From the desk of Dr. Jonathan Sullivan:
For 25 years I practiced emergency medicine in one of the busiest, hairiest Level 1 trauma centers in the United States. It was my calling and my privilege, and I wouldn’t trade those 25 years for anything.
But for virtually all of that time, I had to grapple with the horrible conviction that, for many of our patients, I was making beds in a burning house. I would find myself confronted by a very overweight, deconditioned 52 year-old, going on 70, with battered joints, atrophic muscles, no physiologic reserve, an inability to get off the gurney without groaning and wheezing, and a grim future. Often I would find no medical emergency, just what some of us call “diatensionolesity”—type II diabetes, hypertension, a screwed-up blood-lipid profile, and obesity. I knew I could probably address today’s symptoms or instability, but that my impact on their underlying condition and long-term prognosis would be close to zero.
By 2011, I had stumbled on a new form of medicine, and when I walked up to that same patient’s bedside, I would tell myself: if I could get you under a barbell, I could change your life.
I explored this perspective in an article entitled Barbell Training is Big Medicine, and the ideas laid out there have continued to develop and expand. In The Barbell Prescription, which I wrote with the Starting Strength Coach and Master Programmer Andy Baker, I explored this Big Medicine in detail. Let me tell you about it.
In the 21st century, we have the best opportunities for healthy aging in the history of the human species. And yet, this age of peace, plenty and leisure, with our fantastic medical technology, has seen an increase in a horrific form of unhealthy aging that I call the Sick Aging Phenotype. It includes diabetes, obesity, cardiovascular disease, frailty, and loss of independence.
This is a horrible way to get old. It robs us of opportunity, vitality, joy, dignity and hope—and it’s usually entirely preventable. That’s because, while the Sick Aging Phenotype can be promoted by genetics and environment, it is primarily a product of our lifestyle choices.
Sick aging is a tough nut once it gets underway, and to treat it, we need the most powerful medicine in the world—physical exercise. And we need the most powerful form of exercise medicine. As we show in The Barbell Prescription, that medicine is barbell training for strength.
Why? Because barbells check all the boxes.
Barbell training is incredibly safe—just normal human movement patterns on a stable surface, without weird positions or unpredictable forces, loaded ergonomically.
Barbells are exquisitely dose-able, more so than with any other form of exercise medicine, with precision loading and carefully prescribed sets, reps and frequencies.
Barbell training is comprehensive, hitting every fitness attribute: strength, power, mobility, endurance, balance, and body composition.
Barbell training is a specific medicine, beautifully targeted to the Sick Aging Phenotype. It fights diabetes, obesity, muscle loss, and bone loss, and increases our functional independence and resistance to illness and injury.
Finally, barbell training is simple and efficient. Just four simple exercises, two or three sessions a week, a three or four hour weekly commitment.
The barbell won’t reverse the arrow of time, but it WILL blunt it. Time always wins in the end. But there’s a mountain of scientific evidence that we can change the TRAJECTORY of decline. We can recover FUNCTIONAL years that would otherwise have been lost. This is what’s called the “compression of morbidity,” a shortening of the dysfunctional phase of the death process. Instead of slowly getting weaker and sicker over miserable years or even decades, we can squeeze our dying into a tiny sliver of our life cycle. Instead of slowly dwindling into a puddle of sick fat, our death can be like a failed last rep at the end of a final set of heavy squats. We CAN remain strong and vital well into our last years, before succumbing rapidly to whatever kills us. Strong to the end.
But it’s not like other medicines—it’s not just a pill you can pop or a procedure you can undergo. This medicine is on you. It’s hard work, and it requires time, effort, discipline, and a long-term commitment. But if you can bring those virtues to the platform, they will repay you a thousand-fold in renewed strength, vigor, health, confidence, and an entirely different perspective on what growing old can be.
So yes: If we can get you under the bar, we can change your life. The barbell can transform you from merely another aging adult into an Athlete of Aging—a Master’s Athlete.
That, my friends, is Big Medicine.
