00:00:00
we've not spoken for 2 years but I have to say you look remarkably different so I lost three stone in a year and there's secret to that statement Johan Hari the
00:00:11
bestselling author who's using his own body to unearth the extraordinary benefits and disturbing risks of the new
00:00:17
weight loss drugs OIC it is literally the hottest drug in the country right now I really worry about the risk of
00:00:24
these drugs you're nine times more likely to get this particular condition which is excruciatingly pain for and
00:00:30
these drugs are working very hard on key parts of your brain in fact there are 12 significant risks and we'll get into
00:00:36
that but it seems extraordinary that we' reached the point where we would inject ourselves with a potentially risky drug
00:00:41
to stop us from eating and we've had 40 Years of relentlessly promoting diet and exercise as the only solutions and only
00:00:48
10% of people really do lose huge amounts of weight on diets and keep it off but now we have the most effective
00:00:54
tool for self- starvation human beings have ever come up with when I started taking zpic I was literally 80% % less
00:01:00
hungry than I normally am these drugs really do massively reduce or reverse obesity and a few years from now we'll
00:01:06
have 50% of the population taking it the new miracle drug now this is when I go through the 12 big risks some of which have not really been explained to the public So within a year of stopping you
00:01:17
regain 70% of the weight you've lost muscle mass loss is a real problem there's concern that it may be causing
00:01:23
suicidal feelings and then there's one of the really big risks and it's absolutely Grim beyond belief and that
00:01:28
is congratulations Dio gang we've made some progress 63% of you that listen to this
00:01:35
podcast regularly don't subscribe which is down from 69% our goal is 50% so if you've ever
00:01:44
liked any of the videos we've posted if you like this channel can you do me a quick favor and hit the Subscribe button it helps this channel more than you know
00:01:50
and the bigger the channel gets as you've seen the bigger the guest get thank you and enjoy this
00:01:57
[Music] episode Yan we've not spoken for 2 years but I have to say you look remarkably different there's a secret to
00:02:09
that Stephen really we can dig into yeah what is the secret so for me it started it's a kind
00:02:17
of weird story it started in the winter of 2020 so it was that weird period when
00:02:22
kind of the world was opening up again after the pandemic and i' gained a lot of weight in lockdown like loads of people
00:02:30
and because of that kind of weird moment of reopening I went to a party for the first time in like I don't know a year
00:02:36
and a half two years and it was a party thrown by a kind of famous Hollywood actor and on the way there I remember
00:02:42
thinking oh this is going to be kind of funny because all these Hollywood people are going to put on weight as well right
00:02:48
they're going to have gained weight what are they going to look like so I remember getting there looking around
00:02:55
and having this really weird feeling because it's not just they hadn't gained weight everyone was gaunt right like
00:03:03
everyone looked like their own Snapchat filter like they had like higher cheekbones they looked cleaner and
00:03:09
clearer and sharper and I was kind of wandering around feeling bit like oh [ __ ] and I
00:03:14
bumped into a friend of mine on the dance floor and I said to her what it looks like um looks like everyone really
00:03:20
did do Pates during lockdown and she laughed and then she looked at me and I S looked at her and
00:03:26
she said well you know it wasn't Pilates right and I sort of looked at her blankly and she pulled out her phone and she showed she Googled an image and she
00:03:36
showed me an OIC pen and I didn't know what it was and I said what are you talking about and said it's a drug
00:03:42
everyone here is on this drug right not just the Stars like their wives their agents their agents kids everyone right
00:03:49
and I've been really thrown and then over the next few days I I read a lot about these these new weight loss drugs
00:03:55
and I've never I don't remember ever coming across a topic where I felt so deeply conflicted from the very beginning and that conflict remained all the way through right the subtitle to my
00:04:07
book is the extraordinary benefits and disturbing risks of the new weight loss drugs and that's even right from the
00:04:14
start I was I was aware that was that was the the tension so the benefits are kind of obvious right you know I'm older
00:04:21
than my grandfather ever got to be because he died of a heart attack loads of the men in my family get really fat
00:04:26
and die of heart attacks my uncle died of a heart attack my dad had a lot of heart problem problems um there's a lot
00:04:32
of evidence that obesity unfortunately does cause a whole range of health problems over 20000 diseases and
00:04:39
complications uh there's a lot of evidence these drugs really do massively reduce or reverse obesity the average
00:04:45
person who uses them as z p wovi loses 15% of their body weight in a year with the new generation of the drugs the next ones that are coming down the line the average person loses 24% of their body
00:04:57
weight it's staggering it's just below barrier atric surgery so I could see the obvious health benefit and I could see
00:05:04
that the Alternatives that most of us have been pursuing diets have not worked well for most
00:05:10
people but at the same time I thought I mean just I had so many doubts straight away I thought well we've seen this story before there have been lots of miracle diet drugs that have been
00:05:22
announced they caus dramatic weight loss at first and we always discover some horrendous side effect that causes you
00:05:29
know cat Ric outcomes that mean the whole thing has to be pulled I thought that I
00:05:35
thought well we know what causes obesity right the reason obesity is massively increased is because of a complete
00:05:41
change in the food supply we eat completely different food to what our grandparents ate we need to deal with
00:05:46
that not kind of drug everyone I also thought well what will happen to people with eating disorders when they get a
00:05:52
hold of this what will this do to the kind of positive changes that were happening in accepting a kind of broader
00:05:57
range of Weights so I was really deeply conflicted so to really get to the bottom of this for my book magic pill I I spent a year taking the drugs and going on this big Journey all
00:06:09
over the world from rekovic in Iceland to Minneapolis to Tokyo to interview the leading experts in the world on these drugs the biggest supporters the biggest critics all sorts of uh kind of alleys
00:06:21
and avenues that follow from them and at the end of it it's really weird I know far more than I did before I know far more about benefits and risks and far more about what this is going to do to the culture and it will be
00:06:33
massive but I'm still really conflicted so if we if we start there then you're at the party someone
00:06:39
mentions this zmek thing to you can have you got the zmek um pen on you I have it
00:06:44
as a a prop you've got it here okay so it's very simple um you it's just a little pen it's like um an epip pen so you take that you uh put on the little lid I won't take it out because I need
00:06:56
this one later but the um although this one's empty you put a little you twist a little needle onto there and you inject
00:07:04
yourself with it and you inject yourself once a week and it's really strange the
00:07:09
effect it has I remember the first day I took the injection couple of days later I
00:07:16
remember waking up and I was lying in bed and I had this weird feeling you know feeling when you wake up and you're not quite with it and
00:07:23
you think what am I feeling and I was struggling to articulate it and I I was I thought I felt mly nauseous which everyone gets when they start taking but
00:07:29
that wasn't the thing that was puzzling me and then I realized I'd woken up and I wasn't
00:07:35
hungry I don't remember that ever happening to me before I mean don't mean that as an exaggeration I I used to be woken up every day like really hungry
00:07:43
often I would be woken up by hunger by my stomach rumbling and I went on my kind of typical routine for the day I went to this Cafe just around the corner from where I live and I ordered the same
00:07:55
thing I would always order which was a kind of big kind of a Brown roll with lots of chicken and mayo in it and I had
00:08:03
like three mouthfuls and I was full I just didn't want to eat anymore I remember leaving I remember
00:08:08
Tatiana the woman who works in the cafe kind of shouting after me to see if I was Ill or something and then for lunch I went to
00:08:14
the same place I always go or went at the time next to my office there's a Turkish kind of restaurant I went there
00:08:21
I ordered a Mediterranean lamb again I had like three or four mouthfuls I wasn't hungry it was like the kind of had come down on my appetite I was literally 80% less hungry than I
00:08:32
normally am and it basically stayed that way from then on it was a very uh physically and psychologically strange experience so on the on the on the pen itself cuz I just want to make sure I
00:08:45
fully understand this is that that little pen you have in your hand for people that can't aren't watching on video there's a it kind of looks like a
00:08:51
big sharpie yeah exactly and is that one dose yeah there's load of doses in there
00:08:56
so you twist the base yeah and um that each time you twist it it would release with this pen 1 milligram okay yeah and how many twists you get out of one pen uh I think each one contains
00:09:09
four dozes yeah and how much does that cost so it varies massively because as you know I live half in the US half in Britain a lot of the time um so in Britain this cost you at the moment about £250 a month in the US it's way
00:09:22
more like $800 a month so £250 a month how many sort of doses do I get for that £250 you that would cover your whole month so each month you'd have to pay £250 you get four doses in each one and
00:09:33
you said in the US it's way more way more how much more so it's about $800 between 800 and 1,200 bearing in mind
00:09:39
there' have been lots of shortages which I'm sure we'll talk about so the price has kind of been a bit sensitive to how much is actually available at any given
00:09:46
time okay interesting and are these drugs new relatively so I interviewed the scientists who played the key role in the breakthroughs that led to the development of the drugs and then scientists who worked on it at every
00:09:59
stage so in one sense they're not that new diabetics have been using them on license now for 18 years so for obesity
00:10:07
they're relatively new for diabetes they've been around for nearly 20 years and it was fascinating talking to the
00:10:12
scientists involved because one of the things that's really weird about this is there's a huge debate about how they
00:10:17
even work so there's certain things that we know for sure so if you now ate something right you it don't matter what it is after a while a hormone would start to be produced it in your body
00:10:30
called glp1 and that is one of many gut hormones that would start to be created and it's basically glp1 is a natural signal saying Stephen you've had enough stop eating right just stop now right
00:10:41
but gp1 natural glp1 only remains in your system for a couple of minutes and then it's washed away so if you sort of
00:10:46
push through it you can carry on eating right most people do stop when they get the signal um so what these drugs do is
00:10:54
they simulate glp1 they inject into you an artificial copy of glp 1 but instead of that glp1 remaining in your system for a few minutes and then disappearing it stays in your system for a whole week
00:11:06
so when I go to that cafe and I eat the thing I'd normally eat my system is filled with signals that say you're
00:11:12
already full Johan you don't need anymore right so that was initially that is definitely a key part of how it works
00:11:19
and it was initially thought that these drugs worked on your gut right these gp1
00:11:24
is a hormone that's made in the gut um it's thought that the effect was it slows down your gut it slows down
00:11:30
gastric emptying that is definitely happening but The Cutting Edge science and the kind of leading neuroscientists
00:11:36
that I interviewed now believe actually it primarily has an effect on your brain it changes what you want and how you
00:11:43
want it which brings with it a huge parallel set of both benefits and risks interesting so it's once a week and you basically feel Fuller for a whole week
00:11:54
from one injection yeah not everyone gets to that state immediately some people it takes longer some people the
00:12:00
side effects are just intolerable and they can't take it at all or they can't continue to take it and I interviewed
00:12:05
plenty of people who were in that position but for most people the best way I can describe it is
00:12:13
imagine you just had Christmas dinner yeah and I came up to you so you're completely bloated you're lying on the
00:12:18
sofa and I came up to you and said hey Steven I got you a Big Mac here it is and you be like I mean you could
00:12:24
physically force yourself to eat that Big Mac you might throw up but you probably could eat it but you just don't want to you feel full so it creates a
00:12:31
very rapid sense of fullness in response to far so I used to eat 3,200 calories a
00:12:36
day roughly I now eat about 1,800 there a huge drop and the benefits are kind of obvious of that but there are really big costs I discovered there's in fact 12 really big risks and
00:12:48
there's all sorts of Cu at first when you hear all this you're like well this is just kaching win win right who wouldn't want this but there's a lot of
00:12:56
risks and downsides as well so I want to get on to all those risks and downsides but one of the I think rebuttal that
00:13:02
some people would have when they hear this um is kind of contrary to the reaction I think you expect which is
00:13:08
Johan I really love eating food I really really enjoy the process of eating food aren't you losing happiness because food
00:13:15
gives a lot of people happiness in various ways so aren't you a little bit annoyed now that you've lost your desire
00:13:21
to have you know that role that you used to have for breakfast in the morning hasn't that taken something from you
00:13:27
this is a big drawback for lots of people I think I'm quite unusual so I'll explain how most people feel about this then I'll explain how I feel about it um
00:13:33
you're absolutely right even yenil Holst who was one of the scientists who developed o zenic said look for most
00:13:40
people it's just a life without pleasure in food is just unbearable and after a couple of years they just give up
00:13:46
because they want to enjoy life right and one of the key things that gives us pleasure throughout the day is eating uh
00:13:53
and a lot of people feel that way if you look at for example Jay Raina a brilliant food critic here in Britain
00:13:58
you know he just described how he started taking it he would go to the best restaurants in Paris places he
00:14:05
loves and he just couldn't get any pleasure out of it so for him it was just awful it's a very
00:14:13
common complaint that it drains pleasure from food honestly I I had almost the opposite experience but I want to stress
00:14:19
I do think I'm quite unusual so I realized when I started taking these drugs one of the fascinating things
00:14:25
about these drugs is they will bring to the surface whatever psychological issues you had with food right because
00:14:31
it so radically interrupts your eating patterns um and that can be very challenging for a lot of people I'm sure
00:14:37
we'll get into that but for me I realized how much of my eating from when I was very
00:14:43
young the pleasure I got from food was not primarily from like tasting it and savoring it the pleasure I got from food was mostly from kind of a feeling of stuffing myself so stuffing is like you
00:14:55
you do it at Christmas din we all do it sometimes stuffing is when you sort of eat deliberately beyond the point at
00:15:01
which you're full and you feel it as a physical sensation you can feel it sort of pushing up on your esophagus and out on your stomach and I think from when I
00:15:08
was very young I grew up in a very violent and crazy environment I think one of the ways I learned to cope with
00:15:15
that there are many productive and positive ways I learn to cope with that but one of the kind of downsides is I learned to really eat to soothe myself
00:15:21
and I would stuff and when I started taking o zenic I actually couldn't eat like that anymore you you can't stuff
00:15:27
yourself I would literally throw up if I you know tried to stuff myself so actually for me it massively slowed down
00:15:34
my eating and I actually enjoy food a fair bit more now I don't want to overstate it I'm not a foodie I'm never going to be that person but like I
00:15:41
remember going for dinner with one of my friends I know maybe three or four months after I started taking it and I
00:15:47
saying to me you know it's always been a bit stressful to eat with you because you eat so quickly but you don't seem to really enjoy it and now you do actually
00:15:54
look like you're enjoying your food but I stress again I don't think I'm typical in that respect there are
00:16:00
far more people like J Raina than there are like me I really want to go into why people you know people's
00:16:07
relationship with food more generally um but I wanted to close off on that what you were saying about a Zex impact on
00:16:13
the brain you talked about gp1 in the gut and the you know the impact that hasn't making you feel satiated but you
00:16:19
also alluded to there's now research that suggests it's doing something to the brain as well this is totally
00:16:24
fascinating it opens up a whole new set of potential benefits for these drugs in relation to add
00:16:30
and a whole set of potential risks for these drugs in relation to depression so I want to stress there is very big
00:16:37
scientific disagreement about what is happening in the brain in relation to these drugs and it's a bit like when you
00:16:43
interview people it's like it's like looking at a picture that's just coming into shape so a year from now we'll know
00:16:48
much more than we do now but what was discovered this actually discovered in the 90s um here in London at Hammer
00:16:56
Smith hospital was that in fact we don't only have glp receptors in our guts we have glp receptors in our brains in fact glp one can be made in the brain right which is fascinating it could also made
00:17:08
in your thyroid which is very significant I'm sure we'll come back to um so when you take these drugs um as
00:17:16
John Wilding one of the key figures in the development of these drugs said to me you can tag the drug which means that
00:17:21
you can sort of D it and you can give it to animals and then cut open their brains obviously you can't do that with humans and when you do that when you
00:17:27
just give them the drug and you in their brain afterwards what you find is this drug goes everywhere in the brain it's
00:17:33
going all over the brain it is primarily having a brain effect right and it definitely also much more anecdotally
00:17:40
feels that way when you take it it feels like you want different things right it
00:17:45
doesn't just feel like a physical sensation of I'm full it feels I remember taking my godsons to McDonald's
00:17:51
maybe a week after I started taking it and I didn't want a McDonald's and then one of my godsons saying to me who are
00:17:57
you and what have you done with Yan right was so contrary to my preferences and my fact um one of my low points in
00:18:04
life was Christmas Eve 2009 I went to my local branch of KFC just around the corner from where we are
00:18:10
now cuz I used to live in here and I said to the guy behind the counter my standard order which is so gross I won't
00:18:15
repeat it and the guy behind the counter said oh yoan I'm really glad you're here wait a minute I was like all right and
00:18:20
he went off behind where they fry the chicken and everything and he came back with a massive Christmas card and
00:18:26
everyone was working that day and they'd written to our best customer and they all clapped me and one of the things
00:18:32
that was so terrible is I thought this isn't even the Fried Chicken shop I come to the most right how can this be
00:18:37
happening to me but so when you speak to the The Cutting Edge neuroscientists and I interviewed them in great depth
00:18:42
there's basically three theories about what these drugs are doing to your brain right very broadly I mean they this is a
