Docs Who Lift

5:37 PM Dr. Spencer Nadolsky and Karl sit down with Dr. Henning Langer, PhD researcher at the Charité in Berlin and founder of his own muscle metabolism lab, to break down his newly published paper combining rodent and human data to look directly at what GLP-1 medicines actually do to skeletal muscle beyond what a DEXA scan can tell you. Dr. Langer spent time at Boehringer Ingelheim specifically studying skeletal muscle during obesity and anti-obesity treatment before bringing that work to his own lab, and this paper is one of the only studies to date that has looked at muscle directly rather than lean body mass as a proxy. In this episode they cover why the step one trial's 40 percent lean mass loss figure may not be as alarming as it sounds and why most incretin trials actually land closer to the expected 25 percent, why lean body mass on a DEXA scan conflates muscle with glycogen, liver weight, and water in ways that overstate actual muscle loss, why the mice on semaglutide that looked the roughest in their cage ran the best on the treadmill to exhaustion, what mitochondrial protein changes in the proteome data suggest about a possible fatigue resistance benefit that cannot be explained by fat loss alone, how absolute muscle force tended to drop slightly while relative strength and endurance held up, what the human data from Nottingham showed about maximum voluntary contraction and knee extension force in patients on GLP-1 treatment, why the geriatric population is the next big unanswered question in this space, and why resistance training combined with high protein still cuts muscle loss in half and remains the most powerful lever available regardless of what the pharmacology does. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Spencer Nadolsky and Dr. Karl Nadolsky sit down with Dr. Stuart Phillips, senior author on the newly updated American College of Sports Medicine position stand on resistance training, to break down what 137 systematic reviews and over 30,000 participants actually tell us about building muscle, getting stronger, and improving function across the lifespan. The last version of these guidelines was published in 2009 and the science has come a long way, even if the fundamentals have not. In this episode they cover why lifting weights twice a week is already getting most of the available benefit and three times is better but not by as much as you think, why the hypertrophy rep range is far broader than the classic 8 to 12 and what that actually means for your training, why getting stronger still requires lifting heavy things regardless of what anyone tells you, how power training is about moving with intentional velocity and why it matters more as you age than most people realize, why periodization showed no statistically significant advantage over non-periodized programs in the systematic review and what that means in practice, why eccentrically biased training produces slightly better muscle growth but is an optimization tool not a fundamental one, why time under tension does not have the evidence base people think it does, why blood flow restriction remains a niche tool rather than a strategic advantage, and why the best workout is simply the one you will actually show up and do consistently. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Spencer Nadolsky, Dr. Karl, and chief science officer Dr. Grant Tinsley sit down with Dr. Stephen Heymsfield, physician at the Pennington Biomedical Research Center and lead author on the BELIEVE trial, to break down what happens when you combine bimagrumab with semaglutide and why over 90 percent of weight lost in the combination group was pure fat. Dr. Heymsfield has published over 600 peer reviewed articles and is widely considered one of the foremost body composition researchers in the world, and Grant Tinsley credits him as a foundational influence on his own work in the field. In this episode they cover what bimagrumab actually is and how blocking the activin receptor causes muscle to grow, the origin story of the drug from Novartis to Versanus to Lilly and why sarcopenia research accidentally opened the door to obesity treatment, the nine group trial design and what it really boils down to, why the bimagrumab only group lost 7 percent of their weight entirely as fat without reducing food intake, the LDL cholesterol finding that has everyone talking and whether it actually matters, what happens to muscle and weight when you come off both drugs, why visceral adipose tissue practically disappeared in the antibody treated groups, the functional outcomes data including grip strength and physical activity scales, whether a subcutaneous version is coming, and what the future of this drug class looks like now that Lilly has deprioritized it. The Docs Who Lift podcast distills and simplifies the complexities of exercise, medicine, and weight loss. Subscribe so you never miss an episode. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Dr. Spencer and Karl Nadolsky bring on Dr. Alyssa Olenick, exercise physiologist and postdoctoral researcher in menopause and metabolism, to cut through the noise on one of the most misrepresented topics in women's health. Dr. Olenick holds a PhD in exercise physiology, completed postdoctoral training focused on menopause and body composition, and is the founder of the Liss Method, a hybrid training program combining strength and endurance. She has been doing women-specific and sex-difference research since her master's degree and is one of the sharper voices pushing back on the wave of pseudoscience targeting women in the fitness space. In this episode they cover what actually changes in body composition during the menopausal transition and what does not, why fitness status matters more than menstrual cycle phase or contraceptive use, how the fitness industry profits from pinkifying advice that was never women-specific to begin with, the truth about rep ranges and why effort matters more than the number, cortisol myths and why the adaptive stress response to exercise is not your enemy, and how to approach training adjustments during perimenopause without overcorrecting into low intensity fear-based programming. No pseudoscience. No pink packets. Just the research. Follow Dr. Olenick Here Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Creatine