1 00:00:05,800 --> 00:00:06,200 Speaker 1: Kyota. 2 00:00:06,280 --> 00:00:09,320 Speaker 2: I'm Chelsea Daniels and this is the Front Page, a 3 00:00:09,400 --> 00:00:16,599 Speaker 2: daily podcast presented by The New Zealand Herald. From Celery 4 00:00:16,760 --> 00:00:22,360 Speaker 2: juice cleanses to infomercial ad busting gadgets, society has always 5 00:00:22,600 --> 00:00:26,800 Speaker 2: been on a diet. It's a global, multi billion dollar 6 00:00:26,960 --> 00:00:31,080 Speaker 2: powerhouse industry. The latest trend that you would have heard 7 00:00:31,120 --> 00:00:36,120 Speaker 2: about are golp ones or weight loss injections. Far MAC 8 00:00:36,240 --> 00:00:39,199 Speaker 2: is seeking advice on whether they should be funded for 9 00:00:39,360 --> 00:00:43,600 Speaker 2: certain people. Australia is committed to it for certain patients, 10 00:00:43,720 --> 00:00:47,000 Speaker 2: taking the cost to about twenty nine dollars per script. 11 00:00:47,360 --> 00:00:51,240 Speaker 2: A drug like Wagovi, for instance here costs about four 12 00:00:51,320 --> 00:00:55,480 Speaker 2: hundred and sixty dollars per script. But are they really 13 00:00:55,560 --> 00:00:59,960 Speaker 2: beneficial or is it just the next get skinny quickplow. 14 00:01:00,320 --> 00:01:04,560 Speaker 2: Today on the Front Page, obesity specialist doctor Gerrard mcquinlan 15 00:01:04,680 --> 00:01:07,640 Speaker 2: is with us to explore whether these drugs should be 16 00:01:07,760 --> 00:01:12,840 Speaker 2: funded or is diet and exercise really the only answer? 17 00:01:17,080 --> 00:01:20,400 Speaker 2: First off, Gerard, can you give me a brief history 18 00:01:20,440 --> 00:01:23,600 Speaker 2: of weight loss drugs, because it seems like you know 19 00:01:23,640 --> 00:01:27,839 Speaker 2: they've been around for ages. Weren't the first iterations essentially 20 00:01:27,920 --> 00:01:28,600 Speaker 2: just speed? 21 00:01:28,880 --> 00:01:31,760 Speaker 3: Yeah, certainly back in the sixties and seventies. You know, 22 00:01:31,800 --> 00:01:34,800 Speaker 3: the weight loss drugs were emphetamine based and they had 23 00:01:34,800 --> 00:01:39,160 Speaker 3: that addictive component to the medication, so you know, the 24 00:01:39,240 --> 00:01:42,080 Speaker 3: long term use back then sort of led to concerns 25 00:01:42,120 --> 00:01:46,839 Speaker 3: about heart disease being a stimulant and sort of lost 26 00:01:46,880 --> 00:01:50,240 Speaker 3: a lot of popularity when the heart issues came out. 27 00:01:51,640 --> 00:01:56,880 Speaker 3: Then they reformulated that sort of appetite for presant drugs 28 00:01:56,920 --> 00:02:03,360 Speaker 3: to take out the addictive part, and I guess for 29 00:02:03,520 --> 00:02:07,080 Speaker 3: probably three or four decades there wasn't really much in 30 00:02:07,120 --> 00:02:10,679 Speaker 3: the way of medications to treat obesity. They tried zenecaw, 31 00:02:10,840 --> 00:02:15,800 Speaker 3: which was a drug that limited absorption of fat through 32 00:02:15,880 --> 00:02:19,440 Speaker 3: the gut, but it wasn't very well tolerated. It work 33 00:02:19,520 --> 00:02:23,000 Speaker 3: for some people, but most people didn't tolerate it. And 34 00:02:23,040 --> 00:02:27,880 Speaker 3: then about two thousand and five, these new GLP medications 35 00:02:27,960 --> 00:02:33,359 Speaker 3: came into existence to treat obesity. So that was they 36 00:02:33,360 --> 00:02:36,680 Speaker 3: came about because of studies into gut hormones and the 37 00:02:36,760 --> 00:02:41,760 Speaker 3: influence that that had on insulin and diabetes. And then 38 00:02:41,840 --> 00:02:44,519 Speaker 3: the treatments for diabetes sort of came out in the 39 00:02:44,560 --> 00:02:50,119 Speaker 3: twenty tens twenty fifteens, and what they noticed treating diabetic 40 00:02:50,160 --> 00:02:52,760 Speaker 3: patients with these drugs is a lot of lost weight, 41 00:02:53,400 --> 00:02:57,639 Speaker 3: which wasn't really seen with the diabetes treatments. So then 42 00:02:57,760 --> 00:03:01,720 Speaker 3: that's how they became a weight loss strikes was because 43 00:03:01,760 --> 00:03:05,320 Speaker 3: they saw the effect