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I'll never forget the second day I took a zenic I woke up oh I feel something really weird what is it I'd woken up and I wasn't hungry I don't remember that ever happening before one of the West's most prolific authors and he has a brand
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new book magic pill award-winning journalist Johan har 47% of Americans want to take these drugs they are going to change all our lives for better and for worse and this is something I think people are not being warned [Music]
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about hey everyone I've got some huge news to share with you in the last 90 days 79.4% of our audience came from viewers and listeners that are not subscribed to this channel there's research that shows that if you want to create a habit make
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the world subscribe right now the number one Health and Wellness podcast Jett Jett the one the only J hey everyone welcome back to onp purpose the place you come to become a happier healthier and more healed you know that my goal here is to sit down
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with Incredible thinkers thought leaders people who are crafting the way our mind works and defining culture to have conversations that truly truly matter today I get to interview one of my favorite authors I've been wanting him
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to be on the show for such a long time and I can't believe he's finally finally here and this new book is one of the ones that I really hope that you take the time to read Because I promise you you your friend a family member is
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having to deal with the challenges that come with this theme and concept in their daily weekly and monthly life today's guest is none other than Yan Hari his new book is called the magic pill the extraordinary benefits and
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disturbing risks of the new weight loss drugs and I can't wait to dive into it with him if you don't have a copy of the book already make sure you go and grab one we'll put the link in the comments and caption below please welcome to on
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purpose Johan hurry Johan thank you for being here oh I'm ridiculously happy to be here thank you so much honestly I mean it I was saying this to you offline but I I'd like to repeat it for my audience you're one of the most gripping
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and captivating authors that I've read in a long time in the non-fiction space I enjoy your work so deeply I feel completely enthralled when I'm reading your work I love the way you tell stories and you effortlessly with so
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much grace and kindness bring people into a universe that they can understand very complex things and make sense of how to apply them in their life which is so hard hard to do so thank you so much for all the work that you do and the
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experiments you do on yourself oh cheers thanks J yeah and and the fact that we're from very similar places World we're basically neighbors neighbors yeah exactly we might go a little bit too British in this podast going to try and
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remember we are talking to mostly American audience I was saying to I once I was once in a diner in fact in an IHOP in a place called Cactus Arizona and I was trying to order pancakes I kept saying can I have some pancakes please
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and she kept going what what and after a while she said to me do you speak English I was like my people invented it what do you mean right so I'm very conscious that you know we sound like weird refugees from Downtown Abbey I'm
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going to try and americanize slightly well it's funny because every time I'm in when I'm in I live in the United States but everyone in the United St always tells me that they find the British accent quite authoritative and
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they see it as a sign of education and knowledge and for me when I hear a TED Talk in the American accent from a professor or or a researcher that's when I find that it's authoritative do you feel that way or what's your dat oh
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that's so interesting I think because I spend I live here half the year I I think I'm kind of torn between our the value of our accents but I'm conscious that we get given like we we basically go in with the Assumption of 10 added IQ
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points in any situation right so yeah and I'm like if you knew me I'm not from a posh part of England like I'm not anyway we sound like hilariously part like I was rally raised by my grandmother whose job was to clean toilets but we sound basically like the queen which we're not but uh Yan so I want to dive straight into this and I want to start off by saying what are some of the biggest misconceptions you've heard about OIC almost things
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that people may even be thinking as they're tuning into this or watching this right now what are some of the things people already think they know but you actually believe a m conceptions I think the biggest misconception is that we should either
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be yay these drugs are amazing or boo these drugs evil the biggest misconception is that we can be certain or confident about these drugs at the moment I never forget from the moment I learned about these drugs existence I felt so
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conflicted it's why I wrote the book right I remember the moment so vividly it was the winter of 2022 and it was that moment when the world was opening up again and I got invited to a party for the first time in God knows how long
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and I decided to go and I was in an Uber on the way there and the party was thrown by an Oscar winning actor I think someone you know actually and I'm not saying that just a name drop it's relevant to what happened next and um on
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the way there I was feeling kind of gained quite a lot of weight during lockdown was feeling kind of schlubby I was quite fat at the start of lockdown I was fatter then and I and I was thinking oh this is going to be awkward and then I suddenly realized that kind of everyone I knew had gained some weight during lockdown and I thought oh this is going to be fascinating to see all these Hollywood stars with a bit of chub on them right
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and I arrived and I started walking around and it wasn't just that no one had gained weight everyone was gone right everyone looked like their own Snapchat filter right they were like clearer and cleaner and sharper and I
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was kind of wandering around a bit of a days and I bumped into a friend of mine on the dance floor and I said to her whoa looks like everyone really did take up Pates during lockdown and she laughed like you just didn't I must have looked puzzled and
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she said well you know it's not Pilates right and I had had no idea what she was talking about and she pulled up on her phone and her zic pen and that was when I learned I guess in the next couple of days that we now have a new form of
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weight loss drug that works in a completely new way that causes the average person who uses it to lose 15% of their body weight in fact with mojarro the next in this class of drugs you lose 21% of your body weight and for
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the next which will be available next year Triple G you lose 24% of your body weight on average and I remember as soon as I heard that just feeling this tremendous division in my mind between on the one hand I could obviously see the benefits
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I'm older now than my grandfather ever got to be he died when he was 44 of a heart attack loads of the men in my family get heart problems my dad had terrible heart problems my uncle died of a heart attack my other uncle had a
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heart attack but survived it and I knew that sadly the EV scientific evidence is very clear that obesity makes it much more likely you'll have heart problems along with many other medical problems so I thought okay if there's a drug that can reverse or really reduce obes that could have really big health benefits but I also thought wait a minute wait a minute I've seen this story before right every 20 years or so a new Miracle weight loss drug is
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announced we're told it's going to save us all uh loads people take it they always Discover it has some horrendous side effect that you know means it has to be pulled from the market leaving a wave of terribly damaged people in its W
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so I thought are we going to see that again I also thought what about the progress we've made with body posit it what about the you what about people with eating disorders there was just so many doubts that came into my mind so to
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really get to the bottom of this I ended up going on this big Journey all over the world from Iceland to Minneapolis to okanawa in the south of Japan to interview the leading experts in the world on it the biggest Defenders of the
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drugs the people who made the breakthroughs that made them possible the biggest critics of the drugs and I learned a huge amount about the extraordinary benefits of these drugs the disturbing risks of these drugs there's 12 quite disturbing risks how
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it's going to transform the culture in all sorts of ways that even people who don't want to take these drugs it's going to change the world around you in really fascinating ways but at the end of all that it's a slightly weird
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feeling I still feel quite conflicted about it so I guess my the misconception is that we should be so sure right this is complicated and we have to think through the complexity so and this idea that we have of or this misconception
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that you just mentioned that we have of this idea of that it's all good or all bad I wondered through your research kind of how you felt about that type of thinking I feel like as humans we have this very binary thinking about anything
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and everything right that's a good person they're a mean person they're a healthy person they're an unhealthy person when it comes to drugs oh this one's perfect this one's going to ruin your life what did you discover about
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people's binary types of thinking through the research of this drug I guess because there's if you think about this this drug and the book is called Magic Pilker there's three ways we could think about this is Magic and the first
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two are the kind of binary ways right the first way is these drugs could be magic in the sense that they could just solve the problem of obesity and I've got to tell you there are days it feels like that my whole life I've hugely
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overeaten because I was screwed up by the food industry and various other things and now you know to do the book I've been taking OIC for a year there's been lots of ups and downs but you know now that problem has largely gone away
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I've lost an enormous amount of weight 42s also I've lost these a lot of these destructive habits so you know it could be magic in the sense of just like whoa the problem's solved the second way it could be magic and I think this is a real
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possibility is it could be like a magic trick it could be like you know The Conjurer who shows you a card trick while secretly picking your pocket it could be that in addition to giving you these benefits the risks and there are
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really significant risks here are so substantial that they undo the good a don't rule that out in fact I think it's a significant possibility but the Third Way is actually the the most likely and I think it's the one that gets us out of that
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kind of binary thinking and it's the think about the stories of magic that we grew up with as kids right think about I don't know Aladdin right you find the lamp you rub it the genie appears and he grants your wishes and your wish comes
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true but never quite in the way you expected right you get what you wanted but always at some weird right angle that you never anticipated and we're already seeing that with these drugs you got to get out the binary good or bad to
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think about that but you know Barkley's Bank uh commissioned a really interesting sober-minded financial analyst called Emily field to just look at these drugs to figure out okay what's this going to mean for our investment
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decisions going forward what should we investing in what should we not investing in and she came back and said if you if you want a comparison for the effect of these drugs you've got to look at the invention of the smartphone right
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so if you and me had been speaking in whatever it was 2007 when Steve Jobs unveiled the iPhone we would not have been able to game out you know door Dash and Tick Tock and all these things that have transformed our lives that flowed
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from that I think we're already beginning to see outside that kind of narrow binary such an array of things that are happening as a result of these 47% of Americans want to take these drugs they are going to change all our lives for
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better and for worse in a way that I think we need to take a moment as this extraordinary transformation happens all around us to really think through the benefits the risk and what it's going to mean for all of us and what we should do about it now
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yeah let's talk about how we got here you mentioned there that the food industry is screwed us up screwed you up you mentioned just there let's talk about how we got here how we even needed to turn towards these drugs starting
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with some of the issues that you think the food industry has caused and how we've been trained to almost eat more eat worse eat unhealthier for ourselves for a long time uh I thought when I was researching the book that I was looking
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at two separate topics CU I thought at first so I was looking at why did obesity explode in our lifetimes massively explode and how do the drugs work but actually I discovered these are not separate topics the same thing
