Understanding the Truth About Obesity and Weight Loss Drugs with Johann Hari

In this episode, Johann Hari explores the complexities of obesity and weight loss drugs. He dives into the seemingly simple relationship between our food choices and innate biological responses. Reflecting on his upbringing, shaped by a diet of processed and junk food, Johann’s journey is intertwined with scientific revelations. His research and personal experience offers a thought-provoking narrative on the impact of modern diets on our bodies and minds.

In this episode, you will be able to:

• Understand the long-term impact of weight loss drugs on your health and well-being
• Explore the health risks associated with obesity and effective management strategies
• Uncover the role of GLP-1 receptor in appetite regulation and weight management
• Embrace body positivity and learn how to combat the stigma surrounding obesity
• Compare the pros and cons of bariatric surgery and weight loss drugs for effective weight management

To learn more, click here!

See omnystudio.com/listener for privacy information.

Episode Transcript

Speaker 1 (00:00):
It's not the individuals ful. We need to release them

(00:02):
from shame while also having an honest conversation. We can't
talk honestly about the risk and benefits of these drugs
if we don't stop by talking about Unfortunately, there are
really significant risks continuing to be ibes.

Speaker 2 (00:17):
Wow, welcome to the one you feed. Throughout time, great
thinkers have recognized the importance of the thoughts we have.
Quotes like garbage in, garbage out, or you are what
you think, ring true, and yet for many of us,
our thoughts don't strengthen or empower us. We tend toward negativity,

(00:39):
self pity, jealousy, or fear. We see what we don't
have instead of what we do. We think things that
hold us back and dampen our spirit. But it's not
just about thinking. Our actions matter. It takes conscious, consistent
and creative effort to make a life worth living. This
podcast is about how other people keep themselves moving in

(01:00):
the right direction, how they feed their good wolf. Thanks
for joining us. Our guest on this episode is one

(01:20):
of our favorites, Johann Harry. He's a writer journalist and
has written for New York Times, Lamonde, The Guardian, and
other newspapers. His TED talks have been viewed tens of
millions of times. Johann's work has been praised by a
broad range of people, from Oprah Winfrey to Noam Chomsky
and Joe Rogan. Today, Johanna and Eric discuss his new

(01:41):
book Magic Pill, The Extraordinary Benefits and disturbing Risks of
the new weight loss Drugs.

Speaker 3 (01:47):
Hi, Johann, Welcome to the show.

Speaker 1 (01:49):
I'm so happy to be here and this is week
because we're in my neighborhood, right. I used to live
just a couple of blocks away from here, so it's
slightly surreal to see you in the flash. We've done
so many interviews. I didn't realize you exist in poor
real form. Is indeed, I do very impressive. We're in
New York City and we're gonna be discussing your book,
magic Pill, the extraordinary benefits and disturbing risks of the

(02:10):
new weight loss drugs. I think that for this episode
and one episode only, we should rename your podcast the
one you don't feed Yes Drugs.

Speaker 3 (02:19):
But we will do the parable to start like we
always do, so you know it by now. But there's
a grandparent who's talking with a grandchild and they say,
in life, there's two wolves inside of us that are
always at battle. One's a good wolf, which represents things
like kindness and bravery and love, and the other's a
bad wolf, which represents things like greed and hatred and fear.

(02:39):
And the grandchild stops. They think about it for a second.
They look up at their grandparent and they say, well,
which one wins? And the grandparent says, the one you feed.
So I'd like to start off by asking you what
does that parable mean to you now? After writing this book?

Speaker 1 (02:54):
You know, I was thinking about it on the way here.
Make me think about a whole area of science that
I learned about for the book that really haunted me
because for a long time when I was researching the book,
I thought I was looking at two quite different questions.
So I started by looking at why did ob City
blow up so rapidly that we've reached the point where
forty seven percent of Americans say they want to take

(03:16):
the new weight loss drugs?

Speaker 4 (03:17):
What happened?

Speaker 1 (03:18):
Because this is unprecedented in human history. This, You know,
I think we're probably about the same age.

Speaker 4 (03:22):
How old are you? Eric?

Speaker 3 (03:23):
Fifty two?

Speaker 1 (03:24):
I was just slightly older than me, but in our lifetime.
So I was born in nineteen seventy nine. Between the
year I was born and the year I turned twenty one,
B city doubled here in the United States, more than
trebled in Britain, where I'm from, And in the next
twenty years, severo B city doubled again. So about in
the entire world, according to the World Health Organization, i'd

(03:44):
B city trebled. This has never happened in the holy
human history. Look at a picture of just an ordinary
beach in Atlantic City or wherever anywhere in the world.
In nineteen seventy everyone is what we would call slim,
right literally everyone. It's very strange at it. So first
I thought I was looking at why do we become obese?
And then separately, what do these new weight loss drugs do?

Speaker 4 (04:06):
Right? How do they work? One of the benefits and risks?

Speaker 1 (04:10):
But then I actually learned that there's a word that
kept coming up in both conversations with the scientists, and
that word is satiety. So it's not a word we
use that often in every day English, but we know
what being sated is, right, It's when you feel like
you've had enough, you don't want any more. Thanksgiving dinner,
you feel stuffed, you don't want anymore. You're sated, right,
that's actually even beyond being sated, that's when you're stuffed.

(04:31):
And I was thinking about your paraboy in relation to
one really disturbing bit of science that I learned. So
I was raised my mother and my grandmother were kind
of working class Scottish women, and they fed me basically
nothing but processed and junk food, right, And this was
an act of love on their part. They liked this food.
They wanted me to have it, and it was a
gift to themselves because they were exhausted, extremely hard working women.

(04:54):
And the day we got a microwave was the happiest
day of my grandmother's life. She's like, it's cooking, but
you don't have to do anything right. And what we
now know was a huge amount of science has shown
that we're eating in a way that destroys our ability
to get a sense of satiety or profoundly undermines it.
And I thought about your peril because in relationship experiment
that happened here in New York. So it's a brilliant
scientist called Professor Paul Kenny. He's the head of neuroscience

(05:16):
at Mount Sinai and not so far from where we
are now. And he grew up in Ireland and he
grew up eating the kind of food Irish people ate
at the time in the seventies and eighties, and then
he moved to San Diego to continue as neuroscientific research
and quickly discovered that Americans do not eat like Irish
people did at the time. They eat a lot more
processed food, a lot more ultra processed food, a lot
more junk food, a lot more sugar and salt and fat.

(05:39):
And like any good immigrant, he assimilated pretty quickly and
within a year he'd gained thirty pounds and he felt
like this different American diet was in some ways changing
his brain, changing what he wanted, changing his desires, obviously
changing his body. So he designed an experiment to test this,
which I have nicknamed Cheesecake Park. That's not his official name.

(06:00):
So he got a lout of rats and he raised
them in a cage, and for the first part of
their life they've got nothing but access to the kind
of healthy, non processed food that they evolved eating for
thousands of years. So it's palettes, but they're pellets based
on the kind of food they bold to have, and
when they have the kind of food that they've eaten
for thousands of years, even though the rats had loads
of these pellets, they could.

Speaker 4 (06:21):
Have eaten a huge amount.

