The Prescription Strength Podcast

"I spent twenty-five years trying to be skinnier and then accidentally got jacked, and I'm happier." That's roughly what Niki Sims, a strength coach at Barbell Logic, posted, and I loved it.In this episode, I'm joined by Niki to ask whether you can change your body without trying to make it smaller. There are still plenty of old gremlins knocking around for women about shrinking our bodies, and she has years of coaching experience to draw on.Niki tells me what made her sit down and write that post: being exhausted by stressing over the scale, and seeing old photos of herself and realising she was skinnier than she thought she was at the time. We talk about why you can't work on your muscle and spot-treat fat, why you need to fuel your training if you want to perform, and what Niki says to a new client who wants to be strong but "could still do with losing ten, fifteen, twenty pounds". Her answer starts with why, and then an honest look at what losing those pounds would take.We also get into the gremlins that never quite go, and the jeans that bring them back. Then there are the people around you, including cake at work and comments that say more about the person making them. We cover the pull of super lean bodies, where weight loss injections fit in, and how we encourage women to get strong without creating another ideal to live up to. Niki also answers a fear I think still exists among women: that if they start lifting heavy weights, they'll end up looking massive.We finish on what strength gives you outside the gym. For Niki, that means saying yes more often, and making a little change to see what happens.In this episode:Why Niki wrote the postSeeing old photos and realising you were skinnier than you thoughtYou can't spot-treat fat: the body as a whole systemStrength and still wanting to lose ten poundsWhat losing ten pounds would takeThere is never an end, and learning to love the boring partGremlins and the jeans that weren't made for youEating differently, not always eating lessCake at work and comments that are about the other personSuper lean ideals, weight loss injections and asking how you want to feelWill lifting make you look massive?What strength gives you outside the gymAs Niki puts it: "I'm proud of the body that I built."Find Niki on Instagram at @niki.in.the.gym, and on her podcast, Beast Over Burden.If you enjoyed this, listen back to my conversation with Tat Armstrong Gray, a personal trainer in East London who found that being smaller felt frail rather than strong: "A Broken Back, Fat Loss and Feeling Fragile. Tat Armstrong Gray": https://pod.link/1762298788/episode/ZWRmY2I4N2MtMTI1OS00NWU2LWFlYmQtOWVhYTIwNWI2NDJh

In this episode, I'm joined by Matt Hussey, a therapist and former journalist behind Griftonomics, who makes videos taking apart the claims of wellness influencers.Matt trained as a therapist after years as a journalist, and now has a private practice. He started making videos to find a better way of talking about mental health and the internet, and the one that really took off was a two minute piece on Mel Robbins. Around the same time he noticed influencers creeping into his clients' sessions, which led him into the world of wellness grifting.We talk about what makes someone a grifter, from exploiting anxiety, uncertainty and mistrust for financial gain, to why borrowed authority works so well and why the biggest podcasts so rarely challenge their guests. We look at Mel Robbins, Steven Bartlett and Mindy Pelz, the questions raised about Jay Shetty's monk story, and whether any of them know they are doing it. Matt's view is that many have bought into their own story so completely that it is the truth for them.We also get into what sits underneath it all: the terms and conditions that mean no refunds and no recourse, Trustpilot reviews being pushed around, and the companies that make the product and then go looking for someone with an audience to put their name on it. I share a sad story from my work as a medical examiner, and we talk about why harm that arrives years later almost never traces back to the person who sold the idea. Matt closes by naming the four things the playbook sells you.In this episode:What actually makes someone a grifterFrom journalism to therapy, and a video about Mel RobbinsBorrowed authority, and experts on everythingWhy big podcasts rarely challenge their guestsSteven Bartlett, Mindy Pelz and the story you tell about yourselfThe questions over Jay Shetty's monk storyDo grifters know they are doing it?Terms and conditions, Trustpilot and what happens in a crisisThe companies that make the product and find the faceSunscreen, uranium water and harm that never comes back to the sellerFrom trusting institutions to trusting your gutThe four things the playbook sellsAs Matt puts it: a customer that gets what they need and leaves is a bad customer.Find out more about Matt's work, including Griftonomics: https://linktr.ee/matthusseyIf you enjoyed this, listen back to my conversation with Deb Cohen, former BMJ investigative journalist and co-author of Bad Influence: "Bad Influence: How the Internet Hijacked Our Health": https://pod.link/1762298788/episode/Y2MxYjg1OWItYmQ3Yy00MDYzLTliZjYtMWRkNTNhMWQ0ZjE0