00:18:49
quite crude way of putting it um so one is you have in your brain something called the reward system the reward
00:18:56
system is what motivates you to do anything so you know you have sex you eat you meet up with a friend your
00:19:02
reward centers hum right it's what makes you feel good when you do something pleasurable and one theory about these
00:19:09
drugs is they dampen your reward system so the reason I don't want a Big Mac is that a Big Mac is not as rewarding to me
00:19:15
as it would have been before I took these drugs right that obviously brings with it a set of risks because then you
00:19:22
go okay if it's dampening my reward system for Big Mac is it dampening my reward system for the things I love
00:19:29
writing reading there's a big debate about this there's concern that in some people it may be causing suicidal
00:19:35
feelings and in some people it may be causing depression there is a warning on the drug to that effect required by the
00:19:41
FDA the the fin drug agency in the United States that's one concern but there are other scientists who say that
00:19:48
we don't that that's not correct that um that the suicide risk is not accurate and that they don't work by dampening a reward system some people like aelia G
00:19:59
who's at the University of um Alabama in Birmingham said to me what he thinks that it does is it resets your
00:20:04
preferences it's almost like taking your phone back to the factory settings it resets key elements of the kind of food
00:20:10
you want to a healthier level can I just say on that sorry to interrupt but um I was thinking constantly as you were
00:20:15
talking about your trip to McDonald's and not wanting the McDonald's anymore I I've come to see in my life that if I
00:20:21
have something unhealthy if I have sugar or a cookie today I'm I feel like I'm much more compelled to have another one
00:20:27
tomorrow I feel like I I I look back on certain periods of my life where I almost get into a bit of a sugar spiral and it could be because of stress or some other Factor but it made me think that the sugar itself is somewhat
00:20:39
addicting so when you were talking I was thinking is it is it not just a case that you're consuming less sugar and you
00:20:46
know some of these addictive food substances so you want it less the next day if you know what I'm saying yeah
00:20:53
there's an experiment that proves you're right but in a complicated way um can I just finish off one thing about the
00:20:58
brain and then come back to that raised a super important and and truthful point the third theory about how it could be
00:21:04
working in the brain and this comes from a scientist called Professor Paul Kenny who actually did the experiment relates
00:21:09
to what you just said he argues that in your brain you don't just have a reward system you have something called the satiety system and this is a crucial
00:21:17
concept for people who want to understand these drugs and what's gone wrong with our diets more generally to understand satiety is just the feeling
00:21:23
of having had enough right we've all had the feeling of being sated you're like okay I'm done I don't want anymore we
00:21:28
get that with food sex all sorts of things right you're just sated um he argues that in your brain there there's
00:21:34
basically alongside the reward system there's also a satiety system A system that just says Stephen you've had enough
00:21:41
stop now and he argues that what these drugs do is they dial up your satiety system they don't dial down your reward
00:21:47
system right there's a huge and ongoing debate about that what we do know is they're having some really significant
00:21:52
effect on the brain and that has all sorts of implications that we need to think about when I was learning about
00:21:58
this I remember thinking this is a much more intimate and risky transformation than when you first hear oh I'm taking something that affects my stomach right so there's a
00:22:10
lot there about the brain and implications for addiction as well which we can talk about but to come to the thing you asked about which is so
00:22:16
important of all the things I learned there was an experiment that kind of freaked me out about this um because
00:22:22
obious I was trying to figure out well how did we get to this point because at first glance I can see how it seems crazy in a way it did to me you know we
00:22:31
gained an enormous amount of weight in the last 40 years I was born in 1979 the year I was born 6% of British people
00:22:38
were obese it's now 26% right staggering increase unprecedented in human history
00:22:45
and it seems extraordinary that we've reached the point where we would inject ourselves with a potentially risky drug
00:22:51
to stop us from eating it seems so unnatural and so wrong and I was trying well how did we get here right what
00:22:57
happened which is why satiety is so important so it's this experiment that I think helps
00:23:03
to understand that thing you were saying about sugar it's done by this guy Professor Paul Kenny who's the head of
00:23:08
neuroscience at Mount siai in New York and a brilliant neuroscientist so Paul grew up in Dublin
00:23:16
and he moved to the US when he was in his 20s to do his PhD I think and he moved to San Diego first and it quickly
00:23:23
clocked Americans do not eat like Irish people right they eat much more sugar much more fat they eat just much more
00:23:29
right and within being within like a year of being there he'd gained I think a stone and a half or something uh so he
00:23:35
gained I think it was 23 pound so it gained a lot of weight and he started to wonder sort of like the question you were asking does this food when you
00:23:44
consume it change your brain in ways that compel you to consume it more what's going on so he designed an
00:23:51
experiment that sort of investigated this uh which I've nicknamed cheesecake park that's not its official name right
00:23:58
um you get a load of rats and you raise them in a cage and they've just got the kind of food that rats evolved to eat
00:24:04
over thousands of years it's pellets based on their natural diet and if you do that even though they've got far more
00:24:09
pellets than they could actually eat they will eat enough to deal with their hunger and then they just naturally stop
00:24:15
right so when they've got the kind of food they evolve to have they never become overweight or obese they just
00:24:20
stabilize their weight they've got a kind of natural nutritional wisdom then Professor Kenny introduced the American
00:24:27
diet to them he fried up some bacon he bought some Snickers bars and crucially he gives them a load of cheesecake and they come
00:24:34
along and they nibble the cheesecake and the other stuff and quite quickly they just go wild for it they shun the food
00:24:41
they evolved to have and they just start obsessively eating the cheesecake the fried the fried bacon the Snickers bars
00:24:49
he described to me how they would like he would put the cheesecake in and they would just hurl themselves into the cheesecake and then like eat their way
00:24:55
out and emerge like completely slicked with the cheesecake so given this kind of food all their nutritional wisdom
00:25:01
disappeared just went away and they became obsessed with this new kind of food um and as he put it to me within a couple of days they were different animals their all their health
00:25:12
indicators were worse they were obsessively eating within a few weeks they were their health was really bad they became extremely obese and then he
00:25:20
varied the experiment even more in a way it seemed to me as a former junk food addict a little bit cruel he took all
00:25:26
the American diet away and they just have the food they evolved to have the food they used to eat right and he was
00:25:31
quite sure he knew what would happen that they would eat a lot more of the kind of natural food than they had
00:25:37
before and this would prove that junk food expands your appetites that isn't what happened what happened was much
00:25:43
worse they completely shunned the natural food it was like they no longer recognized it as food at all they just
00:25:50
refused to eat it they starved and it was only when they were really starving that they went back to eating the
00:25:55
natural food there's lots of human examples of but there's something as Professor Gerald M who's a nutritionist
00:26:01
at Harvard said to me there's something about the food we're eating which I think you're getting out in that question which is undermining our
00:26:08
ability to know when to stop which is how we got to the point where we so many people 47% of Americans want to take a
00:26:15
drug that will make them stop I was reading about this um thing you call the Cheesecake Park in your book in Chapter
00:26:23
2 and the other sort of Step he took the experiment to was the whole idea of electrocuting the animals when they ate certain foods and you say in the book that he then um would electrocute the
00:26:35
animals while shining a yellow light in their eyes so that they would eventually become scared of this yellow light and
00:26:40
in the case of um the natural food when he Shone the yellow light in their eyes they would run away but even if you
00:26:46
Shone the yellow light in their eyes while they were eating the junk food they would stay and continue to eat the cheesecake which kind of the conclusion
00:26:52
in Chapter 2 of your book as I've written it here is and the thing this came from the researcher if you're
00:26:58
exposed um to this food for a while Paul concluded the desire for it is so great that you will ignore all sorts of
00:27:04
negative consequences to eat it as we know as I know in my own life right my KFC Obsession had obvious negative
00:27:11
consequences in my life and the reason this is so important in relation to these drugs so for a long time I was looking at two things right I was
00:27:17
looking at why did we so many of us gain so much weight so rapidly obesity has trebled globally in my lifetime right completely unprecedented human history why did that happen
00:27:28
and how do these drugs work and at first I thought they were like parallel lines right but actually I realized they were like kind of braided plats the answer is
00:27:35
completely densely interconnected what we know is the kind of food we eat profoundly undermines our sense of satiety it completely disrupts just like it did with the rats it we don't get
00:27:47
that signal you're full you've had enough stop from the kind of food we're eating and what these drugs do is they
00:27:54
res restore a sense of satiety Carell Laro another one of the key scientists who develop these drugs said to me what
00:28:00
these what these drugs give you is satiety hormones they give you back a sense of being full and in a way at
00:28:06
first I thought well that makes the whole thing seem crazy right because there's a guy called Michael low brilliant Professor um at Drexel University in Philly he said to me look
00:28:18
you got to understand these drugs are an artificial solution to an artificial problem we've artificially created this
00:28:24
problem through a catastrophic food system that is screwing bring us up from childhood and then Along come these
00:28:31
drugs as the artificial solution to that and the first thing you think is right we' got to deal with the fear system
00:28:37
right and that is absolutely true and correct and I remember going to one of my closest friends um I call her Judy in
00:28:43
the book it's not a real name who you know she'd had cancer seven years before so I've been with her all through that
00:28:49
kind of really grueling process and it was an absolute nightmare she's a single mom and you can imagine how how Grim
00:28:55
that was um and I said to her I feel like a complete fraud taking these drugs right I'm always talking about how we need to deal with the causes of social problems I can see very clearly the
00:29:06
cause of this problem and this is just sort of dealing with the symptom and she said to me look
00:29:15
Johan you can stop taking this drug that's fine do it if you want to but when I had cancer we know there is
00:29:22
something in the environment that is triggering breast cancer in women right one in seven women in now get breast
00:29:28
cancer that didn't happen in the past it's not happening in Japan where it's only one in 38 women something is really
00:29:34
wrong in Britain and the US in the way we're living that is triggering breast cancer right but she said to me you
00:29:39
didn't say to me when I got breast cancer well [ __ ] me all this environmental problem has caused this
00:29:46
breast cancer and now you want to inject yourself with another poison chemotherapy in order to deal with it no
00:29:51
you said okay we've got an environmental problem obviously that environmental problem needs to be dealt with but
00:29:56
you've got to stay alive or you you can't deal with it right the analogy she gave me that really helped me was she
00:30:02
said if your house is on fire right you could say well look we need to build houses that aren't made of flammable materials and we should make it the law that you've got to have Sprinklers and
00:30:13
of course I agree but the first thing you got to do is put out the fire in your house right and I after that
00:30:20
conversation it was just after it I I met a guy called Jeff Parker he's in San Francisco he's a 66 year old lighting
00:30:27
designer who was about 16 Stone when I when when he first started taking weight loss drugs and he was in real trouble
00:30:34
heart problems liver problems kidney problems it was very painful for him to walk and he got mjo which is the next
00:30:41
Generation up of these weight loss drugs and he lost loads of weight and all his
00:30:46
health problems reversed and now he walks his dog over the Golden Gate Bridge every day and is really happy and
00:30:51
said look I feel like now I'm going to enjoy my retirement and I said to him but Jeff I'm don't you feel like we
00:30:57
should be dealing with the environment mental causes and he said absolutely I totally agree with you you start that
00:31:02
campaign sign me up but I've got to tell you by the time we achieve that I'm going to be dead right we're not going
00:31:08
to get there in the next few years and I want to live and I found that I found it hard to dispute what what if people say well you know you could um you could just not
00:31:20
choose the role at the coffee shop in the morning you could have just gone for I don't know a salad or something yeah
00:31:26
it's a choice you're making Johan make better choices so this was completely the voice in my head I remember another one of my friends when
00:31:33
I was at dinner and I was doing this I was talking through everything I've been learning and I was talking about you know the r What You Got Away here I
00:31:40
thought was the risks of obesity which are really disturbing when you learn about them I was actually surprised we
00:31:47
all know obesity is not good for your health but I was actually stunned when you look at the evidence about how bad obesity is view in relation to not just
00:31:54
diabetes but cancer dementia across the board we can come back to that so I was like well you got to weigh these risks
00:32:00
of obesity against the risks of these drugs and I learned that there are 12 significant risks associated with these
00:32:06
drugs and he said what are you talking about you haven't got to weigh those risks at all there's a third option go
00:32:13
on a diet exercise right and he said I've seen you do it you've done it plenty of times right do that and of
00:32:19
course I had this voice in my head I thought I was cheating um and I thought well why don't I do why why am I not
00:32:25
doing that right um and I really began to get an insight into this when I I went to interview an amazing person called Professor Tracy man who's in Minneapolis where I met her um who's
00:32:36
done some of the most important research on diet ever I remember actually I met her I interviewed her in a place called
00:32:41
is bun which is um cinnamon bun shop famous cinon bun shop in Minneapolis when I arrived the guy on the door said
00:32:48
have you ever been here before and I said no and he said I will give you a free cinnamon bun then they gave me this like 2,000 calorie massive cinnamon bun
00:32:55
that sat there the whole time we were talking about diets and Professor man she began to research this in the year
00:33:00
2000 and she wanted to figure out how much do diets work right are they effective and at that time the science
00:33:07
was very clear diets are really effective if you go on a diet you will lose weight right but she looking she's
00:33:15
looking at all these studies almost 24,000 studies and she noticed as part of this big it's called a
00:33:20
metaanalysis and she discovered something a bit weird which is most of these studies the overwhelming majority
00:33:27
would follow people who were on a diet for 3 months so you you exercise your willpower you go on a diet for three
00:33:33
months you lose a load of weight and then they just stopped and the implication was you stay at that lower rate forever she' be like I know quite a
00:33:40
lot of people who are not in that position that doesn't happen to them so she looked in more detail and discovered there were 24 studies that had followed
00:33:46
diers not just over this short period but for two years and in a handful of cases five years and when you look at
00:33:52
the longer picture the picture is really different after 2 years the average person on a diet has lost 2 pounds in weight right so it's not nothing but it's pretty close to nothing
00:34:05
right it's it's extraordinarily low so what we know from the research on dieting is there's a very small number
00:34:11
of people around 10% of people who really do lose huge amounts of weight on diets and keep it off we all know people
00:34:18
like that I've got someone in my family like that right but for the vast majority of people it doesn't work and I remember saying to Professor man and
00:34:24
loads of other scientists who looked at this well how can that be because we know you only have to know the laws of physics to know if you consume fewer calories than you burn obviously you
00:34:36
will lose weight to dispute that you have to dispute the laws of physics right so how can it be that these people are dieting but they're not losing
00:34:42
weight and BR man and other people explained to me um something that's sort of missing in this picture that I think
00:34:49
really helps us to understand it and is actually important for understanding these drugs I think so a lot of the
00:34:55
scientists explained that there are biolog iCal changes that happen as you gain weight which make it harder for you
00:35:02
to find your way back in a in a way that you can sustain so in the 60s and 70s there was this theory about weight that
00:35:08
was almost universally accepted it's called set point Theory it sounds a bit complex but it's pretty simple if you
00:35:14
think about your temperature your body temperature right your body wants you to be at the temperature you and me are at right now right and if our temperature
00:35:21
goes higher than that if we get a fever or if we go to the Sahara Desert our body will work really hard involuntarily
00:35:27
to bring us down it'll make us sweat it will make us really uncomfortable and again if you're and also if your temperature goes below the temperature we're currently at your body will start to shiver again it will make you really
00:35:39
crave heat right so your body has a set level at which it keeps your temperature and it works extremely hard to keep you
00:35:46
in that zone for your whole life and it was thought for a long time that your weight was a bit like that that when
00:35:52
you're born or possibly even in the womb you have a biological set point for your weight that That Remains the Same
00:35:58
throughout your life and you can go a bit higher or a bit lower but basically you're fixed there but then the Obesity
00:36:05
crisis happened starting in the late 70s early 80s there's a huge weight rise in such a large part of the population and
00:36:11
it looked like oh set point theory is just wrong right that can't be correct because if it was true then you couldn't
00:36:17
possibly have this but then Professor low at Drexel and other places and other people um discovered what what is really happening in my view I think they produced very compelling evidence for
00:36:29
this as you gain weight your body's set point Rises right so let's say my body wanted me to be 18% body fat as I get to 30% body fat my body will then fight
00:36:41
very hard to keep me at that higher level right which seems really weird at first why would that be so if you if you
00:36:47
let's say you gained three stone right and then you tried to lose weight we have think of a hypothetical Robert dairo for the movie Raging Bull gained