Speaker 1 (06:23):
They would eat enough until they felt sated, you know,
to deal with their basic hunger, and then they stopped eating.
So they never made themselves obese, they never made themselves overweight.
Given the kind of food they evolved to have, they
had a kind of natural nutritional wisdom, and they stopped.
Then Professor Kenny introduced them to the American diet. He
gave them a load of cheesecake. He fied up some bacon,

(06:44):
He gave them a load of Snickers bars, and they
went wild for it. He put down the cheesecake, and
the rats would hurl themselves into it and eat their
way out and emerge just going slicked with this cheesecake
all over their whiskers, and very quickly the nutritional whist
that they had when they had the kind of food
they avolved to eat, just disappeared and they gorged themselves.

(07:05):
The way Professor Kenny put it to me, it's within
a few days they were different animals, right, they were
physically different, and they were psychologically different, and they ate
and ate and ate and ate, and quite rapidly they
were severely obese. Then Professor Kenny tweaked the experiment again
in a way it seems a bit cruel to me
as a former junk foo addict.

Speaker 4 (07:24):
He took away all this.

Speaker 1 (07:25):
American food and just gave them back the healthy food
they'd grown up with. And he was sure he knew
what would happen if the war happened, is they will
eat more of the healthy food than they ate in
the past, and this will prove that junk food and
process food expands your palate, expands the amount of calories
you eat, and makes you want more. That's not what happened.
What happened was much weirder. Once they'd had the American

(07:46):
diet and they had it taken away, they refused to
eat any of the healthy food at all. It was
like they no longer recognized it as food at all.
They shunned it and they chose to starve rather than
eat it. And it was only when they were really
starving that they eventually went back and started eating it again.
And I think this show is obviously in a very
the one you feed my God, what could be a

(08:07):
more direct experiment than that, right, as Gerald manned, who's
one of the leading experts at Harvard on this, he
designed the nutritional labels or food in this country. As
he said to me, there's something about the food we're
eating that is profoundly undermining our ability to know when
to stop. And what these drugs do, with some cost,
is they give you back your sense of satiety. They

(08:28):
boost the parts of your biology in your gut, particularly
in your brain, that make you feel full again. So,
as one scientist, professor Michael Lowe, put it to me,
they're an artificial solution to an artificial problem. Right, So
we fed ourselves with something that undermines our sense of satiety.
It's caused a huge crisis in obesity. And now you know,
forty seven percent of us want to take these drugs

(08:48):
that artificially give us back that sense of society. It obviously
leaves us with all sorts of practical and philosophical dilemmas.

Speaker 3 (08:54):
Right, yeah, yeah, that makes a lot of sense to me. Listener,
while you were listening to that, resonated with you, what
one thing to feed your good Wolf comes to mind.
If the thing that came to your mind was more
time for stillness, or you've tried meditation before and you
really haven't liked it, then I want to give you
a quick tip that might make it better for you.

(09:15):
And it's simply to stop expecting that you're not going
to have thoughts. Nearly everyone has this expectation that they're
going to sit down and meditate and they're going to
stop having thoughts. And when they stop having thoughts, that
means they're doing it well. But no one does that,
and so we end up feeling like we're failing all
of the time. Every three seconds, failed again, failed again.

(09:37):
We develop a relationship with meditation that is aversive. So
if you want to stop dreading meditation and actually find
it relaxing, check out my free meditation guide at Goodwolf
dot me slash calm. In it, I walk you through
my process to engage with meditation in a new way,
and a lot of people have found it really helpful.
That's good Wolf dot me slash calm. That rat it seems,

(10:01):
I mean, poor rats. They go they really get put
through the ringer. But that's a different show. Rings true
to me in general, right, because I know that when
I'm eating a lot of sweets, and then I try
and stop eating sweets, it's really difficult for a little while,
and then it's almost as if something sort of resets

(10:21):
and settles down a little bit and it's not so bad.
But then if I eat them again, you know, And
I've often been like, well, that seems to lend credence
to the idea that you know, sugar is sort of addictive.
But I think that your book, to me, and you
illustrate it kind of right out of the gate, is
one of profound conflict, right. It's one where you are

(10:43):
recognizing and it's in the title the amazing benefits to
both perhaps individuals and society of these weight loss drugs,
things like ozepic and wagov Do I say that, right? Yeah,
And yet there's risks and as you said, you know,
an artificial solution to an artificial problem. And in the

(11:03):
end of the book you say, I've decided at least
for now, because the book is very much a personal
journey of you beginning to take these medicines. At the
end of the book you say I have decided for now.
Then it makes sense for me to continue to take
these I know that books get written and turned in
well in advance of publication, so I'm guessing that that
maybe was a year ago or so, that you might

(11:25):
have written much.

Speaker 4 (11:26):
More recent than be am. Oh, okay, that's a pretty
quick time, your.

Speaker 3 (11:28):
Books turning around really quick. Okay, all right, So is
that still a place you're at.

Speaker 1 (11:33):
I don't remember ever feeling so intensely conflicted about a
subject right from the start. So for people who don't know,
and some people who listen to this won't know, we
now have a new kind of weight loss drug working
in a completely new way, on a new kind of
mechanism that I can explain, that delivers extraordinary levels of
weight loss. The average person taking azempicle will go be

(11:53):
loses fifteen percent of their body weight within a year.
From Munjaro, which is the next generation of the same
class drug, the average person is just twenty one percent
of their body weight, and for the next one that
will come out next year, it's twenty four percent of
your body weight, which is only a little bit below
bariatric surgery.

Speaker 4 (12:09):
Staggering levels of weight loss.

Speaker 1 (12:11):
And when I first learned about these drugs, of course
immediately I thought. I learned about them just as I
was crossing a kind of psychologically strange threshold where I
was older than my grandfather ever got to be, because
he died of a heart attack when he was forty four.
A lot of the men in my family on both
sides have heart problems. My dad had to have major surgery,
my uncle died of a heart attack, my other unquie
to have major surgery. And I knew the scientific evidence

(12:33):
is overwhelming that obesity makes you much more likely to
have a very broad range of health problems, one of
which is the heart problems, but have extremely broad, over
two hundred complications and diseases, and made much more likely
by obesity. And we know that when you can reduce
or reverse obesity, which is very hard to do, but
where you can do it, you largely reverse those diseasries.
So of course I could immediately see the benefits, right,

(12:54):
But I immediately thought just so many things. Well, we've
seen this story before. There's been loads of weight loss
drugs in the part, but pretty much every twenty years,
going back to the First World War, there's a new
miracle weight loss drug announced. They say it's you know,
solution to obesity, loads of people take it, then it
causes some horrendous side effect and has to be withdrawn

(13:15):
from the market, leaving a trail of terribly damaged people
in its wake. So it's very conscious of that risk.
I also just thought, well, can there be really such
a thing as a free lunch or I guess in
this case, a smaller free lunch, right, Like, can you
really get such extraordinary benefits without incurring costs? I worried
about will this reverse some of the progress we've made
on body positivity? What will this do to people with

(13:36):
eating disorders? I had a whole kind of a array
of worries in my mind as well as excitement right
from the start. And it was a really weird experience
because I went all over the world for the book.
I went on this big journey from Rekievik in Iceland
to Minneapolis to Tokyo. I interviewed over one hundred of
the leading experts, the people who pioneered the drugs, their
biggest critics, everyone in between. And I know much more

(13:58):
now than I did at the start. A benefits and
the risks about the cultural effects, but the psychological effects
of these drugs. But to be honest with you, Eric,
this has never happened to me with any of the
books I've worked on before, all of which we've talked about. Weirdly, Yeah,
I'm as conflicted now as I was at the start.
I mean, maybe not quite as conflicted.