In this episode, I'm joined by Tat Armstrong Gray, a personal trainer based in East London, who is here to share her story of recovering from a serious spinal injury through lifting weights.At about 19, Tat broke two vertebrae in a skiing accident and had a spinal fusion, with a bone graft from her hip to rebuild the one that was shattered. She has also lived with type 1 diabetes since the age of 14. Over the years that followed, the pain got steadily worse and the weight kept going on, until she could barely walk. At 31 she decided to change that, and went on to lose 30 kilos, and the back pain went away. Then something surprised her: being smaller felt frail rather than strong, and that is what led her to the weights.We talk about approaching strength training with a fragile back: finding a trainer who will listen, starting with no weight at all, and learning to tell the pain of getting stronger from the pain that is a warning. She explains why a scaled-down burpee is a good way to measure progress, why technique is everything with a deadlift, and why the advice from a consultant was to be as strong as possible while being as light as possible.We also talk about what lifting gave back beyond strength: a sense of autonomy over a body with conditions that can't be controlled, an outlet for rage, and needing about half the insulin. And we get into the barriers that stop people starting, from personal training qualifications that barely cover medical conditions, to exercise referral schemes that turn people away for the very things exercise would help, to why she thinks the health at any size message can hold people back.In this episode:A skiing accident, two broken vertebrae and a spinal fusionLiving with type 1 diabetes and chronic painLosing 30 kilos, and feeling frail rather than strongBeing as strong as you can while being as light as you canStarting strength training with a fragile backGood pain, bad pain, and a traffic light systemWhy burpees make a good measure of fitnessAutonomy, rage and the mental side of liftingWhy so few people are ever pointed towards the gymThe risks and costs of doing nothingHealth at any size, and why it worries herLeading by example, for friends and for childrenAs Tat puts it: fitness people want you in the gym.If you enjoyed this, listen back to my conversation with Mick Wadge, who started lifting at 85, and his coach Ross Starkie: "He Started Strength Training at 85. This Is What Happened": https://pod.link/1762298788/episode/NGQ2NmZmNzQtMjI2NS00YzI0LWE2MTktNTRkZmI5ZTAyMTE4

In this episode, I'm joined by Dr Fraser Gordon, consultant physician in the NHS and founder of Xvera Medical, a consultant-led online clinic offering testosterone replacement, perimenopause and menopause care, and weight management.Fraser started out in pharmacology and research into adverse drug reactions before moving into medicine, and has spent twenty years working at the acute end of the NHS. What finally pushed him into private practice was watching medicine become more commercial: people confidently presenting opinions as established facts, and forgetting the basic scientific and statistical principles that need to sit behind them.We talk about why simple explanations are so easy to believe, from rhyming sayings to adrenal fatigue, a claim he found convincing at first and says has no real scientific basis. We talk about finding a patient to fit a treatment rather than a treatment to fit the patient, and why a test needs a question before it is done, explained with a police officer, New Year's Eve and a woman in a pink unicorn hat.We also get into the commercial pressure that comes with owning a private clinic. When his marketing team asked for a target conversion rate of 95%, his answer was that converting nearly everyone would mean the clinic was not doing the right job. Not prescribing, he argues, isn't a failure. We talk about a young stroke patient who would not take a statin but was using anabolic steroids and recreational drugs, and what that says about risk perception and marginal gains. And we talk about menopause care, why he was adamant the clinic had to offer it, and the gaps in what doctors are taught.In this episode:From pharmacology to medicine, and why the clinic existsA finite NHS and an almost infinite demandAdrenal fatigue, and why simple explanations are so believableFinding a patient for a treatment, and pretest probabilityHome testing kits and scans without a clinical questionGLP-1s, and what happens when the treatment stopsConversion rates, and why a no can be good careTreating the person, not just the diseaseA young stroke, statins and risk perceptionMenopause care, HRT and the gaps in medical trainingChecking that the person you see is registered and regulatedThe one thing you would fix with a magic wandAs Fraser puts it: it's better medicine, done properly.Find out more about Xvera Medical: https://xveramedical.comIf you enjoyed this, listen back to my conversation with Roxanne Stevenson Brown, founder of Find Care Compare, about finding your way between NHS and private care: "Who Should I See? Navigating NHS and Private Healthcare": https://pod.link/1762298788/episode/OTM4MjdlYjItMTQyYy00ZjhhLWI3N2YtZDU4NTIzNmY3OGIy

