Speaker 1: It's not the individuals ful. We need to release them
Speaker 1: from shame while also having an honest conversation. We can't
Speaker 1: talk honestly about the risk and benefits of these drugs
Speaker 1: if we don't stop by talking about Unfortunately, there are
Speaker 1: really significant risks continuing to be ibes.
Speaker 2: Wow, welcome to the one you feed. Throughout time, great
Speaker 2: thinkers have recognized the importance of the thoughts we have.
Speaker 2: Quotes like garbage in, garbage out, or you are what
Speaker 2: you think, ring true, and yet for many of us,
Speaker 2: our thoughts don't strengthen or empower us. We tend toward negativity,
Speaker 2: self pity, jealousy, or fear. We see what we don't
Speaker 2: have instead of what we do. We think things that
Speaker 2: hold us back and dampen our spirit. But it's not
Speaker 2: just about thinking. Our actions matter. It takes conscious, consistent
Speaker 2: and creative effort to make a life worth living. This
Speaker 2: podcast is about how other people keep themselves moving in
Speaker 2: the right direction, how they feed their good wolf. Thanks
Speaker 2: for joining us. Our guest on this episode is one
Speaker 2: of our favorites, Johann Harry. He's a writer journalist and
Speaker 2: has written for New York Times, Lamonde, The Guardian, and
Speaker 2: other newspapers. His TED talks have been viewed tens of
Speaker 2: millions of times. Johann's work has been praised by a
Speaker 2: broad range of people, from Oprah Winfrey to Noam Chomsky
Speaker 2: and Joe Rogan. Today, Johanna and Eric discuss his new
Speaker 2: book Magic Pill, The Extraordinary Benefits and disturbing Risks of
Speaker 2: the new weight loss Drugs.
Speaker 3: Hi, Johann, Welcome to the show.
Speaker 1: I'm so happy to be here and this is week
Speaker 1: because we're in my neighborhood, right. I used to live
Speaker 1: just a couple of blocks away from here, so it's
Speaker 1: slightly surreal to see you in the flash. We've done
Speaker 1: so many interviews. I didn't realize you exist in poor
Speaker 1: real form. Is indeed, I do very impressive. We're in
Speaker 1: New York City and we're gonna be discussing your book,
Speaker 1: magic Pill, the extraordinary benefits and disturbing risks of the
Speaker 1: new weight loss drugs. I think that for this episode
Speaker 1: and one episode only, we should rename your podcast the
Speaker 1: one you don't feed Yes Drugs.
Speaker 3: But we will do the parable to start like we
Speaker 3: always do, so you know it by now. But there's
Speaker 3: a grandparent who's talking with a grandchild and they say,
Speaker 3: in life, there's two wolves inside of us that are
Speaker 3: always at battle. One's a good wolf, which represents things
Speaker 3: like kindness and bravery and love, and the other's a
Speaker 3: bad wolf, which represents things like greed and hatred and fear.
Speaker 3: And the grandchild stops. They think about it for a second.
Speaker 3: They look up at their grandparent and they say, well,
Speaker 3: which one wins? And the grandparent says, the one you feed.
Speaker 3: So I'd like to start off by asking you what
Speaker 3: does that parable mean to you now? After writing this book?
Speaker 1: You know, I was thinking about it on the way here.
Speaker 1: Make me think about a whole area of science that
Speaker 1: I learned about for the book that really haunted me
Speaker 1: because for a long time when I was researching the book,
Speaker 1: I thought I was looking at two quite different questions.
Speaker 1: So I started by looking at why did ob City
Speaker 1: blow up so rapidly that we've reached the point where
Speaker 1: forty seven percent of Americans say they want to take
Speaker 1: the new weight loss drugs?
Speaker 4: What happened?
Speaker 1: Because this is unprecedented in human history. This, You know,
Speaker 1: I think we're probably about the same age.
Speaker 4: How old are you? Eric?
Speaker 3: Fifty two?
Speaker 1: I was just slightly older than me, but in our lifetime.
Speaker 1: So I was born in nineteen seventy nine. Between the
Speaker 1: year I was born and the year I turned twenty one,
Speaker 1: B city doubled here in the United States, more than
Speaker 1: trebled in Britain, where I'm from, And in the next
Speaker 1: twenty years, severo B city doubled again. So about in
Speaker 1: the entire world, according to the World Health Organization, i'd
Speaker 1: B city trebled. This has never happened in the holy
Speaker 1: human history. Look at a picture of just an ordinary
Speaker 1: beach in Atlantic City or wherever anywhere in the world.
Speaker 1: In nineteen seventy everyone is what we would call slim,
Speaker 1: right literally everyone. It's very strange at it. So first
Speaker 1: I thought I was looking at why do we become obese?
Speaker 1: And then separately, what do these new weight loss drugs do?
Speaker 4: Right? How do they work? One of the benefits and risks?
Speaker 1: But then I actually learned that there's a word that
Speaker 1: kept coming up in both conversations with the scientists, and
Speaker 1: that word is satiety. So it's not a word we
Speaker 1: use that often in every day English, but we know
Speaker 1: what being sated is, right, It's when you feel like
Speaker 1: you've had enough, you don't want any more. Thanksgiving dinner,
Speaker 1: you feel stuffed, you don't want anymore. You're sated, right,
Speaker 1: that's actually even beyond being sated, that's when you're stuffed.
Speaker 1: And I was thinking about your paraboy in relation to
Speaker 1: one really disturbing bit of science that I learned. So
Speaker 1: I was raised my mother and my grandmother were kind
Speaker 1: of working class Scottish women, and they fed me basically
Speaker 1: nothing but processed and junk food, right, And this was
Speaker 1: an act of love on their part. They liked this food.
Speaker 1: They wanted me to have it, and it was a
Speaker 1: gift to themselves because they were exhausted, extremely hard working women.
Speaker 1: And the day we got a microwave was the happiest
Speaker 1: day of my grandmother's life. She's like, it's cooking, but
Speaker 1: you don't have to do anything right. And what we
Speaker 1: now know was a huge amount of science has shown
Speaker 1: that we're eating in a way that destroys our ability
Speaker 1: to get a sense of satiety or profoundly undermines it.
Speaker 1: And I thought about your peril because in relationship experiment
Speaker 1: that happened here in New York. So it's a brilliant
Speaker 1: scientist called Professor Paul Kenny. He's the head of neuroscience
Speaker 1: at Mount Sinai and not so far from where we
Speaker 1: are now. And he grew up in Ireland and he
Speaker 1: grew up eating the kind of food Irish people ate
Speaker 1: at the time in the seventies and eighties, and then
Speaker 1: he moved to San Diego to continue as neuroscientific research
Speaker 1: and quickly discovered that Americans do not eat like Irish
Speaker 1: people did at the time. They eat a lot more
Speaker 1: processed food, a lot more ultra processed food, a lot
Speaker 1: more junk food, a lot more sugar and salt and fat.
Speaker 1: And like any good immigrant, he assimilated pretty quickly and
Speaker 1: within a year he'd gained thirty pounds and he felt
Speaker 1: like this different American diet was in some ways changing
Speaker 1: his brain, changing what he wanted, changing his desires, obviously
Speaker 1: changing his body. So he designed an experiment to test this,
Speaker 1: which I have nicknamed Cheesecake Park. That's not his official name.
Speaker 1: So he got a lout of rats and he raised
Speaker 1: them in a cage, and for the first part of
Speaker 1: their life they've got nothing but access to the kind
Speaker 1: of healthy, non processed food that they evolved eating for
Speaker 1: thousands of years. So it's palettes, but they're pellets based
Speaker 1: on the kind of food they bold to have, and
Speaker 1: when they have the kind of food that they've eaten
Speaker 1: for thousands of years, even though the rats had loads
Speaker 1: of these pellets, they could.
Speaker 4: Have eaten a huge amount.
Speaker 1: They would eat enough until they felt sated, you know,
Speaker 1: to deal with their basic hunger, and then they stopped eating.
Speaker 1: So they never made themselves obese, they never made themselves overweight.
Speaker 1: Given the kind of food they evolved to have, they
Speaker 1: had a kind of natural nutritional wisdom, and they stopped.
Speaker 1: Then Professor Kenny introduced them to the American diet. He
Speaker 1: gave them a load of cheesecake. He fied up some bacon,
Speaker 1: He gave them a load of Snickers bars, and they
Speaker 1: went wild for it. He put down the cheesecake, and
Speaker 1: the rats would hurl themselves into it and eat their
Speaker 1: way out and emerge just going slicked with this cheesecake
Speaker 1: all over their whiskers, and very quickly the nutritional whist
Speaker 1: that they had when they had the kind of food
Speaker 1: they avolved to eat, just disappeared and they gorged themselves.
Speaker 1: The way Professor Kenny put it to me, it's within
Speaker 1: a few days they were different animals, right, they were
Speaker 1: physically different, and they were psychologically different, and they ate
Speaker 1: and ate and ate and ate, and quite rapidly they
Speaker 1: were severely obese. Then Professor Kenny tweaked the experiment again
Speaker 1: in a way it seems a bit cruel to me
Speaker 1: as a former junk foo addict.