is a naturally occurring compound that helps regenerate ATP, the energy currency of the cell. Supplementing with creatine can enhance performance in high-intensity exercise but may not be beneficial for endurance activities. The majority of creatine is stored in muscle, and supplementation can help fill those stores for better energy availability. Creatine monohydrate is the most studied and effective form of creatine, and it's also the cheapest. There is no need to cycle creatine; continuous use is safe and effective. Creatine supplementation is generally safe, but individuals should inform their healthcare providers about its use. The benefits of creatine are most pronounced in individuals engaging in high-intensity exercise. Creatine does not directly build muscle; it requires exercise to be effective. There is a misconception that creatine is harmful to the kidneys; it is safe for healthy individuals. Creatine supplementation may have potential cognitive benefits, but more research is needed. Follow Dr. Lauren Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: The 11-Minute Rule: Why blue light isn't the villain you think it is. The Melatonin Mistake: Why "less is more" (and the exact dosage for success). Trackers vs. Reality: When to throw away your Apple Watch or Oura Ring. The Bedrock Principle: Why sleep is the lead domino for fat loss and metabolic health. Sex & Sleep: The surprising biological difference in how men and women recover. Tap Here to follow Shelby Shelbys Book Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Get The Lucky Egg Book Here Takeaways: Dr. Lucky Sekhon is a reproductive endocrinologist and author of 'The Lucky Egg'. The pathway to reproductive endocrinology involves extensive training in OB-GYN and specialized fellowship. Social media became a tool for Dr. Sekhon to combat misinformation during the pandemic. Common myths in fertility include the idea that one can reverse the biological clock. Understanding the fertility knowledge gap is crucial for patients seeking help. Insulin resistance plays a significant role in fertility issues, especially in women with PCOS. Fertility treatments should be evidence-based and tailored to individual needs. GLP-1 medications can help regulate menstrual cycles and improve fertility outcomes. Endometriosis can significantly impact fertility and requires tailored treatment approaches. The importance of patient education in navigating fertility treatments cannot be overstated. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways Excellence is not a standard but a process of becoming. Involved engagement means caring deeply about what you do. The pursuit of excellence shapes you into a better person. Consistency is key to achieving long-term goals. It's important to align your pursuits with your values. Youth sports can be beneficial but also harmful if not approached correctly. Weight loss should shift from a focus on numbers to health and well-being. Building a diverse identity can help prevent burnout in athletes. The transition out of sports can be challenging due to identity loss. Enjoying the process is more fulfilling than the end goal. Tap or Click Here to Buy Brads Book Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Key Episode Takeaways Oral Wegovy is real, but it’s not “just a pill version of the shot.” Absorption rules, dosing schedules, and patient selection matter a lot more than most headlines suggest. Switching from injections to oral GLP-1s requires a plan. The transition isn’t one-size-fits-all, and dose timing, GI tolerance, and expectations need to be managed carefully. Weight regain after stopping GLP-1s is common, but not universal. SURMOUNT-4 data shows large variability, reinforcing that biology, not willpower, drives outcomes. Maintenance matters as much as weight loss. Some patients need continued therapy at lower doses, while others may maintain with lifestyle plus strategic medication use. Stopping abruptly is usually the worst approach. Gradual transitions and realistic long-term strategies reduce rebound weight gain. GLP-1s are chronic disease tools, not short-term fixes. Treating obesity like hypertension or diabetes leads to better outcomes and fewer surprises. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Dietary guidelines have evolved since the 1980s. The food pyramid was introduced in 1992 and has influenced public perception. New dietary guidelines emphasize healthy fats but retain some old recommendations. There are contradictions in the new guidelines regarding saturated fat and protein intake. The definition of processed foods remains vague and controversial. The guidelines are intended for healthcare professionals, not consumers. Public policy needs to align with dietary guidelines for effective implementation. The emphasis on real food is not a new concept in dietary guidelines. There is skepticism about whether the new guidelines will lead to meaningful changes in public health. The conversation around dietary guidelines is often politically charged. Follow Kevin: Tap Here Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Cortisol is essential for various bodily functions, especially during stress. Adrenal glands have a circadian rhythm that affects cortisol production. Cushing's syndrome can result from excess cortisol and has specific symptoms. Diagnosis of adrenal disorders requires careful testing and consideration of symptoms. Mild autonomous cortisol secretion can complicate diabetes management. The Catalyst trial explored the effects of cortisol antagonism on diabetes. Future research may focus on selective glucocorticoid receptor modulators. Woolly mammoth studies provide insights into historical testosterone levels. Understanding adrenal health is crucial for effective patient care. Endocrinologists must navigate the complexities of hormone testing and treatment. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Slimmer's Paralysis is a recognized condition. Ethical boundaries are crucial in patient relationships. Medical professionals must maintain professionalism at all times. Humor can sometimes arise in serious discussions. Patient stories should always be handled with care. The importance of clear communication in medical settings. Understanding patient experiences is vital for effective care. Ethics in medicine is a complex and nuanced topic. Medical discussions can lead to unexpected topics. Maintaining a professional demeanor is essential. Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Drug transfer during lactation is complex and challenging. Semaglutide was not detected in women taking any dose. Low amounts of tears epitide were found in milk. Tissue damage can affect drug absorption. Mastitis and engorgement complicate the lactation process. Injections are necessary for effective drug delivery. The analogy of an elephant illustrates the difficulty of drug transfer. Detection of drugs in milk is a critical concern for breastfeeding mothers. Understanding turnover is essential in lactation studies. The implications of drug transfer on women's health are significant. Infant Risk Center Link Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways: Behavior change is a complex process that requires understanding motivation and discipline. Motivation is not just a feeling; it's a psychological skill that can be developed. Many common phrases about behavior change are misleading and oversimplified. Exercise should be viewed as a choice rather than a habit that becomes automatic. Self-efficacy is crucial for successful behavior change and can be built through mastery experiences. Future self thinking can help individuals align their actions with their long-term goals. It's important to lower barriers to entry for new behaviors to increase adherence. Modeling healthy behaviors is essential for influencing children and adolescents. The psychological definition of a habit differs from the colloquial use of the term. Resources and support systems are vital for individuals looking to change their behaviors. Follow Dr. Nordin Here Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Tap to Follow Dr.Susan Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Show Notes: In this episode of Docs Who Lift, the Nadolsky brothers welcome back Dr. Sean Wharton, clinical trialist and one of the leading researchers behind the next generation of oral GLP-1 medications. Together, they break down: The OASIS-4 trial results on 25mg oral semaglutide and how it stacks up to injectable Wegovy How orforglipron, Eli Lilly’s new small-molecule GLP-1, differs from peptide-based drugs Why these new therapies could make weight management more accessible and affordable The fascinating pharmacology behind “snack molecules” and small-molecule receptor agonists Common misconceptions about bioavailability, dosing, and side effects The potential role of oral GLP-1s for patients with mild obesity or cardiometabolic disease Whether you’re a clinician, researcher, or patient curious about the future of obesity medicine, this conversation offers a clear look at how science is shifting toward needle-free solutions. Oasis 1 Trial Link Oasis 4 Trial Link Attain 1 Trial Link Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

In this episode of Docs Who Lift, the Nadolsky brothers dive deep into the newly released American Association of Clinical Endocrinology (ACE) Algorithm for Obesity Care led by Dr. Karl himself. They explore: Why ACE moved away from a BMI-only approach to a person-centered, complication-centric model The new staging framework (ABCD) that helps individualize treatment intensity How to interpret “clinical” vs “preclinical” obesity under the new model Updated targets for clinically meaningful weight loss (5%, 10%, 15% tiers) The emphasis on resistance training, sleep, and behavioral health alongside nutrition Practical guidance for selecting anti-obesity medications and identifying the right therapy for each patient Whether you’re a clinician, health professional, or patient trying to understand modern obesity care, this episode breaks it all down in a practical, real-world way without the jargon. Youtube Video to follow along the graphic mentioned Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways Julia Belluz X/Twitter Kevin Hall X/Twitter Purchase Their Book Here Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways Menopausal women often prioritize weight gain concerns over other symptoms. The study observed an association between hormone therapy and weight loss with GLP-1 medications. Retrospective studies have limitations but can provide valuable insights. Future research should focus on randomized controlled trials to confirm findings. The relationship between estrogen and GLP-1 signaling needs further exploration. Funding for research can be challenging, especially for early career investigators. Collaboration between different specialties is crucial for comprehensive patient care. The media often misrepresents research findings, leading to misconceptions. Individualized treatment plans are essential for menopausal women. There is a need for more awareness about the effects of menopause on health. Research Links: Weight loss response to semaglutide in postmenopausal women with and without hormone therapy use Combination of obesity medication tirzepatide and menopause hormone therapy fuels weight loss Hosted by Simplecast, an AdsWizz company. See pcm.adswizz.com for information about our collection and use of personal data for advertising.

Takeaways - Women are not just smaller versions of men; their training and nutrition needs differ significantly. - Fasted training can lead to hormonal and metabolic changes that may not be beneficial for women. - Post-workout nutrition timing is crucial for women to optimize muscle growth and recovery. - Strength training for women should focus on heavier loads and lower reps, especially during perimenopause. - The menstrual cycle can influence training, but individual responses vary widely among women. - Consistency in training is more important than adhering to strict phase-based training protocols. - Women often miss eating opportunities post-exercise, which can hinder their progress. - Research on women's health is still evolving, and more diverse studies are needed. - Understanding the hormonal changes during perimenopause is essential for effective training. Practical application of scientific findings is crucial for helping women achieve their fitness goals. Tap Here for Dr Stacy Sims References Tap Here for Dr. Colenso-Semples References Dr. LCS Instagram Dr. SS Instagram