in diabetic patients losing weight. So 44 00:03:06,040 --> 00:03:12,120 Speaker 3: now we've got this burgeoning attention in medicine about GLP 45 00:03:12,400 --> 00:03:16,799 Speaker 3: medications and GAT hormones. So now we've got much more 46 00:03:16,800 --> 00:03:18,600 Speaker 3: effective treatments for weight loss. 47 00:03:19,240 --> 00:03:22,399 Speaker 2: So what do GLP ones actually do? 48 00:03:22,960 --> 00:03:29,919 Speaker 3: Yeah, so these hormones control the sensation of satisfaction light, 49 00:03:31,919 --> 00:03:35,760 Speaker 3: feeling satisfied with what you've eaten. So with a ba IF, 50 00:03:35,800 --> 00:03:39,200 Speaker 3: I sort of reframe a BC as a disease because 51 00:03:39,400 --> 00:03:43,520 Speaker 3: it hasn't been framed that way, but the Lancet Commission 52 00:03:44,080 --> 00:03:47,320 Speaker 3: sort of looked at ABC. The World Health Organization also 53 00:03:47,920 --> 00:03:52,560 Speaker 3: classified ABC as a disease back in twenty thirteen. So 54 00:03:53,640 --> 00:03:56,000 Speaker 3: trying to cut through the stigma of a BC, lot 55 00:03:56,040 --> 00:03:59,440 Speaker 3: of people thought it was to do a person's personality 56 00:03:59,600 --> 00:04:03,320 Speaker 3: and there's a well powered failure, but it's not. It 57 00:04:03,360 --> 00:04:07,520 Speaker 3: is a disease, and it used to be just tastified 58 00:04:07,520 --> 00:04:11,839 Speaker 3: according to the BMI, the body mass index, but that's 59 00:04:11,960 --> 00:04:15,360 Speaker 3: quite crude. So now we look at you know, we 60 00:04:15,400 --> 00:04:17,480 Speaker 3: asked a couple of questions. You know, does a person 61 00:04:17,560 --> 00:04:21,880 Speaker 3: have excess body tissue in their body? So that's the 62 00:04:21,920 --> 00:04:25,000 Speaker 3: first question, and then the second question is is that 63 00:04:25,160 --> 00:04:29,240 Speaker 3: excess back causing disease? So that's how we look at 64 00:04:29,240 --> 00:04:34,480 Speaker 3: obesity now because we know that patients with obesity it's 65 00:04:34,680 --> 00:04:41,200 Speaker 3: a difficult life. It affects everything day to day, movement, sleep, 66 00:04:41,800 --> 00:04:44,159 Speaker 3: and it contributes to other diseases. You know, it's a 67 00:04:44,200 --> 00:04:49,520 Speaker 3: direct modifiable risk factive for thirteen different canses. But it's 68 00:04:49,600 --> 00:04:54,320 Speaker 3: also related to diabetes, it's related to heart disease about 69 00:04:54,360 --> 00:04:57,839 Speaker 3: turns and thirteen different diseases are impacted by obesity. So 70 00:04:57,920 --> 00:05:01,000 Speaker 3: that's the message that I've get through today is that 71 00:05:01,120 --> 00:05:04,600 Speaker 3: obesi is a disease that needs long term care. 72 00:05:04,920 --> 00:05:07,719 Speaker 2: Well, it's important to ask those other questions, hey, because 73 00:05:07,760 --> 00:05:10,360 Speaker 2: the bear My scale has had its issues. I mean, 74 00:05:10,600 --> 00:05:12,880 Speaker 2: you look at any of the all blacks, for instance, 75 00:05:12,920 --> 00:05:15,960 Speaker 2: and they're probably all technically obese. 76 00:05:15,600 --> 00:05:20,640 Speaker 3: Right, yes, based on that crude measure, But you have 77 00:05:20,680 --> 00:05:24,600 Speaker 3: to ask the second question, you know, is the amount 78 00:05:24,680 --> 00:05:27,480 Speaker 3: of fat in a person's body is it causing disease? 79 00:05:27,600 --> 00:05:30,159 Speaker 3: So we have sort of two groups of patients. Now 80 00:05:30,720 --> 00:05:33,800 Speaker 3: we have those with pre clinical obesity, so they do 81 00:05:33,880 --> 00:05:37,440 Speaker 3: have excess fatty tissue, but they don't have any disease. 