Free Daily Podcast Summary
Barbell Medicine Podcast: Daily Summaries Delivered
by Barbell Medicine
Podcast by Barbell Medicine
Latest Episodes
The most recent episodes — sign up to get AI-powered summaries of each one.
- 4 days ago2h 1m
Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms
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 exceptions2:08 Where "you need a surplus" came from7:12 Heuristics versus theories11:40 Hypertrophy, maintenance, deficit and surplus defined14:58 Body fat as a savings account18:24 How fast anyone can actually build muscle23:39 What sets the ceiling: stimulus, not genetics26:37 Microgravity, astronauts, and a 20 kg barbell31:49 What constrains growth if steroids don't break the ceiling36:44 If training sets the ceiling, what does energy do38:45 What 1 kg of muscle costs to build44:05 Why 3,500 Calories doesn't tell you what to eat44:55 REDs and the dual intervention model47:51 The 2000s bulking studies51:34 Garthe 2013: elite athletes and a 500 Calorie surplus58:30 Protein: 1.6 versus 2.5 g/kg1:03:31 What starvation research shows the body protects1:10:29 Vargas-Molina: maintenance versus deficit1:19:17 What to do if you're lean1:39:34 What would prove this wrong1:57:57 Three bucketsResources:Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comNikolaidis MG, Paschalis V, Margaritelis NV. The energetic cost of building human skeletal muscle. bioRxiv. Preprint posted online August 17, 2026. doi:10.64898/2026.08.17.745156Rozenek 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.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.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:10.1080/17461391.2011.643923Helms 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.2013-0054Slater 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.2019.00131Murphy 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.14075Helms 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-yMountjoy 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-2023-106994Speakman 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.2022.0231Vargas-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/s00421-026-06209-6Our Sponsors:* 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 quince.com/BBM for a great deal: https://www.quince.comAdvertising Inquiries: https://redcir
- 2 weeks ago1h 17m
Is Obesity A Muscle Problem?
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. Timestamps0:00 The one-leg study, and the muscle-centric claim02:06 What obesity is, and the garage analogy05:06 How glucose gets into a muscle cell11:21 Insulin sensitivity improves without building muscle17:11 The best case for muscle-centric medicine21:13 What predicts falls and death: strength, not lean mass25:18 Separating muscle size from muscle function31:33 Liver fat: amount, type, and flux37:54 Should you build muscle first? The arithmetic42:37 Building muscle in a calorie deficit50:29 GLP-1s, DXA, and the lean mass panic58:23 Sarcopenic obesity, and why the name is wrong01:04:37 Why size still tells you something01:11:46 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 ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.com1. 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.1989.66.2.8762. 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/glz0813. 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.163724. 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.htm5. 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.mm6823a16. 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.i3.767. 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-S3028. 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.00038.20129. 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.070540810410. 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.111010510811. Perseghin G, Price TB, Petersen KF, et al. Increased glucose transport-phosphorylation and muscle glycogen syn
- 3 weeks ago1h 26m
Who Needs Testosterone, and Who's Not Getting It I Signal Episode 4