Speaker 4: He took away all this.
Speaker 1: American food and just gave them back the healthy food
Speaker 1: they'd grown up with. And he was sure he knew
Speaker 1: what would happen if the war happened, is they will
Speaker 1: eat more of the healthy food than they ate in
Speaker 1: the past, and this will prove that junk food and
Speaker 1: process food expands your palate, expands the amount of calories
Speaker 1: you eat, and makes you want more. That's not what happened.
Speaker 1: What happened was much weirder. Once they'd had the American
Speaker 1: diet and they had it taken away, they refused to
Speaker 1: eat any of the healthy food at all. It was
Speaker 1: like they no longer recognized it as food at all.
Speaker 1: They shunned it and they chose to starve rather than
Speaker 1: eat it. And it was only when they were really
Speaker 1: starving that they eventually went back and started eating it again.
Speaker 1: And I think this show is obviously in a very
Speaker 1: the one you feed my God, what could be a
Speaker 1: more direct experiment than that, right, as Gerald manned, who's
Speaker 1: one of the leading experts at Harvard on this, he
Speaker 1: designed the nutritional labels or food in this country. As
Speaker 1: he said to me, there's something about the food we're
Speaker 1: eating that is profoundly undermining our ability to know when
Speaker 1: to stop. And what these drugs do, with some cost,
Speaker 1: is they give you back your sense of satiety. They
Speaker 1: boost the parts of your biology in your gut, particularly
Speaker 1: in your brain, that make you feel full again. So,
Speaker 1: as one scientist, professor Michael Lowe, put it to me,
Speaker 1: they're an artificial solution to an artificial problem. Right, So
Speaker 1: we fed ourselves with something that undermines our sense of satiety.
Speaker 1: It's caused a huge crisis in obesity. And now you know,
Speaker 1: forty seven percent of us want to take these drugs
Speaker 1: that artificially give us back that sense of society. It obviously
Speaker 1: leaves us with all sorts of practical and philosophical dilemmas.
Speaker 3: Right, yeah, yeah, that makes a lot of sense to me. Listener,
Speaker 3: while you were listening to that, resonated with you, what
Speaker 3: one thing to feed your good Wolf comes to mind.
Speaker 3: If the thing that came to your mind was more
Speaker 3: time for stillness, or you've tried meditation before and you
Speaker 3: really haven't liked it, then I want to give you
Speaker 3: a quick tip that might make it better for you.
Speaker 3: And it's simply to stop expecting that you're not going
Speaker 3: to have thoughts. Nearly everyone has this expectation that they're
Speaker 3: going to sit down and meditate and they're going to
Speaker 3: stop having thoughts. And when they stop having thoughts, that
Speaker 3: means they're doing it well. But no one does that,
Speaker 3: and so we end up feeling like we're failing all
Speaker 3: of the time. Every three seconds, failed again, failed again.
Speaker 3: We develop a relationship with meditation that is aversive. So
Speaker 3: if you want to stop dreading meditation and actually find
Speaker 3: it relaxing, check out my free meditation guide at Goodwolf
Speaker 3: dot me slash calm. In it, I walk you through
Speaker 3: my process to engage with meditation in a new way,
Speaker 3: and a lot of people have found it really helpful.
Speaker 3: That's good Wolf dot me slash calm. That rat it seems,
Speaker 3: I mean, poor rats. They go they really get put
Speaker 3: through the ringer. But that's a different show. Rings true
Speaker 3: to me in general, right, because I know that when
Speaker 3: I'm eating a lot of sweets, and then I try
Speaker 3: and stop eating sweets, it's really difficult for a little while,
Speaker 3: and then it's almost as if something sort of resets
Speaker 3: and settles down a little bit and it's not so bad.
Speaker 3: But then if I eat them again, you know, And
Speaker 3: I've often been like, well, that seems to lend credence
Speaker 3: to the idea that you know, sugar is sort of addictive.
Speaker 3: But I think that your book, to me, and you
Speaker 3: illustrate it kind of right out of the gate, is
Speaker 3: one of profound conflict, right. It's one where you are
Speaker 3: recognizing and it's in the title the amazing benefits to
Speaker 3: both perhaps individuals and society of these weight loss drugs,
Speaker 3: things like ozepic and wagov Do I say that, right? Yeah,
Speaker 3: And yet there's risks and as you said, you know,
Speaker 3: an artificial solution to an artificial problem. And in the
Speaker 3: end of the book you say, I've decided at least
Speaker 3: for now, because the book is very much a personal
Speaker 3: journey of you beginning to take these medicines. At the
Speaker 3: end of the book you say I have decided for now.
Speaker 3: Then it makes sense for me to continue to take
Speaker 3: these I know that books get written and turned in
Speaker 3: well in advance of publication, so I'm guessing that that
Speaker 3: maybe was a year ago or so, that you might
Speaker 3: have written much.
Speaker 4: More recent than be am. Oh, okay, that's a pretty
Speaker 4: quick time, your.
Speaker 3: Books turning around really quick. Okay, all right, So is
Speaker 3: that still a place you're at.
Speaker 1: I don't remember ever feeling so intensely conflicted about a
Speaker 1: subject right from the start. So for people who don't know,
Speaker 1: and some people who listen to this won't know, we
Speaker 1: now have a new kind of weight loss drug working
Speaker 1: in a completely new way, on a new kind of
Speaker 1: mechanism that I can explain, that delivers extraordinary levels of
Speaker 1: weight loss. The average person taking azempicle will go be
Speaker 1: loses fifteen percent of their body weight within a year.
Speaker 1: From Munjaro, which is the next generation of the same
Speaker 1: class drug, the average person is just twenty one percent
Speaker 1: of their body weight, and for the next one that
Speaker 1: will come out next year, it's twenty four percent of
Speaker 1: your body weight, which is only a little bit below
Speaker 1: bariatric surgery.
Speaker 4: Staggering levels of weight loss.
Speaker 1: And when I first learned about these drugs, of course
Speaker 1: immediately I thought. I learned about them just as I
Speaker 1: was crossing a kind of psychologically strange threshold where I
Speaker 1: was older than my grandfather ever got to be, because
Speaker 1: he died of a heart attack when he was forty four.
Speaker 1: A lot of the men in my family on both
Speaker 1: sides have heart problems. My dad had to have major surgery,
Speaker 1: my uncle died of a heart attack, my other unquie
Speaker 1: to have major surgery. And I knew the scientific evidence
Speaker 1: is overwhelming that obesity makes you much more likely to
Speaker 1: have a very broad range of health problems, one of
Speaker 1: which is the heart problems, but have extremely broad, over
Speaker 1: two hundred complications and diseases, and made much more likely
Speaker 1: by obesity. And we know that when you can reduce
Speaker 1: or reverse obesity, which is very hard to do, but
Speaker 1: where you can do it, you largely reverse those diseasries.
Speaker 1: So of course I could immediately see the benefits, right,
Speaker 1: But I immediately thought just so many things. Well, we've
Speaker 1: seen this story before. There's been loads of weight loss
Speaker 1: drugs in the part, but pretty much every twenty years,
Speaker 1: going back to the First World War, there's a new
Speaker 1: miracle weight loss drug announced. They say it's you know,
Speaker 1: solution to obesity, loads of people take it, then it
Speaker 1: causes some horrendous side effect and has to be withdrawn
Speaker 1: from the market, leaving a trail of terribly damaged people
Speaker 1: in its wake. So it's very conscious of that risk.
Speaker 1: I also just thought, well, can there be really such
Speaker 1: a thing as a free lunch or I guess in
Speaker 1: this case, a smaller free lunch, right, Like, can you
Speaker 1: really get such extraordinary benefits without incurring costs? I worried
Speaker 1: about will this reverse some of the progress we've made
Speaker 1: on body positivity? What will this do to people with
Speaker 1: eating disorders? I had a whole kind of a array
Speaker 1: of worries in my mind as well as excitement right
Speaker 1: from the start. And it was a really weird experience
Speaker 1: because I went all over the world for the book.
Speaker 1: I went on this big journey from Rekievik in Iceland
Speaker 1: to Minneapolis to Tokyo. I interviewed over one hundred of
Speaker 1: the leading experts, the people who pioneered the drugs, their
Speaker 1: biggest critics, everyone in between. And I know much more
Speaker 1: now than I did at the start. A benefits and
Speaker 1: the risks about the cultural effects, but the psychological effects
Speaker 1: of these drugs. But to be honest with you, Eric,
Speaker 1: this has never happened to me with any of the
Speaker 1: books I've worked on before, all of which we've talked about. Weirdly, Yeah,
Speaker 1: I'm as conflicted now as I was at the start.
Speaker 1: I mean, maybe not quite as conflicted.
Speaker 4: But pretty close.
Speaker 1: Like, this is a really complex topic with really significant
Speaker 1: benefits and really significant risks both individuals and the culture.
Speaker 1: And I think what we have to do is really
Speaker 1: way that complexity very very carefully, and it's not easy,
Speaker 1: and the answers are not obvious. So what I hope
Speaker 1: I've tried to do in the book is sort of
Speaker 1: take people on the journey to think through the complexity
Speaker 1: with me, rather than give answers which I can't give.
