How to Keep the Muscle While Losing the Fat with Stuart Phillips

James Hill:

Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:

And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

James Hill:

Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:

Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

James Hill:

Ready for the “And” factor?

Holly Wyatt:

Let's dive in.

James Hill:

Here we go.

Holly Wyatt:

In our last episode, we talked with Dr. Heather Lady about protein and appetite. This week, we're taking it a little further because while protein can help control hunger, we learned all about that, it's also critical for protecting one of your body's most valuable assets, your muscle.

James Hill:

Whether you're trying to lose weight, prevent weight regain, or simply age well, preserving muscle matters. And with more people losing a lot of weight on these new GLP-1-based medications, the question becomes, how do we keep muscle when appetite and food intake drop so dramatically? Well, as usual, to help us unpack this, we have one of the world's experts in the area. I love it because on this podcast, we can just go out and find the best people to talk about it. And we have one today, Dr. Stuart Phillips. He's one of the world's leading experts in muscle physiology and protein metabolism. Now, Holly, you know why this excites me, right?

Holly Wyatt:

Oh, yeah.

James Hill:

One of my big issues is we separate nutrition and physical activity. So we go talk about diet and we never relate it to physical activity. Protein on the intake side and exercise on the output side. This is great. I'm really looking forward to this podcast. Stewart is a distinguished university professor at Master University in Ontario, Canada, where he holds a Tier 1 Canada Research Chair in Skeletal Muscle Health. He's a professor in the Department of Kinesiology and an adjunct in the School of Medicine. He directs the Physical Activity Center of Excellence. Stewart is internationally recognized for his work on muscle protein synthesis, resistance training, and how protein intake impacts muscle mass, especially in the content of aging, weight loss, and chronic disease prevention. His research has shaped how we think about protein requirements, exercise prescription, and body composition, and he's one of the most cited scientists in his field. Welcome, Stuart.

Stuart Phillips:

Thanks for having me, Jim. Holly, it's a pleasure to be on the show.

Holly Wyatt:

Yeah, welcome to the podcast. So let's just dive in. You've said before, I've heard you say before that skeletal muscle is finally getting the recognition it deserves as a key player in metabolic health, not just movement, physical activity, but in really how our body functions overall. Why do you think that muscle has been overlooked for so long, and why should people trying to lose weight care about their muscle?

Stuart Phillips:

Yeah, I mean, I think everybody recognizes that your muscle is the tissue that you need to get around, and nobody would argue that the loss of muscle makes it more difficult. I think the main reason it's sort of been undervalued is there's not really a medical subspecialty in muscle. There's one in heart, there's one in liver, but really not in muscle. So you can find neurologists that deal with the brain, but very few that deal with the muscle. And as a result, I think it's just sort of being consigned to the sidelines. It's like, oh, you know, it's just a tissue, use it to move around, but it's very metabolically active. It's the largest site that we have for storing blood sugar and plays a huge role in our resting energy metabolism. So yeah, it's a pretty big deal metabolically.

James Hill:

And I also hear, Stu, that muscle mass is a great predictor of longevity, which something we're all interested in.

Stuart Phillips:

Yeah, that research that's probably emerged, I think, in the last 15 to 20 years, showing the relationship. Now that we've got good ways to measure muscle, that the relationship between its mass and its function is very intimately tied to not just longevity, but health span and the ability to operate independently. So the longer you want to stick around, be in your own place, do your own thing, you'd better pay attention to your muscle.

James Hill:

I love it. I love it. One question for you, how quickly can muscle mass change? Adding muscle, losing muscle, is this something that happens quickly? Does it happen slowly? What's the story there?

Stuart Phillips:

It's an interesting question because I've been a McMaster now for 28 years and you can almost divide my career in half. When I was younger, I worried about what would happen in younger people, how they could gain muscle. We gain muscle relatively slowly. It takes weeks to months to sometimes years to see a change. If we're going to lift weights and be as big and strong as we can. And then, I don't know, some midlife switch happened. And I thought research becomes me search, right? So, I'm like, what's going to happen as I get older. And I took over the direction, as you said, of, of the physical activity center of excellence, average age of the clients in there is about 73 and I realized they probably had the same goals as the athletes and young folks we were dealing with and that you know their muscle was getting around and trying to do the best that they could with the life that they have. The kind of rough news is that we lose it fast and it takes a long time to gain it. We have a ratio in one study where we actually had people train one leg so it got bigger and stronger. And then another leg we put in a knee brace and you lose muscle about five times as fast as you gain it. So avoid that disuse period. They're not good for you and keep working.

Holly Wyatt:

Oh my gosh, I don't want to be in that study.

Holly Wyatt:

Let's talk about weight loss and so how that impacts muscle and do you lose muscle when you lose weight? About how much do you lose? Get us up to date on that.