Most men who start testosterone never needed it, and some who genuinely do never get treated. In the final episode of the Signal series, Dr. Jordan Feigenbaum and Dr. Austin Baraki work through who actually needs testosterone replacement, who got sold it, and what the evidence says about the risks that scared the field for a decade. We cover the blinded trial where men couldn't tell real testosterone from placebo, what the heart and prostate data actually show now that we have the trials, what testosterone does to fertility, and the framework we use to decide. We also close the story of Mark, the patient whose lab result started the series.This is educational content, not medical advice. Talk to your physician about your personal situation. Here we cover the real diagnosis of testosterone deficiency, primary versus secondary low testosterone, how the system both over- and under-prescribes, the SHBG trap that makes a normal level look low, the gray-zone crossover study, what replacement should actually target, why most men quit within a year, testosterone as a male contraceptive, the TRAVERSE cardiovascular results, the saturation model and prostate safety, the blood side effect worth monitoring, and when not to start at all.Timestamps:00:00 The study almost nobody mentions 01:31 Who this episode is for 03:35 What a real testosterone diagnosis requires 07:18 Primary vs secondary low testosterone 10:12 How testosterone gets over-prescribed 11:35 The SHBG trap: when a low number misleads 18:10 Would GLP-1 plus testosterone work better? 22:19 Why genuine deficiency gets under-treated 24:15 The cardiovascular scare and where it came from 34:11 The gray-zone study, in full 41:02 What TRT should actually target, and the "900" myth 47:38 Running TRT as a trial, and why 70% quit 52:36 Testosterone as a contraceptive: the fertility cost 57:19 Does TRT cause heart problems? The TRAVERSE trial 01:01:40 Testosterone and the prostate 01:09:13 The blood side effect worth watching 01:12:02 When not to start testosterone 01:14:26 Who actually benefits from TRT 01:18:28 The Signal framework, and what happened to Mark 01:21:14 Five things to take away 01:23:33 Our conflict of interest, and the bookResources:Buy the book, Signal: https://www.barbellmedicine.com/shop/learning/signal/Part 1: Is the testosterone crisis real?Part 2: Is you testosterone actually low?Part 3: What's actually driving your testosterone down?New Barbell Medicine Hybrid 5K and 10K Run + Lift ProgramsBarbell Medicine coaching and templates: https://www.barbellmedicine.comTestosterone Action Plan: https://www.barbellmedicine.com/testosterone-action-plan/ Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006;60(7):762-769. doi:10.1111/j.1742-1241.2006.00992.xBaillargeon J, Urban RJ, Ottenbacher KJ, Pierson KS, Goodwin JS. Trends in androgen prescribing in the United States, 2001-2011. JAMA Intern Med. 2013;173(15):1465-1466. doi:10.1001/jamainternmed.2013.6895Bhasin S, Brito JP, Cunningham GR, et al. Testosterone therapy in men with hypogonadism: an Endocrine Society clinical practice guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744. doi:10.1210/jc.2018-00229Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and management of testosterone deficiency: AUA guideline. J Urol. 2018;200(2):423-432. doi:10.1016/j.juro.2018.03.115Corona G, Goulis DG, Huhtaniemi I, et al. European Academy of Andrology (EAA) and European Society of Endocrinology (ESE) recommendations on the diagnosis and management of male hypogonadism. Andrology. 2020;8(5):970-987. doi:10.1111/andr.12770Morgentaler A, Zitzmann M, Traish AM, et al. Commentary: who is a candidate for testosterone therapy? A synthesis of international expert opinions. J Sex Med. 2014;11(7):1636-1645. doi:10.1111/jsm.12546Mok SF, Fennell C, Savkovic S, et al. Testosterone for androgen deficiency-like symptoms in men without pathologic hyp
- Aug 20, 202643 min
Your Fat Has a Storage Limit