82 00:05:38,040 --> 00:05:40,400 Speaker 3: And then you have the patients who do have excess 83 00:05:40,440 --> 00:05:45,400 Speaker 3: fatty tissue and have a disease like osterearthritis, like pre 84 00:05:45,520 --> 00:05:49,960 Speaker 3: diabetes or diabetes high pertension. So if they have those 85 00:05:50,000 --> 00:05:53,640 Speaker 3: two things together, we should start treating that early because 86 00:05:54,680 --> 00:05:57,920 Speaker 3: just take arthritis for instance. You know the arthritis, you 87 00:05:58,000 --> 00:06:01,279 Speaker 3: know it's related to age, and it's related to weight. Now, 88 00:06:01,279 --> 00:06:04,920 Speaker 3: if you can treat the weight part early on with 89 00:06:05,200 --> 00:06:09,560 Speaker 3: orits often it goes away, so people don't need surgeries 90 00:06:09,680 --> 00:06:15,200 Speaker 3: or excess painkillers or so I see that a lot 91 00:06:15,520 --> 00:06:18,799 Speaker 3: people come in with knee pains, joint pains. We treat 92 00:06:18,839 --> 00:06:22,120 Speaker 3: the obesity and then the pains go away and they're 93 00:06:22,200 --> 00:06:23,160 Speaker 3: much more mobile. 94 00:06:23,360 --> 00:06:26,800 Speaker 2: In terms of these drugs and the suppressing of appetite 95 00:06:27,200 --> 00:06:31,680 Speaker 2: portion of it, What is the difference between suppressing your 96 00:06:31,720 --> 00:06:36,160 Speaker 2: appetite and eating disorders, because in both you're limiting what 97 00:06:36,240 --> 00:06:40,839 Speaker 2: you eat, right, but one is unhealthy and the other is, 98 00:06:41,600 --> 00:06:43,520 Speaker 2: you know, being prescribed. 99 00:06:43,920 --> 00:06:47,920 Speaker 3: So eating disorders is important, and that's why people with 100 00:06:47,960 --> 00:06:50,520 Speaker 3: obesity need to have a consultation because some of it 101 00:06:50,560 --> 00:06:54,640 Speaker 3: will be psychological. So we're talking about restrictive eating patterns 102 00:06:54,680 --> 00:06:59,440 Speaker 3: and eurexia not so much, but binge eating disorder in 103 00:06:59,640 --> 00:07:03,240 Speaker 3: disorder eating, So yeah, we want to sort out that 104 00:07:03,320 --> 00:07:07,200 Speaker 3: because the treatments for those are different. We would say 105 00:07:07,320 --> 00:07:11,320 Speaker 3: consider binge eating disorder, would use medications that can alter 106 00:07:12,240 --> 00:07:17,240 Speaker 3: a person's psychology. But we have found that actually treating 107 00:07:18,200 --> 00:07:22,520 Speaker 3: obesity and patients say with binge eating disorder, these treatments 108 00:07:22,560 --> 00:07:25,640 Speaker 3: for OBSI are very effective because it cuts the noise. 109 00:07:25,800 --> 00:07:28,800 Speaker 3: People don't think about food when they're on these medications. 110 00:07:29,880 --> 00:07:32,280 Speaker 3: And I'll just come back to the point about appetite suppression. 111 00:07:33,040 --> 00:07:36,960 Speaker 3: We don't use appetite suppression so that it's like those 112 00:07:37,280 --> 00:07:41,600 Speaker 3: amphetamine stimulants. The glps are more about satiety, that feeling 113 00:07:41,640 --> 00:07:44,360 Speaker 3: that you've had enough to eat. And that's the problem 114 00:07:44,360 --> 00:07:48,000 Speaker 3: with ABC is that people don't feel full, so they 115 00:07:48,120 --> 00:07:50,640 Speaker 3: overeat and that's what keeps the weight up. 116 00:07:56,520 --> 00:07:58,520 Speaker 4: A friend of mine who is a very smart guy, 117 00:07:58,920 --> 00:08:04,200 Speaker 4: very very rich, very powerful man actually, but he's very fat, 118 00:08:05,280 --> 00:08:07,440 Speaker 4: and he took the fact I caught the fat drug. 119 00:08:07,480 --> 00:08:10,600 Speaker 4: I won't give you which one. It was a z 120 00:08:10,600 --> 00:08:12,400 Speaker 4: empic I won't tell you that. 121 00:08:13,520 --> 00:08:16,280 Speaker 5: After I told him that the drug does not work 122 00:08:16,320 --> 00:08:18,720 Speaker 5: on him, because I saw him recently he's actually fatter 123 00:08:18,840 --> 00:08:22,760 Speaker 5: than ever. I said, the drug is not working on you. 124 00:08:22,880 --> 00:08:25,040 Speaker 5: You're going to have to go to something else. But 125 00:08:25,120 --> 00:08:28,920 Speaker 5: it does work on a lot of people. And he said, thanks, 126 00:08:28,960 --> 00:08:31,440 Speaker 5: you make me feel good. I said, well, I got 127 00:08:31,480 --> 00:08:33,079 Speaker 5: to be truthful. You always tell the truth. 