Speaker 3: Yeah, well, you do a great job of it. It's
Speaker 3: a book that first glance I was like, I'm not
Speaker 3: particularly interested, but it's you, right, And so I was like,
Speaker 3: I love your books and I love read and I
Speaker 3: was like, this is absolutely compelling. There's so many aspects
Speaker 3: of this that are fascinating. But let's talk about the
Speaker 3: heart of those conflicts. You know you talked about body positivity, right,
Speaker 3: We've entered into a world where at least we are
Speaker 3: trying to lessen the stigma around being obese, and we've
Speaker 3: made some progress, and we have a long way to go.
Speaker 3: And you take on something in the book that I
Speaker 3: thought was really difficult to take on, and yet it
Speaker 3: felt really important, and it was this idea of how
Speaker 3: do we encourage body positivity and reduce the stigma around
Speaker 3: being obese. We'll also be able to talk about the
Speaker 3: very real health challenges that being obese bring. Walk me
Speaker 3: through your thought process on sort of arriving where you
Speaker 3: did with that.
Speaker 1: The worst moment in writing the book for me, Yeah,
Speaker 1: by father, The worst was a moment it was maybe
Speaker 1: six months into taking the drugs. I've got a niece
Speaker 1: called Erin, and she's the baby in my family.
Speaker 4: She's the only girl.
Speaker 1: She's the youngest of all my nephews and my niece,
Speaker 1: and in my head she's fixed as like a six
Speaker 1: year old forever. She's actually nineteen now, but whenever she
Speaker 1: has a boyfriend, I want to go get away from her.
Speaker 1: Your pedophile And I'm like, oh no, she's such an
Speaker 1: adult woman. And a little while in to taking the
Speaker 1: drug I was facetiming with her and she was saying, oh,
Speaker 1: you've lost so much weight, you know, I'd lost a
Speaker 1: huge amount of weight by then, and I was sort
Speaker 1: of preening. She said, I didn't know you had a
Speaker 1: draw until now, kind of joking, and then I was
Speaker 1: kind of preening and laughing. And then she looked down
Speaker 1: and she said, well, you get me someho zen pic.
Speaker 1: And she's a perfectly healthy way and always has been.
Speaker 1: And I thought she was kidding, so I laughed, and
Speaker 1: then suddenly I realized she was being serious, and I thought,
Speaker 1: oh fuck, what am I doing here? Right all her life,
Speaker 1: I've been trying to give her this message, you shouldn't
Speaker 1: be valued on how you look. Don't internalize these images
Speaker 1: about women only have value when they're thin. And I thought, shit,
Speaker 1: have I just undone all that? And you went to
Speaker 1: the tension there. With almost every topic related to these drugs,
Speaker 1: there's a lot of complexity, and this is one of them.
Speaker 1: And one of the people who really helped me to
Speaker 1: think through this complexity is an amazing woman called Shelly Bovy. So,
Speaker 1: when I was a kid, and when you were a kid,
Speaker 1: it was just taken for granted on television that fat
Speaker 1: people were like the butt of the joke, right they
Speaker 1: were particularly fat women, but fat men as well were
Speaker 1: there to be kind of laughed at, and the fact
Speaker 1: they were fat was itself a joke, right. And the
Speaker 1: first person I ever heard challenge this, and I remember
Speaker 1: it quite vidly, is when I was ten years old.
Speaker 1: So there was a one called Shelley Bowing and I
Speaker 1: saw her on television. She was already the pioneer of
Speaker 1: body positivity in Britain. She was the first person I
Speaker 1: ever heard say, you know, this isn't right, this is
Speaker 1: just a former prejudice and stigma. And I went to
Speaker 1: see Shelley and she lives in the village in England.
Speaker 1: Now had a really interesting day with her because so
Speaker 1: she grew up in a working class town in Britain
Speaker 1: called Port Talbot, and when she was a kid, she
Speaker 1: was the only fat girl in her school. That's the
Speaker 1: word she would have used, fat girl in her school.
Speaker 1: And one day when she was eleven or twelve, her
Speaker 1: teacher told her to stay behind after class. So she
Speaker 1: stayed behind, thinking what have I done wrong? And the
Speaker 1: teacher said to her, you are much too fat. It's disgusting,
Speaker 1: it's wrong. Go to the school nurse. She'll sort you out. So,
Speaker 1: feeling completely taken aback, Shelley went to the school nurse.
Speaker 1: The school nurse said, why are you here. She said, well,
Speaker 1: the teacher says, I'm too fat, and the school nurse said,
Speaker 1: take off your cloes.
Speaker 4: I'm going to look at you. So she took off
Speaker 4: her clothes and the school nurse.
Speaker 1: Said, she's right, too fat. You're going to die young.
Speaker 1: It's disgusting. Stop being so greedy.
Speaker 4: Eat less.
Speaker 1: And Shelley kind of left feeling completely thrown and every
Speaker 1: girl in the school, every other person around her, was
Speaker 1: constantly giving her these messages, You're disgusting, you're revolting.
Speaker 4: She was really smart and.
Speaker 1: She was advised by her teachers to go to university
Speaker 1: and she just couldn't do it. She thought she'd just
Speaker 1: be fat shamed there. And as she got older, it
Speaker 1: was just constant.
Speaker 4: You know.
Speaker 1: She went to a doctor when she was pregnant. First
Speaker 1: thing the doctor said was so you shouldn't be pregnant
Speaker 1: when you're your weight. After she gave birth, she had
Speaker 1: quite a difficult birth. First thing that she's lying there
Speaker 1: covered in blood and the midwife said, he, you know,
Speaker 1: you really need to lose some weight. When her son
Speaker 1: couldn't feed properly, wasn't attaching. She took him to the doctor.
Speaker 1: The doctor said, what are you trying to do? Make
Speaker 1: the baby as fat as you are? She got understand overweight,
Speaker 1: when people, particularly overweight women, are constantly sucking up. Yeah,
Speaker 1: forty five percent of women who have a BMI higher
Speaker 1: than thirty five are insulted every single day. Well, and
Speaker 1: she Lley really pioneered in Britain. Obviously there have been
Speaker 1: some movement here in the US before that that inspired her.
Speaker 1: Pioneered challenging this way talking and thinking, this is just
Speaker 1: a form of bigotry. It's unacceptable, It's a form of
Speaker 1: cruelty and bullying, and we need to fight back. She
Speaker 1: wrote a very beautiful book arguing for this was a
Speaker 1: big and important book in Britain in the late eighties,
Speaker 1: which is when I saw her. And Shelley was very
Speaker 1: proud of what she wrote and stands by every word
Speaker 1: of it. But in the years that passed, something else
Speaker 1: also happened to Shelley. She weighed, you know, more than
Speaker 1: two hundred pounds and a doctor told her there was
Speaker 1: problems with her heart because of her weight, and she
Speaker 1: was losing the ability to walk. She took her kids
Speaker 1: to a theme park one day, but like a kind
Speaker 1: of British version of Disneyland, and she just couldn't walk anywhere,
Speaker 1: and they found a wheelchair for her and her husband
Speaker 1: could push the wheelchair beers. She'd become so large, and
Speaker 1: Shelley was in this real dilemma. She passionately opposed stigma
Speaker 1: and still does and always will, but could also see
Speaker 1: that it's just a scientific fact that there are physical
Speaker 1: harms caused by obesity. You're much more likely to become diabetic,
Speaker 1: your knees and your joints more like to be ruined.
Speaker 4: I mean, you much more like to.
Speaker 1: Get cancer, dementia, heart disease. Is an extraordinarist and there
Speaker 1: is no scientific debate about this among mainstream scientists, no
Speaker 1: scientific debate. And Shelley was like, it's an act of
Speaker 1: love for yourself and for people who are in this situation.
Speaker 1: You have to be able to do two things. You
Speaker 1: have to be able to oppose stigma, which is a
Speaker 1: form of cruelty and hatred, and you have to be
Speaker 1: able to have an honest conversation about the harms caused
Speaker 1: by obesity to human health. We understand those mechanisms. We
Speaker 1: know how they work, and it is not a form
Speaker 1: of stigma to talk about the harms caused by health.
Speaker 1: Of course, it can be done in a cruel and
Speaker 1: stigmatizing a mean way, and we should oppose that. But
Speaker 1: she said, you know what kind of body positivity would
Speaker 1: it be that would lead to my body dying, which
Speaker 1: is the path she was on. So in Shelley's case,
Speaker 1: she lost a huge amount of weight through diet. She
Speaker 1: was the first tepnoledge. That's extremely hard to do. The
Speaker 1: vast majority of people who diet in clearly me it
Speaker 1: doesn't work and they regain the weight. But in her
Speaker 1: case she was able to reverse it and it massively well.
Speaker 1: Her health problems largely went away. And we know this
Speaker 1: is the case wherever you can reverse obesity with, for example,
Speaker 1: at bariatric surgery. One of the best ways of trying
Speaker 1: to figure out the benefits and harms caused by these
Speaker 1: new weight loss drugs. It's not perfect, but one of
Speaker 1: the best ways is to look at bariatric surgery because
Speaker 1: that's actually up to now, that's the only other form
Speaker 1: of medical intervention that's caused a huge amount of weight loss.
