Podcast Summary: You Are Not Broken

Episode 355: Muscle Centric Medicine
Host: Dr. Kelly Casperson
Guest: Dr. Gabrielle Lyon
Release Date: January 25, 2026

Episode Overview

This episode dives deep into “Muscle Centric Medicine” with Dr. Gabrielle Lyon—a leading advocate for shifting our focus from fat to muscle as the central organ of longevity, vitality, and metabolic health. The conversation unpacks why muscle health is often ignored in traditional medicine, the consequences of this oversight (especially for women in midlife), practical strategies for muscle preservation and growth, and the critical mindset shifts required for sustainable health changes. The episode is packed with science, personal anecdotes, humor, and tangible action steps.

Key Discussion Points and Insights

1. Why Muscle is Overlooked in Medicine

• No One “Owns” Muscle in Healthcare:
  • Muscular health doesn’t fall under a medical specialty; obesity and fat dominate the conversation.
  • “No doctor is in charge of the muscle... There's nobody's in charge of the muscle.” – Dr. Casperson [02:02]
• Historical Perspective:
  • 1970s–2000s: Surge in obesity, focus on calories and fat, but muscle largely ignored.
  • Now, with drugs like GLP-1 agonists curbing appetite, we risk swapping obesity for sarcopenia (muscle loss).
  • “We are on the precipice of swapping obesity for sarcopenia.” – Dr. Lyon [03:35]

2. Muscle Beyond Movement: Metabolic and Protective Roles

• Muscle’s function far exceeds “movement”—it acts as body armor (protection from trauma) and is crucial for metabolic regulation.
• “It's more detrimental to lose muscle mass as you age than it is to gain body fat for precisely the reasons that you're talking. Not just the body armor... but also the metabolic protection.” – Dr. Lyon [01:07]

3. Mindset Shifts for Lasting Health Change

• The biggest barrier isn’t knowledge—it’s mindset.
• “If you think it’s difficult, it will be. If you think it’s hard, it will be.” – Dr. Casperson [09:56]
• Dr. Lyon’s playbook starts with mindset: Discipline, discernment, and planning for your weaknesses matter more than motivation.

4. Practical Advice: Nutrition and Training

• Protein:
  • Minimum of 100g per day for adults, especially over 40.
  • Protein isn’t a percentage of calories—it’s an absolute need.
  • “As calories decrease, your protein has to increase. Protein is not a percentage of calories, period.” – Dr. Lyon [15:21]
• Resistance Training:
  • Essential for transforming from low-muscled (C-shaped on InBody scans) to balanced or athletic (I- or D-shaped).
  • Both training and nutrition are non-negotiable for muscle health.
  • “You have to train and you have to get your nutrition right. It's a non negotiable.” – Dr. Lyon [09:42]

5. Overcoming Self-Sabotage and “Deserving” Junk Food

• Entitlement-based eating (“I deserve this treat”) is often a dopamine chase, but it disconnects your present self from your future.
• Dr. Lyon suggests creating “intentional friction”—for example, order the treat but don’t eat it, to build self-discipline.
• “It stings a lot less the fifth time you do it... It increases your ability to maintain your own drive.” – Dr. Lyon [12:39]

6. Protein Needs with Aging and Anabolic Resistance

• Aging blunts the sensitivity of muscles to protein (anabolic resistance), meaning more high-quality protein is required.
• “Anabolic resistance is skeletal muscle’s inefficiency of recognizing and being stimulated by protein.” – Dr. Lyon [17:40]
• Leucine threshold and protein distribution through the day (i.e., 50g at the first meal) matter.

7. Macronutrient Myths and Trends

• Many believe going vegan is key for health, but most can’t sustain it, and protein becomes insufficient.
• 40% of women over 65 are protein deficient.
• “Vegan isn't sustainable for most people... 40% of women over 65 are deficient in protein.” – Dr. Lyon [19:56]

8. Intermittent Fasting, Body Composition, and “Fit Fat” Phenotype

• Intermittent Fasting can help some, but it’s hard to hit protein targets with limited eating windows.
• There’s a “fit fat” phenotype—body fat percentage isn’t all that matters; intramuscular fat (IMAT) may be the bigger risk.
• Movement can decrease IMAT, improving health even in heavier bodies.