128 00:08:35,400 --> 00:08:38,520 Speaker 2: Obesity in New Zealand is obviously nothing new. We hear 129 00:08:38,559 --> 00:08:41,720 Speaker 2: about how we're always one of the most overweight nations 130 00:08:41,760 --> 00:08:45,640 Speaker 2: in the world. Tell me more about the common misconceptions 131 00:08:45,720 --> 00:08:48,880 Speaker 2: about obesity. So number one is treating it obviously like 132 00:08:48,920 --> 00:08:51,199 Speaker 2: a disease, But what are some other things? 133 00:08:51,520 --> 00:08:55,560 Speaker 3: Probably the biggest misconception is that it's a failure of willpower. 134 00:08:55,559 --> 00:09:01,360 Speaker 3: It's a failure of personal attribues. Highly is not a 135 00:09:01,400 --> 00:09:05,560 Speaker 3: failure willpower. In fact, you know people who diet can 136 00:09:05,600 --> 00:09:08,880 Speaker 3: make the obaesitly worse. So we know that diet and 137 00:09:08,920 --> 00:09:11,960 Speaker 3: lifestyle just by themselves, they've worked for a short period 138 00:09:11,960 --> 00:09:15,000 Speaker 3: of time, but only about one in twenty patients will 139 00:09:15,040 --> 00:09:19,360 Speaker 3: actually succeed and keep the weight off. That means, you know, 140 00:09:19,559 --> 00:09:23,720 Speaker 3: nineteen out of twenty patients that doesn't work. And they'll 141 00:09:23,720 --> 00:09:26,000 Speaker 3: actually put on it even more weight. So a common 142 00:09:26,120 --> 00:09:29,080 Speaker 3: story we get is people who've been on like three 143 00:09:29,600 --> 00:09:33,080 Speaker 3: or five diets in their lifetime and over that time 144 00:09:33,160 --> 00:09:36,000 Speaker 3: they just got bigger. And that's not a chance thing. 145 00:09:36,080 --> 00:09:40,839 Speaker 3: That's due to the brain's hormone control of weight. So 146 00:09:41,040 --> 00:09:44,840 Speaker 3: weights controlled by hormones in the brain that interact with 147 00:09:44,880 --> 00:09:45,240 Speaker 3: the gate. 148 00:09:45,679 --> 00:09:48,880 Speaker 2: Isn't that kind of like the fad diets though, you know, 149 00:09:48,920 --> 00:09:53,320 Speaker 2: like the juice cleansers and the drinking citric acid or 150 00:09:53,320 --> 00:09:56,400 Speaker 2: something and hot tea every morning, those kind of things. 151 00:09:56,400 --> 00:09:58,520 Speaker 2: When you stop those we I think we all know 152 00:09:58,559 --> 00:10:01,800 Speaker 2: that you do pile the weight back on. But in 153 00:10:01,880 --> 00:10:08,040 Speaker 2: terms of making long, long term lifestyle changes, would that work, Yeah, I. 154 00:10:08,000 --> 00:10:13,040 Speaker 3: Think if it's if it's if it's monitored by a doctor, 155 00:10:12,760 --> 00:10:16,800 Speaker 3: or if the program even a dietician. So lifestyle and 156 00:10:17,360 --> 00:10:21,240 Speaker 3: diet changes, we want those, but we know that just 157 00:10:21,320 --> 00:10:24,440 Speaker 3: by themselves, they don't. People don't stick to them, and 158 00:10:24,760 --> 00:10:27,520 Speaker 3: it's very hard to keep up with the diet. Keto 159 00:10:27,600 --> 00:10:30,600 Speaker 3: diet has been quite popular. That cance diet. I've heard 160 00:10:30,640 --> 00:10:35,000 Speaker 3: of diet Yeah, yeah, So diets tend to fail because 161 00:10:35,440 --> 00:10:41,079 Speaker 3: the hormone control for dieting and it's overcome because people 162 00:10:41,160 --> 00:10:44,720 Speaker 3: just eventually get hungry if they restrict their diet in 163 00:10:44,760 --> 00:10:47,680 Speaker 3: the end. So you know, most people want a keto 164 00:10:47,720 --> 00:10:50,320 Speaker 3: diet for instance, can maybe hack it for about six 165 00:10:50,400 --> 00:10:54,240 Speaker 3: months before they revert back to their normal diet. 166 00:10:54,559 --> 00:10:56,719 Speaker 2: In terms of I mean, there's a lot of talk 167 00:10:56,760 --> 00:11:02,000 Speaker 2: about taxpayers funding drugs like over like these weight loss injections, 168 00:11:02,040 --> 00:11:07,000 Speaker 2: these GLP ones. Would it be worth perhaps subsidizing gym 169 00:11:07,080 --> 00:11:11,640 Speaker 2: memberships first before subsidizing something like a weight loss drug. 170 00:11:11,880 --> 00:11:14,880 Speaker 3: Now I'd strongly disagree with that. I mean, if you 171 00:11:15,120 --> 00:11:18,560 Speaker 3: take just say one disease related to a busy