness interesting it's when it comes down to the fundamentals it's does this person feel worthy of having the health and wellness that they yes that they desire and if a person doesn't

feel worthy of doing it or worthy of having it they will sabotage themselves once I explained this predictable human nature to this patient of mine the game plan was he was going to be neutral he didn't go too high he didn't go too low and there's very specific strategies that we can talk about the way in which one maintains neutrality but at the end of the day he felt worthy of feeling really good we covered intermittent reward we covered not celebrating every win um conscious uh conscious turning it on and turning it off very controlled

Dynamic expression of what the goal was turning it on turning it off right I see this my husband is a former Navy SEAL I see this in this group of individuals all the time they're able to have controlled intensity but the other individuals that never seem to get better so the individuals listening to this the one thing that they would have to really settle in on is do they feel worthy and if someone does not address at the core that they feel worthy of executing the information that you and so many others are providing they

will never make the change discipline motivation discipline is easy it's not difficult there are constructs in our mind that may tell us it's easier to over sleep or not go to the gym but at the end of the day discipline can be practiced it's not hard motivation is another thing but who Waits on motivation to execute nobody I mean you shouldn't because that is a perishable feeling but understanding that this worthiness has to be addressed before people are going to make any kind of change becomes critical and typically it comes back to what they tell

themselves on a daily basis how they interpret their environment maybe they experience everything as stressful and don't feel worthy of taking action to get out of that distraction of stress so if I came to you and I exhibited worthy worthlessness I didn't think I was worth much in my career and you could start to pick up on it maybe I was I don't know I was carrying myself in the certain way my body language the way I was talking about myself subtly I was putting myself down um and maybe maybe there's other things going on

and you go do not this guy doesn't think he's worthy where would you start with me well first of all I would let you come to that conclusion okay the first thing that I would do is I would say Stephen how are you sleeping are you really sleeping well and I would guess maybe you're not maybe you're staying up late your mind is always going you're really thinking about things I would ask you how you're sleeping how are you eating how is your digestion what are you being exposed to and then I would give you

a handful of tasks I would tell you we got to get your blood work done we have to do a sleep study you know we have to address what's going on gastrointestinally are you reacting to certain foods and maybe you'll get that done or maybe you won't but if you came to me and said I am not feeling the best version of myself I would say are you ready to figure out what this is and then I give you lip service and I say yes I am doctor yeah and then we would have to have

a real conversation because there's this interesting kind of segue CEOs and again a large portion of my population are CEOs is they will the predictable course is they're too busy to get it done it's not a worthiness aspect but it is they're too busy but again health is the great equalizer there will come a point that is very predictable that they will call me um again many of your guests have called me saying hey Gee I'm not feeling well my stomach is really bothering me I feel like it's sour I'm not sleeping well you name

it and I go okay well did you knock out these five tests that we had to get done and they might say no 6 months they will come to a point where they will have to get it done once they get those tests done now we start seeing the worthiness aspect now we have evidence of what needs to change and those individuals that execute on those change typically will understand the importance of the long game right if you want to be as successful as you can be a Maverick and make a mark and do all

of your potential leave all of your potential on the table the only way that you are going to be able to do that is to liberate your Health you have to you cannot push past how you are feeling this worthiness thing is really interesting to me um because I do I can relate when I think about certain people in my life that have been unable to make the change despite having all the resources the time but it's hard to know if they have the time because sometimes people use that as an excuse well Stephen if

people don't have time for health and wellness how are they going to have time for sickness H that's so much more timec consuming but they just people don't assume that they're going to get sick getting sick is a surprise but is it I mean it is it appears to be for most people they just we all kind of live in you think about how we live and the decisions we make in the short term it's evident that we don't believe we're going to either die or get sick which is a huge failure of our culture

um you know when I think about longevity and I think about aging and I think about the individuals that fall and break their hip and end up in a hospital bed because they haven't trained or haven't taken care of this this body which we only get one there is a predictable end point it is happening and we spend all this time trying to increase this concept of anti-aging we are aging aging is not a disease how we do it is largely up to us and if we can condense this future version of ourselves to now

and understand not just the physical attributes but also the mental attributes that will require us to move forward then people would begin to take action can you tell when you meet someone if they're going to make the changes that you describe and that you suggest very quickly yes and what are the whole they're like archetypes okay you know there is the CEO archetype which I'm telling you they are going to put it off for good 3 to six months and eventually they will get it done and once they get it done they will stay on

top of it they will get it done because they recognize that their physicality is the common denominator because they are in it to be the best version of themselves and then there are other people that have gone to 13 other Physicians and have lost hope in the system and those individuals or maybe they had a physician that said something to them and it really scarred them those individuals will be very resistant to execution but once you earn their trust they'll get the job done MH and then there are individuals that really struggle with worthiness that

part of them wants to evolve maybe they had an old trauma maybe they had a physical trauma or something that really really shook them and the trauma can be like a little tea trauma a big tea trauma yeah it could be a small thing their dad left they yeah you know or it could be something bigger more horrific absolutely and one of the things that we see is there is this interpretation of stress and people think stress is all fight or flight and we should try to de-stress and take a hot bubble bath but we

actually evolved to manage and mitigate stress as humans we're much stronger than we recognize and there are additional stress responses that we don't talk about and we know from work out of Stamford and uh other individuals Labs that what you believe about an experience is how your physiology will show up about that experience so for example there was a hotel caretaker study so you could call it um a maid study where they looked at two groups of housekeepers one group they said what you're doing is amazing you are definitely getting physical activity here's all the

positives and the other one the other group they just went about their day and you know maybe they were told that they should do physical activity or not but at the end of the the housekeeper study those individuals that were told that what they were doing was in part like physical activity showed low and that they didn't need to do anymore but what they were doing was amazing those individuals had lower blood pressure they had better glucose regulation better insulin they had lost a little bit of weight and it was all their interpretation of the

environment they were in we tell people that the world is so stressful and that everything your internal response is fight ORF flight but we have one word to describe a million different things and we call that stress I'll give you an example a pet dies or you have um a white sofa and your kids just spilled coffee all over it or you break up with a loved one or there's a death of a spouse we have one word and we call that stress that's it we have one word to define a million different things we

live in an environment where people talk about I'm so stressed and this is stressful but that we don't have any other word in the English language to globally Define something maybe that word Could Be Love but not really not in the way that we talk about stress so people think about stress is fight ORF flight that severely limits both their physiology and their capacity the other two stress responses which are much more enhancing is tend and befriend which releases oxytocin which makes people more capable it makes them more connected this is the their stress yet

they go to help other people immediately that's also a stress response or the courage response the courage response we see that with a lot of military operators a moment of stress they're immediately taking action I'll give you an example if both myself and my husband were getting ready to jump out of a plane I would be terrified and he would be excited to do it he would be a listening courage we're both in the same experience but he is having one of courage and I am having one of fight ORF flight when we both jump

out of the airplane plane who do you think is going to be more capable to get up and do the next thing your husband that's right I would still be in this fear response probably take me at least a couple hours to recalibrate if not a day or a week whereas he has a response which is courageous and can be cultivated his capacity to then not only experience new things but continue on will mitigate much of the physiological damage that would happen from these other fight ORF flight responses and what I would say to that

is fear is a normal response but having courage is a choice you must have you must have met people in your practice that walk in and they've got some kind of trauma which has led to their state of sort of unworthiness how does one do anything about that when you can't go back and write the wrongs of their past and you know I don't know how much you want to dig into their psychology and become their their therapist to try and unpack some of that stuff but if these things are so deeply hardwired into them

in some way you know some Early Childhood trauma that's stopping them feeling worthy which is stopping them having quote unquote motivation to change do you just give up on the person never what could you do and can you give me a specific example when that's happened well the first thing that I would tell you is I would turn to a coach I have an extraordinary coach and his name is Jim kachula he is he has worked with myself helped make that book possible as as well as uh other individuals whom you know and that requires

