A healthy 50 year old can gain muscle but, no offense, that isn't you. Your 1st, 2nd and 3rd priority has to be losing fat and getting in better shape metabolically. At this point you are insulin resistant enough to be requiring insulin, which means your metabolic health is terrible. And because of that, it would not be at all surprising for your body to not be able to build muscle.

You need to focus on fat loss and metabolic health. That means your focus has to be calorie control (for fat loss) and exercise (for metabolic health). Eat 500-600 calories under your estimated maintenance calories, eat a good amount of protein (at least 150g a day, it will significantly help with weight loss and muscle retention), set a goal to get to at least 150 minutes a week of low to mid intensity cardio (zone 1 and 2) which would include walking at different paces, bike riding, etc. I don't think running at this point would give you much if any benefit over walking. With this, you should see about 2 pounds of weight loss a week and you will be at your goal in about 8 months.

Consider asking your doctor about Mounjaro or Ozempic for your diabetes to help you lose weight and get off insulin. Also monitor your uric acid levels and make sure those are under control with meds so you can eat enough protein. After you lose weight, your gout will likely improve

To retain strength and muscle mass during this, lift twice a week or maybe even just once. I would recommend 1 compound leg movement, 1 pulling movement, and 1 pushing movement each workout with a weight that challenges you to get 6-10 reps for 2-3 sets. That's enough to maintain or even build strength without a lot of time or fatigue, which will allow you to focus mainly on the cardio.

Once you get healthy, then you can focus on building muscle and will be much more successful doing so.

This post was edited on 5/29/23 at 7:38 pm