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How much resistance training do you actually need, and is there a point where more stops helping? We trace the "lift weights twice a week" recommendation back to the 1989 study it came from, which found that three days beat two, and to the citation loop that turned it into a guideline anyway. Then we go through the evidence on whether lifting is dangerous, including the heart, injury rates, and the J-shaped mortality curve, and work out where the dose-response actually saturates for strength, muscle mass, bone mineral density, and how your body handles fuel. The short answer is that almost every number in this literature marks where a benefit starts, and very little of it goes far enough to show where a benefit stops. We finish by writing the resistance training guideline the way we think it should be written, with target outcomes, a training dose, and testable targets. Timestamps  • 00:00 Where the "lift weights twice a week" rule came from  • 04:18 What actually counts as resistance training  • 06:56 Does lifting make your heart wall thicker  • 15:34 Anabolic steroids and the heart  • 19:16 Injury rates and cardiac arrest at the gym  • 22:03 How the lifting J-curve got made  • 28:05 ACSM audits its own recommendation  • 31:11 Strength: where the plateau actually sits  • 35:49 Why grip strength can't answer this  • 41:43 Muscle mass versus muscle function  • 44:50 Bone, and the turkey wing that settled the dose  • 49:50 Fuel handling, insulin sensitivity, and the clock  • 1:00:46 The 2018 guidelines, and how I would write them • Resources Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/ New Barbell Medicine Hybrid 5K and 10K Run + Lift Programs (https://www.barbellmedicine.com/shop/training-templates/endurance/hybrid-5k-10k/) Barbell Medicine coaching and templates: https://www.barbellmedicine.com Get early access, ad-free listening, and exclusive content here: https://barbellmedicine.supercast.com/ 1. Braith RW, Graves JE, Pollock ML, Leggett SL, Carpenter DM, Colvin AB. Comparison of 2 vs 3 days/week of variable resistance training during 10- and 18-week programs. Int J Sports Med. 1989;10(6):450-454. doi:10.1055/s-2007-1024942. PMID 2628366. 2. American College of Sports Medicine. Position stand: the recommended quantity and quality of exercise for developing and maintaining cardiorespiratory and muscular fitness in healthy adults. Med Sci Sports Exerc. 1990;22(2):265-274. PMID 2355825. 3. Sandercock GRH, Moran J, Cohen DD. Who is meeting the strengthening physical activity guidelines by definition: a cross-sectional study of 253,423 English adults? PLoS One. 2022;17(5):e0267277. doi:10.1371/journal.pone.0267277. PMID 35507575. 4. Shakespear-Druery J, De Cocker K, Biddle SJH, Gasevic D, Bennie JA. Assessment of muscle-strengthening exercise in public health surveillance for adults: a systematic review. Prev Med. 2021;148:106566. doi:10.1016/j.ypmed.2021.106566. PMID 33878352. 5. Zhang Y, Lee DH, Rezende LFM, et al. Long-term resistance training with all-cause and cause-specific mortality: assessing dose-response and joint associations with aerobic physical activity. Br J Sports Med. 2026;60(12):874-883. doi:10.1136/bjsports-2025-110503. PMID 42230125. 6. Morganroth J, Maron BJ, Henry WL, Epstein SE. Comparative left ventricular dimensions in trained athletes. Ann Intern Med. 1975;82(4):521-524. doi:10.7326/0003-4819-82-4-521. PMID 1119766. 7. Naylor LH, George K, O'Driscoll G, Green DJ. The athlete's heart: a contemporary appraisal of the Morganroth hypothesis. Sports Med. 2008;38(1):69-90. doi:10.2165/00007256-200838010-00006. PMID 18081368. 8. Myerson SG, Montgomery HE, World MJ, Pennell DJ. Left ventricular mass: reliability of M-mode and 2-dimensional echocardiographic formulas. Hypertension. 2002;40(5):673-678. doi:10.1161/01.hyp.0000036401.99908.db. PMID 12411461. 9. Pelliccia A, Maron BJ, Spataro A, Proschan MA, Spirito P. The upper limit of physiologic cardiac hypertrophy in highly trained elite athletes. N Engl J Med. 1991;324(5):295-301. doi:10.1056/NEJM199101313240504. PMID 1824720. 10. Spirito P, Pelliccia A, Proschan MA, et al. Morphology of the "athlete's heart" assessed by echocardiography in 947 elite athletes representing 27 sports. Am J Cardiol. 1994;74(8):802-806. doi:10.1016/0002-9149(94)90439-1. PMID 7942554. 11. Pelliccia A, Spataro A, Caselli G, Maron BJ. Absence of left ventricular wall thickening in athletes engaged in intense power training. Am J Cardiol. 1993;72(14):1048-1054. doi:10.1016/0002-9149(93)90861-6. PMID 8213586. 12. Spence AL, Naylor LH, Carter HH, et al. A prospective randomised longitudinal MRI study of left ventricular adaptation to endurance and resistance exercise training in humans. J Physiol. 2011;589(Pt 22):5443-5452. doi:10.1113/jphysiol.2011.217125. PMID 21969450. 13. Utom... How Much Lifting is Enough? How Much is Too Much?

