June 3, 2024

The new weight loss drugs: Magic solution or magical illusion? with Johann Hari

The new weight loss drugs: Magic solution or magical illusion? with Johann Hari
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The new weight loss drugs: Magic solution or magical illusion? with Johann Hari
The new weight loss drugs: Magic solution or magical illusion? with Johann Hari
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Season 12 Personal Growth & Healing Physical Health

Johann Hari began taking Ozempic in 2023, and subsequently spent 12 months traveling the world talking to experts about every aspect of the obesity crisis and the new weight loss medications which offer a solution to the millions of people who struggle to lose weight on their own.In his book, "Magic Pill", he details the extraordinary benefits of these new medications, as well as outlining 12 disturbing risks which we, as individuals and as a society need to be aware of because, like it or not, these drugs are here to stay.
Johann discusses with Cass the damaging stigma around obesity, the problem with the 'willpower' argument when it comes to weight-loss, and the real cause of the problem which is a faulty food system. They talk about the body positive movement and the need to reduce weight stigma while also acknowledging health risks of obesity, the need for much stricter controls around access, and the risk of an increase in eating disorders.
Johann shares his own internal conflict about taking Ozempic, and some of the factors each individual must weigh up when making the personal decision about whether to take it or not. 
Connect with Johann and buy 'Magic Pill'www.johannhari.com
Connect with Cass:www.crappytohappypod.comhello@crappytohappypod.com 
www.instagram.com/crappytohappypodwww.tiktok.com/crappytohappypod
Join the free 7-day Happiness Challenge:www.cassdunn.com/happiness

Connect with Cass:

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Contact Crappy to Happy:

Email: hello@crappytohappypod.com
www.crappytohappypod.com
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www.tiktok.com/@crappytohappypod


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Transcript
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This is Crappita Happy and I am your host, Cass Dunn.

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I'm a clinical and coaching psychologist. I'm mindfulness meditation teacher

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and of course author of the Crappita Happy books. In

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this show, I bring you conversations with interesting, inspiring, intelligent

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people who are experts in their field and who have

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something of value to share that will help you feel

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less crappy and more happy. Johann Harry is an international

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best selling author. You will know him from his previous

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smash hits, Lost Connections and Stolen Focus. Had him on

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the Podge to talk about that one. Johann has recently

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turned his attention to the extraordinary benefits and disturbing risks

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of the new weight loss drugs. Johannes started taking ozembic

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in January twenty twenty three, and while he was thrilled

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to finally have a solution to his own long term

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battle with his weight, he was also wildly conflicted. There

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is just so much that we don't know about the

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downstream effects of these medications. So Johann spent twelve months

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traveling around the world talking to experts, and as a result,

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he has published his book Magic Pill in which he

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outlines all of the extraordinary benefits that are to be

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gained with these medications, also outlines twelve significant potential risks.

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It is a complex topic. It's a big episode, so

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grab a cup of tea strap in. I think you

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will find this just as fascinating as I did. Here

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is my conversation with Johann Hari.

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Yohn.

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Welcome to the Craft A Happy podcast.

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I'm so happy to be back with you. And last

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time we spoke was the height of COVID when we

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were all kind of sheltering in place, and it seems

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so nice to actually see you in the three dimensions.

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I'm so happy.

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I know this is so weird for me to be

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sitting from you when I'm usually sitting like in front

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of a computer screen. Thank you for having me to

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your house, which nobody can see because camera.

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Thank you so much for coming. I'm well excited, So, Johan.

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What I love about your work, but I think most

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of us appreciate about your work is that you take

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an issue or something that is really culturally relevant and

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then you like just explore it to within an each

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of us. Like you do. You take this issue and

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look at the layers of complexity that are involved in

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just what we consider to be like just one single issue.

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So at the moment, the thing that you have been

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researching which is really interested to hear was these new

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weight loss medications O, zenpic, etc. We go v there's

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lots of new ones coming out, which is really obviously

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very topical at the moment, and people are really divided

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on their opinions about these medications, and there's so many

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conflicting stances and ideas about whether they're good or bad,

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or who should be entitled to use them or who

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isn't so so interested to have this conversation. So can

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you just start by sharing? So when you first came

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across a zempic, for example, which you did as somebody

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who has acknowledged that you've had weight issues for your life, like,

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what was your first reaction to to that?

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I remember exactly how I felt. It was the winter

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of twenty twenty, and it was that moment when it

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looked like the pandemic was finally ending. So for the

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first time in two years, I went to a party.

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I remember it's so Vivily, and it was a party

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thrown by a kind by a Hollywood star, and I

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remember on the way there, thinking this is going to

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be interesting, right, because I'd gained loads of weight during

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the pandemic, like lots of people. But I thought, huh,

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all these Hollywood stars, they're going to have gained weight, right,

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it's going to be And I didn't think they would

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have podged out as much as the rest of us,

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but I thought, hah, it's going to be interesting to

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see them in this different light. And I arrived and

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everyone looked like their own Snapchat filter. Wow. Everyone was

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kind of cleaner and clearer and sharper. And this wasn't

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just the affect of them being famous as people I'd

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known before, And it wasn't just the kind of actors.

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The agents look like that, their wives, their husbands looked

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like that. It was really weird and walking around feeling

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a little bit kind of schlubby and embarrassed. And I

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bumped into a friend of mine at the edge of

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the dance floor and I said to her, Hey, it

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looks like he looks like everyone really did take up

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pilates during the pandemic, and she laughed and I kind

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of looked at her and she said, well, you know

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why they all look like this, And I just looked

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at her blankly. I had no idea what she was

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talking about, and she pulled up on her phone an

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image of an ozembic pen. And in the next few

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days I read a lot about these drugs. And I

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don't think I've ever felt so conflicted, so strongly conflicted

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about anything, as I was when I started learning this.

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I remember, like you said, you know, I'm someone who's

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yoyoed in my life from being you know, slightly underweight

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to being obese many times. And I thought, well, you know,

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I could, I could make a case that I've been

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waiting for this all my life, right, you know. At

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one of the low points in my life was Christmas

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Eve two thousand and nine, when it was lunchtime and

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I went to my local brunch of KFC in East London.

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And I went in and I said my standard order,

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which was so disgusting I were even repeat it. And

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the guy behind the counter said, O yeah, and I'm

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really glad you're here. And I said all right, and

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he he said, wait a minute, and he went off

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behind where they fry all the chicken, and he came

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back with a massive Christmas card and everyone who was

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working that day, and they'd written it to our best customer.

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And one of the reasons my heart sank is I thought,

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this isn't even the fried chicken shop. I come to

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the most, how can this be happening to me? Right?

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So I could make a case. Look, we've all been

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trying to diet for forty years, and every year we

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get fatter and fatter. What we've been trying doesn't work.

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There's clearly a biological component to this. If there's a

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drug you can take that reverses the health harms of obesity,

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that's great. But I also immediately thought, well, there's been

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a lot of diet drugs in the past. They've always

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led to catastrophes. And even more importantly, you know, we

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don't have an obesity crisis because some biological malfunction happened

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in all of us, also many of us, you know,

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massive and rising numbers of us. We've got an obesity

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crisis because the food industry screwed up the way we

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eat in really profound ways. Surely we need to solve

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the problems. So many of my books are about stop

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treating symptoms, deal with actual the actual causes of our problems.

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So I felt incredibly conflicted then, and I spent a

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year taking these drugs. For reasons I'll explain, But I

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spent a year then traveling all over the world, intervening

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the leading experts from Iceland to Minneapolis to Tokyo, the

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biggest critics of the drugs, the biggest proponents of the drugs,

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And at the end of that year, I know a

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lot more. There's a lot of information that we can weigh,

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but the honest truth cast is I'm still really divided, right,

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And I think this is really complicated and difficult topic

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where we're going to have to think our way through

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it inch by inch, point by point, being very sensitive

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to the huge benefits of these drugs and the huge

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potential risks of these drugs.

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Right the point that you make that this is a

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drug that's been created to treat a problem that's been

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created by the food factory, what do you call it?

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Like fake food?

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Even my daughter says to me when her friends come over,

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she's we don't have food in our fridge. Mum, we

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don't have food, and so there's so much Finnish. She goes, no,

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we don't have food, we have ingredients and isn't that

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just the reverse of what you talk about in the

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book about how food is food, food is ingredients. This

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generation has grown up like if you can't just take

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it out of a packet, and that's what we've all

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grown up with pretty much. You know, if you can't

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just take it off the shelf and out of a

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packet and it's easy and convenient and cheap, then what

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are you even doing?

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Totally right, And it's one of the things that shocked

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me is how rapidly this changes happens. If you think

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about obesity, right, I'm blanking on his name, the Australian

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Prime Minister who drowned in charasitydhole, every interesting thing. Go

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and look at the archive footage of the beach that day,

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the day that he drowned, and look at just the

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random sampling of Australians who are on that beach that day.

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They're all by our standards thin, right. You look at

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it and it seems a little bit odd at us,

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like what was this like a fashion models convention that

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was happening on the beach that I ain't know if

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you look at the figures. So the year I was

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born nineteen seventy nine is basically the beginning of a

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massive transformation. The year I was born, six percent of

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British people were obese. It's now twenty seven percent and

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rising rapidly. It's similar figures for Australia. It's not quite

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as bad, but very similar. The average American today is

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twenty three pounds heavier than the average American in nineteen sixty.

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This is an enormously rapid transformation, unprecedented in human history.

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When my parents were kids, were teenagers, there were no

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overweight children at their schools. None, right, And now you know,

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I go to my nephews and niece's schools and my

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god children's schools, you know, a huge proportion of the

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children overweight obese. So it's a weird thing. This has

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happened slowly enough that we've sort of just gone with it, yeah,

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but quickly enough that when you just look back relatively recently,

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you start to see how shocking that is. And we

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know why that happened. There's a few reasons, but we

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know the key reason why that happened, which is that

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we now eat food that bears essentially no relationship to

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the food our grandparents or our great grandparents ate and

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weirdly again, that happened fast enough that there wasn't that

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much friction, except funny enough in my own family, right.

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So my dad's from a little village in Switzerland called Candishegg,

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so he grew up in a wooden heart on the

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side of a mountain. His parents were farmers and in

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Kandershegg when he was a kid, as everywhere in Switzerland

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and has pretty much ever in the world up to then.

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You ate fresh food all the time, right, You ate

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food that had recently been grown or recently killed if

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it was meat, and you cooked it yourself with fresh

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ingredients and you ate it that day. That was what

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food was for all of human history until very recently.

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My mum grew up in a working class part of Scotland,

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which was ahead of the curve. Right. It is the

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country that invented deep fried mars bars. So they didn't

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do that, right, I mean, they did more fresh food

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than we do now, but they, you know, they ate fried,

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stodgy food that you stored up putic because they were

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working really hard. They were exhausted. You needed to do that, right.

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You didn't have time to come home and cook because

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you were so dog tired from all the work you

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had to do. And my parents they met here in London.

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They met in a nightclub in Carnby Street, and my

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dad only spoke ten words of English, and my mother

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always says, he seems so nice when I couldn't understand

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what he was fucking seeing. And they had what my

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mother caused, a series of one night stands, which I

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tried to explain, is not a concept that makes sense.

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If there's more than one of them, it's not a

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one nightstand. And they she got pregnant, they thought they

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had to get married, and then he learned English and

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it all went wrong. But throughout my childhood one of

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the things they really thought over was food and what

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I ate, because between the time I was born and

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the time I was ten, basically the entire diet of

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the Western world shifted from looking a lot like the

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diet my dad grew up eating to one that was

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a lot like the diet my mother grew up eating,

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so from fresh food that people prepare on the day

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to pre process, prepackaged food. And it turns out that

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shift has profoundly altered our bodies, how we move, the

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kind of diseases we get, and I can talk more

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about the conflict within my own family. But there was

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an experiment that I learned about in writing my book

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Magic Pilm that I think perfectly distills what that shift

230
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has done to us. There's a brilliant neuroscientist called Professor

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Paul Kenny who's the head of neuroscience at Mount Sinai

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in New York. And when he was in his twenties,

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he moved to do his PhD from Dublin, where he's from,

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to San Diego in California, and quite quickly he clocked

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Americans do not eat like Irish people, right. They seem

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to eat different kinds of food. They seem to eat

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much more. And he leaned into it and quite quickly

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he gained like thirty pounds. I think it was within

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the two years, again thirty pounds. And he noticed that this

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American food seemed to make him feel very different. He

241
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was eating much more of it and it seemed to

242
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affect him differently. Who started to wonder, what does this

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food do to your brain? Does it change you? So

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we did an experiment which I've nicknamed Cheesecake part that's

245
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not his name, where we he did He's got a group.

246
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It's a pretty simple experiment. He got a group of rats,

247
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and he gave them an infinite supply or a huge

248
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supply of the kind of food that they evolved to eat. Right,

249
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just you know, pellets, that's kind of whole foods, right,

250
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the equivalent of what my dad grew up eating. And

251
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he noticed, you can give them a huge amount of that,

252
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but when you give them the food they grew up with,

253
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the food they evolved for, the eat enough of it

254
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that they're not hungry, and then they'll stop. Right, So

255
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they never made themselves the beast. They could have carried

256
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on eating and eating and eating, and there was a

257
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huge amount of it, but they didn't. They had a

258
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kind of nutritional wisdom when they were given the kind

259
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of food that they evolved to eat, and then they

260
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would stop when they were seated, when they'd had enough.

261
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Then he did an experiment. Then he tweaks the experiment.

262
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He introduced the American diet. He gives them Snickers bars,

263
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he gives them fried bacon, and he gives them cheesecake,

264
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and suddenly they act very differently. Their nutritional wisdom disappears.

265
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With these foods, they would eat and eat and eat,

266
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and they were hugely obese. And he said, literally within

267
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a couple of days, they were different animals. They were

268
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in their brains different, they were physically different. They started

269
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to show signs of all sorts of physical problems, and

270
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they seemed to be unable to stop eating this food

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or to regulate their eating around this food. Then he

272
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tweaked the experiment again. He took away all the junk

273
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food and put them back with a diet that was

274
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nothing but the food they bolt eating, the kind of

275
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healthy pellets, and he thought, he knew what would happen.

276
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He thought, what would happen? So now they're going to

277
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eat more of those pellets, and that will prove that

278
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this kind of junk food makes you expands your diet

279
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and makes you want more. That is not what happened.

280
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Something much worse happened. Once they'd lost the junk food,

281
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once they only had the pellets, they refused to eat

282
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anything at all. It's like they had ceased to recognize

283
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the healthy food as food. They literally starved. Eventually, when

284
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they were literally starving to death, then they went back

285
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to eating the pellets, but they really resisted it. And

286
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I think that's what really happened to me, right, Oh,

287
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never forget Paul, Professor car said that. I said, you know,

288
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ever since he did that experiment, he has never been

289
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able to eat cheesecake again. He partly has his mental

290
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picture of the rats would like hurl themselves into the

291
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cheesecake and eat their way out, and they would come

292
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out just completely slicked with cheesecake all over their faces

293
00:14:12.919 --> 00:14:15.440
and their whiskers, and he's like, no, anyone offers of

294
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any cheesecake. So that I know, thanks, right, And I

295
00:14:18.120 --> 00:14:20.240
think something very similar happened to me when I was

296
00:14:20.279 --> 00:14:23.879
a child. Something very similar has happened to huge numbers

297
00:14:23.879 --> 00:14:26.440
of people across our society. Seventy eight percent of the

298
00:14:26.440 --> 00:14:29.159
calories that the average American child gets now comes from

299
00:14:29.240 --> 00:14:31.879
ultra processed food, so food that is nothing like the

300
00:14:31.879 --> 00:14:35.240
food that our grandparents and great grandparents ate. And as

301
00:14:35.320 --> 00:14:38.159
Gerald Mann, who's one of the leading nutritionists at Harvard,

302
00:14:38.480 --> 00:14:40.720
he's the guy who invented the food label that's on

303
00:14:40.759 --> 00:14:44.840
all food in the United States, said to me, there's

304
00:14:44.879 --> 00:14:49.399
something about the food we're eating that is profoundly undermining

305
00:14:49.480 --> 00:14:51.320
our ability to know when to stop.

306
00:14:51.879 --> 00:14:54.200
There will be people who argue, we know what we

307
00:14:54.200 --> 00:14:55.480
need to do. We need to go back to eating

308
00:14:55.519 --> 00:14:58.519
real food again, and that's a matter of willpower. So

309
00:14:58.559 --> 00:15:00.559
why can't people stop eating junk food start eating the

310
00:15:00.600 --> 00:15:02.799
healthy food. But let's start with like, what is the

311
00:15:02.840 --> 00:15:05.960
effect of the weight loss medication? How is it proposed

312
00:15:05.960 --> 00:15:08.480
to reverse this if we've all been messed up and

313
00:15:08.960 --> 00:15:11.279
hunger signals have all been messed up by the food

314
00:15:11.279 --> 00:15:11.759
we're eating.