In 2004 a surgeon removed about ten kilograms of fat from fifteen women and measured everything that mattered. Nothing improved. Four years later, it still hadn't.That result should have ended an argument about body fat. Instead the argument got more specific, and the version you've heard most recently is that visceral fat, the fat around your organs, is the dangerous kind. I've said a version of that myself on this show, and in this episode I expand upon it.This one starts from the beginning: what your fat is actually for, what insulin is, and what insulin resistance means, in plain terms and assuming nothing. Then four experiments that all point the same direction. Fat removed surgically, and the disease doesn't follow. People born with no fat tissue at all, who get the entire disease anyway. A hormone that reversed a 48% fatty liver without adding a gram of fat. And a diabetes drug that made people heavier and healthier at the same time.The second half is practical. What a fatty liver actually does over twenty years, what BMI can and can't do, why the Lancet Commission changed the definition of obesity in 2025, and the exact order of tests I'd use, including the TyG index, FIB-4, and where each one stops working.Part one of two. Next episode is about muscle.Timestamps:00:00 The Liposuction Experiment02:06 The Visceral Fat Correction05:47 What Fat Is For08:14 The Carb Insulin Model10:51 Filling The Garage14:35 Taking The Fat Out17:57 Born Without Fat Tissue22:52 Heavier And Healthier25:05 Neptune And Vulcan29:57 The Patient Nobody Checked33:59 What Every Ruler Missed36:00 What To Actually Order40:29 What Obesity Actually IsResources:Vital 5 (TyG , waist to height, etc. discussion):https://www.barbellmedicine.com/vital-5-action-plan/Barbell Medicine coaching and templates: https://www.barbellmedicine.comPlus podcast subscription:https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Barbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (now shipping): https://www.barbellmedicine.com/shop/learning/signal/Klein S, Fontana L, Young VL, et al. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med. 2004;350(25):2549-2557. doi:10.1056/NEJMoa033179Mohammed BS, Cohen S, Reeds D, Young VL, Klein S. Long-term effects of large-volume liposuction on metabolic risk factors for coronary heart disease. Obesity (Silver Spring). 2008;16(12):2648-2651. doi:10.1038/oby.2008.418Sommer I, Teufer B, Szelag M, et al. The performance of anthropometric tools to determine obesity: a systematic review and meta-analysis. Sci Rep. 2020;10(1):12699. doi:10.1038/s41598-020-69498-7Donnelly KL, Smith CI, Schwarzenberg SJ, Jessurun J, Boldt MD, Parks EJ. Sources of fatty acids stored in liver and secreted via lipoproteins in patients with nonalcoholic fatty liver disease. J Clin Invest. 2005;115(5):1343-1351. doi:10.1172/JCI23621Spalding KL, Arner E, Westermark PO, et al. Dynamics of fat cell turnover in humans. Nature. 2008;453(7196):783-787. doi:10.1038/nature06902Fabbrini E, Tamboli RA, Magkos F, et al. Surgical removal of omental fat does not improve insulin sensitivity and cardiovascular risk factors in obese adults. Gastroenterology. 2010;139(2):448-455. doi:10.1053/j.gastro.2010.04.056Garg A. Acquired and inherited lipodystrophies. N Engl J Med. 2004;350(12):1220-1234. doi:10.1056/NEJMra025261Al Yaarubi S, Alsagheir A, Al Shidhani A, et al. Analysis of disease characteristics of a large patient cohort with congenital generalized lipodystrophy from the Middle East and North Africa. Orphanet J Rare Dis. 2024;19(1):118. doi:10.1186/s13023-024-03084-2Petersen KF, Oral EA, Dufour S, et al. Leptin reverses insulin resistance and hepatic steatosis in patients with severe lipodystrophy. J Clin Invest. 2002;109(10):1345-1350. doi:10.1172/JCI200215001Miyazaki Y, Mahankali A, Matsuda M, et al. Effect of pioglitazone on abdominal fat distribution and insulin sensitivity in type 2 diabetic patients. J Clin Endocrinol Metab. 2002;87(6):2784-2791. doi:10.1210/jcem.87.6.8567Cusi K, Orsak B, Bril F, et al. Long-term pioglitazone treatment for patients with nonalcoholic steatohepatitis and prediabetes or type 2 diabetes mellitus: a randomized trial. Ann Intern Med. 2016;165(5):305-315. doi:10.7326/M15-1774Taylor R, Barnes AC, Holling
- Aug 12, 202646 min
Lifting and longevity: is 1 hour a week really the limit? Plus GLP1s and mood, training with ME/CFS, and Protein vs. Calories