00:36:55
you know three or four stone right and then tried to cut back but what you'd find was your metabolism would massively
00:37:02
slow down so it would you'd have to burn far more to get the same number of calories as you do now uh you would
00:37:08
crave far more sweet and salty foods you would have lower energy so you would find it harder to exercise so your set
00:37:15
point has risen and it's trying to keep you there and I remember saying to loads of scientists well that just seems
00:37:21
bizarre why would Evolution endow us with that that's such a maladaptation right why would why would um
00:37:28
why would it be and they explained to me well you have to think about the circumstances where we evolved in the
00:37:33
circumstances where humans evolved in fact every human circumstance pretty much until like 100 years ago there was
00:37:40
never a situation where you would have completely abundant calories in fact hyper abundant calories for your whole
00:37:46
life you'd have far more calories around you than you could ever possibly eat that never happened so your body didn't
00:37:51
Evolution didn't prepare us with good instincts for that what you did have what was a big risk was famine
00:37:57
right there was a big risk that at some point in your life food would run out and you would be in real trouble and in
00:38:04
a famine the fattest person at the start is going to be the last man standing right Timothy shalomay will die in week
00:38:09
one of a famine and you know John Candy will still be alive at the end of it Al not a great example because John Candy
00:38:15
has died but you get the point right um so actually that's why our Evolution prepared us that oh if you gain weight fight to hold it cuz sooner or later you're going to have to lose it in a
00:38:25
famine anyway so evolve with this Instinct that when we gain weight we experience these biological changes that
00:38:32
make it harder to go back it's not impossible willpower is a real thing some people can do it but when you try
00:38:39
you are fighting against your own biology you're also fighting against your psychology and your environment for different reasons we can explore so it's
00:38:46
not that dieting doesn't work but we've got to be honest at any given time 177% of people are on a diet we've really
00:38:54
tried that route right we've had you know 40 Years of relentless ly promoting dieting as the o or diet and exercise as
00:39:00
the only solutions and we've gotten fatter and fatter and fatter so there's something missing in that picture I think it's partly set point Theory it's
00:39:07
also important for the drugs because some people argue like the guy I mentioned before in relation to the brain Professor orelio G some of them
00:39:14
argue that what the drug may be doing is actually resetting your biological set point lowering the kind of temperature
00:39:20
at which your body tries to keep your weight it's bringing your set point down so that you don't get those effects like
00:39:26
the metabolism slowing and all the other things that kick in when you try to lose weight I think on average and this might
00:39:31
not be accurate but I think on average we live more stressful lives than we once did as well and I wonder the relationship that are more stressful
00:39:38
more frantic more busy notification filled social media driven screen time lives are having on our relationship
00:39:45
with food and if there's a relationship there at all you know more more kids have ADHD now than ever you know
00:39:51
cortisol level seems to be skyrocketing and it seems there's a relationship between stress and appetite which is as
00:39:57
a gravitational force against our willpower no you're totally right and this is when I go through the 12 risks
00:40:04
of the the drugs in the book this is one that I really worried about one that played out for me so I noticed I had
00:40:10
this weird thing about six months since taking the drug I had this realization so I was losing a lot of weight right I
00:40:16
lost a huge amount of weight I lost three stone three stone in what period of time from from now to when I started
00:40:21
so just over a year and how quick how quick was that weight loss just out of Interest before we move on PR pretty
00:40:27
straight linear line downwards from from the start but I had this strange sensation I had a a my friend Danielle
00:40:33
was pregnant at the time I kept bumping into her and it was like we we were on opposite trajectories like she was swelling and I was shrinking um I
00:40:41
remember walking away from her once and thinking this is really weird I'm getting what I want why don't I feel
00:40:47
better about this right I I didn't actually feel that much better for quite a long time for about six months
00:40:53
thinking why is that so what you mean by better I felt quite m in my emotions I felt I felt I wouldn't say I definitely wasn't depressed but I felt a little bit dulled
00:41:09
I thought this is strange I thought maybe it's just other things going on in my life you never know when it's just an individual but lots of people are
00:41:15
reporting this most people are very happy when they take drugs but there's a significant minority and so I started looking at exactly this question the
00:41:21
psychology of eating and it turns out there's kind of five the scientific evidence for five reasons why we eat
00:41:27
um and obviously the first and most important one is sustenance right I would have thought if you'd asked me a year ago why do you eat I would said
00:41:33
well the main reason is to sustain my body but here I am eating so much less than my body is sustained so all those
00:41:39
other calories I was consuming were doing something else right and one of the things one of the reasons we eat and another one is pleasure which we've
00:41:45
talked about but another reason why people eat is Comfort right people get a tremendous amount of comfort out of food
00:41:52
particularly overeating can be very comforting we know this partly because whenever there's a stressful event uh
00:41:59
junk food orders massively go up after 911 there was a huge increase in ordering people ordering pizzas and fried chicken the night Trump won the
00:42:06
election in blue States on Uber Eats and the other kind of delivery apps there was a massive increase in people
00:42:11
ordering tacos you know um shitty food right um if you if you're you're a man and you lose your job your chances of gaining weight massively increase partly because it's so upsetting and you eat to
00:42:22
comfort yourself um and one of the things that happens when you take these drugs
00:42:28
is your ability to comfort eat is taken away from you you can't Comfort eat and we've got a good analogy I think a good precedent for helping us think about how
00:42:38
that affects you so the best comparison for these drugs if we're trying to figure out their effects I think is
00:42:44
bariatric surgery right so up to now it was very hard to sustainably lose like more than 20% of your body weight the
00:42:51
only way it was possible to do it very quickly was bariatric surgery I think we have to look at the outcomes that's
00:42:57
stomach stapling there's four different kinds of it but it's basically what we think of a stomach stapling stomach operation exactly that's one form of it
00:43:04
right and so I think you have to look at the evidence from gastric surgery and in some ways it's very encouraging so we
00:43:10
know that gastric band surgery and other forms of gastric surgery massively boost your health if you have one of these
00:43:17
operations over the next seven years you are 56% less likely to die of a heart attack 60% less likely to die of cancer and 92% % less likely to die of diabetes
00:43:28
related causes in fact it's so good for your health that of you are 40% less likely to die of any cause over the next seven years right so we know reversing obesity massively boosts physical health
00:43:42
in most cases right sometimes very dramatically but we also know from bariatric surgery there's plenty of
00:43:48
downsides to bariatric surgery it's a horrendous operation and one in a thousand people die during the operation it's Grim but we also know where I think
00:43:55
it's really important to the thing you're asking about is that it has an effect on your psychology so a lot of people are much happier most people who
00:44:01
have that surgery are glad but 177% of people who have that surgery have to have impatient psychiatric treatment afterwards because they're so depressed or distressed your chances of committing
00:44:12
suicide almost quadruple after you've had bariatric surgery and I think there's lots of reasons why some of it
00:44:17
must be the grimness of the operation in the aftermath but I think a lot of it is you know you take away Comfort eating
00:44:24
from people right if you go through life especially people who had gastric band surgery or the other surgeries you know
00:44:30
those are people who were very severely obese so they would have had this effect very powerfully in their lives most of them if you take away something that is
00:44:37
a key way of soothing people when that goes well you can rebuild your life you can find other ways to get that soothing and that's really valuable and important but a lot
00:44:48
of people just experience it as profoundly painful and distressing and I inter a lot of people like that when
00:44:53
people have those surgeries I read in your book in chapter eight that one in 10 people then pick up a different type
00:44:59
of addiction to alcohol or gambling or shopping or drugs or something else so that's pretty clear evidence that
00:45:05
there's the psychological soothing is just moving somewhere else it's fascinating and and and distressing and
00:45:11
OB I spoke to people who'd been through those what called an addiction transfer um I spoke to this amazing woman called Robin Moore who uh had been
00:45:20
303 she'd had um bariatric surgery because just nothing else had worked and she felt she was really a slave to that was how she put it and it had this incredible effect she she knew why she
00:45:32
had gained her gained weight so much in her case it was she when she was a child
00:45:38
she had been sexually abused she'd been raped and she'd never told anyone and she quite deliberately gained weight in
00:45:44
order to keep men away from her she thought well if I'm if I'm really fat I'm less likely to be attacked um which is surprisingly common
00:45:52
and she lost all this weight and she felt great she felt physically much better people were treating her much
00:46:00
better but she had this shift where she she'd never been much of a drinker she had a periods when she was at College where she drank a fair bit but you know she'd never been a heavy drinker and she
00:46:12
just quite rapidly became a very full-blown alcoholic she used to work out by the airport in Toronto and she
00:46:18
would you know drink on the way there drink on the way back and she got fired because she was drunk at work
00:46:24
eventually and um for her she she kind of realized you know and I think it's interesting ways to think about this in relation to these drugs I want to stress this is not going to be everyone I don't think there's
00:46:35
even going to be a majority of people by any means but when you take these drugs the underlying psychological reasons that drove your eating are
00:46:48
profoundly disrupted and in many cases come to the surface and for me that was help painful at first but helpful I
00:46:55
remember having a day in Vegas as you know SP lot of time in Vegas cuz writing a book about a series of crimes that have been happening there I had dayse
00:47:01
investigating something really grim and I I felt really bad and it was relating to someone it's a long story but
00:47:06
something terrible and I went to the KFC on West Sahara it's the grimmest KFC in the whole world I have a secret love for
00:47:12
it and I on kind of autopilot I ordered what I would always have ordered you know like a load of
00:47:18
fried chicken and I sat there and I thinking oh [ __ ] I can't eat this I remember
00:47:27
Colonel Sanders was on the wall looking down and was like he was going to be what happened to my best customer right
00:47:33
so being deprived of comfort eating is is quite apart from the being deprived of pleasure which I think is sort of
00:47:38
related but a bit different is is is very difficult and again my friend who I'd spoken to had cancer went to her and
00:47:44
said this is really hard right and she said look it's not that the drug is causing this problem the drug is making this problem visible to you and now you can deal with that in other ways right
00:47:56
and that's I've been trying to do and write about how in the book but yeah so one of the things that fascinated me
00:48:01
about all the research for for my book magic pill was how incredibly complex this is every
00:48:07
time you look at one effect it seems to have another effect this is a really complicated difficult topic and anyone who's coming in telling you either rah rah these drugs are great and they're
00:48:18
going to save us all or these drugs are devils it's terrible um I don't think it's leveling with people I think it's
00:48:24
complicated I think there's risks every turn and I think we need to think through the complexity together in a way
00:48:29
that's honest and and and honors the complexity you talk there about the impact that early childhood trauma has on our relationship with food and eating um I remember reading a little bit about that in your previous book lost
00:48:41
connections as well but what is what what is the sort of data in the stats that that prove that trauma can cause us
00:48:47
to have this kind of excessive comt seeking relationship with food is there any particular studies that stand out for you oh yeah I mean a guy that I got to know quite well when I worked on Lost
00:48:58
connections and I thought about this Research In a Different Light when I worked on this book there's a guy called
00:49:04
doctor Vincent felitti and in the early 1980s he was a doctor in San Diego and he was contacted by kaisa Permanente who were a big not for-profit MediCal provider in the state and they said to him look we got a
00:49:18
problem we don't know what to do obesity was massively Rising actually it was very low by our standards but it
00:49:23
was hugely rising and they were trying giving people diet plans and exercise plans and nothing was working and they
00:49:29
said we don't know what to do can we give you a load of money to just do blue skies research go away figure out what
00:49:35
we can do and he said okay so he took a load of money and then he's like what can I do and he started working with 200
00:49:42
very very obese people people who were severely obese who had tried all sorts of ways to cut back and it hadn't worked
00:49:48
and he's sitting there working with them and he's thinking what can I do and he had an idea that sounds and actually is
00:49:53
quite stupid he said well what would happen if really obese people literally stopped eating and we medically
00:50:00
supervised it and we gave them vitamin shots so they didn't get like scurvy or whatever would they would they burn
00:50:06
through the fat stores in their body and get back to a healthy weight so with a shitload of medical supervision they did it and Incredibly at first it worked
00:50:14
there was a woman who I'll call Susan that's not her real name who went from being more than 400 to 138 it was
00:50:20
incredible right and you know her family are ringing the doctor and saying you saved Susan's life she's really thrilled
00:50:27
and then one day something happened that no one expected she cracked she went to KFC or
00:50:35
wherever it was she starts obsessively eating and after a while she's back where she was not exactly where she'd
00:50:40
been but similar and Dr feli called her in he said Susan what happened she looked down she was obviously really ashamed she I don't know I don't know he said well tell me
00:50:53
about that day right the day you cracked did anything happened that day that didn't happen any other day it turns out
00:51:00
something happened that day that had never happened to season before um she was in a bar and a man hit on her not in
00:51:05
a nasty way in quite a nice way but she just felt completely freaked out and she went and started eating and that's when
00:51:11
Dr feli said to her well Susan when did you start gaining weight in her case I think it was when she was 10 he said
00:51:18
well did anything happen when you were 10 that didn't happened when you were 9 or 11 or anything happened that year she
00:51:24
looked down and said well that's that's when my grandfather started raping me Dr Fel interviewed everyone in the
00:51:30
program he discovered that 60% of them had made their extreme weight gain in the aftermath of being sexually abused
00:51:37
or assaulted which is a staggering figure right 60% of the women um and it was like well how could this be he was really puzzled and Susan explained it to him really well she said overweight is
00:51:48
overlooked and that's what I need to be right if you're severely overweight you're much less likely to to be
00:51:54
sexually attacked right it's obviously can happen but it's it's rarer um and when you understand that you begin to
00:52:01
see again in relation to these drugs um why some people get really freaked out when they take these drugs because some of them experience it as suddenly oh my God I'm really vulnerable to this
00:52:13
traumatic event being reenacted again and again now that's one example there's lots of if we go down the the list of
00:52:19
reasons why people eat like I do in the book there's lots of other ones that get triggered and activated as and disrupted as well you talk in the book about this
00:52:26
this word I've never really come across before which is um it's a phrase I guess you say the environment is
00:52:32
oogenic I I've only ever heard of that term cogenic carcinogenic carcinogenic yeah which basically means something can give you cancer but you're saying that the environment we live in is I mean the
00:52:44
way that I read it was like that that it's almost contagious like it's going to give me obesity just by being alive
00:52:50
in the modern world um one of the stats that really stood out to me when you're talking about processed food is that on
00:52:56
average when we eat processed food we we end up eating 500 more calories every single day and um that again is
00:53:04
startling you know I've had a few guests on this podcast that I've talked about processed food and the rise of it and I
00:53:09
do Wonder to myself if there's ever going to be a change in society if we if there's any indication that at some point I don't know government will step in and ban it or tax it more or
00:53:21
something will happen what's your what's your view on if we talk about the optimism of the penic environment
00:53:27
changing do you think it can change do you think it will so crucially I went to a country that had completely
00:53:33
transformed its diet and as a result has very low obesity Japan we can talk about that and I went to loads of countries
00:53:39
that are making the changes you're talking about so prompt me to come back to that but I would start by saying well a you're totally right we live in an
00:53:45
obesogenic environment an obesogenic environment is an environment that primes you to be obese and where it's
00:53:51
hard to be a healthy weight right it's hard to get healthy food healthy food is expensive and rare whereas shitty food
00:53:58
that makes you obese is cheap abundant and constantly promoted to you right so that's an obesogenic environment and
00:54:04
there's loads of evidence that well as Professor Michael L put it to me we live in as obesogenic an environment as human
00:54:11
beings could possibly design right um and there's seven ways in which processed food undermines your ability
00:54:17
to stop eating that I go through in the book so if you're feeling pessimistic and I'm
00:54:22
clearly you're right to feel pessimistic someone is charismatic and bril as Michelle Obama could not even get us to
00:54:29
join a campaign to physically move so I get it there's big obstacles here but when you feel pessimistic about it the first thing I would say is think about
00:54:39
smoking right my mother smokes 70 cigarettes a day there's a photograph of me and her where I'm
00:54:45
um she's breastfeeding me I'm about six months old she's smoking and resting the
00:54:50
ashtray on my stomach and when I showed her this photo I thought she'd feel guilty she said you were a [ __ ]
00:54:56
difficult baby I needed that cigarette um but you think about that that was normal right when I mean in Scotland
00:55:01
that was normal when I was a kid right um so you think about smoking when I was seven years old um more than half of the
00:55:08