just 172 00:11:18,640 --> 00:11:22,880 Speaker 3: say ostearthritis. About five hundred thousand people in New Zealand 173 00:11:22,920 --> 00:11:27,839 Speaker 3: lived with some degree of osterearthropis. Probably about one hundred 174 00:11:27,880 --> 00:11:32,480 Speaker 3: thousand people need a joint replacement because of osterearthritis, and 175 00:11:32,520 --> 00:11:36,640 Speaker 3: we only do about fifteen thousand operations per year. Now, 176 00:11:36,840 --> 00:11:40,119 Speaker 3: if you treated the obesity that's present in that population, 177 00:11:40,480 --> 00:11:44,800 Speaker 3: half of the arthritis goes away. Now you also put 178 00:11:44,880 --> 00:11:50,040 Speaker 3: those same group of people into gym memberships, that's really 179 00:11:50,280 --> 00:11:52,840 Speaker 3: not going to help with their weight. It's not really 180 00:11:52,880 --> 00:11:55,360 Speaker 3: going to help with the rights. Well to a degree, 181 00:11:55,440 --> 00:12:01,000 Speaker 3: but not quite losing weight. So I see people getting 182 00:12:01,240 --> 00:12:05,280 Speaker 3: much how they're much better quickly once they start on 183 00:12:05,360 --> 00:12:08,920 Speaker 3: these glps, but it is a lifetime treatment. I think 184 00:12:08,920 --> 00:12:13,040 Speaker 3: if the government, like Australian government, who's invested in subsidizing 185 00:12:13,080 --> 00:12:16,080 Speaker 3: these medications, I think they see the benefits, the economic 186 00:12:16,120 --> 00:12:21,199 Speaker 3: benefits because it reduces the harm from other co morbid 187 00:12:21,320 --> 00:12:23,600 Speaker 3: diseases that a lot of people are the best that 188 00:12:23,600 --> 00:12:27,000 Speaker 3: you have. So I think, you know, they've taken the 189 00:12:27,040 --> 00:12:29,680 Speaker 3: bolt step to fund it. I think our government will 190 00:12:29,679 --> 00:12:33,400 Speaker 3: probably follow so hopefully because they'll see that the benefits 191 00:12:33,440 --> 00:12:38,600 Speaker 3: outweigh the costs. But you know, these medications are expensive, 192 00:12:39,000 --> 00:12:42,680 Speaker 3: and I don't know. I think there could be more competition. 193 00:12:43,080 --> 00:12:46,160 Speaker 3: I think Monjarro is coming to New Zealand and we 194 00:12:46,240 --> 00:12:47,040 Speaker 3: expect that to be. 195 00:12:47,080 --> 00:12:49,680 Speaker 2: Cheaper in terms of I mean, I'm just going to 196 00:12:49,679 --> 00:12:55,040 Speaker 2: play Devil's advocate here. You are an obesity specialist, right, 197 00:12:55,559 --> 00:13:00,480 Speaker 2: and you will get more business if these presumably do 198 00:13:01,200 --> 00:13:06,680 Speaker 2: our taxpayer funded. If you strip all of that away, 199 00:13:07,000 --> 00:13:09,520 Speaker 2: would you still do you reckon? Would you still go 200 00:13:09,600 --> 00:13:13,080 Speaker 2: with this route as opposed to say, getting outside and 201 00:13:13,120 --> 00:13:14,320 Speaker 2: going for walks and stuff? 202 00:13:14,480 --> 00:13:17,559 Speaker 3: Oh? Yes, one hundred percent. Even if it was all funded. 203 00:13:17,600 --> 00:13:21,040 Speaker 3: I mean probably the limiting step for patients to get 204 00:13:21,080 --> 00:13:23,960 Speaker 3: access to the medications, not only the costs, but also 205 00:13:24,240 --> 00:13:27,440 Speaker 3: doctors who are prepared to treat obesity as a long 206 00:13:27,520 --> 00:13:30,480 Speaker 3: term disease. So my clinic, yeah, I'm prepared to trigger 207 00:13:30,520 --> 00:13:33,800 Speaker 3: these patients for life. So well, just like you would 208 00:13:33,920 --> 00:13:38,120 Speaker 3: with any chronic disease, whether it's high blood pressure, you 209 00:13:38,200 --> 00:13:46,720 Speaker 3: need doctors who are skilled in using these medications, that 210 00:13:46,760 --> 00:13:49,960 Speaker 3: are prepared to put on the effort to follow these 211 00:13:49,960 --> 00:13:53,560 Speaker 3: patients long term. So I follow them long term. We 212 00:13:53,640 --> 00:13:56,560 Speaker 3: do cholesterol tests, we do blood pressure tests, and I 213 00:13:56,600 --> 00:14:00,520 Speaker 3: see a lot of reversal of even pre diabetes can 