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explains both it's core so I would just urge everyone watching listening to just stop for a moment and Google photographs of beaches in the United States or Britain in the year I was born 1979 just take a look at them right if you look at
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them they seem really weird to us because almost everyone is what we would call skinny or jacked right you look at it you think that's really weird where's everyone else was it like a skinny person convention in Atlantic City that
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day and then you look at the population figures no that's what people look like in the year I was born we basically humans have bit more than 300,000 years in which obesity is extremely rare and then essentially in your lifetime and
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mine it absolutely blows up between the year I was born and year I turned 21 obesity doubled in the United States and then in the next 20 years severe obesity doubled again and it seems really weird what's going on what would what could
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possibly explain this unprecedented transformation in our bodies where we got to the point where now 42% of Americans are obes right seems really weird what happened we know what happened this change takes place everywhere where one thing happens it's not where people become weak willed or lack willpower or become lazy or all the other cruel stigmatizing things we say about overweight people it always happens where people move from Mostly
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eating fresh Whole Foods that they prepared on the day to mostly eating processed and ultr processed foods which are constructed in factories out of chemicals in a process that actually isn't even called cooking it's called
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manufacturing food and it turns out this new kind of food which never existed before in human history affects our bodies in a completely different way to the old kind of food that All Humans before as eight and there's loads of
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ways that's true I go through seven reasons in the book but there's an experiment that was actually done here in New York that to me just totally distills what happened to us right so it's done by a brilliant Irish scientist
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called Professor Paul Kenny not just out the road from where we are uh so he's the head of neuroscience at Mount Si here in New York and he grew up in Dublin in Ireland and when he was in his 20s he moved to San Diego in California
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to continue his scientific research and he quickly clocked whoa Americans don't eat like Irish people did at the time much more processed and Ultra processed food much more sugary salty food right and like many a good immigrant he
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quickly assimilated within a year he'd gained like 30 pounds and he was like whoa what's going on and he felt like this new kind of food he was eating wasn't just affecting his gut it was affecting his brain it was changing what
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he wanted so he designed this experiment to test it which I have nicknamed cheesecake Park it's not the official name of it it's very simple he got a load of rats and he raised them in a cage and they had nothing to eat but but
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the kind of healthy food that rats evolved to eat over thousands of years right in pellet form so when the rats have got the kind of natural food they used to they would eat when they were hungry and they would stop when they were full and they never became
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overweight or obese given their kind of natural food they had a kind of innate nutritional wisdom that meant they were G I've had enough now then Professor Kenny introduced them to the American diet he fried up some bacon he bought a
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load of Snickers bars crucially he bought a load of cheesecake and he put it in the cage alongside the option the healthy food and the Rats went crazy for the American diet they would literally Hur themselves into the cheesecake and
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eat their way out just completely slicked with cheesecake right and they ate and ate and ate and ate and all that nutritional wisdom they'd had before disappeared they they just rapidly became obese in fact the way Professor
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Kenny put it to me was within a couple of days they were different animals and so this this nutritional wisdom that they'd had before with their natural food just disappeared the brakes were off right then Professor Kenny tweeted
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the experiment in a again in a way that to a lifelong junk food addict seems to me a bit cruel he took away the American diet and left them with nothing but the healthy food they'd grown up with and he was pretty sure he knew what would
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happen that they would you know eat more of the healthy food than they had before and this would prove that junk food expands the number of calories you eat in a day that is not what happened something much weirder happened once
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they'd had the American diet and it was taken away they refused to eat anything at all it was like they no longer recognized the healthy food as food it was only when they were really starving that they finally went back and ate it
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now what this tells us and there's loads of evidence in humans is the diet we're eating is profoundly undermining our ability to ever feel full and to in fact the key word here both in explaining the rise of obesity and how these drugs work
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is satiety it's not a word we use that often in everyday English but it's the feeling of being sated the feeling of having had enough and not want anymore and this kind of food we eat profoundly steals our satiety right and what these
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drugs do is they give you back your sense of satiety they give you back your sense of being full but with a potential cost right yeah and that's it's so fascinating to hear how so much of it has become stigmatized you don't have
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enough self-control you don't have enough willpower you're not disciplined enough and that's why it's leading to these things and as you're saying I mean I've also read different work that talks about how our portion sizes have
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increased and I remember the first time I came to the United States I think I was 9 years old with my family we were coming to Orlando to go to Disney World Orlando yeah yeah I was going to get you to sing the OIC song in a second uh but
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we come to Orlando and I remember like getting one of those you could get like this jumbo size Coke like which was refillable at the gas station and then if you wanted you could get the double jumbo size Coke which was refill every
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gas station and I couldn't believe in that's all I wanted as a kid right I was like that's the coolest thing ever my parents got it for me and then I was drinking refillable Cokes the whole time that's when you got diabetes the first
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time right yeah and I'm predisposed to diabetes because my genetic so it's so interesting and and similarly for me I grew up as a chocolate addict so I ate a chocolate bar a chocolate yogurt a chocolate biscuit and a chocolate ice cream every day growing up and I was very overweight growing up I lost a lot of weight were you really you don't look like you've ever been up until age 14 15 and then at 15 I started playing a lot
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of sports I soon after became vegetarian and I and I lost a ton of weight and for me what happened though was I still had bad habits so I got through University having a Sprite and a chocolate bar every single day and it wouldn't show up
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as fat physically but it would show up as you know now I see it as glucose spikes now I see it as an increase in the chances of having diabetes and and heading in that direction and my wife has been the one to coach me more on the
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side of self-control and discipline and finding Alternatives and I've seen a huge shift in my life ever since I've stopped refined sugars ever since I've uh switched my diet to Whole Foods less processed foods and I've done it in a
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very self-controlled way I know how hard that is I know how prone I still am to having craving sometimes and at the same time I've lost taste for certain and things anyway I'm saying all of that to ask you the question of portion sizes
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have increased we're eating fake foods that are making us want them more we don't feel satiated when we're consuming how does the drug actually make you feel satiated because I think it's important for people to understand
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that what is happening in order for you to feel satiated it's the weirdest thing I'll tell you the how it feels as an individual and then the science of it I'll never forget the second day I took a zenic I woke up and I was lying
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in bed and I thought oh I feel something really weird what is it and I couldn't locate in my body what it was and it took me about five minutes and I suddenly realized I'd woken up and I wasn't hungry I don't remember that ever
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happening before right from when I was very young you know grew up in a workingclass family we ate constant processing junk food and I I was in a bit of a days and I went to there's a cafe just around the corner from where I live and I went in
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and I ordered what I used to order every morning for breakfast when I'm in London it was um a big brown roll with loads of chicken and loads of mayo in it and I I had like three or four mouthfuls and I just didn't want anymore I was full I was full in a way that I never normally felt full I thought that's really weird and I went for lunch that day I went to there a Turkish cafe next to my office and I went in and I ordered what I used to order
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every day when I went there there which was a Mediterranean land and again I had three or four mouthfuls and I was just full it was it was so strange it was like kind of shutters had come down on my appetite I can't think of another way
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to describe it or it was more like when I ate so imagine you had just have had Thanksgiving dinner or Christmas dinner and you were stuffed and then I came along and said hey Jay great news I got you a KFC bucket right you'd just be
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like oh no but you get to that level really really quickly so obviously I interviewed the people who made the breakthroughs for these drug scientists who worked on key stages of developing the drug one of the weird things about this
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drug is we don't actually know how it works but there's some things we know for sure there's a big amount of indeterminacy but there's some things we know for sure if you ate something now it doesn't matter what it is something
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healthy unhealthy after a little while your pancreas would produce a hormone called glp1 and gp1 we now know is just part of like the natural signaling in your body saying hey Jay you had enough stop it's like the breakes right but
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that natural glp1 only stays around in your system for a couple of minutes and then it's just washed away so what these drugs do is they inject you with an artificial copy of gp1 that instead of being washed away in a few minutes stays
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around your system for a whole week it's why when I go to the cafe I only want three or four mouths because I'm already so close to full my gp1 or this artificial boosting of gp1 makes me feel full so quickly so initially it was
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thought when they were developing these drugs that because this hormone is made in the gut it has an effect primarily on the gut this must be a drug that's you know changing your gut in some way and it clearly is right and there's all
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sorts of ways we know that but from interviewing The Cutting Edge scientists working on this particular neuroscientist it's increasingly clear that in fact these drugs work primarily on your brain you don't just have gp1
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receptors in your gut you've got them in your thyroid which is important for something else and your brain and and these drugs are profoundly changing your brain we know that if you give these drugs to rats and then you kill them and
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cut their brain saon which obviously you're not allowed to do with humans for very good reasons what you see is the drug goes everywhere in the rat's brain everywhere right so I remember when I learned that and I learned it quite a
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while into you know a few months into taking the drugs it's disconcerting thing to learn you realize how would I put it it's a much more intimate transformation right something that changes your gut you feel like oh okay that's fine something that's changing
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your brain and profoundly changing your brain um partly explains why the effect is so powerful why these are so much more effective than all previous diet drugs it also potentially raises some other benefits in terms of benefits for
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addiction it also raises some other risks around whether it may cause depression because there's a debate about what what it's actually doing in your brain but for me it just sort of made me realize oh this is a like I say
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a much more intimate change than than than a lot of people realize I think when they start taking it yeah was it who was it was it your nephew who said uh where is Yan Harry and what have you done with him it was nephew my little
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godson I God a to take it I took them to McDonald's so I have a long my relationship with um junk food is probably best typified by one of the low points in my life I was um I can tell you exactly when it happened it was 1
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p.m. on Christmas Eve 2009 and I went to my local branch of KFC in East London and I went in I said my standard order which is so disgusting I'm not going to repeat it in front of some healthy glow it was literally a bucket of fried