A popular paper claimed the longevity benefit of lifting disappears once you train more than an hour a week. It's a real paper, but the claim is a misread. This is the free cut of this month's Direct Line, where Drs. Feigenbaum and Baraki also take on whether GLP-1s affect your mood, the "same calories, more weight loss" protein argument, and what you can actually do in the gym when you have chronic fatigue syndrome. For education and infotainment, not medical advice.To become a member and have us answer YOUR questions, join today:https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Timestamps:0:00 Intro0:38 The paper: does lifting stop helping after an hour?3:19 The newer 147,000-person, 30-year study13:21 GLP-1s, mood, and motivation14:50 The FDA reverses the suicide warning19:29 What happened when they gave people a GLP-1 in a bar24:54 Is a calorie just a calorie?28:17 The "same calories, more weight loss" protein study30:48 Does keto break the laws of physics?34:56 Lifting with chronic fatigue syndrome36:14 The identical-twin experiment37:36 Can lifting in bed do anything?45:33 Get the full Direct LineBarbell Medicine coaching and templates: https://www.barbellmedicine.comBarbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (pre-order)https://www.barbellmedicine.com/shop/learning/signal/ 1. Momma H, Kawakami R, Honda T, Sawada SS. Muscle-strengthening activities are associated with lower risk and mortality in major non-communicable diseases: a systematic review and meta-analysis of cohort studies. *Br J Sports Med*. 2022;56(13):755-763. doi:10.1136/bjsports-2021-1050612. Dankel SJ, Loenneke JP, Loprinzi PD. Dose-dependent association between muscle-strengthening activities and all-cause mortality: prospective cohort study among a national sample of adults in the USA. *Arch Cardiovasc Dis*. 2016;109(11):626-633. doi:10.1016/j.acvd.2016.04.0053. Zhang Y, Lee DH, Rezende LFM, Ma Y, Giovannucci E. 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*. Published online June 2, 2026. doi:10.1136/bjsports-2025-1105034. US Food and Drug Administration. FDA requests removal of suicidal behavior and ideation warning from glucagon-like peptide-1 receptor agonist (GLP-1 RA) medications. Drug Safety Communication. January 13, 2026. Accessed August 12, 2026. https://www.fda.gov/drugs/drug-safety-communications/fda-requests-removal-suicidal-behavior-and-ideation-warning-glucagon-peptide-1-receptor-agonist-glp5. Hendershot CS, Bremmer MP, Paladino MB, et al. Once-weekly semaglutide in adults with alcohol use disorder: a randomized clinical trial. *JAMA Psychiatry*. 2025;82(4):395-405. doi:10.1001/jamapsychiatry.2024.47896. Klausen MK, Justesen SK, Pedersen JN, et al. Once-weekly semaglutide versus placebo in patients with alcohol use disorder and comorbid obesity: a randomised, double-blind, placebo-controlled trial. *Lancet*. 2026;407(10540):1687-1698. doi:10.1016/S0140-6736(26)00305-37. Haghighat N, Ashtary-Larky D, Bagheri R, et al. The effect of 12 weeks of euenergetic high-protein diet in regulating appetite and body composition of women with normal-weight obesity: a randomised controlled trial. *Br J Nutr*. 2020;124(10):1044-1051. doi:10.1017/S00071145200020198. Committee on the Diagnostic Criteria for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome, Board on the Health of Select Populations, Institute of Medicine. *Beyond Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Redefining an Illness*. National Academies Press; 2015. Accessed August 12, 2026. https://www.ncbi.nlm.nih.gov/books/NBK274235/9. Giloteaux L, Hanson MR, Keller BA. A pair of identical twins discordant for myalgic encephalomyelitis/chronic fatigue syndrome differ in physiological parameters and gut microbiome composition. *Am J Case Rep*. 2016;17:720-729. doi:10.12659/AJCR.90031410. Rangan A, Brealey SD, Keding A, et al. Management of adults with primary frozen shoulder in secondary care (UK FROST): a multicentre, pragmatic, three-a
- Aug 7, 20261h 6m
The FDA Voted for 6 Peptides. Its Own Scientists Said No