Speaker 4 (14:14):
But pretty close.

Speaker 1 (14:16):
Like, this is a really complex topic with really significant
benefits and really significant risks both individuals and the culture.
And I think what we have to do is really
way that complexity very very carefully, and it's not easy,
and the answers are not obvious. So what I hope
I've tried to do in the book is sort of
take people on the journey to think through the complexity

(14:38):
with me, rather than give answers which I can't give.

Speaker 3 (14:40):
Yeah, well, you do a great job of it. It's
a book that first glance I was like, I'm not
particularly interested, but it's you, right, And so I was like,
I love your books and I love read and I
was like, this is absolutely compelling. There's so many aspects
of this that are fascinating. But let's talk about the
heart of those conflicts. You know you talked about body positivity, right,

(15:01):
We've entered into a world where at least we are
trying to lessen the stigma around being obese, and we've
made some progress, and we have a long way to go.
And you take on something in the book that I
thought was really difficult to take on, and yet it
felt really important, and it was this idea of how
do we encourage body positivity and reduce the stigma around

(15:23):
being obese. We'll also be able to talk about the
very real health challenges that being obese bring. Walk me
through your thought process on sort of arriving where you
did with that.

Speaker 1 (15:36):
The worst moment in writing the book for me, Yeah,
by father, The worst was a moment it was maybe
six months into taking the drugs. I've got a niece
called Erin, and she's the baby in my family.

Speaker 4 (15:47):
She's the only girl.

Speaker 1 (15:48):
She's the youngest of all my nephews and my niece,
and in my head she's fixed as like a six
year old forever. She's actually nineteen now, but whenever she
has a boyfriend, I want to go get away from her.
Your pedophile And I'm like, oh no, she's such an
adult woman. And a little while in to taking the
drug I was facetiming with her and she was saying, oh,
you've lost so much weight, you know, I'd lost a
huge amount of weight by then, and I was sort

(16:09):
of preening. She said, I didn't know you had a
draw until now, kind of joking, and then I was
kind of preening and laughing. And then she looked down
and she said, well, you get me someho zen pic.
And she's a perfectly healthy way and always has been.
And I thought she was kidding, so I laughed, and
then suddenly I realized she was being serious, and I thought,
oh fuck, what am I doing here? Right all her life,
I've been trying to give her this message, you shouldn't

(16:30):
be valued on how you look. Don't internalize these images
about women only have value when they're thin. And I thought, shit,
have I just undone all that? And you went to
the tension there. With almost every topic related to these drugs,
there's a lot of complexity, and this is one of them.
And one of the people who really helped me to
think through this complexity is an amazing woman called Shelly Bovy. So,
when I was a kid, and when you were a kid,

(16:51):
it was just taken for granted on television that fat
people were like the butt of the joke, right they
were particularly fat women, but fat men as well were
there to be kind of laughed at, and the fact
they were fat was itself a joke, right. And the
first person I ever heard challenge this, and I remember
it quite vidly, is when I was ten years old.
So there was a one called Shelley Bowing and I
saw her on television. She was already the pioneer of
body positivity in Britain. She was the first person I

(17:13):
ever heard say, you know, this isn't right, this is
just a former prejudice and stigma. And I went to
see Shelley and she lives in the village in England.
Now had a really interesting day with her because so
she grew up in a working class town in Britain
called Port Talbot, and when she was a kid, she
was the only fat girl in her school. That's the
word she would have used, fat girl in her school.

(17:34):
And one day when she was eleven or twelve, her
teacher told her to stay behind after class. So she
stayed behind, thinking what have I done wrong? And the
teacher said to her, you are much too fat. It's disgusting,
it's wrong. Go to the school nurse. She'll sort you out. So,
feeling completely taken aback, Shelley went to the school nurse.
The school nurse said, why are you here. She said, well,
the teacher says, I'm too fat, and the school nurse said,

(17:54):
take off your cloes.

Speaker 4 (17:55):
I'm going to look at you. So she took off
her clothes and the school nurse.

Speaker 1 (17:58):
Said, she's right, too fat. You're going to die young.
It's disgusting. Stop being so greedy.

Speaker 4 (18:03):
Eat less.

Speaker 1 (18:04):
And Shelley kind of left feeling completely thrown and every
girl in the school, every other person around her, was
constantly giving her these messages, You're disgusting, you're revolting.

Speaker 4 (18:17):
She was really smart and.

Speaker 1 (18:18):
She was advised by her teachers to go to university
and she just couldn't do it. She thought she'd just
be fat shamed there. And as she got older, it
was just constant.

Speaker 4 (18:27):
You know.

Speaker 1 (18:27):
She went to a doctor when she was pregnant. First
thing the doctor said was so you shouldn't be pregnant
when you're your weight. After she gave birth, she had
quite a difficult birth. First thing that she's lying there
covered in blood and the midwife said, he, you know,
you really need to lose some weight. When her son
couldn't feed properly, wasn't attaching. She took him to the doctor.
The doctor said, what are you trying to do? Make
the baby as fat as you are? She got understand overweight,

(18:49):
when people, particularly overweight women, are constantly sucking up. Yeah,
forty five percent of women who have a BMI higher
than thirty five are insulted every single day. Well, and
she Lley really pioneered in Britain. Obviously there have been
some movement here in the US before that that inspired her.
Pioneered challenging this way talking and thinking, this is just
a form of bigotry. It's unacceptable, It's a form of

(19:10):
cruelty and bullying, and we need to fight back. She
wrote a very beautiful book arguing for this was a
big and important book in Britain in the late eighties,
which is when I saw her. And Shelley was very
proud of what she wrote and stands by every word
of it. But in the years that passed, something else
also happened to Shelley. She weighed, you know, more than
two hundred pounds and a doctor told her there was

(19:31):
problems with her heart because of her weight, and she
was losing the ability to walk. She took her kids
to a theme park one day, but like a kind
of British version of Disneyland, and she just couldn't walk anywhere,
and they found a wheelchair for her and her husband
could push the wheelchair beers. She'd become so large, and
Shelley was in this real dilemma. She passionately opposed stigma
and still does and always will, but could also see

(19:53):
that it's just a scientific fact that there are physical
harms caused by obesity. You're much more likely to become diabetic,
your knees and your joints more like to be ruined.

Speaker 4 (20:00):
I mean, you much more like to.

Speaker 1 (20:01):
Get cancer, dementia, heart disease. Is an extraordinarist and there
is no scientific debate about this among mainstream scientists, no
scientific debate. And Shelley was like, it's an act of
love for yourself and for people who are in this situation.
You have to be able to do two things. You
have to be able to oppose stigma, which is a
form of cruelty and hatred, and you have to be

(20:22):
able to have an honest conversation about the harms caused
by obesity to human health. We understand those mechanisms. We
know how they work, and it is not a form
of stigma to talk about the harms caused by health.
Of course, it can be done in a cruel and
stigmatizing a mean way, and we should oppose that. But
she said, you know what kind of body positivity would
it be that would lead to my body dying, which
is the path she was on. So in Shelley's case,

(20:44):
she lost a huge amount of weight through diet. She
was the first tepnoledge. That's extremely hard to do. The
vast majority of people who diet in clearly me it
doesn't work and they regain the weight. But in her
case she was able to reverse it and it massively well.
Her health problems largely went away. And we know this
is the case wherever you can reverse obesity with, for example,
at bariatric surgery. One of the best ways of trying

(21:07):
to figure out the benefits and harms caused by these
new weight loss drugs. It's not perfect, but one of
the best ways is to look at bariatric surgery because
that's actually up to now, that's the only other form
of medical intervention that's caused a huge amount of weight loss.
Now Baratory surgery is a horrible thing, right, It's a
really grueling operation. One in one thousand people die in
the operation.