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chicken and the trust me I love a bucket of fried chicken you look like you were such a healthy GL you like you've never eaten a chicken drumstick I'm BL based now but back in the day like that popcorn chicken would have been my jam
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yeah the guy behind the counter said to me oh Yan I'm really glad you're here I was like all right and he went off behind when they frow the chicken and everything and he came back with a massive Christmas card in which they'd
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written to our best customer and everyone had written like personal messages to me and one of the reasons my heart sank is I thought this isn't even the Fried Chicken shop I come to the most how can this be happening to me it
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was the second lowest moment in my uh my life as an overweight person that the worst was the time that I was fat shamed by the Dal L but um but no there was this moment where it's not even a joke by the way um you need to tell us tell
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the horror of the D another time but the so I'd had this very intimate relationship with this food all all my life and to have it one of the there were many good things that flowed from Teo zpic for me and there are many benefits to it as
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well as some significant risks but the weirdest moment for me actually was another moment that happened in KFC in fact one of my nephew said to me a lot of the key moments in your life seem to happen in bres KFC I heard that's a good
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point um but the I had a real Epiphany about this because what these drugs do is they profoundly interrupt your underlying eating patterns right you you can't eat the way you did before and this is something I think people are not
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being warned about and I tried to take people through in a lot of detail in the book is you need to be prepared that because of that a lot of the underlying emotional issues that drive your eating May well come to the surface so I had this moment for me I was in Vegas I was um as you know I'm writing a book about a series of crimes that have been happening in Vegas that I've been researching for a long time and I was researching the murder of
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someone that I knew and loved and it was obviously very painful as you can imagine he was an he was an incredible person I was working on this and I just you know felt bad and um I went to this branch of KFC on West Sahara which is
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one of the grimmest KFCs in the world and believe me I could write a book about all of them and I went in and really on autopilot this was like seven eight months into taking the drugs I I went in and I ordered what I would
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have ordered a year before right I ordered a bucket of fried chicken and I had a chicken and I wasn't even really thinking about the eating or anything I was and I had a a a chicken drumstick and I looked at this bucket and I
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thought I can't eat this right like I I would throw up if I tried to eat this and I remember Colonel Sanders was on the wall and it was like he was looking at me going hey what happened to my best customer and I thinking oh you're just
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going to have to feel your feelings right and it's interesting if you look at the scientific evidence there's scientific evidence for five reasons why we eat one of them is the obvious one to sustain our bodies and I would have told
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you before I started taking this drug that was why I ate right but here I am then I ate maybe 3,200 calories a day now I around 1,800 so all that other eating was doing something else right and I go through the the the the the four psychological
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reasons uh why we eat they don't obviously applies differently to different people and those things kind of get surfaced and I remember going to one of my closest friends when I got back from Vegas and saying to her I've got to stop
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taking this I can't take it this is too upsetting and she said to me yoan stop taking it if you want to that's fine but you need to know these drugs are not causing this issue this issue was there along in this case what they're doing is
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giving you an opportunity to deal with those issues in a better way than drowning your feelings in saturated fats right and that's been a bumpy uh transition although I'm glad I I'm glad I stuck with it although lots of people I respect uh I respect the fact they don't walk me through why people don't like what what was what was their reasoning what what were they struggling with so much I think there's a lot of things people struggle with
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with the drugs but in relation to that I'm sure we get into lots of them but if we think about this specific specific one if you want to think about the benefits and risks of these drugs when it comes to obesity I actually think it's quite
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helpful to look at a parallel area of science we've only been giving these drugs to people for obesity for a couple of years but there's a parallel area of science that can help us to think about the benefits and I think some of the
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answer to your question so and it's bariatric surgery right up to now it's been very hard without some kind of external intervention to lose huge amounts of weight and keep it off clearly you did it there are lots of people who do it
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but it's a surprisingly small percentage of the people who try it succeed I go through why in the book and that reasons are really important so actually the most effective way up to now has been bariatric surgery things like you know
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stomach stapling gastric sleeves bariatric surgery is a horrific operation it's really grueling you know one in a thousand people die during the operation it's no joke right but the reason people put themselves through that is because of the extraordinary benefits to their health afterwards if you have now bear in mind they were severely obese the start otherwise you wouldn't qualify for the surgery but if you if you have this surgery in the
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seven years that follow you are 56% less likely to die of a heart attack you are 60% less likely to die of cancer you are 92% less likely to die of diabetes related causes in fact it's so good for your health that you're 40% less likely
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to die at all in that 7-year period right and we know similarly that these drugs are moving us in a similar Direction so if you take these drugs and your BMI is higher than 27 at the start you are 20% less likely to have a heart
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attack or stroke right in the years that follow that's a very that's I was going to say it's close to my heart it is literally close to my heart right but you also when you look at bariatric surgery begin to see some of the
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drawbacks and I think the key to what you're asking might be there so one of the things that I think is really shocking is if you have bariatric surgery your suicide rate quadruples in the years that follow right it's still quite a low risk most
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people have barric surgery glad they did it but quadrupling that's that's that's a big effect right I think why would that be what's going on I think there's lots of things going on there some of it is actually the after effects of the
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surgery are pretty honorous some of it is you can't Comfort it anymore so that pain comes to the surface um some of it is a lot of people who are overweight kind of think well if only I was thin my life would be really great it's that
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magic pill exactly and they lose the weight and you know your husband's still an and you still hate your job and I think there's also some I give an example of a really deep psychological issue that I think is surfaced in some
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cases by these drugs and batric surgery something I learned about from a a wonderful man who you should have on actually um called Dr Vincent felitti it was really hard for me to learn about this so Dr felitti was a doctor in San Diego in the early
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1980s and he was approached by kaisa Permanente the big not for-profit MediCal provider in California and they said look we got a problem we don't know what to do please help us the problem they had was that obesity was
31:34
hugely rising in fact it was very low by our standards but it was rising and they said look nothing we do works we give people you know diet plans we give them personal trainers it's not working can we give you a load of money and just do
31:44
blue skies research figure out what the hell we should do so Dr Fel took the money and was like oh what can I do so he started working with 200 severely obese people people who weigh more than £300 and had for a long time and it's
31:57
like what could I do and he had an idea that sounds and in fact is kind of dumb he said what would happen if really obese people literally stopped eating and we gave them like you know vitamin C shots so they didn't get scurvy or
32:09
whatever would they just burn through the fat supplies in their body and get down to a healthy weight so with a ton of medical supervision they did it and Incredibly at first it worked there was a woman corsan not her real name who
32:21
went down from being more than 400 lb to 138b staggering transformation and you know her family are calling the doctor and saying you saved her life she's thrilled and then one day um she cracked she went to KFC or I think that's
32:40
projection she went somewhere and you know started hugely overeating again and quite quickly got back to a a dangerous way and Dr futi called her in he said Susan what happened what happened and she looked down she was really ashamed she said I don't know I don't know he said well well tell me about the day you cracked did anything in particular happen that day that didn't happen some other day it turned out something had happened that
33:07
day that had never happened to Susan she was in a bar and a man hit on her not in a nasty way in a nice way and she felt completely freaked out and went and started eating that's when Dr feli asked her something he'd never thought to ask
33:18
her before he said Susan when did you gain your weight and her case it was when she was 11 he said well did anything happen when you were 11 that didn't happen when you were nine or when you were 14 anything in particular
33:28
happened that that year and she looked down and she said well that's where my grandfather started raping me Dr feli interviewed everyone in the program he discovered that 60% of the women had made their extreme weight gain
33:44
in the aftermath of being sexually abused or assaulted and at first he was like what's going on it doesn't make any sense and Susan explained it to him really well she said overweight is overlooked and that's what I need to be right clearly obesity for
33:59
women has a protective sexual function you are somewhat it can still happen of course but you are less likely to be sexually assaulted if you gain a lot of weight and so for Susan losing a huge amount of weight made her really
34:12
frightened and feel really vulnerable and brought her back to that terrified place of abuse now there's lots of psychological things that go on that's only one of many but I think and of course it can give you an opportunity to
34:22
deal with those feelings right but again it gives you a sense of like the the the incredible psychological complexity of what's really going on here can kind of come to the surface in complicated ways yeah and
34:34
what's interesting about that is no matter what the psychological reason may be you're almost dealing with that feeling for the first time in three or four decades so it almost feels like a new feeling would that be fair enough to say it almost
34:52
feels like what I mean by that is there are certain feelings and thoughts that we've had since we were young and we found ways to cope with them but if this is something that you've been able to kind of put aside for 10 20 30 years and
35:05
all of a sudden now that this is blocking something which is giving rise to that it almost feels like wow I haven't learned how to deal with this for a long time I think that's really right I think it's I think you're right
35:14
it's even worse than a new feeling it's a buried feeling right and obesity is so Laden with shame and the cruelty in this culture towards you know which I've experienced to some degree but women get it much much worse if you have a BMI higher than 35 and
35:35
you're a woman 42% of those women get insulted literally every day right and I really wanted to think this through because I was very conscious that we've made so much progress in this culture I mean we were nowhere near
35:49
where we need to be but we've made some progress I think about this and one of the things I really worry about in relation to these drugs I think it's really distilled in a moment probably the worst moment in the whole writing of the book for me so I've
36:00
got a niece called Erin who's 19 now but in my head she's fixed as a six-year-old like uh she's the baby of my family she's the only girl she's the youngest of my brothers and sisters children but one day I was um FaceTiming with her
36:11
after been taking the drug for a while and she was sort of praising me in a teasing way she was like oh I never knew you had a jaw yo I never knew you had a neck and I was kind of preining and then she looked down and she said will you
36:22
buy me some oen piic and I laughed because I thought she was kidding and I realized she wasn't and she's like a perfectly healthy weight she always has been and I thought I've undone all the messages I've ever tried to give her
36:41
right about valuing yourself about and I thought you know she's grown up seeing a broader range of body types and female celebrities than we ever grew up with of course you and now all of those women pretty much are bone thin right and I
36:58
really wanted to think this through because I think there there's of two categories here which are quite different there's overweight and obese people who are taking these drugs to get down to a healthy weight right now
37:08
they're still incurring the 12 big risks that I write about in Magic pill there's still a lot to discuss there but I think there's a a lot to defend there then you've got people who were already a healthy weight or indeed skinny who are
37:19
taking them to be super skinny now I don't judge those people we live in a culture that makes women feel about their bodies whatever they do and there are tremendous pressures on them and I I don't judge where those women are coming