Stuart Phillips:

The typical rule is that for every pound that you lose, three quarters of it is generally fat. And then a quarter is what we call lean mass. And a portion of the lean mass is muscle. I know everybody wants to say, well, lean mass is all muscle mass. It's not strictly speaking true. So it's a portion of that lean mass and it could be as little as 40%, but it could be as high as about 60%. So, for every pound that you're losing, there's a risk that you're going to lose some muscle mass as well.

James Hill:

It's sort of normal that you're going to lose some muscle mass as you lose weight. But again, the goal would be to lose as little as possible.

Stuart Phillips:

Exactly. So, to take you back to the career paradigm of mine in the athletic realm, all the time athletes go through what we call body composition recomp, where they struggle mightily to lose fat mass and hang on to every last gram of muscle because that's what their sport dictates that they need to have happen or if you're an aesthetically oriented athlete that needs to have that lean physique so bodybuilders would be the most extreme example. And then in weight loss scenarios, of course, it's a little bit different and that muscles sort of like the tissue that gets given up. It's as if it's a reservoir and obviously it'll give up its reserves in a time where we're not consuming sufficient energy and in that scenario, you're going to lose fat, but you're going to lose some muscle at the same time. But ideally if we could, we would like to practice the same strategies as those athletes do and hang on to as much muscle as we can.

Holly Wyatt:

You know, I had some friends who were doing bodybuilding or physique type competitions when we wrote Stay of Slim. And a lot of the principles they used, we didn't do it exactly like they're doing, but we used a lot of the principles trying to preserve the muscle and lose the fat because they're really good at doing that. They know how to do that really and kind of almost against what the body would naturally do. And in that case, we want to do it because so many times I see individuals where they lose weight and let's say they lose 50-50, you know, 50% fat and 50% muscle. They gain the weight back and guess what? They don't gain 50-50. They gain more fat than muscle, go back to the same weight, but have a very different composition. They kind of go the opposite way of a physique builder, so to speak.

Stuart Phillips:

That's the situation you described there, Holly, that I think is one of the things that really troubles me. And, you know, we've written several commentaries around these GLP-1 drugs, which, you know, they're amazing drugs. Like it's a watershed moment, obviously. And, you know, I see Dr. Hill nodding his head down there. I mean, how long did we have to wait for these drugs to really achieve the efficacy that they've got? And it must be incredible as a physician to have something like this as a tool to be able to talk to people about weight loss. But for older people who lose that weight and at the end say, well, I've lost the weight now, I'm going to get off the drug. And just like it is with the diet, we know what happens. This recidivism, the weight regain is probably not the best scenario. So if you're older and you're already losing a bit of muscle, the weight regain, if it's not the muscle that you lost, then you're putting yourself in a worse position than you were before. So, it's a good, but the physique folks, they've got the formula down. So there's no, there's, I wish, you know, you could have me on, I'm going to give you some special formula, but it's really not hard. So they know how to do it. And if we practice those same strategies in just about anybody, we can modify that fat to lean weight loss ratio.

James Hill:

My gosh, I have so many follow-up questions, Holly. But let's go back to the weight loss and regain with the GLP-1 meds. We don't have great data, but the data we're getting, Stu, shows that although these drugs are meant to be taken forever, people don't. And when they go off the meds, they most often regain the weight. And that's one of my fears, particularly in older folks, that when you go off and regain the weight, you don't end up where you were before. You might end up at a worse place than you were before.

Stuart Phillips:

Yeah, no, and I'd echo your concern in that area. I think it's a hard sell for some of these people to realize that, you know, the medication for life route. And that's a hard message, I think, for some people to swallow. This is wave one of these drugs. So, I think, to be clear, maybe as time goes on, the side effect burden will become less and less. And maybe people worry about it a little bit less as well. But most people, as they do, they lose the weight and they want them to live at their new weight. And we know how difficult that is. I think the want to get off the drug at the end is pretty natural. And people would like to sort of kind of quote, go back to the way they were before, but then they go back to eating the way they were before. So if you're an older person and we know older people are losing muscle, that's aging. It's going to get you at some point. And then you have a weight regain in which you gain back fat and not the muscle, which is most often what happens, particularly in the elderly. It could be doubly bad. Yeah.

Holly Wyatt:

So I know some people are out there nervous now. How do you know? Someone asked the question. I know they're thinking, how do you know if you're losing muscle, losing fat, or gaining fat, gaining muscle? How do you keep track of this?