Speaker 4 (21:26):
Dreadful. But the reason people take.

Speaker 1 (21:28):
That tremendous risk and go through such a grueling process
is because the benefits for health are so enormous. If
you have bariatric surgery in the seven years that follow
you are fifty six percent less likely to die of
a heart attack. You are sixty percent less likely to
die of cancer, you are ninety two percent less slightly
to die of diabetes related causes. In fact, the benefits

(21:49):
are so great you're forty percent less slightly to die
of any cause at all. And we now know that
increasingly the evidence is becoming clear that the benefits from
these new weight loss drugs are similar. If you start
with a BMI higher than twenty seven and you take
these drugs, you are twenty percent they're slightly to have
a heart attack or stroke in the next few years.
Obviously a topic very close to my own heart, literally

(22:09):
very close to my own heart. So the reason I've
given this monstrously long answer is because there's so much
complexity here, and there's so much pain, and there's so
much shame, and Shelley is the first person to stress
it is no individual's fault if they have become overweight
or obese. There are people to blame. It's the process, field, industry,
and the society that's failed to regulate them. But it's

(22:30):
not the individual's fault. We need to release them from
shame while also having an honest conversation. We can't talk
honestly about the risks and benefits of these drugs if
we don't start by talking about unfortunately, there are really
significant risks continuing to be obese.

Speaker 3 (23:12):
It makes me think a little bit about the journey
as a recovering drug addict, right, because there's this delicate
balance that kind of has to happen within the addict.

Speaker 4 (23:23):
Right.

Speaker 3 (23:23):
My experience is the stigma and the shame perpetuates the
using right. You talk about that pretty convincingly in the book.
The same thing with weight loss. Stigma makes people less
likely to lose weight.

Speaker 1 (23:36):
It's a catastrophic tool to promote change. A lot of
stigma is just cruelty, yeah, and fear. But some people
use stigma. I think we should take them at their words.
Some people think, while I'm stigmatizing this person, for their
own good to have benefit if she loses weight or
his benefit. But actually, there's lots of research on this
and the evidence is overwhelming. If you stigmatize people, they

(23:56):
are more likely to gain right, right, putlicause people will
comfort more Putlica's as Lindy West, a very beautiful writer
and a body positivity advocate. You can't take good care
of a thing you hate. If we make people hate
their bodies, that doesn't make them take better care of it, right.
And also some of other reasons is why it makes
people not want to exercise because they're feel humiliated.

Speaker 4 (24:16):
I mean, there's a whole range of reasons.

Speaker 1 (24:18):
So, yeah, stigma is a catastrophically not only a poor
tool for change, it's a counterproductive right tool for change.
It will make the problem worse for most people.

Speaker 3 (24:25):
Right, So stigma doesn't work to change, right, So as
an addict, you've got to lose that stigma. And yet
there does have to be very honest consequences or very
honest conversation about the consequences of your use. Right At least,
my experience was there was a way to do both
those things. There was a way to go you know what,
this isn't really my fault that I'm this way, right,

(24:47):
I need to take responsibility for it. It's not my fault.
But if I'm not willing to look clearheadedly at what
this is doing to my life and my health, I'm
also not motivated to get better. And so you know,
it's not exactly the same thing by any stretch. But
I think there's some parallels there that we can draw
from recovery. When recovery is done in a healthy and

(25:11):
life promoting way.

Speaker 1 (25:12):
That's really interesting. I think there's a lot of insight
in that. And I think it brings us to the
drugs because for me, it was such a strange experience
taking them of so I thought, I can't really honestly
write about this, but I don't take them. And also
I was very conscious of the heart risks in my family,
and I was quite a beast at the time. And
it's the weirdest thing. I started taking ozen pic and
never forget it. I woke up two days later, I

(25:33):
was lying in bed and I thought, oh, I feel
something really weird.

Speaker 4 (25:36):
What do I feel?

Speaker 1 (25:37):
And I couldn't locate the feeling and it took me
a good five minutes or so to realize, oh, I'm
not hungry. Every other day in my life I had
woken up feeling hungry, often ragingly hungry. Yep, I thought,
I'm not hungry at all. I was in London at
the time, I lived in London half the year, and
I went to this here we would call a diner,
just up the street from where I live, and I

(25:58):
went in and I ordered the same thing I order
every day, which was a kind of huge brown role
with loads of mayo and chicken in it.

Speaker 4 (26:06):
And I had like three mouthfalls. I didn't want anymore.
I felt full.

Speaker 1 (26:10):
I remember when I left Tatiana, the woman who runs
it shouting off to it.

Speaker 4 (26:13):
You okay, right.

Speaker 1 (26:14):
And then for lunch that day, next to my office
there's a Turkish restaurant and I went in. I ordered
the same thing I was ordered, which was a Mediterranean lamb. Again,
I had like three four mouthfalls. I just didn't want anymore.
It was like the kind of shutters had come down
on my appetite. Fcilater interviewed the scientists who play key
roles in the breakthroughs that led to the drug and

(26:34):
so if you ate now, Eric, if you had anything
after a little while your pancreas would release hormone produce
and release a hormone called GLP one, and GLP one
is just part of the natural signaling in your body,
saying Eric, you've had enough, stop eating, right, But the
natural signal for GLP one stays in your system for
a few minutes and then goes away, So you can

(26:54):
just kind of power through.

Speaker 4 (26:55):
It if you want to. A lot of people don't.
You can't.

Speaker 1 (26:57):
What these drugs do is they injected into you an
artificial copy of GLP one, but instead of being washed
away in a few minutes, it stays in your gut
and crucially in your brain for a whole week, right,
So instead of just lasting a few minutes, it lasts
a long time. Which is why when I go as
I literally did on the way to the studio here hurrying,
you know, I was thinking this chroc monsieur from prep,

(27:19):
you get that sensation of fullness very very rapidly. Now,
it was initially thought that effect was primarily on the gut. Increasingly,
from interviewing lots of neuroscientists who are at the cutting
edge of research on this, evidence is increasingly clear it's
primarily in your brain, which brings with it a whole
different set of benefits and risks that we can talk
about if you like. It was so strange to feel
such a dramatic transformation so rapidly as the result of

(27:42):
something so small. It was very disorientating.

Speaker 4 (27:46):
Yeah.

Speaker 3 (27:46):
Yeah, Well, I know some people who are taking these
drugs and they describe I think you talk about it
a little bit in the book too, that the noise
around food in their head sort of disappears to some degree,
that they felt like their life was always a lot
of noise up here about what am I going to eat?
When am I going to eat next, craving, wanting this,

(28:07):
wanting that, and then it's just been turned way way down.