214 00:14:00,559 --> 00:14:03,920 Speaker 3: reverse with weight loss. So yeah, I'm measuring, you know, 215 00:14:04,480 --> 00:14:08,440 Speaker 3: and managing other does the other conditions that patients have. 216 00:14:08,640 --> 00:14:12,200 Speaker 3: So that'll be a right limiting step is actually are 217 00:14:12,240 --> 00:14:17,120 Speaker 3: there enough doctors to actually treat the population. There's about 218 00:14:17,120 --> 00:14:20,000 Speaker 3: one point five million people in the Zelan have a 219 00:14:20,080 --> 00:14:23,480 Speaker 3: BE study, and I would say probably half of those 220 00:14:23,520 --> 00:14:27,240 Speaker 3: patients probably have significant other diseases that go with a BESTY. 221 00:14:33,160 --> 00:14:36,440 Speaker 1: I read that you were initially skeptical of the GLP one. 222 00:14:36,560 --> 00:14:39,400 Speaker 1: Absolutely yes, because it's like this guinea shot and like 223 00:14:39,440 --> 00:14:41,760 Speaker 1: it's a shortcut, and so for years I didn't well, 224 00:14:41,880 --> 00:14:43,440 Speaker 1: not for years, but for a long time I didn't 225 00:14:43,480 --> 00:14:45,040 Speaker 1: do it, and I didn't want to do it. Yeah, 226 00:14:45,120 --> 00:14:47,880 Speaker 1: and I thought like, I'm not going to take the shortcut, 227 00:14:48,000 --> 00:14:50,240 Speaker 1: you know, I'm going to work harder. But then eventually 228 00:14:50,360 --> 00:14:53,720 Speaker 1: I was like, I've tried everything. I've tried every diet, 229 00:14:53,880 --> 00:14:57,000 Speaker 1: I've tried every workout. I've tried walking for hour. I 230 00:14:57,000 --> 00:14:59,040 Speaker 1: would go to Europe in Paris and I would just 231 00:14:59,080 --> 00:15:02,560 Speaker 1: walk for hours, the twenty thousand steps a day, like 232 00:15:02,800 --> 00:15:06,040 Speaker 1: every single thing, you know, and nothing was working well. 233 00:15:06,040 --> 00:15:08,880 Speaker 1: I would so this was killing me. Backstage, I would 234 00:15:08,920 --> 00:15:11,000 Speaker 1: lose the weight, but my body liked to be at 235 00:15:11,000 --> 00:15:14,120 Speaker 1: a certain way. So eye opening for me. 236 00:15:16,560 --> 00:15:18,680 Speaker 2: Do you reckon there are still doctors out there though, Like, 237 00:15:18,800 --> 00:15:22,560 Speaker 2: for example, if I use the example of going to 238 00:15:22,600 --> 00:15:27,480 Speaker 2: the doctor and the doctor saying not prescribing anti antibiotics 239 00:15:27,520 --> 00:15:30,680 Speaker 2: because of you know, your immune system and we need 240 00:15:30,720 --> 00:15:32,320 Speaker 2: to build that up, et cetera. You know, you've got 241 00:15:32,360 --> 00:15:36,640 Speaker 2: those doctors out there who are very hesitant to prescribe medications. 242 00:15:36,960 --> 00:15:38,680 Speaker 2: Do you think there are still a lot of doctors 243 00:15:38,680 --> 00:15:41,400 Speaker 2: out there who would be hesitant to just prescribe these 244 00:15:41,440 --> 00:15:44,960 Speaker 2: medications and instead maybe sign you up to go see 245 00:15:44,960 --> 00:15:46,120 Speaker 2: a nature path or something. 246 00:15:47,280 --> 00:15:51,320 Speaker 3: Oh, most definitely, And we doctors need to have education 247 00:15:51,640 --> 00:15:54,840 Speaker 3: to see ABC as a disease because the stigma about 248 00:15:54,960 --> 00:15:57,920 Speaker 3: BC is that it's your faults, the patient's fault and 249 00:15:57,960 --> 00:16:00,920 Speaker 3: if only they could diet and exercise and do those things, 250 00:16:00,920 --> 00:16:04,480 Speaker 3: that that will get better. But if it's a hormone condition, 251 00:16:04,880 --> 00:16:07,600 Speaker 3: if you accept that it's a disease of hormones that 252 00:16:07,720 --> 00:16:11,920 Speaker 3: control weight, you know you're fighting a losing battle. You 253 00:16:12,120 --> 00:16:14,880 Speaker 3: die and their size will work for some people, maybe 254 00:16:14,880 --> 00:16:16,960 Speaker 3: for some of the time, but it won't work for 255 00:16:17,000 --> 00:16:21,280 Speaker 3: the long term for most patients. So yeah, I do 256 00:16:21,560 --> 00:16:24,800 Speaker 3: get patients who've come from doctors