Speaker 1: Now Baratory surgery is a horrible thing, right, It's a
Speaker 1: really grueling operation. One in one thousand people die in
Speaker 1: the operation.
Speaker 4: Dreadful. But the reason people take.
Speaker 1: That tremendous risk and go through such a grueling process
Speaker 1: is because the benefits for health are so enormous. If
Speaker 1: you have bariatric surgery in the seven years that follow
Speaker 1: you are fifty six percent less likely to die of
Speaker 1: a heart attack. You are sixty percent less likely to
Speaker 1: die of cancer, you are ninety two percent less slightly
Speaker 1: to die of diabetes related causes. In fact, the benefits
Speaker 1: are so great you're forty percent less slightly to die
Speaker 1: of any cause at all. And we now know that
Speaker 1: increasingly the evidence is becoming clear that the benefits from
Speaker 1: these new weight loss drugs are similar. If you start
Speaker 1: with a BMI higher than twenty seven and you take
Speaker 1: these drugs, you are twenty percent they're slightly to have
Speaker 1: a heart attack or stroke in the next few years.
Speaker 1: Obviously a topic very close to my own heart, literally
Speaker 1: very close to my own heart. So the reason I've
Speaker 1: given this monstrously long answer is because there's so much
Speaker 1: complexity here, and there's so much pain, and there's so
Speaker 1: much shame, and Shelley is the first person to stress
Speaker 1: it is no individual's fault if they have become overweight
Speaker 1: or obese. There are people to blame. It's the process, field, industry,
Speaker 1: and the society that's failed to regulate them. But it's
Speaker 1: not the individual's fault. We need to release them from
Speaker 1: shame while also having an honest conversation. We can't talk
Speaker 1: honestly about the risks and benefits of these drugs if
Speaker 1: we don't start by talking about unfortunately, there are really
Speaker 1: significant risks continuing to be obese.
Speaker 3: It makes me think a little bit about the journey
Speaker 3: as a recovering drug addict, right, because there's this delicate
Speaker 3: balance that kind of has to happen within the addict.
Speaker 4: Right.
Speaker 3: My experience is the stigma and the shame perpetuates the
Speaker 3: using right. You talk about that pretty convincingly in the book.
Speaker 3: The same thing with weight loss. Stigma makes people less
Speaker 3: likely to lose weight.
Speaker 1: It's a catastrophic tool to promote change. A lot of
Speaker 1: stigma is just cruelty, yeah, and fear. But some people
Speaker 1: use stigma. I think we should take them at their words.
Speaker 1: Some people think, while I'm stigmatizing this person, for their
Speaker 1: own good to have benefit if she loses weight or
Speaker 1: his benefit. But actually, there's lots of research on this
Speaker 1: and the evidence is overwhelming. If you stigmatize people, they
Speaker 1: are more likely to gain right, right, putlicause people will
Speaker 1: comfort more Putlica's as Lindy West, a very beautiful writer
Speaker 1: and a body positivity advocate. You can't take good care
Speaker 1: of a thing you hate. If we make people hate
Speaker 1: their bodies, that doesn't make them take better care of it, right.
Speaker 1: And also some of other reasons is why it makes
Speaker 1: people not want to exercise because they're feel humiliated.
Speaker 4: I mean, there's a whole range of reasons.
Speaker 1: So, yeah, stigma is a catastrophically not only a poor
Speaker 1: tool for change, it's a counterproductive right tool for change.
Speaker 1: It will make the problem worse for most people.
Speaker 3: Right, So stigma doesn't work to change, right, So as
Speaker 3: an addict, you've got to lose that stigma. And yet
Speaker 3: there does have to be very honest consequences or very
Speaker 3: honest conversation about the consequences of your use. Right At least,
Speaker 3: my experience was there was a way to do both
Speaker 3: those things. There was a way to go you know what,
Speaker 3: this isn't really my fault that I'm this way, right,
Speaker 3: I need to take responsibility for it. It's not my fault.
Speaker 3: But if I'm not willing to look clearheadedly at what
Speaker 3: this is doing to my life and my health, I'm
Speaker 3: also not motivated to get better. And so you know,
Speaker 3: it's not exactly the same thing by any stretch. But
Speaker 3: I think there's some parallels there that we can draw
Speaker 3: from recovery. When recovery is done in a healthy and
Speaker 3: life promoting way.
Speaker 1: That's really interesting. I think there's a lot of insight
Speaker 1: in that. And I think it brings us to the
Speaker 1: drugs because for me, it was such a strange experience
Speaker 1: taking them of so I thought, I can't really honestly
Speaker 1: write about this, but I don't take them. And also
Speaker 1: I was very conscious of the heart risks in my family,
Speaker 1: and I was quite a beast at the time. And
Speaker 1: it's the weirdest thing. I started taking ozen pic and
Speaker 1: never forget it. I woke up two days later, I
Speaker 1: was lying in bed and I thought, oh, I feel
Speaker 1: something really weird.
Speaker 4: What do I feel?
Speaker 1: And I couldn't locate the feeling and it took me
Speaker 1: a good five minutes or so to realize, oh, I'm
Speaker 1: not hungry. Every other day in my life I had
Speaker 1: woken up feeling hungry, often ragingly hungry. Yep, I thought,
Speaker 1: I'm not hungry at all. I was in London at
Speaker 1: the time, I lived in London half the year, and
Speaker 1: I went to this here we would call a diner,
Speaker 1: just up the street from where I live, and I
Speaker 1: went in and I ordered the same thing I order
Speaker 1: every day, which was a kind of huge brown role
Speaker 1: with loads of mayo and chicken in it.
Speaker 4: And I had like three mouthfalls. I didn't want anymore.
Speaker 4: I felt full.
Speaker 1: I remember when I left Tatiana, the woman who runs
Speaker 1: it shouting off to it.
Speaker 4: You okay, right.
Speaker 1: And then for lunch that day, next to my office
Speaker 1: there's a Turkish restaurant and I went in. I ordered
Speaker 1: the same thing I was ordered, which was a Mediterranean lamb. Again,
Speaker 1: I had like three four mouthfalls. I just didn't want anymore.
Speaker 1: It was like the kind of shutters had come down
Speaker 1: on my appetite. Fcilater interviewed the scientists who play key
Speaker 1: roles in the breakthroughs that led to the drug and
Speaker 1: so if you ate now, Eric, if you had anything
Speaker 1: after a little while your pancreas would release hormone produce
Speaker 1: and release a hormone called GLP one, and GLP one
Speaker 1: is just part of the natural signaling in your body,
Speaker 1: saying Eric, you've had enough, stop eating, right, But the
Speaker 1: natural signal for GLP one stays in your system for
Speaker 1: a few minutes and then goes away, So you can
Speaker 1: just kind of power through.
Speaker 4: It if you want to. A lot of people don't.
Speaker 4: You can't.
Speaker 1: What these drugs do is they injected into you an
Speaker 1: artificial copy of GLP one, but instead of being washed
Speaker 1: away in a few minutes, it stays in your gut
Speaker 1: and crucially in your brain for a whole week, right,
Speaker 1: So instead of just lasting a few minutes, it lasts
Speaker 1: a long time. Which is why when I go as
Speaker 1: I literally did on the way to the studio here hurrying,
Speaker 1: you know, I was thinking this chroc monsieur from prep,
Speaker 1: you get that sensation of fullness very very rapidly. Now,
Speaker 1: it was initially thought that effect was primarily on the gut. Increasingly,
Speaker 1: from interviewing lots of neuroscientists who are at the cutting
Speaker 1: edge of research on this, evidence is increasingly clear it's
Speaker 1: primarily in your brain, which brings with it a whole
Speaker 1: different set of benefits and risks that we can talk
Speaker 1: about if you like. It was so strange to feel
Speaker 1: such a dramatic transformation so rapidly as the result of
Speaker 1: something so small. It was very disorientating.
Speaker 4: Yeah.
Speaker 3: Yeah, Well, I know some people who are taking these
Speaker 3: drugs and they describe I think you talk about it
Speaker 3: a little bit in the book too, that the noise
Speaker 3: around food in their head sort of disappears to some degree,
Speaker 3: that they felt like their life was always a lot
Speaker 3: of noise up here about what am I going to eat?
Speaker 3: When am I going to eat next, craving, wanting this,
Speaker 3: wanting that, and then it's just been turned way way down.