Stuart Phillips:

Yeah, well, you need some magic device to tell you not just weight on a scale, but what you're losing, right? And I think that there are some commercial devices out there that you could get at a gym or maybe your doctor's office that would give you those types of metrics. But for a lot of people, we don't know. I mean, you can do the mirror look and sort of gauge what happens, but that's a pretty inaccurate test. I mean, one of the things I would say is that the two main stimuli that your physique folks use to hang on to muscle, one is resistance exercise or weightlifting and the other is dietary protein. And then they can sort of push the ratio in the other direction and hang on to a little bit of lean. But one of the indicators that a lot of people like to use is to say how strong am I? Grip strength is one thing, or how do I feel and everything. But a lot of people describe weakness as a part of being on these drugs. Personally, I think that's because they're consuming very, very low protein intakes, and it's not true muscle weakness. But it would be interesting to power some of these future trials with these drugs using some muscle performance indicators and actual measures of muscle strength, because that's what I would worry about more than anything. If you're weaker as a result, then are you really in a better scenario?

James Hill:

I love it. I love it. But this is the meat of what we wanted to talk about. What you can do to minimize muscle loss. We're talking protein. We're talking exercise, resistance exercise. So, Stu, What does each alone do, and why is the combination of protein and exercise maybe synergistic?

Stuart Phillips:

Let's start with protein first, because I think that's the sort of message that a lot of people hear from whoever puts them on these drugs or when they decide, is to try and shift your diet towards sort of a higher protein intake. Everybody, I think, hopefully, or has a grasp that protein is the nutrient that drives muscle and muscle normally is receptive to protein and it makes new muscle proteins from that. But in the scenario of weight loss, of course, the muscle is sort of actually turning over the proteins that it has and giving up some of the protein that it normally stores for us to make things like blood sugar and, you know, burn as a fuel because we're not taking in enough. The question then becomes, if you put more protein into the system, does the muscle use it? And the answer is yes, it does, but it also burns some of that fuel. So we get a little bit better at just oxidizing the fuel for energy, because remember we're inan energy imbalance. And so the body's in a mode where it's burning things for energy. So protein can help, but it's only a small part of the equation.

Holly Wyatt:

I think the other thing for people to realize that this same thing about putting protein in really works, we're talking about the GLP-1s, but really with any weight loss, you know. You're wanting to preserve, not lose that lean muscle. And so protein is important for the reasons you're saying. And then what else? What else do you need?

James Hill:

What happens when you add exercise?

Stuart Phillips:

Yeah, well, I'm going to rewind a little bit because I heard you just had Dr. Heather Leidy on the podcast. And so Heather's a good friend of mine. I think, for your people who listen to your show, it's interesting, right? So Heather would have talked about how powerful a satiety nutrient protein is. And now when people usually just use diet-induced weight loss, the protein is what gives you the almost GLP-1-like effect. And now you've taken a drug and you've completely overridden that satiety center and it's knocked down because of the drug. And so the protein isn't really doing that same job. So now it's the substrate.

So yeah, it helps. And to your point, Holly, absolutely. Even if we were doing diet-induced weight loss, protein is a good nutrient to focus on. The big driver, though, and when we look at what really helps people retain body lean mass or muscle mass is resistance exercise. Everybody goes, oh, you know, I go for a walk and I'm like walking, it's a fine form of exercise. Don't let me tell you not to do it or anything. But resistance exercise describes putting your muscle under a load that is normal than usual and performing some sort of resistive contraction. So everybody thinks, oh, going to the gym and pumping heavy weights, and that is one form. But what we're really talking about is some form of exercise that's going to create fatigue within your muscle probably after you've done it about, say, 20 times at the most. So heavy weights is one way of doing it, but lighter body weight exercises, resistance bands that people can use at home. There's lots of different videos on how to do this without using an actual weight that would put your muscle under resistance. And that, as far as we know, is the much more powerful stimulus for you to hang on to muscle in a weight loss situation.

James Hill:

So it's the combo of the protein that's basically fuel for your muscle and the exercise which causes your muscle to use that in a way that's actually going to preserve the mass. I love it.

Stuart Phillips:

Exactly.

Holly Wyatt:

So I want to get a little bit of nitty gritty because I know people are going, okay, I like it. You talk about resistance in the muscle, right? How much, you know, how many days do I have to do it? How long? Give us something.

James Hill:

What's the minimum I can do, right? That's what people want to know.

Stuart Phillips:

The least I can do, yeah.

James Hill:

The least I can do.

Stuart Phillips:

It's a good question. We don't have as much information about resistance exercise and its health benefits, although it's coming as well. We know a lot more about aerobic, but it appears from everything that we've got and when we look at disease incidents and all kinds of things is that resistance and aerobic share a lot more in common than they are sort of different forms of exercise. And so they're, you know, one's better for you than another. But the two days a week of resistance exercise, which is what the guidelines recommend anyway, and they outline a number of activities that that could be fulfilled by, strengthening work is what they talk about, appears to be a sufficient dose. Now, is one day a week enough? Well, one day a week is a whole lot better than zero days a week. If you chose to do something, I think it would be hopefully two days a week. People want to do more and I'm never going to say if you can handle more you enjoy doing more, do less. But two days a week pretty much appears to hit the system sufficiently that the retention of muscle that you get even in some really big energy deficits is actually enough to allow your muscle to hang on to a lot of what it's got.