An FDA advisory committee just voted to open a legal compounding supply line for six of seven peptides, including BPC-157 and TB-500, over the objection of the FDA's own scientists, who recommended against all seven. Dr. Jordan Feigenbaum walks through what the Pharmacy Compounding Advisory Committee actually voted on, why a vote about ulcerative colitis ends up governing tendon and joint use, what the single human BPC-157 trial does and doesn't show, and why "a pharmacy makes it safe" and "there's no money to study it" don't hold up. Evidence-based, no hype, no nocebo.Timestamps: | 00:00:00 | The FDA voted 8-6. What it actually means | 00:01:25 | What I am, and am not, claiming | 00:03:21 | How they got here: Category 2 and the paperwork | 00:07:17 | Who was in the room: the panel that flipped | 00:10:57 | What they voted on: compounding and the bulks list | 00:15:37 | "No money in it, you can't patent it" | 00:18:24 | The trials already run: Plevna and MK-677 | 00:22:55 | "I took it and it worked": placebo and fake surgery | 00:27:02 | The one human trial: Ruenzi 2005 | 00:32:28 | Is it natural? Is it even a drug? | 00:36:58 | Harm reduction, or follow the money? | 00:42:45 | Three times a missing trial went wrong | 00:50:58 | Safety: known, unknown, and unknowable | 00:55:22 | The other six peptides | 00:58:22 | What I'd actually tell you | 01:02:08 | What actually works, and what would change my mindResources:Barbell Medicine coaching and templates: https://www.barbellmedicine.comPlus podcast subscription: https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Barbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (book pre-order): https://www.barbellmedicine.com/shop/learning/signal/1. US Food and Drug Administration. FDA Briefing Document: Pharmacy Compounding Advisory Committee Meeting. July 23-24, 2026. Silver Spring, MD: FDA; 2026.2. US Food and Drug Administration. FDA review of BPC-157-related bulk drug substances. PCAC Briefing Document. July 23-24, 2026. Media 193343. Accessed July 24, 2026. https://www.fda.gov/media/193343/download3. US Food and Drug Administration. FDA review of TB-500-related bulk drug substances. PCAC Briefing Document. July 23-24, 2026. Media 193349.4. US Food and Drug Administration. FDA review of KPV-, MOTS-c-, Semax-, Epitalon-, and Emideltide-related bulk drug substances. PCAC Briefing Documents. July 23-24, 2026.5. US Food and Drug Administration. Questions for the Pharmacy Compounding Advisory Committee. July 23-24, 2026.6. US Food and Drug Administration. Pharmacy Compounding Advisory Committee meeting roster. July 23-24, 2026. Media 193772.7. US Food and Drug Administration. Pharmacy Compounding Advisory Committee meeting roster. 2022. Media 159040.8. openFDA. FAERS adverse event reports for BPC-157. Accessed July 24, 2026. https://open.fda.gov9. Pharmacy compounding; 503A bulk drug substances. 21 CFR §216.23 (2026).10. Federal Food, Drug, and Cosmetic Act §503A, 21 USC §353a (pharmacy compounding).11. Abigail Alliance for Better Access to Developmental Drugs v von Eschenbach, 495 F3d 695 (DC Cir 2007).12. United States v Rutherford, 442 US 544 (1979).13. Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017, Pub L No. 115-176, 132 Stat 1372 (2018).14. US Food and Drug Administration. Regulatory considerations for human drug products containing peptides. Guidance for Industry (draft). 2020.15. Ruenzi M, Stolte M, Veljaca M, et al. Efficacy and safety of PL 14736 (BPC 157) in patients with active ulcerative colitis [abstract]. Gastroenterology. 2005. Meeting abstract; full study not published.16. Staresinic M, Petrovic I, Novinscak T, et al. Effective therapy of transected quadriceps muscle in rat: gastric pentadecapeptide BPC 157. J Orthop Res. 2006;24(5):1109-1117. doi:10.1002/jor.2008917. Gwyer D, Wragg NM, Wilson SL. Gastric pentadecapeptide body protection compound BPC 157 and its role in accelerating musculoskeletal soft tissue healing. Cell Tissue Res. 2019;377(2):153-159. doi:10.1007/s00441-019-03016-818. Sikiric P, Skrtic A, Gojkovic S, et al. Stable gastric pentadecapeptide BPC 157 and hemorrhage/thrombosis. Pharmaceuticals (Basel). 2026;19(3):463. doi:10.3390/ph1903046319. Stavchansky VV, Filippenkov IB, Dergunova LV, Limborska SA. The role of glyprolines in the regulation of gene expression: focus on Semax. Genes (Basel). 2022;13(12):2380. doi:10.3390/genes1312238020. Mendias CL, Awan TM. The safety and efficacy of approved and unapproved pepti