How Much Lifting is Enough? How Much is Too Much?

Barbell Medicine October 8, 2026 14:03

Nearly every warning you've heard about lifting weights was written down before anybody checked it. We trace where those warnings came from, starting with a Harvard student in 1854 and ending with a curve on a graph that's being used today to argue you can lift too much. Along the way: the men who built themselves with barbells and then sold the public five-pound dumbbells, because iron was expensive to mail and a booklet cost pennies. The muscle-bound myth, which nobody could define when a graduate student surveyed 45 physiologists about it. The 1961 report that took the deep squat out of every branch of the American military, measured with a device its author built himself and never validated. The claim that lifting stunts a child's growth, which no professional body ever actually made. And the argument women got, which was never about injury at all. Timestamps: • 0:00 Intro • 2:33 2,500 years of people picking up heavy things • 7:24 George Windship and the Health Lift • 10:56 Blaikie's truck horse and the muscle-bound myth • 14:59 Bernarr Macfadden • 19:39 Charles Atlas and Dynamic Tension • 27:01 Carl Klein, a homemade device, and the parallel squat • 30:57 Thomas Delorme and three sets of ten • 35:20 Kids, growth plates, and where the stunting idea came from • 41:43 Women, "you'll get bulky," and Dudley Sargent in 1912 • 50:05 Pregnancy, from 1949 to a 2025 barbell study • 53:40 The pattern, and the curve on next week's graph Resources: Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/ New Barbell Medicine Hybrid 5K and 10K Run + Lift Programs (https://www.barbellmedicine.com/shop/training-templates/endurance/hybrid-5k-10k/) Barbell Medicine coaching and templates: https://www.barbellmedicine.com 1. Downs DS, Chasan-Taber L, Evenson KR, Leiferman J, Yeo S. Physical activity and pregnancy: past and present evidence and future recommendations. Res Q Exerc Sport. 2012;83(4):485-502. doi:10.1080/02701367.2012.10599138. PMID 23367811. 2. McMurray RG, Mottola MF, Wolfe LA, Artal R, Millar L, Pivarnik JM. Recent advances in understanding maternal and fetal responses to exercise. Med Sci Sports Exerc. 1993;25(12):1305-1321. PMID 8107536. 3. Smith KM, Campbell CG. Physical activity during pregnancy: impact of applying different physical activity guidelines. J Pregnancy. 2013;2013:165617. doi:10.1155/2013/165617. PMID 23476778. 4. American College of Obstetricians and Gynecologists. Physical activity and exercise during pregnancy and the postpartum period. ACOG Committee Opinion No. 804. Obstet Gynecol. 2020;135(4):e178-e188. doi:10.1097/AOG.0000000000003772. PMID 32217980. 5. American Academy of Pediatrics Committee on Sports Medicine and Fitness. Strength training by children and adolescents. Pediatrics. 2001;107(6):1470-1472. doi:10.1542/peds.107.6.1470. PMID 11389279. 6. Stricker PR, Faigenbaum AD, McCambridge TM; Council on Sports Medicine and Fitness. Resistance training for children and adolescents. Pediatrics. 2020;145(6):e20201011. doi:10.1542/peds.2020-1011. PMID 32457216. 7. Gardiner EN. Athletics of the Ancient World. Clarendon Press; 1930:54. See also Gardiner EN. Olympia: Its History and Remains. Clarendon Press; 1925. 8. Heffernan C. The Bybon stone and ancient strength. Physical Culture Study. 2021. Accessed September 2026. https://physicalculturestudy.com. 9. Pausanias. Description of Greece. 6.14.5. Jones WHS, trans. Loeb Classical Library. Harvard University Press. 10. Quintilian. Institutio Oratoria. 1.9.5. Butler HE, trans. Loeb Classical Library. Harvard University Press. 11. Heffernan C. Milo of Croton and the invention of progressive overload. Physical Culture Study. 2026. Accessed September 2026. https://physicalculturestudy.com. See also H.J. Lutcher Stark Center for Physical Culture and Sports, University of Texas at Austin, Milo Bar-Bell Company holdings. 12. Liddell HG, Scott R. A Greek-English Lexicon. 9th ed. Clarendon Press; entry γυμνάσιον. Thucydides. History of the Peloponnesian War. 1.6. Crawley R, trans. 13. Tomlinson RA. Gymnasium. In: Oxford Classical Dictionary. Oxford University Press; 2015. doi:10.1093/acrefore/9780199381135.013.2963. See also Stavrou D. The Greek Gymnasium [thesis]. University of Leicester; 2016:38. 14. Xenophon. Constitution of the Lacedaimonians. 1.4. Marchant EC, trans. Loeb Classical Library. Harvard University Press. 15. Plutarch. Life of Lycurgus. 14. Perrin B, trans. Loeb Classical Library. Harvard University Press. 16. Ollier F. Le Mirage Spartiate. Vols 1-2. Boccard; 1933-1943. Discussed in Rahe PA. The Grand Strategy of Classical Sparta. Yale University Press; 2016. See also Christesen P. Utopia on the Eurotas: Economic Aspects of the Spartan Mirage. In: Powell A, Hodkinson S, eds. Sparta: The Body Politic. Classical Press of Wales; 2010. 17. Pausania... Where did the advice to not lift heavy weights come from?

