The Skinny Confidential Him & Her Show

Dr. Gabrielle Lyon On Reaching Your Body Goals, The Truth About GLP-1's, & The Under Muscled Crisis

February 9, 2026

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  • Women should consume a minimum of 100 grams of protein daily to age optimally and support recovery and repair, with the first and last meals of the day being critical for hitting this target. 
  • The primary health crisis is shifting from an obesity epidemic to an epidemic of sarcopenia (muscle loss), which is exacerbated by rapid weight loss methods like GLP-1s if not paired with adequate protein and resistance training. 
  • Skeletal muscle is an essential organ system that must be prioritized, as its health is linked to various outcomes including better erections (sex span) and tighter skin, and resistance training is the primary way to build and maintain it. 
  • Skeletal muscle health, specifically the percentage of fat within the muscle (intermuscular adipose tissue), is a more critical driver of metabolic health issues like insulin resistance and PCOS than overall body fat percentage. 
  • Physical activity alone improves muscle health and reduces intermuscular adipose tissue, even if body fat percentage does not change. 
  • Essential amino acids, creatine (3-5g for muscle, 10-12g for brain), omega-3 fatty acids, Urolithin A (Mitopure), and beta hydroxybutyrate (ketones) are recommended supplements for optimizing muscle and overall health. 