315
00:15:12.120 --> 00:15:14.679
So the way it works, if you ate, now, if

316
00:15:14.720 --> 00:15:17.240
you had a kit cat or anything, you would get

317
00:15:17.679 --> 00:15:19.320
your in your gut, you would get the release of

318
00:15:19.360 --> 00:15:22.480
a hormone called GLP one, and gopo on GLP one

319
00:15:23.080 --> 00:15:26.080
is basically a natural signal in your body saying stop

320
00:15:26.120 --> 00:15:29.559
eating now, cass, You've had enough, Right, But natural GLP

321
00:15:29.679 --> 00:15:32.440
one only stays in your system for about for less

322
00:15:32.480 --> 00:15:34.480
than ten minutes and then it's washed away. Right, But

323
00:15:34.519 --> 00:15:36.279
it's usually enough that you kind of go, oh, I

324
00:15:36.320 --> 00:15:39.679
want to stop now. Right. What these drugs do A

325
00:15:39.840 --> 00:15:43.320
zenpic would go the monjano and others. There's additional mechanism

326
00:15:43.360 --> 00:15:44.840
and some of the other drugs, but the core thing

327
00:15:44.879 --> 00:15:48.639
they do is they inject into your body a copy,

328
00:15:48.919 --> 00:15:52.320
a replica of that GLP one hormone, but instead of

329
00:15:52.360 --> 00:15:54.639
it being washed away in a few minutes, it stays

330
00:15:54.639 --> 00:15:57.519
in your system for a whole week, which means that

331
00:15:57.600 --> 00:16:00.519
when you start to eat, you very rapidly get the

332
00:16:00.519 --> 00:16:02.960
feeling that you're full and you don't want anymore, so

333
00:16:02.960 --> 00:16:06.000
it hugely dials down your hungers. I remember the second

334
00:16:06.080 --> 00:16:08.840
day I took I'm taking a zmpic. I remember the

335
00:16:08.879 --> 00:16:11.879
second day I took it, waking up and having this

336
00:16:11.960 --> 00:16:15.720
really weird sensation and lyne there thinking what am I feeling?

337
00:16:16.480 --> 00:16:18.120
And I could feel like mild nausea, which are very

338
00:16:18.120 --> 00:16:19.480
common sighted of it, but that's not what I was

339
00:16:19.759 --> 00:16:25.879
trying to lookay, And I suddenly realized, Oh, I'm not hungry,

340
00:16:25.919 --> 00:16:28.399
like I don't ever remember a day before that when

341
00:16:28.440 --> 00:16:30.879
I didn't wake up hungry right when I wake up,

342
00:16:30.879 --> 00:16:32.759
I would usually wake up rabbitus anger off and be

343
00:16:32.759 --> 00:16:35.360
woken up by my stomach grumbling. Right, I thought, oh,

344
00:16:35.399 --> 00:16:38.559
I'm not hungry, and I went to the caf just

345
00:16:38.600 --> 00:16:41.080
around the corner from here, run by a lovely Brazilian

346
00:16:41.120 --> 00:16:43.600
woman called Tasiana, and I ordered the thing that I

347
00:16:43.600 --> 00:16:46.120
always have for breakfast at the time and had for years,

348
00:16:46.159 --> 00:16:50.799
which was a big chicken mayo bread roll. Right. She

349
00:16:50.879 --> 00:16:53.919
brought it over to me and I had like four

350
00:16:54.000 --> 00:16:58.039
mouthfuls and I just couldn't see anymore. I was full.

351
00:16:59.080 --> 00:17:00.799
Whereas normally I would that whole thing and I would

352
00:17:00.799 --> 00:17:02.200
still be a little bit hungry, but I would get

353
00:17:02.200 --> 00:17:04.759
through to lunchtime right, probably with a snack in between

354
00:17:04.759 --> 00:17:07.480
that and lunch. I thought, that's really weird, and then

355
00:17:07.759 --> 00:17:10.160
I went for lunch. I went to the Turkish restaurant

356
00:17:10.200 --> 00:17:11.440
well sort of the road where I have my normal

357
00:17:11.440 --> 00:17:16.880
breakfast lunch, which was a Mediterranean lamb, and again few mouthfuls,

358
00:17:17.119 --> 00:17:19.079
I was full. That night, I went to Camden Market

359
00:17:19.240 --> 00:17:22.240
not far from here, and I can hear anything, and

360
00:17:22.279 --> 00:17:24.599
I thought, this is like the shutters had come down

361
00:17:24.599 --> 00:17:27.839
on my appetite. It was very strange. Now we know,

362
00:17:28.599 --> 00:17:31.039
and this is a very important thing to think about

363
00:17:31.039 --> 00:17:34.039
for all sorts of reasons. It was initially thought that

364
00:17:34.039 --> 00:17:37.920
that injecting that copy of GLP one into your body

365
00:17:38.599 --> 00:17:40.559
primarily has an effect on your gut, that it must

366
00:17:40.599 --> 00:17:43.039
slow down your gut or something like that, and it

367
00:17:43.079 --> 00:17:45.720
does indeed have significant effects on the gut. But we

368
00:17:45.880 --> 00:17:48.720
now know actually it primarily works by having an effect

369
00:17:48.759 --> 00:17:50.839
on your brain. There are GLP one receptors in your

370
00:17:50.920 --> 00:17:53.359
brain in addition to in your gut, and these drugs

371
00:17:53.400 --> 00:17:56.240
actually primarily work by changing your preferences in your brain,

372
00:17:56.920 --> 00:17:59.880
not your gut, which opens up a whole other set

373
00:17:59.880 --> 00:18:04.720
of potentially alarming and potentially liberating effects. But yeah, that's

374
00:18:04.799 --> 00:18:07.400
the kind of that's how it begins when you're taking

375
00:18:07.440 --> 00:18:08.319
it for most people, not.

376
00:18:08.279 --> 00:18:11.839
Everyone, So it reduces your appetite and amazing, so you're

377
00:18:11.839 --> 00:18:14.279
eating less and therefore people lose weight, and they do

378
00:18:14.400 --> 00:18:18.960
lose weight very quickly. And then the argument is that

379
00:18:19.039 --> 00:18:22.359
you have to be on the medication. Most people will

380
00:18:22.599 --> 00:18:24.920
need to be on it long term in order to

381
00:18:24.960 --> 00:18:27.759
maintain that effect. So is it not the case that

382
00:18:27.960 --> 00:18:29.759
when you've been taking it for a period of time

383
00:18:29.799 --> 00:18:31.720
and you've eaten less. I'm just thinking of the old

384
00:18:31.759 --> 00:18:35.160
way of thinking of your stomach shrinks and you get

385
00:18:35.279 --> 00:18:36.799
used to eating less, So then you can come off

386
00:18:36.799 --> 00:18:39.640
it and then you'll continue to eat less or do

387
00:18:39.839 --> 00:18:44.640
people typically revert back to being very hungry again? And

388
00:18:44.720 --> 00:18:47.480
is this why people tend to need to stay on it.

389
00:18:47.759 --> 00:18:49.039
Yeah, So to start with the first bit of what

390
00:18:49.079 --> 00:18:51.839
you said, which is about losing weight, Yes, so it's

391
00:18:51.839 --> 00:18:54.920
really important to uncertn how significant the weight loss is.

392
00:18:55.400 --> 00:18:57.720
So the average person taking ozm pic will go V,

393
00:18:57.799 --> 00:19:00.519
they're the same drug with different names marketed for different purposes,

394
00:19:01.240 --> 00:19:03.759
loses fifteen percent of their body weight within a year.

395
00:19:04.160 --> 00:19:08.240
For Monjano, which adds another gut hormone. So as M people,

396
00:19:08.319 --> 00:19:11.440
go V works on GLP one, Monjarano works on GLP

397
00:19:11.519 --> 00:19:15.079
one and another gut hormone called GOP. The average weight

398
00:19:15.119 --> 00:19:17.039
loss is twenty one percent within a year.

399
00:19:17.119 --> 00:19:17.559
Wow.

400
00:19:18.200 --> 00:19:20.799
And the next drug coming down the line, triple G,

401
00:19:20.920 --> 00:19:23.480
which is not available yet, the average weight loss is

402
00:19:23.599 --> 00:19:26.440
twenty four percent, which is only a few points lower

403
00:19:26.480 --> 00:19:29.799
than barotric surgery. Right. That is a staggering level of

404
00:19:29.839 --> 00:19:31.920
weight loss. And we're going to talk. I'm sure about

405
00:19:31.960 --> 00:19:33.720
lots of the risks and reasons why I'm very worried

406
00:19:33.720 --> 00:19:35.799
about some aspects of these drugs, but I do think

407
00:19:35.799 --> 00:19:38.640
it's important to talk about the overwhelming benefit of that.

408
00:19:39.799 --> 00:19:42.200
And the overwhelming benefit is very simple. I wish this

409
00:19:42.319 --> 00:19:44.680
wasn't the case, but the scientific evidence is very clear

410
00:19:44.680 --> 00:19:48.720
that obesity enormously harms your health. There are over two

411
00:19:48.839 --> 00:19:51.519
hundred known diseases and complications that I'm either caused or

412
00:19:51.519 --> 00:19:55.359
made significantly more likely by obesity, and even the ones

413
00:19:55.400 --> 00:19:58.720
that we kind of think of quite casually are horrendous.

414
00:19:58.759 --> 00:20:02.039
I mean, I'm embarrassed. Say, until I started doing research

415
00:20:02.039 --> 00:20:07.000
on diabetes, for example, I thought, Okay, diabetes is bad

416
00:20:07.000 --> 00:20:09.400
if you don't get treatment. But if you're diabetic and

417
00:20:09.480 --> 00:20:12.119
you're getting insulin, then you're basically like everyone else, right,

418
00:20:12.160 --> 00:20:14.640
that it's not that bad as long as you get treatment.

419
00:20:15.319 --> 00:20:18.079
That is really wrong. If you get diabetes when you're young,

420
00:20:18.240 --> 00:20:21.519
it knocks on average, fifteen years off your lifespan. Right.

421
00:20:21.680 --> 00:20:24.240
It's the single biggest course of black preventable blindness in

422
00:20:24.279 --> 00:20:27.319
our society. More people have to have a limb amputated

423
00:20:27.359 --> 00:20:29.319
in the United States every year because of diabetes than

424
00:20:29.359 --> 00:20:32.559
because of being shot. I mean, it is a huge

425
00:20:33.240 --> 00:20:36.759
and devastating health condition, which you know, fourteen percent of

426
00:20:36.799 --> 00:20:40.319
Americans already have and nearly a third are pre diabetic.

427
00:20:40.880 --> 00:20:43.640
So we're talking about and that's just one of the

428
00:20:43.759 --> 00:20:47.039
many many It makes you much more likely to develop cancer, dementia,

429
00:20:47.680 --> 00:20:51.480
heart attack, stroke, have knee problems, hit problems. I mean

430
00:20:51.480 --> 00:20:56.079
that the list is devastating. And what we know is

431
00:20:56.119 --> 00:21:00.359
when you reverse obesity, you massively reverse these risks. Reversing

432
00:21:00.400 --> 00:21:03.920
obesity has been extremely hard up to now. The best

433
00:21:04.359 --> 00:21:07.920
comparison point we have is bariatric surgery. Right, So obviously,

434
00:21:08.000 --> 00:21:09.960
in it's important to stress people who get bariatric surgery

435
00:21:10.000 --> 00:21:12.160
obviously severely obese. So bear that in mind when you

436
00:21:12.160 --> 00:21:14.240
think about these figures. But if you look at the

437
00:21:14.240 --> 00:21:16.319
improvement in people's health, and they are big drawbacks to

438
00:21:16.319 --> 00:21:18.839
bariatric surgery, but if you look at the improvement in

439
00:21:18.880 --> 00:21:21.680
people's health after bariatric surgery, it's kind of staggering. In

440
00:21:21.720 --> 00:21:25.279
the seven years after you have bariatric surgery, you're fifty

441
00:21:25.359 --> 00:21:28.480
six percent less likely to have a heart attack, you

442
00:21:28.519 --> 00:21:31.799
are sixty percent less likely to develop cancer, and you're

443
00:21:31.880 --> 00:21:34.640
forty percent less lightly to dive any cause at all. Right,

444
00:21:34.920 --> 00:21:38.119
So what these drugs are doing is giving that benefit

445
00:21:38.200 --> 00:21:41.680
to you without the horrors of barractric surgery, which are

446
00:21:41.759 --> 00:21:44.519
very invasive and very unpleasant. People might know about that.

447
00:21:44.880 --> 00:21:47.000
So there's a huge I mean, I can feel how

448
00:21:47.079 --> 00:21:49.799
much healthier I am now I have reversed my obesity.

449
00:21:49.839 --> 00:21:53.799
You know, my BMI went from over thirty to I

450
00:21:53.839 --> 00:21:56.200
think it's twenty three at the moment. So I've lost

451
00:21:56.200 --> 00:21:58.039
a lot, I've lost three stone, right, But also if

452
00:21:58.079 --> 00:22:00.880
my body weight decline has been incredible. My my body

453
00:22:00.880 --> 00:22:04.480
weight was I think thirty two percent, which is quite shocking.

454
00:22:04.519 --> 00:22:06.640
I mean a whale, it's thirty five percent, right, and

455
00:22:06.640 --> 00:22:08.440
it's gone down to twenty two percent, So it's a

456
00:22:08.640 --> 00:22:12.000
huge for I've lost basically I've lost nothing but fat. Wow.

457
00:22:12.640 --> 00:22:15.920
So yeah, there are obvious, really significant benefits to that

458
00:22:15.920 --> 00:22:18.480
that we need to weigh alongside the significant risks.

459
00:22:19.160 --> 00:22:21.880
Thing about weight is there are so many reasons. So

460
00:22:22.079 --> 00:22:24.440
we talked about the food industry and the manufactured food

461
00:22:24.440 --> 00:22:26.400
and the impact that that has. There are so many

462
00:22:26.440 --> 00:22:30.079
other reasons why people gain weight and struggle with their weight.

463
00:22:30.200 --> 00:22:32.920
People eat for all sorts of reasons besides nutrition, clearly,

464
00:22:33.240 --> 00:22:35.079
and you cover this in the book as well, like

465
00:22:35.119 --> 00:22:39.319
people eat for emotional reasons. But there is this persistent

466
00:22:39.400 --> 00:22:43.000
way of thinking in our society, Like the argument is valid,

467
00:22:43.440 --> 00:22:47.839
obesity is a health crisis. It's a really significant health crisis,

468
00:22:47.839 --> 00:22:51.319
and this medication to reverse that is that's amazing. Is

469
00:22:51.640 --> 00:22:55.160
this persistent view in society that it's an individual issue,

470
00:22:55.200 --> 00:22:57.119
it's a will power issue. So why do you need

471
00:22:57.160 --> 00:23:00.200
to take this medication. This isn't me talking this, Yes,

472
00:23:00.519 --> 00:23:01.920
this is what's out there. This is what you see

473
00:23:01.920 --> 00:23:05.680
people saying on the internet. You know, well, why don't

474
00:23:05.720 --> 00:23:08.640
you Why can't you just get some willpower about you? Like,

475
00:23:08.720 --> 00:23:11.799
why can't you just make different decisions? What's your answer

476
00:23:11.839 --> 00:23:12.559
to those people?

477
00:23:13.240 --> 00:23:15.359
Those people aren't wrong, but they're only seeing a small

478
00:23:15.359 --> 00:23:17.640
part of the picture. Right. Willpower is real, and will

479
00:23:17.640 --> 00:23:20.319
power can need to weight loss. But the way I

480
00:23:20.599 --> 00:23:22.960
started to understand it, you know, that was the dialogue

481
00:23:22.960 --> 00:23:24.680
I had in my own head, right, so I really

482
00:23:24.759 --> 00:23:28.359
understand where it comes from. Whenever I gained away, I'd

483
00:23:28.400 --> 00:23:32.200
just go to myself, are you fat, prick? Just eat less?

484
00:23:32.200 --> 00:23:34.240
What's wrong with you? And I would have periods where

485
00:23:34.279 --> 00:23:37.640
I exerted my willpower and I ate significantly less and

486
00:23:37.680 --> 00:23:39.960
I lost weight, right, and then it would always break.

487
00:23:40.880 --> 00:23:42.720
And I only really began to understand this when I

488
00:23:42.720 --> 00:23:44.599
went to interview one of the leading experts on diet

489
00:23:44.640 --> 00:23:46.720
in the world, an amazing woman called Professor Tracy Mann

490
00:23:46.759 --> 00:23:50.119
at the University of Minnesota. Interviewed her in Minneapolis in

491
00:23:50.160 --> 00:23:53.160
a interviewed her in a bakery where they literally when

492
00:23:53.200 --> 00:23:54.640
I came in, they said, have you been here before?