Where did the advice to not lift heavy weights come from?

Barbell Medicine October 1, 2026 18:21

Parts of the country now get a few weeks of wildfire smoke every year, and the obvious question is whether there is a point where the air is bad enough that the workout costs you more than it gives you. We went and looked. There is a real number, it comes from about 1.5 million people, and it is not the number that gets quoted. This is a free preview of Direct Line, our monthly ask-us-anything for Barbell Medicine Plus subscribers. Two of this month's twelve questions are here in full. First: training in wildfire smoke. What PM2.5 is, why the AQI on your phone and the number in the paper are not the same quantity, where the 90-minutes-at-100-micrograms figure comes from and why it is softer than it sounds, what happened when six cities modeled telling people to stay inside, and why your breathing rate during a set of squats matters more than you would think. Second: the effective reps model. A subscriber noticed that if a set only counts when you are within five reps of failure, the triceps in a heavy bench press should not count, and if you are going to count that as a fractional set for the triceps, then a warm-up set counts for the chest. Both cannot be true. We go through the meta-regression on proximity to failure, the 67-study analysis that tested whether an indirect set should count as one, as half, or as zero, and where we actually put our sets. Join Barbell Medicine Plus today: https://barbellmedicine.supercast.com/ Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/ New Barbell Medicine Hybrid 5K and 10K Run + Lift Programs (https://www.barbellmedicine.com/shop/training-templates/endurance/hybrid-5k-10k/) Barbell Medicine coaching and templates: https://www.barbellmedicine.com Timestamps • 1:47 The question: is there a point where the air is too bad to train? • 2:37 What PM2.5 actually is • 3:05 AQI vs micrograms, and why your phone disagrees with the paper • 3:50 Where the "90 minutes" number comes from • 4:54 Austin: what breathing this air does to your lungs • 9:14 1.5 million adults: does dirty air cancel the benefit of exercise? • 10:44 Six cities modeled staying indoors. Mortality did not improve. • 11:22 Lifting vs cycling: breathing rate is the whole mechanism • 12:33 Indoor air during a wildfire, and what filtration does not fix • 13:24 Is wildfire smoke worse than city pollution? • 14:38 What we would actually tell a patient • 18:35 The question: hard sets, fractional sets, and the five-rep rule • 19:18 Reps in reserve, hard sets, and fractional sets defined • 20:19 The meta-regression: no threshold, just a line • 21:13 Do indirect sets count as half a set? • 23:08 Would you rather: every set at 5 RIR, or every set to failure? • 25:22 Why you get worse at judging RIR the further you are from failure • 28:42 The numbers we use: RPE 7 to 9 for hypertrophy, 4 to 6 for strength • 29:20 Austin: individual variation dwarfs all of this • 33:28 Why nobody can measure training load in the weight room Resources Tainio M, de Nazelle AJ, Götschi T, et al. Can air pollution negate the health benefits of cycling and walking? Prev Med. 2016;87:233-236. doi:10.1016/j.ypmed.2016.02.002. PMID 27156248 Ku PW, Steptoe A, Hamer M, et al. Does ambient PM2.5 reduce the protective association of leisure-time physical activity with mortality? A systematic review, meta-analysis, and individual-level pooled analysis of cohort studies involving 1.5 million adults. BMC Med. 2025;23(1):647. doi:10.1186/s12916-025-04496-y. PMID 41310726 Giallouros G, Kouis P, Papatheodorou SI, Woodcock J, Tainio M. The long-term impact of restricting cycling and walking during high air pollution days on all-cause mortality: health impact assessment study. Environ Int. 2020;140:105679. doi:10.1016/j.envint.2020.105679. PMID 32353667 Sun S, Cao W, Qiu H, et al. Benefits of physical activity not affected by air pollution: a prospective cohort study. Int J Epidemiol. 2020;49(1):142-152. doi:10.1093/ije/dyz184. PMID 31504557 Robles P, Araujo T, Brooks D, et al. Cardiorespiratory responses to short bouts of resistance training exercises in individuals with chronic obstructive pulmonary disease: a comparison of exercise intensities. J Cardiopulm Rehabil Prev. 2017;37(5):356-362. doi:10.1097/HCR.0000000000000282. PMID 28858033 Liang Y, Sengupta D, Campmier MJ, Lunderberg DM, Apte JS, Goldstein AH. Wildfire smoke impacts on indoor air quality assessed using crowdsourced data in California. Proc Natl Acad Sci U S A. 2021;118(36):e2106478118. doi:10.1073/pnas.2106478118. PMID 34465624 Aguilera R, Corringham T, Gershunov A, Benmarhnia T. Wildfire smoke impacts respiratory health more than fine particles from other sources: observational evidence from Southern California. Nat Commun. 2021;12(1):1493. doi:10.1038/s41467-021-21708-0. PMID 33674571 US Environmental Protection Agency. Air Quality Index (AQI) breakpoints... Is It Safe to Train When the Air Is Full of Wildfire Smoke?

Is It Safe to Train When the Air Is Full of Wildfire Smoke?

