Why is muscle so important for women over 40?

Start with metabolism. On Ep. 386, Nikkiey says muscle is metabolically active and burns calories at rest, while sleeping, sitting at your desk or watching TV. Fat tissue just sits there. More muscle means a higher resting metabolic rate, so fat loss gets easier and so does keeping it off. A woman with more muscle can eat more food. Her blunt version: you don't have a fat loss problem, you have a muscle problem. On Ep. 301 she adds that muscle shapes how efficiently you burn fat, how you balance blood sugar and even how regulated your hormones are. If dieting harder hasn't worked, the missing piece may be the muscle, not your effort.

Then there's longevity. On Ep. 52, Nikkiey says building muscle helps you withstand a fall and lowers the risk of chronic diseases that may run in your family. On Ep. 46 she draws on her years in long-term care and the emergency room, where she saw people over 65 break a hip and often never walk again. Her takeaway: we're not over fat, we're under muscled.

That same episode looks at GLP-1 medications. Nikkiey's view is that when appetite drops and a woman eats very little, muscle can become the first casualty, so protecting it is part of the conversation. If you're considering one of these drugs, work through that with your doctor.