Speaker 1 (28:10):
Did you notice people talk about the food and noise
thing weirdly? That wasn't actually mine. Okay, I did not
have a big issue around food noise. It's not that
I obsessively thought about food. For me, it was slightly different,
and it's a funny thing, and I want to stress
that I think I'm unusual in this respect. So one
of the big drawbacks to these drugs. I go through
a lot of the drawbacks in the book, and twelve
quite big risks. I think probably the biggest drawback for

(28:31):
most people is one that I didn't experience at all,
and I explained why most people experienced a profound loss
of pleasure in food. Some people say they don't enjoy
food at all, and some people say they enjoy food
much less. So for example, there's a brilliant British food
critic who writes for The Guardian who started taking a
Zmpic and just said, you know, he would go to
the finest restaurants in Paris and just nothing wasn't doing

(28:53):
anything for him.

Speaker 4 (28:53):
And this is a really big drawback. You know, people
who are.

Speaker 1 (28:56):
One of the scientists who designed the drugs has talked
about how a lot of people will just after a
few years because it's just not tenable to live like that.
I did not have that experience because I don't think
it's for a particularly good reason. One of the things
I realized, and it's related also to the food noise thing,
I think I grew up in a quite violent and
chaotic environment and it gives a lot of addiction in

(29:16):
my family. And I realized I've never been someone who
took a great deal of pleasure in tasting food. For
me one of the pleasures I took in food, By far,
the biggest pleasure I took in food was by stuffing myself.
Stuffing is where you deliberately eat beyond the point of fullness, right.
We all do it sometimes Thanksgiving whatever, and you feel
like the pressure outward on your stomach and upward on
your esophagus. And some people it's clearly a minority, but

(29:38):
some people get the sort of sense of calming or
relief from that feeling of stuffing. And I realized I
was definitely in that category. Once I started taking these drugs.
I could not stuff myself. You can't, I mean, you
would just throw up if you tried to do I
think you literally couldn't do it. I certainly am not
inclined to try because I think it would make me sick. Right,
And so for me, I had to eat much more
slowly than I ever had before. Going out to dinner

(30:00):
with a friend of mine and has saying it, so
it's been a bit we're going out to eat with
you because you eat so fast, but you don't ever
seem to really enjoying the.

Speaker 4 (30:05):
Food you eat.

Speaker 1 (30:06):
And now you do actually look like you're enjoying the
food you eat. It's actually much nicer to watch. So
for me, stress out a typical and I was starting
from a very low base. But I think for me
it actually increased the amount of pleasure I taking for it.

Speaker 3 (30:19):
I'm tasting it a bit more now, all right, Now,
let's pause for a quick good Wolf reminder, and this
one is on meditation. If while you're meditating your mind wanders,
you probably, like most people, treat that as a moment
of failure, like, ugh, my mind wandered again. But let's
flip that and instead treat that as a moment of
celebration because in that moment, your mind actually woke up

(30:43):
and you were mindful of the fact that your mind wandered.
So it's a win. So if we can flip that
right on its head and say, oh, good job, brain,
we actually make it more likely that a our brain
is going to do it more often because we're training it,
and b that we're going to enjoy it more secifically.
It's about how to make you not dread meditation so

(31:03):
much and actually find it relaxing. Check out my free
meditation guide at Goodwolf dot me slash calm. It's interesting
that someone I know who's taking these has reported that
as the week goes on, the effects seem to sort
of taper down, and so in the later part of
the week they start to enjoy food a little bit

(31:25):
more again, and then it comes time to take the thing.
But the point I was making around the food noise
is that again tying it sort of the idea of addiction, right,
is that one of the good things about addiction is
that for most people I know who are able to
achieve abstinence is that if you do that long enough,
eventually that craving just kind of goes away. And it's

(31:47):
really hard to function when that noise, the craving for
whatever it is you want is really that high. And
I think it's part of what speaks to what makes
food so difficult for people, right, that that doesn't necessarily
in a lot of people go away without the help
of these medicines.

Speaker 1 (32:07):
Well, I think there's another parallel addiction, which were curious
what you think about, Eric, So, I had this weird
thing that happened to me when I was taking them.
You know, I remember I had I've got a friend
called Danielle who was pregnant at the time, and every
time I saw her. It was like we were on
reverse trajectories, right. She was getting bigger and I was shrinking.
And I remember one day running into her and I
was getting what I wanted. I was losing huge amounts

(32:28):
of weight, all sorts of nice benefits, not just to
my health, like my neighbor's hot gardener hit on me.
Like I remember one morning just thinking I'm getting what
I want. Why don't I feel good?

Speaker 3 (32:39):
Yeah?

Speaker 1 (32:40):
Actually, I don't want to overstate this, but I wasn't depressed,
but if anything, I felt like my emotions were a
little bit more muted.

Speaker 4 (32:46):
Yep. And there's a big debate about why.

Speaker 1 (32:49):
So I want to stress the majority of people taking
the drugs on not experiencing this, and there's a scientific
debate about it, but the FDA does have a suicide
warning on these drugs here in the United States. European
Medicine Agency was not persuaded by that risk. But there
is a debate about is this causing depression in some
people or indeed even suicide in some people. It's an
ongoing scientific debate, but it's plausible enough that there was
a safety signal raised and that the FDA has this

(33:11):
has this warning and of course, if it's causing that
effect on some people, it's plausible that it could be
causing muted feelings or somewhat lowered emotional affect in other people.
And I wondered, why would that be, And some people
arguing maybe literal brain effects, and we can talk about them,
because I talk about them a lot in the book,
but I suspect for me it was a different thing.
So again, maybe six or seven months, maybe a little

(33:31):
bit more into taking the drugs, I was in Vegas.

Speaker 4 (33:34):
I spent a lot of time in Vegas.

Speaker 1 (33:34):
Can write a book about a series of crimes that
are happening there, a non fiction book I've been researching
for a thousand years.

Speaker 4 (33:40):
I will have to eventually write it.

Speaker 1 (33:41):
And that day I was investigating the murder of someone
that I knew and I loved, and I've been I
was looking into it in a great detail, and as
you can imagine, it's not a pleasant thing to do.

Speaker 4 (33:50):
It's a tough day.

Speaker 1 (33:51):
And on auto pilot, I went to the KFC on
where Sahara and I did what I would have done
a year before.

Speaker 4 (33:56):
I went in.

Speaker 1 (33:56):
I ould a bucket of fried chicken, something I've done
a million times in my life. And I sat there
and I looked at this chicken and I think I
had one drumstick, and I thought, I can't eat this.
And I looked at Colonel Sanders who was on the wall,
and it was like he was looking down and me going, hey,
what happened to my best customer?

Speaker 4 (34:11):
Right?

Speaker 1 (34:12):
But I could eat it, and I suspect for me,
And I'm sure this dynamic is happening with lots of people.
That may not be the primary determinant of what we're
talking about. That's more contested. There's an enormous amount of
evidence for comfort eating. Right, Huge numbers of people company
after any shocking or surprising event, there's a massive spike
in fast food consumption. It's really an interesting study of

(34:32):
the NFL. If the home team wins, junk food sales
massively go down that week. If the home team loses,
junk food sales massively go up that week.

Speaker 2 (34:39):
Right.

Speaker 4 (34:40):
That's why comfort eating, there's a lot of evidence for it.

Speaker 1 (34:42):
Men lose their jobs, they're massive increase in comfort eating
in particular, and on these drugs, you cannot comfort eat.
And what I would say to people is people who
think you're taking these drugs. One of the things you
should be aware of, which I don't think is being
discussed very much, is for many people, the underlying psychological
drivers of your eating will come to the s. There
are lots of potential underlying psychological drivers of over reading,

(35:04):
not just comfort eating. I go through lots of them
in the book, and how they can emerge in this way.