said no way, you know, 257 00:16:25,440 --> 00:16:29,360 Speaker 3: And I think that's just really an education thing and 258 00:16:29,440 --> 00:16:34,000 Speaker 3: having statements from the Lance that Commission on Obesity, they 259 00:16:34,080 --> 00:16:37,280 Speaker 3: will falter through. I think students in med school will 260 00:16:37,280 --> 00:16:40,080 Speaker 3: start learning about OBC and treating as a disease, and 261 00:16:40,160 --> 00:16:41,040 Speaker 3: same for GPS. 262 00:16:41,600 --> 00:16:44,000 Speaker 2: So there are going to be some people listening to 263 00:16:44,040 --> 00:16:46,520 Speaker 2: this and they're going to be angry that their taxes 264 00:16:46,640 --> 00:16:51,240 Speaker 2: might be going towards funding these in the future. How 265 00:16:51,440 --> 00:16:56,160 Speaker 2: does it though, compare to funding obesity. In the long term, 266 00:16:56,640 --> 00:16:57,560 Speaker 2: I think. 267 00:16:57,640 --> 00:17:00,840 Speaker 3: If it's tracked well, I think the government could probably 268 00:17:00,880 --> 00:17:05,800 Speaker 3: see savings less liver transplants, less patients with diabetes who 269 00:17:05,800 --> 00:17:12,000 Speaker 3: then have other significant operations, less ostere arthritis, less disability, 270 00:17:12,480 --> 00:17:15,359 Speaker 3: And don't forget that people with obesity, you know, their 271 00:17:15,680 --> 00:17:19,080 Speaker 3: quality of life, like getting a job, performing a job, 272 00:17:19,520 --> 00:17:21,840 Speaker 3: they are all quite reduced. And I'll tell you that 273 00:17:22,040 --> 00:17:24,800 Speaker 3: when I treat patients with obesity, you know, I don't 274 00:17:24,840 --> 00:17:28,040 Speaker 3: imagine their productivity goes up because they tell me I 275 00:17:28,080 --> 00:17:30,360 Speaker 3: can walk up the steps, I can move better. When 276 00:17:30,400 --> 00:17:32,520 Speaker 3: I wake up, I feel like I've had a good sweap. 277 00:17:33,200 --> 00:17:36,000 Speaker 3: So it's quite life changing. Losing weight, I think the 278 00:17:36,040 --> 00:17:40,760 Speaker 3: cost benefit of just treating the BC itself is key 279 00:17:40,840 --> 00:17:46,160 Speaker 3: because it reduces the occurrence of other diseases like osteoarthritis, 280 00:17:46,560 --> 00:17:50,080 Speaker 3: like diabetes, even high blood pressure gets better as people 281 00:17:50,160 --> 00:17:50,680 Speaker 3: lose weight. 282 00:17:51,119 --> 00:17:54,200 Speaker 2: Are these weight loss medications kind of like the silver 283 00:17:54,280 --> 00:17:57,880 Speaker 2: bullet through obesity? Or am I just looking up too 284 00:17:57,920 --> 00:17:59,600 Speaker 2: many social media profiles? 285 00:18:00,080 --> 00:18:03,359 Speaker 3: Yeah, definitely not a silver bullet. It's helpful, so you know, 286 00:18:03,400 --> 00:18:06,320 Speaker 3: there's a limit to what medications can do, and it 287 00:18:06,400 --> 00:18:11,040 Speaker 3: sits alongside say weight loss surgery, so you know, some 288 00:18:11,080 --> 00:18:14,880 Speaker 3: people surgery will be a better option than weight loss medications. 289 00:18:15,280 --> 00:18:18,040 Speaker 3: And then there's other patients. We have lifestyle and diet 290 00:18:18,119 --> 00:18:21,119 Speaker 3: if managed, and people need to coach for this stuff. 291 00:18:21,200 --> 00:18:24,280 Speaker 3: So if they can do that and lose weight, the 292 00:18:24,320 --> 00:18:26,959 Speaker 3: goal should be to reduce our weights of obesity. You know, 293 00:18:27,280 --> 00:18:29,920 Speaker 3: in the last six years, you know, we've gone from 294 00:18:30,560 --> 00:18:33,960 Speaker 3: thirty one percent of the population having obesity to about 295 00:18:33,960 --> 00:18:37,480 Speaker 3: thirty five percent, so just in a short space of 296 00:18:37,600 --> 00:18:43,879 Speaker 3: six eggs, So there's an avalanche of pre diabetes diabetes coming. 