493
00:23:54.720 --> 00:23:55.960
I said no. They said, oh, we'll give you a

494
00:23:55.960 --> 00:23:58.799
free cinnamon mum. Then there's this massive eye cinembon the

495
00:23:58.839 --> 00:24:01.039
must I like a thousand glories and it at least

496
00:24:02.319 --> 00:24:05.359
and Professor Mann has been researching this for a long time.

497
00:24:06.079 --> 00:24:08.839
When she started researching the effects of diets in the

498
00:24:08.920 --> 00:24:12.519
year two thousand, she noticed this slightly weird thing. So

499
00:24:12.880 --> 00:24:16.599
there is no dispute that if you run a calorie deficit,

500
00:24:16.880 --> 00:24:19.079
if you burn more calories than you eat, you will

501
00:24:19.079 --> 00:24:21.559
lose weight. Right, No one could dispute that unless they're

502
00:24:21.559 --> 00:24:24.000
disputing the laws of physics. Right. And she would look

503
00:24:24.000 --> 00:24:28.480
at the studies success in diets and the scientific evidence

504
00:24:28.480 --> 00:24:30.640
of the time. She showed diets really work. If you

505
00:24:30.680 --> 00:24:33.839
look at diets, you follow people for three or six months,

506
00:24:34.599 --> 00:24:36.839
lots of people, not everyone, but lots of people lose

507
00:24:36.880 --> 00:24:39.160
lots of weight. But she also knew lots of people

508
00:24:39.160 --> 00:24:40.799
who'd been on diets and it had not worked. And

509
00:24:40.839 --> 00:24:43.000
she was kind of puzzled because she kind of go, well,

510
00:24:43.079 --> 00:24:45.839
these studies they seem to act like so you lose

511
00:24:45.839 --> 00:24:47.839
weight for three months or six months, and then the

512
00:24:47.880 --> 00:24:50.160
story ends and you stay at that lower level forever. Right,

513
00:24:50.559 --> 00:24:52.480
That doesn't seem to match the experience of most people

514
00:24:52.519 --> 00:24:54.440
I know. So she looked at at that time, there

515
00:24:54.480 --> 00:24:55.920
was only a very small number of studies I think

516
00:24:55.920 --> 00:24:59.200
it was twenty four that had looked at the effects

517
00:24:59.200 --> 00:25:01.799
of diets, not three months out or six months out,

518
00:25:01.799 --> 00:25:04.160
but two years out or in a handful of cases,

519
00:25:04.200 --> 00:25:07.920
five years out. What she found is, over the longer term,

520
00:25:08.039 --> 00:25:10.960
the diets almost always failed, not invariably, but it was

521
00:25:11.160 --> 00:25:14.400
a very small number who succeeded. The average person two

522
00:25:14.440 --> 00:25:16.839
years after starting a diet weighs two pounds less than

523
00:25:16.880 --> 00:25:18.759
they did at the start. So it's not nothing, but

524
00:25:18.799 --> 00:25:21.000
that's a really, really small effect, and it was a

525
00:25:21.079 --> 00:25:22.920
small minority. For him, there was a bigger effect, but

526
00:25:22.920 --> 00:25:25.799
it was it was tiny, right. I think, well, why

527
00:25:25.799 --> 00:25:27.839
would this be? And I spoke to a lot of

528
00:25:27.880 --> 00:25:30.640
experts about this and the way they explained it to me,

529
00:25:31.160 --> 00:25:33.519
and the science for this is really solid. If you

530
00:25:33.559 --> 00:25:36.759
go back to the sixties and the seventies, scientists thought

531
00:25:36.799 --> 00:25:41.079
they understood what determined any individual's wait. They thought that

532
00:25:41.119 --> 00:25:43.200
when you were born, you had something called a biological

533
00:25:43.200 --> 00:25:45.480
set point, a kind of amount of body fact that

534
00:25:45.519 --> 00:25:47.960
your body wanted you to carry, and you know, you

535
00:25:47.960 --> 00:25:49.680
could go a little bit above or below it depending

536
00:25:49.720 --> 00:25:52.079
on circumstances. But basically your weight was kind of fixed

537
00:25:52.079 --> 00:25:54.839
from when you were born. Right way of thinking about

538
00:25:54.880 --> 00:25:58.880
it by analogies with temperature. Right, so your body, everyone listening,

539
00:25:58.920 --> 00:26:01.799
your body wants you to be a particular temperature, whatever

540
00:26:01.799 --> 00:26:03.799
it is, thirty nine degree centigrade, whatever it is, right,

541
00:26:04.400 --> 00:26:06.319
and if you go above that, your body will work

542
00:26:06.400 --> 00:26:08.759
really hard to bring you down. It will sweat you

543
00:26:08.799 --> 00:26:11.880
know it, it will make you really really want shade.

544
00:26:12.319 --> 00:26:14.759
And that's completely involuntary, right, Your body does that without

545
00:26:14.759 --> 00:26:16.720
your conscious mind having to do it. Or if you

546
00:26:16.759 --> 00:26:19.039
get below that temperature, if you're really cold, it will

547
00:26:19.079 --> 00:26:21.519
make you shiver, which warms your body up, so your

548
00:26:21.599 --> 00:26:25.319
body really has will fight very hard to keep your

549
00:26:25.440 --> 00:26:28.519
temperature set point. And then the obesity crisis comes along

550
00:26:28.720 --> 00:26:31.160
and the idea of an obesity a kind of body

551
00:26:31.160 --> 00:26:33.200
weight set point just kind of falls apart because they

552
00:26:33.200 --> 00:26:35.720
were like, well, it doesn't make any sense anymore if

553
00:26:35.920 --> 00:26:38.559
if so many people are getting so much more overweight,

554
00:26:38.880 --> 00:26:40.480
it can't be there's a set point. But then they

555
00:26:40.519 --> 00:26:42.880
realize what was actually happening. According to many scientists. Not

556
00:26:42.880 --> 00:26:45.200
all of them agree, but it's there's a broad agreement

557
00:26:45.240 --> 00:26:48.920
on this. Is that actually your body has an expanding

558
00:26:48.960 --> 00:26:54.000
set point. So let's say that you now gained three stone, right,

559
00:26:54.799 --> 00:26:58.440
your body set point would rise. It would try to

560
00:26:58.599 --> 00:27:02.000
keep you at that hi higher weight. Right, It would

561
00:27:02.039 --> 00:27:04.720
try to hold you. It would try to keep you

562
00:27:04.799 --> 00:27:07.200
at three stone heavier than you are now. And if

563
00:27:07.279 --> 00:27:09.240
you tried to come below that, and you could exert

564
00:27:09.240 --> 00:27:12.680
your willpower and you would have some effect, your body

565
00:27:12.720 --> 00:27:15.160
would fight really hard to bring you back up. It

566
00:27:15.200 --> 00:27:19.640
would slow down your metabolism, it would make you crave sweet,

567
00:27:19.920 --> 00:27:23.200
fatty foods, it would change your hormonal balance, it would

568
00:27:23.240 --> 00:27:26.920
make you more tired when you contemplated exercise. So as

569
00:27:26.960 --> 00:27:30.720
you become obese, a series of biological changes kick in

570
00:27:31.279 --> 00:27:33.920
where your body tries to resist you going below that level.

571
00:27:34.079 --> 00:27:37.039
As Dr Giles Yohe, who's one of the leading obesity

572
00:27:37.079 --> 00:27:40.240
researchers at Cambridge University put it to me, your brain

573
00:27:40.680 --> 00:27:42.720
hates it when you lose weight, and it will fight

574
00:27:42.839 --> 00:27:45.000
really hard against it. And remember when I was told that,

575
00:27:45.039 --> 00:27:46.759
thinking well, how could that be? Why would that be?

576
00:27:46.759 --> 00:27:49.640
That's such as that would be such a bizarre biological malalapdation,

577
00:27:50.359 --> 00:27:53.400
because obesity harms health. But they kept explaining to me,

578
00:27:53.519 --> 00:27:55.279
you have to understand it in the context in which

579
00:27:55.319 --> 00:27:58.240
human beings evolved, in the context where human beings evolved.

580
00:27:58.240 --> 00:28:00.480
In fact, in every human context until four years ago,

581
00:28:00.519 --> 00:28:03.920
fifty years ago, there was never a situation where the

582
00:28:04.000 --> 00:28:06.720
danger was that you would, for your whole life, have

583
00:28:07.200 --> 00:28:09.960
far more calories to consume than was good for you. Right,

584
00:28:10.000 --> 00:28:12.119
That would never happen. Right. There might be small pockets

585
00:28:12.160 --> 00:28:14.000
where you'd have a surplus, but they would go away

586
00:28:14.079 --> 00:28:17.359
quite quickly. Right. The risk in the circumstances where we

587
00:28:17.359 --> 00:28:19.440
evolved and where we existed for three hundred thousand years

588
00:28:19.559 --> 00:28:22.799
was very different. The risk was famine. Right. The risk

589
00:28:23.039 --> 00:28:26.599
was you've got weight now, but tomorrow the food supply

590
00:28:26.680 --> 00:28:30.000
could go away and you could starve. And in a famine,

591
00:28:30.079 --> 00:28:31.839
the fattest guy at the start is going to be

592
00:28:31.839 --> 00:28:33.960
the last man standing at the end. Right, Kate Moss

593
00:28:34.000 --> 00:28:35.640
is going to die in week one of the famine,

594
00:28:35.880 --> 00:28:38.359
and you know, a very overweight person is going to

595
00:28:38.400 --> 00:28:43.319
still be alive. So our biology prepared us to survive

596
00:28:43.359 --> 00:28:46.279
a famine that is no longer coming, and all our

597
00:28:46.279 --> 00:28:49.640
biologies meant we've got this maladaptation. So when people say

598
00:28:50.000 --> 00:28:53.519
just go on a diet, right, dieting can make a difference.

599
00:28:53.880 --> 00:28:55.799
And there's a small minority for whom it works, and

600
00:28:55.799 --> 00:28:57.960
there's an interesting debate about why there's this small minority

601
00:28:58.000 --> 00:29:00.640
when it fails for most people. But we've just got

602
00:29:00.640 --> 00:29:04.000
to be honest, we've really tried that as a culture

603
00:29:04.039 --> 00:29:06.000
and as a society is the primary response to the

604
00:29:06.039 --> 00:29:08.599
problems caused by this totally new kind of food that

605
00:29:08.599 --> 00:29:14.039
we're all consuming, and it has failed catastrophically for most people. Right,

606
00:29:14.119 --> 00:29:16.720
the best argument for these drugs, and there's lots of

607
00:29:16.799 --> 00:29:18.480
arguments against them that I'm sure we're going to get to,

608
00:29:19.160 --> 00:29:21.200
but the best argument for these drugs, in addition to

609
00:29:21.240 --> 00:29:25.720
the health benefits of reversing obesity, is we are stuck

610
00:29:25.720 --> 00:29:27.759
in a trap. Yeah, and this is a trap door

611
00:29:27.920 --> 00:29:29.119
right now, it's not the only trap door, and the

612
00:29:29.240 --> 00:29:30.400
other ones that I looked at that we can get

613
00:29:30.400 --> 00:29:31.839
to it, which are not just the simplicity of an

614
00:29:31.839 --> 00:29:34.680
individual going on a diet. But yet, if the answer

615
00:29:34.880 --> 00:29:37.480
was go on a diet, we wouldn't be in this crisis.

616
00:29:37.519 --> 00:29:40.319
Because I doubt there's a single overweight or obese person

617
00:29:40.319 --> 00:29:42.079
who hasn't been on a diet. And the way I

618
00:29:42.119 --> 00:29:45.759
began to think about willpower is will power is definitely real, right.

619
00:29:46.119 --> 00:29:51.079
Willpower is like an umbrella in a really bad storm

620
00:29:51.359 --> 00:29:53.559
right now. For some people, that umbrella is going to

621
00:29:53.559 --> 00:29:56.279
get them dry across the street, you know. But for

622
00:29:56.400 --> 00:29:58.319
most of us, the storm is so powerful it's going

623
00:29:58.359 --> 00:30:00.079
to break that umbrella.

624
00:30:00.119 --> 00:30:02.839
And is it for that reason that they're quite clear

625
00:30:02.880 --> 00:30:06.079
that they consider this to be a lifetime medication.

626
00:30:06.200 --> 00:30:08.599
Oh yeah, so you asked about that's really important. So

627
00:30:08.880 --> 00:30:11.079
there's a question about what happens when you stop taking

628
00:30:11.119 --> 00:30:13.359
these drugs, and this is much debated. Actually, it's been

629
00:30:13.359 --> 00:30:16.119
even more debated since I've finished the book, relatively recently.

630
00:30:16.960 --> 00:30:20.240
So what the initial studies show is if you stop

631
00:30:20.279 --> 00:30:23.079
taking the drug, seventy percent of people regain the weight

632
00:30:23.119 --> 00:30:25.720
they lost within a year. So it's very rapid reversion

633
00:30:25.720 --> 00:30:28.000
to what you were like before. Their evidence is becoming

634
00:30:28.000 --> 00:30:30.440
a little bit more ambiguous since then. I mean, seventy

635
00:30:30.480 --> 00:30:33.400
percent still means there's thirty percent who who don't go

636
00:30:33.440 --> 00:30:35.160
back to the weight they were before. All those within

637
00:30:35.200 --> 00:30:37.279
that many of them will have regained some weight. So

638
00:30:37.559 --> 00:30:39.319
the way the drug companies are talking about this, and

639
00:30:39.359 --> 00:30:41.559
of course take this with a pinch of salt because

640
00:30:41.559 --> 00:30:43.319
they have a vested interest in saying this for obvious

641
00:30:43.319 --> 00:30:46.519
reasons is you have to take this for your whole

642
00:30:46.519 --> 00:30:48.359
life or the effect goes away. So in that sense,

643
00:30:48.400 --> 00:30:51.000
it's not like if I get malaria, there's drugs I

644
00:30:51.039 --> 00:30:53.200
can take the treat malaria. The malaria goes away. Right,

645
00:30:53.599 --> 00:30:56.319
This is not like that. This is more like statins

646
00:30:56.480 --> 00:30:59.640
for a heart condition. You get a benefit from taking

647
00:30:59.640 --> 00:31:01.640
status and if you stop taking the statins, you lose

648
00:31:01.640 --> 00:31:06.000
the benefit. So, yeah, the the whatever the benefits these

649
00:31:06.039 --> 00:31:10.599
drugs are giving for most people, it seems the benefits

650
00:31:10.640 --> 00:31:12.640
last as long as you take the drug and then stop.

651
00:31:12.960 --> 00:31:13.200
Yeah.

652
00:31:13.279 --> 00:31:13.599
Right.

653
00:31:13.880 --> 00:31:16.240
What I find really interesting when I see this coming

654
00:31:16.319 --> 00:31:18.839
up online, like Oprah at the moment is really plugging

655
00:31:18.960 --> 00:31:21.920
get it over the weight shame, you know, there's people

656
00:31:21.920 --> 00:31:25.039
shouldn't be shamed for using these medications when they've been

657
00:31:25.279 --> 00:31:27.759
struggling their whole life with obesity. I'm seeing a lot

658
00:31:27.799 --> 00:31:29.960
more of that come out. The argument up until this

659
00:31:30.079 --> 00:31:34.559
point from people has been there's been two Number one

660
00:31:34.920 --> 00:31:38.519
has been all of these overweight OBEs people are taking

661
00:31:38.559 --> 00:31:40.279
the drugs away from the people who really need them

662
00:31:40.319 --> 00:31:42.960
because it's a diabetic medication, and there's obviously there has

663
00:31:43.039 --> 00:31:45.240
been a shortage. I'm sure there's going to be less

664
00:31:45.240 --> 00:31:48.559
of a shortage as more manufacturers keep producing more versions

665
00:31:48.599 --> 00:31:50.559
of it, et cetera. But you know there has been

666
00:31:50.640 --> 00:31:52.359
a shortage over the past couple of years. Number One,

667
00:31:52.400 --> 00:31:55.799
you're taking these like really necessary, important medications away from

668
00:31:55.799 --> 00:31:57.559
the people who really need them, who are the diabetics.

669
00:31:57.720 --> 00:31:59.480
And the second one is nobody knows what they're going

670
00:31:59.519 --> 00:32:00.839
to do to you. It's going to be all sorts

671
00:32:00.839 --> 00:32:04.079
of horrible health consequences down the line, Like you said,

672
00:32:04.119 --> 00:32:06.079
those weight loss medications in the past that have turned

673
00:32:06.079 --> 00:32:09.680
out to be catastrophic. I always read those two arguments

674
00:32:09.880 --> 00:32:13.559
and ask myself, why is nobody concerned about the awful, horrible,

675
00:32:13.599 --> 00:32:17.200
negative health consequences for the diabetics who apparently supposedly need

676
00:32:17.240 --> 00:32:21.079
these mirac called drugs, Like it's so contradictory. So I

677
00:32:21.119 --> 00:32:23.440
think people just generally, to be honest, I think people

678
00:32:23.480 --> 00:32:26.839
just generally don't like the idea that there's an easy,

679
00:32:27.160 --> 00:32:29.720
you know, a magic pill, a simple solution for all

680
00:32:29.759 --> 00:32:33.680
of these people who who should just have more willpower,

681
00:32:33.799 --> 00:32:34.960
you know, So I think they just come up with

682
00:32:35.000 --> 00:32:37.319
whatever argument that they can. But you make the point

683
00:32:37.319 --> 00:32:39.039
in the book, which I thought was just to get

684
00:32:39.039 --> 00:32:40.440
back on to my point. You make the point in

685
00:32:40.440 --> 00:32:43.319
the book that obesity is as much of a health

686
00:32:43.480 --> 00:32:47.559
issue as diabetes is, and in fact, diabetes is also

687
00:32:47.880 --> 00:32:51.759
a lifestyle disease. So why do we make the distinction.