James Hill:

Wow. That's great. I want to relate it to my personal situation here, Stu, which we do oftentimes. I try to exercise every day. And for me, the cardio stuff is pretty easy. And I do the resistance, but I have to force myself. What can I do to be more motivated to want to do the resistance?

Stuart Phillips:

Yeah. You know, I have a colleague here at McMaster University. His name is Martin Gibala. And he and I, we made an online course. I'll mention it because it's free. So I'm not making any money off of it. It's called Hacking Exercise for Health. And it was one of these sort of open courses that anybody could take. And the whole idea was, is that Marty was the aerobic guy and I was the resistance guy. And we initially started out by arguing, which is better, which is better for you. And we went our separate journeys and then eventually we come back and we have a big makeup and we're like, you need both of, which is true. I think Marty would be like you, he would find it a lot easier to do the aerobic work. I'm like not like you.

James Hill:

You're weird, man.

Stuart Phillips:

Yeah. I'm the freak, right? I enjoy lifting weights. I enjoy pumping iron and all that sort of stuff. But I also realized that being aerobically fit is a big part of being healthy. My plan now people say, what are you training for? I'm like, I'm training to age well.

James Hill:

That's me. I'm with you, buddy.

Stuart Phillips:

Everything that I look at it, it's something, hopefully it's helping me get to the horizon and the horizon is a long way in the distance. So I get on the bike, I go for a walk. I don't run as much as I used to. It just my knees can't handle it. You know, used to lift a lot of heavy weights. I don't do that anymore. I can't do that anymore. It hurts. My joints hurt but I sort of switched to using lighter weights. Ijust work to a high level ofwhat's called effort. We use that actually in our center here to get people to grade the amount of exercise that they do. We say, give me an effort that finishes in the the orange zone on the scale here so eight to nine out of ten. I don't need the red 10 out of 10 effort, but something where in the 7th or 8th or 9th. 10th time you lift the weight, you're like, that was hard. I think if you do that a couple of times a week, you're going to see the benefits.

Holly Wyatt:

I tend to be on the aerobic side. I tend to be a runner. And I think you have to find your own motivation, right? So it's aging for Jim, apparently, because he's got this on the brain. But, you know, I probably should have it on the brain.

Stuart Phillips:

It's all good. It's all good. Jim, I'm with you, buddy. I'm with you.

James Hill:

Oh, yeah.

Holly Wyatt:

Yeah. So I have other motivators. So I have to work hard kind of to figure out how to do the resistance training. Can you combine the two? If you can put cardio and resistance together.

Stuart Phillips:

There's a lot of, I think, confusion particularly when you get out on social media you find people that are like cardio people and people that are resistance people. And then people that are coaches that say, well you should do cardio day, resistance day. And I'm like, well, okay, we're all mere mortals, nobody's specializing in in one or the other. Nobody has a particular event that they're training for. This is life this is what I'm doing for myself. And of course you could do them all in one day. Classes where you step up and down aerobics are resistive in nature, and probably to the extent that they're helping not just your muscle, but your bone as well, which is another tissue that you can lose in weight loss. And you get a great cardio workout as well. So stair climbing is another one that everybody goes, that's tough. And I'm like, it is. And every time you push off and you use one leg to push yourself to the next step, that's a resistive move. Now, it doesn't do much for your upper body. But, I mean, my point in the end is that there's probably a lot of activities that we do that we don't think of. Like, I get a great workout from doing stairs. It's insanely good for you in a short period of time. Go up and down those stairs a few times. You'll feel your legs the next few days. And that's the resistive stimulus that will be enough for your legs to hang on to some muscle.

James Hill:

All right. I want to go in a little bit different direction, Holly, if that's okay.

Holly Wyatt:

Yeah, I will allow it.

James Hill:

So, Stuart, Holly and I have just written a book, and the book is for people who decide to or have to stop the GLP-1 meds. And the idea is without a plan, you're likely going to regain the weight.

Stuart Phillips:

Yeah.

James Hill:

And one of the things we do with our guests is we're sort of checking some of the things that we say in the book to make sure we're not too far afield.

Holly Wyatt:

No, don't tell people that.

James Hill:

No, I know. But it was great with Heather because she sort of validated what we're saying about protein. But the other thing that we say is you can't do this with diet alone. You cannot keep your weight off unless you're prepared to make a real commitment to exercise. And one of the things, Stuart, that we talk about, it's not just burning calories. We talk about how exercise optimizes your metabolism.