someone who is really willing to go in and dissect that I have to know where physiology ends and psychology begins MH I will also say I trained in Psychiatry for two years and the mind was of course the most fascinating part for me at first that's actually what brought me into my work with the military that I do today I will tell you that if I were to think of a very particular patient I will she had a lot of trouble sleeping and this woman we later found out we did everything we did a sleep

test didn't have sleep apnea was extremely unsettled really um had hormonal problems put her on hormone replacement still really struggled with sleep did all of the things that one would need to do like a dark room I know you had Andy Galpin on he does talks about sleep and has absolute rest and you know looked at her environment did everything at the end of the day it turns out that the reason she wasn't sleeping is cuz she had been assaulted and she had had forgotten but every time she would go to bed her heart rate

would spike um and it was something that that wasn't my domain but I knew that she had to really deconstruct that if she was ever going to move forward part of it is figuring out where there are weaknesses and vulnerabilities within a person because we think about the way that Healthcare is set up right is that it's used see a doctor for 15 minutes maybe it's a half an hour intake and then you're on to the next but a real therapeutic relationship is exactly that it is a real relationship it is not transactional if you

are a physician you know being a physician it used to be a very honorable thing and they were on the council for people it was you know they were your right hand and we have really changed from that you know I'm talking about maybe in the 1800s it was a very honorable privileged position and I still believe it is that and so part of moving people to from where they are to a level of wholeness requires being a teammate do you try and motivate people all the time do you think that's part of your your

remit as a physician to motivate them part of my job as a physician is seeing what they are capable of MH is seeing what their true potential is and to push them yeah do some do sometimes people need a bit more pain before they yes and I mean this speaks to What mo what's going on with like motivation and discipline because if you need a little bit more fear and a little bit more pain then it kind of illuminates what this what's actually going on with people's motivation you can almost put it into a formula

where like the strength of their their why is at one side of the that equation and then there's some some other factors in the equation but it seems to start with the strength of their why and pain more fear a bad result seems to amplify their why to the point they go okay [ __ ] it I'm going to do something about this now yes and I think that there is a potential to not wait till that happens because is very predictable you know and if someone is listening to this or thinking about it you

don't need to have to wait to get to that point because that point of breakdown is going to come and you might as well get ahead of it you can only push so far your original question is do do I think that part of my job is to motivate people yes do I think it is also to see their weaknesses and vulnerabilities being a physician and and taking care of some of the most extraordinary people in the world you get to see behind the scenes and the people that are doing extraordinary things their characteristics are

actually not that different they are often times extremely motivated by service they are it's not a selfservice it's an other service and when you can tap in to say Hey listen in order for you to really be able to expand your reach grow this Legacy change the world then we have to fall back on the things that you are completely ignoring and again uh vulnerability is hard for people but exposing that and letting them come to those conclusions then you see a full evolution of a person you how I mean how many patients do you

think you've seen over the last thousand thousands why did you do what you do I find the greatest joy aside from my kids and my husband and my family being able to be of service why well I would say that I'm always I've always been wired to be this way I have always been wired to take care of people and I would say right now when I think about my patients like danah or um some of the other entrepreneurs that you've had on I believe that no one is going to be able to get the

job done better than me and is going to care more and it feels really good to be able to be there for people are you a happy person yes for the most part I would say I have a very positive disposition I do when are the seasons of unhappy in your life I think during training was very hard for me during my fellowship saw a lot of death and that was really hard work a lot of hours see a lot of death that was hard you still remember that oh yeah changed you yeah that's why

I got into social media I had just finished my fellowship um 200 15 and I hadn't been on social media or anything and I had just been you know you go through and you see patient after patient and you know none of them are getting out of the hospital they're all going to die there can you imagine so you're seeing 30 30 patients a day this one is on pain meds you know this one is going to die this one is 18 and she's going to die and she's planning her wedding but she is um

she's planning a wedding she was never going to be able to she had um cystic fibrosis there was nothing that they could do for her and she was never going to have a chance to get married or do anything and she was planning her wedding she wanted to pretend like she was going to be able to get married picked her dress to have an experience she was never going to have and um you know during that time I you know as I was coming out of Fellowship in 2015 we seeing all this BS on social

media these people talking about you know this cleanse and this fake diet and like all of this stuff and the information was so bad that I felt responsible that if I had the privilege to have you know had a 17-year education and have seen all of this stuff and then to not say anything that I knew was going to make a difference or be impactful for People's Health and Wellness the end comes the decisions you make become critical but where it really becomes critical is in the beginning the children and then at the end and

if you start hearing all of this Narrative of how we you know um should reduce our dietary protein and do all these other things and just destroy our skeletal muscle based on this input that we're getting the information was so wrong that I felt a responsibility to say something and if I didn't I would be contributing to the same problem but it was very hard it was very hard does that come at a cost the caring yes yes yes it does nobody has ever asked me that yes it does it um and this might not

be the best trait but I am willing to be there at midnight at 1:00 if someone needs something I got it and yes does that come at a cost to myself it does and my family it does I am very careful about protecting the time but um yeah it's is there an em cost to this as well because if I if I was every day I was waking up and I was being involved with other people's problems in such a way other people's challenges their sickness their illness their their death I I don't know if

I'd need some strategies to to cope with that like getting invested in somebody and then seeing a bad outcome and that sort of feeling of like what could I have done or you know well luckily um my patients are no longer knock on wood life or we are dealing with things like um hey you live in a toxic mold environment or you have lime um we can move past this or hey you have covid and you're in Washington let me get some Pax liid sent to you or um maybe this person is going through a

bad breakup or their thyroid is off it's light in that way I mean sometimes I have to send people to the hospital but it's no longer carrying for end of life but now it is positive and it is challenging but again I've been a physician for 20 years you build up capacity I was thinking the other day about some of the like mind because a good idea that infiltrates your mind can change your life yeah because it's kind of like corrective it like it's almost like it goes in there like a vaccine and it attacks

a mind virus that you had something that was holding you back some kind of limiting belief about the nature of life in your work what are those kind of mind viruses those myths that people carry with them that ultimately inhibit their chance of becoming this optimal performer that you want them to be there's a handful of things and also we have to recognize that we're talking about two things physiology and psychology from a physiology from a physical perspective there is a one of the things that is extremely detrimental is this comparison individuals that compare themselves

physically to other people will stay hooked in that typically is a comparison of Youth as individuals mature in their late 30s 40s I do see that dissipate but if that doesn't dissipate they will continue to hone in on this physical Readiness and that allows for certainty so think about this we all see amazing athletes or people that are incredible are incredible shape and your ultimate question is what are the things that limit whether it's a mind virus or something limiting to allow somebody to become the best version of themselves an uninhibited version of themselves or

unencumbered from a physical standpoint when an individual is solely focused on the physicality mhm and that can be from a looks perspective that can be from you know my husband always tells me stories about those guys that go into SEAL training the first guys to wash out this is what he tells me were always the great athletes because they had trained physically they were capable of dealing with certainty you throw a ball you know how to do that they hadn't prepared themselves for mental uncertainty or fortitude and this circles back to this so the individuals

that are fully focused on this external comparison it's about looking good it's about being fit it's about having more plastic surgery less wrinkles whatever it is those individuals are chasing a game that they will never catch the perspective is wrong we all get older we all will at some point not be as physically capable as we are now you're in your how old are you 31 getting up there you are 31 me getting up there me I'm getting old no I cannot talk um but there is this physical capacity that if you were to just

say Gabrielle let's just focus on the physical then we know by the time you are 50 and listen 50 is not a great number because we I a ton of amazing fit 50y olds but when you are 80 if all you did was look at that physicality by the time you were more mature you would become and I don't want to say more depressed but this if your world is purely external there is an inevitable decline in that and you know what I'm talking about right time is against you it's toen yeah you know your