37:29
from at all but they're incurring all the physic all the 12 risks for none of the benefits right I mean well rather for aesthetic benefits but not health benefits and in fact they're endangering their own health um in all sorts of
37:42
complicated ways to give an obvious example as you age you naturally lose muscle mass muscle mass is the total amount of soft tissue in your body that you need to like get out of a chair walk the walk up the stairs whatever it might
37:53
be so as you age you naturally lose muscle mass from the age 30 depressingly um so if you're going into the aging process already with quite low muscle mass which people have taken the drugs to be super skinny likely will be it could cause you real problems when you're older you know you'll be much less mobile you'll find it harder to walk up the stairs you're at risk of a condition called sarcopenia which means Poverty of the flesh it's where
38:17
basically you just can't do much because you're quite physically weak so I think we've got to distinguish between those two things and then we've got to think about also what this means for body positivity and how we think about in
38:28
relation that was a particular person who helped me to think about that I could tell her tell you a bit about her if you like yeah please please so this woman you probably remember her Jay because we're from the same place um so
38:38
when we were kids you only ever saw fat people on television as the butt of a joke right particularly overweight women right it was vicious and the first person I ever saw challenge that I remember it blew my mind it was on
38:52
killroy which people don't know it's like a if you imagine a kind of Dollar Store version of Ricky Lake right the first person I ever saw challeng it was this woman called Shelley bovie who basically introduced body positivity to
39:03
Britain she was the first person to ever talk about this and write about it in Britain in a on a big public stage so I went and track her down because I really want to think this through with her she's 76 now and her story I think
39:14
really helps us to Think Through the complexity of this so she grew up in a um a kind of Big workingclass Town in Britain called Port talber I guess the equivalent in the US would be like Scranton she was as she would put it the
39:25
only fat girl at her school this was the 1960s and one day after class her teacher said to her bie stay behind I need to talk to you so she's sort of sitting there thinking hey what did I do and she goes up to the teacher and the
39:39
teacher said you're much too fat it's disgusting go see the school nurse she'll sort you out so completely thrown she goes to see the school nurse and the nurse says why are you here she said well the teacher says I'm too fat and
39:52
the nurse said take off your clothes I'm going to look at you and the nurse looked at her and said ah disgusting too fat and just berated her said you're greedy you're a pig eat less and shell completely thrown kind of leaves she was
40:03
get soaking up this kind of abuse the whole time right girls were constantly saying to her thank God I don't look like you and really her whole life she pych this abuse when she got pregnant she went to the doctor first thing the
40:16
doctor said was shouldn't be pregnant when you're as fat as you are uh when she gave birth she had a very painful birth difficult birth she's lying there covered in blood and the Midwife said to her you know you really need to lose
40:26
some weight um when her her baby wouldn't attach he wasn't feeding properly she went to the doctor the doctor said what are you trying to do make the baby as fat as you are overweight and obese people are soaking this up all the time and most of
40:40
them just internalize it shell told me she had never looked at her body naked even in the shower she would sort of wash herself but not look because she felt such hatred for her own body and one day she learned in the US there was this movement which at the time called itself fat Pride there's still some people who use that term now we would probably call it more body positivity who just said why are we taking it this is like this is just
41:01
cruelty this is like racism or homophobia or sexism just no we're not going to be talk treated like this you're not going to get to talk to us like that and so she wrote the first ever book advocating for body positivity
41:13
still stands up now brilliant book called The Forbidden body in which she argued against this stigma and when I track Shelly down she stressed to me she's really proud of everything she said about stigma and I think she's 100% right B stigma a is
41:29
just a form of bullying and B makes the problem much worse right um Lindy West is a brilliant body positivity Advocate said people don't take good care of a thing they hate if you make people hate their bodies it doesn't make them take
41:41
better care of them but something happened to Shell next I think if we're going to be truthful and compassionate we have to talk about shell was very overweight she was not yet 50 and she was losing the ability to walk
41:58
and so she had to be in a wheelchair and she went to a doctor and her doctor said well because of your weight because of the strain that's putting you you've got problems with your heart and Shel felt this profound dilemma because she was so proud of
42:10
everything she said about stigma At first she thought well I want to talk about these health challenges but is this contradictory there was at the time a a newsletter in Britain called fat news which is like a body positivity
42:19
newsletter and she wanted to write about this and they said no no that's not what we want we we're here to tell the positive news and he said but don't if we love ourselves don't we want to tell the whole truth and she felt really conflicted
42:30
about this and for a long time she felt like it was either or either you're against stigma or you're in favor of reducing obesity where you can but you know she then and she's the first to acknowledge this is extremely hard to do
42:42
but she lost a lot of weight through dieting she went from being unable to walk to being able to run um her health massively improved her heart problems went away which tends to happen when you reverse obesity like when we talked
42:55
about with the bariatric surgery and shell I thought put it to me in a really wise way she said it's not either or it's both and if you love someone who's obese as everyone watching will I'm pretty sure you want to protect them
43:09
from two things you want to protect them from cruelty and bullying and you want to protect them if you possibly can from the more than 200 diseases and health complications that are made much more likely by being overweight or obese and I was kind of shocked when I you know I looked at at the science of this with an open mind I'm very happy to challenge scientific consensus I've done it before in my previous books but when you look at the
43:33
scientific evidence and I was trained to assess scientific evidence at Cambridge University I was kind of taken back by how bad obesity is for your health on average of course there are exceptions my mother smokes 70 cigarettes a day
43:47
she's alive and well at the age of 78 but she's an outlier I mean even think about something as simple as diabetes right I'm really embarrassed to say this but I thought if you'd ask me a couple of years ago okay I knew that obesity makes diabetes
43:59
much more likely if you're obese when you're 18 you have a 70% chance of becoming diabetic in your life but I thought okay that's not good but as long as you've got good health insurance and you get di insulin you're basically like
44:11
everyone else a diabetic with insulin is like me or you that's not true at all when I interviewed the leading you know doctors who are leading people who treat diabetics when you look at the scientific evidence you know diabetes
44:21
knocks 15 years off your life on average it's the biggest preventable cause of blindness in this country more people have to have a limb or extremity amputated because of diabetes in the US than because they got shot and you will have noticed a lot of us get shot right um in fact it's the effects are so bad that one of the leading doctors in Britain who treats diabetics Dr Max pton said to me if you gave me a choice between becoming diabetic or
44:45
becoming HIV positive I would choose to become HIV positive because if you're HIV positive and you get treatment you live as long as everyone else that is not true of diabetics type two diabetics you you you you have a shorter life and
44:57
you're much more likely to have a terrible last few years where you're blind or you horribly you know your body is mutilated um and I found that so frightening to take on and I'm conscious that loads of people hearing that will
45:10
experience that and is very painful it is extremely painful to hear and it's an extremely painful truth and we have to communicate it with great compassion and love and not as concern trolling or and I hate even saying it because you can see how it
45:26
gives um ammunition to the bullies in a way because they use that as like oh babe I'm just worried about your health I get that but shell really taught me yeah she put it we have to live in reality and we have to be as
45:41
compassionate as we can within that reality we have to do both right and I'm conscious this is a long answer but I'll just give an example one other person helped me to think about this there's a brilliant guy interview called Jeff
45:51
Parker he's a 67-year-old retired lighting engineer in San Francisco and Jeff a couple of years ago was very severely overweight he was finding it painful to walk he had gout he had liver problems kidney problems he was taking fistfuls
46:06
of pills every day and he started to take munaro which is one of the new weight loss drugs and he lost a lot of weight all his health problems went into remission he was Doctor almost took him off the pills now he walks his dog over
46:18
the Golden Gate Bridge every day he said you know I feel like I'm going to enjoy my retirement now I don't think we can say to someone like Jeff that that Improvement is not meaningful right there are many maybe the risks of the
46:31
drugs will outweigh that benefit to him and for others that's a real possibility it's why I put a lot of weight on the 12 wrists on of these drugs in the book but I do think we have to acknowledge that a lot of people who do
46:42
successfully reverse their obesity which is much easier to do now than it's been before do experience a massive Improvement in the quality of their life I do think we're not being honest with people if we don't explain that as well
46:54
thank you for going into that actually it wasn't a it wasn't it was a very thoughtful answer and those stories give us an entryway into the psychology and the mind of so many of us and what we're all struggling with with
47:06
Shelly I'm intrigued how is she now perceived by her community that she was the face for having now dieted lost weight it sounds like and may appear different visually how is she now perceived and how does she feel about reconnecting with that community and
47:25
talking about it with them so as she would say there's a and she speaks for herself much better than I can I don't want to too much trilo quiser but uh she's a very articulate person I think it's really complicated and I understand
47:37
why it's complicated some people saw her as a sellout and I think shelle's attitude was what kind of body positivity would it be that would shame me for keeping my body alive and there's a big division going on now my body positivity
47:52
Advocates where they have many good arguments and it's worth stressing so if we we think about the history of diet drugs think about the 70s right one of the things that one of the first things the fat Pride movement did was point out
48:03
so there were diet drugs in the 70s that were amphetamines right they hugely popular there were staggering figures like more than 10 million amphetamin prescriptions were written in 1970 in this country for weight loss right um
48:17
and it turns out taking LS of speed to lose weight not a good idea who knew but uh and they had to be taken off the market because it it screws you up right partly because you develop tolerance to the drugs you have to take higher and
48:28
higher doses to get the same effect and if you're taking really high doses of speed as anyone who knows any recreational drug users will know don't end so well for you um uh you know skinny but psychotic is not a great
48:39
trade-off maybe for some people it is but uh not for me and so a lot of the fat Pride movement very preent warned at the time you know this is really going to screw people up don't do it right and they've been entirely Vindicated by that
48:52
and it may be and I I think there's a significant chance of this I don't think it's the most likely option but I do think it's a significant chance that they'll be Vindicated on these drugs as well going look this is a big risk right for
49:05
me especially with the history of my own family what I felt I had to do was weigh two risks and I think that's what most people watching and listening will will this will be the position they're in realistically I was going to remain
49:23
obese I tried dieting many times I always ended up fatter than I was at at the start I tried insane and intense diets I'd gone to diet camps in Austria where they give you tea for a week i' done i' done it all right realistically
49:34
I was going to carry on being obese to some level so for me the choice was what are the risks of continuing to be obese versus what are the risks of these drugs that is not an easy calculation there's a lot we don't know uh there's we're learning more and more there's a lot of detail in the book that I think people don't know about it's a hard calculation and I don't know if I've made the right choice for myself so it may well be there's a
50:01
significant chance that they will that their caution about this will be Vindicated and they're right that they're also right to say it's clearly not the case that we're only taking this to deal with health problems right and
50:15
that's true to me as well there's a significant amount of just relief from the stigma of being fat vanity I like being thinner right because of the culture we live in some of that is the health benefits and the risk to my heart
50:28
of course but some of that isn't a big part of it isn't we've got a level with people about that so it's possible that they'll they'll be Vindicated and even if they aren't we've really got to understand where it comes from if you are soaking
50:46
up abuse your whole life that cruelty that bullying I totally get you know that's an analogy I always think of which is I'm gay the height of the age crisis when doctors explain to gay men look because of the nature of anal sex
51:08
and because gay men tend to have a lot more sexual partners than other sexual combinations this is going to affect gay men much worse than other communities so they wanted to you know shut down the bath houses in San Francisco really warn
51:18
people say while we don't know you shouldn't have sex right and a lot of gay men were like our whole lives we've been told our sexuality is disgusting we're diseased we're evil and now you come along and tell us this as well
51:32
we're going to carry on going to the bath houses we're going to carry on and I get where they're coming from I might well have been like that myself at the time but now we realize looking back well you have to separate the stigma
51:41
from the scientific advice right there was I'm sure there were lots of homophobes picking up those arguments and bullying gay people exactly but equally there was the scientific reality which is it was much more likely to