James Hill:

You know this from more mitochondria to insulin sensitivity, et cetera. Talk a little bit about that and the way that I think people misinterpret what exercise can do because it's more than burning calories.

Stuart Phillips:

Yeah. You bring up a great point. And I'm often frustrated. I was trained as a biochemist first and then made myself into a physiologist. And now I consider myself an exercise physiologist. So I proselytize about how great exercise is for you as well as diet, obviously.

Stuart Phillips:

And people always, the common retort is, well, you can't lose weight with exercise. You can't outrun a bad diet. And I said, well, you can't out-diet being sedentary. And they're like, what does, what does that mean? And I'm like, well, if you've got a healthy body weight and you just do what a lot of us do, which is, you know, all three of us are sitting here having this conversation. I spend most of my day sitting in front of my computer. I might walk to a few meetings which is why I got to get my exercise in usually for me early in the morning because otherwise I wouldn't do it in any given day. So some people have jobs where they can move around and that's awesome. But it does appear that being sedentary, just sitting, and the more sitting you do and the longer you sit without breaking it up as well, that's extraordinarily bad for you. And it doesn't matter actually if your body weight is in a healthy range. It's worse probably for you if you're in an unhealthy range. So from that standpoint then I think you have to have this expanded definition and knowledge of what it is that exercise does for you. So you mentioned insulin sensitivity and, you know, it only takes, it's almost a trivial amount of getting up and moving around to break that whole cycle of being insulin resistant. But two days of being in bed if you're sick can induce insulin resistance. So it sets in really quickly, but you can undo it really quickly on the other hand. If you keep looking at exercise through this sort of myopic weight loss only lens, it's always going to be a failure. It's ridiculously difficult to lose weight through exercise alone. So my trite phrase is you get fit and strong in the gym, but you lose weight somewhere in the kitchen.

James Hill:

We're with you 100%.

Stuart Phillips:

Awesome. So I haven't contradicted anything in your book so far.

James Hill:

No, but it totally switches with weight loss maintenance.

Holly Wyatt:

Yeah.

James Hill:

Because I think we've got decades to show that you cannot keep weight off with diet alone. People try, you know. As you lose weight, your energy requirements go down, you try to eat less, you get hungry, you eat more, you regain it. Exercise is the way that you can break that cycle.

Stuart Phillips:

From the standpoint of everything that we're learning about what exercise and activity does for you. If you'd have told me 15 years ago, if you exercise, it actually changes something, the size of the hippocampus in your brain, which is a really important part of your brain for memory and cognition. I'd have been like, no, that, that just doesn't happen, but it does. Exercise is insanely good for you on so many fronts. In fact, people say, give me the one thing you need to do. And I'm like, just be as physically active as you can. Diet, of course, body weight, everything else, and then probably a whole lineup of other things. But I mean, from the standpoint of looking at exercise beyond just weight loss: good for your muscle, good for your brain, good for your immune system, reduces your risk of dementia. So many things that are actually unrelated to anything related to body weight and so to your point, I think, is a weight loss regain antidote if you like. It's part of the formula and I think that your work on the weight control registry would back that up. People who lose that weight and keep it off are people that incorporate and maintain physical activity in their lives some way or another.

James Hill:

And there's also data to suggest that exercise actually feeds back on appetite too. Some of John Blundell's work suggesting that if you exercise, you more normalize your appetite.

Stuart Phillips:

Yeah.

Holly Wyatt:

I'm going to put you on the spot. I loved this quote. You can't out-diet a sedentary lifestyle. I wrote it down. I'm going to steal it. No, I'll give you credit.

Stuart Phillips:

No, no, it's not patented or trademarked. Go for it. Yeah. It's the good pushback to you can't outrun a bad diet. I'm like, I'm so tired of that phrase. I'm like, well, you can't out diet being sedentary. And they go, what does that mean? I'm like, think about it.

Holly Wyatt:

Oh, it's really good. But this is something I think about. And this is where I'm going to put you on the spot of it. You can with GLP-1 meds. So a GLP-1 med, by keeping your appetite low, you know, by using high amounts of the drug to block the appetite, you can be sedentary and, maintain a weight. So what do you think about that? Is that a good way to do it? Is there a downside to that? That's how they're working.