skin is going to Sag whatever it is hopefully it doesn't but those individuals that are fully externally focused those individuals really struggle with aging and you will not focus on the things that matter and that is a virus that will happen you will always be comparing because it will bleed over to everything how you manage your psychology will be how you manage your physiology so what should I be aiming at what if I'm not going to be aiming at the physical attributes and the comparison what what kind of measure should I apply to myself to

understand if I'm doing a good job you should focus on physical Readiness but it shouldn't be about how you look okay it should be about how you perform when you think about gaining physical Readiness it should be about the acquisition of skill the acquisition of strength I talk a lot about muscle I believe skeletal muscle is the organ of longevity you should be focused on becoming physically strong but the physical performance outcome how you look is not the end point the idea that you are training for Life able to whether it is to run or

to squat or to Bene press or to get stronger in a meaningful tactical way you should continue to move that needle a lot of people though they we were talking before we started recording about how people are driven by like short-term incentives and it's quite insane for someone to focus on a long-term incentive in the face of like a short-term incentive so if I if my short-term incentive is for someone in the office to think I'm hot or you know to find a partner I'm going to be so focused on getting that blow dry I'm

going to want that like facial and I'm going to if I've got you know an hour of free in a day I'm going to aim at the facial the blow dry how can you convince me that that's a bad idea versus aiming it at I don't know building muscle or becoming physically strong time is finite and we are given time how we spend our time will determine our outcomes it will determine where we're going how globally strong we become because strength is clearly not physical there is a level of global strength which which means becoming

masterful at something for example you are masterful at business at interviewing at learning and thinking about people if you were distracted and you could totally choose a life of distraction you could be distracted by the external shiny objects perfectly okay but that outcome if that becomes regretful then that becomes devastating you know um taking care of people at the end of life you hear a lot of regrets and it wasn't that they wish they had had another blow dry and I know what you're saying is that how do we think about later life if we

can't identify in the short term or take in the short term what makes us happy right we are thinking about I want this cake I want this thing I want to buy this car shout out to my husband no we are not getting that Defender but the shortterm term is very limited and we live in very fast-paced society that will tell us to embrace that and to fight for that thing but it only takes a moment of spending time with the elderly or the Aging or people that are wiser than us to look back and

say these are the moments that you can fully develop yourself and again from a physical standpoint should you focus on physical Readiness absolutely you are 31 do you think it's going to be easier at 41 I hope so we got to get you on a good program um I'll call Lan later but you have to do these things and you have to bring back into perspective what is important and what is valuable I'm thinking about a particular friend of mine who I was describing there with the blow dry thing and and the like spray tan

and the blow dry they're they're you know approaching 40 they're looking for a partner they are spending any free time they have on the on the spray tan and the blow dry listen I'm not not judging I'm a case study and there's many people like that and they're spending zero time on physical strength don't go to a gym Don't Go Near it don't do any exercise and I'm just wondering you know how you make a case to that individual that actually to achieve the goal that they want to achieve which might be to find a

partner actually it's the inverse it's they should be doubling down on the internal versus the sort of surface the first thing that this person is obviously driven by the external M and you have to recognize that you cannot have a strong physical body if you are mentally weak because you will never feel good about what you are doing you will be distracted you will live a life of distraction that will then rob you of your future and the case I would make to your friend is these immediate distractions and being a good friend would be

telling them this or allowing them to come to that understanding when you say you can't have a strong body unless you have a strong mind how are you defining and how do you define a strong body you should be able to be physically capable in whatever it is that you want should you be able to do a pull-up probably should you be able to do at least 10 push-ups yes is that number different for everybody yes if I asked you to please run a mile could you do it and do it well I think being

and having physical sovereign and being able to be in control of your body and to be strong and not require someone to help you with things I mean granted you probably couldn't lift a car by yourself or a bed but but but this becomes extremely important for our aging population and for where we are now what do I mean by this we are becoming increasingly weak as a society the majority of individuals are moving towards obesity children are becoming more and more obese are they strong are they as strong as they could be from a

physical perspective I would say no and again you can choose a marker of goals to hit which I recommend that everyone does whether it's squat deadlift you name it run but you have to be able to have accountability for your physicality if you were going to be giving me goals to hit right and I don't necessarily mean like 10 reps whatever but just the types of goals that I should be aiming at to have a strong body what what are those types of goals so you mentioned squatting there you mentioned you know maybe being able

to pull myself up being able to run are these the kind of goals that you would give to me so say a 30 40 year old what kind of goals would you be aiming at and are the goals different if I'm 50 and 60 they are you should at a minimum and I'll give you an example um you should at a minimum be training 3 days a week with with weights doing resistance training you've had many uh you just had my friend Mike Israel on I mean that guy he is jacked he could probably lift

you with one hand and me with a pinky and he would be going all over the place you should be training your muscles from a strength and or hypertrophy standpoint three days a week okay so is that everyone yes everyone regardless of age yes yes that part is regardless of age three listen could you get it done in two days a week which is the recommendation the current recommendation for activity is 150 minutes of moderate vigorous activity and two days a week of resistance training is that going to be enough to keep you walking around

yes is that going to be enough to evolve your body to manage and mitigate aging no it is not we have to call ourselves to a higher standard 3 to four days a week four you've added a day okay well I was going to say three I was going easy on you okay so three days a week you should be doing and I only train I do resistance training three days a week I might throw a fourth day in there for anyone that doesn't know what resistance training is moving um your body or a load

against um uh resistance so it would be for example taking a weight and moving that through space whether it is a squat or a bench press these are all resistance training moving against a resistance of some load it could be body weight it could be a Band 3 days a week everybody I mean I I'm okay with two days a week but in an Ideal World it should be three days a week my recommendation is you train for muscle hypertrophy which is muscle growth 10 to 20 sets per muscle group a week you can break

musle groups so I would say um you could do a upper body lower body split you could do what's that um a push pull like a bench press or a a back row so back and um chest you could do full body training which was which I think is the best for people compound movements like a squat or a deadlift this is full body you should be doing some kind of movement but Stephen if someone said like my dad before I came on this podcast he FaceTime he lives in Ecuador and he was doing resistance

bands with bicep curls mhm I'm okay with that if you want to do that and that's how you're going to do your upper body or your arms fine so it could be chest back you know glutes legs why should I be doing three days a week what am I going to get out of that make make the case to me number one you are never going to regret being stronger period end of story you need to be physically strong skeletal muscle is the organ of longevity it is not just about get looking good in a

bathing suit it helps it's so great um your friend who is getting her hair blown out and doing all these other things put her in some training and listen it's probably going to be a killer skeletal muscle is your primary site for glucose metabolism fatty acid metabolism it's your glucose snc if you decide that you want to eat carbohydrates and you care about metabolic Health you have to have skeletal muscle you're not convinced yet are you I'm listening okay well you're you're kind of like maybe convinced that you think skeletal muscle is important but if