51:51
affect gay people and lots of those people who refus that advice tragically are not here now because they refused it so I think and that doesn't mean I stand over those people and go what fools I I totally get it but I do think we have to
52:05
as shell says we have to separate out two things we have to separate out the stigmatizing cruel things that are said from things that are just physical think about think about cancer right the leading cancer group in Europe cancer
52:17
research UK explain if you carry excess weight in your body it doesn't just sit there it's not iner it's active right it sends signals through your body and one of those signals is for your cells to divide more rapidly which can
52:30
cause cancer this is why obesity is one of the biggest causes of cancer in in the developed world right that's true even if we got rid of all the stigma in the world which we passionately should fight to do it's still going to make you
52:41
more likely to get cancer right we can't that's not something we can undo with an argument and therefore we do need to think about this also though I'm very conscious the most important thing we got to do so people like me are in a
52:55
shitty trap right you got to choose risky medical condition risky drug but that is not inevitable and we should not tolerate that being the choice for our children right Japan for example right um I can explain how they did it but the key thing to understand
53:10
is the way one expert put it for me a brilliant man named Professor Michael low at Drexel University in Philly is processed and ultr processed feeds dug this hole they stole our sociiety and the drugs fill it in the way he put it
53:24
was so you got to see that these drugs are an artificial solution to an artificial problem right so we've got to pull back in addition to the Dilemma about the drugs for people like me we've got to pull back and go how did we get
53:35
here and how do we make sure the next generation of kids are not in that position and absolutely we this is the Dilemma a lot of us but it doesn't have to be the Dilemma for our children and grandchildren and I went to places that
53:46
have solved this dilemma that show us the way out so that's the kind of broader argument which I think is so important to stress as well yeah absolutely before we get to Japan and before we get to those so the barley Bank produced a report to
53:59
guide investors and it told them to get out of investing in fast food and ice cream because those markets are going to tank financial advisers are also expecting a decline in the demand for neon hip replacement but when you look at investment I found that fascinating I'm like do I believe that fast food is growing or is shrinking and while I see the rise of organic vegetables while I see but still expensive while I see the rise in people
54:29
proposing a largely plant-based diet if not not not full but a larger plant-based diet again more expensive harder to access maybe maybe difficult to know what to do I I don't see fast food shrinking as an industry is did you
54:43
see that are you seeing that through your research were you seeing investment shift and redirect or is that a myth as well Crispy Cream stock is down the head of nestle Mark Schneider has been making very nervous noises about their ice scam
54:56
and confectionary market so we got to look at the the longer term Trend 47% of Americans say they want to take these drugs and the there's a big access question at the moment but eight years from now OIC goes out of patent at that
55:10
point it will be a daily pill and it will cost about a dollar a day I would anticipate 47% is an underestimate for how how how many people will take it provided some of the 12 big risks that I write about in the book don't blow up
55:22
which is a real problem think about Jeff Parker the guy I just talked about in San Francisco everyone like Jeff becomes a walking advertisement for the drug every goes what happened to Jeff he looks completely different my God he's so much
55:33
healthier so you can see how it creates a huge growth growth effect so you're right at the moment we've got two Trends we've got the ongoing explosion of fast food which is you know blowing up and blowing up and is implanted in us from
55:45
the moment we're born more three-year-old children in this country know what the McDonald's m means they know their own last name more people yeah more people in the world recognize the McDonald's M as a symbol of McDonald's then recognize the cross as a symbol of Christianity right so this is really deep in our Consciousness so you've got that huge explosion in fast food which is growing and growing and growing and you've got huge numbers of
56:07
people who want to take these drugs now one of those Trends is going to win right so as more and more people take the drugs we''re already seeing the effects and I think in a way the best some of the best predictors are the
56:18
financial markets jeffre Financial just did a big report for the US Airlines saying you're going to have to spend a lot less money on jet fuel pretty soon because a lighter population takes less jet fuel to fly there's um even just
56:33
like crazy little things there's been a huge run on Jewelers in Los Angeles um because people's fingers have shrunk so much that they need their wedding bands refitted or think about you mentioned the hip and knee Replacements companies
56:43
that manufacture KNE and hip replacements the joints for them their stock is going down because the main driver of KNE and hip replacements is obesity and if there's a lot less obesity there's going to be a lot fewer
56:54
KN and HIIT replacement operations so do think we're we're you're right that the trend you're seeing which is the growth of fast food which earning more and more I mean thank God when I was a child you couldn't just push a button on a device
57:04
and they'd bring McDonald's to you right you have to actually leave your house at least um imagine how overw that would have become if that been the case that trend is is driving the other Trend as well right so they're they're they're
57:15
densely interconnected it's also a big question comes out as and like you kept saying like you keep saying we don't know enough and I want to talk about the risks now because we've talked about some of how we've got here the challenges that we're facing mentally psychologically societally into why we're in this situation in the first place but what's fascinating to me is are a lot of the 12 Big 12 which we I want to dive into the Big 12 risks and
57:45
the issues with the drugs are a lot of them more long-term than shortterm and based on your own personal experience are the short-term ones tolerable in the longterm ones the ones that we would consider intolerable and complicated so
58:00
I would distinguish between the well-known side effects and these 12 big risks things like nausea almost everyone who takes these drugs feels nauseous at first throughout the day no different people have different experiences so
58:10
some people have horrible experiences I interviewed someone called Sunny Newton in Vermont who um you know she had like she said it was like there was an alien living inside her and it was like thrashing about and she just wanted to
58:20
vomit the whole time that's rare but not unheard of I mean in the clinical trial it's about 5% of people did just stop because the nausea was so bad for me it was like um it was mild it was like when I would get on the bus or
58:35
something I would get a little bit of exaggerated travel sickness um but like if I'd got that feeling just randomly on a normal day it wouldn't have stopped me going about my day it just would have been a bit
58:45
unpleasant and after a few months um you generally you get it worse the day you take it or the day after and then you're okay for the rest of the week and then again you inject yourself and it gets and and the regularity of injecting yourself is it
58:59
the same for everyone or can you accelerate the dose is there a slower version I mean I should just say because a lot of people get horrified by injection and I am a complete wor I'm the kind of person who when you give me a blood test I like I don't want to look
59:11
at it I literally look away and sing like you know do Casey Perry songs to pretend it's not happening but um and my singing is not pleasant um but this it's an EpiPen it's the tiny and I wish someone had told me at the start I
59:23
didn't know this at first you can inject yourself in the leg or the stomach and for some reason the idea of injecting in your stomach seems to be so horrifying for the first month I was injecting in my stomach I was like a and actually the
59:32
leg is just the same no I mean it's you it's literally like the tiniest scratch it's like a mosquito bite it's but are there different doses in terms so everyone starts at 0.25 milligrams is to get you used to the nausea and the
59:45
effect is quite mild and most people go up and up and up so generally you go up to 1 milligram you can go as high as 2.4 milligrams it would depend on your level of obesity I think a lot of people are on too high a dose and who's advising
59:59
you on that dose I mean the official guidance from Novo Nordisk and Eli Lily the companies that own it is is you know build up to one milligram and then you can go higher if you need greater effects but because you're
1:00:09
self-medicating you're not self-medicating you I mean part of the problem is people are buying it online and not actually getting it from a doctor and that's a really big problem that particularly relates to probably my
1:00:19
single biggest worry about these drugs there's a lot but the thing I'm most concerned about not for myself but for the society is eating disorders we went into the pandemic with an unprecedentedly high level of Eating Disorders probably
1:00:35
because of social media and what it's doing to young girls you'll interview my friend Jonathan he high he can tell you much more about that and everyone should read His Brilliant amazing work then during the pandemic eating sers went up
1:00:45
even further which is mind-blowing and what these drunks do is they give you an unprecedented tool to amputate your appetite right and anyone who knows anyone who's got Eating Disorders imagine I'm sure do pretty much everyone
1:00:57
does they're in a conflict there's the psychological part of them that wants to starve themselves for complex reasons created by the Sick culture we have mostly and then there's the biological part of them that wants to live and
1:01:12
wants to eat and what these drugs do is they you know if you take them and you're you're in that position they massively empower the part of you that wants to starve yourself so I am and people like Dr kimbery Dennis who's one
1:01:22
of the leading Eating Disorders experts in Britain another person you should interview very WID and Brilliant person are really worried about this right my my biggest fear is that we could have an opioid like death toll of
1:01:35
huge numbers of young girls and unfortunately these disorders do mostly affect young girls there are of course some young men and boys I mean I'm really really worried about that now there are things we could do right now as Dr Dennis says we need
1:01:49
to I I got them on Zoom you know when I when I got them in Britain initially in in Vegas I had to go in person they're meant to check your BMI on Zoom I mean good luck with that you basically you are very visibly not eligible for these
1:02:02
drugs right you clearly have a BMI lower than 27 and yet I have no doubt you could go on Zoom literally your lovely team here could arrange in half an hour we get a zoom call and you would get it delivered in the you know biked over to
1:02:16
you today right we need to stop that as Dr Dennis says we should only have in-person prescription and the inperson prescription should be done by doctors who are given clear guidance about how to spot eating disorders and how to
1:02:29
prevent uh the prescription of these things to eating disorders it's not perfect people might still buy it online but it would it would put at least some barrier that between these drugs and people who should not be getting them at
1:02:39
the moment there is basically no barrier is that one of the big risks yeah massive I mean if you said to me what are the risks that most that's the risk that most worries me for the society the one that most worries me for myself is
1:02:53
quite different so how would I put it it's weird I feel a away of anxiety as I said it we don't know the long-term effects of these drugs at all no one knows we know they're chronically activating key parts of your brain so a brilliant
1:03:12
expert called Dr Greg Stanwood who works on these drugs at uh Florida State University said to me now he stressed to me he's broadly in favor of these drugs he's considering taking them himself but as a responsible scientist
1:03:26
he has to warn people so he gave an analogy I want to be clear he's not suggesting these drugs will have this effect but it's an analogy that helps us to think about it if you look at antis psychotic drugs if you go back to when
1:03:35
they were first given to people in the late 1950s at the time doctors judged that the benefits outweigh the risk it's always been controversial but they judge that so loads of people were given antic psychotics for really long periods of
1:03:49
time and it was only what 40 50 years later that they discovered if you take these drugs for decade after decade you are much more likely to get dementia Alzheimer's in fact all forms of dementia are much more likely it's not
1:04:02
that the doctors were being neglen in the 1950s you how you couldn't know that right you had to have people take it for a really long time to know that what could these drugs do over the long term we don't know right um now
1:04:17
against that Dr sha alev a brilliant obesity specialist at Tila School Tain University School of Medicine in New Orleans said to me me well look we don't know the long-term effects of these drugs we do know the long-term effects
1:04:30
of obesity and they are very serious but you know I'm 45 right if you stop taking the drugs for almost everyone they stop you just go back to where you were before and there's big debate about that but for most people that seems to be
1:04:43
happening so I'm assuming I'm going to be taking these drugs for 40 years that's anxiety provoking I asked Dr clemon blue who's a one of the leading obesity specialists at Cambridge University so what brain areas do these
1:04:58
drugs activate and she T me through it the H brain and so on I saidwell what else do those areas of the brain do she said oh are they memory processing taste processing gut motility like not this me speaking now but not trivial things
1:05:10
right so for me that was of the 12 that was the one where I thought trying to more eloquent way to say but that was yeah yeah what's the debate you were saying there about the idea of if you stop taking these drugs you go back to the same way you were
1:05:27
what's the debate so we don't have that much research on it what the drug companies say is these drugs are like uh statins you take statins it lowers your cholesterol if you stop taking statins your cholesterol goes back to what it
1:05:39
was so the drugs are not a cure they're a treatment an ongoing treatment right so they say these drugs are like that now they have a vested interest in saying that they want you to carry on buying the drugs forever it would not be
1:05:50