688
00:32:51.799 --> 00:32:54.440
Why do people make the distinction between diabetics who are

689
00:32:54.480 --> 00:32:56.799
the real sick people who need it versus just the

690
00:32:56.799 --> 00:32:58.799
fat people who just need to use some willpower.

691
00:32:59.279 --> 00:33:01.640
Yeah, We've raised so many important things there, I just

692
00:33:01.640 --> 00:33:03.200
don't know when to go through. And I'm very glad

693
00:33:03.240 --> 00:33:05.200
you mentioned Oprah. The highlight of my entire life is

694
00:33:05.240 --> 00:33:06.920
that I am now friends with Oprah, which is like

695
00:33:07.079 --> 00:33:09.160
such a bizarre. Every now and then she texts me

696
00:33:09.200 --> 00:33:11.759
and my friend and I'm like, she love everyone needs us.

697
00:33:12.359 --> 00:33:16.079
Oh no, I'm now friends with Oroby Association friend.

698
00:33:16.920 --> 00:33:19.119
I've been to her house, which, oh my god, I know,

699
00:33:19.200 --> 00:33:21.440
it's like it was literally like a bizarre. I know

700
00:33:21.519 --> 00:33:22.960
this would be a big deal for anyone, but I

701
00:33:23.039 --> 00:33:25.000
was like obsessed with Oprah from when I was like

702
00:33:25.160 --> 00:33:27.000
eleven to when I was twenty one. I watched me

703
00:33:27.039 --> 00:33:29.319
and my grandmother watched the Oprah Show every day, So

704
00:33:29.359 --> 00:33:33.039
to me, being friends with Oprah is infinitely surreal, right

705
00:33:33.160 --> 00:33:38.440
the Yeah, it was madness, but setting aside my Oprah excitement,

706
00:33:38.799 --> 00:33:40.519
and so you've raised a few things there that I

707
00:33:40.519 --> 00:33:44.559
think are really important, and those criticisms are not illegitimate.

708
00:33:44.720 --> 00:33:48.599
I think it's worth thinking them through. The argument about diabetes,

709
00:33:49.000 --> 00:33:52.039
Some people who don't know a zen pic in addition

710
00:33:52.079 --> 00:33:56.920
to producing weight loss, also GLP one, the gut hormone.

711
00:33:57.000 --> 00:34:01.200
GLP one stimulates the creation of incident. So if you

712
00:34:01.279 --> 00:34:05.960
take it, and obviously type two diabetics or indeed any diabetic,

713
00:34:06.440 --> 00:34:08.920
if you take them, it stimulates the creation of incident,

714
00:34:08.920 --> 00:34:10.840
which obviously the regulation your blood sugar levels, and it

715
00:34:10.880 --> 00:34:13.960
is incredibly important for diabetics and massively improves their health.

716
00:34:14.559 --> 00:34:17.920
And the huge demand for this from people who want

717
00:34:17.920 --> 00:34:21.840
to lose weight has led to a global shortage across

718
00:34:21.880 --> 00:34:23.800
the board. And so for the book, I interviewed at

719
00:34:23.840 --> 00:34:28.639
a wonderful guy called Zami Jaliel who is type two

720
00:34:28.639 --> 00:34:32.599
diabetic couldn't get the medication, and I felt really ashamed

721
00:34:32.599 --> 00:34:34.639
of speaking to him because I had some in my fridge, right,

722
00:34:35.400 --> 00:34:37.800
and there is. So I would start for the position

723
00:34:38.320 --> 00:34:41.360
that we should have done what we did with the

724
00:34:41.360 --> 00:34:46.920
COVID vaccine. We should have centrally controlled the supply, and

725
00:34:46.960 --> 00:34:49.119
it should have been distributed with the people are the

726
00:34:49.159 --> 00:34:52.079
greatest need at the front. And at the front there

727
00:34:52.119 --> 00:34:55.840
would certainly have been mostly type two diabetics. There would

728
00:34:55.840 --> 00:34:57.840
also have been some people who were civillely obese, because

729
00:34:57.840 --> 00:35:01.679
obesity is terrible for your health, and the more severe obesity,

730
00:35:01.719 --> 00:35:03.920
the worse it is for your health. I mean, I'm

731
00:35:03.960 --> 00:35:06.440
now older than my grandfather ever got to be because

732
00:35:06.480 --> 00:35:08.320
he had a heart attack, and my dad had heart problems.

733
00:35:08.360 --> 00:35:11.239
My uncle died of a heart attack. So somewhere in

734
00:35:11.280 --> 00:35:13.679
that mix of weighing the medical need would also have

735
00:35:13.760 --> 00:35:16.480
been people like me. Now clearly at the bottom of

736
00:35:16.519 --> 00:35:18.000
the medical need. There would have been people who were

737
00:35:18.039 --> 00:35:19.760
already thin who wanted to be even thinner. Some of

738
00:35:19.800 --> 00:35:21.400
the people who were that you know, the Hollywood party

739
00:35:21.400 --> 00:35:24.039
that I was talking about right now, Clearly them taking

740
00:35:24.079 --> 00:35:29.280
these drugs away from someone like Zami is not right,

741
00:35:29.639 --> 00:35:32.199
is terrible, right, But I think you're right that there's

742
00:35:32.239 --> 00:35:36.880
a charged nature to that kind of accusation, which I

743
00:35:36.920 --> 00:35:39.000
think is partly about the thing that it appears to

744
00:35:39.039 --> 00:35:41.000
be about about diabetics, but I think there's a deeper

745
00:35:41.039 --> 00:35:44.239
thing going on which is not for everyone. I don't

746
00:35:44.239 --> 00:35:46.280
want to overstate it, but I think there are these

747
00:35:46.599 --> 00:35:48.360
and I know this because I can actually affect it

748
00:35:48.400 --> 00:35:51.280
how I felt about myself taking these drugs. I think

749
00:35:51.280 --> 00:35:55.639
there are these much deeper tectonic ways of thinking about

750
00:35:55.960 --> 00:36:00.440
fatness and obesity that are really leeching out when we

751
00:36:00.440 --> 00:36:02.519
talk about these drugs. So one of them is I

752
00:36:02.599 --> 00:36:05.000
really felt like I was cheating when I was taking

753
00:36:05.039 --> 00:36:07.400
these drugs, right, Like that, I felt like I was

754
00:36:07.400 --> 00:36:10.480
the equivalent of Lance arms Strong, right, And I think

755
00:36:10.599 --> 00:36:13.519
that's really that's a really odd way to think about myself.

756
00:36:13.559 --> 00:36:16.960
Like I'm taking this drug because yeah, I want to

757
00:36:16.960 --> 00:36:19.000
look better. I'm not ashamed to say that. But I also,

758
00:36:19.639 --> 00:36:21.960
you know, I have family history of heart disease and

759
00:36:22.039 --> 00:36:24.079
it's really not and I particularly had the kind of

760
00:36:24.119 --> 00:36:26.239
obesity which is added post obesity, which is where you're

761
00:36:26.280 --> 00:36:28.119
kind of got skinny arms and legs but a big

762
00:36:28.159 --> 00:36:32.360
gut that is particularly bad for increasing your heart disease risk.

763
00:36:32.800 --> 00:36:36.239
Why am I sort of feeling like I'm doing something immoral.

764
00:36:36.719 --> 00:36:39.960
And if you look at the kind of people, the

765
00:36:40.079 --> 00:36:41.639
kind of weight loss weird mind. I think it goes

766
00:36:41.679 --> 00:36:43.360
to this even deeper way of thinking about it, which

767
00:36:43.400 --> 00:36:45.320
is obesity as a sin. Right, if you look at

768
00:36:45.360 --> 00:36:47.480
the seven deadly sins that were first formulated by Pope

769
00:36:47.480 --> 00:36:51.519
Gregory the First in the sixth century, you know gluttony

770
00:36:51.599 --> 00:36:53.360
is one of them. It's always depicted with a fat

771
00:36:53.400 --> 00:36:56.880
person sort of stuffing their face, right, And we've been

772
00:36:57.000 --> 00:37:00.000
taught to think of obesity as a sin, as an

773
00:37:00.079 --> 00:37:03.480
offence against everyone else and indeed against God and against

774
00:37:03.519 --> 00:37:05.519
the individual. Right. And if you look at the kinds

775
00:37:05.519 --> 00:37:08.320
of weight loss we admire, they follow the pattern of sin,

776
00:37:08.440 --> 00:37:12.679
punishment redemption. Right. You sin, you've got to suffer and

777
00:37:12.719 --> 00:37:15.000
then we'll say that you're redeemed. So who do we

778
00:37:15.039 --> 00:37:18.280
admire your Your former podcast host was on The Biggest Loser, Right,

779
00:37:18.639 --> 00:37:21.000
People who don't know, a horrifying game show where you know,

780
00:37:21.400 --> 00:37:25.920
very overweight people compete to lose weight in incredibly macabre

781
00:37:25.920 --> 00:37:29.199
ways where they suffer and wail on camera. Okay, if

782
00:37:29.239 --> 00:37:31.840
you go through that, we'll like you. Right, if you pay,

783
00:37:31.960 --> 00:37:34.679
you suffer in the stream exactly, then it's Okay, you

784
00:37:34.719 --> 00:37:37.159
paid the price for your sin, right, But you know

785
00:37:37.519 --> 00:37:39.079
this isn't a sin. I think there is a sinner here.

786
00:37:39.079 --> 00:37:41.920
It's the processed food industry. But this is not a

787
00:37:41.960 --> 00:37:45.039
sin that I ate the food that was advertised to

788
00:37:45.039 --> 00:37:47.880
me from the moment I was born, Right, I don't

789
00:37:47.880 --> 00:37:50.000
believe that's a sin if I think about it rationally.

790
00:37:50.039 --> 00:37:51.719
Do I think about my friends who my friend who

791
00:37:51.800 --> 00:37:53.280
died who was obeast, Do I think she was a

792
00:37:53.320 --> 00:37:55.320
sinner who deserved to be punished? No? Do I think

793
00:37:55.320 --> 00:37:57.400
my grandmother who was very overweight, do I think she

794
00:37:57.480 --> 00:37:59.920
deserves to be No? Of course I don't. But it's

795
00:38:00.199 --> 00:38:02.400
these ideas are just beneath the surface, and I think

796
00:38:02.400 --> 00:38:05.119
we need to sort of bring them out so we

797
00:38:05.159 --> 00:38:07.559
can think about them in a kind of calmer way,

798
00:38:07.599 --> 00:38:10.159
because I think in a way with these drugs, we

799
00:38:10.239 --> 00:38:12.920
have to weigh the benefits and risks very carefully, and

800
00:38:12.960 --> 00:38:16.760
different individuals will reach different conclusions, and it's very complicated

801
00:38:16.840 --> 00:38:18.679
and it's very difficult, and I'm not sure I've made

802
00:38:18.679 --> 00:38:22.559
the right decision for myself even But if our ability

803
00:38:22.599 --> 00:38:26.360
to weigh those risks is polluted by these the ideas

804
00:38:26.360 --> 00:38:29.679
of a sixth century pope and or these kind of

805
00:38:29.760 --> 00:38:34.719
other stigmatizing, angry ideas. I don't think that I'll get

806
00:38:34.719 --> 00:38:36.280
as we want, which is not to say that the

807
00:38:36.280 --> 00:38:38.760
people who are critical don't have lots of good points.

808
00:38:38.800 --> 00:38:41.360
They absolutely do think about you know, you mentioned there

809
00:38:41.360 --> 00:38:44.079
are loads of unknown risks, right, I mean probably alyout

810
00:38:44.079 --> 00:38:46.639
half of my book is about analyzing what we know

811
00:38:46.760 --> 00:38:50.800
about those risks, and many people will reach the conclusion.

812
00:38:51.360 --> 00:38:52.880
It's been so interesting for me when I went to

813
00:38:52.880 --> 00:38:56.000
meet the marketing department of my British and American publishers

814
00:38:56.000 --> 00:38:58.639
in London and New York and they they'd read the book.

815
00:38:58.639 --> 00:38:59.920
They were the first people other than me and my

816
00:39:00.039 --> 00:39:01.840
fact checkers and some of my friends whove read the book.

817
00:39:01.960 --> 00:39:03.360
And some of that came up to me and said,

818
00:39:03.880 --> 00:39:06.360
I loved your book. It made me absolutely convinced to

819
00:39:06.400 --> 00:39:08.280
take ozen pic and that it's a great thing. And

820
00:39:08.320 --> 00:39:10.079
some other people come up to me and said, I

821
00:39:10.119 --> 00:39:12.840
loved your book. It made me convince you'd be absolutely

822
00:39:12.880 --> 00:39:14.920
insane to take these drugs. And it was a bit

823
00:39:15.000 --> 00:39:18.880
like what was that dress, you know, or a gold right.

824
00:39:19.400 --> 00:39:20.880
It was a bit like that, and I thought, that's

825
00:39:20.920 --> 00:39:23.239
a sign I've done my job, right, Yeah, because you

826
00:39:23.280 --> 00:39:26.159
should be able to see the evidence and make your

827
00:39:26.199 --> 00:39:29.239
own judgment on this, but you can't see the evidence

828
00:39:29.880 --> 00:39:32.639
if you're not aware of the unconscious forces that are

829
00:39:32.679 --> 00:39:35.559
sort of polluting our judgment. Which is not to say

830
00:39:35.599 --> 00:39:38.000
they do have a legitimate point about diabetics. They absolutely do.

831
00:39:38.239 --> 00:39:40.719
It is outrageous that diabetics who needed that drug didn't

832
00:39:40.719 --> 00:39:43.159
get it because some people who were rich, who had

833
00:39:43.239 --> 00:39:45.480
much less medical need got it. But to me, the

834
00:39:45.519 --> 00:39:46.719
answer to that is not to be angry at the

835
00:39:46.760 --> 00:39:48.559
individual person who bought it, to be angry that we

836
00:39:48.559 --> 00:39:51.360
didn't build a system like the COVID vaccine that would

837
00:39:51.400 --> 00:39:53.559
have made sure that people who need it get it. Yeah.

838
00:39:53.639 --> 00:39:57.119
Yeah, So on that though, on that sort of stigmatization

839
00:39:57.280 --> 00:39:59.960
of weight and being overweight, which you know people have

840
00:40:00.079 --> 00:40:03.519
experienced for the longest time, and there's there's a thirty

841
00:40:03.599 --> 00:40:07.000
billion dollar I don't know the figure, but the diet culture, diet,

842
00:40:07.480 --> 00:40:11.199
the diet industry, industry, industry is an enormous industry, and

843
00:40:11.239 --> 00:40:13.800
it's been playing to this four years and you know,

844
00:40:13.800 --> 00:40:18.599
there's been this big pushback against it and to encourage

845
00:40:18.719 --> 00:40:22.039
people to be okay, you know, they don't need to

846
00:40:22.079 --> 00:40:24.280
be a certain achieve a certain ideal weight, and they

847
00:40:24.320 --> 00:40:25.840
don't need to be flogging themselves at the gym, and

848
00:40:25.880 --> 00:40:29.480
everybody should be okay and accepting themselves as they are.

849
00:40:30.079 --> 00:40:34.639
The whole body positive movement has been great, and then

850
00:40:34.719 --> 00:40:37.920
these weight logs drugs come along and it's like, what

851
00:40:38.079 --> 00:40:40.599
is the how much is that going to send back

852
00:40:41.199 --> 00:40:43.159
that movement? You know, like, I think that's what goes

853
00:40:43.199 --> 00:40:46.880
through my mind as well, because you push back against this.

854
00:40:47.079 --> 00:40:48.480
You know, you're not a good person if you're not

855
00:40:48.519 --> 00:40:51.159
working out and walking all the rest of the messages

856
00:40:51.199 --> 00:40:53.840
that we're fed we should just all accept ourselves as

857
00:40:53.880 --> 00:40:56.960
we are. But then, oh, when this thing is offered

858
00:40:57.000 --> 00:41:00.039
that could potentially be the solution, and maybe I I

859
00:41:00.039 --> 00:41:02.440
don't have to just learn to live with myself in

860
00:41:02.480 --> 00:41:07.159
this bigger body. It feels almost like wrong to want

861
00:41:07.320 --> 00:41:09.239
to take it. I don't know if you experienced something

862
00:41:09.320 --> 00:41:11.760
like that. You know, right, we've all been encouraged to

863
00:41:11.800 --> 00:41:14.000
just accept ourselves. We don't have to be waf thin.