Speaker 1: Did you notice people talk about the food and noise
Speaker 1: thing weirdly? That wasn't actually mine. Okay, I did not
Speaker 1: have a big issue around food noise. It's not that
Speaker 1: I obsessively thought about food. For me, it was slightly different,
Speaker 1: and it's a funny thing, and I want to stress
Speaker 1: that I think I'm unusual in this respect. So one
Speaker 1: of the big drawbacks to these drugs. I go through
Speaker 1: a lot of the drawbacks in the book, and twelve
Speaker 1: quite big risks. I think probably the biggest drawback for
Speaker 1: most people is one that I didn't experience at all,
Speaker 1: and I explained why most people experienced a profound loss
Speaker 1: of pleasure in food. Some people say they don't enjoy
Speaker 1: food at all, and some people say they enjoy food
Speaker 1: much less. So for example, there's a brilliant British food
Speaker 1: critic who writes for The Guardian who started taking a
Speaker 1: Zmpic and just said, you know, he would go to
Speaker 1: the finest restaurants in Paris and just nothing wasn't doing
Speaker 1: anything for him.
Speaker 4: And this is a really big drawback. You know, people
Speaker 4: who are.
Speaker 1: One of the scientists who designed the drugs has talked
Speaker 1: about how a lot of people will just after a
Speaker 1: few years because it's just not tenable to live like that.
Speaker 1: I did not have that experience because I don't think
Speaker 1: it's for a particularly good reason. One of the things
Speaker 1: I realized, and it's related also to the food noise thing,
Speaker 1: I think I grew up in a quite violent and
Speaker 1: chaotic environment and it gives a lot of addiction in
Speaker 1: my family. And I realized I've never been someone who
Speaker 1: took a great deal of pleasure in tasting food. For
Speaker 1: me one of the pleasures I took in food, By far,
Speaker 1: the biggest pleasure I took in food was by stuffing myself.
Speaker 1: Stuffing is where you deliberately eat beyond the point of fullness, right.
Speaker 1: We all do it sometimes Thanksgiving whatever, and you feel
Speaker 1: like the pressure outward on your stomach and upward on
Speaker 1: your esophagus. And some people it's clearly a minority, but
Speaker 1: some people get the sort of sense of calming or
Speaker 1: relief from that feeling of stuffing. And I realized I
Speaker 1: was definitely in that category. Once I started taking these drugs.
Speaker 1: I could not stuff myself. You can't, I mean, you
Speaker 1: would just throw up if you tried to do I
Speaker 1: think you literally couldn't do it. I certainly am not
Speaker 1: inclined to try because I think it would make me sick. Right,
Speaker 1: And so for me, I had to eat much more
Speaker 1: slowly than I ever had before. Going out to dinner
Speaker 1: with a friend of mine and has saying it, so
Speaker 1: it's been a bit we're going out to eat with
Speaker 1: you because you eat so fast, but you don't ever
Speaker 1: seem to really enjoying the.
Speaker 4: Food you eat.
Speaker 1: And now you do actually look like you're enjoying the
Speaker 1: food you eat. It's actually much nicer to watch. So
Speaker 1: for me, stress out a typical and I was starting
Speaker 1: from a very low base. But I think for me
Speaker 1: it actually increased the amount of pleasure I taking for it.
Speaker 3: I'm tasting it a bit more now, all right, Now,
Speaker 3: let's pause for a quick good Wolf reminder, and this
Speaker 3: one is on meditation. If while you're meditating your mind wanders,
Speaker 3: you probably, like most people, treat that as a moment
Speaker 3: of failure, like, ugh, my mind wandered again. But let's
Speaker 3: flip that and instead treat that as a moment of
Speaker 3: celebration because in that moment, your mind actually woke up
Speaker 3: and you were mindful of the fact that your mind wandered.
Speaker 3: So it's a win. So if we can flip that
Speaker 3: right on its head and say, oh, good job, brain,
Speaker 3: we actually make it more likely that a our brain
Speaker 3: is going to do it more often because we're training it,
Speaker 3: and b that we're going to enjoy it more secifically.
Speaker 3: It's about how to make you not dread meditation so
Speaker 3: much and actually find it relaxing. Check out my free
Speaker 3: meditation guide at Goodwolf dot me slash calm. It's interesting
Speaker 3: that someone I know who's taking these has reported that
Speaker 3: as the week goes on, the effects seem to sort
Speaker 3: of taper down, and so in the later part of
Speaker 3: the week they start to enjoy food a little bit
Speaker 3: more again, and then it comes time to take the thing.
Speaker 3: But the point I was making around the food noise
Speaker 3: is that again tying it sort of the idea of addiction, right,
Speaker 3: is that one of the good things about addiction is
Speaker 3: that for most people I know who are able to
Speaker 3: achieve abstinence is that if you do that long enough,
Speaker 3: eventually that craving just kind of goes away. And it's
Speaker 3: really hard to function when that noise, the craving for
Speaker 3: whatever it is you want is really that high. And
Speaker 3: I think it's part of what speaks to what makes
Speaker 3: food so difficult for people, right, that that doesn't necessarily
Speaker 3: in a lot of people go away without the help
Speaker 3: of these medicines.
Speaker 1: Well, I think there's another parallel addiction, which were curious
Speaker 1: what you think about, Eric, So, I had this weird
Speaker 1: thing that happened to me when I was taking them.
Speaker 1: You know, I remember I had I've got a friend
Speaker 1: called Danielle who was pregnant at the time, and every
Speaker 1: time I saw her. It was like we were on
Speaker 1: reverse trajectories, right. She was getting bigger and I was shrinking.
Speaker 1: And I remember one day running into her and I
Speaker 1: was getting what I wanted. I was losing huge amounts
Speaker 1: of weight, all sorts of nice benefits, not just to
Speaker 1: my health, like my neighbor's hot gardener hit on me.
Speaker 1: Like I remember one morning just thinking I'm getting what
Speaker 1: I want. Why don't I feel good?
Speaker 3: Yeah?
Speaker 1: Actually, I don't want to overstate this, but I wasn't depressed,
Speaker 1: but if anything, I felt like my emotions were a
Speaker 1: little bit more muted.
Speaker 4: Yep. And there's a big debate about why.
Speaker 1: So I want to stress the majority of people taking
Speaker 1: the drugs on not experiencing this, and there's a scientific
Speaker 1: debate about it, but the FDA does have a suicide
Speaker 1: warning on these drugs here in the United States. European
Speaker 1: Medicine Agency was not persuaded by that risk. But there
Speaker 1: is a debate about is this causing depression in some
Speaker 1: people or indeed even suicide in some people. It's an
Speaker 1: ongoing scientific debate, but it's plausible enough that there was
Speaker 1: a safety signal raised and that the FDA has this
Speaker 1: has this warning and of course, if it's causing that
Speaker 1: effect on some people, it's plausible that it could be
Speaker 1: causing muted feelings or somewhat lowered emotional affect in other people.
Speaker 1: And I wondered, why would that be, And some people
Speaker 1: arguing maybe literal brain effects, and we can talk about them,
Speaker 1: because I talk about them a lot in the book,
Speaker 1: but I suspect for me it was a different thing.
Speaker 1: So again, maybe six or seven months, maybe a little
Speaker 1: bit more into taking the drugs, I was in Vegas.
Speaker 4: I spent a lot of time in Vegas.
Speaker 1: Can write a book about a series of crimes that
Speaker 1: are happening there, a non fiction book I've been researching
Speaker 1: for a thousand years.
Speaker 4: I will have to eventually write it.
Speaker 1: And that day I was investigating the murder of someone
Speaker 1: that I knew and I loved, and I've been I
Speaker 1: was looking into it in a great detail, and as
Speaker 1: you can imagine, it's not a pleasant thing to do.
Speaker 4: It's a tough day.
Speaker 1: And on auto pilot, I went to the KFC on
Speaker 1: where Sahara and I did what I would have done
Speaker 1: a year before.
Speaker 4: I went in.
Speaker 1: I ould a bucket of fried chicken, something I've done
Speaker 1: a million times in my life. And I sat there
Speaker 1: and I looked at this chicken and I think I
Speaker 1: had one drumstick, and I thought, I can't eat this.
Speaker 1: And I looked at Colonel Sanders who was on the wall,
Speaker 1: and it was like he was looking down and me going, hey,
Speaker 1: what happened to my best customer?
Speaker 4: Right?
Speaker 1: But I could eat it, and I suspect for me,
Speaker 1: And I'm sure this dynamic is happening with lots of people.
Speaker 1: That may not be the primary determinant of what we're
Speaker 1: talking about. That's more contested. There's an enormous amount of
Speaker 1: evidence for comfort eating. Right, Huge numbers of people company
Speaker 1: after any shocking or surprising event, there's a massive spike
Speaker 1: in fast food consumption. It's really an interesting study of
Speaker 1: the NFL. If the home team wins, junk food sales
Speaker 1: massively go down that week. If the home team loses,
Speaker 1: junk food sales massively go up that week.
Speaker 2: Right.
Speaker 4: That's why comfort eating, there's a lot of evidence for it.
Speaker 1: Men lose their jobs, they're massive increase in comfort eating
Speaker 1: in particular, and on these drugs, you cannot comfort eat.
Speaker 1: And what I would say to people is people who
Speaker 1: think you're taking these drugs. One of the things you
Speaker 1: should be aware of, which I don't think is being
Speaker 1: discussed very much, is for many people, the underlying psychological
Speaker 1: drivers of your eating will come to the s. There
Speaker 1: are lots of potential underlying psychological drivers of over reading,
Speaker 1: not just comfort eating. I go through lots of them
Speaker 1: in the book, and how they can emerge in this way.