In this episode, I'm joined by Sir Muir Gray, public health doctor and one of the people behind the NHS programme Live Longer Better.Anti-ageing is booming, and with it the idea that if you optimise yourself enough, you can add years to your life. Muir's take is that ageing itself, the normal biological process, is not the cause of major problems until our late nineties. What causes most of the problems we put down to age is three other things: loss of fitness, disease, and the world we live in.We talk about why your genes matter much less than was once thought, and why what he calls your exposome, everything you have been exposed to since birth, matters far more. Muir explains why he never uses the word lifestyle, why he wants chairs recognised as an occupational hazard, and why he stands up from his chair 82 times a day.We also talk about the risk of caring too much. Thirty years ago Muir wrote an article in The Lancet asking whether we care too much for our elders, and he would still like to change the word carer to enabler. And he sets out what actually matters if you are 50 or 60 and want to make a difference to the years ahead: a Mediterranean diet, thirty minutes a day of brisk walking, ten minutes for strength, suppleness and skill, and keeping your brain and your social life busy.In this episode:Why ageing itself is not the problem until your late ninetiesGenes, the exposome, and what your parents died ofLoss of fitness, and the five S'sWhy the NHS is a national disease serviceClubs, communities, and moving a little money out of the NHSDo we care too much for our elders?Retirement as a renaissance, and retirement regretWhat matters at 50 or 60: diet, activity and staying engagedCreative health, and staying connected when you can't get outWhat a clinician can do in nine secondsAs Muir puts it: it's never too late.Find out more about Live Longer Better: https://www.livelongerbetter.ukIf you enjoyed this, listen back to my conversation with Christine Hobson, who ran her first marathon in her 60s: "At 50 She Was Struggling. At 73, She's Fitter Than Ever": https://pod.link/1762298788/episode/ZTkyNGE1YTYtZDM3ZC00NzY5LWI0ZTMtNWU3NDlmZDU4ZmRk

In this episode, I'm joined by Mick Wadge, the 88-year-old weightlifting grandad who has taken TikTok by storm, and his coach, Ross Starkie.Mick spent years caring for his wife Margaret, who had rheumatoid arthritis and osteoporosis. When she died, he found himself at a loss, and carrying far more weight than he wanted to. So he took an old broom handle, hung two milk bottles full of water on it, and started training on his patio.When he turned 85, his grandson booked him four sessions with Ross, a strength and conditioning coach who works with professional athletes. Three years on, Mick has deadlifted 100kg, come off his metformin, had a letter from Arnold Schwarzenegger and lifted on national television.We talk about why so many people, health and fitness professionals included, are frightened of older people lifting weights, and why Ross thinks doing nothing is the bigger risk. Ross explains how he coached Mick up from an empty bar with nothing more complicated than adding a little weight over time, and why the things Mick already did every day were a squat, a hinge and a deadlift by another name.We also talk about getting up off the floor, a skill that can matter far more than any personal best, and the technique Ross taught Mick that local firefighters have since asked to share.In this episode:Caring for a partner, and putting your own health lastStarting with a broom handle and two milk bottlesWhy a council gym can be a great place to startWhat structured coaching adds as you get olderWhy coaches are nervous of training older clientsAngina, prediabetes, and why Ross says keep the coffee and cakeGetting up off the floor, and why it mattersArnold Schwarzenegger, This Morning, and saying no to Britain's Got TalentWhat to look for in a gym and a coachWhy it is never too late to startAs Ross puts it: it's scarier not to do anything at all.Follow Mick on TikTok: @old.man.mick2If you enjoyed this, listen back to my conversation with Christine Hobson, who ran her first marathon in her 60s: "At 50 She Was Struggling. At 73, She's Fitter Than Ever": https://pod.link/1762298788/episode/ZTkyNGE1YTYtZDM3ZC00NzY5LWI0ZTMtNWU3NDlmZDU4ZmRk