Speaker 4 (35:09):
That's not necessarily a bad thing.

Speaker 1 (35:10):
I remember going to one of my friends when I
was really struggling with that after that day the KFC
and Wessahara and saying, you know, I think I should
stop taking these drugs.

Speaker 4 (35:18):
I want some fucking comfort food.

Speaker 1 (35:20):
And she said to me, look, you can stop if
you want, but you should know these drugs are not
causing this problem. This is a problem that was there
all along. What these drugs are doing is surfacing these problem,
which again is very familiar concept from addiction. One of
the great difficulties in stopping addiction, let's say, to heroin
or gambling or whatever, is that the underlying feelings that
were being numbed or suppressed or managed by these addictions

(35:42):
will come to the surfaces. Is a very familiar concept.
But yeah, so I was surprised when I started writing
about this by how many things there are given this
is one of the hottest topics.

Speaker 4 (35:51):
In the culture right now.

Speaker 1 (35:53):
How much about this is not being discussed. How much
of the effects, the concerns the cultural and not just
the first personal effects. I'm not really being talked about
the moment. So I'm surprised by how much there is
to bring to the surface here.

Speaker 3 (36:25):
I think that that point of whatever you're using as
a coping mechanism, when you take it away, you either
are going to do one of a number of different things, right,
You're just going to find another unhealthy coping mechanism, or
you're going to be forced into facing the thing that
is happening. And we see this with addiction all the time. Right,

(36:48):
you stop one thing and you pick up another.

Speaker 4 (36:50):
I think that's true.

Speaker 1 (36:50):
And this is one of the risks associations with drugs
ICHO through twelve ERSCS in the book, because some people
will be thinking, well, that's not going to play out
for me. So there were some real flashing red lights
for me. When you look at the safety of these drugs.
There's a very good argument put forward by the proponents
of these drugs. By the defenders of the drugs that
we should give a lot of weight to. So it's
so difficult to even talk about this that these always
like way or wait, by any way, you know what

(37:11):
I mean, we should give a lot of no nozenpiicy
weight too, which is they say, diabetics have been taking
these drugs for eighteen years on prescription for people who
don't know. In addition to having these effects on appetite,
these drugs also stimulate the creation and more insulin, which
of course is what diabetics need. So diabetics have been
taking these drugs for eighteen years, We've got a lot

(37:31):
of evidence on those diabetics. If it caused some catastrophic
short to medium term effect, we would know by Now
that's a really compelling argument and there's a lot of
truth in it. But some scientists have responded by saying, okay,
so let's look at the diabetics.

Speaker 4 (37:47):
Let's really dig into that.

Speaker 1 (37:48):
So, for example, there's a brilliant scientist called Professor Jean
luc Faye who's at the University Hospital in Montpellier, and
he was tasked by the French Medicines Agency to investigate
the safety of these drugs. So he started looking at them,
and he chose one issue in particular. We know if
you give these drugs to rats, their thyroid cancer risk
massively increases, which also has makes sort of intuitive sense.

(38:10):
In addition to having GLP one receptors in your gut
and in your brain, you also have them in your thyroid,
so you can see the some plausible mechanism there. So
France has very good medical databases. They don't have the
equivalent of HIPPA. It's really hard to opt out, so
you can do this research in France, so it's too
much harder to do here. What they did is they
looked at diabetics who've been taking these drugs for more

(38:32):
than three years between I think it was two thousand
and six and twenty sixteen, and they compared them to
comparable diabetics who'd not taken these drugs. And what Professor
Paie and his colleagues found is pretty sobering. If his
research is right, and there's a debate about it, these
drugs increase your thyroid cancer risk by between fifty and
seventy five percent. Now it's important to understand what that

(38:52):
doesn't mean, because when you first hear it, you're like
What it doesn't mean fifty to seventy five percent of
people who take it will get thorough cancer. Obviously, if
that was the case, they'd immediately pull it from market.
What it means is whatever your thyroid cancer risk was
going in, it will if this research is right again
stress it's contested, it will go up by between fifty
and seventy five percent.

Speaker 4 (39:11):
That's a big risk.

Speaker 1 (39:13):
Now, it's a big increase in a relatively small risk.
Only one point two percent of people get thyroid cancer
in their lifetime. Eighty four percent of them survive it. Nonetheless,
that's pretty sobering, right, and that's just one of the
many risks that are emerging now. Against that, the defenders
of the drug say, and you begin to see again
the ferocious complexity of this debate. They say, even if

(39:35):
that's true, and some of them dispute it. Even if
that's true, if the alternative is continuing to be obese, well,
being obese causes cancer for a lot of people, right.
In fact, it's one of the biggest causes of cancer.
Cancer research UK, the biggest British cancer charity, explains, if
you carry excess weight, it doesn't just sit there. It's
not inert. It's active. It sends signals to the rest

(39:56):
of your body, and one of the signals it sends
is for your cells to divide more rapid which can
cause cancer. Right, So every turn, when you feel like, oh,
that's really pulls you up short, you have to then
go okay, But then let's compare it to the alternative scenario.

Speaker 4 (40:10):
That's way. This very careful at each stage.

Speaker 1 (40:13):
It's like looking at a picture that's only slowly forming
and is very complicated. So I think every individual really
has to go through the benefits and risks for themselves
and think very deeply about it. And you know, maybe
you'll have thyro cans in your family, maybe you're thinking
of becoming pregnant. And one of the big risk is
we know these drugs cause birth deformities in rats. You
can't do experiments on humans in this in the same way.

(40:35):
So there's all sorts of things where you want to
game out as an individual, what's the risk here?

Speaker 4 (40:40):
Yep.

Speaker 3 (40:40):
So one of the things that people talk about with
these drugs very often is that once you're on them,
you have to remain on them to get benefit out
of them, and that if you stop taking them you know,
most people will see a return to weight loss gain.
Is that primarily because they will resume the behaviors that
they did before, or is there something else that's the

(41:04):
mechanism of action of causing that weight loss to stop.
Meaning if I stop taking them, my satiety cues will
go down, these other things will stop. I will suddenly
have the same relationship I had with food before. I
will begin to eat as much as I did. I
will gain the weight back. Is that the mechanism of
action or are they doing something else that makes it

(41:26):
more likely you'll gain the weight back?

Speaker 1 (41:29):
Well, no, you just regain the weight you had. I mean,
it's like blood pressure medication or statins. They work as
long as you take them, and when you stop taking them,
you don't get the benefits for your blood pressure or
cholesterol anymore. There's a debate about can you make changes
while you're taking them that would mean that when you stopped,
you would be able to sustain that benefit. As with
a million things related to these drugs, the honest answers

(41:49):
we don't know, yep, and itcdotally there are some people.

Speaker 4 (41:51):
Who are reporting that.

Speaker 1 (41:53):
I mean, even if you think about that more basic level,
we don't even know if people develop tolerance to these
drugs when they use them for abaicity, right, the longest
term studies we have, so people don't know when you
take a drug many drugs isn't the case, but often
your body gets used to the drug and the effect
sort of wears off over time. Think about the older
amfetamine based diet drugs. One of the reasons they were
such a disaster is because if you take amfetamins, you

(42:16):
lose loads of weight, but you develop tolerance to Anyone
who's been a recreational and fetamine user will know this.
You develop tolerance term fetamins over time, so you have
to take higher and higher doses to get the same effect.
And if you take very high doses of and fetamins
you develop psychosis. So probably not a price worth paying
to be thin. Psychotic but skinny not the best slogan,
not a great ad slogan, I don't think.

