Dr. Spencer Nadolsky, Dr. Karl, and chief science officer Dr. Grant Tinsley sit down with Dr. Steven 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.

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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.
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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.

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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.

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Shelbys Book

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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.

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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.

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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.

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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.

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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.

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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.

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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

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