9. Supplements and Extras

• Creatine: Supported for brain and muscle health, especially in older adults.
  • “The more convincing data is like 65 and up, but it doesn’t hurt.” – Dr. Lyon [33:04]
• Essential Amino Acids: Especially as appetites fall or with GLP-1 medications; Dr. Lyon recommends Body Health brand.
• Omega-3s and Urolithin A: Noted for women's health and mitochondrial function.
• Collagen: Doesn’t “count” as a high-quality protein source for muscle—a protein score of zero.
  • “It's zero quality protein.” – Dr. Lyon [35:28]

10. Testing and Tracking Progress

• Protein deficiency isn’t easily seen on labs in the short term; tracking intake and measuring muscle mass over time is key.
• InBody and DEXA scans are helpful, but changes in trained individuals show up slowly.
• Psychological health is critical—don’t obsess over minute fluctuations.

11. Mindset and Motivation for Midlife Women

• It’s never too late to build muscle and strength.
• Dr. Lyon: “Of course it can be done. And it has to be. It's not an option. You can always get stronger, and it happens quickly.” [39:47]
• Hanging from a bar, lifting weights—skills can return and improve with training, regardless of age.

12. Systemic Barriers in Medicine

• Doctors often miss the muscle message: overlooking testosterone, misunderstanding protein and nutrition, and failing to emphasize muscle as the organ of longevity.
  • “You've got to protect muscle at all costs. Muscle is your medicine.” – Dr. Lyon [39:00]

Notable Quotes and Moments

• “If you don't believe that you have the time for it, how would one manage the time for illness? You don't have the time or the luxury not to.” – Dr. Lyon [13:17]
• “One of the ways we improve cognitive function is through training... It improves vascular health and executive function.” – Dr. Lyon [05:31]
• “We’re eating too much, but we’re not eating enough of the proper things.” – Dr. Casperson [35:03]
• “Don't start with a five day a week program, you start with a three day a week program.” – Dr. Lyon [14:13]
• “Muscle is your medicine. Muscle is what is responsible for your aging trajectory.” – Dr. Lyon [39:00]
• “Aging is inevitable. Suffering is optional.” – Dr. Casperson & Dr. Lyon [44:43]

Timestamps for Important Segments

• The importance of muscle as “body armor”: [00:41–02:27]
• How muscle was ignored in the obesity epidemic and why GLP-1 drugs may exacerbate sarcopenia: [02:27–03:42]
• Why muscle isn’t a specialty in medicine: [02:02]
• Changing body shapes and InBody scanning (C, I, D shapes): [08:27–09:04]
• Addressing the “eat less” myth – why muscle needs both training and protein: [09:04–09:56]
• Mindset, habits, and self-sabotage with food: [11:57–12:39]
• Intermittent fasting and protein intake for midlife women: [14:42–17:08]
• Aging, anabolic resistance, and protein needs: [17:32–17:40]
• Why veganism is often unsustainable: [19:35–19:58]
• Collagen as a near zero-quality protein: [35:26–35:28]
• Supplements: creatine, essential amino acids, omega-3s: [33:02–34:10]
• Debunking the “getting bulky” myth: [24:17–24:57]
• Fit fat phenotype and importance of intramuscular fat over body fat %: [25:41–28:37]
• Doctors' gaps: why muscle matters for aging: [38:44–39:17]
• Midlife transformation is possible: [39:47–39:54]

Tone and Language

The conversation is lively, direct, and approachable—blending deep science with humor and real-life examples. Both Dr. Casperson and Dr. Lyon use candid, relatable language (“girl, yeah, you got it”, “I don’t even know where my ass is, it’s gone on vacation forever”, “aging is inevitable, suffering is optional”) to convey the message that muscle is central not just to appearance, but to living—and thriving—through midlife and beyond.

Action Steps and Takeaways

• Shift your health focus from losing fat to building and preserving muscle.
• Prioritize lifting and protein—train at least three times a week, and eat 100g+ protein daily.
• Mindset matters: Create friction against unhealthy habits and don’t wait for motivation to strike.
• Supplements like creatine, essential amino acids, and omega-3s can be helpful, especially for midlife women.
• Don’t fear “bulk”—building muscle is slow and protective.
• Track progress, not perfection. Use DEXA/InBody for trends, not instant results.
• It is never too late to get stronger—start where you are.

Find more from Dr. Kelly Casperson at kellycaspersonmd.com and pre-order Dr. Gabrielle Lyon’s “The Playbook” out January 27, 2026.