- Jul 31, 20261h 10m
The Man Who Couldn’t Stop Gaining Weight | A Medical Mystery
A previously healthy 21-year-old shows up with seven months of headaches and 30-plus pounds of weight gain he can’t explain. He’s eating the same and training more, and the scale climbs anyway. We hand the case to Dr. Austin Baraki cold and work it in real time: the exam, the labs, the MRI, and two diagnoses that turn a headache workup into the clearest proof we’ve got that body weight is set by the brain, not by character. This is the capstone of our weight series (willpower, calories, protein), and it ends on the drug that, this year, did something for these patients that nothing had done before.Timestamps00:00:00 Cold open: the man who couldn’t stop gaining weight00:01:49 Meet the case (and the rules of the game)00:02:36 The presentation: 21, headaches, unexplained weight gain00:03:57 Austin’s one-liner and how a clinician builds a differential00:05:10 Secondary headaches: what raises the red flag00:13:12 The exam: vitals, and the eye findings that matter00:14:37 The labs, one number at a time00:16:08 Raised pressure and a visual-field clue (bitemporal hemianopia)00:20:45 The MRI00:21:54 First diagnosis: craniopharyngioma00:25:32 The name: a tumor built from tooth tissue00:25:50 Surgery, and what it costs00:27:43 The new mystery: gaining weight faster than ever00:33:41 Second diagnosis: acquired hypothalamic obesity00:39:17 How your brain sets your weight: the POMC brake and the AgRP accelerator00:42:07 What about leptin?00:45:46 Monogenic vs common obesity00:50:30 Why GLP-1 drugs still worked: the brainstem backdoor00:52:11 Responders and non-responders00:55:40 Setmelanotide: a drug for the broken circuit00:56:53 TRANSCEND, and the new FDA approval00:58:55 What it costs01:01:32 Why we care about body fat at all: the garage01:04:36 Flux: which fat is actually dangerous01:09:15 CloseResourcesBarbell Medicine coaching and templates: https://www.barbellmedicine.comPlus podcast subscription: https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Barbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (book pre-order): https://www.barbellmedicine.com/shop/learning/signal/1. Brijmohan A, et al. Acquired hypothalamic obesity following craniopharyngioma resection in a young adult [case report]. 2025. PMCID: PMC12268545; PMID: 40677794. 2. Miller JL, et al; TRANSCEND investigators. Setmelanotide in acquired hypothalamic obesity: a phase 3 randomized trial. N Engl J Med. 2026. 3. Rhythm Pharmaceuticals. FDA approves IMCIVREE (setmelanotide) for acquired hypothalamic obesity. News release. March 19, 2026.4. US Food and Drug Administration. FDA approves first treatment for weight management for people with certain rare genetic conditions (setmelanotide). 2020.5. Montague CT, Farooqi IS, Whitehead JP, et al. Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature. 1997;387(6636):903-908.6. Farooqi IS, Jebb SA, Langmack G, et al. Effects of recombinant leptin therapy in a child with congenital leptin deficiency. N Engl J Med. 1999;341(12):879-884.7. Krude H, Biebermann H, Luck W, et al. Severe early-onset obesity, adrenal insufficiency and red hair pigmentation caused by POMC mutations in humans. Nat Genet. 1998;19(2):155-157.8. Farooqi IS, Keogh JM, Yeo GS, et al. Clinical spectrum of obesity and mutations in the melanocortin 4 receptor gene. N Engl J Med. 2003;348(12):1085-1095.9. Clément K, Vaisse C, Lahlou N, et al. A mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature. 1998;392(6674):398-401.10. Fabbrini E, Tamboli RA, Magkos F, et al. Surgical removal of omental fat does not improve insulin sensitivity and cardiovascular risk factors in obese adults. Gastroenterology. 2010;139(2):448-455.11. Klein S, Fontana L, Young VL, et al. Absence of an effect of liposuction on insulin action and risk factors for coronary heart disease. N Engl J Med. 2004;350(25):2549-2557.12. Guyenet SJ. The Hungry Brain: Outsmarting the Instincts That Make Us Overeat. Flatiron Books; 2017. Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.com* Check out FIGS: https://wearfigs.com* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.fac