Women’s health is about far more than hormones and HRT. In this episode, I’m joined by scientist and researcher Dr Gayathri Delanerolle, whose experience of endometriosis, pregnancy loss and medically induced menopause helped shape the questions she now asks in her research.Gayathri shares what it was like to live with severe symptoms for years, why finally seeing the extent of her endometriosis brought both relief and difficult questions about fertility, and how those experiences led her to develop the Marie Project.We talk about gaps in women’s health research, the experiences that conventional menopause discussions can miss, and what Gayathri is learning by listening to women across different countries and cultures. It’s a conversation about asking better questions—and making room for the answers women actually give.

In this episode, I’m joined by Dr Andy Ward, a GP working with people experiencing homelessness in Leicester, and Kyra Biddle from Dear Albert’s Stairway Project, who brings her own lived experience of homelessness, addiction and recovery.Kyra shares what happened when her family lost their home when she was just 14, how alcohol became a way of coping, and what it really means to live in survival mode.We talk about the barriers people experiencing homelessness can face when trying to access healthcare, why appointments, medication and even apparently simple health advice can become almost impossible to navigate when you don’t have somewhere safe to live, and how stigma can destroy trust.Andy explains how working in homeless healthcare changed the way he practises medicine, and why behaviour that can look “difficult” makes much more sense when you understand what someone may be living through.But this is also a conversation about recovery. Kyra is now more than four years into her own recovery and uses her experience to support others. We talk about what helped her, why being listened to and treated as a human being matters, and how sometimes the beginning of recovery can be as simple as a cup of tea, a Hobnob and somewhere you feel welcome.A conversation about homelessness, addiction, healthcare, recovery — and the importance of seeing the person in front of you.You can contact Dear Albert here: https://www.dearalbert.co.ukSee the fantastic work of Inclusion Healthcare here: https://www.inclusionhealthcare.co.uk

We all know exercise is good for our heart — but most people still think that means cardio.In this episode, I’m joined by Emily McGrath, Senior Cardiac Nurse at the British Heart Foundation, to talk about why strength training deserves a place in the conversation about cardiovascular health.Emily shares some of the most common worries she hears from people after a heart diagnosis, from palpitations and medication to the fear of exercising again. We talk about why a heart problem can completely change the way you see your body — and why people can end up treating themselves as far more fragile than they really are.We also talk about the evidence for strength training and heart health, including its effects on blood pressure, and why getting stronger can make everyday life easier as we age.Emily shares her own experience of starting strength training, despite initially feeling intimidated by it, and we discuss how to begin without needing to become a gym person, lift enormous weights or completely overhaul your life.Finally, we talk about the British Heart Foundation’s Strong Woman Challenge, a free 31-day challenge designed to help women try strength training at home and build confidence with it.Because cardio is excellent for your heart. But it doesn’t have to do all the work.In this episode:Why people can feel frightened of exercise after a cardiac diagnosisPalpitations, smart watches and health anxietyWhy strength training is still overlooked in heart healthThe effect resistance training can have on blood pressureStarting strength training when you feel intimidated or unsureWhy our bodies are often less fragile than we imagineStrength, function and maintaining independence as we ageCutting through the noise about strength training in midlifeThe BHF Strong Woman ChallengeJoin the October challenge here  www.bhf.org.uk/strongwoman

Feeling tired all the time is one of the most common reasons people see their GP. But before assuming it must be your thyroid, hormones, cortisol or a vitamin deficiency, what else could your energy be telling you?In this episode, I talk through the energy audit I’d encourage you to do: when did your energy change, when does your battery drain, and where are the best hours of your day actually going?We look at sleep, work and caring responsibilities, food, alcohol and exercise; what your GP may reasonably investigate; and why blood tests are only one part of the picture.Most importantly, I explain how to experiment with one thing at a time, look for patterns and collect useful information about yourself.You don’t need to diagnose yourself. Become a detective before you become a diagnostician.