good news for them if they discovered that actually you can take the drugs for a short time stop and then you'd stay at the lower weight some people this is anecdotal because we don't have any research on it yet other people are studying it so we'll know in a while like I give an example someone I know took manaro lost Lo of weight interrupted their relationship with junk food started exercising a lot in a way they felt too embarrassed to do when
1:06:12
they were obese and has now stopped and seems to be maintaining that lower weight so how many people will there be like that we don't know I mean the early studies we have we're just looking at if you take and then stop but what about
1:06:27
motivated people who change use it as a tool to promote change we just don't know how long will it how long does it take to measure for us to realize how long do you need to be on it for to have those long-term implications like how
1:06:39
long will we have to study research and measure I mean when you talk about the the the medium term effects and I gu it's important to be balanced about this because it's a complicated truth so a lot of people a
1:06:51
lot of the experts will say and these are really good scientists and it's a good point actually we know loads about the medium-term effects of these drugs because diabetics have been taking them for 18 nearly 19 years right so for people who don't
1:07:04
know these drugs in addition to having this effect on your appetite also stimulate the creation of insulin which is what diabetics both type 1 and type two diabetics are lacking is why it's a diabetes treatment and so actually we've got 18
1:07:17
years of data on diabetics so there I mean this I'm putting it more crudely than they would but if the drugs made you grow horns the diabetics would have grown horns by now right and that's a good and important point
1:07:27
and it should give people some degree of security but some other people say some other leading experts say well hang on if we're going to base a lot of our confidence on these drugs on the diabetics let's dig a bit deeper into
1:07:42
the diabetics so give an example there's a brilliant scientist called Professor Jean Luke F who's at the University Hospital in melier in France and he was commissioned by the French medicines agency to look at the safety of these drugs for the French market
1:07:56
and so he started looking at What's called the preclinical research which is on animals and something really took him AB which is if you give these drugs to rats they're much more likely to get thyroid cancer and it's like huh okay let's do
1:08:08
some digging so what he did is they have very very good medical databases in France he compared a large number of diabetics who've been taking these drugs between I think 2006 and 2012 with a large number of diabetics who were
1:08:22
similar in every other way but hadn't taken these drugs and what he calculated with his colleagues was if he's right and it's highly contested these drugs increase your thyroid cancer risk by between 50 to 75% and he said to me well
1:08:37
you got to understand what it doesn't mean doesn't mean if you take the drugs you have a 50 to 75% chance of getting thyroid cancer if that was the case we'd be having bonfires of OIC all over the world what it means is if he's right
1:08:49
whatever your thyroid cancer risk was at the start these drugs increase it by 50 to 75% now thyroid cancer is an overall low risk 1.2% of people get it in their lives 82% of them survive so it's a relative but it's a big increase in a
1:09:06
small risk right and I'm very conscious a that you got to weigh that against just the cancer risk of continuing to be obese but also one of the things that really worries me about that is if you think about the history of diet
1:09:19
drugs very often they began to unravel based on small warnings so if you think about there was a diet drug in the '90s called fenfen the most popular diet drug ever before asmic so if you look at how it was a combination of two drugs it was
1:09:33
an appetite suppressant called flex fomine and um an amphetamine called phentramine and it really worked people who took it got the same level of weight loss as people get on his zic and people talked about it in a very similar way
1:09:45
front page of Time Magazine was the new Miracle weight loss drug right very similar in 1995 there were million fenfen prescriptions in this country it was huge and then it was discovered a a small group of doctors in a in a practice in Fargo in North Dakota noticed ha um a lot of people using this drug in our practice seem to be uh having trouble breathing wow and so they raised what's called a safety signal it was then investigated it turned out
1:10:22
these drugs caused in a lot of people something called primary pulmonary hypertension a horrific condition where the blood vessels in your lungs contract and you can't breathe it it kills you or it can kill you if if not you're on
1:10:32
oxygen the rest of your life it's horrendous so it obviously got withdrawn from the market led to the biggest um payout in history of the pharmaceutical industry 122 billion actually emerged the drug companies had known about this
1:10:45
risk all along you look at the stuff the drug companies you know one of the leak doc one of the documents that was presented at the civil case was just um someone saying one of the people at the drug company saying oh I'm I going to have to spend my retirement writing check compensation checks for silly fat women with lung who can't breathe I mean horrendous right now I want to stress Eli Lily and noo Nordisk I'm very happy to criticize drug
1:11:11
companies I do it a lot but they are not shyers like those people were they are reputable drug companies there's no reason to believe that they're like that but I'm conscious that small things could lead to the whole thing unraveling we need to be vigilant I'm
1:11:25
alert to that um is why if you have thyroid cancer in your family I mean I going to say I recommend it don't really matter why I recommend the FDA recommends don't take the drugs it's not a good idea um are there any others in
1:11:39
that line any oh loads yeah I mean yeah I mean I would there's all sorts of things all sorts of categories of people I would say shouldn't take it um if your BMI is lower than 27 don't take it you're incurring all the risks for none
1:11:51
of the benefits if you have thyroid cancer in your family if you have history of eating disorders you there's a whole array of people who who should not be taking it who who currently are taking it another big one which obviously doesn't apply to
1:12:03
me is if you think you might get pregnant so one of the things that really worries me is we have really no data on what it does to um people who are pregnant obviously you're told to not take it if you think you might get pregnant but
1:12:18
people get pregnant and all sorts of ways you know you don't that you don't expect so we know rats when they're given Sagle the active component are much more likely to have children with birth deformities fetuses with birth
1:12:31
deformities Dr stanard Who I mentioned before at Florida State said to me again stressed he's broadly confident but has to alert people to potential concerns because he's a very responsible scientist he said to think about this you might want to look at um the long-term research on mothers who are exposed to contaminants when they're pregnant so think about for example mothers who are exposed to lead this happens scandalously frequently in
1:12:59
this country because a lot of poor people still live in housing that still has lead in it and um still get water from we know about Flint Michigan but actually in lots of places get water from uh pipes that are made of lead it's
1:13:10
insane that in the richest country in the world we allow that the poisoning of children but anyway if you look at the if you look at mothers who are pregnant and get exposed to lead during pregnancy actually their babies look like all the
1:13:20
other babies there's no you it seems like there's no difference but when those kids get get to be 12 13 we know that they have less impulse control they're more likely to have attenion problem so it seems to have affected their developmental trajectory even though that wasn't immediately obvious at first right could that happen with these drugs yes I mean it might not it might affect the trajectory in a positive way we don't know maybe they'll
1:13:41
be less likely to become obese it could have a protective effect on that but it's just disturbing when you when you look when you it's a really weird feeling to go all around the world inter these leading experts sit with them and
1:13:51
to realize oh this is an experiment on millions of people and I'm one of the guinea pigs right it's a weird feeling right and it makes me angry that we've been put in the position where we have to make these choices like I say there are countries
1:14:05
that don't have to make these choices because they didn't allow their population to Beed up with process and Ultra processed food in the first place and that pissed me off yeah yeah what what has been the most horrific asmic Story
1:14:19
So Far most horrific OIC story but I interview people who' gone through rough experiences there's a I'm going to this is very rare but there's a condition called pancreatitis which is excruciatingly painful it's basically
1:14:31
where your pancreas doesn't work properly doctors compare the pain of pancreatitis to being stabbed and it makes you nine times more likely to get pancreatitis these when you take these drugs so pancreatitis is very rare but
1:14:41
it's obviously a huge increase in this very rare thing I interviewed a woman called Michelle Stak who uh lives in mytle Beach in South Carolina which is a place I only thought existed in country songs until I interviewed her and um
1:14:53
Michelle said to me you know she went for a zenic for weight loss the doctor said well this is rare side effects one of those pancreatitis she said no my Lu I'll probably get it and she started taking it lost Lo away six weeks later
1:15:03
she went to visit her daughter in Pittsburgh and um she woke up she said in the most excruciating Agony she'd ever been in she felt like she like she was being stabbed all over her body and she was rushed to hospital and they
1:15:16
identified pancreatitis and the first thing they said was are you an alcoholic she said no then they said are you taking a zic she was like yes um so that was probably the P Michelle said to me you know I've had children it was much
1:15:29
worse than the pain of childbirth right so which thank God you and I will never have to go through but um unless you got something you want to announce Jay but the um there's some real horror stories and most people are not having these horror
1:15:42
stories most people are having I want to be responsible most people's experience is more like Jeff Parker or Oprah than it is like you know Michelle yeah but that's now mhm 20 years from now 30 years from now 40 years from
1:15:58
now we don't know what the picture will be which which puts us in this difficult position so we've got some questions from the team that I wanted to refer to so team this is the team so what is your view on when AIC should be used for kids
1:16:13
if at all for me the debate about AIC for kids threw open the whole thing for me because for so many reasons because it's when you look at kids that you realize how this is a crisis created by the fast food industry right and by
1:16:31
processed food industry and by the fact that we as a society have allowed that industry to poison our kids right think about where we are in Brooklyn try walking around Brooklyn with a kid and them not seeing ads the whole time
1:16:45
saying you don't feel good hey stuff your face with that right the first thing I want to say is this is a crisis created by them and we need to stop them doing that and we can do that and I went to places that have done it but given
1:16:57
that's where we are I think people are in a really tough position because there's so I'm very sympathetic to both sides of that debate so for example I interviewed A really lovely woman called Deborah Tyler who's a nurse in
1:17:11
Connecticut um her daughter was very severely obese for when she was very young and um she took her daughter to the doctor when I think she was eight and the doctor to said she had liver problems and just like can you imagine
1:17:26
when you you've been told your child has liver problems at the age of eight and she faced this agonizing decision about whether to put her daughter on o zenic and in the end she decided to do it um and her daughter's liver problems
1:17:38
have gone away so I have a and and she's still very agonized about it all the problems are accentuated when it comes to children I mean there are benefits Dr jles yo who's one of the leading experts at Cambridge University on Obesity
1:17:52
explained to me if you are obese when you're a child it is very hard to become un obese I mean you're unusual right it happens you're proof of that there are other people proof of it but most people don't right it's really
1:18:05
partly because as you become obese all sorts of changes happen in your brain that make it very hard to go back that I go through in the book so there's a case for dealing with it early right and we know childhood obesity I mean has really
1:18:20
devastating impacts on your health throughout your life and radically shorten your life on average there are other people who have a lot of sympathy for like Professor Dan Cooper who's at UC Irvine who say well a and I can't
1:18:32
believe anyone would disagree with this we need to deal with the underlying causes but the environmental factors but B children are not miniature adults right this could affect children in different ways for example one of one of
1:18:44
the things children use calories for is bone mineralization and if you don't have enough calories maybe your bones don't form properly maybe they'll get become osteoporotic as they get older so it's really complicated Novo Nordisk is currently doing a trial on
1:18:58
giving these drugs to children as young as six years old it turns my stomach it's a sign of a sick society that we've reached this point we need to fix the society but if you're trapped in the choice that Deborah Tyler is trapped
1:19:14
in honestly I think I would probably do what she's done and I would feel as anguished as she does about it so this came up with what you just mentioning now like what is your view on uh Oprah asmic speci and what were the benefits
1:19:26
and some of the challenges that came from it on people's perspectives so I can't think dispassionately about Oprah right like I know everyone loves Oprah and a kind of oh we love Oprah Oprah is one of the two or three humans alive who
1:19:37
has most influenced me like when I was a kid you remember this when we were kids remember so vividly the Oprah show would be on at 5:00 pm on Channel 4 right and no one in Britain when we were kids spoke like Oprah right no one spoke
1:19:48
about them no one spoke about their emotions no one spoke about in this extraordinary and profound way that Oprah does and I really think one of the reasons I get on well with Oprah I think is because I've I've so inter internalized her voice that I sort of I mean clearly as a British person you can't talk like Oprah but like well clearly no one can talk like Oprah but you know what I mean like so I can't think dispassionately about it because I
1:20:11
love her so much and I'm weirdly friends with her um which is like still to me the most surreal whenever she emails me or texts me and my friend I was like shut up everyone o needs us be quiet right but um I thought her special was
1:20:23
incredible um I cried a lot my for the minute it started I cried and my friend said Thank God Oprah has not brought her show back because if you had this emotional reaction every day you'd be in a psychiatric hospital because just seeing