- Jul 24, 202632 min
The Protein Scaries: What the Research Says About Your Kidneys, Cancer, Bones, and Body Fat
Every couple of years a new headline warns that the protein you eat is quietly hurting you. This year the target is your kidneys. Before that it was cancer, then your bones, then the claim that your body can only use twenty or thirty grams of protein at a meal. In this episode, Dr. Jordan Feigenbaum goes through the actual studies behind each scare: the kidney trials, the 2014 IGF-1 and cancer paper that started the panic, the acid-ash bone hypothesis, and the per-meal "cap." Each fear starts from a real mechanism, and each one was run straight to a frightening conclusion the clinical outcomes never supported.The take home is simple. For a healthy adult, protein is not the lever people think it is, and where a real signal exists (processed and red meat, or a kidney that is already diseased) it tracks the whole dietary pattern more than the protein number. The two things that actually decide your health here are whether you eat mostly real food and whether you train.Timestamps00:00 The protein scare cycle 01:23 The four fears 01:59 Kidneys: healthy kidneys under higher protein 06:22 Kidney disease: does cutting protein help? 09:38 Red meat and the dietary pattern, not protein 12:00 Muscle, aging, and lifting on a restricted diet 13:54 Cancer: IGF-1 and the 2014 study everyone cites 16:22 The age reversal, and what travels with protein 18:48 Bigger data, processed meat, and the IGF-1 tell 22:15 Bones and the acid-ash myth 25:13 The 30-gram cap 27:17 What protein actually does, and how much you need 32:20 The two questions that matterResources:Barbell Medicine coaching and templates: https://www.barbellmedicine.comPlus podcast subscription: https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/Barbell Medicine Premium: https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/Signal (book pre-order): https://www.barbellmedicine.com/shop/learning/signal/Our Protein Content:https://www.barbellmedicine.com/blog/protein-and-weight-loss/https://www.barbellmedicine.com/blog/protein-on-ozempic/https://www.barbellmedicine.com/blog/barbell-medicine-protein-recommendations/StudiesLevine et al. Cell Metabolism 2014. doi:10.1016/j.cmet.2014.02.006Naghshi et al. BMJ 2020. doi:10.1136/bmj.m2412 Devries et al. J Nutr 2018. doi:10.1093/jn/nxy197 Antonio et al. J Nutr Metab 2016. doi:10.1155/2016/9104792 Knight et al. Ann Intern Med 2003. doi:10.7326/0003-4819-138-6-200303180-00009 Klahr et al. (MDRD). NEJM 1994. doi:10.1056/NEJM199403313301301 Hahn, Hodson & Fouque. Cochrane 2020. doi:10.1002/14651858.CD001892.pub5 Obeid, Hiremath & Topf. Kidney360 2022. doi:10.34067/KID.0001002022 Lew et al. J Am Soc Nephrol 2017. doi:10.1681/ASN.2016030248Castaneda et al. Ann Intern Med 2001. doi:10.7326/0003-4819-135-11-200112040-00008 Bauer et al. (PROT-AGE). JAMDA 2013. doi:10.1016/j.jamda.2013.05.021Fenton et al. Nutrition Journal 2011. doi:10.1186/1475-2891-10-41Shams-White et al. Am J Clin Nutr 2017. doi:10.3945/ajcn.116.145110Witard et al. Am J Clin Nutr 2013. doi:10.3945/ajcn.112.055517 Macnaughton et al. Physiol Rep 2016. doi:10.14814/phy2.12893Trommelen et al. Cell Reports Medicine 2023. doi:10.1016/j.xcrm.2023.101324 Wycherley et al. Am J Clin Nutr 2012. doi:10.3945/ajcn.112.044321 Moore et al. JAMA Intern Med 2016. doi:10.1001/jamainternmed.2016.1548 Larsson et al. Cancer Med 2020. doi:10.1002/cam4.3345 Brenner, Meyer & Hostetter. NEJM 1982. doi:10.1056/NEJM198209093071104 Chan et al. PLoS One 2011. doi:10.1371/journal.pone.0020456Berryman et al. Am J Clin Nutr 2018. doi:10.1093/ajcn/nqy088 Morton et al. Br J Sports Med 2018. doi:10.1136/bjsports-2017-097608Our Sponsors:* Check out Chilipad and use my code BBM for a great deal: https://sleep.me* Check out CovePure and use my code CovePure.com/bbm for a great deal: https://covepure.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 quince.com/bbm for a great deal: https://www.quince.comAdvertising Inquiries: https://redcircle.com/brands
Get Barbell Medicine Podcast summaries in your inbox
Free AI-powered daily recaps. Key takeaways, quotes, and mentions — in a 5-minute read.