population of Britain smoked right and people smoked everywhere people smoked on the tube people smoked on planes people smoked on game shows the doctor would smoke while he was examining you
00:55:20
I'm not joking I remember that happening right so if I could take you back to the Britain of 1987 and you could walk
00:55:26
around you would just you would feel sick because the smell of smoke was everywhere right and there were just
00:55:32
ashtrays everywhere funny enough I was with my mother when it was the anniversary of there was a terrible
00:55:37
catastrophic fire at King's cross station here in London in 1987 I think and I was with my mother when it was the
00:55:43
anniversary a few years ago and uh it was a terrible disaster there was a fire someone had put out a cigarette near an
00:55:48
escalator and it killed more than 50 people it was awful uh and my mother said oh that was the worst day of my
00:55:55
life and I said oh were you there did you know someone who died she said no that's the day they banned smoking on
00:56:01
the tube anyway the so if I could take you back and I said to you right how many
00:56:07
years we are on from that now um only 12% of British people will be will smoke it will be falling and the British government will be about to progressively ban smoking you won't be allowed to smoke indoors anywhere except
00:56:20
your own home the rates will have tanked young people will there'll be almost no cigarette smoking among young people and
00:56:27
they're going to progressively ban it by age that would have seemed ludicrous right you would have said well tobacco
00:56:32
industry is one of the most powerful Industries in the whole world uh you've got a very motivated half the population
00:56:38
are addicted it's never going to happen these things can change that's a huge Public Health uh transformation in a
00:56:45
very short period of time these things can change and I've seen how it can change with food so that we're not in
00:56:50
this situation where we have to choose as we are at the moment between for many of us not all between the risk of
00:56:57
obesity and the 12 big risks associated with these drugs what are they waiting for because the government knows this
00:57:03
the government knows that processed foods and you know the sugar quantities that the average person's eating is bad
00:57:09
so they could presumably get something done this year so but they won't there's a brilliant writer called Rebecca solnet who says politicians are weather veins and it's our job to be the weather if
00:57:20
you're a politician you're constantly making a calculation right if I do this thing how much praise will I get and how
00:57:26
much [ __ ] will I get for it right and you know some of them are good people many of them are good people but you're
00:57:31
constantly making that calculation in a democracy and right now if you do the right thing on food and there are loads
00:57:38
of things we do I saw in Japan we can go down the list of all the things we need to do um that could transform Health
00:57:44
particularly for our children you'd get some praise but you get a lot of [ __ ] right you get a lot of [ __ ] for it and
00:57:51
for many years of my life I would have been one of the people who gave them that [ __ ] right so I I understand it
00:57:57
we have to change that calculation by helping people understand and make better choices in ways that I saw happen so I can explain how they did it if you want please Japan is really important I
00:58:08
think for thinking about how we get out of this trap because at the moment um the way it's often presented is look
00:58:16
we're just screwed right there's just this huge obese population that's the product of being rich if you're a rich
00:58:22
country you've got lots of calories around you inevitably we're going to have loads of obesity and inevitably
00:58:27
we're just going to need to give loads and loads of people these drugs forever and you know a few years from now as
00:58:33
many people predicted to me we'll have 40% 50% of the population taking these weight loss drugs right and what Japan
00:58:39
showed us is we don't have to choose that fate right so if you look at Japan Japan is the only country that got rich
00:58:47
without getting fat 4.5% of Japanese people are obese compared to 26% in Britain and 42.5% in United States and it's actually 42% 42% 4.5% are obese 70% are obese are
00:59:01
overweight right Jesus the norm is to be obese or overweight right whereas in Japan it's completely the opposite it's
00:59:07
kind of weird that when we picture Japan we often picture sumo wrestlers it's a bit like expecting the average American
00:59:13
to look like a bald eagle or something right seers are completely atypical and I learned a huge amount about what's
00:59:19
happening there so the first thing you think when you hear that is it must just be genetic right theyve just they've won the genetic Lottery that must be what's
00:59:25
going on on but we know that's not true because in the late 19th century loads of Japanese people went to live in
00:59:31
Hawaii where I just was um and there's now this settled Japanese population in Hawaii who've been there for four or
00:59:37
five generations and they're almost as fat as other Hawaiians right so they're five times fatter than they're five times more likely to be obese than Japanese people in Japan so actually
00:59:48
when the environment changes Japanese people become obese like everyone else so there's something else going on so I
00:59:54
wanted to understand how did Japan do it and one of the really interesting things is it was very consciously done there's
01:00:01
a guy called Professor Barack kushna who's a professor of East Asian history in um in Cambridge University who's
01:00:07
talked about how actually if you go back to the 1920s Japanese people had one of the worst diets in the world they only ate protein once a week they almost
01:00:14
never ate fish right they only ate fish once a week they had a terrible diet and the Japanese government at the time
01:00:20
wanted a healthy population so they could form armies that would go and invade the rest of Asia
01:00:26
so they deliberately transformed the food culture in Japan very consciously so I want to see how do they do that now
01:00:31
right what's going on so I went to a school called COI school um which takes kids from 5 to 18 and it was totally
01:00:39
fascinating so when I arrived there I went with my translator uh the first you arrive and
01:00:45
all the kids walk to school on their own from the age of five all Japanese children just leave the house and walk
01:00:51
to school on their own so they get a lot of exercise in the morning and they walk home on their own as well and we were
01:00:56
greeted at the entrance by a woman called harumi tati who's the nutritionist at the school by law every
01:01:03
Japanese school has to employ a professional nutritionist it's a difficult qualification to get it's three years of study on top of learning
01:01:09
to be a teacher and your job is to design and oversee the creation of the food in the school all processed food is
01:01:16
banned no one is allowed to have Pro there's no processed food in any Japanese schools ever every meal has to
01:01:21
be prepared from scratch at the start of the day um and no one is allowed to bring it a pack lunch so every kid has
01:01:27
to eat the food that's prepared in the school uh her job is also to use those meals to educate the children about how
01:01:35
to eat healthily so they teach them all sorts of key principles one of them is in Japan this is a very deep cultural
01:01:42
norm you should only eat until you're 80% full so it it takes a while for your body to realize you're full so if you get the signal that you're full while you're still eating they're like you've
01:01:52
eaten too much right so you should eat until you're 80% full and then stop um there's all sorts of norms that are
01:01:58
very different to ours so if you look at a typical Japanese meal it will have five portions significantly more than
01:02:04
USS but they're pretty small right so you might have some fish some Mis miso soup a whole range of things um and you
01:02:12
which is important for your gut health because there's a bigger variety of ingredients which makes your gut much healthier but also you eat it
01:02:19
differently if you gave us you know a meal with three bits generally you'd eat all of one then all of another then all
01:02:26
of another you'd have all the lasagna then you have the carrots or whatever in Japan that's regarded as like a crazy way to eat you have a mouthful of the
01:02:33
Miso soup then you have a mouth full of the white fish then you have a mouth full of the sashimi and you you have it
01:02:40
slows your eating down massively if you eat that way um they're also taught I remember her standing there so the the meals in all the schools are designed to be nutritionally balanced through these
01:02:51
five components and so she stands in front of the class and teaches the kid kids you know okay this is a red rope
01:02:58
this represents calcium what does calcium do kids it makes your bone stronger like yes that's this on your
01:03:03
plate this represents carbohydrates what do they do they give you energy and the kids yell out so then and then she ties
01:03:10
the rope together she goes you see now it's all tied together now it's a balanced meal so they use this healthy food to educate the children about how
01:03:18
to eat healthily it's a very um beautifully designed system and it was fascinating looking at them I mean got
01:03:25
tast stepen it was really weird this is a school of a thousand children I walked through that school all day there was
01:03:31
not one fat child it it it was it's odd like it's jarring when you go right that
01:03:38
they have you know they have extraordinarily low childhood obesity and I remember with these kids I
01:03:44
was asking them their favorite foods the first kid I asked said my favorite food is broccoli it's like all right the
01:03:51
second kid said my favorite food is seaweed and the third one's like I like white rice and I said to CH my
01:03:57
translator are these kids trolling me right like what their favorite foods are broccoli and like white rice and she
01:04:04
just looked kind of puzzled and every Japanese person I asked said but we teach our children to like
01:04:09
healthy food don't your children like healthy food and I was so taken about by these kids I I brought up on my phone some pictures of like typical British school dinners and showed it to them and
01:04:21
they literally reacted like I had shown them an Isis beheading video they like screamed they were like what is this and one said did you eat
01:04:27
this every day I was like yes they're saying where's the salad I said there is no salad they're just completely baffled
01:04:34
so they partly start with this very strong culture creating a very deliberate culture of how to eat differently that begins at a very very young age there are some other steps
01:04:47
that are a bit more dodgy that we can come to I'm sure but that that was the kind of um first um that was the first
01:04:53
pillar of it that I saw and then over here we're in we're in this sort of craze of injecting ourselves with this
01:04:59
thing called a zek can I see the pen actually I've never actually seen one before I won't open it or anything sure course I W contaminate it Z I've just
01:05:06
been so intrigued to see what these things are like once weekly Nova nordis Nova Nordisk now the
01:05:14
most valuable company in the whole of Europe what what are they give me some context on Nova Nordisk they're a Danish
01:05:19
pharmaceutical company so there's two companies that are kind of pushing the main drugs in this pushing sounds too
01:05:25
there you know what I mean so Novo Nordisk who a Danish company the entire Danish economy has had a massive growth
01:05:31
because of the popularity of these drugs since they came out they've become the most valuable company in Europe um the
01:05:38
market for these drugs is predicted to be $200 billion do by the end of this decade and the other one is Eli
01:05:44
Lily and if I how do I get this do I have to go to a doctor and get a prescription or can I just go buy this
01:05:51
on online or something so this is part of the problem and this leads to one of the really big risks associated with the
01:05:56
drugs which is eating disorders I am really really worried about this so there are lots of young girls in
01:06:02
particular some boys but it's mostly girls who want to starve themselves right we know that it hugely Rose during
01:06:08
the pandemic and this is the most effective tool for self- starvation human beings have ever come up with so I
01:06:13
interviewed a lot of Eating Disorders experts who are terrified about what's coming down the line and the truth is it
01:06:19
is very easy to get hold of it I went you know you could go online now you clearly do not meet the criteria for
01:06:25
getting these drugs right you've got to have a BMI of higher than 27 which is a BMI that comes from fat Mass not muscle
01:06:30
mass so you would not meet the criteria at all if you went online you could go and see a doctor on Zoom lie about your
01:06:37
BMI and you would get it in the mail two days later right um they're meant to check your BMI but on Zoom that's very hard to do if in the unlikely event you were turned down by a doctor on Zoom you
01:06:49
can just order effectively counterfeit ones online very very easily so I'm EXT extremely wide I think we're going to have a there are many downsides to these drugs possibly the worst from my point
01:07:02
of view one of the two or three worst is you're going to have a huge wave of young women who get hold of these drugs and and do a lot of harm to themselves now that is something we can immediately
01:07:16
do to massively limit that harm uh lots of the Eating Disorders experts I interviewed like Dr Kimberly Dennis
01:07:22
who's one of the leading experts in the US said to me these drugs should only be given by prescription if you go to a
01:07:29
physical doctor and the doctor you physically go to to get them needs to be trained in detecting eating disorders
01:07:35
and referring people for help with eating disorders if that's what they think they've got so these were initially created for people that had
01:07:42
diabetes they have a dual effect so glp1 the hormone gp1 and this kind of replica
01:07:48
of it uh stimulates the creation of insulin which is obviously what diabetics are lacking either type one or
01:07:54
type two diab ICS so it was the whole thing was discovered by accident I interviewed the guy who discovered it a
01:08:00
guy called Daniel draer amazing man so they discovered he was just looking at um so your whole body is made out of
01:08:05
cells right and in the 70s it was discovered there were new ways of looking inside cells that human beings
01:08:11
had never had before so by the 80s 1984 was when he made a breakthrough they were just going through different cells
01:08:17
in the human body trying to figure out what they do and they got to the glucagon Gene which exists inside your
01:08:23
your pancreas and they were trying to figure out the glucon gene is a long chain and at the end of it is gp1 and
01:08:29
they were trying to figure out well can you break off that little bit of the chain or if you break it off does it
01:08:34
just wither and die and he discovered Dr duer discovered you can break it off and then he was like well what does it do so
01:08:41
he starts experimenting in lab dishes in Massachusetts General Hospital and he discovered that if you combine it with insulin it produces more insulin so that's why it's so valuable for
01:08:52
diabetics and immediately he was like whoa that's really significant so then other people in the lab um Professor
01:08:58
spana mjoy um gave it to rats put it in rats and discovered it in fact produced insulin in rats a team in Copenhagen put it into the pancreas of pigs discovered it produced insulin there and that
01:09:11
setting set in train what later became giving it to diabetics so that's the most one obviously greatest benefit of
01:09:18
these drugs that was initially discovered is they hugely helped diabetics then the effects around
01:09:23
appetite were discovered separately initially here in in London in the Hammer Smith hospital that was when they
01:09:29
discovered oh if you inject people with gp1 this is before they had copies of it if you inject people with gp1 it reduces
01:09:35
their appetite oh okay you can see where their thinking went from there so there's dual uses and the Dual uses are
01:09:41
kind of incredible if you look at uh the effects on diabetics obvious but um if you look at the health effects we that
01:09:47
are emerging around these drugs and this is very close to my heart literally because of the heart problems in my
01:09:53
family um if you take these drugs if you started with a BMI higher than 27 and you take these drugs over the next 5 years you are 20% less likely to have a heart attack or stroke so we're talking
01:10:03
about this is some people are like oh this is Vanity and there's an element of vanity in me and in most people taking
01:10:09
these drugs I'm sure but this is having massive health benefits for lots of people how many people are willing to take it because as you as we discuss this now say that there's I don't know a
01:10:21
million 10 million people that listen what percentage of those people on average would go do you know what that sounds like the thing I've been looking
01:10:27
for if they're Americans and the polling is Right 47% of Americans have said they would be willing to take they want to
01:10:33
take these drugs actively want oh they want to so about 50% of this a the audience will be actively wanting to
01:10:39
take it as we sit here now yeah and now tell me why they shouldn't well there's a huge
01:10:46
array of risks um some of which are very very serious so I'll give you a few examples I go through Lots in the book there's a professor in France called Professor Jean Luke F who works at the
01:10:58
University Hospital in melier who was commissioned by the French medicines agency to investigate these drugs and
01:11:03
the safety around these drugs and one of the reasons lots of people have felt very happy about the safety of these
01:11:08
drugs and it's a good reason is that in their roll out for obesity if people have said like Daniel duer for example
01:11:14
who I mentioned who discovered gp1 they say quite rightly well look diabetics have been taking these drugs
01:11:21
for 18 years now if there was some catastrophic effect we would know it would have
01:11:26
emerged in diabetics right now he would also add well it could affect obese people a bit differently than diabetics
01:11:32
so there's some gaps in the knowledge he said look we this drug has been used by enormous numbers of people all over the
01:11:39
world without some huge safety concern emerging but others have said okay let's really dig into those diabetics then so that's what Professor f e did so they've got they've got very good health
01:11:51
databases in France the best in the world so he decided to look at diabetics who' taken these drugs for three years sometime between 2006 and I think 2015
01:12:03
so he looks at loads of the diabetics who' taken them and then he compared them to a group of other diabetics who
01:12:09
were very similar in every other way but had not taken these drugs to see are their differences and outcome and he was particularly looking for one outcome we
01:12:16
know that when you give these drugs to rats they are much more likely to develop thyroid cancer so he's looking
01:12:21
okay is there a difference in thyroid cancer risk in this population and what he discovered was very sobering
01:12:27
it was published so the people who' taken the drugs had a 50 to 75% increase in their risk of thyroid cancer now when I first said that I was like what the [ __ ] you have to understand what that doesn't mean that doesn't mean 50 to 75%
01:12:40
of people who take the drug get thyroid cancer if it was that outcome they would pull it immediately and no one would ever take it again what it means is
01:12:48
whatever your thyroid cancer risk was at the start it will go up by between 50 to
01:12:53
75% if this res Arch is correct right this then is being further investigated there are some scientists who dispute it the European medic medicines agency has not been persuaded by the evidence so
01:13:05
far but that's pretty sobering right that's you know 1.2% of people get thyroid cancer in their lifetime 84% of them I think survive you know a big increase in people getting thyroid
01:13:16
cancer when you're talking about millions of people across the world taking it is is very alarming what about this thing called
01:13:23
zmek face yeah I'm not worried about that purely purely for a selfish reason so a zic face is where um I'm worried
01:13:31