864
00:41:14.239 --> 00:41:16.760
But oh, but that would be nice. But should I

865
00:41:16.800 --> 00:41:17.079
want that?

866
00:41:17.559 --> 00:41:19.400
One of the worst moments in the writing of the book,

867
00:41:19.400 --> 00:41:22.639
I think actually the worst moment for me was about

868
00:41:22.960 --> 00:41:27.360
six months into taking these drugs, I facetimed with my niece, Erin,

869
00:41:27.920 --> 00:41:30.280
and Erin is the youngest member of my family and

870
00:41:30.320 --> 00:41:32.280
she's the only girl. I've got lots of nephews and

871
00:41:32.360 --> 00:41:34.880
lots of godsons, but she's the only girl. And no

872
00:41:34.920 --> 00:41:37.199
one makes me more protective in the whole world than Erin. Right,

873
00:41:37.679 --> 00:41:39.599
And in my head, she's always six years old. Whenever

874
00:41:39.639 --> 00:41:41.519
she gets a boyfriend, I was like, who are these pedophiles?

875
00:41:41.719 --> 00:41:43.480
Get away? But actually she is like eighteen at that

876
00:41:43.599 --> 00:41:48.480
university and we're facetiming and we're having this lovely chat.

877
00:41:48.519 --> 00:41:50.000
She's like, oh, look, you've lost so much weight. You

878
00:41:50.000 --> 00:41:52.239
look great, and we were talking about it and I

879
00:41:52.280 --> 00:41:54.400
was sort of preening a little bit, and then she

880
00:41:54.480 --> 00:41:57.039
said she looked down at herself and she said, well,

881
00:41:57.079 --> 00:41:59.760
you get me somemo zen pic And she's a completely

882
00:41:59.800 --> 00:42:01.679
held the way, And for a moment I thought she

883
00:42:01.719 --> 00:42:03.880
was joking, and I realized she was actually asking me

884
00:42:03.920 --> 00:42:06.360
to get her, and I thought, what the fuck am

885
00:42:06.360 --> 00:42:11.280
I doing. I've spent eighteen years working so hard to

886
00:42:11.320 --> 00:42:14.000
give her the message you don't have to be super thin,

887
00:42:14.719 --> 00:42:18.280
you know, embrace who you are and have I just

888
00:42:18.360 --> 00:42:22.239
completely undercut all of that, and I want to explore

889
00:42:22.239 --> 00:42:23.920
this in a lot of details. There's a lot about

890
00:42:23.920 --> 00:42:24.920
this in the book, and I spent a lot of

891
00:42:24.960 --> 00:42:26.840
time talking to people with different in different aspects of

892
00:42:26.840 --> 00:42:29.039
the debate about this. And one of the people who

893
00:42:29.119 --> 00:42:30.800
most helped me to understand this is a woman called

894
00:42:30.800 --> 00:42:34.280
Shelley Bovy, a wonderful person. So when I was a kid,

895
00:42:34.960 --> 00:42:36.559
like when you were a kid, I think we're the

896
00:42:36.599 --> 00:42:38.960
same age. It was just completely taken for granted that

897
00:42:38.960 --> 00:42:40.800
fat people were like a joke on television, right, They

898
00:42:40.800 --> 00:42:43.760
were like the what of a punchline? Right? And the

899
00:42:43.800 --> 00:42:46.000
first person I ever saw challenge that was this woman,

900
00:42:46.119 --> 00:42:49.119
Shelly Bovy. So I remember I was ten, and she

901
00:42:49.199 --> 00:42:52.119
went on the British equivalent of Oprah, not that there

902
00:42:52.119 --> 00:42:54.480
can ever be a British equivalent vote but obviously just

903
00:42:54.519 --> 00:43:00.639
in case she's listening, but the my podcast, and she

904
00:43:00.679 --> 00:43:03.239
went on this program. And so Shelley had grown up.

905
00:43:03.239 --> 00:43:06.599
She's from a town called Port Talbot, which was a

906
00:43:06.639 --> 00:43:10.079
working class town in Wales, had the biggest steel works

907
00:43:10.079 --> 00:43:11.840
in Europe at the time when she was growing up,

908
00:43:12.159 --> 00:43:14.559
and she was the only fat girl in her school

909
00:43:14.719 --> 00:43:17.599
and One day when she was twelve, her teacher said

910
00:43:17.599 --> 00:43:20.039
to her, at the end of a lesson, stay behind bovy.

911
00:43:20.360 --> 00:43:21.719
And she was sitting there the younger what have I've

912
00:43:21.719 --> 00:43:24.239
done wrong? And the teacher said to her, you are

913
00:43:24.400 --> 00:43:26.800
far too fat. Go to the school nurse. She'll sort

914
00:43:26.840 --> 00:43:29.559
you out. So Shelley goes to the school nurse and

915
00:43:29.599 --> 00:43:31.599
the school nurse looks and says, take off your clothes,

916
00:43:32.159 --> 00:43:33.840
and she takes up a clothes and she looks. The

917
00:43:33.960 --> 00:43:36.800
nurse looks and says, you're much too fat, and just

918
00:43:36.800 --> 00:43:39.119
gives her this kind of angry lecture about how disgusting

919
00:43:39.119 --> 00:43:41.639
it was that she was fat, and says, pull yourself

920
00:43:41.679 --> 00:43:45.360
together or you'll die young. And Shelley left feeling absolutely

921
00:43:45.400 --> 00:43:49.599
wretched about herself, and throughout her entire school career, she's

922
00:43:49.719 --> 00:43:52.480
constantly being told just so fat, you so disgusting, you

923
00:43:52.559 --> 00:43:55.719
make me sick. Thank God, I'm not you. She had

924
00:43:55.719 --> 00:43:57.800
one teacher, I Meselves like a story from a Roll

925
00:43:57.920 --> 00:44:01.400
Dahl's novel or something, but who was watching her eat

926
00:44:01.400 --> 00:44:03.639
a lunchtime and said, you're a pig. I'm going to

927
00:44:03.679 --> 00:44:05.280
make you eat all of these desserts that made it

928
00:44:05.320 --> 00:44:07.639
eat all these deserts in front of everyone until she vomited.

929
00:44:08.000 --> 00:44:10.840
So this kind of humiliation which she completely internalized. She

930
00:44:10.920 --> 00:44:12.800
would never look at her own body naked because she

931
00:44:12.920 --> 00:44:16.639
was so disgusted and so internalized this this hatred of

932
00:44:16.639 --> 00:44:20.199
her own body. And she actually she's really clever and

933
00:44:20.239 --> 00:44:23.320
she was Her teachers wanted her to apply for Cambridge,

934
00:44:23.519 --> 00:44:25.320
which was a huge deal for a working class girl

935
00:44:25.320 --> 00:44:27.679
at the time. What I mean would be now, and

936
00:44:27.719 --> 00:44:29.159
she wouldn't do it because she's just like, they'll be

937
00:44:29.199 --> 00:44:31.079
so cruel to me, they'll humiliate me. She didn't go

938
00:44:31.119 --> 00:44:33.079
to university. She end up working in her parents pub

939
00:44:33.800 --> 00:44:37.199
when she had kids. You know. The first thing happened

940
00:44:37.199 --> 00:44:38.519
when she was pregnant and went to the doctor was

941
00:44:38.519 --> 00:44:40.079
the doctor said, well, you shouldn't even be pregnant when

942
00:44:40.079 --> 00:44:42.360
you're as fat as you are. After she gave birth,

943
00:44:42.400 --> 00:44:44.639
she had a very difficult birth. I just gave birth.

944
00:44:44.679 --> 00:44:47.960
She's lying there sort of covered in blood, and one

945
00:44:47.960 --> 00:44:50.400
of the first things the midwife said to her is, yeah,

946
00:44:50.440 --> 00:44:54.039
you're so fat, you should lose weight or this constant

947
00:44:54.239 --> 00:44:57.679
her baby actually had difficulty eating, feeding, breastfeeding, and when

948
00:44:57.679 --> 00:45:00.400
she took into the doctor, the doctor said to the

949
00:45:00.440 --> 00:45:04.480
baby as fat as you are. So it's just constant humiliation,

950
00:45:04.880 --> 00:45:07.039
which she just took us her due, right, She's like, well,

951
00:45:07.199 --> 00:45:10.639
it's my fault. I'm fat, I'm greedy, all the horrible

952
00:45:10.679 --> 00:45:13.239
things that we say about overweight people. And then she

953
00:45:13.400 --> 00:45:15.639
learned that there had been this movement in the United States,

954
00:45:15.880 --> 00:45:19.480
she's sometimes called fat Pride, which had argued against these

955
00:45:19.519 --> 00:45:21.320
forms of stigma. Actually one of the reasons they one

956
00:45:21.360 --> 00:45:23.800
of their early campaigns was against an early diet drag

957
00:45:23.840 --> 00:45:27.320
and fetamines, which really screwed people up and can indeed

958
00:45:27.320 --> 00:45:30.280
call psychosis. And just hey, kids, it's not a good

959
00:45:30.280 --> 00:45:32.920
idea to take her fetterments all the time, right, And

960
00:45:32.960 --> 00:45:35.639
Shelley wrote the first book ever in Britain, a wonderful

961
00:45:35.639 --> 00:45:39.320
book called The Forbidden Body, arguing against this form of prejudice.

962
00:45:39.760 --> 00:45:41.840
And I remember seeing her and she was treated as

963
00:45:41.880 --> 00:45:43.760
like a joke, right, the daily mail around this arsca

964
00:45:43.760 --> 00:45:46.119
about how big she was, as kind of mad fat

965
00:45:46.119 --> 00:45:50.840
woman saying this glorifying obesity. And Shelley became this incredibly

966
00:45:51.199 --> 00:45:55.840
articulate and thoughtful opponent of stigma and the leading thing,

967
00:45:55.920 --> 00:45:57.960
the most well known figure in Britain in this fight

968
00:45:58.199 --> 00:46:00.880
and she really fought against this shaming and was very

969
00:46:00.880 --> 00:46:03.599
good at it. And then something happened to Shelley that

970
00:46:03.639 --> 00:46:05.800
it was difficult for her to think about. So by

971
00:46:05.840 --> 00:46:07.599
the time she was fifty, she weighed nineteen and a

972
00:46:07.639 --> 00:46:10.360
half stone, and she was losing the ability to walk.

973
00:46:10.599 --> 00:46:12.679
As she went to Center Parks at a theme park

974
00:46:12.719 --> 00:46:15.599
with her family, and she just she couldn't walk anywhere.

975
00:46:15.639 --> 00:46:16.880
She had to be pushing in a wheelchair, and even

976
00:46:16.880 --> 00:46:18.639
though her daughter was a personal trainer, she couldn't get up.

977
00:46:18.639 --> 00:46:22.239
It was very humiliating, and she was having heart problems

978
00:46:22.760 --> 00:46:24.639
and a young woman to be losing the ability to

979
00:46:24.639 --> 00:46:27.360
walk and have heart problems, and she had to think

980
00:46:27.360 --> 00:46:32.199
about this very difficult question, which was I'm passionately opposed

981
00:46:32.199 --> 00:46:35.599
to the stigma that is directed towards obese people. But

982
00:46:35.639 --> 00:46:37.679
there's another thing going on here, which is the physical

983
00:46:37.679 --> 00:46:41.800
effects of obesity. Now, stigma makes those problems worse. The

984
00:46:41.800 --> 00:46:43.840
body positivity people absolute right about that and go into

985
00:46:43.840 --> 00:46:45.400
more detail about why. But there are one hundred percent

986
00:46:45.480 --> 00:46:47.480
right about that. Firstly, stigma is just to form a

987
00:46:47.480 --> 00:46:50.679
cruelty and meanness and bullying, but secondly actually makes the

988
00:46:50.679 --> 00:46:54.320
problem worse. If you insult and terrorize overweight people. They

989
00:46:54.360 --> 00:46:57.960
eat more to comfort themselves. You know, forty five percent

990
00:46:58.000 --> 00:47:01.239
of women with a BMI higher than thirty five get

991
00:47:01.239 --> 00:47:04.880
insulted every single day. Like Shelley was right. But Shelley

992
00:47:04.920 --> 00:47:09.360
had to explore irrespective the debate about stigma, even if

993
00:47:09.400 --> 00:47:10.960
we got rid of all the stigma in the world,

994
00:47:12.039 --> 00:47:14.400
it would still make me much more likely to become diabetic,

995
00:47:14.599 --> 00:47:18.199
to develop cancer, to develop dementia. And she really struggled

996
00:47:18.199 --> 00:47:20.280
with this, and within the body positivity movement at the time,

997
00:47:20.320 --> 00:47:23.559
there was a newsletter that they had called fat News,

998
00:47:24.400 --> 00:47:26.400
and she and other people wanted to write about the

999
00:47:26.440 --> 00:47:30.079
struggles are living with diabetes and the fat newsletters. Right, No,

1000
00:47:30.199 --> 00:47:34.559
this is about celebrating and challenging stigma. That's deepening stigma.

1001
00:47:34.639 --> 00:47:37.480
And even then Shelley was like, but surely we can.

1002
00:47:37.880 --> 00:47:41.119
We have to do two things. We have to challenge

1003
00:47:41.119 --> 00:47:44.559
the stigma that harms our minds and our souls, and

1004
00:47:44.679 --> 00:47:46.840
we have to challenge if we possibly can, and it

1005
00:47:46.880 --> 00:47:49.039
was very hard to do at the time, challenge the

1006
00:47:49.079 --> 00:47:51.800
obesity that harms our bodies. They're both forms of self love.

1007
00:47:52.079 --> 00:47:55.239
She said, it's not either or, it's both, and Now,

1008
00:47:55.239 --> 00:47:57.719
there are very cruel ways of encouraging overweight people. There's

1009
00:47:57.800 --> 00:48:00.760
something called concern trolling, where you to be worried about

1010
00:48:00.760 --> 00:48:02.480
their health, but you're actually using it as another excuse

1011
00:48:02.519 --> 00:48:05.599
to bully and terrorize people. And there's a lot of that.

1012
00:48:06.119 --> 00:48:10.599
But Shelley says there's concern trolling and then there's actual concern. Right.

1013
00:48:10.920 --> 00:48:12.760
And Shelley was one of the minority of people who

1014
00:48:12.800 --> 00:48:15.199
was able to lose a huge amount of weight by

1015
00:48:15.639 --> 00:48:18.559
a dieting right, a small minority. She always stressed that

1016
00:48:18.599 --> 00:48:21.199
she was in a small minority, but she lost seven

1017
00:48:21.239 --> 00:48:25.480
stone by dieting. Wow, and kept it off. She had

1018
00:48:25.519 --> 00:48:28.360
that sort of dilemma in the more than twenty years ago,

1019
00:48:28.440 --> 00:48:30.039
and she's kept it off. I went to I spent

1020
00:48:30.119 --> 00:48:32.320
a lot of time with her and became friends with her.

1021
00:48:32.400 --> 00:48:36.320
But I think Shelley is right that where we can,

1022
00:48:37.000 --> 00:48:41.519
we should do both. We should challenge stigma and if

1023
00:48:41.559 --> 00:48:44.199
we can, we should help people reverse the health harms

1024
00:48:44.239 --> 00:48:46.960
that are caused to them by obesity. Now, there are

1025
00:48:47.000 --> 00:48:49.239
some people in the body positivity movement who have a

1026
00:48:49.280 --> 00:48:51.960
lot of sympathy for and I understand where it comes from,

1027
00:48:51.960 --> 00:48:53.880
and it comes from a lifetime of soaking up the

1028
00:48:53.880 --> 00:48:59.440
most vile abuse who argue that presenting the evidence the

1029
00:48:59.679 --> 00:49:03.280
overwhelming medical consensus around the harms caused by obesity, which

1030
00:49:03.280 --> 00:49:06.440
is as overwhelming as the evidence that greenhouse gas emissions

1031
00:49:06.480 --> 00:49:09.559
cause climate change or that vaccines work, they argue that

1032
00:49:09.599 --> 00:49:11.960
putting forward that evidence is itself a form of stigma,

1033
00:49:12.039 --> 00:49:14.440
and they have tried to dispute some of the science

1034
00:49:14.519 --> 00:49:16.079
around that. And I did look into that with an

1035
00:49:16.119 --> 00:49:18.239
open mind and a lot of detail, like Shelley did,

1036
00:49:18.639 --> 00:49:21.239
and I'm afraid the sciences just couldn't be more clear

1037
00:49:21.280 --> 00:49:23.159
about this. Right, of course, there are some overweight people

1038
00:49:23.159 --> 00:49:26.119
who remain healthy, just like my mother smokes seventy cigarettes

1039
00:49:26.119 --> 00:49:27.599
a day and she is She's alive and well at

1040
00:49:27.639 --> 00:49:30.880
seventy eight. But the odds are rigged against you. Yeah, right.