Get Free Summaries →Free forever for up to 3 podcasts. No credit card required.
You Might Also Like
Listeners also like.
Peak Performance Life Podcast
Covers health, energy, and mental performance optimization through biohacking, nutrition, and lifestyle strategies.
Muscle for Life with Mike Matthews
Discusses science-based strategies for building muscle, losing fat, and improving overall health and well-being.
FoundMyFitness
A podcast exploring health, science, nutrition, aging, and fitness.
Mind Pump: Raw Fitness Truth
Three fitness experts debunk myths and expose science-backed truths about training, nutrition, and health in the fitness industry.
The Dr. Gabrielle Lyon Show
Discusses health, longevity, and mental resilience through science-based conversations with medical and wellness experts.
The Dr. Hyman Show
Explores root causes of chronic disease and promotes functional medicine, nutrition, and preventive health through expert discussions.
The Stronger By Science Podcast
A science-focused fitness podcast that breaks down research, trends, and practical strategies for strength and health.
The Genius Life
A science-based wellness podcast exploring nutrition, longevity, and health with a focus on practical, evidence-driven insights.
Modern Wisdom
Discussions with experts on psychology, philosophy, and self-improvement to help navigate life’s challenges.
Paul Saladino MD podcast
A physician explores the root causes of chronic disease and optimal health through science and personal experimentation.
Wellness, Actually with Emily Oster & Perry Wilson, MD
Two experts analyze health news, debunk wellness myths, and answer listener questions using data and medical evidence.
The Model Health Show
Shawn Stevenson explores health and fitness topics including nutrition, sleep, hormones, and exercise with expert guests.
Customized Recaps
AI-powered recaps with compact key takeaways, quotes, and insights.
Straight to Your Inbox
Get key takeaways from Barbell Medicine Podcast in a 5-minute read.
Save Hours Every Week
Stay current on your favorite podcasts without falling behind.
Frequently Asked Questions
What is Podzilla's Barbell Medicine Podcast daily summary?
It's a free AI-powered email that summarizes new episodes of Barbell Medicine Podcast as soon as they're published. You get the key takeaways, notable quotes, and links & mentions — all in a quick read.
How does the Barbell Medicine Podcast podcast summary work?
When a new episode drops, our AI transcribes and analyzes it, then generates a personalized summary tailored to your interests and profession. It's delivered to your inbox every morning.
Is this an official Barbell Medicine Podcast product?
No. Podzilla is an independent service that summarizes publicly available podcast content. We're not affiliated with or endorsed by Barbell Medicine.
Can I get summaries of other podcasts too?
Absolutely! The free plan covers up to 3 podcasts. Upgrade to Pro for 15, or Premium for 50. Browse our full catalog at /podcasts.
How often does Barbell Medicine Podcast release new episodes?
Barbell Medicine Podcast publishes weekly. Our AI generates a summary within hours of each new episode.
What topics does Barbell Medicine Podcast cover?
Barbell Medicine Podcast covers topics including Fitness, Health & Fitness. Our AI identifies the specific themes in each episode and highlights what matters most to you.
Start getting Barbell Medicine Podcast summaries tomorrow morning.
Free forever for up to 3 podcasts. No credit card required.
Free forever for up to 3 podcasts. No credit card required.