Barbell Medicine September 24, 2026 06:18

Most lifters have been told they need to eat in a Calorie surplus to build muscle. That rule has always come with a list of exceptions: unless you're new, unless you're carrying extra body fat, unless you're coming back from time off. Dr. Eric Helms joins Dr. Jordan Feigenbaum to work out what the rule is actually tracking, starting from a question with a real number attached: what does a pound of muscle cost to build? And then, do you need to be in a surplus to build muscle?  Timestamps: • 0:00 The rule, and its exceptions • 2:08 Where "you need a surplus" came from • 7:12 Heuristics versus theories • 11:40 Hypertrophy, maintenance, deficit and surplus defined • 14:58 Body fat as a savings account • 18:24 How fast anyone can actually build muscle • 23:39 What sets the ceiling: stimulus, not genetics • 26:37 Microgravity, astronauts, and a 20 kg barbell • 31:49 What constrains growth if steroids don't break the ceiling • 36:44 If training sets the ceiling, what does energy do • 38:45 What 1 kg of muscle costs to build • 44:05 Why 3,500 Calories doesn't tell you what to eat • 44:55 REDs and the dual intervention model • 47:51 The 2000s bulking studies • 51:34 Garthe 2013: elite athletes and a 500 Calorie surplus • 58:30 Protein: 1.6 versus 2.5 g/kg • 1:03:31 What starvation research shows the body protects • 1:10:29 Vargas-Molina: maintenance versus deficit • 1:19:17 What to do if you're lean • 1:39:34 What would prove this wrong • 1:57:57 Three buckets Resources: Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/ New Barbell Medicine Hybrid 5K and 10K Run + Lift Programs (https://www.barbellmedicine.com/shop/training-templates/endurance/hybrid-5k-10k/) Barbell Medicine coaching and templates: https://www.barbellmedicine.com 1. Nikolaidis MG, Paschalis V, Margaritelis NV. The energetic cost of building human skeletal muscle. bioRxiv. Preprint posted online August 17, 2026. doi:10.64898/2026.08.17.745156 2. Rozenek R, Ward P, Long S, Garhammer J. Effects of high-calorie supplements on body composition and muscular strength following resistance training. J Sports Med Phys Fitness. 2002;42(3):340-347. 3. Garthe I, Raastad T, Refsnes PE, Koivisto A, Sundgot-Borgen J. Effect of two different weight-loss rates on body composition and strength and power-related performance in elite athletes. Int J Sport Nutr Exerc Metab. 2011;21(2):97-104. 4. Garthe I, Raastad T, Refsnes PE, Sundgot-Borgen J. Effect of nutritional intervention on body composition and performance in elite athletes. Eur J Sport Sci. 2013;13(3):295-303. doi:10.1080/17461391.2011.643923 5. Helms ER, Zinn C, Rowlands DS, Brown SR. A systematic review of dietary protein during caloric restriction in resistance trained lean athletes: a case for higher intakes. Int J Sport Nutr Exerc Metab. 2014;24(2):127-138. doi:10.1123/ijsnem.2013-0054 6. Slater GJ, Dieter BP, Marsh DJ, Helms ER, Shaw G, Iraki J. Is an energy surplus required to maximize skeletal muscle hypertrophy associated with resistance training. Front Nutr. 2019;6:131. doi:10.3389/fnut.2019.00131 7. Murphy C, Koehler K. Energy deficiency impairs resistance training gains in lean mass but not strength: a meta-analysis and meta-regression. Scand J Med Sci Sports. 2022;32(1):125-137. doi:10.1111/sms.14075 8. Helms ER, Spence A, Sousa C, et al. Effect of small and large energy surpluses on strength, muscle, and skinfold thickness in resistance-trained individuals: a parallel groups design. Sports Med Open. 2023;9(1):102. doi:10.1186/s40798-023-00651-y 9. Mountjoy M, Ackerman KE, Bailey DM, et al. 2023 International Olympic Committee's (IOC) consensus statement on Relative Energy Deficiency in Sport (REDs). Br J Sports Med. 2023;57(17):1073-1097. doi:10.1136/bjsports-2023-106994 10. Speakman JR, Hall KD. Models of body weight and fatness regulation. Philos Trans R Soc Lond B Biol Sci. 2023;378(1888):20220231. doi:10.1098/rstb.2022.0231 11. Vargas-Molina S, García-Palumbo A, García-Sillero M, et al. Comparison of two nutritional protocols in body re-composition of resistance-trained participants. Eur J Appl Physiol. 2026;126(7):4019-4030. doi:10.1007/s00421-026-06209-6 Our Sponsors: * Check out Cometeer and use my code BBM for a great deal: https://www.cometeer.com * Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com * Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com * Check out Quince and use my code BBM for a great deal: https://www.quince.com * Check out Ten Thousand and use my code PODCAST15 for a great deal: https://www.tenthousand.cc Advertising Inquiries: https://redcircle.com/brands Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms

Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms

Barbell Medicine September 17, 2026 15:42

The word peptide is doing more work than it can support. A peptide is a short chain of amino acids, and in 2020 the FDA drew a legal line at 40. Forty or fewer, peptide. Forty-one or more, protein. Watch what that does. Semaglutide is 31, so it is a peptide. Insulin is 51, so by that rule it is a protein, even though every clinician calls it a peptide hormone. It is a regulatory convention, not a fact of chemistry. The FDA’s definition of a peptide is a number someone picked.

The FDA’s definition of a peptide is a number someone picked.

Barbell Medicine September 16, 2026 07:00

Even taking the trial at face value, it does not match what people buy. It was an enema, in ulcerative colitis patients, at 80 mg a day for two weeks. The companies wanted to sell capsules, injections, nasal sprays, creams, and suppositories. The FDA went looking for human studies of BPC-157 by any of those routes and found nothing. The closest match, a suppository, still does not match, because an enema reaches much further up the colon. What does this trial say about the vial in your gym bag? Nothing.

What does this trial say about the vial in your gym bag? Nothing.

Barbell Medicine September 8, 2026 07:00

Burning amino acids for energy is just your body using them for fuel, which is a long way from wasted and further still from stored as fat. A group in the Netherlands tested the real question in 2023. They gave people either 25 grams of protein or 100, then used tagged amino acids to follow it through the body for a full 12 hours. The 100-gram meal did not hit a wall. It produced a larger building response and a longer one. Almost none of it was burned off. None was wasted. Your body holds onto it and puts it to work over the hours that follow. There is no trapdoor that dumps the extra. They fed people 100g of protein in one meal. There was no limit on absorption.

They fed people 100g of protein in one meal. There was no limit on absorption.