about it for other people a zic face is where you lose so much weight that your face looks really gaunt and you look
01:13:38
kind of hollow and a bit my face is so naturally round like babies always smile at me I think because they think I'm
01:13:43
their King I'm just like a baby that inexplicably got to walk around um I'm I could lose so much weight in my face and
01:13:49
not look G I'm not worried about that myself it's there's no um health problem with OIC face it's just it's the vanity
01:13:55
thing well vanity is too negative a word it's you know people don't want to look gone and Ill that's fair enough
01:14:02
pancreitis pancreatitis is a rare side effect but it's very very unpleasant so um pancreatitis is basically where uh
01:14:10
your pancreas just goes Haywire as a result of taking these drugs I interviewed a woman called Michelle stnc
01:14:16
who's in mytle beach in North Carolina she she started taking these drugs and her doctor said to her you know there's
01:14:21
a few side effects one of them is pancreatitis and she said go no my luck I'll probably get it she starts take it
01:14:27
was really happy with the weight loss six weeks later she went to Pittsburgh to visit her daughter she woke up in the
01:14:34
worst Agony she's ever been in she had this excruciating pain running all from below her breast around to her back she was vomiting she was [ __ ] herself she was screaming in pain and her
01:14:46
son-in-law phoned for an ambulance he thought she was about to die she was in such a state of distress she arrives at
01:14:52
the hospital and they um discover gone really wrong with her pancreas they said are you a heavy drinker she said no then
01:14:59
they said are you taking OIC and it's kind of revealing that was the second question they asked so we know that um
01:15:07
if you take OIC there's a study by the University of British Columbia that found it increases your risk of
01:15:12
pancreatitis by a factor of nine so you're nine times more likely to get it it's still rare you're very unlikely to
01:15:17
get pancreatitis even when you times it by nine it's still a very rare outcome but you know doctors often compare it to
01:15:24
the pain of being stabbed Michelle said to me it was much worse than the pain of child birth right they had to give a
01:15:30
fenil to take the pain away so if you get medical care you recover but so it's worth people knowing that is a
01:15:36
significant risk uh of just an excruciatingly painful condition one of my friends has started taking a zmek you know there's this word on the side of this pen in front of me semaglutide
01:15:48
semaglutide yeah what did I say it's you said it the way it's intuitive the way the scientist say I think it says it
01:15:55
looks like semaglutide exactly that's how I said it until all the scientists kept correcting me in a slightly patronizing way but yeah what's the
01:16:00
actual word semaglutide and is that the chemical and is thenex the brand yeah exactly so semaglutide so there's
01:16:07
there's several Brands um so there's seaglide which is the drug which has this gp1 Agonist effect um OIC is the
01:16:15
one for diabetes wovi is the one for obesity that exactly the same drug they're made in the same Factory they're
01:16:21
identical it's just that wovi is marketed for obesity and you you can in the US not here yet prescribe wovi for
01:16:28
higher doses than you would for for for diabetics and then there's other drugs that are coming along the line so there's munaro which is made by Eli Lily
01:16:35
so oena wovi produces an average of 15% loss of body weight over a year mojarro causes a loss of 21% on average and the next one that will come down the line is probably going to come out next year
01:16:49
Triple G causes 24.2% the reason mararo Works differently so this only works on gp1 munaro adds another gut hormone Gip so it works on two gut hormones not just
01:17:00
one and Triple G works on three gut hormones and there's going to be more and more drugs I mean there's 37 gut
01:17:06
hormones that can affect appetite they think so there's going to be lots of variance of these drugs with different
01:17:13
side effect profiles different risks different benefits so yeah this is you know one of the South African
01:17:18
psychiatrist called Carell laru who's been at the absolute Forefront of the developments and they said to me you
01:17:24
know when a baby starts to walk it's been crawling for ages and then it just stands up and it walks and we are at
01:17:30
that point and it was striking how how much the scientists kept describing it as a game changer you know one of them Tim Spectre who I think you might have had on described as um it's like they
01:17:41
found the Holy Grail they found the thing that causes weight loss right uh Robert Kushner said that to me who's
01:17:47
another one of the scientists been at the heart of it said we cracked open the treasure chest we found the thing that
01:17:52
controls weight it's your gut hormone B so I worry about the parallels with previous diet drugs and we can talk about that these are new drugs working in a new way and the the overwhelming
01:18:05
feeling in the science is no this really is different my friend is um a biotech billionaire and um when I when I saw him
01:18:12
so he's at the very Forefront of all of these things he takes so many different things to optimize his life one of them
01:18:18
he started taking as a zek and last time I saw him he was um we're in the gym together and he was significantly weak
01:18:25
he was significantly skinnier but I noticed when we did our exercises he was significantly weaker as well and that strikes me as a bit of an unspoken about side effect is muscle loss it's one of
01:18:37
the 12 big risks that I write back in the book so muscle mass loss is a real problem people who don't know muscle mass is the total amount of soft tissue
01:18:44
that you have in your body and it's essential for doing anything that requires movement and strength basically
01:18:49
and any form of weight loss causes a reduction in muscle mass so if you if someone's bur overweight and they lose a
01:18:55
huge amount of weight on a diet they lose a lot of muscle mass hopefully you lose more fat mass than muscle mass but
01:19:00
you lose a lot of muscle mass you can't control that right you just there's no way to lose a lot of weight that doesn't involve some muscle mass loss unless
01:19:06
you're very very lucky right um so obviously this triggers a huge amount of muscle mass loss and there's real worries with that right um if you lose
01:19:17
muscle mass so you naturally lose muscle mass from when you're 30 onwards anyway you lose quite a lot every year it's incredibly depressing when you look at
01:19:23
the figures you lose muscle mass natur every year anyway um but if you lose too much muscle mass you won't you'll be a bit weaker now but the real risks are when you're older so if you have really
01:19:35
low muscle mass when you're older you're at risk of a condition called sarcopenia which is Greek for poverty of the flesh
01:19:41
basically just means you'll really struggle to climb the stairs do any kind of physical activity you're more likely
01:19:48
to fall if you do fall you're more likely to die it's it's quite a serious thing and this I think is particularly
01:19:53
going to be an issue for people who are already skinny like the people at that party we were talking about right at the
01:19:59
start none of them were fat at the start right people who were already skinny who are taking it to be super skinny they're
01:20:05
going to see they're going to have real issues with their muscle mass likely when they're older so this is a very serious problem we could be building up
01:20:11
a time bomb of more frail older people further down the line you lose up to 20 to 30% of your lean muscle mass when you start taking a zet says in your book as one of the RIS Prof that's for for some
01:20:22
people yeah not actually weirdly was 33% fat Mass when I started and I went down to 22% I think it is now so I lost
01:20:29
nothing but fat Mass but I suspect that might be for the slightly humiliating reason that I had no muscle to start with but I'm not sure and then on the
01:20:37
psychology the mental health side of things suicidality there's some cases where suicidality things like feelings
01:20:43
of anxiety and depression increase is that because of the underlying reasons why we're eating the self- soothing
01:20:49
stuff or is that a separate side effect so it's hugely debated there isn't even agreement that the drugs C caus that
01:20:54
effect in a minority of people you got to bear in mind at any given time some of the population becomes suicidal some
01:21:01
of them will be taking these drugs so it's very hard to disentangle that especially early on uh so some
01:21:07
scientists would say there isn't even any evidence they cause suicidality among the scientists who fear that it
01:21:12
may cause suicidality there's a big debate some of it will be you're deprived of comfort food uh or pleasure
01:21:19
some of it will be as Carell Laro put it to me a lot of people who are over wait for a long time say you know the reason
01:21:27
my life is [ __ ] is cuz I'm overweight if I finally lose weight my life will be good and then they lose weight and
01:21:32
they've still got the same assle husband and they've still got the same job they don't like and they suddenly go into
01:21:38
this crisis where they're like oh it wasn't the weight that was blocking me it was everything else right they say don't they that um the difference
01:21:44
between like happiness is your expectations and reality so you can imagine if you have that expectation that losing this weight is going to make
01:21:51
me happy and you fall short of the expectation because it doesn't the anticlimax can cause so much
01:21:58
psychological discomfort yeah and I spoke to people who've been through that and I think that's that that can be a really a really big issue there's also
01:22:05
with Su suicidality so some other people who would say well okay the psychological effects are probably real
01:22:10
but it might come back to what we were saying about dampening the reward system in the brain right there were people like um Professor Patricia grigson who's
01:22:18
done some of the really cutting edge research on effects with addiction in this who said to me you know that's a
01:22:23
real concern now she stress we don't know yet no one definitively said yes it is causing these problems we know how it was weird it was like a um like I said
01:22:34
before it's you're seeing this picture form it was fascinating that you're there's so much we don't know which makes it kind of disconcerting it's like
01:22:41
oh so this is an experiment on millions of people and I'm one of the guinea pigs great right so it's disconcerting how
01:22:46
much we don't know um but yeah that is a big worry and we've been here before with diet drugs as you alluding to where
01:22:53
we kind of rush into party and then everyone rushes out of the party because we realize that the history of diet
01:22:58
drugs Steven is absolutely Grim beyond belief so the first kind of modern diet drug was something called dinitrophenol so there were a load of um people in France who were working in ammunition
01:23:09
factories during the first world war and people noticed that they lost loads of weight right not that they had didn't
01:23:15
have weight problems at the start but they lost a huge amount of weight and it turned out they were ingesting this explosive powder you know through their
01:23:22
skin and breathing it in so after the war a load of scientists at Stanford were like oh maybe this can be a weight
01:23:27
loss treatment so they made it into a pill called redu alls uh which were very popular there was 100,000 people taking
01:23:34
them in 1934 which when you consider there was very low obesity back then that's a huge number of
01:23:40
people and then they discovered just I mean it's it it's almost unbelievably terrible what happened so loads of the people taking them went blind and then they went into this
01:23:51
horrific fever where their bodies were burning up so it's an explosive right so it was discovered that the way it works
01:23:57
is it massively speeds up your metabolism but when you take a high dose it gives you cataracts makes you go
01:24:03
blind and then your body goes into a fatal fever and the way one person put it is you become cooked from the inside
01:24:10
so they stopped marketing that one it continued to be used as a pesticide for like years and years because it is so good at killing anything it comes across
01:24:17
so then there was a craze for amphetamin so during again during the a war during the second world war radar um people are
01:24:24
to watch Radars soldiers who had to watch Radars were extremely bored so they gave them amphetamines to sort of
01:24:30
keep them on the job keep them active mentally alert and it was discovered they lost loads of weight as well so
01:24:36
after the war they started marketing amphetamines as a weight loss drug right and they became hugely popular they were
01:24:41
described as Mother's Little Helper by the time you get to 1970 8% of all the prescriptions in the United States were F amphetamines for weight loss but it was discovered that when you take
01:24:54
amphetamines you develop tolerance to them your body gets used to them so you need higher and higher doses to get the
01:24:59
same effect but if you take really high doses of amphetamines you just lose it I mean you can become psychotic you it has
01:25:06
a really bad effect on you you don't sleep it's terrible so then there was a real rolling back of amphetamines and
01:25:12
then there were some real horror shows like Jaw wiring where they would wire up the jaws of obese people so they could
01:25:17
they literally couldn't get any food into their mouths but then it was discovered if you vomit while your jaw is wide you can choke to death I mean
01:25:23
just like nightmare marish horrifying humiliating Solutions and then we get to the worst of them all and also the most popular of them all until these new drugs which is called fenfen so this was
01:25:36
in the 1990s early 1990s a group of scientists decided to combine two diet drugs that had existed until then one
01:25:43
was called Flex fomine it's an appetite suppressant but it was never very popular because it makes you very drowsy
01:25:49
so they combined it with phentramine which is an amphetamin so it had the kind of it counteracted the drowsiness
01:25:54
and it had an additional weight loss effect and it worked incredibly well people taking it lost as much weight as
01:26:00
they lose on OIC and it's actually Eerie when you go back and look at the coverage front page of Time Magazine the
01:26:06
new miracle drug was the headline you know by the time you got to the mid90s there were 18 million prescriptions for
01:26:14
fenfen every year in the US and then a group of ordinary doctors in Fargo in North Dakota were like a lot of our patients are getting really ill
01:26:25
when they take this and raised a safety signal turned out the drug company had known about this risk all along so it
01:26:32
was discovered that when you take these drugs they cause something called primary pulmonary hypertension it's where the blood vessels in your lungs
01:26:38
massively contract and you can't breathe properly they also damage your heart I mean the stories were just horrendous
01:26:44
there was a um a young woman in Massachusetts called Mary linen who was about 28 wanted to lose weight for her
01:26:51
wedding day starts taking fenfen couple of weeks later is trying to climb a hill and just gets really breathless and it's
01:26:58
like so weird here goes home is really breathless goes to the doctor he takes her off the drug but by then she had the
01:27:05
problem um she needed oxygen her whole life she was told she could never have children and then one day she she
01:27:12
couldn't breathe and she died this happened to lots and lots of people it led to the largest payout in the history
01:27:18
of the pharmaceutical industry up to that point they had to pay 12 billion dollar to the people whose hearts and lungs were harmed
01:27:24
and that is not that long ago now I want to stress again that was given to people with a very poor there was a single
01:27:31
study of 120 people of fenfen at the point at which it was marketed to people which is staggering this has a much
01:27:38
bigger body of evidence so this is not going to be in the short-term fenfen but when I looked at the 12 big risks associated with these drugs some of which have not really been explained to the public one of the ones that was most
01:27:50
disconcerting and was explained to me by a brilliant scientist called Greg Stanwood who Florida State University
01:27:55
and is researching these drugs the biggest risk is what he called unknown unknown so you remember that
01:28:01
Donald Rumsfeld thing right so when he was talking about um the invasion of Afghanistan but um when he was the US
01:28:08
Secretary of Defense said you know when it comes to these things there are things there are what called known
01:28:13
knowns there are things we know we know there are known unknowns there are things we know we don't know where is
01:28:19
Osama bin Laden and there are unknown unknowns things we don't know we don't know that might hit us out of the blue
01:28:26
and with these drugs there's a big worry about longer term unknown unknowns so for example we know very little about
01:28:33
what happens to pregnant women when they're taking these drugs right we know that in the animal studies um when
01:28:39
animals are other non-human animals are exposed to these drugs they're much more likely to get birth defects so one thing
01:28:46
Dr Stanwood said that we should think about and he stressed this is speculative we don't know was think
01:28:51
about antipsychotics right in the 1950s doctors started giving people antis psychotics they were judged to be safe lots of people dispute that but park that for a second and people took them
01:29:02
for many many decades and then it was discovered really late in the day that when you get into your 70s and 80s if
01:29:08
you've been taking antis psychotics you are much more likely to get Alzheimer's disease and other forms of dementia like
01:29:13
much more likely now there's no way you could have known that at the start it was an unknown unknown you couldn't have known that you had to have people taking
01:29:19
it for a really long time before you could find that out now one of the concerns about these drugs is that there
01:29:25
will be unknown unknowns that we can't know about these drugs are working on your brain they are working very hard on
01:29:32
key parts of your brain parts that relate to memory processing taste processing um gut motility right we
01:29:40
don't know but there's at least some risk there now again you have to weigh that against the risks of obesity as Dr sha alevy who's at tillan school of medicine put it to me we don't know the
01:29:52
long-term risks of these drugs we do do know the long-term risks of obesity and they are horrific really horrific and
01:29:59
much worse than I thought at the start you know for example I'm actually quite embarrassed to say this diabetes right
01:30:07
okay I knew that you were much more likely to become diabetic if you were obese um figures on that are kind of
01:30:12
shocking if you're obese when you're a teenager your your chances of developing diabetes are 70% in your life right
01:30:18
shocking but I thought all right diabetics they get insulin and then they're basically like the rest of us
01:30:23
right as long as you've got Healthcare you're fine interviewing doctors they were like no no no lots of people think
01:30:29
that if you get diabetes it it knocks on average 15 years off your life there's a
01:30:34
doctor here Dr Max pton a close friend of mine and a brilliant Doctor Who Says something to me it seemed really
01:30:40
shocking when he first said it but then he went through the evidence he said if you gave me a choice between getting
01:30:45
diabetes or becoming HIV positive I would choose HIV every time if you become HIV positive as long as you get
01:30:52
medical treatment you live as long as everyone else if you get diabetes you know not only does it knock 15 years off
01:30:58
your life your chances of all sorts of catastrophic complications in your life are really high it's the biggest single
01:31:05
cause of blindness in Britain preventable cause of blindness it's massive cause of leg amputation more
01:31:11
people get an extremity cut off in the US because of diabetes every year than because of being shot right I mean it's
01:31:17
and you go down the list of all the harms associated with obesity diabetes isn't even number one
01:31:24
right so every time I talk about the risk of these drugs I really worry about the risk of these drugs right there it's
01:31:30