Stuart Phillips:

I'm gonna bring it back to my rider statement so the rider statement is, so if exercise is only ever viewed through a body weight lens and and that's the one lens that you use then yes is the answer to your question. But to my point is that what comes from exercising beyond just regulating body weight and normalizing blood glucose are a host of health benefits besides that the cognitive and brain benefits are the ones that I would point to that no GLP-1 can do for you, even if you lose all the weight that you need to normalize your blood glucose, normalize your lipids and everything else like that. The immune function benefits and just the general mood benefits that come. So people who exercise have a reduced sleep latency. They have better, higher quality sleep scores. They have lower anxiety. It's now being used in standard treatment for certain types of depression, anxiety, mood disorders. I think that there's a lot of other things. There was an argument probably about a decade ago with Ron Evans and his exercise in a pill concept and he's got this compound that mimics certain part of exercise. It tricks the muscle into thinking that it's burning more energy and he could normalize blood sugar by doing this and everything. And so, we've got exercise and a pill and I'm like, no, we have an aspect of exercise in a pill. And I think that's where the GLP-1s sit. They are. They're a revolutionary drug. It's a new era in terms of treating overweight and obesity and a lot of metabolic disorders, but nothing will ever do what exercise does for you in a holistic manner. I know I'm forgetting probably a few. If Frank Booth were here, he'd remind me.

Holly Wyatt:

I totally agree with you. And this is what worries me a little bit about the GLP-1s, is people having success with their weight and their weight may be what motivates them. And they may not be motivated by some of these other things at this point. And they're successful or what they consider successful in terms of keeping their weight low at a low sedentary, living a sedentary lifestyle. So that worries me a little bit. Now, that doesn't have to be what people do. People can exercise on the GLP ones. But I think thinking about that's important.

Stuart Phillips:

Yeah, and I think, I'll bring up a symposium that took place at the American College of Sports Medicine that I had the privilege of chairing, and John Jacasic and Renee Rogers spoke there. And John was a big sort of advocate for the idea that maybe these GLP-1 drugs, for the first time in some people's lives, allow the weight loss that they've never been able to achieve.

And it's a gateway. It's a gateway to them initiating health behaviors. The concept of which they couldn't even entertain because they couldn't get over the body weight that they were carrying for some time. It could be that forms of exercise like walking are now possible where they previously weren't. The idea of going to a gym is now acceptable where it previously wasn't. Healthy eating is now something that they can entertain because they're down at this new weight. So he sort of looked at these GLP-1 drugs as maybe the gateway to a whole suite of healthy behaviors. You folks have worked in, in weight loss and I'll call it your jam than mine per se, but I do have experience with some friends and colleagues for whom weight loss is, I'd even call it an epiphany moment where they begin to start their new life. So maybe this is the beginning and the exercise and all of the other things that go along with that are, you know, hopefully follow.

James Hill:

Stu, that's the optimistic viewpoint. And I love it. And I think it's something we should pursue because I think it is an opportunity. But Holly and I live in Alabama. And I will tell you, I think many of the people here want to take the drugs and keep sitting on the couch and not worrying about it, too. So, again, I agree. I think it's a heck of an opportunity for those of us who do lifestyle change to use it as an opportunity. But I do worry that there are a lot of people that just say, I've got the pill. It's all good. I'm done.

Stuart Phillips:

It's point well taken. I'm Canadian, Jim. So we're the glass is always half full.

James Hill:

You guys are all always optimistic.

Stuart Phillips:

I agree. I think a lot of people are like, well, you know, I'll just keep taking the drug. And then if I gain back something, I'll just get back on the drug again.

James Hill:

Exactly.

Stuart Phillips:

That's the drug recapitulation of the yo-yo dieting that we've known for years is not it's not good for you. And it may have been better to just not lose the weight even to begin with. So, you know, beware. And I do think that is something that we have to be cognizant of, of course.

Holly Wyatt:

Well, especially if what's happening is what you're talking about. When you regain the weight, when you yo-yo, you gain more fat and you keep doing that, you're going to totally end up with a really high percent body fat and a low percent of lean muscle.

Stuart Phillips:

Right.

Holly Wyatt:

I want to go back to one thing really quickly because I know my listeners are going to be upset if I don't answer this, Jim. We didn't talk about, and you can just give us your thoughts, type of protein, how much protein, and timing of protein specifically for muscle. We did have Heather talked about that in terms of appetite control, but what about in terms of muscle prevention of loss?

Stuart Phillips:

Yeah. So, I mean, let's start with the protein type. And this is something that I've changed my position on basically because science has shown me different. 25 years ago, I'd have been like, yeah, animal-based proteins, they're higher quality than plant-based proteins. You just stick to animal-based. And then 10 years ago, I've been like, oh, there's some new research coming out. There's a few things show. It's maybe not as different as we thought. Now, everything that we've done where we've put plant-based, you know, as opposed to animal-based proteins head to head, we find that the differences are remarkably small. And if they're even there at all. Now, I will say that people who are vegan, so exclusively plant-based, have to be a bit more judicious about how they pick what it is that they eat. Most vegans that I talk to are pretty well-schooled in how to balance their protein. And there's always a grain paired with a legume. They've got all kinds of protein sources that I don't even think about because I'm dyed-in-the-wool omnivore. But if you're sort of flexitarian, let's call it, so you're trying to eat less meat, I don't think it's an issue. If you're getting dairy in your diet, then I think It's not a non-issue. Eggs. It's sort of a non-issue as well.