I told you that this is your body armor that if you are in the top onethird of strength compared to if you are in the lower oneir of strength those that are in the lower oneir for strength have a 50% greater risk of dying from nearly anything if you are in the lower onethird of strength you have a roughly 50% chance of dying from all cause mortality but I'm getting old Dr Lon I I'm I'm 58 yeah um when people get old they put on weight they lose muscle we get weaker we get frailer this

is what this is just the nature of life don't fight life the first thing that I would say is congratulations making it to 58 well done sir and then I would say that is totally not true that is not what we see in the literature anyone at any time can get stronger and put on muscle anyone at any time can get stronger and put on muscle do you know what it is yeah part of the reason why I think people don't believe that is because we look at our parents and our parents looked at our

parents and our parent their parents looked at their parents and our parents are like a case study of what we what we should expect they set the expectation and when a lot of us look up at our our parents we see people that are maybe have had a little bit of weight added um maybe our dads have a bit of a pot belly because of all the beer they've been drinking or whatever yeah maybe they walk a little bit slower they can't run they're out of breath so we kind of just assume that that is

normal and that's what we should expect of ourselves and I think I I did that I looked at my dad who um he's on a bit of a health Journey at the moment but before he was on that Health journey I did kind of I think at some point in my mind I conceded maybe that's just what like genetics do they just give you a pot belly they slow you down you lose your muscle you get weak yeah the funny thing about humans is when we hear and see things over and over again we believe

them to be true whether they are or they're not humans are funny creatures in that they experience repetition as truth mhm what do I mean by that I say Stephen this is stressful this is stressful our fight ORF flight is the only way and then you go you know what Gabrielle fight or flight is the only way that's all I've ever heard we see our parents age and we believe that that's just the way that it is but I can show you many individuals that are aging well and strong both of my parents are incredibly

fit is that genetic maybe I picked my parents well but what I will say is that the traditional framework of Aging is in part the way that it is because we have divorce the idea of skeletal muscle from Health the Bros got it right you need to be jacked you need to be tan and if you're not jacked and tan or if you are resistance training is only [Music] for the Bros nothing could be further from the truth and because of of that thought process we have divorced skeletal muscle Health from overall health and wellness

and Longevity if I as a trained geriatrician were to say and by the way I did seven years of nutritional science training as well if I were to tell you what is the one most important thing to take you through life do you know what I would say probably muscle that's right hands down across the board the weaker you are the less muscle mass you have the greater chances you will die so in terms of cardio is do you think muscle mass is more important than cardiovascular exercise as you age you're putting me in the

hot seat and I would say both we know are important but again both are very important but there is no replacement for resistance training and muscle mass there is none you will not get the same stimulus by doing cardiovascular activity and you know you mentioned your parents or your dad you see and we see collectively our aging population shrink right they become thinner and scrawnier and more sarcopenic we see this happen there is a transition of fiber types there's different fiber types and they transition from from type two fiber types to type one what is

that type two are the big bulky fibers that you train for hypertrophy strength and hypertrophy for there is a transition that happens if you are not constantly fertilizing these muscles through strength and hypertrophy training through resistance exercise if an individual is solely focused on cardiovascular activity this will not maintain in a meaningful way these type to your bigger bulky muscle fibers when you lose skeletal muscle mass you also see a change in metabolic Health Muscle is the primary site for glucose disposal it is primary site for fatty acid oxidation when you lose skeletal muscle you

see an increase in blood sugar insulin type 2 diabetes skeletal muscle is what allows us to buffer the foods that we eat so if I'm eating lots of sugar and carbs for example and I've got lots of muscle then the the sugar in the carb is going to be basically stored in my muscle but if I don't have any muscle then where is it going to go exactly liver fat you are going to become increasingly unhealthy unless you are training so if I if I have more muscle does that mean I can eat more carbs

and there' be less of a consequence like likely yes especially if you are training and you have healthy skeletal muscle um skeletal muscle can be marbled you can get an increase in myosteatosis which is fat infiltration in skeletal muscle in order for skeletal musle there is no such thing as a healthy sedentary person you will look in the literature and you will see people say oh healthy sedentary there is no such thing as a healthy sedentary person what do I mean by that there was some wonderful work out of Yale they looked at 18-year-old college

students that were considered lean and healthy put them in a a time frame of inactivity and they become they became insulin resistant they had skeletal muscle insulin resistance even though there were no outward signs of obesity or fat if you are an active you will not be turning over your glass glycogen stores which is the stored form of carbohydrates you will begin to build up byproducts your skeletal muscle will be increasingly more unhealthy over time you cannot get out of doing resistance type exercises and to be clear you do not have to be doing a

one rep max you could simply start by body weight resistance training it could be yoga it could be bands but at some point you will have to stimulate that tissue in a meaningful way to age well how many people are meeting the activity guidelines at the moment and how many people aren't roughly 6 to 8% are meeting the resistance training guidelines 6 to 8% yes sir just if you were to look at resistance training guidelines now 50% of Americans don't even work out over 70 roughly 70 5% do not meet both recommendations the majority of

individuals are sedentary individuals it's interesting because people would then say well you know these stats are all bad but our life expectancy seems to have gone up you know year-over year for well I mean I think it's had a little bit of a blip recently because of Co but it's typically going up into the right our life expectancy so we must be doing something right is it about life expectancy or is it about quality could we keep someone alive on bed rest probably would one say that that would be a good quality of life you

cannot have a high quality life without high quality muscle more specifically people care about autonomy can you imagine if you couldn't physically get your groceries you are young We Are Young we take for granted the physical capacity that one has that is a gift it is a skill that must be continuously pushed or the trajectory of Aging is exactly what we see people get to a point where they can no longer lift their suitcase on an airplane overhead do you see that yeah yeah people struggle to get their bag on the Belt to go through

security is that normal that is not normal how do we know this are there other sort of societies where they just age better than us um and they're you know they've got 60y olds that are being able to lift their bags above their head I mean I can tell you from my father's community in Ecuador my dad is 74 if something is a 3our walk or less he'll walk it I definitely don't like to go visit him as you can imagine it's a lot of walking they are extremely physically active they seem to age well

and I think that you will find pockets of individuals who do things that are very Physically Active throughout their lifespan which will allow them to maintain a muscle span which is the time in which they have quality skeletal muscle I will also say we control our environment everything can be easy for us if we choose you can take the escalator you can take the elevator you can get in the car you can do all of these things inoculating yourself against muscle aging takes effort but it has to be done each time someone has a choice

to either do it physically themselves or to take the easy way each time an individual can continues to take the easy way the predictable decline will it's like putting another coin in the bank but maybe that bank is being spent on something worthless that's exactly what happens what are the misconceptions people have about um weight loss you've touched on it a little bit but if I've come to you and I say listen Dr L I'm going to be honest with you I just want to lose some of this belly fat I just want to be

um lean and I want to be beautiful um should I get liposuction um what diet should I go on what would you say to me first thing that we have to figure out is your muscle mass I mean this is a little complicated because I would of course ask them how we got to where we were right H how do we get here are you emotionally eating are you I don't know not sleeping or what are the are you drinking too much what are you doing what are we up against what are the actual tactical

behaviors that we are up against M and then I would say let's go we got to build some muscle we have to work on some body recomposition and really the two ways that we're going to start are the two basic and that is diet and exercise so no lipo section I mean Stephen if you wanted to I do know a great plastic surgeon okay but no unnecessary and again this goes back to this hyperfixation on body fat when the conversation should not be about obesity drugs or body fat the conversation needs to swing back to

not about making people less obese but to making them have more healthy skeletal muscle what's the link though so how is having more skeletal muscle going to okay gluc the glucose is going to be stored in it so that means less glucose is going to be stored in my belly fat my metabolism is going to be better you said as well so your your ability to store glucose yeah will be from you know obviously store it in your liver but skeletal muscles the primary site for glucose disposal am I going to be less hungry now

that is a great question and there is observational data and I say this very hesitantly because it hasn't been published yet but I believe that we are going to begin to see that skeletal muscle has a role in appetite regulation because because of receptors on skeletal muscle you will not find anything out there yet but I do believe that there is observational data from some of my colleagues that are doing research that we will see that there is some appetite connection with skeletal muscle well I burn more calories when I'm working out if I have

more muscles you will what about a zmek should I should I consider a little bit of a zek on top it depends on how long you've been struggling okay I am I do recognize that these are very complex issues whether it's OIC or mongero gp1s or Gip these drugs these drugs are here to stay I do think they play a role I know you had Dr Tina [ __ ] I am fully in alignment with much of what she said there is an absolute role for this I will also say that why is it that