1:20:34
Oprah in front of an audience may be emotional but um I thought it was amazing and I think part of it made me really sad because you think about how much Oprah has given us right how much she's given to the culture people forget you
1:20:49
know I mean even just think about the incredible work she did on Breaking the taboos around sexual abuse right where what she's done is incredible and I could list like 15 things like that that Oprah's done that have transformed the
1:21:02
culture and you think all that time she was doing that and Rising she was being bullied in the most hateful ways I really recommend people watch and this is someone else who I admire and was a damaged person so I don't want to say
1:21:17
this in a spirit of judgment but the you can watch it on YouTube there's an interview between Oprah and Joan Rivers from I think 1985 and I'll preface this by saying a Joan Rivers was the funniest comedian I've ever seen and B um Joan Rivers was
1:21:31
someone who hated her own body and was at war with her own body so she's externalizing something that's an internal horrifying battle but it's viscerally shocking when you watch it now she says to Oprah something like I haven't watched it in a long time so I'm going to get the exact wording wrong but she says something like you can't be this fat you need to lose weight and and it's not said as a joke it's not framed as like I mean it' be be
1:21:54
acceptable as a joke but it's not even framed as a joke and you can see Oprah just gets looks really thrown and makes some joke about herself because what else could she do you think God that's the tonight's show she's they're on the tonight's show right that's because Jord was the guest host what how many people watch that 25 million people that's being brutally shamed in front of 25 million people you think Oprah's carrying that the whole
1:22:15
time she's torturing herself you know that famous the famous image of her with the you know the thing that represents as much f as she's lost and you think God I feel so sad if you even if you're Oprah you get tortured about it right it
1:22:30
just you just realize so to see her overcome that and see her looking so well and to see her given a space beyond that stigma I found incredibly moving but that's tied up for me with so many other feelings about oo that I can't
1:22:46
really yeah you know no for sure and do do you feel like some of that stigma is now going the other way too right oh you lost weight because of OIC so then that stigma creeping in have you I think I think what's happening is a complicated
1:22:58
thing just like the drugs interrupt the way we eat and bring to the surface these emotional feelings we didn't know were there I think culturally OIC is leeching out some deep underlying ideas about obesity so for example I'm I'm a feeling
1:23:15
experiencing them to myself when I was taking the drug I kept thinking I'm cheating I'm doing something wrong think that's really weird one of my best friends tell statins right to lower his cholesterol I've never once thought
1:23:28
cheating to get lower cholesterol than me you'd think I was crazy if I said that right that's really weird what's going on here and I think it lies with looked a lot into the history of obesity and how we talk and think about it so if
1:23:37
you look back in the sixth Century the pope Pope Gregory the first was the first one to lay out the seven deadly sins and one of them is gluttony and it's always depicted with like some hugely fat person pigging out it's very
1:23:51
deep in our kind of psyches to think of obesity as a sin right and one of the ways you know that is what are the forms of weight loss we admire there's basically only one form it's and it follows the classic Catholic pattern of like the
1:24:05
sinner you're a sinner you've got to be tormented you've got to go to through hell and purgatory and then we'll forgive you so think about that game show the world uh is it called The Biggest Loser repulsive and wicked show
1:24:17
in my view um but it's where people haven't seen it people are very unwell very seriously overweight are humiliated made to take part in very extreme and in fact dangerous forms of exercise and starve themselves and whoever loses the
1:24:31
most weight is the biggest loser and therefore wins it's like oh yeah if you torture yourself and go through Agony then we'll forgive you for your sin then we'll go well done good job Joe right but I think one of the things that's weird with
1:24:46
those EMP is it's so easy right so it's like I think a lot of people look at it and go well you haven't paid for your sin right you haven't suffered if you suffer we might forgive you suffer with bariatric surgery just I also think it
1:24:58
underlies you think about cheating right in this culture which D which makes it so easy to be to overeat and be obese and so hard to be healthy lots of people are making daily sacrifices to not gain weight particularly women they're
1:25:14
starving themselves they're denying themselves they're going hungry they're doing extreme forms of exercise and I think to them people like me must look a bit like Lance Armstrong looks to a cyclist it's what you you bastard I work
1:25:30
so hard for this and you just inject yourself once in the Lego week and you get the same benefit as me screw you I can see where that impulse comes from and I think we have to re I think we have to acknowledge those feelings are
1:25:40
there they were there in me they there in everyone I think it's you can't live in this culture and not absorb those ideas at some level but then we have to say well a I don't think obese people are sinners I think we're typical products of this
1:25:52
environment and I'd hope we can move beyond the ideas of a sixth century pope but also in terms of being in a race and competing against each other well we are competing but it's not me against you it's all of us against the forces driving up obesity which other the processed food industry if we reframe it that way we can get out look we live in a as you know very well a toxic age where you know every conversation turns toxic very quickly
1:26:20
partly because of social media algorithms which prioritize negativity all sorts of fact that are going on if we want to have a non-toxic conversation about obesity and about asmic I think we've got to acknowledge those ideas about Sin and cheating are
1:26:35
there and then we got to move Beyond them well said well said yeah I wonder whether you saw did you dive into any research on investors in fast foods and weight loss drugs did you find any patterns between I didn't but I'd be
1:26:49
surprised if and there was some reporting in the Washington Post which I only read brief so I don't want to get it wrong but if I remember rightly I suspect I don't know this but I suspect the fast food industry will soon be
1:27:01
funding anti asmic propaganda just like the um tobacco industry used to fund you know claims that smoking isn't bad for you did for years and years or like the oil industry still funds claims that global warming isn't happening or is
1:27:14
actually a good thing or you know I I would be amazed if that isn't I mean they're going to lose a lot of money and they are some of the most profitable companies in the whole world so I'd be suspect they're already doing it but I
1:27:25
don't know yeah yeah no it's an interesting to think about because I feel like we part of our part of the environment we all live in is somewhat of an illusion and ignorance of not understanding who's behind the narrative
1:27:38
storytelling you know when fast food first came around how did everyone not go wait a minute this is going to ruin the world like how did we not do that or when as you said we're trying to find artificial solutions to artificial
1:27:50
problems and now that we're living in an artificial world it's like well where did we allow that to happen and I want to talk about Japan in that vein because that was a place where you found that at least tried to deal with this in a much
1:28:04
healthier smarter way this completely BW up have you been to Japan by way I so that's number one on my list right now okay if there's one thing you take away from this conversation go to Japan go to Japan it I expected it to be great and
1:28:16
it massively exceeded my expectations but it's completely amazing I'll give you a list of things to do but the um so Japan is really important because some people say about these drugs look if a country gets to be rich people
1:28:29
are going to have more food than they can eat obesity is just inevitable right and therefore these drugs become inevitable but actually Japan is the third richest country in the world in the history of the world and now is the
1:28:39
third rich country in the world and they have almost no obesity at all 42.5% of Americans are obese it is 4% of people in Japan right there's almost no childhood obesity in Japan I went to a school in Tokyo typical middle class
1:28:55
school went several schools it's the weirdest thing walking around a school with a thousand children and they're being not one overweight child anywhere it's it it's it's weird if you're used to going to British and American schools so I wanted to understand how did Japan do it because I remember at first I read about you know AIC has been approved in Japan and there ain't any sales because there's no one to take it right almost nobody it's a
1:29:21
tiny tiny market for it and it's kind of weird that we expect Japanese people to look like sumo wrestlers it would be like expecting an American to look like a bald eagle and at first I thought it must just be that Japanese people won
1:29:31
the genetic Lottery right but that's not true we know that because um in the late 19th century lots of Japanese people moved to Hawaii I was just there and they've been there ever since and Japanese Hawaiians are almost as
1:29:44
overweight as other Hawaiians so and it's not that their genes suddenly mutated in 120 years since so something else is going on right there's something in the environment that's that's driving up obesity in in our societies and hasn't
1:29:56
in Japan and there's so many fascinating things about this I went to a the most important to understand is Japan deliberately created an environment in which it is hard to get fat and hard to eat badly if you go back to the 1920s
1:30:10
Japanese people had one of the worst diets in the world they only ate protein on average once a week right they they were quite unwell they had poor life expectancy and the Japanese government at the time deliberately transformed the
1:30:23
societ not for a good reason it's because they were they wanted to have an army to go and invade the rest of Asia so we all got our motives for weight loss not the best one uh but you know whatever it it worked right and they and
1:30:34
and they deliberately created this new new diet and this new way of being which is now continued in policy in Japan um so I went to a school like I say in Tokyo to see how how does it begin there's lots of layers at which they do this and uh I was
1:30:49
greeted at the door by a woman called harumi tati who's um the nutritionist at this School COI school every school by law in Japan has to employ a professional nutritionist it's a difficult qualification to get it's
1:31:02
three years on top of your teaching qualification your job is to design the food that the kids eat by law the kids can't bring pack lunches they have to eat what's prepared there and they can only that food has to be fresh prepared
1:31:16
on the day and have no processed ingredients at all and then they use this healthy food which has to contain all the food groups every day to educate the kids about how to make their bodies healthy so you know they're eating this
1:31:29
food and Japanese people love food it's not a place where people will deny themselves food they love it right so I'm with this group of kids they're eating the school lunch which literally is more like something from noou than
1:31:39
like anything we ever ate at school right and um they're eating it and I say to these kids through my translator CH I said to these kids and never forget it this the class I think of in particular there were nine 10 year olds I said what's your favorite food
1:31:53
the first kid said broccoli I love broccoli I was like okay little freak said to the next kid um what's your favorite food she said white fish I said to the next kit and she said um oh boiled white rice and I turned to cheer
1:32:06
and I said are these kids trolling me right their favorite foods are broccoli or what at CH like all Japanese people could not understand why I was puzzled and said what do you mean we we teach our kids to eat healthy food don't you
1:32:17
do that and every food group they have they have a rope a colored rope so they like uh when they're eating the uh calcium she holds up the white rope she goes this is calcium what does it do and someone yells at it makes your bone
1:32:29
strong and she goes the red rope this is carbs what do they do give you energy and she ties the ropes together in every lesson and that surrounded meal that you should have in every meal right so they teach kids from a very young age how to
1:32:43
nurture their bodies and I was with these kids and I couldn't help res I couldn't resist the temptation I pulled up on my phone videos of British and American School meals and these kids reacted like I had shown them an Isis
1:32:54
beheading video they like screamed they were like what have they said to me where are the vegetables I said there are no vegetables they where's the salad I said there is no salad they were just complet and one it was very touching one
1:33:06
little girl put her hand on my shoulder and said I'm worried about you thought it was completely adorable right it begins there and then all through the society there are measures taken to make processed food you can buy it if you
1:33:19
want to but it's very much a minority Pursuit um it exists but it's a tiny part of the Japanese diet overwhelmingly they eat fish fresh food vegetables most people eat fresh food that's prepared on the day and I think probably the most
1:33:33
moving conversation I had for the whole book was in okanawa which is an archipelago of islands in the south of Japan where I really saw what you win if you get this right so Japan has the longest life expectancy in the world
1:33:50
women live to be 88 men I think it's 82 but not just that they have the healthiest lifespan in the world so the average British person is in poor health I think it's 16 years before they die in Japan it's like a few years so it's a
1:34:03
very different relationship and so I went to this place that sounds almost mythical it's called ogimi it's the oldest village in the whole world it has 215 houses and 192 have someone older the age of older than the age of 90
1:34:18
living there and I went there and I went to they got this little Community Center and the the first person I met the first woman who walked through the door was a 102y old woman called Matsu fuchi who walked there on her own from
1:34:30
her home down the hill and she said I can't stay long because I'm looking after my son who fell off the roof fixing it the other day I was like Jesus how old is your son but okay um and we sat down and we talked and she talked about how much she
1:34:44
loved life it was volleyball season she' been watching her great grandchildren play volleyball actually loved volleyball you could see how much joy she took in life talk to all the women and then someone put on some old um
1:34:56
Okinawa music and she put on a kimono and she started dancing and so I start dancing with this 102y old woman and I thought wow you were born before they started doing radio broadcasts in Japan and here I am dancing with you and