Speaker 4 (42:34):
So, we don't know.

Speaker 3 (42:37):
Skinny but psychoic Righty's just the order of words.

Speaker 4 (42:40):
R R.

Speaker 1 (42:40):
That's the way, that's the way exactly higher that guy
mak him work for no other orders. We know with diabetics,
they don't develop tolerance over time. They don't need high
and higher doses to get the same benefits from these
drugs controlling their blood sugar. But we don't know about weight.
So the longest term study of these drugs was I
think sixty two months espaily. If you look at the graph,
so it's a very familiar graph massive weight loss. Then

(43:04):
you hit a plateau and stabilize a much lower weight,
which is a good thing. That's what you'd want. Obviously,
people just infinitely lost weight, they would die. So plateaus
are much lower weight depending on what dos are on
depends on the plateau, and then it continues at that
lower weight, and then in the only long term study
we have at the end, it very slightly ticks up again,
obviously at a much lower level than it was.

Speaker 4 (43:24):
Yeah.

Speaker 1 (43:25):
Probably, if I had to guess, and I stress, this
is a guess, I would stress again and we have
to go back to bariatric surgery. If we look at
what happens with bariatric surgery, people have bariatric surgery, they
lose staggering amounts of weight, They retain that lower weight
for a few years, and then their weight goes slightly
up again and stabilizes again at a slightly higher level,
which is much much lower than where they began. If
you made me guess, I think that's.

Speaker 4 (43:45):
Probably where it is.

Speaker 1 (43:46):
There are lots of ways in which the benefits and
risks of these drugs seem to game out in a
similar way to baractry. Surery both the benefits. Obviously we
talked about the benefits from reversing obesity or reducing it,
but also some of the risks we were talking about,
you know, depression and so on. So if you have
biometric surgery, your suicide risk almost quadruples.

Speaker 4 (44:04):
Wow.

Speaker 1 (44:04):
Now it's still though, most people in barratric surgery are
glad they did it. And some of that maybe because
of the grueling physical effects of the surgery, but I
suspect it's because of what we were talking about, right,
also other people who worked on barratric surgery, And this
will be true for the drugs as well. I think
say some of it will be people who've said all
their lives, you know, if only I wasn't fat, my
life would be great, I'd be happy. And then they

(44:26):
lose the weight, but their husband's still an asshole and
they've still got a job they hate, and they realize, oh,
this was not the magic solution we wanted it to be,
and a way they think about it was solutions. React
to the title is the book is called magic pill,
And some people think that's like a lauding of the drugs.
But for me, there's three ways in which these drugs
could be a magic pill.

Speaker 4 (44:46):
Right.

Speaker 1 (44:47):
The first is the most obvious. They could just solve
the problem right, so rapidly and so swiftly and so
effectively that it feels life magic. And there are days
where it feels like that, well, my whole life, I
craved this shitty food, and then once this week I
do a little pinprick into my leg and it's gone.
Like there are days when I think that. The second
way in which it could be magic is it could

(45:07):
be a magic trick.

Speaker 4 (45:08):
Right. It could appear to give you.

Speaker 1 (45:10):
These benefits but actually pick you over in some other way,
like a conjurer that you know shows you a can't trick.

Speaker 4 (45:14):
But picture pocket.

Speaker 1 (45:15):
I would run out the companies are not deliberately conning us,
but I wouldn't rule out that there's some disastrous side
effect that will outweigh the benefits. There's a real risk
of that. The third way to be honest, I think
is the most likely. If you think about all the
classic tales about magic, like a Laddin or Fantasia. You
get your wish, but it plays out in a way
you didn't imagine. You make a wish with the genie

(45:35):
and he grants your wish, but it's not quite how
you thought he would at the start. Or in Fantasia,
the magic runs away from you, right, it creates all
these effects that you can't control. I suspect these are
going to be magic in that sense. Right, There are
all sorts of unpredictable effects. We can begin to see.
There's going to be a huge rise in people with

(45:56):
eating disorders dying. I think that's practically baked in. I
know that, which is catastrophic. There are huge numbers of
people we know who want to starve themselves. In fact,
going into the pandemic, eating disorders.

Speaker 4 (46:07):
Were very high.

Speaker 1 (46:07):
Then they massively rose during the pandemic. I'm really worried
about that. There are things we can do to reduce
that risk that I can talk about. There's things like that.
There's a whole array of risks, and it's very striking
to me. Buckley's Bank a very sober minded financial institution
commissioned a very sober minded financial analyst called Emily Field,
to just look into these drugs to game out how
it's going to affect long term investing decisions. And she

(46:30):
came back and said, if you want the best comparison,
it's the invention of the smartphone that this will just
have all speaking now, this will have all sorts of
enormous and unpredictable effects on the society. If we've been
sitting here in two thousand and seven, the day Steve
Jobs unveils the iPhone, we would not have been able
to predict TikTok and Trump and you know a million

(46:52):
other things that have transformed delivery, all the things that
have transformed Uber eats, door Dash, all these things that
have transformed how we live. They were only just at
the beginning of seeing how these drugs are gonna explode
like a bomb over us. And there was a moment
I remember was inter being one of the experts at
Cambridge University and we were sitting in a cafe and
she's explaining these extraordinary effects to me, and there's people

(47:16):
just walking past the cafe, and you know it's Britain.
A's the normal distribution of body weight in Britain, which is,
you know, not quite as severe as here in the
United States, but we're the most obese country in Europe
by quite a long way. And I'm seeing lots of
overweight and obese people. As I was at the time
walking past, we were thinking, oh, wow, you don't know
what's coming. You don't know what's about to hit us,

(47:38):
right right.

Speaker 4 (47:38):
It was a very strange feeling.

Speaker 3 (47:40):
Yeah, I love that comparison to magic, And you know,
I do think that that makes sense, right, that obesity
is a huge health risk, right, and there are a
lot of emotions that come with it. But dramatically reducing
your propensity to in the future get cancer or in
the future have a heart attack doesn't immediately change the

(48:01):
quality of your life right here, you know. And so
I think it makes sense, like with the bariatric surgery,
that you may get to the other side of that
and go oh. And I think there's a similar effect
in recovery too. There's a pink cloud, you know, some
people have, which says you stop doing drugs and all
of a sudden, lots of pretty big problems in your
life go away. I no longer was looking at going

(48:23):
to jail for twenty five years, that's pretty.

Speaker 4 (48:25):
Good, right.

Speaker 3 (48:26):
I no longer weighed one hundred pounds, I was no
longer homeless. Things got really better, right, and then life
is life, right, and life becomes challenging, and you start
to face the challenges that everybody faces in life. And
you kind of come off that pink cloud, and it
sounds like there's something similar you're describing here.