But the difference is relatively small. The amount question is a tough one, but let me just say that the recommended dietary allowance or the RDA is a number that I think, and I think Heather would probably agree, is too low for most people, particularly people who are in a weight loss scenario or looking to curb their appetite. And I think it should be closer to about 1.2 grams per kilo, maybe up as high as 1.6, so twice the RDA. The difficulty becomes if somebody has a high body fat percentage such that their body mass index is over 30 and then do we use their actual body weight. And what we do is we just calculate protein as if a person had a BMI of 30 and we stop it there. So we don't you know overfeed protein to people who have body mass indices in their high 30s and 40s we just sort of clamp them at 30. It's not perfect i think it's pretty good in terms of the amount of protein that you would get it's certainly higher than the RDA and I think it covers all of the bases now so.

Holly Wyatt:

Just let's clarify for the listener because I know they're thinking right now, so if they look at the weight that they would be at a BMI of 30 turn that into kilograms and then take that times 1.2 To 1.6.

Stuart Phillips:

Sorry, I'll switch from kilos because I know you folks deal in pounds. So the RDA sits at about 0.35 grams of protein per pound of body weight. And I know it's a decimal, I can't do any better than that. Sorry. So twice the RDA is about 0.7 grams per pound. And so if you have a body mass index that puts you over 30, then you use the weight that would put you at a body mass index of 30, multiply those pounds by between 0.3 and 0.7, I would recommend 0.5 is a good number to shoot for. And that's what you should be taking in.

James Hill:

Good.

Stuart Phillips:

And that kind of covers it. People could argue about that one way or another, but I think it's higher than the RDA, but it's not so high that would make some people like a little bit nervous about too much protein and you get the satiety effect. But if you're taking a GLP-1, the satiety is not your major concern, obviously.

Holly Wyatt:

Got it. Yeah.

James Hill:

Okay, Holly, you know what time it is?

Holly Wyatt:

Listener questions.

James Hill:

Let's do a couple of listener questions.

Holly Wyatt:

Okay, Jim, you start.

James Hill:

Here's one. How soon should I eat protein after a workout to maximize its value?

Stuart Phillips:

Yeah, great question. I'll say this. There was a whole craze with nutrient timing probably peaked, I'd say, about 15 years ago, that exercise made your muscle very responsive to nutrients and the nutrient that is really responsive after exercise, it's responsive to glucose or blood sugar. The message around protein, it was thought was sort of the same as that you have to get your protein in really soon after your workout. And it's actually not true. For reasons that we don't fully understand, The window for getting protein in so that your muscle is receptive to it, that window is open a much longer time. I have a friend, Shawn Arent at University of South Carolina, and he calls it the garage door of opportunity as opposed to the window. And it's probably about 24 hours. So there's no, there's no rush to get the protein and, you know, the other world I live in, you go over to the student gym here and you'll see the people with the protein shakers as soon as they're…

James Hill:

Get it right away.

Holly Wyatt:

Hitting that. Well, we used to think there was a time period where you needed to get it in and you couldn't even get home. You needed to drink it in the car.

Stuart Phillips:

No, no, no. Not true. Not true. Yeah. Relax. It's okay. You'd go to the gym or go for a workout, come back, have a cup of coffee, and then the meal that you'll eat a couple hours later will do the job.

James Hill:

Great advice.

Holly Wyatt:

Yeah. All right. Here's one more listener question, at least. I'm over 60. Do I really need to lift weights if I eat enough protein? And what I think's behind it, is it too late? Like at a certain age, does lifting weights not really matter? Can you just concentrate on the protein?

Stuart Phillips:

The short answer is it's never too late. We've got studies that show that even people in their 90s can gain strength if they lift weight. So, that's a non-issue. And everybody goes, oh, well, what about muscle? And I'm like, okay, but let's not worry about muscle for now. Let's worry about strength and function because that's the key commodity that really does matter. So, can you hang on to muscle with just protein? The short answer is no. In sort of relation and back to what's the big stimuli to hang on to muscle and weight loss? Well, it's resistive exercise and not the protein per se. And outside of the muscle issue, I mean, at some point we're beginning to gather the data now, as you age, an activity that will limit you and you name it, getting up in and out of a chair, up and down a flight of stairs is related to your muscle strength and power. And that doesn't get better just by eating protein. It gets better by practicing the act of strength and power. So in short, yes, you have to lift weights. And the answer is the benefits will be a lot more than just what you think, I believe.

James Hill:

All right, Holly, vulnerability questions. And I'm going to go first.