Barbell Medicine September 5, 2026 07:00

Muscle is where most of the glucose goes, and muscle insulin resistance is the first thing that breaks on the road to type 2 diabetes. Both of those are true, and neither one means that building more muscle is the treatment for obesity. This episode works through what actually decides whether a tissue handles fuel well: not how much of it you have, but how fast it's moving fuel through. We go through the one-legged exercise studies, the 18,000-person analysis of what body composition actually predicts, the athlete's paradox, the energy cost of building a kilogram of muscle, the GLP-1 lean mass panic, and why sarcopenic obesity is named after the wrong organ. This is part two of a two-part series on storage capacity. Part one covered where body fat goes and what happens when the storage runs out.  Timestamps • 0:00   The one-leg study, and the muscle-centric claim • 02:06   What obesity is, and the garage analogy • 05:06   How glucose gets into a muscle cell • 11:21   Insulin sensitivity improves without building muscle • 17:11   The best case for muscle-centric medicine • 21:13   What predicts falls and death: strength, not lean mass • 25:18   Separating muscle size from muscle function • 31:33   Liver fat: amount, type, and flux • 37:54   Should you build muscle first? The arithmetic • 42:37   Building muscle in a calorie deficit • 50:29   GLP-1s, DXA, and the lean mass panic • 58:23   Sarcopenic obesity, and why the name is wrong • 01:04:37 Why size still tells you something • 01:11:46 So what is obesity? Resources: Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/ New Barbell Medicine Hybrid 5K and 10K Run + Lift Programs (https://www.barbellmedicine.com/shop/training-templates/endurance/hybrid-5k-10k/) Barbell Medicine coaching and templates: https://www.barbellmedicine.com 1.   Richter EA, Mikines KJ, Galbo H, Kiens B. Effect of exercise on insulin action in human skeletal muscle. J Appl Physiol (1985). 1989;66(2):876-885. doi:10.1152/jappl.1989.66.2.876. PMID: 2496078. https://doi.org/10.1152/jappl.1989.66.2.876 2.   Cawthon PM, Travison TG, Manini TM, et al. Establishing the link between lean mass and grip strength cut points with mobility disability and other health outcomes. J Gerontol A Biol Sci Med Sci. 2020;75(7):1317-1323. doi:10.1093/gerona/glz081. PMID: 30869772. https://doi.org/10.1093/gerona/glz081 3.   Bhasin S, Travison TG, Manini TM, et al. Sarcopenia definition: the position statements of the Sarcopenia Definition and Outcomes Consortium. J Am Geriatr Soc. 2020;68(7):1410-1418. doi:10.1111/jgs.16372. PMID: 32150289. https://doi.org/10.1111/jgs.16372 4.   