1041
00:49:31.559 --> 00:49:34.920
So I want to communicate that as delicately as I can,

1042
00:49:34.960 --> 00:49:37.679
and with a huge amount of love and sympathy, and

1043
00:49:37.719 --> 00:49:40.280
with a desire to protect people, and an awareness that

1044
00:49:40.280 --> 00:49:43.599
that would be really upsetting and painful and challenging to hear.

1045
00:49:44.280 --> 00:49:45.320
And I know it is because it is for a

1046
00:49:45.360 --> 00:49:46.840
lot of my relatives, and it was difficult for me

1047
00:49:46.880 --> 00:49:50.360
to hear. But I think we can have It's very

1048
00:49:50.360 --> 00:49:52.119
hard to do in a social media age where everything

1049
00:49:52.119 --> 00:49:55.639
gets simplified into screaming abuse at each other, yeap and tribalism.

1050
00:49:55.920 --> 00:49:58.320
But I have to believe that we can have that

1051
00:49:58.400 --> 00:50:01.159
complex conversation with each other, and we can have it

1052
00:50:01.159 --> 00:50:04.039
in a spirit that's not angry, but that's loving and compassionate.

1053
00:50:04.360 --> 00:50:08.239
Yeah, you mentioned before, Johan about people who are already

1054
00:50:08.280 --> 00:50:11.840
thin accessing the drugs and how that's really wrong when

1055
00:50:12.000 --> 00:50:14.599
diabetics potentially couldn't get a hold of it. The other

1056
00:50:14.599 --> 00:50:16.480
people that can potentially get a hold of these drugs,

1057
00:50:16.559 --> 00:50:18.320
just talking about the kind of the supply chain and

1058
00:50:18.360 --> 00:50:21.239
the accessibility. Who who can get them and who can't?

1059
00:50:21.719 --> 00:50:24.679
You know, I know that you can jump online and

1060
00:50:24.960 --> 00:50:28.800
order these things and they will ask you what's your uh,

1061
00:50:28.920 --> 00:50:31.760
you know, put in your details, what are your wait like,

1062
00:50:31.800 --> 00:50:34.519
nobody's checking. You can type in any information that you

1063
00:50:34.639 --> 00:50:38.480
want and qualify to have these medications delivered straight to

1064
00:50:38.519 --> 00:50:41.840
your front door. So you know, the other group of people,

1065
00:50:42.119 --> 00:50:44.320
not just the thin people who want to be thinner,

1066
00:50:44.360 --> 00:50:45.920
but what about the people who at the other end

1067
00:50:45.920 --> 00:50:48.559
of that extreme, who potentially eating disordered people and are

1068
00:50:48.559 --> 00:50:53.360
exit people potentially having access to these medications, and you know,

1069
00:50:53.400 --> 00:50:55.199
what are your thoughts about that and what we need

1070
00:50:55.239 --> 00:51:00.960
to do to be controlling who who's prescribing and who monitoring.

1071
00:51:01.239 --> 00:51:03.519
Now, this isn't a potential problem. This is happening. So

1072
00:51:04.079 --> 00:51:07.599
in the book, I go through these these twelve risks

1073
00:51:07.599 --> 00:51:10.280
that are associated with these drugs, and this is one

1074
00:51:10.320 --> 00:51:13.320
of the two that most worries me. We've got a

1075
00:51:13.360 --> 00:51:16.920
lot of evidence around this, so there's a significant as

1076
00:51:16.960 --> 00:51:19.440
everyone knows, there's some people in the population who want

1077
00:51:19.440 --> 00:51:22.440
to starve themselves for a complex range of reasons, and

1078
00:51:22.480 --> 00:51:25.519
that was hugely has actually massively exploded during the pandemic,

1079
00:51:25.840 --> 00:51:28.519
and it was already very high because of all sorts

1080
00:51:28.519 --> 00:51:31.400
of pressures. Particularly is overwhelmingly teenage girls, although there are

1081
00:51:31.400 --> 00:51:34.880
some boys as well. And you know, people like Kimberly Dennis,

1082
00:51:34.880 --> 00:51:38.039
doctor Kimberly Dennis, who's in Chicago, who's one of the

1083
00:51:38.119 --> 00:51:40.400
leading people treating eating disorders. We're talking to me about

1084
00:51:40.400 --> 00:51:42.960
how they're seeing people in their clinics who are you know,

1085
00:51:43.320 --> 00:51:46.000
they're very worried about in relation to these drugs. So

1086
00:51:46.079 --> 00:51:49.199
these drugs give you a tool to amputate your appetite,

1087
00:51:49.480 --> 00:51:53.519
which obviously, if you're trying to starve yourself, is catastrophic.

1088
00:51:54.000 --> 00:51:55.679
And we don't have to speculate about this. We've been

1089
00:51:55.719 --> 00:51:59.079
here before. So in the early nineteen nineties, there was

1090
00:51:59.519 --> 00:52:02.880
a popular diet drug and there was a huge explosion

1091
00:52:02.880 --> 00:52:05.119
in teenage girls getting hold of it and starving themselves.

1092
00:52:05.119 --> 00:52:08.239
There were congressional hearings in the early nineties called by

1093
00:52:08.480 --> 00:52:11.599
Rob Widen, who at the time was a congressman for Oregon,

1094
00:52:11.920 --> 00:52:14.280
and I mean, it's chilling when you read it now,

1095
00:52:14.920 --> 00:52:17.559
so that it's a string of people testifying. There was

1096
00:52:17.599 --> 00:52:22.400
a young woman who testified called Jennifer, who you know,

1097
00:52:22.440 --> 00:52:25.760
she'd wanted to get into ballet. She'd taken these diet drugs.

1098
00:52:25.880 --> 00:52:27.960
She'd absolutely I mean she took something dark drugs that

1099
00:52:27.960 --> 00:52:32.719
she would just pass out from extreme hunger. There was

1100
00:52:32.719 --> 00:52:37.480
a really heartbreaking testimony by a guy called Tony Smith

1101
00:52:38.159 --> 00:52:41.159
who his daughter Noel, from when she was very young,

1102
00:52:41.320 --> 00:52:43.480
became obsessed with the idea that she was fat, obsessed

1103
00:52:43.519 --> 00:52:47.039
with fashion magazines, and when she was in her early

1104
00:52:47.119 --> 00:52:50.119
teen started buying loads of these diet drugs but also diuretics.

1105
00:52:50.960 --> 00:52:54.039
And he was from a place called State Center in Iowa,

1106
00:52:54.440 --> 00:52:57.079
and she died in her early twenties of a heart

1107
00:52:57.079 --> 00:52:59.880
attack because she'd starved herself death right, and he read

1108
00:53:00.239 --> 00:53:03.760
this heartbreaking poem that she'd written about you know, I

1109
00:53:03.800 --> 00:53:07.440
want to eat, but not yet, not yet. And so

1110
00:53:08.440 --> 00:53:11.880
this is a huge problem, and you're absolutely right. This

1111
00:53:11.920 --> 00:53:13.199
is going to get into the hands of people who

1112
00:53:13.239 --> 00:53:14.800
eat disorders, is already and it's going to cause a

1113
00:53:14.800 --> 00:53:17.000
lot of deaths, and in the worst case scenarios, it

1114
00:53:17.000 --> 00:53:19.000
having a death toll like the opioid crisis. I mean,

1115
00:53:19.000 --> 00:53:22.079
it could be really catastrophic. There's something we should do

1116
00:53:22.239 --> 00:53:25.039
immediately to limit that. It won't eliminate that risk, but

1117
00:53:25.039 --> 00:53:28.280
it will limit that risk, which is these drugs should

1118
00:53:28.320 --> 00:53:32.079
only be prescribed in person, never on zoom, and they

1119
00:53:32.079 --> 00:53:35.159
should only be prescribed by doctors who have an expertise

1120
00:53:35.159 --> 00:53:38.199
in spotting eating disorders and can refer you for treatment

1121
00:53:38.239 --> 00:53:40.360
for eating disorders. Now, there's a whole other debate about

1122
00:53:40.360 --> 00:53:42.519
whether they will or a parallel debate, but whether it

1123
00:53:42.559 --> 00:53:46.039
will cause eating disorders. We don't know much about that yet.

1124
00:53:46.719 --> 00:53:50.440
I suspect it will in some people. But absolutely we

1125
00:53:50.480 --> 00:53:52.679
should be doing that to protect the most vulnerable people

1126
00:53:52.679 --> 00:53:55.760
because We've already got staggeringly high deaths from anorexia and

1127
00:53:55.760 --> 00:54:00.280
bolimia and rising even before these drugs came along. So yeah,

1128
00:54:00.400 --> 00:54:02.360
we should be absolutely urgently doing that.

1129
00:54:02.679 --> 00:54:05.679
You said that was one of your biggest concerns. What's

1130
00:54:05.719 --> 00:54:06.679
the second biggest one?

1131
00:54:06.719 --> 00:54:09.280
I mean, because there's twelve, This is just purely like

1132
00:54:09.320 --> 00:54:11.280
on a personal level, what I fear the most. Actually,

1133
00:54:11.360 --> 00:54:15.559
all twelve of them are pretty serious, but the one

1134
00:54:15.599 --> 00:54:18.679
that most sobered me was the risk around thyroid cancer.

1135
00:54:18.800 --> 00:54:21.440
So we know that when you give these drugs to rats,

1136
00:54:21.559 --> 00:54:25.000
you massively increase the risk of thyroid cancer. So when people,

1137
00:54:25.119 --> 00:54:27.559
when scientists have looked at what are the risks surrounding

1138
00:54:27.559 --> 00:54:30.599
these drugs, what the proponents of the drugs say, and

1139
00:54:30.639 --> 00:54:33.159
there's a lot of truth in this is what we

1140
00:54:33.159 --> 00:54:35.480
can be pretty confident about the safety of these drugs

1141
00:54:35.760 --> 00:54:38.199
because diabetics have been taking them for what is it,

1142
00:54:38.280 --> 00:54:42.519
sixteen years now, and so if it caused some horrendous

1143
00:54:42.559 --> 00:54:44.840
short or medium term effect, we would know by now

1144
00:54:45.119 --> 00:54:47.119
right that it would show up. And there's a lot

1145
00:54:47.119 --> 00:54:49.400
of truth in that. Now, though scientists will almost always

1146
00:54:49.440 --> 00:54:51.840
say we have to caveat that by saying it could

1147
00:54:51.840 --> 00:54:54.119
affect people who are taking it for obesity differently to

1148
00:54:54.119 --> 00:54:57.000
how it affects diabetics. But in the main that's actually

1149
00:54:57.079 --> 00:55:00.360
quite a long period. Most drugs are not to for

1150
00:55:00.400 --> 00:55:02.360
that long, right, So that's a reason that should give

1151
00:55:02.400 --> 00:55:06.480
people some reassurance. But there are a series of problems

1152
00:55:07.119 --> 00:55:10.679
which scientists are investigating may be emerging among that population.

1153
00:55:10.840 --> 00:55:14.320
So interview guy called Professor Jean Luc Fay, who's professor

1154
00:55:14.360 --> 00:55:17.679
of pharmacology at the University Hospital in Montpellier in France,

1155
00:55:17.719 --> 00:55:20.719
and he was asked by the French Medicines Agency. He

1156
00:55:20.880 --> 00:55:26.079
was tasked with the it's called Pharmacovigilance program. He was

1157
00:55:26.159 --> 00:55:28.159
tasked with looking at the risk of these weight loss

1158
00:55:28.199 --> 00:55:30.320
drugs for French people. And France is in the best

1159
00:55:30.360 --> 00:55:32.239
position in the world to investigate this because they have

1160
00:55:32.559 --> 00:55:36.440
really good medical databases. It's almost impossible to opt out

1161
00:55:36.440 --> 00:55:39.400
of their databases, so they can really check this out.

1162
00:55:39.599 --> 00:55:42.679
So what Professor Fai did with his colleagues is saying,

1163
00:55:42.719 --> 00:55:44.960
it's kind of in a way very simple. They look

1164
00:55:45.000 --> 00:55:47.960
at all the people who were taking all the diabetics

1165
00:55:48.000 --> 00:55:51.159
who were taking these drugs. Sorry, it was a representative sample.

1166
00:55:51.320 --> 00:55:54.000
I think it was ony five hundred diabetics who were

1167
00:55:54.039 --> 00:55:56.159
taking these drugs between I think it was two thousand

1168
00:55:56.199 --> 00:55:59.039
and six and twenty twelve, so all of them, and

1169
00:55:59.079 --> 00:56:01.679
they compared them to a very similar group of diabetics

1170
00:56:01.920 --> 00:56:04.199
who are not taking these drugs to see is there

1171
00:56:04.239 --> 00:56:07.960
any difference in their thyroid cancer outcome, And it's pretty striking.

1172
00:56:08.519 --> 00:56:10.840
The group that had taken the drug, it seemed to

1173
00:56:10.880 --> 00:56:13.320
have caused a fifty to seventy percent increase in the

1174
00:56:13.360 --> 00:56:15.920
risk of their thyroid cancer. That's really important to understand

1175
00:56:15.920 --> 00:56:18.079
what that doesn't mean. That doesn't mean you had a

1176
00:56:18.119 --> 00:56:20.239
fifty to seventy percent risk of gaining thyroid cancer. That

1177
00:56:20.239 --> 00:56:22.199
would be obviously they would immediately take the drug off

1178
00:56:22.239 --> 00:56:24.360
the market if that was the case, that would be horrifying.

1179
00:56:24.400 --> 00:56:26.880
Beyond words, what it means is whatever your thyroid cancer

1180
00:56:26.960 --> 00:56:30.440
risk was going in, it was increased by fifty to

1181
00:56:30.440 --> 00:56:33.320
seventy percent. Right, I am saying to press a fight

1182
00:56:33.679 --> 00:56:36.440
that that doesn't sound like a small effect to me. Now,

1183
00:56:36.559 --> 00:56:40.239
what the scientists say rightly is you have a very

1184
00:56:40.239 --> 00:56:43.440
small risk of your in thyroid cancer. So even though

1185
00:56:43.480 --> 00:56:45.719
that's a big increase in the risk, the overall risk

1186
00:56:45.800 --> 00:56:48.280
remains very small. Nonetheless, Professor fy You said to me,

1187
00:56:48.280 --> 00:56:50.800
you're right, it's not a small increase, right, Fifty to

1188
00:56:50.800 --> 00:56:53.519
seventy five percent is a big increase in the risk.

1189
00:56:53.920 --> 00:56:56.840
Now again, I know it's frustrating, but there's so much

1190
00:56:56.880 --> 00:57:00.079
complexity in this that you have to keep weighing against that.

1191
00:57:00.599 --> 00:57:03.159
Some of the scientists say, you have to also look

1192
00:57:03.199 --> 00:57:06.800
at how much continuing to be obese increases your cancer risk,

1193
00:57:06.920 --> 00:57:09.519
and it massively increases your canceerris. Look at what Cancer

1194
00:57:09.599 --> 00:57:11.039
UK say. They don't say this in the context of

1195
00:57:11.079 --> 00:57:14.039
these drugs, but they say the Cancer Research UK are

1196
00:57:14.000 --> 00:57:16.480
the biggest cancer charity in Britain. And what they explain

1197
00:57:16.519 --> 00:57:19.159
is when you carry excess weight, that weight doesn't just

1198
00:57:19.199 --> 00:57:22.280
sit there, right, it's active. It sends signals to your

1199
00:57:22.320 --> 00:57:24.639
body and one of the signals it often sends is

1200
00:57:24.679 --> 00:57:28.760
for yourselves to divide more rapidly, which can cause cancer. Right.

1201
00:57:29.039 --> 00:57:31.960
It's why Actually obesity is one of the biggest preventable

1202
00:57:32.159 --> 00:57:35.440
factors contributing to cancer. So at every stage of this,

1203
00:57:35.559 --> 00:57:41.039
you've got this, you're weighing these these tremendous complexities. So

1204
00:57:41.119 --> 00:57:43.000
I can well imagine you know, there are many different

1205
00:57:43.079 --> 00:57:47.559
scenarios for these drugs. Don't think it's likely, but there

1206
00:57:47.599 --> 00:57:49.840
is one plausible scenario. I kind of end the book

1207
00:57:49.840 --> 00:57:53.039
by talking about the five possible scenarios, but where I

1208
00:57:53.079 --> 00:57:54.719
think we could go from here? And it's kind of daunting,

1209
00:57:54.880 --> 00:57:56.760
having spent a year doing so much research on this

1210
00:57:56.800 --> 00:57:59.480
to actually not know. I mean, I have some sense,

1211
00:58:00.199 --> 00:58:04.840
But the first possible scenario is that where we were

1212
00:58:04.840 --> 00:58:07.599
with fen fens so. Fenfen was a hugely popular diet

1213
00:58:07.679 --> 00:58:10.639
drug in the nineties. In nineteen ninety six, there were

1214
00:58:11.159 --> 00:58:14.679
eighteen million Fenfen prescriptions written in the United States. It

1215
00:58:14.719 --> 00:58:17.440
was massively popular drug, and then it was discovered it

1216
00:58:17.480 --> 00:58:22.400
had horrific physical effects. It caused something called primary pulmonary hypertension,

1217
00:58:22.400 --> 00:58:24.400
which is where the blood vessels and your lungs contract

1218
00:58:24.400 --> 00:58:28.119
and you can't breathe very well. It also caused heart defects.

