To this day, everybody focuses on

obesity, but obesity is not our problem.

If you are in the lower 1/3 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 of. And there's only

two ways to stimulate skeletal muscle.

Number one, Dr. Gabrielle Lyon 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,

optimize 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 no 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?

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, 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 Diary of a

CEO, who would you choose?

Here's a challenge for the entire Diary

of a CEO community. If we hit 10 million

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[Music]

Dr. Gabrielle Lyon.

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 as to what

I mean.

Yeah, 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 do 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.

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 and

aging.

And when I finished that, I started a

concierge medical practice.

And I take care of, right now, many of

the guests who have been on this

podcast, like, um, Evy Poumpouras and,

um, yeah, woman named Danica Patrick. I

don't know if you know who that is.

She's a race car driver extraordinary.

And many Tier 1 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 your

practice, what is it that they typically

say? What is it that 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,

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, an 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 raise. Mhm.

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 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 work so hard,

you

launch this book into the world, or

maybe your first massively successful

episode, which now maybe a little bit

less because they're all massively

successful,

but right after that, there's 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

lows. 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.

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 Really? that they 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

oversleep 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 corner and you

could start to pick up on it. Maybe I

was

I don't know, I was carrying myself in a

certain way, my body language, the way I

was talking about myself subtly. I was

putting myself down. Um

and maybe you maybe there's other things

going on and you go, "Do you know what?

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, "Steven,

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's your digestion,

what are you being exposed to?

And then I would give you a handful of

tasks.

I would tell you you got to get your

blood work done. You 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, G, 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."

Six months,

they will come to a point where they

will have to get it done.

Once they get those testing 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, also, Steven,

if people don't have time for health and

wellness, how are they going to have

time for sickness?

Mhm. That's so much more time consuming.

Mhm.

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 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 endpoint.

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 hallmarks of someone?

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 6 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

cuz they are in it to be the best

version of themselves. Mhm. And then

there are other people that have gone to

13 other physicians and

have lost hope in the system. Mhm. 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.

Mhm.

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 T

trauma or a big T trauma. Yeah. It could

be a small thing that 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

Stanford 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

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 any more of 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 or 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 as fight or

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 they're

stressed, 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 read ready to jump out of a

plane, I would be terrified, and he

would be excited to do it. He would be

eliciting courage.

We're both in the same experience, but

he is having one of courage, and I am

having one of fight or flight.

When we both jump out of the airplane,

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 or 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 I I don't know if 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} and {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 Kwik.

He is

He's worked with myself, helped make

that book possible, as as well as 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.

I will also say I trained in psychiatry

for 2 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, we 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 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

health care is set up, right, is that

it's you 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.

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. Mhm.

Is seeing what their true potential is.

And to push them? Yeah.

Do Do some Do sometimes people need a

bit more pain

before they

Yes. And then I mean, this speaks to

what 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 it's

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's

going to come.

And you might as well get ahead of it.

You can only push so far.

Your original question is, 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 self-service, it's

an other service.

And when you can tap into 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 many I mean, how many patients

do you think you've seen over the last

Thousands. Why do 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 Danica, 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. What are the seasons of

unhappiness in your life?

I think during training was very hard

for me, during my fellowship.

Saw a lot of death.

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

2015,

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 has um

She's planning her 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

I was seeing all this BS on social

media.

These people talking about you know,

this cleanse and this fake diet and this

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 I've 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 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 the 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 emotional 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 feel 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 death. We are dealing with

things like um

hey, you live in a toxic mold

environment or you have Lyme. Um we can

move past this or hey, you have COVID

and you're in Washington, let me get

some Paxlovid 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 caring 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 cuz

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 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 in

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. Oof. Getting up there. Mhm.

You are 31.

getting up there? You mean I'm getting

old.

No, I cannot talk. Um

but there is this physical capacity that

if you were to just say, Gabriel

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 50-year-olds.

But when you are 80, if all you did was

look at that physically, 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 going to

happen.