within that conversation of body composition why is it that it is so much more socially acceptable to give someone a medication to decrease obesity yet the idea of giving someone a medication or an anabolic like testosterone or a testosterone derivative would be shocking to people I can administer a drug to make an individual less obese but there is an incredible amount of stigma if I wanted to administer a drug to allow someone to have stronger bigger muscles what kind of drugs would you administer to give them stronger bigger muscles testosterone would be my first one

how much testosterone there depends Michael he was uh on the podcast previously he told me that taking testosterone and steroid roids made him angry and gave him really vicious thoughts dark thoughts but Michael is a professional bodybuilder and we know that there is health and wellness and that those that operate at the Pinnacle of their sport that does not mean that those individuals are training in a healthy amount right there is a cost of doing business at the peak of anyone's career in anything and from a phys IAL standpoint certainly that utilization would be different

than someone coming to say hey I need to work on my body composition the big Point here is the dichotomy and conversation between the two it's fully skewed in the way that it is much more acceptable to give a medication to address obesity and much less acceptable to give a medication to address skeleton muscle mass and I personally believe that that conversation needs to shift a lot of people say that zmek causes muscle loss as well it doesn't really I have not seen a direct mechanism of action that OIC affects skeletal muscle in a negative

way in fact I have seen the contrary there is evidence to suggest that OIC and individuals like these drugs in this class can actually support skeletal muscle Health the reason individuals are losing muscle mass on these drugs are because they are not training and managing their dietary protein there's only two ways to stimulate skeletal muscle and that is through resistance training and dietary protein you cannot outm medicate poor Behavior oh but but because they're on a appetite suppressant like a zmek that means they're probably just not getting their protein we utilize these drugs in my

medical practice all the time we track body composition all the time it is routine we track muscle mass we do not see a decrease in skeletal muscle mass when individuals are dosing protein appropriately and training does a zmek and these that category of drugs will people have a certain psychological mindset benefit that's a wonderful question and here is what I would say as a physician who is in practice removing physical obstacles are critical and individuals can spend time obsessing about their body um just really it can infiltrate their thoughts it takes away from their capacity

to show up in life to be present because they're worried about their weight and can you imagine if someone was struggling with that for a decade or two or three now we have a new class of drugs that will take away in part a desire to binge eat or take away in part a desire to even potentially drink alcohol what it allows for is physical Freedom do I think that that comes with a cost of not doing the hard thing and and doing those kinds of behaviors it does it does make things easier however there

is utility in that yeah because if someone suggested it to me I'd say the first thing I'd say is Dr Li what's the cost because nothing's free in life so and if I don't know what the cost is that's even more scary I'd rather be able to balance the trade-off but not many people are giving many cost with a zmek at the moment well number one you don't need it right you would not be someone who needs o zmek or mno or Zep bound you you just want to be someone who needs that um but

I do actually believe that this in combination with hormone replacement therapy is going to be the way of the future for longevity what's the cost I cannot tell you what the cost is and here's why because people will say it slows down gastric emptying um yes that's exactly what it is supposed to do will that have a meaningful outcome not necessarily these drugs are not new drugs this class of drug is not a new drug it has been around for last 20 years I know at least for the last 10 there must be a cost

though the cost is when you go off of this yeah you likely have and again this is just my perspective is once you titrate off then normal hunger cues should return and if you do not have appropriate strategies in place an individual will then begin to struggle potentially regain the weight have you seen this I haven't we take people off these medications all the time and they don't rebound they do not rebound they do not rebound but again we do very intensive lifestyle interventions we also figure out why people got into the place or the

hole where they are starting why right you say there's no free lunch and maybe the no free lunch is you have to address old trauma maybe one will really have to explore the way in which they cope right cannot cope with emotional e like they you cannot do these things if you want to maintain your body composition as you age you have to be accountable for these things did diets work do you ever put someone on a diet if they're overc consuming calories yeah and what does that look like for us I mean we've been

doing this for a very long time we the first thing that we decide is dietary protein which is unfortunately seems to be the most controversial macronutrient which by the way you looked at me crazy and you're absolutely right why would any macronutrient be controversial but dietary protein again it wasn't like this until the influx of social media and what do I mean by that dietary protein it just seems as if there's always a reason why people are trying to remove it from the diet which seems somewhat ridiculous and counterintuitive the first thing that we do

is we recognize that dietary protein is what the foundation of any solid nutrition plan should be built on and that is 7 to one gram per pound ideal body weight if you eat High nutrient-dense foods like animal products you could probably go to the lower end at 7 if you are someone who does not eat any kind of animal product you're probably going to be closer to 1 gram per pound ideal body weight of um whatever that source of protein is but protein is what is going to maintain hunger you know uh dietary protein does

cause an increase in glp glp1 in the body and people will talk about that although it's only meal to Meal which is so you know you have these glp1 Agonist which improve satiation so like a zenek is a GP one Agonist which makes you less hungry yes dietary protein in part works on that same kind of mechanism also releases glp which makes me less hungry yes okay improve your improve your satiation okay dietary protein we know can help regulate hunger can also maintain blood sugar right if you have carbohydrates in in check not a very

efficient way but your body can generate glucose from dietary protein a lot of people associate protein with like bodybuilders and stuff like that I know it's such a mistake it's a mistake because as individuals age they need double the the minimum recommendation to prevent a deficiency the current recommendation is8 gram per kilogram or 37 gram per pound if someone was 115 lb their dietary protein recommendation would be 45 gr that would be the minimum to prevent a deficiency as individuals age they require more dietary protein because skeletal muscle becomes what we call anabolically resistant it

means it becomes less efficient at utilizing dietary protein if you were to eat the way you did maybe in your teens and 20s body at that time is extremely anabolic I mean you look like you're pretty fit have you always been pretty fit no pretty fit in terms of what though I've not always had as as much muscle mass as I have now but I've always been um fit as in playing sports and stuff my whole life and has it been easy to put on muscle generally I'd say yes when I was younger it was

it felt a bit more difficult but I just think I had had things wrong I don't think I was consuming enough calories but as I've as I got to sort of 25 26 27 it became a little bit more straightforward which is amazing your body is highly anabolic you are now consuming calories protein you're able to put on skeletal muscle that tissue is very anabolic it's sensitive to the foods that you're eating to the stimulus you're providing as you age that tissue becomes more resistant I've Got Friends that tell me they can't put on muscle

easily how old are they one of them's 27 and the other one I think is about 29 okay and they're men and they've told me that no matter what they do they just can't put muscle on well first things that I would do is ask them what they're doing are they are they consuming enough calories do they have enough protein where do you think they're going wrong when I said that the F you want me to be honest the first thing that I thought was I am seeing a huge increase in low testosterone levels in

younger individuals interesting and um I know it's just me and you and not the millions of people that watch your show but um the medical answer would be they should look at their diet and training and sleep but what I am seeing clinically is that young young men have increasingly low levels of testosterone and how does that link to them not being able to put on muscle they are um less anabolic than they should be what does anabolic mean building they are less capable of building okay if if I this is a problematic question um

is there any way to tell if someone has low testosterone just by kind of looking at them some of my colleagues might disagree with this I would say you could potentially guess but do they have less um hair on their legs do they have less muscle mass do they have um what would look like potentially more estrogen in a male you know you're putting me on the spot here right yeah but all those things I was thinking of my one particular person I think all those things are true so maybe it is low testosterone my

next question becomes is there a way that they can stimulate their testosterone without having needles stuck into them absolutely I mean the first thing is you have to look at lifestyle what is their diet you do need nutrients if they are not sleeping and they are um taking potentially uh recreational drugs this can all affect testosterone it could be it can affect sleep it can affect a number of things the first thing that I would do is are these guys sleeping are they eating well eating well being the protein we talked about yeah are they