Segments

Dr. Lyon’s Role in Dietary Guidelines
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(00:00:24)
  • Key Takeaway: Dr. Gabrielle Lyon helped position her mentor, Dr. Donald Lehman, to write the protein section of the new dietary guidelines, shifting focus from the previous carb-heavy pyramid.
  • Summary: Dr. Lyon was instrumental in influencing the updated dietary guidelines by advocating for expert representation on the committee. The previous food pyramid was inverted, emphasizing grains and carbs over protein. Her efforts ensured that world-class scientists informed the new protein recommendations.
Identifying Protein Deficiency Signs
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(00:03:53)
  • Key Takeaway: Physical signs of inadequate protein intake can include brittle hair, dull skin, potential Vitamin B deficiencies around the mouth, and eventually, sarcopenia.
  • Summary: While not definitive science, visual cues like brittle hair and dry skin can suggest low protein. Deficiencies may manifest around the mouth (periorbital dermatitis) and lead to a decrease in muscle mass over time. Protein is essential for recovery and repair.
Minimum Daily Protein Intake for Women
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(00:04:23)
  • Key Takeaway: Women should consume no less than 100 grams of protein daily to avoid risks associated with aging suboptimally and poor recovery.
  • Summary: The bare minimum protein requirement for women is 100 grams per day; falling below this increases health risks. This can be achieved easily by targeting 30-50 grams in the first and last meals of the day. For example, a first meal could be a 50-gram shake plus two eggs (12g).
Protein Timing and Plate Composition
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(00:06:21)
  • Key Takeaway: The total protein intake over a 24-hour period is more critical than the exact timing relative to training, and a balanced plate should be one-third protein.
  • Summary: The science supports focusing on total daily protein intake rather than strict pre- or post-workout timing. A simple visual guide for meals is allocating one-third of the plate to high-quality protein, one-third to fruits/vegetables, and one-third to starchy carbs if training. Adequate protein intake naturally promotes satiety, aligning with the protein leverage hypothesis.
Muscle as a Health Organ System
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(00:09:45)
  • Key Takeaway: Skeletal muscle must be viewed as a critical organ system, not just for aesthetics, but as the focal component for health and aging well, shifting focus from what to lose (fat) to what to gain (muscle).
  • Summary: The conversation around health has historically focused on obesity rather than skeletal muscle as an organ system. Prioritizing muscle gain proactively solves many health problems. Furthermore, 30 grams of dietary protein naturally stimulates gut peptide hormones, including GLP-1.
Nutrient Density of Organ Meats
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(00:10:49)
  • Key Takeaway: Organ meats are incredibly nutrient-dense, acting as an ‘ultimate multivitamin’ due to high levels of fat-soluble vitamins and iron, which is why they were historically sought after.
  • Summary: Organ meats are highly recommended for their nutrient profile, especially liver, which is beneficial for low iron in women (recommended once per week). In the U.S., consumption is low compared to historical or other global cultures that valued these parts for nutrition.
GLP-1s and Sarcopenia Epidemic
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(00:13:26)
  • Key Takeaway: The increased use of GLP-1s is causing a swap from the obesity epidemic to an epidemic of sarcopenia, as patients lose muscle mass rapidly, which they regain as fat upon stopping the medication.
  • Summary: A common denominator in new patients is poor body composition, often linked to GLP-1 use without muscle protection. GLP-1s can accelerate muscle loss, leading to sarcopenia, which increases frailty and risk of injury in older adults. Strategic use of GLP-1s requires concurrent training and protein intake.
Muscle Quality and IMAT
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(00:18:52)
  • Key Takeaway: Muscle quality, specifically low Intermuscular Adipose Tissue (IMAT), is a key driver of metabolic disease, and GLP-1s may improve this quality when combined with resistance training.
  • Summary: Rapid weight loss from GLP-1s without muscle protection can lead to accelerated aging and increased risk of fractures. Muscle quality is defined by reducing IMAT—the fat within the muscle tissue—making the muscle resemble a lean fillet rather than marbled Wagyu. This quality, not just quantity, impacts insulin resistance and cardiovascular health.
Friction, Resilience, and Default State
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(00:31:17)
  • Key Takeaway: Comfort is detrimental to health and capacity; success requires intentionally cultivating friction (hard things) to build resilience, which then becomes the new default state.
  • Summary: People must actively seek friction—like cold plunges, difficult conversations, or training in adverse conditions—to build capacity and toughness. Successful individuals adopt the behaviors of their desired future state as their daily default, rather than sprinting toward a goal and reverting to old habits.
Muscle Mass and Erectile Function
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(00:44:14)
  • Key Takeaway: Research links healthy muscle mass and strength directly to better erectile function, supporting the concept of ‘sex span’ and establishing muscle as a key health metric beyond just body fat percentage.
  • Summary: A significant percentage of men experience erectile dysfunction by age 50, which is connected to low muscle quality. Published research connects skeletal muscle mass to improved erections, emphasizing that muscle is a voluntary organ system that impacts overall health outcomes. Good muscle composition also correlates with tighter skin and better blood flow.
Muscle Quality Assessment Gap
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(00:55:50)
  • Key Takeaway: Muscle quality assessment requires advanced imaging beyond standard DEXA scans.
  • Summary: MRI and CT scans are generally not recommended for routine muscle assessment, though ultrasound can be used. A major gap exists in assessing muscle quality, not just quantity. Future methods will likely incorporate MRI to better evaluate intermuscular adipose tissue.
Fat Percentage Misconception
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(00:56:05)
  • Key Takeaway: Infertility risk is linked to intramuscular fat, not just overall body fat percentage.
  • Summary: The scientific focus has long been on body fat percentage as the primary health determinant. Dr. Melanie Cree indicated that for conditions like PCOS, the critical factor is the percentage of fat within the muscle tissue. Improving muscle health through activity can reduce this intermuscular adipose tissue, potentially mitigating insulin resistance and metabolic issues.
Essential Supplement Stack
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(00:58:17)
  • Key Takeaway: Essential amino acids are crucial for meeting protein goals, especially with lower calorie intake or GLP-1 use.
  • Summary: Essential amino acids are recommended to supplement lower-calorie meals to ensure adequate protein synthesis. Recommended supplements include creatine (3-5g minimum, higher for poor sleep), omega-3 fatty acids, and Urolithin A (Mitopure at 1000mg daily). Beta hydroxybutyrate (ketones) is also highlighted for brain function.
Forever Strong Playbook Content
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(01:03:14)
  • Key Takeaway: The Forever Strong Playbook is a tactical manual covering nutrition, movement, and recovery.
  • Summary: Dr. Gabrielle Lyon’s new book functions as a tactical field manual containing workouts, recipes (like the berry crumble and egg in a hole), and recovery tools. It is structured around key areas: how to think, eat, move, and recover, incorporating insights on implementing new dietary guidelines.
Relatable Relationship Anecdotes
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(01:04:08)
  • Key Takeaway: Even highly trained individuals struggle with basic organizational tasks like locating misplaced items.
  • Summary: The conversation humorously shifted to anecdotes about Dr. Lyon’s husband, a former Navy SEAL and surgical resident, being unable to find his socks or misplaced pants. This highlights a common dynamic where logistical organization often fails despite high-level competence.