297 00:18:44,960 --> 00:18:48,200 Speaker 3: That's what the epidemic's all about, is all the ill 298 00:18:48,240 --> 00:18:51,399 Speaker 3: health from that stems from obesity. So we need to 299 00:18:51,400 --> 00:18:54,920 Speaker 3: do something right now, sort of like on the front 300 00:18:55,000 --> 00:18:59,840 Speaker 3: lines as well as public health policy. So it's really 301 00:19:00,160 --> 00:19:04,399 Speaker 3: the tool for us to treat obasily right now. 302 00:19:04,840 --> 00:19:07,640 Speaker 2: And in terms of I mean, I've seen these articles 303 00:19:07,680 --> 00:19:10,400 Speaker 2: about you know, if you go on the weight loss drugs, 304 00:19:10,400 --> 00:19:12,800 Speaker 2: you're on them for life. If you ever stop them, 305 00:19:12,840 --> 00:19:16,360 Speaker 2: you're just going to pile everything back on. Is there 306 00:19:16,480 --> 00:19:20,480 Speaker 2: enough research anyway to suggest that I do have. 307 00:19:20,400 --> 00:19:24,639 Speaker 3: Patients who've been on these GLP medications and then stop 308 00:19:24,760 --> 00:19:28,800 Speaker 3: for whatever reason, Maybe it's financial, maybe it's other Yeah, 309 00:19:28,800 --> 00:19:32,040 Speaker 3: and the weight does come back on, so we understand that. 310 00:19:32,119 --> 00:19:35,440 Speaker 3: We know that even with surgery. We see patients who've 311 00:19:35,440 --> 00:19:39,840 Speaker 3: had bariatric surgery, so they've had most of their stomach 312 00:19:39,960 --> 00:19:44,240 Speaker 3: bypassed or removed. Even those patients put on weight, So 313 00:19:44,320 --> 00:19:49,960 Speaker 3: it's not just a mechanical physical part. It's really again 314 00:19:50,000 --> 00:19:52,880 Speaker 3: to do with those hormones that control how much people eat, 315 00:19:53,320 --> 00:19:56,720 Speaker 3: how much they think about food, whether they're satisfied with 316 00:19:56,800 --> 00:20:00,960 Speaker 3: how much they've eaten. But there's always a pressure on 317 00:20:01,040 --> 00:20:04,000 Speaker 3: people to put on weight. And one of the biggest 318 00:20:04,000 --> 00:20:06,919 Speaker 3: triggers for gaining weight, believe it or not, is actually 319 00:20:06,920 --> 00:20:10,119 Speaker 3: losing weight, and it's mediated through hormones that work in 320 00:20:10,160 --> 00:20:14,840 Speaker 3: the brain, hunger hormones, the appetite hormones, and obviously these 321 00:20:14,880 --> 00:20:18,960 Speaker 3: society hormones. So when I talk to patiency, I spell 322 00:20:19,000 --> 00:20:21,640 Speaker 3: that out at the beginning, that these medications are for life. 323 00:20:21,680 --> 00:20:23,520 Speaker 3: We need to manage your obesity for life. 324 00:20:23,920 --> 00:20:24,480 Speaker 4: It might not. 325 00:20:24,600 --> 00:20:28,919 Speaker 3: Be an injection. There's new tablets coming into the market. 326 00:20:29,000 --> 00:20:31,879 Speaker 3: We gave these in a tablet form now, so I 327 00:20:31,920 --> 00:20:34,600 Speaker 3: think with new developments, new research will be able to 328 00:20:34,640 --> 00:20:40,280 Speaker 3: manage long term obsy, just like we would manage blood 329 00:20:40,320 --> 00:20:45,080 Speaker 3: pressure or hypertension diabees, we manage that with medication. So 330 00:20:45,640 --> 00:20:48,639 Speaker 3: I see a future where we would manage obesity with medication. 331 00:20:48,800 --> 00:20:52,639 Speaker 3: Because whatever we're doing, it's the current date. It's not 332 00:20:52,760 --> 00:20:54,880 Speaker 3: working right because the rates are going out. 333 00:20:55,800 --> 00:21:02,720 Speaker 2: Thanks for joining us, Jared, my pleasure. That's it for 334 00:21:02,800 --> 00:21:06,000 Speaker 2: this episode of the Front Page. You can read more 335 00:21:06,000 --> 00:21:10,520 Speaker 2: about today's stories and extensive news coverage at enzidherld dot 336 00:21:10,520 --> 00:21:13,920 Speaker 2: co dot enz The Front Page is hosted and produced 337 00:21:13,920 --> 00:21:18,200 Speaker 2: by me Chelsea daniels Kine. Dickie is our studio operator, 338 00:21:18,440 --> 00:21:22,320 Speaker 2: Richard Martin, our producer and editor, and our executive producer 339 00:21:22,480 --> 00:21:25,879 Speaker 2: is Jane Ye. Follow the Front Page on the iHeart 340 00:21:25,920 --> 00:21:29,040 Speaker 2: app or wherever you get your podcasts, and join us 341 00:21:29,240 --> 00:21:32,360 Speaker 2: next time for another look beyond the headlines.