eating a diet that is fully processed are they training training in and of itself isn't going to generate testosterone per se but it would increase the receptors increase the skeletal muscle receptors increase those Androgen receptors um the other thing that I would say and this may be a little bit outside the box but what are they being exposed to we do a lot of heavy metal testing uh we see we do see a lot of exposures those things can affect fertility whether it's lead or Mercury those kind of things absolutely and where do these things

come from these heavy metals I mean we're drinking out of a metal cup I know I know this is stainless steel I don't think that this gets into the water um they could certainly get it from aluminum cans they could get it from eating a lot of seafood they could have exposures um maybe they're training on weapons maybe not you could be getting lead you're in great shape than thank you what' you eat diet and protein and I eat a lot of carbs I train a lot so run me through your day what time did

you wake up between 5:30 and 6:00 my husband wakes up at 4: mhm so and then problem and then what you do I get up um see if the kids are asleep or awake usually one is in the bed two is in bed and then I get ready to go train Get Up 3 days a week I I head over to meet my coach shout out to Carlos Mana he's the man and we hit it hard and I'm usually 5 minutes late every single time because in the morning one or both children will decide if

they're going to come with me or not I include my kids in my training how old are they three and five oh damn you're getting them training at 3 and five I am my 5-year-old is in Jiu-Jitsu they have their own kettle bell sets um because people and children they don't care what you say they care what you do so sometimes they decide to come with me sometimes they don't um and I train fasted wait I didn't tell you I caffeinate a lot a lot I am drinking coffee now I may be someone who is

tired I drinking water or coffee how long did you train for an hour and you only do three times a week I do three times times a week of lifting okay I try to train as hard as I possibly can by that second day I'm tired it would take a lot for me to do some kind of major lifting I'm in the middle of rehab the next day so I'll train Mondays uh Wednesdays and Fridays Tuesdays Thursdays will be some kind of light cardio maybe I'll do 20 minutes maybe it'll be intense whatever I'm feeling

I'm very active during the day sometimes I wear a weighted vest I take calls walking I move a lot my friends joke that I am someone who never sits still period end of story you can see me now I'm moving all over the place I have high energy expenditure my first meal of the day will either be a shake it might be 30 to 50 grams of a whey protein shake uh typically I might even have collagen in my coffee collagen um in coffee doesn't necessarily stimulate muscle but I use it for Hair Skin and

Nails it's an inkle me protein has a protein score of zero I just wanted to clarify so am I training FCD yes uh mostly FCD might be shot of collagen 30 to 50 grams at that first meal I might have some kind of carbohydrate but usually um running around got to get the kids to school or whatever it is my my next meal might be some lean beef I'll definitely have carbs I'll have either rice or potato and some kind of greens and that will be another you know if I were to think about how

much protein I'm a tiny person um maybe 110 lbs I might have 12 grams of protein a day and then the last meal is also between 30 and 50 gram of protein and probably close to 50 grams of carbs and what what time is that last meal typically if you can help it around 7:00 I eat it with the family nothing crazy I'm very consistent I think it's important that one meal or one workout doesn't take you off track I don't really think twice about it I know what I have to eat food is not

um complicated it's effective I don't drink alcohol I don't like the way it tastes I don't really have a sweet tooth is that the only reason you don't drink alcohol because of the taste did you did you drink alcohol before no you've never drank alcohol no tastes terrible I'm sure you've had it tastes like rubbing I mean tastes terrible maybe I'm lucky but also think that you know can be toxic for the brain but I choose not to have it because I do think it tastes terrible every single time you eat you have an opportunity

to improve your health and that's why I love Zoe because Zoe helps me to make the smartest food choices for me and my body and as you guys will know by now Zoe is a sponsor of this podcast and I'm an investor in the company and if you haven't tried Zoe I highly recommend you do because Zoe combines My Health Data with Zoe's World Class class science and using those two things Zoe guides me to Better Health every single time I make a food choice and eat which means that I have more energy better sleep

better mood and I'm less hungry and the most important thing is Zoe actually works it's backed by their recent clinical trial something called the method study which is the gold standard of scientific research I started Zoe just over a year ago now and I've been able to track my progress week after week so I can learn how to be even smarter the following week and if you haven't joined Zoe yet I'm giving you 10% off when you join Zoe now just use the code ce10 at checkout are there small parts of your protocol that people

can imp Implement you talked there about not sitting you know you said weighted vest yeah um are there anything else that we can do that might help us build muscle mass without having to go to the gym yes what are the key things you think about there if you can take a call walking or rocking you can load up weight it is Extreme easy to do and you can do it slowly whether you start with you could start with 7bs I have a 5B weight vest I have a 7 PB weight vest 20 and then

from there you can load up weight so you can build up over time um people should be doing that it is effective and easy everyone can do that people are taking calls you don't have to do a zoom call why not get on the phone get moving human body will like to sit right as opposed to be forced to move but you become it's almost like a roote activity if you are someone who is sedentary it becomes easier to become sedentary and stay sedentary it requires friction to change you can mitigate some of that friction

by incorporating movement into your life for example walking with a weighted vest easy training with your kids people will say I don't have time I'm so busy pick up your kids after school we instead of go and play video games we do a push-up challenge or a dance party in our have you ever heard of Texas holdom the Poke game no the dance have you ever seen this uh Beyonce um made an amazing song called Texas holdom and I thought she was talking about poker she might be but there is a line dance associated with

that there are a million fun ways to do something we just have become accustomed to doing less and we'll dance we'll do whatever push-ups physical challenges playing outside get the Nerf guns whatever it is easy I mean it couldn't get easier than that what do you think a good goal is to have what kind of goal because it was i' said this before but there's a time in my life where my goals were very like superficial um and they were like anchored to a a date what are the best kind of goals that we should

set ourselves as it relates relates to our health I don't think we should set goals no goals I think we should set standards okay when you set a goal you can either reach that goal or not but if you set a standard then you will always keep your standard and that standard will allow you to reach a goal but the standard won't change for example the standard is you wake up and you set whatever that is you train every day for me I train three days a week um depending on how intense that training was

on Saturday I might do a fourth day of training and on Sunday I forgot to tell you this we do a group workout my standard is physical activity has defined moments and that is my standard even if I'm traveling I know exactly what that's going to be before I get to the hotel that is a standard of physical activity I don't have to think about a goal I don't have to have a goal of am I going to hit that or not because I know that those are things that I won't fall short of my

standard is my nutrition plan I have between 110 to 120 gram of protein I have between 110 to 120 grams of carbs I know what that looks like that is my standard I don't deviate from that and what are you struggling with as it relates to your own advice um sleep you're struggling with sleep yeah is that because of the two little kids or is it is because I have to make a choice am I going to spend time uninterrupted and undivided Ed with them or am I going to do work and my choice is