Speaker 4: That's not necessarily a bad thing.
Speaker 1: I remember going to one of my friends when I
Speaker 1: was really struggling with that after that day the KFC
Speaker 1: and Wessahara and saying, you know, I think I should
Speaker 1: stop taking these drugs.
Speaker 4: I want some fucking comfort food.
Speaker 1: And she said to me, look, you can stop if
Speaker 1: you want, but you should know these drugs are not
Speaker 1: causing this problem. This is a problem that was there
Speaker 1: all along. What these drugs are doing is surfacing these problem,
Speaker 1: which again is very familiar concept from addiction. One of
Speaker 1: the great difficulties in stopping addiction, let's say, to heroin
Speaker 1: or gambling or whatever, is that the underlying feelings that
Speaker 1: were being numbed or suppressed or managed by these addictions
Speaker 1: will come to the surfaces. Is a very familiar concept.
Speaker 1: But yeah, so I was surprised when I started writing
Speaker 1: about this by how many things there are given this
Speaker 1: is one of the hottest topics.
Speaker 4: In the culture right now.
Speaker 1: How much about this is not being discussed. How much
Speaker 1: of the effects, the concerns the cultural and not just
Speaker 1: the first personal effects. I'm not really being talked about
Speaker 1: the moment. So I'm surprised by how much there is
Speaker 1: to bring to the surface here.
Speaker 3: I think that that point of whatever you're using as
Speaker 3: a coping mechanism, when you take it away, you either
Speaker 3: are going to do one of a number of different things, right,
Speaker 3: You're just going to find another unhealthy coping mechanism, or
Speaker 3: you're going to be forced into facing the thing that
Speaker 3: is happening. And we see this with addiction all the time. Right,
Speaker 3: you stop one thing and you pick up another.
Speaker 4: I think that's true.
Speaker 1: And this is one of the risks associations with drugs
Speaker 1: ICHO through twelve ERSCS in the book, because some people
Speaker 1: will be thinking, well, that's not going to play out
Speaker 1: for me. So there were some real flashing red lights
Speaker 1: for me. When you look at the safety of these drugs.
Speaker 1: There's a very good argument put forward by the proponents
Speaker 1: of these drugs. By the defenders of the drugs that
Speaker 1: we should give a lot of weight to. So it's
Speaker 1: so difficult to even talk about this that these always
Speaker 1: like way or wait, by any way, you know what
Speaker 1: I mean, we should give a lot of no nozenpiicy
Speaker 1: weight too, which is they say, diabetics have been taking
Speaker 1: these drugs for eighteen years on prescription for people who
Speaker 1: don't know. In addition to having these effects on appetite,
Speaker 1: these drugs also stimulate the creation and more insulin, which
Speaker 1: of course is what diabetics need. So diabetics have been
Speaker 1: taking these drugs for eighteen years, We've got a lot
Speaker 1: of evidence on those diabetics. If it caused some catastrophic
Speaker 1: short to medium term effect, we would know by Now
Speaker 1: that's a really compelling argument and there's a lot of
Speaker 1: truth in it. But some scientists have responded by saying, okay,
Speaker 1: so let's look at the diabetics.
Speaker 4: Let's really dig into that.
Speaker 1: So, for example, there's a brilliant scientist called Professor Jean
Speaker 1: luc Faye who's at the University Hospital in Montpellier, and
Speaker 1: he was tasked by the French Medicines Agency to investigate
Speaker 1: the safety of these drugs. So he started looking at them,
Speaker 1: and he chose one issue in particular. We know if
Speaker 1: you give these drugs to rats, their thyroid cancer risk
Speaker 1: massively increases, which also has makes sort of intuitive sense.
Speaker 1: In addition to having GLP one receptors in your gut
Speaker 1: and in your brain, you also have them in your thyroid,
Speaker 1: so you can see the some plausible mechanism there. So
Speaker 1: France has very good medical databases. They don't have the
Speaker 1: equivalent of HIPPA. It's really hard to opt out, so
Speaker 1: you can do this research in France, so it's too
Speaker 1: much harder to do here. What they did is they
Speaker 1: looked at diabetics who've been taking these drugs for more
Speaker 1: than three years between I think it was two thousand
Speaker 1: and six and twenty sixteen, and they compared them to
Speaker 1: comparable diabetics who'd not taken these drugs. And what Professor
Speaker 1: Paie and his colleagues found is pretty sobering. If his
Speaker 1: research is right, and there's a debate about it, these
Speaker 1: drugs increase your thyroid cancer risk by between fifty and
Speaker 1: seventy five percent. Now it's important to understand what that
Speaker 1: doesn't mean, because when you first hear it, you're like
Speaker 1: What it doesn't mean fifty to seventy five percent of
Speaker 1: people who take it will get thorough cancer. Obviously, if
Speaker 1: that was the case, they'd immediately pull it from market.
Speaker 1: What it means is whatever your thyroid cancer risk was
Speaker 1: going in, it will if this research is right again
Speaker 1: stress it's contested, it will go up by between fifty
Speaker 1: and seventy five percent.
Speaker 4: That's a big risk.
Speaker 1: Now, it's a big increase in a relatively small risk.
Speaker 1: Only one point two percent of people get thyroid cancer
Speaker 1: in their lifetime. Eighty four percent of them survive it. Nonetheless,
Speaker 1: that's pretty sobering, right, and that's just one of the
Speaker 1: many risks that are emerging now. Against that, the defenders
Speaker 1: of the drug say, and you begin to see again
Speaker 1: the ferocious complexity of this debate. They say, even if
Speaker 1: that's true, and some of them dispute it. Even if
Speaker 1: that's true, if the alternative is continuing to be obese, well,
Speaker 1: being obese causes cancer for a lot of people, right.
Speaker 1: In fact, it's one of the biggest causes of cancer.
Speaker 1: Cancer research UK, the biggest British cancer charity, explains, if
Speaker 1: you carry excess weight, it doesn't just sit there. It's
Speaker 1: not inert. It's active. It sends signals to the rest
Speaker 1: of your body, and one of the signals it sends
Speaker 1: is for your cells to divide more rapid which can
Speaker 1: cause cancer. Right, So every turn, when you feel like, oh,
Speaker 1: that's really pulls you up short, you have to then
Speaker 1: go okay, But then let's compare it to the alternative scenario.
Speaker 4: That's way. This very careful at each stage.
Speaker 1: It's like looking at a picture that's only slowly forming
Speaker 1: and is very complicated. So I think every individual really
Speaker 1: has to go through the benefits and risks for themselves
Speaker 1: and think very deeply about it. And you know, maybe
Speaker 1: you'll have thyro cans in your family, maybe you're thinking
Speaker 1: of becoming pregnant. And one of the big risk is
Speaker 1: we know these drugs cause birth deformities in rats. You
Speaker 1: can't do experiments on humans in this in the same way.
Speaker 1: So there's all sorts of things where you want to
Speaker 1: game out as an individual, what's the risk here?
Speaker 4: Yep.
Speaker 3: So one of the things that people talk about with
Speaker 3: these drugs very often is that once you're on them,
Speaker 3: you have to remain on them to get benefit out
Speaker 3: of them, and that if you stop taking them you know,
Speaker 3: most people will see a return to weight loss gain.
Speaker 3: Is that primarily because they will resume the behaviors that
Speaker 3: they did before, or is there something else that's the
Speaker 3: mechanism of action of causing that weight loss to stop.
Speaker 3: Meaning if I stop taking them, my satiety cues will
Speaker 3: go down, these other things will stop. I will suddenly
Speaker 3: have the same relationship I had with food before. I
Speaker 3: will begin to eat as much as I did. I
Speaker 3: will gain the weight back. Is that the mechanism of
Speaker 3: action or are they doing something else that makes it
Speaker 3: more likely you'll gain the weight back?
Speaker 1: Well, no, you just regain the weight you had. I mean,
Speaker 1: it's like blood pressure medication or statins. They work as
Speaker 1: long as you take them, and when you stop taking them,
Speaker 1: you don't get the benefits for your blood pressure or
Speaker 1: cholesterol anymore. There's a debate about can you make changes
Speaker 1: while you're taking them that would mean that when you stopped,
Speaker 1: you would be able to sustain that benefit. As with
Speaker 1: a million things related to these drugs, the honest answers
Speaker 1: we don't know, yep, and itcdotally there are some people.
Speaker 4: Who are reporting that.
Speaker 1: I mean, even if you think about that more basic level,
Speaker 1: we don't even know if people develop tolerance to these
Speaker 1: drugs when they use them for abaicity, right, the longest
Speaker 1: term studies we have, so people don't know when you
Speaker 1: take a drug many drugs isn't the case, but often
Speaker 1: your body gets used to the drug and the effect
Speaker 1: sort of wears off over time. Think about the older
Speaker 1: amfetamine based diet drugs. One of the reasons they were
Speaker 1: such a disaster is because if you take amfetamins, you
Speaker 1: lose loads of weight, but you develop tolerance to Anyone
Speaker 1: who's been a recreational and fetamine user will know this.