1:35:12
recording it on my iPhone that's what you get if you solve obesity you don't get destroyed clearly not everyone will live to be 102 but you you don't get your knees destroyed and your heart destroyed and your you know you get to
1:35:24
live and you get more years of joy and more years of laughter and more years of dancing that's what we get if we solve this this crisis and it is within our grasp to solve it these drugs are one tool they are a difficult and
1:35:38
controversial tool and I'm not sure I've made the right decision to carry on taking them it was the heart benefits that did it for me but we absolutely can deal with this wider crisis they've done it in Japan think about smoking right when we were
1:35:52
kids people smoked everywhere people smoked on the subway people smoked on the bus people smoked on the plane doctors used to smoke while they examined you I remember it happening there's a photo of me and my mother where she's breastfeeding me when I'm a
1:36:06
baby obviously uh smoking and resting the ashtray on my stomach and when I found this photo a few years ago I thought she'd feel guilty I showed it to her she said you were a difficult baby I needed that cigarette right but you
1:36:16
think about how normal that was then right now if you saw that you'd call the police right we've gone from you know more than 50% of people were smokers when we were kids it's now 12% you very rarely see a young person smoking
1:36:27
cigarettes now okay we've got an issue with vaping but you know that's an enormous transformation that's happened in our lifetimes through concerted action right we can do the same with food we can free future Generations from
1:36:39
this shitty Choice Japan showed me you can do it with joy right Japanese people aren't sitting there being miserable they love food their food is great I've never eaten better than in the two and a half weeks I was in Japan right
1:36:50
literally never right it's not about depriving yourself it's about making better choices and empowering everyone to be in an environment where we can make better choices do they still have a stigma around uh body shape size weight
1:37:03
and all of that as well yeah this is one of the complexities so I don't want to shy away from it Japanese people are horrifically stigmatizing towards overweight people and that informs some of their policies which are just so strange to us
1:37:17
that they sound like a kind of just bizarre parallel universe give you an example so in 2008 they had their obesity level went up by like 0.4% and they had a massive like National freak out and it was like this huge debate in
1:37:30
Japan what it it was from like you know I can't remember literally for something like 3% to 3.4% or something like say that like we wouldn't even notice in in the US if that happened right um and there this huge debate and they
1:37:44
introduced something that I frankly just when I read about it thought this can't be true it's something called the Metabo law it's B named after metabolic syndrome which is a kind of combination of problems you can get when you're
1:37:55
obese this has very bad Health effect so they introduced this rule actually can't even say it without like it deciding insane in Japan every single employee once a year has to be weighed by their employer if your weight has gone up you
1:38:13
have to by law drop a plan with your employer to bring your weight down and a company overall has to report its weight levels to the government wow and if you're overall Workforce got fatter you can be fined by the government right so
1:38:27
I like how can this work so I went to this company that does it uh I mean every company does it but this is a company that agreed to show me part because they manufacture uh products to keep you healthy so they they can't want
1:38:37
people to know about it and they're super nice people but it was freaky so you arrive the first thing you see when you arrive at work is a face recognition thing it says hi Jay you walked 1,300 steps yesterday or whatever because you
1:38:51
have to wear a Fitbit equivalent of a Fitbit bit and then it says you were number 121 in the company by the way Susie who sits two desks away from you hasn't weighed herself this week oh my gosh tell her to weigh herself you're
1:39:05
like go and then so every you're encouraged it's not required but you're encouraged um to take a photograph of every meal you take and post it so you can literally go H I wonder what bar sits next to me ate yesterday and you
1:39:17
can look at it all it's just bizarre and I was interviewing people there so I interviewed the the boss who's this 58 Old Man Inc I have to say incredibly hot boss um and he was like talking about yeah this is you know this great it's really good for everyone and I was interviewing the employees and they would go yeah this really helps me be healthy and I would kind of go right so if you did this in the US or Britain we would burn the
1:39:42
office building down and they genuinely didn't understand what saying they would kind of go but why I they just it was it really was a moment I thought a profound cultural Chasm right I thought this is you're not like us and we're not like we
1:39:57
can't yeah just as they can't understand us we can't understand that exactly so there are lots of things about the Japanese model I definitely would not I mean we couldn't integrate that even if we wanted to but I if we could I
1:40:07
wouldn't want to so there's lots of things about the Japanese model we can't integrate including just shame right it's a very particularly to women who are overweight it's really brutal the shaming there so yeah there's lots of
1:40:18
things we wouldn't want to integrate and and lots of things we would yeah yeah it's one thing that has stayed with me as we've been on this beautiful journey together today I feel like we've you know I've learned so much from you I
1:40:28
learned so much from the book I I really want people to read the book to dive into it we've kind of nicely kind of visited different chapters and and different sections inside of the book but there's one thing that stayed with
1:40:40
me is this idea of even after being on OIC if people are unable to change their eating habits even though they're satiated quicker does that not necessarily double up on the health problems too so it inevitably changes your eating patterns in one key
1:40:59
way you eat much less right but the an issue and this was definitely true of me for the first six months is to put it crudely I was eating smaller portions of the same o that's what I mean yeah how does yeah yes I was going to McDonald's
1:41:10
but instead of getting like a large Big Mac meal and nine nuggets I was getting a hamburger right and that's a moveing the right direction but still very imperfect as um Robert Kushner one of the scientists who was involved in the
1:41:22
studies about these drugs explain to me look there's an issue about nutrition just separate to weight if you're eating food that doesn't give your body what it needs even if you're not obese that's still really bad for you right so for me
1:41:34
I it made me realize I had to do I'm super embarrassed to say it but I didn't know how to cook I didn't know how to do really basic things I learned that partly because I realized I had to make that change but you could I could have
1:41:44
just carried on eating smaller portions and frankly I'm on the road at the moment I am eating smaller portions of the same I this morning I had a travel is imposs travel is really tough or even try living in Las Vegas not
1:41:54
ideal um but the if you worried about portion size in this country generally you want to try Vegas but um yeah so yeah the issue you're pointed to is real I mean you're still moving in a positive direction but it can leave you yeah far
1:42:09
from from the ideal position yeah yeah absolutely yeah and it's been such a joy talking to you today deeply insightful I appreciate the honesty of just what a challenging nuanced layered subject matter this is and I feel your analysis
1:42:25
research and thought through it is actually so so so helpful in that if people are confused in their decision- making for themselves their family I think you've at least given them every angle possible to think about which is I
1:42:39
think somewhat sometimes what's missing right sometimes we are just presented a binary angle which is where we started and now we're ending today feeling like we can look at this from 12 different angles and 12 different points of view
1:42:51
we end every episode of on purpose with a fast five or a final five these have to be answered in one word to one sentence maximum okay this is very hard for me as you can tell do my brutal right okay these are your final F you
1:43:03
should have someone to your colleague should taser me if I go beyond a sentence right we should we should wire you up yeah exactly uh the first question is what is the best health advice you've ever heard or received
1:43:14
it's what Lindy West said that I quoted before you can't it's hard to treat well an object you hate you've got to learn to love your body that's great advice I love that one uh second question what is the worst advice Health advice you've
1:43:26
ever heard or received I went to an Austrian diet clinic in Claren Fort where they made me eat nothing but tea for like days and days and days yeah not good advice yeah just tea how did that end up tell us I want to know well I was surrounded by people I would go like so there were people there who'd he'd been there for like three weeks and they were on the tea diet and I said how do you feel and they said terrible I was like yeah you're going to
1:43:53
die get out of here I felt like Jack Nicholson want Flew Over The Cook Nest get out of here that's amazing going to buy a brat first up the road uh question number three what's something that surprised you about this journey that you went on
1:44:07
with the magic pill how hard it is how complicated it's not I'm not normally such an even-handed person it's really complicated and that surprised you you thought it would be a lot more clearcut I thought every other book I've ever
1:44:19
written I've come to a more firm conclusion at the end than this you know with this it's sort of like you've really got to go down the list of the risks and benefits for yourself and it will really help you to know all these risks and benefits
1:44:30
but I I can't tell you at the end and now dear reader do it or don't do it or do these things you know I'm completely failing at these one sentence unconscious that's great I'm asking you too permissive Jay give angry face when
1:44:42
I go one sentence uh question number four if you had to ask people to reflect on three things while they're making their decision there are many things in the book that they need to read and study but three things while they're
1:44:54
reading the book that you'd like them to reflect on as they're making their own decision what would they be that are not related to BMI or some of those more tactical ele not tactical those U tangible elements you shared with us
1:45:06
earlier think about what your relationship with food was in your family when you were a child because all sorts of issues around that will come to the surface which we haven't touched on but it's really important number two is
1:45:18
think about how important pleasure in food is for you because a lot of people experience a huge reduction in it although I didn't a lot of people do number three is these drugs might be significantly reducing addiction this is
1:45:29
hugely contested but there are serious scientists who think they are and that's a whole dimension we need to think about not just food addiction but actually like cocaine addiction venal addiction across the board those would I guess be
1:45:41
the three things that we haven't covered that would be the things I there's about 100 things from the book we haven't cover yeah exactly yeah okay great uh Fifth and final question if you could create one law that everyone in the
1:45:51
world had to follow what would it be oh one [Music] law can I get rid of a law oh you be the first person to do it I love it the law I would get rid of would be the criminalization of addiction you know had a lot of addiction in my family um punishing people who got addiction problems makes the problem worse most of the money we spend on drug policy in this country is shaming humiliating and literally caging people with addiction problems in
1:46:26
Portugal when they took all that money they spent on putting people in prison shaming them and humiliating them and spent it instead on like helping them addiction massively fell overos deaths massively fell we could do the same and
1:46:39
we'd get the same results so it would be I guess take the current law on criminalizing addiction and drug use more generally and transfer all that money to helping people instead brilliant you're the first person ever to get rid get rid
1:46:53
of a law great Happy Days I'm not normally salarian but there we go everyone the book is called the magic pill the extraordinary benefits and disturbing risks of the new weight loss drugs Johan Harry thank you so much make sure you go and grab and order a copy right now I really really want this make this the book of your book clubs the book that you're reading with your friends your family I think it will as Yan said there's so many parts of it
1:47:17
that we didn't even get to cover I hope he'll come back and we'll dissect it a second time but I really believe that this book is so significantly important at this time especially and especially for the younger generations to follow so
1:47:30
highly highly recommend magic pill thank you so much than much really mean it I feel quite emotional hearing you say that thank you so much I really mean it I think there's so many things like you said that we we still haven't covered
1:47:42
and I hope you'll come back to do those anytime because uh yeah I I I think this is it's it's it's the biggest thing right now and and especially with the way you've dived into when you're talking about just the amount of stigma
1:47:55
there is from day one and it seems to never go like you said even with Oprah right like it's like whether you're here or you're here it's like that experience of that stigma doesn't disappear and so if you're living with that for your
1:48:10
whole life and it was created by a system that that needs to be addressed and I think you're addressing in a in a really deep and profound way so thank you I think I meant to say my lovely publicist is in the corner so she taser
1:48:22
me if I don't say this um the anyone who wants to know anything more about the book can go to magic pill book.com they get the audio book which I read the ebook physical book um and I think I meant to say you can get it from
1:48:34
good book shops or good book shops but you can also get it from shitty book shops as well get any book shop at all yeah I've never understood that St I know it's like weird it feels weirdly like exct we don't have like a quality
1:48:42
test so let's go order some KFC on Uber Eats now shall let do it let's do it yeah we got some for you to end by bringing buckets of KFC I hope that's you aming I hope you felt of course it was amazing you got to share what you wanted to share oh thanks
1:48:58
everyone thank you if you love this episode you'll enjoy my conversation with Megan Trainer on breaking generational trauma and how to be confident from the inside out my therapist told me stand in the mirror naked for 5 minutes it was already tough for me to love my body but after the c-section scar with all the stretch marks now I'm looking at myself like I've been hacked but day three when I did it I was like you know what her thigh are cute