I spend time with them and then when they go to sleep I work another two to three hours and I should probably do a better job and know that eventually everything is going to get done but I set standards do you find it difficult you know because people always talk about um not being able to have everything at once this is what a lot of women have said to me there were there was a time where we were sold this dream that you could have everything you can you can I think so do you you

must see a lot of excuses in people I do I do because it's hard to face the truth and what's the truth what is the truth the truth is are you doing this or are you not doing this because of some kind of internal Choice there has to be some truth telling and sometimes that truth is uncomfortable any you can get the job done there might be things that um you have to sacrifice but the job the the thing that you want the outcome that you want the standard that you set it can be done

it can be done it's you tell yourself you can't do it I mean I have a three and a 5-year-old do you know what kind of chaos ensues at my house you should come over and I guarantee you you will hold off having any kind of children for at least 5 years but nothing is perfect it can't ever everything cannot be curated do I still get my training in do I still get my nutrition in am I anything special I am not but my discipline is I am very disciplined have you always been yes a

lot of people aren't and they haven't ever been it's much more difficult to not be disciplined the reason I am disciplined is to be able to manage my life how do I get you a discipline you execute you don't overthink it there's nothing to think about what do you want I want to be like you no what do you want where are you falling short I want to be like you you would not be nearly as successful if you were undisciplined you have to be disciplined I'm just trying to embody the audience I'm just trying

to I'm trying to think through all the [ __ ] that people tell themselves and we all tell ourselves [ __ ] in various aspects of our life if we're not telling ourselves [ __ ] as it relates to like exercise it's something else it's our relationship and we and so many people struggle with personal responsibility because if I was to post if you were to post or I was to post anything on my story that you just said in the last sort of five minutes they would be very offended yeah and there' be well

not every B there's a small group of like so are they going to edit this out so come oh no don't don't send crazy people after me no we will but um it's like the water Bouy gang and the water Bouy gang you could say anything and they say yeah but what about yeah but what about and I understand some people have they have legitimate exceptions the truth is it is very difficult to do what I do I run three different businesses I take care of some of the most incredible humans on the planet I

have my own podcast I'm writing two more books and I don't have full-time help I'm a mom the one thing I don't find is I don't find excuses I figure out ways to get it done because if it matters you find ways to get it done you know if I were to say and this is an extreme example but let's say I said to someone who I'll just make this up loved cupcakes I said if you eat another cupcake then something catastrophic is going to happen to your dog do you think that they would ever

touch another cupcake no not in a second just like that so the consequence is just not meaningful enough when you find a meaningful consequence and you understand the consequence of your actions in that moment it becomes easy and this goes to what we were saying about the discipline and the why part of that equation you you refer to it there as consequence like why does this matter to you is the central part of the equation and deep in your head somewhere there's you're so clear on why this matters yeah because you've you've seen the research

you've studied it you've seen the the consequence of I've seen the end result yeah you SE I've seen end result at the end of the day today we are all health and age and death these things nobody's getting out of them like nobody so if I follow your protocols for the next 30 Years yeah then I'd be 60 years old I'd be 61 years old can you describe to me what you think my life will look like as a 61 year old I can versus if I just sit in this chair and eat processed foods

and do zero assistance training for the next 30 Years can you describe the two different Stevens we'll call it we'll call one sedentary Steve and we'll call one um Dr Lion Steve okay let's start with sedentary Steve mhm I will say you're 30 so right now you're sedentary Alzheimer's disease is likely beginning cardiovascular disease is likely beginning right now at 30 that's right remember these diseases that we believe are diseases of Aging are at their core and at their root in part due to the health of skeletal muscle the only organ system that you have

direct voluntary control over that's it I cannot say Stephen I want your heart to beat at 45 beats per minute go I cannot not control you might be able to control your respiration but you can't physically contract your diaphragm go ahead contract it okay maybe it's a muscle skeletal muscle is the only organ system that you have voluntary control over that's it now if you decide to not hear what I am saying then if you are someone who has a genetic propensity maybe you have I don't know uh when you overeat you get high triglycerides

or you um choose not to exercise we will start to deteriorate your brain because Contracting skeletal muscle is an endocrine organ not only does exercise increased blood flow to your brain um I just wrote a narrative review with a colleague of mine um Louisa Nia amazing we looked at the influence of resistance training and brain function I cannot restore your brain but I'd love to be able to prevent from the uh connections to become weaker and weaker and weaker so you decide not to exercise I can do nothing for your brain eventually you might forget

I don't know your neighbor's name your kids's name your um anything what you did any meaningful memory if we don't address your brain now then the potential outcome is clear right 2third of Alzheimer's um the majority of dementia is Alzheimer's dementia which plays a role in uh metabolic regulation type three diabetes of the brain if your skeletal muscle is unhealthy you are likely having now not only skeletal muscle insulin resistance but brain insulin resistance no such thing you cannot be sedentary and be healthy so that will begin now the other thing is your cardiovascular activity

can't help can't help you there not getting increase in blood flow you're not um moving your cardiovascular health the way that it should your lung capacity your cardiovascular capacity you're probably going to be extremely winded walking upstairs it might take so much effort for you to get up you might not even be able to fully stand up and sit down from your chair multiple times you might struggle with that if I said Stephen I need you to go to grab something out of the car for me you would probably say oh man hey Doc um

that's going to take a lot of effort I I I'm not sure I'm not sure I could even grab that I don't know 15 pound grocery bag you um likely have central obesity probably have sleep apnea which means you're further deteriorating both your brain and your metabolic health I would just throw in there you haven't trained your entire life your testosterone is probably low and maybe throughout your lifespan who knows maybe you have challenges with fertility because your sperm quality isn't as good as it could have been if you were training and eating well are

you convinced yet so there's a there's a link between my fertility for men and women and my muscle mass there is um a link between exercise training metabolic health and definitely fertility I think we are going to see more and more literature come out on this muscle mass infertility as um by the time you're 60 will definitely have more is there a link between polycystic ovary syndrome and muscle mass you talk about I think in chapter two I do there is insulin insulin resistance when you think about skeletal muscle and insulin resistance skeletal muscle makes

up 40% of your body weight or so depending for me it might be less for you it might be more when skeletal muscle becomes insulin resistant again which means insulin is a uh peptide hormone that is released from the pancreas you require insulin to move glucose out of the bloodstream into cells when you you exercise you do not require insulin to move blood glucose out of the bloodstream into skeletal muscle tissue it can be insulin independent polycystic ovarian syndrome is multifactorial there is a component of polycystic ovarian syndrome that is related to skeletal muscle insulin

resistance once an individual manages their skeletal muscle mass again there's a various number of reasons as to why someone would have it but in part addressing skeletal muscle mass and skeletal muscle insulin resistance can help resolve polycystic ovarian syndrome in certain cases I was reading on the subject of sort of um PCOS and fertility I was reading a study by Earth which was um done at Harvard that found that men who reported to frequently lift heavy weights and objects at work had a 46% higher sperm concentration and a 44% higher total sperm count compared to

those with less physical jobs so you're telling me if I want to up my sperm count and have a baby and health and health I should start lifting some weights yes I was thinking about the 61y old guy that listens to Dr Lion's protocols but also let's say you didn't we didn't talk about what would happen if you listened yeah which is what I'm saying so the guy that listened so the 61-year-old Steve bartett that listens to your protocols holy cow the guy's a beast he's now taking over the world because does he have a

sixpack of course he does really at 61 yes is it possible yes what's the healthiest oldest person you've ever seen my dad really oh my gosh he's 74 he could put on a little more muscle okay his testosterone is like 800 he's not any hormone replacement he has been following what I've been telling him unfortunate for him because I'm his daughter he's been listening to this message just sitting here with you but we are talking about over 10 years of talking about this of seeing this with patients and people he has amazing um hemoglobin A1c

fasting blood sugar cholesterol is in check I mean he is strong he is capable he's 74 what is the most important thing that we haven't talked about Dr lion I would say that nobody's getting out of this alive and it's all going to come down to choices choices for how we execute our present choices will determine our outcomes and it is not difficult it's not complex you have to prioritize skeletal muscle this is the organ of longevity with this physical framework comes mental strength and what's most important about this isn't for us now like this

is great you can do it but it provides hope and an example for our children that them those people the little ones that is who I am truly worried about because we have normalized supersizing everything including ourselves we have more Electronics than ever before we are more more disconnected from people people will say the internet has done a great job at connecting face-to-face conversations connection is huge the most important is our youth and how we raise them and the messages that we give them because they are our responsibility and if we cannot advocate for our

own health whatever those limitations are whether it's personal or worthy it is our responsibility to do a much better job so that we not tell them but we show them the way forward and what's the most important subject in your book that we haven't covered Forever Strong a new science-based strategy for aging well how to reboot your body to burn fat fight heart disease reverse diabetes stay sharp build muscle and Boost energy I mean we talked about dietary protein we talked about how that potentially can be controversial controversial for some people um we discussed carb