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 cuz 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 should in 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 bench 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 means

becoming masterful at something. For

example, you're 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'd 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 short 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're 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 Lane 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 just

saying that as 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. Mhm.

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. Mhm.

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

sovereignty 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 this

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 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 Israetel 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 3 days a week.

Okay, so is that everyone? Yes. Everyone

regardless of age?

Yes. Yes. So That part is regardless of

age three to

Listen, could you get it done in 2 days

a week, which is the recommendation?

The current recommendation for activity

is 150 minutes of moderate to vigorous

activity and 2 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. Three 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. Three days a

week. You should be doing And I only

train I do resistance training 3 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. Three days a week,

everybody I mean, I'm I'm okay with 2

days a week,

but in an ideal world, it should be 3

days a week.

My recommendation is you train for

muscle hypertrophy. Which is? Muscle

growth.

10 to 20

sets per muscle group a week. And how

many reps?

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 is 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

FaceTimed, 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 3 days a week?

What 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 good

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,

she's probably going to be a killer.

Skeletal muscle is your primary site for

glucose metabolism, fatty acid

metabolism, it's your glucose sink.

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

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 1/3

of strength

compared to if you are in the lower 1/3

of strength,

those that are in the lower 1/3 for

strength

have a 50% greater risk

of dying from nearly anything.

If you are in the lower 1/3 of strength,

you have

a roughly 50% chance

of dying from all cause mortality.

But I'm getting old, Dr. Lyon. I I'm I'm

58.

Yeah. Um when people get old, they put

on weight, they 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.

That 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.

What do I mean by that? I say, "Steven,

this is stressful. This is stressful.

Our fight or 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 divorced 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 for

the bros.

Nothing could be further from the truth.

And because 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 7 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

need You mentioned your parents or your

dad. You see and we see collectively

our aging population shrink,

right? They become thinner and 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 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 two or 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 two 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,

Yeah. and I've got lots of muscle,

then

the sh- the sugar and the carbs 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? Likely, yes.

Especially if you are training and you

have healthy skeletal muscle.

Um skeletal muscle can be marbled. A-

You can get an increase in myosteatosis,

which is fat infiltration in skeletal

muscle.

In order for skeletal muscle 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 not active,

you will not be turning over your

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 75%

do not meet both recommendations.

The majority of individuals are

sedentary individuals.

It's interesting cuz people will 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 COVID, 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. 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 60-year-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 3-hour

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 life span,

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

continues to take the easy way,

the

predictable decline

will

conti- 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 i- if I've come to

you and I say, "Listen, Dr. Lyon, 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.

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're up against? Mhm. And then, I would

say,

let's go.

We're going 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-suction? 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

hyper-fixation 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 there? So, how is having

more skeletal muscle going to My gluco-

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's going to be better, you

said as well, so

your ability to store glucose Yeah. will

be from,

you know, obviously stored in your

liver, but skeletal muscle is 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 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 Ozempic?

Should I Should I consider a little bit

of Ozempic 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 Ozempic or Mounjaro,

GLP-1s, 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 though?

It depends.

Michael, he was uh on the podcast

previously, he told me that taking

testosterone and steroids 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 physical 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 in

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 skeletal muscle mass.

And I personally believe that that

conversation needs to shift. A lot of

people say that Ozempic causes muscle

loss as well. It doesn't. Really?

I have not seen a direct mechanism of

action

that Ozempic

affects skeletal muscle in a negative

way. In fact, I have seen the contrary.

There is evidence to suggest that

Ozempic 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 out-medicate

poor behavior.

Oh, but but because they're on a

appetite suppressant like Ozempic, that

means that 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 Ozempic and these that category of

drugs will people of 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, cuz if

someone suggested it to me, I'd say, the

first thing I'd say is, "Dr. Lion,

what's the cost?"

Cuz 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 me many costs for Ozempic at the

moment.

Well, number one, you don't need it.

Yeah. You would not be someone who needs

Ozempic or Mounjaro or Zepbound. You You

just wouldn't 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 the last 20 years. I

know at least 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 eat 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.

Do diets work?

Do you ever put someone on a diet?

If they're over 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