1219
00:58:29.400 --> 00:58:33.360
Thirty six thousand women, most of the women were horrifically

1220
00:58:33.440 --> 00:58:35.599
harmed by these drugs. That led to the biggest payout

1221
00:58:35.639 --> 00:58:37.360
in the history of the pharmaceutical industry at the time.

1222
00:58:37.360 --> 00:58:40.039
They had to pay out twelve billion dollars in compensation

1223
00:58:40.119 --> 00:58:43.119
to women for the families of women who died, and

1224
00:58:43.119 --> 00:58:46.960
also women who are catastrophically harmed. It's possible. I think

1225
00:58:47.000 --> 00:58:50.159
it's pretty unlikely, but it's possible that that will play

1226
00:58:50.199 --> 00:58:54.079
out again. Right that twenty years from now, we'll look back,

1227
00:58:54.119 --> 00:58:55.960
people will find my book in some second book shop

1228
00:58:55.960 --> 00:58:58.800
and they'd be like, Wow, the worst case scenario happened,

1229
00:58:59.119 --> 00:59:02.079
that there's some effect from this drug that is horrendous.

1230
00:59:02.320 --> 00:59:04.639
And you know, this is always a risk with new drugs.

1231
00:59:04.679 --> 00:59:07.760
Think about antipsychotics, for example. Yeah, so it's a huge

1232
00:59:07.760 --> 00:59:10.159
debate about antipsychotics. Park that for a second, but let's

1233
00:59:10.239 --> 00:59:13.400
just say one thing about it, which is that antipsychotics

1234
00:59:13.440 --> 00:59:15.800
were judged by scientists. It was much disputed, but they

1235
00:59:15.880 --> 00:59:18.960
were judged by scientists to be safe or for the

1236
00:59:19.280 --> 00:59:22.280
benefits to outweigh the harms for years and years. And

1237
00:59:22.320 --> 00:59:24.199
it was only after people have been taking these drugs

1238
00:59:24.199 --> 00:59:26.719
for like forty fifty years that they discovered a very

1239
00:59:26.760 --> 00:59:29.159
long term effect, which is they make you much more

1240
00:59:29.199 --> 00:59:31.519
likely to develop dementia. Now, there was just no way

1241
00:59:31.559 --> 00:59:33.320
to know that because people had to be taking them

1242
00:59:33.679 --> 00:59:35.920
in evans, because people had to be taking them for

1243
00:59:35.920 --> 00:59:38.320
forty to fifty years. So one of the risks is

1244
00:59:38.360 --> 00:59:44.199
just the unknown right. These drugs are activating chronically activating

1245
00:59:44.920 --> 00:59:47.440
parts of the brain, as even the advocates of the

1246
00:59:47.480 --> 00:59:50.239
drugs said to me, Well, of course that could have

1247
00:59:50.239 --> 00:59:53.199
all sorts of unknown effects, right, So there is a

1248
00:59:53.360 --> 00:59:56.400
significant risk there just in that alone. Never mind the

1249
00:59:56.440 --> 00:59:57.159
other risks.

1250
00:59:57.599 --> 01:00:00.960
There's lots of other issues that you've raised and researched

1251
01:00:01.000 --> 01:00:03.239
in the book. But the conclusion that you have come

1252
01:00:03.280 --> 01:00:06.920
to for you personally is that the benefits outweigh the

1253
01:00:07.039 --> 01:00:09.559
risks and that you will continue to take the drug.

1254
01:00:09.880 --> 01:00:13.440
Have you decided that that is something that you'll continue

1255
01:00:13.480 --> 01:00:15.280
to stay on it, or have you thought that you'll

1256
01:00:15.320 --> 01:00:16.559
come off and see what happens?

1257
01:00:16.559 --> 01:00:20.920
Like, what's your personal for me? And this is very

1258
01:00:21.000 --> 01:00:23.880
much a personal decision, And you know, different people with

1259
01:00:23.960 --> 01:00:26.320
the exact health profile of me might look at these

1260
01:00:26.360 --> 01:00:28.480
risks and way them differently. Diferent people are different appetites

1261
01:00:28.519 --> 01:00:31.000
for risk and different budgets. Right, I'm in the very

1262
01:00:31.079 --> 01:00:32.719
lucky position that my books have sold well, so I

1263
01:00:32.719 --> 01:00:35.000
can afford this. Right, lots of people listening, I'll be like, well,

1264
01:00:35.280 --> 01:00:37.880
screw you. There's all these benefits that I can't afford them,

1265
01:00:37.880 --> 01:00:39.639
which is why I'm very strongly in favor of healthcare

1266
01:00:39.679 --> 01:00:43.079
systems providing them to people who need them. The judgment

1267
01:00:43.119 --> 01:00:45.599
I've made is given the history of heart disease in

1268
01:00:45.599 --> 01:00:48.639
my family, given the research that was published relatively recently

1269
01:00:48.679 --> 01:00:51.519
that showed that these drugs, if you start with a

1270
01:00:51.519 --> 01:00:54.079
BMI higher than twenty seven, which I did, and you

1271
01:00:54.119 --> 01:00:55.960
take these drugs, you reduce your risk of a heart

1272
01:00:55.960 --> 01:00:58.760
attack or stroke by twenty percent over a couple of years.

1273
01:00:59.400 --> 01:01:02.119
For me, that benefit outweigh and I don't have a

1274
01:01:02.159 --> 01:01:04.960
history of thyroid cancer in my family, and I'm obviously

1275
01:01:04.960 --> 01:01:09.119
not trying to get pregnant, and I'm relatively young. I mean,

1276
01:01:09.159 --> 01:01:10.400
I don't know if I can still camp as red

1277
01:01:10.440 --> 01:01:11.880
to be young, but I'm read to be young in

1278
01:01:11.920 --> 01:01:14.800
some senses, so I'm not worried about losing muscle mass

1279
01:01:14.800 --> 01:01:16.760
if you're older. These drugs tend to make you lose

1280
01:01:16.800 --> 01:01:19.360
muscle mass, as any formal weight loss does, and that

1281
01:01:19.400 --> 01:01:21.320
can cause real problems as you get older. So if

1282
01:01:21.320 --> 01:01:23.800
I was sixty five with the exact healthcare profile, it

1283
01:01:23.840 --> 01:01:26.840
might be different. So given all of those factors, I

1284
01:01:26.880 --> 01:01:29.840
have decided to continue taking them. But I hugely respect

1285
01:01:29.880 --> 01:01:31.719
people who look at this evidence and go I'm not

1286
01:01:31.760 --> 01:01:34.239
fucking touching this right, and I also respect people look

1287
01:01:34.239 --> 01:01:36.440
at this evidence and go get me on them as

1288
01:01:36.480 --> 01:01:39.360
soon as possible. It's very difficult. We'll know more a

1289
01:01:39.360 --> 01:01:41.280
few years from now. We're I feel like we're a

1290
01:01:41.280 --> 01:01:43.679
bit like I was about to say that if I

1291
01:01:43.719 --> 01:01:45.440
can say this now, about to say it's like, look

1292
01:01:45.480 --> 01:01:47.320
at Rolf Harris picture, you know, can you see what

1293
01:01:47.360 --> 01:01:49.800
it is? Yet? It's like those pictures where it's just

1294
01:01:49.840 --> 01:01:52.199
for me, but unfortunately that's somewhat tainted memory for us

1295
01:01:52.199 --> 01:01:54.599
all now. But you're looking at a picture that's sort

1296
01:01:54.599 --> 01:01:57.760
of slowly coming into focus. And even in the period

1297
01:01:57.800 --> 01:01:59.400
I was researching the book, we knew much more at

1298
01:01:59.400 --> 01:02:01.239
the end than we did at the start of that year.

1299
01:02:01.559 --> 01:02:03.280
So we're going to know more and more and more.

1300
01:02:03.360 --> 01:02:06.039
There's an enormous a moment. The drugs are becoming better

1301
01:02:06.119 --> 01:02:08.039
and better and better as well, they'll have fewer side

1302
01:02:08.039 --> 01:02:11.199
effects and they'll be more effective, which again postes even

1303
01:02:11.239 --> 01:02:12.880
more RICI if they get better and better at promoting

1304
01:02:12.880 --> 01:02:14.960
weight loss, well then you have an even more stream

1305
01:02:14.960 --> 01:02:17.079
effect on the people with eating to sort of it's

1306
01:02:17.199 --> 01:02:21.039
super complicated, but I hope people who read Magic Pill

1307
01:02:21.119 --> 01:02:24.440
you understand the really big and unpredictable effects of this.

1308
01:02:24.480 --> 01:02:28.199
You know, Buckley's Bank commissioned a kind of very sober

1309
01:02:28.239 --> 01:02:31.519
minded financial analysts called Emily Field, to just look into

1310
01:02:31.559 --> 01:02:33.360
how is this going to affect the economy because they

1311
01:02:33.400 --> 01:02:36.639
want it to guide investment decisions. And she said, if

1312
01:02:36.639 --> 01:02:38.239
you want a comparison, you've got to look at the

1313
01:02:38.239 --> 01:02:41.199
invention of the smartphone. Wow, it's like this is going

1314
01:02:41.239 --> 01:02:44.800
to have all sorts of hugely unpredictable If we were

1315
01:02:44.800 --> 01:02:47.039
sitting here talking in two thousand and seven when Steve

1316
01:02:47.119 --> 01:02:49.679
Jobs first unveiled the iPhone, we would not have been

1317
01:02:49.679 --> 01:02:52.559
able to game out TikTok trump all these kind of

1318
01:02:52.599 --> 01:02:55.960
crazy effects of the iPhone. So there's going to be

1319
01:02:56.000 --> 01:02:58.119
lots of things. I hope it helps people to understand

1320
01:02:58.159 --> 01:03:00.440
the cultural context of the psychological content if you've not

1321
01:03:00.440 --> 01:03:01.719
talked about and people have to look at in the

1322
01:03:01.719 --> 01:03:05.800
book the physical consequences. There's so much going on here

1323
01:03:06.320 --> 01:03:08.559
that we need to think about really urgently because this

1324
01:03:08.599 --> 01:03:10.679
is coming out as whether we like it or not. Right,

1325
01:03:10.880 --> 01:03:12.760
you might want to disinvent these drugs, but you're not

1326
01:03:12.800 --> 01:03:14.760
going to be able to write. You might wish away

1327
01:03:14.800 --> 01:03:16.239
the invention of the iPhone. But you're going to live

1328
01:03:16.239 --> 01:03:17.840
in a world where the iPhone exists, whether you like

1329
01:03:17.880 --> 01:03:21.719
it or not. So I really believe we have to

1330
01:03:21.760 --> 01:03:23.280
get through. The book is called magic Pill. It's it's

1331
01:03:23.280 --> 01:03:26.639
slightly ambiguous or ironic title because there's three ways in

1332
01:03:26.679 --> 01:03:29.039
which this could be magic. Right. It could be magic

1333
01:03:29.079 --> 01:03:31.159
in the sense something solves a problem so quickly and

1334
01:03:31.239 --> 01:03:35.039
rapidly you're like, WHOA, it's magic. It could be magic

1335
01:03:35.079 --> 01:03:37.079
in the sense of a trick. It could be like

1336
01:03:37.119 --> 01:03:40.079
a conjurer's trick. It could be screwing as over, or

1337
01:03:40.079 --> 01:03:41.679
it could be magic in a third sense. I think

1338
01:03:41.719 --> 01:03:45.239
of it as like the famous Disney cartoon Fantasia, where

1339
01:03:45.400 --> 01:03:49.280
and this happens in most parables about magic, the magic works,

1340
01:03:50.039 --> 01:03:52.440
but then starts to work in ways we didn't anticipate

1341
01:03:52.480 --> 01:03:55.559
at the start, Right, it starts to spiral away from

1342
01:03:55.639 --> 01:03:58.239
us in all sorts of weird and complex ways. So,

1343
01:03:58.280 --> 01:03:59.960
in a way, what I'm really curious to see is

1344
01:04:00.000 --> 01:04:01.599
what kind of magic is it. Is it the magic

1345
01:04:01.599 --> 01:04:03.320
of a solution, Is it the magic of a trick,

1346
01:04:03.880 --> 01:04:06.000
or is it the magic that begins to spiral away

1347
01:04:06.039 --> 01:04:08.400
from you? You know, you make a wish with the

1348
01:04:08.440 --> 01:04:09.880
genie and you get much more than you have a

1349
01:04:09.880 --> 01:04:10.360
bargain for.

1350
01:04:12.199 --> 01:04:17.760
Yeah, it's very clever. Actually, yeah, Han, what you said

1351
01:04:17.800 --> 01:04:21.840
is true. Though they're coming, there's more, they're being improved.

1352
01:04:22.079 --> 01:04:24.360
They're going to get cheaper. Like you talk about the

1353
01:04:24.400 --> 01:04:27.320
cost prohibitiveness of those drugs now, but they're only going

1354
01:04:27.320 --> 01:04:28.719
to get cheaper and more accessible.

1355
01:04:28.960 --> 01:04:31.400
So well, I think it's really important that only costs

1356
01:04:31.440 --> 01:04:33.760
about forty dollars a month to make these drugs. I

1357
01:04:33.840 --> 01:04:36.159
read that it's that Obviously, the rest of it is

1358
01:04:36.440 --> 01:04:38.880
enormous amounts of profits going to Nervo, nordiskanty Li literally

1359
01:04:38.920 --> 01:04:40.719
the companies who make it. And now what they argue,

1360
01:04:41.119 --> 01:04:43.079
and I think there's some reason in this, but they

1361
01:04:43.119 --> 01:04:45.719
take it too far, is Look, we spent an absolute

1362
01:04:45.760 --> 01:04:48.400
fortune developing these drugs. They wouldn't exist without us, so

1363
01:04:48.440 --> 01:04:51.119
we should profit from them. That's absolutely true. We want

1364
01:04:51.119 --> 01:04:54.960
to incentivize companies to make drugs. I mean, do they

1365
01:04:55.000 --> 01:04:57.719
need two hundred billion dollars? Do they need to be

1366
01:04:57.760 --> 01:05:00.840
the most profitable company in the whole of Europe? Probably not.

1367
01:05:02.880 --> 01:05:05.159
So I think what we should be doing in terms

1368
01:05:05.159 --> 01:05:06.920
of the price coming down, and the price will come

1369
01:05:06.920 --> 01:05:10.400
down one way or another in the medium term, because

1370
01:05:10.400 --> 01:05:14.239
in twenty thirty two the patent passes fort a zenpic

1371
01:05:14.400 --> 01:05:16.400
so at the very least in twenty thirty two, which

1372
01:05:16.440 --> 01:05:17.880
seems a long way away, but it's not that far.

1373
01:05:18.639 --> 01:05:20.960
It's only eight years away, which it seems really weird

1374
01:05:20.960 --> 01:05:22.360
to me because I can remember when it was nineteen

1375
01:05:22.360 --> 01:05:24.920
eighty seven. But anyway, in twenty thirty two the patent passes.

1376
01:05:24.920 --> 01:05:27.280
At that point you'll be able to manufacture cheap versions

1377
01:05:27.280 --> 01:05:30.119
that are forty dollars and by then it will overwhelm

1378
01:05:30.159 --> 01:05:32.559
only be a pill, so you'll be talking about buying

1379
01:05:32.559 --> 01:05:35.239
a daily pill for forty dollars a month that can

1380
01:05:35.440 --> 01:05:37.239
cut your weight by twenty percent. I think that's going

1381
01:05:37.320 --> 01:05:38.840
to be a very appealing prospect a lot of people,

1382
01:05:38.880 --> 01:05:41.239
and if we don't see these catastrophic effects that I'm

1383
01:05:41.239 --> 01:05:43.639
worried about, it's partly that. But in the medium term,

1384
01:05:43.679 --> 01:05:46.679
you know, we're talking in Britain, it's possible the British

1385
01:05:46.760 --> 01:05:49.320
National Health Service could bulk buy. You could have similar

1386
01:05:49.400 --> 01:05:53.000
situation with Australian medical providers. It's possible this will lead

1387
01:05:53.039 --> 01:05:56.880
to some regulation in the United States around drug buying

1388
01:05:56.960 --> 01:05:59.920
or it's possible that the drug companies will just decide

1389
01:06:00.159 --> 01:06:02.159
to compete based on we want to reach the biggest

1390
01:06:02.159 --> 01:06:05.440
possible audience for a lower prices, and they'll start because

1391
01:06:05.440 --> 01:06:08.480
it's now more than one company that has these drugs

1392
01:06:08.559 --> 01:06:11.320
or drugs with these effects, it's possible they'll start to

1393
01:06:11.360 --> 01:06:13.360
compete on price and we'll see the price come down

1394
01:06:13.480 --> 01:06:15.760
that way. So yeah, I think there's a range of

1395
01:06:15.800 --> 01:06:17.880
options where the price is going to come down. At

1396
01:06:17.880 --> 01:06:20.639
the moment is you know it's very expensive.