Speaker 1 (48:44):
Yeah, and the reason to do it, especially you said
at the stop your question about the health risks, I'm
really embarrassed to emit. This The most shocking bit of
all the research I did for the book was looking
at the scientific evidence of what obesity actually does to you.
So I think about diabetes, right, I guessed that I've
known since I was ten years old that if you're abese,
you're more likely to get diabetes. In fact, it's much

(49:06):
more likely. If you're abeste when you're eighteen, your chances
of developing diabetes in your life are seventy percent. It's
extremely high, much more likely than not. But I thought, okay,
diabetes if you live in a country where you've got
a good healthcare system. Admittedly, this is not one of them.
But if you live in a country that's got a
good healthcare system and you get access to insulin, then
basically your life is like mine. Right, You're like everyone else.

(49:27):
You just you have to take a drugon but then
you're okay. That is not the case at all. I mean,
diabetes knocks fifteen years off your life. It causes horrendous complications.
It's the biggest cause of blindness, preventable cause of blindness.
I mean more people have to have a limb or
extremity amputated in this country every year because of diabetes
than because of being shot. Right, this is are really serious.

(49:49):
It's such a serious healthcare condition in terms of your
life expectancy, in your quality of life that one of
the most well known doctors in Britain, DTR Max Pemberton,
said to me, if you gave me a choice between
being hi BE positive and being diabetic, purely on medical grounds,
I would choose to be HIV positive because if you're
HIV positive and you get treatment, you live as long
as everyone else. If you're diabetic, even with the best treatment,

(50:11):
you know, it has devastating effects on your body and
your life expectancy and all sorts of and just your
quality of life. And I thought, and that's just one
of just an extraordinary ray of factors. So sometimes when
you talk about the I did interview the other day
where I was talking about the risks of these drugs.

Speaker 4 (50:26):
Right.

Speaker 1 (50:26):
The interview went very heavily on the risks of these drugs.
And I take those risks very very seriously, and I'm.

Speaker 4 (50:33):
Very worried about them.

Speaker 1 (50:34):
And it is plausible. I don't think it's the most
likely scenario, but it is plausible the twenty years from now,
someone will find my book and go, Wow, all the
bad stuff turned out to be right, and the good stuff,
you know, and massively outweigh the good stuff. So when
people just look at the bad side, the downsides of
the drugs, it's very tempting to go, well, why would
anyone take these drugs? And then you've got to go, well,

(50:55):
if you've tried dieting and it really hasn't worked, And
the vast majority of overweight people have tried dieting, seventeen
percent of people in this country or on a diet
at any given time, and I don't know an obese
person who hasn't dieted a lot. If you've tried that
and it hasn't worked, and the alternative is obesity. There's
a brilliant expert called Dr Shana Levy at Tulaneticol of
Medicine in New Orleans said to me, you know, we

(51:17):
don't know the long term risk of these drugs, but
we do know the long term risks of obesity. And
this is me speaking now, not to Levy, but they
would have to be really bad to outweigh the long
term risk of obesity. And I'm conscious that would be
people hearing that, for whom that's very painful thing to hear.
It's an extremely painful thing. It was extremely painful thing
for me to Partly lots of the people I love

(51:37):
are obese, partly because my obesity was intimately tied to
things that soothed and comforted me.

Speaker 4 (51:45):
Partly because they will have heard some.

Speaker 1 (51:47):
Arguments that claim that obesity is not bad for you,
and I, with an open mind, investigated those claims and
I'm afraid they're not true. The evidence that obesity harm health,
it's one of the most solid scientific findings in the
whole of medical science. Is as certain as that smoking

(52:07):
causes lung cancer. Now, of course there are exceptions. My
mother smokes seventy cigarettes a day. She's alive, and well
she's seventy eight.

Speaker 3 (52:13):
Right.

Speaker 1 (52:13):
There's a photograph of me and my mother when I'm
six months old. She's breastfeeding me, smoking me and resting
the ashtray on my stomach.

Speaker 4 (52:19):
Right.

Speaker 1 (52:20):
When I found that photo and showed it to her,
she said to you were a difficult berb. I needed
that con cigarette.

Speaker 3 (52:25):
Right, So of course there are exceptions.

Speaker 1 (52:27):
But we don't judge science by outliers. We judge it
by average effects. And unfortunately the average effects. There was
one study, big study that was done in Britain at
UCL University College London, followed twenty five hundred government bureaucrats
over a long period of time, more than twenty years,
and found that if you were obese, you were eight
times more likely to become unwell over that period than

(52:49):
people who were not obese. So it's a really significant effect.
That doesn't mean anyone. Of course, we need to passionately
oppose people being shamed for it. It's not their fault
that someone who's thought is it's the process of an industry.

Speaker 3 (53:02):
Like I said, get to talk about but they fucking.

Speaker 1 (53:04):
Did this to us right, And there's definitely people who
deserve to be the recipient of our anger. And it's
not individual people like me who were overweight.

Speaker 4 (53:11):
It's them.

Speaker 1 (53:11):
But I do think you know, we know this because
we spent so much time in the addiction world. It's
not love to not level with people about what's really
going on. It's not love to pretend something that's a
problem isn't a problem. You might get some temporary psychological
relief from that, but we all know the case for
hearing bad news, the bill that you can't pay, the

(53:33):
letter from the doctor that might be news that you
can't bear to hear. We all feel the impulse to
not open those letters, and most of us open them
because we know we're better off knowing the truth, even
if it's a very painful truth. And especially now, if
we're in a trap, and I believe we are, there
is at least something of a trap door. It's a
risky trap door, and in the longer term, there are

(53:55):
definitely solutions to this. I went to countries that have
massively reduced their amount of obesity. I went to Japan,
where they never had an ob city crisis because they
made big social changes that we can introduce if we
want to and talk about how we can do that,
and that's the thing we absolutely need to fight for
in the longer term. But we've got to be honest
about this because the stakes are really high here. Whether
we get this right on these drugs and on obesity

(54:17):
more generally, will determine whether millions of people live or die.
We can't go into this trivially. We can't go into
this denying scientific evidence. We've got to go in with
an open minded, open hearted engagement with the evidence, and
we've got to really reckon with it in all its
ambiguity and complexity and the painful truths that it contains.

Speaker 3 (54:37):
I think that's great. So listener in thinking about all
of that and the other great wisdom from today's episode.
If you are going to isolate just one top insight
or thing to do that you're taking away, what would
it be. Remember that, little by little, a little becomes
a lot, and a habit for me that has accrude
and benefit over time is meditation. However, one of the

(54:58):
things that gets in our way of building a steady
meditation practice is that very striving right. Of course, we're
doing it because we want certain benefits, but in the
moment of actually meditating, we need to let striving go
and focus on just being there and experiencing it. No
matter what's happening. It becomes not enjoyable because I'm trying

(55:19):
to make something happen some special moment. We want to
let go of that. So if you want to stop
dreading meditation and actually find it enjoyable, check out my
free meditation guide at goodwolf dot me slash calm. I
think that's what you did do, is you really took
an open hearted, open minded look at all these things.
It's a really great book. I think I recommend it

(55:39):
to everybody, and it's always such a pleasure to have.

Speaker 4 (55:41):
You at Oh, it's totally my pleasure.

Speaker 1 (55:43):
We did this face to face too, And I meant
to say my publisher's tasing me that anyone wants to
know where to get the audiobook, the ebook, or the
physical book, you can go to magic pillbook dot com.
I'm also meant to say you can get it from
all good bookstores, but I always want to say you
can get it from shitty bookstores as well.

Speaker 3 (55:57):
We don't have a quality test store these days. Any
probably a good one, thank you jeez.

Speaker 2 (56:19):
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