a lot of them people should go through it very carefully if you have thyroid cancer in your family for example I
01:31:36
would strongly recommend you don't take them if you know you're already um worried about your muscle mass don't
01:31:42
take them there's a whole range of caveats and clauses but we have got to be honest about the risk of obesity and
01:31:49
for me if I'm being honest I think the choice was ongoing obesity or these drugs and so for me personally I have
01:31:56
made the Judgment call after looking at all of this evidence that I'd rather take the risk of OIC than the risk of
01:32:01
ongoing obes it especially given my family's history and how many men Die Young of heart attacks but loads of
01:32:08
people will look at the evidence that I present in Magic pill and take totally the opposite point of view and they may
01:32:14
well turn out to be right and I might well turn out to be wrong right I wouldn't debar that there's a fenfen like scenario down the road right I
01:32:21
don't it's not likely but you'd be a fool to dismiss it it I am in a different camp and I have to say before I express my own opinion that I understand there's a lot of people out
01:32:31
there where drugs like this will literally save their life and if they don't take these drugs then you know
01:32:36
you've gone through some of the stats but they I mean they will probably die from something you know some kind of
01:32:42
form of uh you know we talk about all cause mortality a lot like something will kill you in the next couple of
01:32:47
years whether it's a cardiovascular issue or something related to another um element related to obes obesity my thing and this is I think developed over time we're doing this
01:32:58
podcast and speaking to so many experts in health and fitness and wellness and psychology and psych Psychiatry is I
01:33:04
just have this really deep innate belief that there's no such thing as a free lunch in life and I've just The more
01:33:13
I've done these interviews The more I've come to learn that everything is a trade-off and I almost see life as like
01:33:18
a scale so if you if you if you if you put a weight on one end there's going to be an equal and an opposite Force somewhere else you know like the what's the law of physics is it Einstein that
01:33:29
said that that you can't like destroy energy you can just move it and I think about the same with like drugs often and
01:33:37
other things that seem like Miracles or shortcuts you're you're moving the set of issues somewhere else you've talked
01:33:43
about some of those movements uh today like the psych psychological transfer of a uh soothing Behavior to an addiction
01:33:49
for example that's always been my like belief that um whenever one my friends says Steve I'm taking this uh Limitless
01:33:56
pill mfil and it's making me super productive and it's fixed all my problems in life and I'm killing the
01:34:02
game now I go what's the cost yeah and my friend said to me remember when he started taking it he was like there's no
01:34:07
cost there's no side effects and my brain goes history shows if you wait long enough there's always a cost it's
01:34:15
just being conscious of the cost and when you balance up as you've done in your life the pros and cons you say okay
01:34:22
I'm willing to take the cost now when I I see things like a zek and people say to me there is no downside I get more
01:34:28
scared because I can't run the numbers to see whether the cost is worth the upside for me so I don't know what the
01:34:35
the big obvious downsides of a zek and these magic drugs are but I feel like logically there must be one we do know there are some medications where pretty dependably the
01:34:47
benefits outweigh the risk think about statins right if you have a problem with your cholesterol what statins do is they
01:34:54
block part of your body that makes cholesterol right so it's the most commonly prescribed drug in the US it's
01:35:00
pretty close to it in Britain almost every doctor would agree there are some downsides to statins but sometimes there
01:35:05
are just like you have to stay on them for life right yeah you have toay like with these drugs right the minute you stop taking them so within a year of
01:35:12
stopping you regain 70% of the weight you've lost right this is one of the big questions around these drugs now that's not 100% uh of the people regain it um but it's most people seem to regain
01:35:24
their weight so I think there are sometimes when a drug a medication I'm not saying these drugs are that definitely not but there are some
01:35:30
medications which do seem to be just not that there's no cost but the benefits are really unambiguous and
01:35:37
massively outweigh the cost this is a much more finally judged thing and it's interesting to me it's been funny talking to people who read the book
01:35:43
because remember talking to the marketing teams at both my Publishers because some people who were the first
01:35:49
people to read the book apart from my friends so some of them came up to me and said oh yeah Han I loved your your book it made me really want to take oen
01:35:55
piic someu came up to me and said Yan I loved your book it made me think convinced that you'd have to be
01:36:01
completely insane to take o zic and it was a bit like you know the dress the uh some people saw it as gold some people
01:36:06
saw it as blue and I felt like that meant I'd done my job because unlike pretty much
01:36:13
everything else I've ever written I've ended this feeling as conflicted almost as I was at the start
01:36:21
right this is a huge thing it's going to change and we've talked a lot about the
01:36:26
personal dilemmas it's going to have a huge social effect Barkley's Bank commissioned a very sober-minded analyst
01:36:31
named Emily field to um make predictions that could guide investment based on these drugs and she said if you want an analogy you have to think of the invention of the smartphone right I mean
01:36:43
this is going to have so many unpredictable effects um already crispy K cream donut stocks have been tanking
01:36:49
the head of nestle Mark Schneider has said we they're worried about their ice cream and infection ranges and Jeff
01:36:56
Financial did a report for the airlines in the US saying they're going to have to spend much less on jet fuel pretty
01:37:01
soon because it cost takes so much less jet fuel to fly a much thinner population what I was fascinated by is
01:37:08
um companies that manufacture hinges for knee and hip replacements are seeing their stocks tank because people are going to need far fewer neon hip replacements cuz that overwhelmingly
01:37:20
that's driven by obesity right so not entirely but overwhelmingly um so yeah if we were talking in 2007
01:37:27
when the day Steve Jobs unveiled the iPhone I don't think we could have gained out you know one tenth of what was about
01:37:35
to hit us and I kept having these moments traveling all over the world interviewing these experts remember one
01:37:42
day I was in a cafe I was interviewing one of the key neuroscientists at Cambridge University
01:37:47
who was working on this we were in a cafe and there were loads of people walking past and it's you know just
01:37:53
random British people a lot of whom are overweight or obese like I was and I thinking wow you don't know
01:38:00
what's about to hit us all it was a slightly weird unreal feeling I mean this is is for better and for worse and I think there will definitely be positive effects and there will definitely be negative effects and I
01:38:13
think we can see early on what quite a lot of them are this will change the lives of all of us in one way or another
01:38:21
how do you guys manage your stress this is Stress Awareness Month and it's a topic that I'm super passionate about
01:38:27
and we talk about a lot in this podcast I personally manage my stress by prioritizing my health and well-being
01:38:32
going to the gym is my number one form of therapy and I couldn't be without those two things as you guys know whoop
01:38:39
is a sponsor of this podcast and I'm an investor in the company as well for those of you that don't know whoop actually created a stress monitor within
01:38:46
this device not only does this helped me to identify periods of high stress in real time throughout the day but it also
01:38:51
provides me with the tools I need to to deal with stresses as they come up throughout the day and it's based on
01:38:57
scientifically backed breathing exercises and research that's been developed by Leading neuroscientists
01:39:03
it's a feature that has been gamechanging for me and I highly recommend if you're someone that's looking to manage your stress levels
01:39:09
then head over to join. woop.com CEO where we'll give you 30 days risk-free and zero commitment to try whoop let me know how you get on I'm
01:39:21
just I was thinking as you were speaking there about bunch of Statistics that I've read recently humans are getting
01:39:26
more and more sedentary which means we're moving a lot less um obviously obesity is going up across the sort of
01:39:32
Western World um most obviously uh and then you've got this rise in a zmek which allows us to stay
01:39:40
skinny basically and suppress our appetite I was just wondering there's going to be it feels like there's going to be two groups of people when these
01:39:45
drugs drop in cost and they become really accessible and i' I've saw you say in the book that the next sort of
01:39:51
iteration of these drugs is going to be a pill a lot of people won't want to inject something I'm one of the people that just I'd get too squeamish about
01:39:56
having to inject myself so the minute something becomes a pill it brings down one of the psychological barriers it's cheap it's a pill a lot of people are
01:40:04
doing it if you're not doing it in the obesogenic whatever that long word was environment we live in it's almost like you're going to be a an inferior human to some degree like there's going to be
01:40:16
two parts of society the 50% that are down to take the pill and they're going to be skinny and they're going to be whatever and then the 50% that are
01:40:22
struggling in this this difficult food environment we live in with the ultra processed food um I can't I almost can't
01:40:29
play out a scenario where most people aren't taking this magic pill so there's a few assumptions of what you've said um I think you're probably right but there's a few assumptions so in a way
01:40:41
what you're saying there's sort of few different dystopias that could emerge one is actually that we don't
01:40:48
even get to where you are because it's restricted to a tiny number of rich people right so let's start with the
01:40:53
first like dystopian Vision we could have the first is that we never even get to that point let's imagine we basically
01:41:00
we have a situation at the moment where the Real Housewives of New Jersey get to be super super skinny and the real
01:41:05
school children of New Jersey get diabetes at the age of 12 right so we could have a situation where these drugs
01:41:12
exist and they work very well but they are restricted to a tiny Elite of rich people which is kind of where we are
01:41:19
it's not going to stay like that though is it in the longer term it won't and it's not that far off so 2032 The Paton
01:41:25
on OIC passes so then it's not actually that expensive to make these drugs it's $40 a month to actually make them it's
01:41:31
the rest is profits for NOA Nordisk who argue understandably you know look we took all the risks of developing this we
01:41:37
should cash in now um you can see that argument although I don't think they need to cash in quite as much as they
01:41:42
are uh so one scenario is it go it will go out of patent in 2032 by then it looks like the main way
01:41:49
of taking some agati will be pills anyway so you can well imagine in a situation where you've got $40 a month
01:41:55
to take a daily pill that will make you much thinner I think in that scenario you're right now what I'm most
01:42:03
hope is that a the drugs don't have a catastrophic side effect obviously B the people who want them get them and see it wakes us up and we go how did we get to
01:42:15
this point how did we get to the point where we're looking at potentially drugging our children forever not
01:42:21
knowing the long-term effects who did this to us and how can we be more like Japan and all the other
01:42:26
countries that are making these changes that's optimistic that requires a lot of uh raising of Consciousness between now
01:42:32
and then but that's the most optimistic scenario thing but you're totally right there could be a a scenario it's
01:42:38
probably the most likely scenario if there isn't some big risk that emerges that we'll just have staggering amounts
01:42:44
of the population taking these drugs unless the government intervene that feels like the most likely scenario
01:42:51
unless the government introdu some laws that put restrictions on what children can eat at school and all those kinds of
01:42:56
things in a more severe way I can't see a scenario where especially with this younger generation you know you hear all these stats around young girls on Tik
01:43:03
Tok being more anxious than ever before the suicidality going up men are struggling more than ever with body
01:43:09
dysmorphia which no one's talking about I was reading some stats about that yesterday yeah shocking the figures on
01:43:15
that and the antidote appears to be I mean this it's not a good solution right and perfectly normal healthy people who just
01:43:26
have a little bit of belly fat and they hear this you know they hear about this stuff they go you know going to the gym
01:43:31
is hard and I do love those burgers and that KFC is really nice it does tastes really good so I could eat my KFC and I
01:43:37
could stay skinny I think that last bit then they're wrong you you if you take it you won't want to eat the KFC in the
01:43:43
burgers and believe me I have been the king of KFC just three bites I got a couple of bites though well but you
01:43:48
don't get you actually don't even want that particularly right and huge numbers of people seeing that I mean for most of
01:43:55
the time I have been eating smaller portions of similar [ __ ] but um actually even your taste for that tends to kind
01:44:01
of Wayan over time right so the last bit's wrong but I think yeah you it's one of the things it's funny I
01:44:07
didn't it's one of the things that made me really angry in Japan I was thinking all this agonizing I've done all this worrying and I worry even more
01:44:19
about the fact we're almost certainly about to start a mass wave of drugging children with asmic already begun in the
01:44:25
US I interviewed parents who drugging their kids because their children are obese and I thought this whole dilemma
01:44:32
never had to happen right this happened because the food industry screwed us over and we didn't regulate them and we didn't stop them and we can start to do that and I went to places that have done
01:44:42
it I went to Mexico where they introduced a sugar tax usually reduce the amount of sugar that people consume
01:44:47
I went to Minneapolis where they prescribe healthy food for poorer people who can't afford it has a a really
01:44:53
positive effect I went to Finland where they had a huge transformation in the food supply I went to Japan there's load
01:44:59
here in Britain there was a really interesting experiment bread used to have far more salt in it and a really
01:45:05
heroic guy called Professor Gran McGregor who I interviewed persuaded the government to just to get the food
01:45:10
companies to sort of lore them I mean they would have they threatened regulation which meant that the companies gave in before they did it to
01:45:16
just massively reduce the amount of salt in bread no one even noticed and it reduced Strokes every year in written by
01:45:23
between 6,000 and 9,000 right and a stroke is one of the worst things that can ever happen to you now we could do
01:45:29
it's called reformulation there's loads of other things we can do like that we could reformulate loads of foods in ways
01:45:35
that aren't even painful to us right there's so much we can do as so much we can do to be like Japan I mean it was a bit weird in Japan though because there were things they did that we can't do
01:45:46
right so I'll give you an example this was one of the weirdest days in the research for the book in 2008 obesity
01:45:53
very slightly went up in Japan it was still like laughably low and they had a real panic and they introduced this new
01:45:59
law it's called the Metabo law um it's named after metabolic syndrome which is a really nasty combination of like diabetes obesity and other problems you can get when you're when you're very
01:46:09
overweight and um the law is very simple every single company in Japan on a particular day every year has to weigh every single person who works there and
01:46:21
if their weight has gone up they have to drop a plan with their employer to bring their weight down and as a company
01:46:27
overall if your weight goes up you can be fined by the government and I was like how could this possibly work so I went to a company that does it tanita
01:46:34
they all do it but a company that let me go and see how it works and it's really weird right you at
01:46:40
this workplace you arrive you show your face to a video screen it says hi Stephen you walked 14,000 steps
01:46:46
yesterday you're number 121 in the company in terms of steps taken cuz everyone has to wear like a Fitbit well
01:46:52
equivalent to a Fitbit everyone uploads pictures of every meal they have to this system where you can see it it was
01:46:59
bizarre right um and yeah explain to Japanese people who kept going you know every morning in this office when we'd all be having donuts and coffee they do aerobics together it was bizarre and I
01:47:13
sort of explain to these Japanese people right if you tried to do this in Britain we would burn the [ __ ] office down right like and they would just go well
01:47:20
why why they couldn't understand why I was so affronted by it and that okay that's a big cultural Chasm and we can't do that and I wouldn't want us to do that but if you look at so many of the
01:47:31
other changes in Japan I started to see like what you win if you get this right so Japan has the longest life expectancy in the whole world and one of the best things I did
01:47:42
for the book One the most moving things for me is I went to the oldest village in the whole world it's in okanawa in
01:47:48
the deep south of Japan and there's a village called ogimi where there's 20 15 households and 190 of them have someone who's over the age of 90 living there right so it's the oldest place on Earth
01:47:59
um Japan has the by far the longest life expectancy in the world and not just that um you're far less likely to get
01:48:07
sick as you age so they have not just more life but more healthy life and I went to their little Community Center and the first person I met was a
01:48:18
102y old woman called Matsu fukuchi who was this like almost like Kind of Perfect crumple of wrinkles right she
01:48:25
was so cheerful chatting to her she was like I can't stay for long cuz I'm looking after my son who fell off the roof the other day fixing it I was like
01:48:32
Jesus how old is your son um and she was like oh I love you know she was so full of joy she I love life I spent all of
01:48:39
yesterday watching volleyball with my grandchildren it's so great she was so happy she'd walked there on her own and
01:48:47
then there was this moment where they put on some music she put on this red kimono and she started dancing and all
01:48:54
these old in these women as old as a century start dancing right and I danced with her and I was thinking God this is
01:49:02
this woman was born before radio started broadcasting in Japan and here I am recording an interview with her on my iPhone this is what you get if you get
01:49:13
this right if you sort out the Obesity crisis you get to have more years of health and joy and dancing right that's what we're fighting for here I think
01:49:25
about how many people I know who died young because of complications related to obesity everyone listening and watching will know someone who would be alive now if we had sorted out the
01:49:37
Obesity crisis but has died everyone right and it doesn't have to be this way you know now part of that solution in the short and medium term is going to be these drugs in the longer term it
01:49:52
doesn't have to even be that right Japan is a real country it exists they solved
01:49:57
this problem there are other countries in the world that are solving these problems we don't have to tolerate this
01:50:02
being done to our children we don't have to accept us being made sick and our children being made sick but it requires
01:50:09
an Awakening around what's really happening who's doing this to us at the moment you know whenever I my weight
01:50:15