Speaker 1: You develop tolerance term fetamins over time, so you have
Speaker 1: to take higher and higher doses to get the same effect.
Speaker 1: And if you take very high doses of and fetamins
Speaker 1: you develop psychosis. So probably not a price worth paying
Speaker 1: to be thin. Psychotic but skinny not the best slogan,
Speaker 1: not a great ad slogan, I don't think.
Speaker 4: So, we don't know.
Speaker 3: Skinny but psychoic Righty's just the order of words.
Speaker 4: R R.
Speaker 1: That's the way, that's the way exactly higher that guy
Speaker 1: mak him work for no other orders. We know with diabetics,
Speaker 1: they don't develop tolerance over time. They don't need high
Speaker 1: and higher doses to get the same benefits from these
Speaker 1: drugs controlling their blood sugar. But we don't know about weight.
Speaker 1: So the longest term study of these drugs was I
Speaker 1: think sixty two months espaily. If you look at the graph,
Speaker 1: so it's a very familiar graph massive weight loss. Then
Speaker 1: you hit a plateau and stabilize a much lower weight,
Speaker 1: which is a good thing. That's what you'd want. Obviously,
Speaker 1: people just infinitely lost weight, they would die. So plateaus
Speaker 1: are much lower weight depending on what dos are on
Speaker 1: depends on the plateau, and then it continues at that
Speaker 1: lower weight, and then in the only long term study
Speaker 1: we have at the end, it very slightly ticks up again,
Speaker 1: obviously at a much lower level than it was.
Speaker 4: Yeah.
Speaker 1: Probably, if I had to guess, and I stress, this
Speaker 1: is a guess, I would stress again and we have
Speaker 1: to go back to bariatric surgery. If we look at
Speaker 1: what happens with bariatric surgery, people have bariatric surgery, they
Speaker 1: lose staggering amounts of weight, They retain that lower weight
Speaker 1: for a few years, and then their weight goes slightly
Speaker 1: up again and stabilizes again at a slightly higher level,
Speaker 1: which is much much lower than where they began. If
Speaker 1: you made me guess, I think that's.
Speaker 4: Probably where it is.
Speaker 1: There are lots of ways in which the benefits and
Speaker 1: risks of these drugs seem to game out in a
Speaker 1: similar way to baractry. Surery both the benefits. Obviously we
Speaker 1: talked about the benefits from reversing obesity or reducing it,
Speaker 1: but also some of the risks we were talking about,
Speaker 1: you know, depression and so on. So if you have
Speaker 1: biometric surgery, your suicide risk almost quadruples.
Speaker 4: Wow.
Speaker 1: Now it's still though, most people in barratric surgery are
Speaker 1: glad they did it. And some of that maybe because
Speaker 1: of the grueling physical effects of the surgery, but I
Speaker 1: suspect it's because of what we were talking about, right,
Speaker 1: also other people who worked on barratric surgery, And this
Speaker 1: will be true for the drugs as well. I think
Speaker 1: say some of it will be people who've said all
Speaker 1: their lives, you know, if only I wasn't fat, my
Speaker 1: life would be great, I'd be happy. And then they
Speaker 1: lose the weight, but their husband's still an asshole and
Speaker 1: they've still got a job they hate, and they realize, oh,
Speaker 1: this was not the magic solution we wanted it to be,
Speaker 1: and a way they think about it was solutions. React
Speaker 1: to the title is the book is called magic pill,
Speaker 1: And some people think that's like a lauding of the drugs.
Speaker 1: But for me, there's three ways in which these drugs
Speaker 1: could be a magic pill.
Speaker 4: Right.
Speaker 1: The first is the most obvious. They could just solve
Speaker 1: the problem right, so rapidly and so swiftly and so
Speaker 1: effectively that it feels life magic. And there are days
Speaker 1: where it feels like that, well, my whole life, I
Speaker 1: craved this shitty food, and then once this week I
Speaker 1: do a little pinprick into my leg and it's gone.
Speaker 1: Like there are days when I think that. The second
Speaker 1: way in which it could be magic is it could
Speaker 1: be a magic trick.
Speaker 4: Right. It could appear to give you.
Speaker 1: These benefits but actually pick you over in some other way,
Speaker 1: like a conjurer that you know shows you a can't trick.
Speaker 4: But picture pocket.
Speaker 1: I would run out the companies are not deliberately conning us,
Speaker 1: but I wouldn't rule out that there's some disastrous side
Speaker 1: effect that will outweigh the benefits. There's a real risk
Speaker 1: of that. The third way to be honest, I think
Speaker 1: is the most likely. If you think about all the
Speaker 1: classic tales about magic, like a Laddin or Fantasia. You
Speaker 1: get your wish, but it plays out in a way
Speaker 1: you didn't imagine. You make a wish with the genie
Speaker 1: and he grants your wish, but it's not quite how
Speaker 1: you thought he would at the start. Or in Fantasia,
Speaker 1: the magic runs away from you, right, it creates all
Speaker 1: these effects that you can't control. I suspect these are
Speaker 1: going to be magic in that sense. Right, There are
Speaker 1: all sorts of unpredictable effects. We can begin to see.
Speaker 1: There's going to be a huge rise in people with
Speaker 1: eating disorders dying. I think that's practically baked in. I
Speaker 1: know that, which is catastrophic. There are huge numbers of
Speaker 1: people we know who want to starve themselves. In fact,
Speaker 1: going into the pandemic, eating disorders.
Speaker 4: Were very high.
Speaker 1: Then they massively rose during the pandemic. I'm really worried
Speaker 1: about that. There are things we can do to reduce
Speaker 1: that risk that I can talk about. There's things like that.
Speaker 1: There's a whole array of risks, and it's very striking
Speaker 1: to me. Buckley's Bank a very sober minded financial institution
Speaker 1: commissioned a very sober minded financial analyst called Emily Field,
Speaker 1: to just look into these drugs to game out how
Speaker 1: it's going to affect long term investing decisions. And she
Speaker 1: came back and said, if you want the best comparison,
Speaker 1: it's the invention of the smartphone that this will just
Speaker 1: have all speaking now, this will have all sorts of
Speaker 1: enormous and unpredictable effects on the society. If we've been
Speaker 1: sitting here in two thousand and seven, the day Steve
Speaker 1: Jobs unveils the iPhone, we would not have been able
Speaker 1: to predict TikTok and Trump and you know a million
Speaker 1: other things that have transformed delivery, all the things that
Speaker 1: have transformed Uber eats, door Dash, all these things that
Speaker 1: have transformed how we live. They were only just at
Speaker 1: the beginning of seeing how these drugs are gonna explode
Speaker 1: like a bomb over us. And there was a moment
Speaker 1: I remember was inter being one of the experts at
Speaker 1: Cambridge University and we were sitting in a cafe and
Speaker 1: she's explaining these extraordinary effects to me, and there's people
Speaker 1: just walking past the cafe, and you know it's Britain.
Speaker 1: A's the normal distribution of body weight in Britain, which is,
Speaker 1: you know, not quite as severe as here in the
Speaker 1: United States, but we're the most obese country in Europe
Speaker 1: by quite a long way. And I'm seeing lots of
Speaker 1: overweight and obese people. As I was at the time
Speaker 1: walking past, we were thinking, oh, wow, you don't know
Speaker 1: what's coming. You don't know what's about to hit us,
Speaker 1: right right.
Speaker 4: It was a very strange feeling.
Speaker 3: Yeah, I love that comparison to magic, And you know,
Speaker 3: I do think that that makes sense, right, that obesity
Speaker 3: is a huge health risk, right, and there are a
Speaker 3: lot of emotions that come with it. But dramatically reducing
Speaker 3: your propensity to in the future get cancer or in
Speaker 3: the future have a heart attack doesn't immediately change the
Speaker 3: quality of your life right here, you know. And so
Speaker 3: I think it makes sense, like with the bariatric surgery,
Speaker 3: that you may get to the other side of that
Speaker 3: and go oh. And I think there's a similar effect
Speaker 3: in recovery too. There's a pink cloud, you know, some
Speaker 3: people have, which says you stop doing drugs and all
Speaker 3: of a sudden, lots of pretty big problems in your
Speaker 3: life go away. I no longer was looking at going
Speaker 3: to jail for twenty five years, that's pretty.
Speaker 4: Good, right.
Speaker 3: I no longer weighed one hundred pounds, I was no
Speaker 3: longer homeless. Things got really better, right, and then life
Speaker 3: is life, right, and life becomes challenging, and you start
Speaker 3: to face the challenges that everybody faces in life. And
Speaker 3: you kind of come off that pink cloud, and it
Speaker 3: sounds like there's something similar you're describing here.
Speaker 1: Yeah, and the reason to do it, especially you said
Speaker 1: at the stop your question about the health risks, I'm
Speaker 1: really embarrassed to emit. This The most shocking bit of
Speaker 1: all the research I did for the book was looking
Speaker 1: at the scientific evidence of what obesity actually does to you.