Elgaddal N, Kramarow EA, Reuben C. Physical activity among adults aged 18 and over: United States, 2020. NCHS Data Brief No. 443. Hyattsville, MD: National Center for Health Statistics; 2022. PMID: 36043905. https://www.cdc.gov/nchs/products/databriefs/db443.htm 5.   Whitfield GP, Carlson SA, Ussery EN, Fulton JE, Galuska DA, Petersen R. Trends in meeting physical activity guidelines among urban and rural dwelling adults, United States, 2008-2017. MMWR Morb Mortal Wkly Rep. 2019;68(23):513-518. doi:10.15585/mmwr.mm6823a1. PMID: 31194722. https://doi.org/10.15585/mmwr.mm6823a1 6.   Wang T, Wang J, Hu X, Huang XJ, Chen GX. Current understanding of glucose transporter 4 expression and functional mechanisms. World J Biol Chem. 2020;11(3):76-98. doi:10.4331/wjbc.v11.i3.76. PMID: 33274014. https://doi.org/10.4331/wjbc.v11.i3.76 7.   DeFronzo RA, Tripathy D. Skeletal muscle insulin resistance is the primary defect in type 2 diabetes. Diabetes Care. 2009;32(Suppl 2):S157-S163. doi:10.2337/dc09-S302. PMID: 19875544. https://doi.org/10.2337/dc09-S302 8.   Richter EA, Hargreaves M. Exercise, GLUT4, and skeletal muscle glucose uptake. Physiol Rev. 2013;93(3):993-1017. doi:10.1152/physrev.00038.2012. PMID: 23899560. https://doi.org/10.1152/physrev.00038.2012 9.   Petersen KF, Dufour S, Savage DB, et al. The role of skeletal muscle insulin resistance in the pathogenesis of the metabolic syndrome. Proc Natl Acad Sci U S A. 2007;104(31):12587-12594. doi:10.1073/pnas.0705408104. PMID: 17640906. https://doi.org/10.1073/pnas.0705408104 10. Rabøl R, Petersen KF, Dufour S, Flannery C, Shulman GI. Reversal of muscle insulin resistance with exercise reduces postprandial hepatic de novo lipogenesis in insulin resistant individuals. Proc Natl Acad Sci U S A. 2011;108(33):13705-13709. doi:10.1073/pnas.1110105108. PMID: 21808028. https://doi.org/10.1073/pnas.1110105108 11. Perseghin G, Price TB, Petersen KF, et al. Increased glucose transport-phosphorylation and muscle glycogen synthesis after exercise training in insulin-resistant subjects. N Engl J Med. 1996;335(18):1357-1362. doi:10.1056/NEJM199610313351804. PMID: 8857019. https://doi.org/10.1056/NEJM199610313351804 12. Mikines KJ, Sonne B, Farrell PA, Tron... Is Obesity A Muscle Problem?

Is Obesity A Muscle Problem?

Barbell Medicine September 4, 2026 09:00

There are two ways to read this. One is that money bought the vote. I cannot prove that. The other is simpler and worse: whoever filled the seats picked people who already believed peptides work, and they voted the way they already believed. Nobody had to be bought because nobody had to change their mind. That version cannot be fixed by anyone recusing themselves. Nobody had to be bribed. The room was built to say yes.

Nobody had to be bribed. The room was built to say yes.

Barbell Medicine September 4, 2026 07:00

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