hydrates carbohydrates are earned through activity if someone is metabolically unhealthy they have to understand that potentially starting with 100 grams and titrating up or down depending on their activity level is important how quickly do I lose muscle you if you were in the ICU you could lose 2% of your muscle mass in a day G God what if you are in a highly catabolic State on bed rest you will lose muscle rapidly depending on your age um within 7 days you could lose if you're young and healthy 2 lbs of scelto musas because I'm thinking

if I go to the gym today and I did my biceps and I really smashed it how long before those gains were lost I would give you you'll lose strength and then Mass um you will lose it rapidly 7 Days of bed rest you will lose it and but it will return if you've been well trained and it will return faster the second time than it did the first time right people talk about muscle memory a lot that is a interesting perspective yes if you are well trained will it return Yes it also depends on

how long you have been untrained for it also will depend on how highly catabolic you are for example if someone had cancer they're in a highly catabolic State their body is breaking down skeletal muscle mass will improve their survivability if someone goes on bed rest you will lose muscle mass and strength extremely rapidly now will you able to impr uh re return insulin sensitivity yes if you decided to just begin basic activities of living and not exercising you will not be able to recover that muscle getting out of the hospital just doing basic things will

not be enough and now as you can imagine that happens to people I can imagine yeah yeah I go through periods of my life where for whatever reason I have to be a bit more sedentary um things like filming TV shows I filmed a show called Dragon's Den where we basically sit in a room for 10 hours a day it's like Shark Tank here and whenever I go through that season of life it's very difficult I I I always see this correlation between how much activity I have I've been doing and how much motivation I

have uh so if I've been sat down and not been exercising for a while I find it harder to find the motivation to go again and it's this kind of vicious downward spiral one thing that we didn't talk about is how skeletal muscle mass functions as an endocrine organ what's an endocrine organ an endocrine organ is something that produces hormones that act systemically locally and um interor there an interorgan connection when you exercise based on intensity and duration you release myocin myocin like interlukin 6 or interlukin 15 these are what people typically think is cyto

kindes that are released from inflammatory cells or macrophases but when you contract skeletal muscle in a meaningful way based on the intensity and duration you release myocin from skeletal muscle that interface with your brain they affect mood they affect neurogenesis it also affects your liver and your kidney there's this interorgan cross talk you know we talked about skeletal muscle about how important it is from a metabolic perspective as a body armor perspective but also as this endocrine organ that can affect mood because of the components that it's releasing and that is fascinating it can counterbalance

inflammation based on the activity duration and intensity so that explains why if I've not been moving I don't feel as good in terms of motivation and um I feel more fatigued when I've done less exercise over a long period of time I mean yes and it doesn't take much to maintain what you have for example if you could during those days do you have to be so you're shooting for 10 hours you don't have breaks we have lunch break you should be training on that lunch break I don't care how tired you are I'm hungry

then you should eat in 10 minutes and get to training it's a good point and you're totally right push-ups have a weighted vest do whatever you have to you will feel exponentially better and also this is predictable so here is an example you know it's it's coming right you know that you'll be filming this for 10 hours a day yeah what is your strategy to execute in a way that is effective and meaningful and that's really it isn't it it's about forward planning yeah you know it's coming it's predictable it's also predictable how you're going

to feel afterwards and then you are going to have to account for how you feel and then you are going to have to deal with the repercussions of now not being motivated now having to address your diet and now probably feeling a little bit more down than you would have we it's com it's one of the big things I've just real realized as you talking is I don't schedule my workouts so my workouts are kind of this residual residual beneficiary I either get whatever time's left over in the day which might mean last night it

was super late it was almost at midnight and then today I've got a flight after this so it's 10hour flight so it's like but I I could quite easily I have the fortune and privilege of just being able to ask my assistant to change something so I can say while you schedule everything else also schedule an hour for me to train but I think everyone could probably do that I would I wonder how many people schedule their workouts everybody who is you show me your habits and I will tell you how successful you will be

able to continue to be in the long run you could probably look at someone's calendar and figure out what they're going to look like in 10 years time I definitely can but I will say that there's this privilege of Youth and then there becomes a Tipping Point yes you should be scheduling those things you can add let's say you say to me Gabrielle I don't have time to do it you are not you could schedule three days a week you know that we're filming all day you know that you're doing these things that is a

non-negotiable because you're setting a standard you set a standard for everything in here and everything else you do nothing is going to be more critical for your impact than being able to manage your health because again there comes a point in time where um it's a very predictable Turning Point inflection point if we get together again and I don't know say it was 30 years from now and I say to you how and you've been successful over the next 30 Years however you define that what happened we've completely changed the conversation we are no longer

at nausey I'm talking about obesity that is a side component we are focused on physical and mental strength we are focused on understanding that it is a muscle problem and a problem and a solution that we can do something about obesity is an afterthought and personally my kids have done amazing and they're happy and adjusted and can withstand whatever whatever comes their way and my husband will be picking up his socks if he stopped taking care of himself he would never he's an he would never but just say play out the scenario yeah would you

say something to him U yes what would you say probably don't want to put on camera but it would be something totally inappropriate and somewhat aggressive but yes I would say something to him but ultimately he has to be an example for our kids it is his responsibility it's not about him we have a closing tradition on this podcast where the last guest leaves a question for the next not knowing who they're going to be leaving it for and the question that's been left for you is Regret can occur due to action taken or action

not taken in light of that what what is your biggest meaningful regret and why my biggest meaningful regret and why I don't know if I have a regret I I don't know if I have a regret that I can think of because I think that we are responsible for our choices what if I put the word mistake in there I mean the only thing that I could think of is I again this isn't a mistake or I don't even know if I consider this meaningful is that um outcomes unfold and instead of you know I

was so driven and I've been so driven by doing good you know thinking like I have to contribute I have a responsibility to contribute to the world I could have put a lot less pressure on myself but is that is that meaningful is that a meaningful regret or a mistake I can't say that that's true would the outcome have been any different would I have worked any less more diligently I don't know well it's a good thing you have because um you've really led the charge as it relates to muscle and the conversation around muscle

and these subjects more broadly but when I think of someone that is at the very Forefront of educating the world on muscle and its importance and especially as we age that we can be Forever Strong um at least strong while we're still alive then that person is you and I can't imagine how many millions of people are better for that I can't imagine it'd be crazy if you could put them all in like a stadium or something and and get to meet them all that have just had their lives just subtly altered even if it's

just you know one decision to go for a walk or to do a little bit more resistance training once a week that matters right it does and that's a really wonderful thing and that's I kind of guess what your your all of your work is really aiming at is to find understand someone but then give them the the missing piece of information or inspiration so that they can pursue their very best self and I thank you for doing the work that you do because I I'm sure those millions of people can't thank you themselves but

it's um it's really altering not just their lives but also as you say the generations that are set to come after them and their children and so on and that's one of the things I'm actually thinking much more about having spoken to you is the I've never thought because I don't have kids yet about the role model that I that I am or aren't to those kids that are watching me and as you said it I I had this s Flash back of my mom outside my house when I was like a four five-year-old and

just watching her run up and down the street um over and over again in this tiny little sort of circle that she used to do and how that stayed with me for forever that she cared about that and that what that meant for us is um her children and it's a really powerful thing it's a really wonderful thing because you know this isn't really about muscle at the end of the day this is not about much more it's not and medicine is the gateway to really be able to provide freedom for people that's what I

want MH muscle is the way in medicine is the way in but what I really want for people is I want them to have freedom and that freedom is happiness it is yeah or whatever it is that they want to do mhm thank you so much it's such an honor to meet you thank you for having [Music] me isn't this cool every single conversation I have here on the D ofo at the very end of it you'll know I asked the guest to leave a question in the Diary of a CEO and what we've done

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