Speaker 1: So I think about diabetes, right, I guessed that I've
Speaker 1: known since I was ten years old that if you're abese,
Speaker 1: you're more likely to get diabetes. In fact, it's much
Speaker 1: more likely. If you're abeste when you're eighteen, your chances
Speaker 1: of developing diabetes in your life are seventy percent. It's
Speaker 1: extremely high, much more likely than not. But I thought, okay,
Speaker 1: diabetes if you live in a country where you've got
Speaker 1: a good healthcare system. Admittedly, this is not one of them.
Speaker 1: But if you live in a country that's got a
Speaker 1: good healthcare system and you get access to insulin, then
Speaker 1: basically your life is like mine. Right, You're like everyone else.
Speaker 1: You just you have to take a drugon but then
Speaker 1: you're okay. That is not the case at all. I mean,
Speaker 1: diabetes knocks fifteen years off your life. It causes horrendous complications.
Speaker 1: It's the biggest cause of blindness, preventable cause of blindness.
Speaker 1: I mean more people have to have a limb or
Speaker 1: extremity amputated in this country every year because of diabetes
Speaker 1: than because of being shot. Right, this is are really serious.
Speaker 1: It's such a serious healthcare condition in terms of your
Speaker 1: life expectancy, in your quality of life that one of
Speaker 1: the most well known doctors in Britain, DTR Max Pemberton,
Speaker 1: said to me, if you gave me a choice between
Speaker 1: being hi BE positive and being diabetic, purely on medical grounds,
Speaker 1: I would choose to be HIV positive because if you're
Speaker 1: HIV positive and you get treatment, you live as long
Speaker 1: as everyone else. If you're diabetic, even with the best treatment,
Speaker 1: you know, it has devastating effects on your body and
Speaker 1: your life expectancy and all sorts of and just your
Speaker 1: quality of life. And I thought, and that's just one
Speaker 1: of just an extraordinary ray of factors. So sometimes when
Speaker 1: you talk about the I did interview the other day
Speaker 1: where I was talking about the risks of these drugs.
Speaker 4: Right.
Speaker 1: The interview went very heavily on the risks of these drugs.
Speaker 1: And I take those risks very very seriously, and I'm.
Speaker 4: Very worried about them.
Speaker 1: And it is plausible. I don't think it's the most
Speaker 1: likely scenario, but it is plausible the twenty years from now,
Speaker 1: someone will find my book and go, Wow, all the
Speaker 1: bad stuff turned out to be right, and the good stuff,
Speaker 1: you know, and massively outweigh the good stuff. So when
Speaker 1: people just look at the bad side, the downsides of
Speaker 1: the drugs, it's very tempting to go, well, why would
Speaker 1: anyone take these drugs? And then you've got to go, well,
Speaker 1: if you've tried dieting and it really hasn't worked, And
Speaker 1: the vast majority of overweight people have tried dieting, seventeen
Speaker 1: percent of people in this country or on a diet
Speaker 1: at any given time, and I don't know an obese
Speaker 1: person who hasn't dieted a lot. If you've tried that
Speaker 1: and it hasn't worked, and the alternative is obesity. There's
Speaker 1: a brilliant expert called Dr Shana Levy at Tulaneticol of
Speaker 1: Medicine in New Orleans said to me, you know, we
Speaker 1: don't know the long term risk of these drugs, but
Speaker 1: we do know the long term risks of obesity. And
Speaker 1: this is me speaking now, not to Levy, but they
Speaker 1: would have to be really bad to outweigh the long
Speaker 1: term risk of obesity. And I'm conscious that would be
Speaker 1: people hearing that, for whom that's very painful thing to hear.
Speaker 1: It's an extremely painful thing. It was extremely painful thing
Speaker 1: for me to Partly lots of the people I love
Speaker 1: are obese, partly because my obesity was intimately tied to
Speaker 1: things that soothed and comforted me.
Speaker 4: Partly because they will have heard some.
Speaker 1: Arguments that claim that obesity is not bad for you,
Speaker 1: and I, with an open mind, investigated those claims and
Speaker 1: I'm afraid they're not true. The evidence that obesity harm health,
Speaker 1: it's one of the most solid scientific findings in the
Speaker 1: whole of medical science. Is as certain as that smoking
Speaker 1: causes lung cancer. Now, of course there are exceptions. My
Speaker 1: mother smokes seventy cigarettes a day. She's alive, and well
Speaker 1: she's seventy eight.
Speaker 3: Right.
Speaker 1: There's a photograph of me and my mother when I'm
Speaker 1: six months old. She's breastfeeding me, smoking me and resting
Speaker 1: the ashtray on my stomach.
Speaker 4: Right.
Speaker 1: When I found that photo and showed it to her,
Speaker 1: she said to you were a difficult berb. I needed
Speaker 1: that con cigarette.
Speaker 3: Right, So of course there are exceptions.
Speaker 1: But we don't judge science by outliers. We judge it
Speaker 1: by average effects. And unfortunately the average effects. There was
Speaker 1: one study, big study that was done in Britain at
Speaker 1: UCL University College London, followed twenty five hundred government bureaucrats
Speaker 1: over a long period of time, more than twenty years,
Speaker 1: and found that if you were obese, you were eight
Speaker 1: times more likely to become unwell over that period than
Speaker 1: people who were not obese. So it's a really significant effect.
Speaker 1: That doesn't mean anyone. Of course, we need to passionately
Speaker 1: oppose people being shamed for it. It's not their fault
Speaker 1: that someone who's thought is it's the process of an industry.
Speaker 3: Like I said, get to talk about but they fucking.
Speaker 1: Did this to us right, And there's definitely people who
Speaker 1: deserve to be the recipient of our anger. And it's
Speaker 1: not individual people like me who were overweight.
Speaker 4: It's them.
Speaker 1: But I do think you know, we know this because
Speaker 1: we spent so much time in the addiction world. It's
Speaker 1: not love to not level with people about what's really
Speaker 1: going on. It's not love to pretend something that's a
Speaker 1: problem isn't a problem. You might get some temporary psychological
Speaker 1: relief from that, but we all know the case for
Speaker 1: hearing bad news, the bill that you can't pay, the
Speaker 1: letter from the doctor that might be news that you
Speaker 1: can't bear to hear. We all feel the impulse to
Speaker 1: not open those letters, and most of us open them
Speaker 1: because we know we're better off knowing the truth, even
Speaker 1: if it's a very painful truth. And especially now, if
Speaker 1: we're in a trap, and I believe we are, there
Speaker 1: is at least something of a trap door. It's a
Speaker 1: risky trap door, and in the longer term, there are
Speaker 1: definitely solutions to this. I went to countries that have
Speaker 1: massively reduced their amount of obesity. I went to Japan,
Speaker 1: where they never had an ob city crisis because they
Speaker 1: made big social changes that we can introduce if we
Speaker 1: want to and talk about how we can do that,
Speaker 1: and that's the thing we absolutely need to fight for
Speaker 1: in the longer term. But we've got to be honest
Speaker 1: about this because the stakes are really high here. Whether
Speaker 1: we get this right on these drugs and on obesity
Speaker 1: more generally, will determine whether millions of people live or die.
Speaker 1: We can't go into this trivially. We can't go into
Speaker 1: this denying scientific evidence. We've got to go in with
Speaker 1: an open minded, open hearted engagement with the evidence, and
Speaker 1: we've got to really reckon with it in all its
Speaker 1: ambiguity and complexity and the painful truths that it contains.
Speaker 3: I think that's great. So listener in thinking about all
Speaker 3: of that and the other great wisdom from today's episode.
Speaker 3: If you are going to isolate just one top insight
Speaker 3: or thing to do that you're taking away, what would
Speaker 3: it be. Remember that, little by little, a little becomes
Speaker 3: a lot, and a habit for me that has accrude
Speaker 3: and benefit over time is meditation. However, one of the
Speaker 3: things that gets in our way of building a steady
Speaker 3: meditation practice is that very striving right. Of course, we're
Speaker 3: doing it because we want certain benefits, but in the
Speaker 3: moment of actually meditating, we need to let striving go
Speaker 3: and focus on just being there and experiencing it. No
Speaker 3: matter what's happening. It becomes not enjoyable because I'm trying
Speaker 3: to make something happen some special moment. We want to
Speaker 3: let go of that. So if you want to stop
Speaker 3: dreading meditation and actually find it enjoyable, check out my
Speaker 3: free meditation guide at goodwolf dot me slash calm. I
Speaker 3: think that's what you did do, is you really took
Speaker 3: an open hearted, open minded look at all these things.
Speaker 3: It's a really great book. I think I recommend it
Speaker 3: to everybody, and it's always such a pleasure to have.
Speaker 4: You at Oh, it's totally my pleasure.
Speaker 1: We did this face to face too, And I meant
Speaker 1: to say my publisher's tasing me that anyone wants to
Speaker 1: know where to get the audiobook, the ebook, or the
Speaker 1: physical book, you can go to magic pillbook dot com.
Speaker 1: I'm also meant to say you can get it from
Speaker 1: all good bookstores, but I always want to say you
Speaker 1: can get it from shitty bookstores as well.
Speaker 3: We don't have a quality test store these days. Any
Speaker 3: probably a good one, thank you jeez.
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