goes up and down right it has gone up and down throughout my life and whenever I was fatter I would blame myself right I wasn't angry with the forces that have
01:50:21
done this to us right more three-year-old children know what the McDonald's m means than know their
01:50:27
own last name right I didn't choose that world I didn't choose to live in a world where we were you know constantly
01:50:34
promoted and fattened and physically changed such that it's hard to come back right that don't mean I had no
01:50:40
responsibility in that I did but we don't have to continue like this do you think you could stay at the we you are now without this as EK it's funny you
01:50:52
holding this I feel like we're in a weird dystopian version of QVC right um do I think uh honestly well if I'm
01:51:00
typical we know from the clinical trials 70% of people regain the weight within a year no I don't think so if I'm being
01:51:06
really honest with myself I don't think so I think I have made lots of changes in my life that mean I don't think I
01:51:11
would go back to quite where I was but I think I would very rapidly regain a lot of weight so you have to take this for
01:51:18
life now to stay the way you're at therefore yeah and there's a big debate about we mentioned before with the amphetamin based um diet drugs from the
01:51:26
past that people develop tolerance one of the big question marks around this is do people develop tolerance does it mean
01:51:32
that over time it will have less of an effect right now some scientists the scientists asked about this just were
01:51:38
wildly all over the place some said no we do know diabetics don't seem to develop tolerance they because if they
01:51:44
did they would need higher and higher doses to get the same level of control for their blood sugar so that's a point
01:51:50
against tolerance but others said it would seem quite likely we developed tolerance we developed tolerance for
01:51:55
most drugs it would be surprising if we didn't probably what's most likely again Carell luro the South African
01:52:01
psychiatrist said to me again probably the best comparison is bariatric surgery you have bariatric
01:52:08
surgery you lose an absolute [ __ ] ton of weight and then you regain a little bit of it over the next few years and then
01:52:14
you sort of plateau at that higher point but we don't know the truth is no one knows I'm also concerned that if you is
01:52:21
there a world where if you stopped taking this your body had become reliant on your gp1 coming from this so your
01:52:28
body makes less glp1 itself don't think it's so much I don't think that's the concern I think but there is I think
01:52:33
you've gone to a really important point we know all forms of diet slow down your metabolism right that's a reality about
01:52:41
diet um which is why often people end up fatter at the end than they were at the
01:52:46
start um I'm worried about and again I asked lots of scientists and people just said we don't know I'm worried about um is my metabolism slowing down as I
01:52:58
take this drug if I let's say they discovered some terrible problem with it and it had to be withdrawn would I then
01:53:05
have a slower metabolism and be fatter than I was at the start yeah no one knows that's a significant risk and the
01:53:11
other big sort of risk here is you've talked about a few times is this eating disorder um epidemic it seems I think
01:53:18
you talk about in your book that since March 2020 rates of anorexia and bmia were 42% higher than they would be
01:53:24
expected for teenage girls aged 13 to 16 I think that's cuz of lockdown to be fair that's not that's not a result of
01:53:29
the drugs that's because of the massive stress of lockdown yeah some research in the lon journal and 32% higher for those
01:53:36
aged 17 to 19 what I'm saying here is that we we do have an issue with eating disorders in in the Western World
01:53:42
especially um they they skyrocketed after the the pandemic but when I think about eating disorders and bulimia and
01:53:49
anorexia and I think about this and and what it might mean for those Eating Disorders I feel somewhat concerned especially when kids get their hands on them go beyond concerned and we don't
01:54:01
have to speculate about this we've been here before so in the early '90s there was a very popular amphetamin based diet
01:54:07
drug that was marketed in the United States and it was huge and lots of teenage girls used it and it led to a
01:54:13
catastrophe there was a guy called Rob weyden who was a congressman for Ohio at the time who held Congressional hearings
01:54:19
on this and they are really chilling to read because they show what happens when a popular diet drug combines with eating
01:54:26
disordered young women right so there was a a woman called Jessica McDonald who testified at the hearing she was um
01:54:34
she was in her early 20s at the time so she was a ballet dancer obviously we know about the horrendous pressures on
01:54:40
body shape for ballet dancers and she would take this drug like this amphetamin based drug until she passed
01:54:47
out to be thin she would take it to starve herself because she wanted to be that that ballet shap there's a guy called Tony Smith from state center in
01:54:53
Iowa who testifies that his daughter Noel from when she was very young became obsessed with the idea that she was fat she would go and look at these fashion magazines and say daddy do you think I'm
01:55:03
fat why don't I look like these women and she got hold of these diet drugs massively starved herself and died
01:55:10
of a heart attack and he read out this heartbreaking poem where she describes like you know I'm
01:55:16
hungry I want to eat but not yet not yet right so we know that when a diet drug combines with eating disorders it leads to catastrophic outcomes we don't have to speculate so yeah that's one of my
01:55:29
three or four biggest concerns now like I say we can introduce regulation now to mean you only get it from a doctor the
01:55:34
doctor has to see you that will cut some of that but I don't see how and and that's really important and anyone we
01:55:41
save is worth saving but yeah I'm very very concerned about that I'm also concerned about a more subtle effect in
01:55:46
relation to that so the worst moment I had in writing the book was not any of the physical side effects for me
01:55:53
although there were some Grim moments there early on it was a moment when um so M I've got a niece called Erin and she's 18 now although she's 19 actually but in my head she's sort of six years
01:56:05
old all the time like CU she's the baby of my family she's the only girl she was the youngest so no one makes me more
01:56:10
protective and one day a few months into taking these drugs I was FaceTiming with her she was in a pub in
01:56:16
Liverpool and she was like oh Yan you've lost so much weight and I was like preining she's like oh look I can see your drawer I never knew you had a
01:56:21
drawer and I was like oh yeah I was looking you're happy and then she looked down and she
01:56:29
said will you get me some oamic she's a perfectly healthy weight she always has been and I thought what the [ __ ] am I doing all her life I've been trying to
01:56:41
give her this message don't be judged by how you look don't worry about that you know and I
01:56:48
thought I've counteracted everything I wanted to communicate and we know and and she decided not to
01:56:56
take it and all and ended fine with her but when I was a kid there were no fat people on television except as the butt
01:57:01
of the joke and I think about my niece she's grown up seeing actually quite a lot of women who have a broader range of body shapes in the public eye and in the
01:57:08
last two years almost all of those women have massively shrunk now they're not talking about a zic but unless there's been some kind of outbreak of dentry in Malibu I think we know what's happening right some of them are talking about it
01:57:20
but most are not can I just ask on that cuz we've seen a lot of very famous faces suddenly shrink over the last
01:57:27
couple of years and when you read their autobiographies they talk about like going to the gym and eating getting their lifestyle right do you think
01:57:34
they're lying I mean obviously yes it does appear I wasn't sure if it was just me but I look I look think about a lot of people that were a little bit bigger and it seems that
01:57:45
suddenly everybody's kind of cracked weight loss and it's rapid and it's super fast I don't want to name any particular names cuz it's not my place to talk about individuals like that but
01:57:56
it really does seem like Hollywood has found a p a great personal trainer and I'm I'm just like I'm wondering if um if this is what it is yes although I think
01:58:10
I would say the people you and I think about are almost all women and I do think we should be I know you would agree with this I'm not making this as a point against you women get so much more
01:58:21
[ __ ] than men men for this sort of thing right like actually one of my editors said to me you know I was saying why has
01:58:28
no one else written a book about OIC yet why am I the only one and they said cuz only a man could write this because a
01:58:33
woman would be crucified for writing it right she would be monstered and if you look whenever even someone as
01:58:39
unbelievably popular and amazing as Oprah slightly C is my friend um gets Savaged for it right and there's lots of deep underlying reasons for that that
01:58:51
came out for me as well actually that I I I projected towards myself I remember for a long time taking the
01:58:58
drug I felt like I I mentioned this a little bit before but I felt like I was cheating I felt like I was sinning
01:59:05
almost and I started to look at the kind of deep ideas they're so deep in our kind of collective unconscious if you look at so for example in the 6th Century the pope Pope Gregory the first
01:59:17
draws up the seven deadly sins right and one of them is gluttony and it's this image it's always depicted with an image of some hugely fat person looking like a
01:59:24
pig you know and it's horrible it's very deep in our culture the idea that being obese is a sin right
01:59:32
if you look at the forms of weight loss we admire they follow the pattern of sin right the kind of classic Catholic
01:59:38
pattern of sin you sin then you have to suffer and redeem yourself and then we forgive you right so if you look at the forms of weight loss we admire there're ones where people are humiliated and
01:59:49
suffer terribly you starve yourself you um you know you think about that show The Biggest Loser which I hate uh you know where severely obese people are made to sort of compete and gring
02:00:00
horrific forms of exercise then we're like okay Jabba we forgive you now you know what I mean we use this kind of
02:00:06
stigmatizing ways of thinking cheating is a bit more subtle because I kept thinking I'm
02:00:12
cheating as I do this and I was like well that's really weird if I if I had a heart problem and I took statins I would
02:00:17
not think I was cheating right I said why is that and I think it's partly so people put in a huge amount of effort to
02:00:22
be thin right loads of women watching this and it's disproportionately women will suffer some privation and
02:00:30
deprivation in their life because they are really trying to be thin and then they hear a this [ __ ] just injects
02:00:36
himself once a week and he gets to be thin like me it's like they feel the way I imagine cyclists do when they look at
02:00:42
Lance Armstrong right and the only way out of those that negative conversation where we turn on each other like rats in a sack is to realize oh there is a sin and there are people
02:00:54
who are cheating but it's not Oprah it's not someone who Jeff Parker that guy I mentioned who you know didn't want to die young it's the food industry that [ __ ] all of us that's why we're in
02:01:06
that race right that's why you're starving yourself that's why we feel we're Sinners okay well we can collectively
02:01:13
come together and challenge that shared opponent if we want but if we're just going to get into look it's very hard in
02:01:19
this age of social media Madness to not have every conversation turn into a toxic conversation and it's not
02:01:25
surprising that something is charged as a debate about a zenic and weight has become so toxic so quickly but again we
02:01:34
don't have to do that that the toxicity isn't going to get us out of this right we're in a shared crisis everyone
02:01:39
watching has someone they love who is on course to Die Young because of the problems associated with obesity because
02:01:45
obesity is so widespread in this Society in a very recent amount of time look at a picture of a beach in Britain
02:01:52
in 1975 not a million years ago everyone is thin by our standards right this happened in the blink of an eye in human terms right again we don't have to tolerate that part of it is also we
02:02:05
don't like when people lose weight some of us because it shines the light on us and I think about someone like Adele who
02:02:12
dropped a ton of weight very quickly and the shocking thing when she when she dropped that photo I think it was at
02:02:17
like a birthday party because she went from like being you know a certain way to then dropping weight very quickly so
02:02:23
we because we don't see Adele's private life life much it was just this the selfie she dropped and if you look
02:02:28
online at the reaction people were betrayed they felt betrayed by Adele's weight loss not because they're they're
02:02:35
assuming she used a zenic or anything the fact she's now not the way she was in terms of her
02:02:41
weight people were like almost angry about it and the same happened with Rebel Wilson When Rebel Wilson dropped a
02:02:46
ton of weight because in her book she talks about you know she wanted to increase her chance of having a kid so
02:02:52
her doctor advised her to lose lose the we people were Ang like almost angry that they lost someone they could maybe
02:02:59
relate to or that made them feel a certain way about themselves which I find to be really interesting that we
02:03:04
actually don't like it when someone loses way we've got to understand where that's coming from obviously I don't support anyone being cruel to people online and it's good for
02:03:15
both ad Del and Rebel Wilson that they've improved their health um but I think where it comes
02:03:21
from and a lot of these things that can seem a little bit odd that that are kind of said we've got to realize how much
02:03:28
shame people are soaking up on this issue you know if you have a BMI higher than 35 and you're a woman 45% of women
02:03:35
in that position get insulted every single day in public every day right so you're walking through the world constantly being made to feel there's something wrong with you being treated
02:03:45
like [ __ ] um and I can see how people in that position develop a sort of parasocial relationship with Rebel
02:03:51
Wilson or Adele like oh look we can look to Adele and they feel trapped they feel they can't lose weight and then they see
02:03:58
Adele and Rebel Wilson and they're just like oh two brute [ __ ] you you know I get it now it's not the right response I
02:04:05
would want to talk to them more about okay what we want to think deeper about this but I can see where it comes from
02:04:11
and I can see why some people look at me and go you [ __ ] right I totally get it
02:04:17
I suspect I would have felt that anger were I not me looking at me right so I get where the anger this comes from from
02:04:23
the moment we're born in this culture we are primed to be overweight and we are primed to feel tremendous amounts of Shame about being overweight right and
02:04:35
anything that comes along and brings up those stories and forces us to think to them brings them to the surface like
02:04:40
these new weight loss drugs just leeches out of all of us so many negative and angry and hurt feelings and I felt it myself right I felt so much self-doubt all the
02:04:55
way through this I still feel self-doubt about it I still have days where I wonder am I doing completely the wrong
02:05:02
thing so I do think we have to understand where it's coming from and not just sort of know you're not doing
02:05:07
this you're always interested in understanding where people come from but it's tempting to just condemn people and
02:05:13
go look at this bad behavior and I'm always more interested when people are behaving badly and it is cruel to say to Adele you [ __ ] you betrayed us uh I
02:05:21
mean I would never say anything about to Adell anyway because I love Adell but I saw her in Vegas she's incredible but
02:05:26
um I do think we always have to try to understand and it comes from a place of profound pain and that's not a pain that
02:05:32
those people deserved right that and that's a pain they should never have been subjected to but one of the really
02:05:37
surprising things you talk about in your book is the relationship that a zek has on addiction and I couldn't quite figure
02:05:43
out why there'd be any impact on addiction if we start taking AE drugs you talk about the how it eases the food
02:05:49
chatter in our brains and the sort of food cravings we have but then there's a lot of research you go into that shows
02:05:55
um a zenek and these kinds of drugs can actually have an impact on our um addiction to things like cocaine and
02:06:01
alcohol so this is much disputed and there are serious scientists on both sides but I found it mindblowing and
02:06:08
totally fascinating so for example woman called Elizabeth yog who's a professor at the University of gothenberg in Sweden has done some of the pioneering work on this I interviewed her a
02:06:19
lot they get a loot of rats and they put them in a cage and they give them loads of alcohol and rats will like alcohol
02:06:26
and they get hammered like the rest of us and they wobble about and they love it right so they put them in this cage for a while they've got plenty of
02:06:31
alcohol they get drunk over many weeks and then once it starts to resemble like a dive bar in vas they do an
02:06:38
intervention they come along and they inject them with gp1 Agonist the exact drug you've got in front of you stide um
02:06:45
and then they watch and what they discovered what professor yog and her colleagues discovered is afterwards the
02:06:50
rats drink about 60% less than they did before and the Rats who drank most heavily are the ones who cut back on
02:06:56
their drinking the most like whoa what's going on there but then they thought okay maybe it's because alcohol's got a
02:07:02
caloric content it's like they want the calories less right so then there were experiments done with drugs that don't
02:07:08
contain any calories so Professor Patricia grigson who's at Penn State University gets rats heavily using
02:07:15
heroin and fenil gives them a GP Agonist again finds the same thing 50% reduction
02:07:21
ction in the rats using the her self administering the the heroin and the fenil Then Greg stanard who I mentioned
02:07:27
before who's at Florida State University does it with cocaine in it was mice not rats for him again 50% reduction in them
02:07:34
using cocaine we don't know why again it come some of the theories come back to that question about the reward system
02:07:41
could it be dampening the reward system one of the things a lot of the scientists find fascinating is these
02:07:46
drugs appear to have what they call SEL activity so SEL activity is where the drug makes you want less of the Big Mac but not less of a salad right so it seems to it doesn't just generally
02:07:58
dampen you don't just not eat at all some people do with malnutrition as a risk but most people don't right so
02:08:05
given that it's some of them argue again it's highly speculative at this point it
02:08:12
seems to be activating downgrading your desire for things that are bad for you but not things that are good for you right I'm thinking how can that be that seems so weird let's I'm Elton John
02:08:22
right and I get my pleasure from playing music how can it know to tell me to eat fewer Jam sandwiches but not to engage
02:08:29
in jamming right how can it do that and they kept saying we don't know there does seem to be a mechanism that does that we're trying to explore it so obviously hugely encouraging results in
02:08:40
animal studies with uh addiction so now there's lots of experiments going on with giving these drugs to humans to see
02:08:47
if they reduce addiction there there's been a huge amount of anecdotal evidence interview to a nurse in Canada called
02:08:52
Tracy who had a bad relationship breakup and just became completely addicted to shopping she would just obsessively buy
02:08:59
books she'd never read clothes she'd never wear she was doing a lot of um skin picking um and obsessive eating she goes
02:09:07
on as mpic and all these addictions like disappeared so there's now this debate okay is it going to have this effect