Holly Wyatt:

All right. All right.

James Hill:

Because I'm going to do a self-serving question.

Holly Wyatt:

I knew it. See, he's all about that, all about himself.

James Hill:

So, Stuart, what's your plan for healthy aging when it comes to lifestyle.

Stuart Phillips:

Four pillars. Clearly, physical activity. Like you, Jim, I try to do something every day. It's what I do and I'll admit that there are days when I don't want to do it. For me, I'm at my peak in terms of ready to exercise and ready like first thing in the morning. I am and have always been an early morning person. That's my chronotype, I guess. And first thing, is the right thing for me, I try to be judicious about what I eat. I still enjoy good food. I think one of the lost parts in the nutrition world is to talk purely about nutrition, a little less about food and making food, and being with friends and everything else like that. And having a good meal which leads into part three, which is to have a good social circle. Family. If it's your church, whatever it is that allows you to feel supported and that you're part of something. And the last part, I always leave it to last because I'm not very good at it, and that's sleep. And I think if you can master those four things, man, a lot of stuff falls in place.

James Hill:

I love it. I love it. And just an aside, you know, we've been looking a lot at reasons why people do stop the GLP-1 meds. And one of the reasons is because they miss food and they miss the social aspects of food.

Stuart Phillips:

Yeah.

James Hill:

All right, Holly, you get to ask one.

Holly Wyatt:

Well, you took the best one, but I like this one too. Do you ever catch yourself overthinking your own plan or have you found a way to keep things maybe simple? And what I kind of mean by this is a lot of times people say, this is great. We got people talking about protein. We got people talking about physical activity. And then we got to sleep a certain amount. And then we need to work on our mind state. And then we also need to do that. We need to have connections with others. And then we need to work on our environment. How do you put all this advice and not feel overwhelmed by it?

Stuart Phillips:

Yeah, that's a great question. I play on social media and I play on social media for the main reason that I think that's now where a lot of people get their information. I stand in front of 200 undergraduates every year and try to teach them about exercise and nutrition. And they tell me they get all their information from Tiktok or Instagram and, and I'm like, okay, well, that's clearly where I need to be or other people need to be if they want to get their message out. You get on social media and it seems like there's an endless stream of things that we need to do.

I always say to the students to remind them that before we had this endless stream of bio hacks and little bespoke things that are supposed to get this part out of life and everything else like that, people still lived to be 100. Maybe more now than ever because of a lot of reasons. It was possible before so I think the broad strokes the four things that I just gave you there. To me, that's like taking a big roller and sort of painting the wall the rest of this sort of the other pieces I call that's the fine tuning. That's the small brush filling in some some gaps or maybe you know tightening the screw on the system or the lid. The other analogy I say is that dip the cloth in the water and rinse it once and that's being active. Rinse it twice, and that's the nutrition. Rinse it three times, that's the social support. Rinse it four times, that's the sleep. And now the fifth turn, you're not getting a lot of water out of the cloth. You pretty much squeezed it dry. That's the name your latest supplement that is supposed to make you live another year longer or something like that.

Holly Wyatt:

Yeah. We talk about it. You build your cake, and then you can put your icing on it. But without a cake, the icing really doesn't do much.

Stuart Phillips:

I use that analogy all the time. I say to people, because the other part of my life is people who are looking to maximize their muscle. And the big thing, they say, what's your number one piece of advice in terms of protein? I said, well, it's not in terms of protein. It's go to the gym and do it regularly. And they're like, well, but. And I'm like, because that makes the cake and the protein is just the icing on top of the cake. So, and they are like, you know. So I'm with you. I think that there are so many big picture things that you could dial in before the, I call them smaller, in the margin, call them whatever you want. It could inundate you and make you feel like you're doing nothing right when actually you've got a big part of the picture right.

James Hill:

All right, Holly, I'm going to wrap this up very simply. It's the combination of high protein and exercise, particularly resistance exercise. If you want to maximize your muscle mass, do that combination. Protein alone, good. Exercise alone, good. The combo of high protein resistance training, that's the magic place.

Stuart Phillips:

Good summary. I like it.

Holly Wyatt:

Good summary. And never too late.

James Hill:

Never too late.

Stuart Phillips:

That's an interesting one. I think people think I'm too far gone or something like that. And nothing could be further from the truth. You still possess the ability, even into your late, late years, to respond to exercise.

Holly Wyatt:

Right.

James Hill:

Stuart, thank you. This has been a wonderful conversation. You've given me a lot of optimism for healthy aging. So, thank you. And thank you for joining us on Weight Loss And.

Stuart Phillips:

You're most welcome. Thanks for having me.

Holly Wyatt:

Bye, everybody.

James Hill:

And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:

If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

James Hill:

We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:

And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.