02:09:13
more widely the early research is kind of mixed so there's only very very small studies on humans so far uh it found
02:09:20
that it reduce smoking but only if you pair it with a nicotine patch they found that it does reduce alcohol consumption but only if you were a heavy drinker at the start so we're going to know a lot
02:09:32
more we're going to get a lot of results actually this year and definitely a lot next year but it's a very promising so
02:09:38
some people argue so the most extreme I want to stress this is speculative the biggest cheerleaders for
02:09:44
the drug would say actually we haven't found a drug that causes appetite regulation what we found is a drug that
02:09:50
boosts self-control across the board right now that's very contested I'm always conscious you know of the
02:09:57
overselling of drugs generally we want to be careful about it but it's a possible scenario and the
02:10:02
animal research is mind-blowing and really is highly highly exciting and you don't normally see this right there's no
02:10:09
other drug that I'm aware of pretty sure there isn't um that just reduces addiction across the board in animal
02:10:15
studies right it's remarkable I mean there's a debate about whether you can even call it Addiction in animals but
02:10:20
you know what I mean heavy compulsive use what impact has zek had on your weight loss Journey how much have you
02:10:26
lost I me I just lost a huge amount of weight so I lost three stone across a year and actually it was even more
02:10:32
dramatic was the percentage of body fat that I lost so at the start I was 33% body fat I remember the day Josh my
02:10:38
trainer measured that and it sort of looked winced as he saw it and um I said oh God if you if I was a sandwich you wouldn't want to eat me I later looked up whales at only 35% body fat so it
02:10:48
started disconcerting so I went from 33% body fat to 22% body fat so it's a really dramatic fall and did you
02:10:54
increase your dose yeah so everyone starts at 0.25 milligram partly because the most common side effect by far is
02:11:01
nausea right almost everyone feels nauseous a bit when they start taking it for some people the nausea is unbearable
02:11:08
I interviewed someone called Sunny Newton in Vermont who said you know it felt like an alien had entered her body and was thrashing and trying to get out
02:11:15
yeah a significant minority experienced such extreme nausea they just have to stop for me the nausea has now totally
02:11:20
gone away way um and Carell laru one of the scientists who worked on there said look when it comes to nausea you've got
02:11:26
a level with people there are two kinds of drugs there are drugs that have side effects and there are drugs that don't work right and he's right about that but
02:11:33
yeah the nausey is pretty bad but but for me it's all gone away now I really do admire Oprah I've um watched her she's kind of like a role model of mine for how she's kind of conducted herself throughout her career and as you say
02:11:44
she's a friend of yours and she's I think recently come out and admitted to using as zc she's talked about how she
02:11:50
struggled with with weight for her life um andna zek has been a bit of a Magic Bullet it seems for her in her weight
02:11:57
loss Journey um you know her as a person I've not been paying enough attention to her describing her decision to know why
02:12:05
she decided to take a zek verses I don't know some other form of dieting has she
02:12:10
explained that yeah she talks about it very movingly um she talked about an interview with People magazine and then
02:12:15
a brilliant special for ABC I think um I mean nobody has publicly tortured themselves with diets more than Oprah there's this famous clip that you've probably seen where she comes on stage
02:12:28
on her show and she's Wheeling a a huge bucket of fat and that's the amount of fat she'd lost on this diet and she describes very movingly in this special she says it much better than I can how
02:12:39
she had starved herself to get that right and you think about so she had tried all the extreme diet and exercise options that were available and they'd always yyo
02:12:51
back for the reasons that we talked about before so and you know and she had to have a knee operation I'm not giving
02:12:57
away anything she's she's disclosed this you she had to have a knee operation and she was very worried about her
02:13:03
health and so for those reasons she's made this this Choice there are lots of reasons to be worried about these drugs
02:13:09
but I have found it very hard when you talk to people who really struggled with this like that guy Jeff Parker I mentioned before in San Francisco like Oprah people who've made
02:13:22
the decision to do it and seen the benefits of the weight loss staggering benefits whatever the other arguments
02:13:28
are I've NE I don't want to argue against them right if if you are taking these drugs and experiencing an enormous Improvement in your in your health as they both have and as lots of other
02:13:40
people have then that's been the right choice for you now that won't be right for everyone I met people who really regretted taking the drugs for all sorts
02:13:46
of reasons including many of the terrible side effects and risks but I think we have to be truthful
02:13:52
to the complexity of these drugs right I mean one of the reasons it's called Magic pill the book is because there's
02:13:58
three different ways you could think about this as magic loads of people who take the drug go this is Magic right so
02:14:03
the first form of magic is obvious it seems to solve a problem so quickly so effectively that you're like whoa It's like a miracle right that's one way the second way is it could be magic like a
02:14:17
conjures illusion right it could be like a magic trick it seems to solve the problem but doesn't or sets up and
02:14:23
trains something else or the Third Way is think about almost every fable about magic is you get what you want but then
02:14:30
you get what you want in a way you didn't quite expect you you make a wish with the genie and you get what you want but the wish doesn't quite work out how
02:14:37
you thought most famous story about magic is Fantasia you know the magic can spiral away from you so I think one of
02:14:43
the things we're still trying to figure out is what kind of magic is this is it a magic solution is it a magic trick or
02:14:49
is it a magic solution that's going to spiral in all sorts of unpredictable directions I have to say when you know
02:14:54
when you were holding that pen looking at me I got weird like you were doing slightly judgmental Dragon's Den eyes
02:15:00
and I was like I was like [ __ ] how do I persuade him to invest in me right so funny I I was you I was thinking I was
02:15:06
thinking I was having a conversation with myself and I staring at thinking God this would be easier than going
02:15:12
because after you leave here I I haven't eaten yet today I'm going to have my lunch and then I'm going to go to the gym for about an hour and a half and
02:15:18
much of the reason why I go to the gym is to try and stay in shape you know I want to keep my I want to keep my belly fat off I want to keep my muscles strong
02:15:24
I want to be strong I want to look good that's the that's the reasons I go to the gym also the positive consequence of
02:15:31
me going to the gym later on after this conversation is it will make my brain feel really good yeah now as I was
02:15:36
looking down at the pen I was thinking I could take this and then the belly fat you know would wouldn't be
02:15:42
there but then I would lose the positive upside of the exercise that I'm going to get from going to the gym as well so I was wondering to myself are people going
02:15:49
to exercise less and is there a consequence to us not ex not exercising as much um to our mental health and our
02:15:56
feelings of you know happiness and all the things that exercise does for us yeah the answer to both your questions is yes people will exercise less and it
02:16:03
will have negative effects so we know I want to add to that the point that I alluded to earlier on people are getting
02:16:08
more and more sedentary we're living in like a Vision Pro headset don't need to move World well you know what I mean so
02:16:16
we're going to be able to inject to keep the weight down but we're we're still going to be moving less and there's a lot of upside to moving and exercise
02:16:22
yeah so we know that there's there are enormous benefits to exercise which exist quite separate to the question of weight loss right if you exercise for 270 hours a year you add three years
02:16:34
onto your life even if it doesn't cause weight loss right so that benefits in terms of preventing disease slowing down
02:16:41
aging mental health are just enormous from exercise and I think you've gone to a really important drawback which is
02:16:48
yeah if you can get the benefit in the short ter medium-term just from a jab but that calculation you were thinking through as you were holding the pen in the slightly Sinister Dragon Den way um is a calculation lots of people
02:17:01
were going to make and there's um there's a lot of things I'm not sure about in these drugs but there's a few bits of advice which I am very sure
02:17:07
about if you are not overweight or obese you definitely shouldn't take these drugs right you are incurring all the
02:17:14
risks for none of the benefits so that I'm certain of and there are lots of people who are not overweight or obese
02:17:20
who are taking the drugs to be super thin my friend Elise lonen who used to be the chief content officer at goop
02:17:25
said she won't even go out for dinner in LA with people we know now because no one eats anything like why did we come
02:17:31
out for dinner you're all starving she says you know dieting is out elimination is in the way she put it so I'm
02:17:36
confident about that I'm also fairly confident although slightly less but fairly confident if your BMI is higher
02:17:44
than 35 or your body fat percentage is very very high and you're not someone with thyroid
02:17:52
cancer in your family and you're not trying to get pregnant I would recommend taking the
02:17:57
drugs I think for you the balance of risk and and assuming you've tried diet and it didn't work I think for you the balance of risk is is more towards the benefits of taking the drug I'm not as
02:18:09
confident about that but I'm pretty the people I love who have BMI higher than 35 who are in that position I have
02:18:14
recommended the drug to them for people between with a BMI between 27 and 35 I think it's much more or um you've got to just go down the list of the benefits and drawbacks um and really think it
02:18:26
through for yourself and reasonable people will reach completely different conclusions it's going to be quite interesting to see that people who do
02:18:32
decide to do exercise and they change their diet and they've start running marathons when they lose weight every
02:18:39
everybody is going to say no you didn't that's so funny everyone's going to say it was impc if some celebrity now drops
02:18:44
I don't know three stone or four stone and they did it you know in the gym and with a diet change no one is going to
02:18:50
believe them no one that's very funny and I think think certainly yeah I think you're right there I had thought of that
02:18:56
you wouldn't believe them of course you wouldn't believe them no you're right one of the big rebuttal that I see online is that because people are now
02:19:03
taking these drugs people like you are taking them to lose weight diabetics can't get their hands on these drugs anymore and I saw some articles that
02:19:09
said the um the drugs have been in such high demand that diabetics who really really need them to save their lives now
02:19:16
can't get access to them I think those people have a really good point and I interviewed some of them for the book
02:19:21
and it was a very painful conversation I think the solution is what we should have done right from the start and what
02:19:26
we should do now is what we did in Britain with the covid vacine so we should um ration the drug and the people
02:19:32
with the greatest need should be given it first and everyone agrees severely obese people and
02:19:38
diabetics together would be the people who most need the drug and they should be given it first people like me who've
02:19:45
got heart disease in my family but were not hugely obese would probably be around the middle and you know people
02:19:50
who don't have heart disease and are just sort of overweight would be at the bottom we didn't have that system what we had unfortunately because the
02:19:56
government didn't set up that system was a scramble which meant that you know some diabetics didn't get the drug they
02:20:03
needed had to go on insulin earlier which poses a real threat to their health that's awful and I feel a bit
02:20:09
ashamed about it because of course if people like me hadn't hadn't all together bought it that wouldn't have
02:20:15
happened in practice for me personally I was worried about my own heart risk you know I mean year older
02:20:21
than my granddad was when he died um but that's not much of an excuse and when I
02:20:26
met the diabetics in that position like for example a guy called zami Jalil who was exactly in that position he could as
02:20:32
a musician 41 couldn't get the the ASM pick he needed for his diabetes for his type two diabetes I felt um ashamed you know clearly his need was
02:20:45
greater Yan thank you thank you for a few things I think it's worth saying that the first time you came on my
02:20:51
podcast I had basically no listeners you were like a tiny little baby podcaster I remember it really clearly you came to
02:20:56
my flat I showed up at your flat in London I'd read your book lost connections I was so fascinated by it so I reached out to you and asked you if
02:21:02
you'd come on and you said yes when I was when no one was listening to the podcast I don't I wasn't even videoing it back then um and it was an incredible
02:21:09
conversation the audio was terrible there was Lo we had loads of issues and stuff like that but you were one of the first people to really give me a chance
02:21:14
so it's so wonderful that that we can still stay in touch and that I get to cover your work still to this day so thank you for giving me a chance back in
02:21:21
the day I really appreciate it oh my pleasure and thank you for writing this book because one of the the most sort of popular things that our audience have
02:21:27
been seeking to understand is a zmek we've seen that in all the data and the way that you approach this even though
02:21:33
you are someone that's taking it so it's easy to see how you would be biased in various ways to defend it or whatever
02:21:39
that's not the approach you take and in the book magic pill you're able to be incredibly nuanced and how you look at
02:21:45
the pros and the cons in a way that I was not expecting from someone who is taking it themselves and I think that's
02:21:50
really important because you're right you finished the book and in a weird way you you have more information but I can
02:21:59
understand how the decision Still Remains with the individual and I think that's really what any book on this
02:22:05
subject should should aim to achieve it should kind of not have a dog in the fight but present you both sides of the
02:22:11
trade-off so that you can make a decision for yourself and that's what you do so skillfully and the real thing you know as an author that you've taught
02:22:16
me over the years is you're just remarkably good at writing and it's really your your storytelling is phenomenal it's influenced me profoundly as an author myself and uh whenever I
02:22:28
read a book now I often wish that they had written it like one of your books because you take a you take a concept
02:22:33
that's difficult and widely discussed and you take us on a journey and that journey is so much more enjoyable than
02:22:40
just reading like a science book so I recommend everybody to go and get magic pill right now it's um it's obviously a
02:22:45
huge point of conversation at the moment these these magic pills um and this is the book to read on it magic pill the
02:22:51
extraordinary benefits and disturbing risks of the new weight loss drugs it's due to be released on the 2nd of May
02:22:57
2024 so we're a couple of days away from that now and um yeah I would just highly
02:23:03
highly recommend this book thank you so much Johan oh I'm really touched by that Stephen thank you so much I almost forgot we have a tradition on this
02:23:09
podcast oh yes the question what is the question who who posed this question I'm not going to tell you who who this is
02:23:15
but the question that's been left for you is it's a really interesting one why should Humanity continue to exist so as you
02:23:27
know I've been writing for God 12 years now 13 years a book about a series of crimes that have been happening in Las
02:23:33
Vegas I'm not allowed to talk about but it will come out next year and I promise we'll finally talk about it I think you're just saying this so you can hang out in Vegas every time I see you say
02:23:39
You're Just in Vegas writing a book I'm like where's the book your hand yeah there are people many people in Vegas
02:23:44
have said to me yeah your book's been a long time [ __ ] coming but so um I know two people called Rob banghart and Paul Vino who um a lot of people won't know
02:23:56
but there's many thousands of homeless people who live in the drainage tunnels beneath Las Vegas and Rob and Paul used to live in
02:24:03
the tunnels and Rob lived in a particular set of tunnels that I know very well and have spent a lot of time
02:24:10
in and in 2017 so Rob was known as hobo Santa he would steal things and give them to people and um he was also a kind of low-level dealer very low-level and
02:24:23
there was a a group of uh rival Cuban dealers who didn't like him and one day in 2017 they hit him in the head with an axe split his skull open dragged him
02:24:33
onto the railway tracks and left him there for a train to run him over but fortunately someone spotted him pulled
02:24:40
him off the tracks and he survived and he in the next six months as he recovered he um turned his life around
02:24:49
and he began to volunt here for a group that my friend Paul runs uh called shine a light which is a group of people
02:24:55
overwhelmingly people who used to live in the tunnels who managed to get out turn their lives around who now help the people who are still down there they
02:25:01
give them loads of practical things from tampons to flashlights and they most importantly give them support when they want to leave and I've got lots of people out and every month get people out of the tunnels and I've seen them do
02:25:13
it with some people I really love who were down there and one day few years ago I was I was with Rob
02:25:22
and um um so one day a few years ago I was with Rob when he got word that uh a friend of his from the tunnels called picket had
02:25:33
died he' ODed in in the tunnel they used to live in so we went straight down there and um picket stuff was still
02:25:41
there they'd taken away his body and we bumped into a woman who also lives down there and whenever Rob goes
02:25:48
to the tunnels even in a situation like that he always BRS supplies you know food and stuff and he said to
02:25:54
her who's in the tunnel over there and she said oh you don't want to go there and he said why and she named some
02:26:00
people and he said no I'll go there I'll give them some stuff and he went and gave them some stuff anyway I didn't really think about it very much I was
02:26:05
thinking about pick it and what happened and a few days later I said to Rob what did she mean when she said you
02:26:11
don't want to go there and he said oh it's just these guys and I said what guys he said oh well they're the guys
02:26:17
who hit me in the head with an axe they're the guys who tried to kill me and I saidwell why did you go and help
02:26:24
them and he said because they're human beings and they're suffering and they need
02:26:30
help and um I thought a lot about Rob every day him and Paul go back into those tunnels you know
02:26:42
they could do anything they could leave and do a million things right they're incredibly intelligent and talented
02:26:47
people every day they go back and they help the people who got left behind and they make no money doing it and they
02:26:54
don't have great lives doing it in any material sense and I've say to them why do you do it and they just they say because it's the right thing to do and if you said to me why should
02:27:06
human beings continue to exist I could give you a load of abstract answers I could talk to you about philosophy and I could talk to you about art and I just
02:27:12
say come and meet Rob and Paul there why humans should continue to exist thank you cheers Stephen
02:27:26
[Music]