1397
01:06:20.199 --> 01:06:23.920
Right, Yeah, it is. And I think that as the

1398
01:06:23.960 --> 01:06:26.159
price comes down and it becomes more available to people,

1399
01:06:26.159 --> 01:06:28.400
it's much more important for people to be across all

1400
01:06:28.440 --> 01:06:30.440
of the issues that you've covered in your book, because

1401
01:06:30.679 --> 01:06:32.679
you know, right now there's probably people who may not

1402
01:06:32.719 --> 01:06:35.559
be aware of the possible downsides who if they could

1403
01:06:35.559 --> 01:06:37.440
afford it, they would they'd go and they'd go and

1404
01:06:37.440 --> 01:06:37.800
get it.

1405
01:06:37.880 --> 01:06:39.840
And what we what we really want to avoid is

1406
01:06:39.880 --> 01:06:42.760
a situation where you know, the real housewives of New

1407
01:06:42.800 --> 01:06:46.199
Jersey are super thin because they can buy these expensive drugs,

1408
01:06:46.199 --> 01:06:48.440
but the real school children of New Jersey get more

1409
01:06:48.440 --> 01:06:51.400
and more obesis that passes because you know, it's about

1410
01:06:51.480 --> 01:06:53.000
kids and getting the rug which are talking about the book.

1411
01:06:52.960 --> 01:06:54.679
But you know, because they did to do they're denied,

1412
01:06:54.840 --> 01:06:58.440
you know, the access to either a healthy food environment

1413
01:06:58.639 --> 01:07:00.599
or drugs that can reverse some of the effects of

1414
01:07:00.639 --> 01:07:02.559
the catastrophic food and rone. And one thing that makes

1415
01:07:02.559 --> 01:07:05.639
me really angry is this shouldn't be the choice. Right Japan,

1416
01:07:06.159 --> 01:07:08.400
We've got twenty six percent obesity in this country, twenty

1417
01:07:08.440 --> 01:07:10.840
seven percent in the US, it's forty two percent. In Japan,

1418
01:07:10.880 --> 01:07:13.920
it's just over three percent, and it's falling. Right, I

1419
01:07:13.960 --> 01:07:15.920
went to Japan. I learned how they did it. Japan

1420
01:07:16.039 --> 01:07:18.199
is not a science fiction country, right, that could feel

1421
01:07:18.199 --> 01:07:21.360
like it sometimes it's a real country. We can become

1422
01:07:21.480 --> 01:07:25.159
more like Japan. Right, It's a false choice to say

1423
01:07:25.159 --> 01:07:28.400
we are trapped forever with a choice between the dangers

1424
01:07:28.440 --> 01:07:30.800
of obesity and the dangers of these drugs. We can

1425
01:07:30.840 --> 01:07:33.880
make big social changes that will mean that our kids

1426
01:07:33.920 --> 01:07:36.760
and grandkids will not face these choices. That can sound

1427
01:07:36.800 --> 01:07:39.320
a bit pie in the sky. But think about smoking. Right,

1428
01:07:39.440 --> 01:07:42.239
It's photo me and my mother when I'm six months old.

1429
01:07:42.599 --> 01:07:46.800
She's breastfeeding me, smoking and resting the astray almost stomach. Right,

1430
01:07:46.840 --> 01:07:49.199
this is something all Scottish posts made. My mother was

1431
01:07:49.239 --> 01:07:51.559
the more hardcoured. When I discovered that photo a few

1432
01:07:51.639 --> 01:07:53.199
years ago, I showed it to her. I thought she'd

1433
01:07:53.239 --> 01:07:56.320
feel guilty. She said, you were a difficult fucking bb

1434
01:07:56.519 --> 01:07:59.960
I needed that cigarette, right. But you think about that.

1435
01:08:00.639 --> 01:08:04.760
When we were kids, people smoked everywhere. They smoked on

1436
01:08:04.800 --> 01:08:06.880
the train, they smoked on the plane, they smoked on

1437
01:08:06.920 --> 01:08:09.039
game shows. You would go to the doctor and the

1438
01:08:09.039 --> 01:08:11.719
doctor would smoke while he was exabitting you. I remember

1439
01:08:11.760 --> 01:08:14.280
this happening, right, Yeah, it's funny. I remember my mother.

1440
01:08:14.559 --> 01:08:18.159
My mother's a chronic chainsmoker. We had a terrible catastrophe

1441
01:08:18.199 --> 01:08:23.119
here in London where the underground station King's Cross. Someone

1442
01:08:23.319 --> 01:08:25.600
put out a cigarette at the bottom of an escalator

1443
01:08:25.600 --> 01:08:27.560
and it caused a fire. In about seventy people died.

1444
01:08:28.039 --> 01:08:29.319
And it happened to be with my mother when it

1445
01:08:29.319 --> 01:08:31.279
was the anniversary a few years ago, and someone on

1446
01:08:31.319 --> 01:08:34.399
the radio mentioned, you know, the King's crossfire, and she

1447
01:08:34.439 --> 01:08:36.840
said that was the worst day of my life. And

1448
01:08:36.880 --> 01:08:39.159
I said, oh, did we know someone who died? She said, no,

1449
01:08:39.840 --> 01:08:43.880
that's the deer. They're bands smoking on the tube. But

1450
01:08:43.960 --> 01:08:46.239
you think about the scale of that transformation, right, Okay,

1451
01:08:46.239 --> 01:08:48.199
there's an issue about vaping, which is a separate thing.

1452
01:08:48.199 --> 01:08:51.520
But yeah, almost none of my nephew's friends, my grand

1453
01:08:51.520 --> 01:08:54.560
godchildren's friends, my niece's friends smoked cigarettes, right, almost none,

1454
01:08:54.640 --> 01:08:56.600
in fact, in Britain were about to literally start legally

1455
01:08:56.640 --> 01:08:59.800
phasing it out. I would not have conceived that that

1456
01:08:59.920 --> 01:09:02.920
was possible in nineteen eighty seven, right, that's true. It

1457
01:09:02.960 --> 01:09:06.359
would have seemed ludicrous. So big social changes that boost

1458
01:09:06.359 --> 01:09:09.199
public health can happen. They can happen relatively quickly. We're

1459
01:09:09.199 --> 01:09:13.199
not that old, right, So that should be irrespective of

1460
01:09:13.199 --> 01:09:15.119
what you think about the drugs, we should all unite

1461
01:09:15.119 --> 01:09:17.399
to fix the environment. And I go through how we

1462
01:09:17.439 --> 01:09:18.760
can do that, and I went to loads of countries

1463
01:09:18.800 --> 01:09:21.319
that have done it, from Mexico to the Netherlands to

1464
01:09:21.840 --> 01:09:24.399
you know, the parts of some small parts of the

1465
01:09:24.439 --> 01:09:29.560
United States. We absolutely can do that Finland, not that

1466
01:09:29.560 --> 01:09:31.399
that's part of the United States. I said, that's it was.

1467
01:09:32.119 --> 01:09:33.920
We absolutely can deal with that, and then we get

1468
01:09:33.960 --> 01:09:36.000
out of this terrible bind. Okay, that doesn't help us

1469
01:09:36.039 --> 01:09:37.159
in the short to medium term, and the short to

1470
01:09:37.239 --> 01:09:39.079
medium term, we've got a way these risks and make

1471
01:09:39.119 --> 01:09:41.239
this choice. But we don't have to be trapped in this.

1472
01:09:41.600 --> 01:09:43.880
I was just reading the Japan chapter in your book

1473
01:09:43.920 --> 01:09:45.600
on the Way over Here actually, and I was really

1474
01:09:45.680 --> 01:09:49.119
surprised to read that that that change in the way

1475
01:09:49.119 --> 01:09:52.560
that they eat is so recent. Yeah, Like I thought

1476
01:09:52.600 --> 01:09:54.479
what you thought, which is they're just I don't know

1477
01:09:54.600 --> 01:09:58.319
genetically why differently, or they're just culturally they do things differently.

1478
01:09:58.359 --> 01:10:00.800
But no, that was that was a change that came

1479
01:10:00.840 --> 01:10:01.520
about what.

1480
01:10:01.560 --> 01:10:03.479
Was it after World War Two? Yeah, I mean it

1481
01:10:03.520 --> 01:10:07.000
was really fascinating. So we Japanese people eat very very

1482
01:10:07.000 --> 01:10:08.880
differently to us. There's lots of reasons why I go.

1483
01:10:09.039 --> 01:10:10.760
I spent a lot of time in Japan to research

1484
01:10:10.840 --> 01:10:13.840
this and it blew my mind for all sorts of reasons.

1485
01:10:13.920 --> 01:10:17.520
But Japanese people eat very differently. And you think, okay,

1486
01:10:17.600 --> 01:10:19.880
well that's just some ancient cultural thing. There's nothing we

1487
01:10:19.920 --> 01:10:22.359
can how we we're not going to learn thousands of

1488
01:10:22.439 --> 01:10:25.399
years of history. But actually, a guy called Professor Barak Kushner,

1489
01:10:25.399 --> 01:10:28.479
who's professor of East Asian History at the University of Cambridge,

1490
01:10:29.520 --> 01:10:31.840
this is a very recent invention. You just go back

1491
01:10:31.840 --> 01:10:33.720
to the First World War. Time of the First World War,

1492
01:10:34.159 --> 01:10:37.479
Japanese people ate appallingly. They only had protein once a week,

1493
01:10:37.520 --> 01:10:40.800
they barely ate any fish. It was because the Japanese

1494
01:10:41.520 --> 01:10:44.800
Imperial Army in the well, the imperial government in the

1495
01:10:44.880 --> 01:10:48.880
nineteen twenties needed conscript soldiers to go and invade the

1496
01:10:48.920 --> 01:10:52.760
rest of Asia, China and eventually attacking the US, that

1497
01:10:52.800 --> 01:10:56.680
they had to very consciously make the population healthier. So

1498
01:10:56.720 --> 01:10:59.199
this was a huge kind of top down project to

1499
01:10:59.319 --> 01:11:01.399
change the japan His diet. And in a way, the

1500
01:11:01.439 --> 01:11:04.640
wonderful food writer B. Wilson has written about this that

1501
01:11:04.760 --> 01:11:08.600
should really encourage us. Right, yeah, Japan didn't have Japanese food, No,

1502
01:11:08.920 --> 01:11:11.560
until relatively recently. We can change out. That's We're never

1503
01:11:11.600 --> 01:11:13.960
going to be exactly like Japan. But but yeah, these

1504
01:11:14.039 --> 01:11:16.239
changes they can happen, can happen, and it can happen

1505
01:11:16.319 --> 01:11:18.520
relatively quickly, and once they happened, they seem like I

1506
01:11:18.640 --> 01:11:21.000
was always like this, right, But it is possible we

1507
01:11:21.000 --> 01:11:22.720
get to a situation where we look back on this

1508
01:11:22.840 --> 01:11:25.880
forty year period, which is just by coincidence, the period

1509
01:11:25.920 --> 01:11:27.880
of my life. You know, it really is nice to

1510
01:11:27.840 --> 01:11:29.239
seventy nine, the year I'm born, as the year the

1511
01:11:29.239 --> 01:11:32.039
IBST starts to really blow up. I don't think I

1512
01:11:32.079 --> 01:11:35.079
don't blame myself. I feel like Damien from the Omen,

1513
01:11:35.199 --> 01:11:37.079
like I can get bored. It's like, oh, and I

1514
01:11:37.119 --> 01:11:38.840
think about that. You know, I felt like such a

1515
01:11:38.880 --> 01:11:41.960
failure when I gained weight. I was an entirely typical

1516
01:11:42.000 --> 01:11:45.520
product in my times. Yes, right, And there's something reassuring

1517
01:11:45.560 --> 01:11:47.680
about that. You know. Oprah's talking a lot of the

1518
01:11:47.680 --> 01:11:50.079
moment about lifting shame, and part of it is to say,

1519
01:11:50.880 --> 01:11:54.359
you know, you're not so strange. No, you're like everyone else.

1520
01:11:54.520 --> 01:11:56.760
Yeah, exactly. The other thing that I saw to there,

1521
01:11:56.800 --> 01:11:59.239
which I thought was very wise, was it was it

1522
01:11:59.279 --> 01:12:02.640
was actually on TikTok, and it was I don't use ozembic,

1523
01:12:02.720 --> 01:12:03.640
but I invest in.

1524
01:12:03.640 --> 01:12:07.319
It right at the start, right.

1525
01:12:07.079 --> 01:12:12.279
I thought, good, good point.

1526
01:12:12.439 --> 01:12:14.520
I mean, if you if you look at Yeah, there's

1527
01:12:14.520 --> 01:12:17.760
two things. I really I'm not a financial person at all.

1528
01:12:17.800 --> 01:12:20.560
I'm like the worst, the worst. I know nothing about

1529
01:12:20.560 --> 01:12:23.920
finances anyway, I'm terrible at it. But the before my

1530
01:12:23.920 --> 01:12:25.920
book about attention problems came out. In my book, I

1531
01:12:25.920 --> 01:12:27.760
talk a lot about this thing called a k which

1532
01:12:28.199 --> 01:12:30.680
plastic safe you can lock your phone away. Their shares

1533
01:12:30.800 --> 01:12:32.720
blew up after my book came out. It's like I

1534
01:12:32.720 --> 01:12:35.520
should have invested. But the I did, maybe they'll give

1535
01:12:35.520 --> 01:12:37.880
me a conflict of interest, but also with thoseembic right

1536
01:12:37.920 --> 01:12:40.640
at the start for a good friend of mine, I

1537
01:12:40.640 --> 01:12:43.520
started talking about it very just after that party, literally

1538
01:12:43.520 --> 01:12:45.399
in the week after that party, is like, she's literally

1539
01:12:45.720 --> 01:12:47.560
I'm going on, I'm going online and buying no own

1540
01:12:47.600 --> 01:12:50.479
order stock. That seems a bit premature to me. Dev

1541
01:12:50.600 --> 01:12:53.239
I don't know right what a fool I was. It's

1542
01:12:53.279 --> 01:12:57.399
like octopled in value since she did that. So I'm like,

1543
01:12:57.439 --> 01:12:59.039
I want, I want commission on this one.

1544
01:12:59.159 --> 01:13:01.479
Right. One of the comments on that TikTok was what

1545
01:13:01.560 --> 01:13:03.479
I heard was if you're if you're seeing it on live,

1546
01:13:03.479 --> 01:13:05.279
seeing that advice on line, you've already missed the book.

1547
01:13:05.640 --> 01:13:07.720
Well, and also look at it the other way. This

1548
01:13:07.800 --> 01:13:09.399
is one of the things that so fascinates me. If

1549
01:13:09.399 --> 01:13:11.079
you want to game out the effects of these drugs,

1550
01:13:11.399 --> 01:13:13.600
look at what's happening to shares the other way. Krispy

1551
01:13:13.680 --> 01:13:17.600
Kreme Donuts that shares are massively down. And there's a company,

1552
01:13:17.840 --> 01:13:20.079
a kind of market dominant company, I forget their name,

1553
01:13:20.520 --> 01:13:25.359
who manufacture the hinges for hip and near replacements. Their

1554
01:13:25.399 --> 01:13:27.800
stock is right down because a few people are going

1555
01:13:27.800 --> 01:13:32.319
to need near and hip replacements relatively soon. Yeah, there's

1556
01:13:32.359 --> 01:13:37.119
an accompanying Jeffrey's Financial who did a report that advised

1557
01:13:37.159 --> 01:13:39.560
airlines your stock's going to gout because you're gonna have

1558
01:13:39.560 --> 01:13:42.119
to spend much less money on jet fuel because it

1559
01:13:42.239 --> 01:13:45.640
costs much less money to fly thinner people you think about,

1560
01:13:46.000 --> 01:13:47.159
I'm fascinated about how this.

1561
01:13:47.079 --> 01:13:50.239
Is effect Yeah, it's fascinating.

1562
01:13:50.159 --> 01:13:52.359
Fascinating, and we're going to see much more of that,

1563
01:13:52.520 --> 01:13:57.800
even like jewelers. Jewelers have seen a huge in the US,

1564
01:13:57.800 --> 01:13:59.920
in New York and LA in particular. This is the

1565
01:14:00.079 --> 01:14:01.960
called o Zmpic finger. When you take a zem pit,

1566
01:14:02.039 --> 01:14:04.359
your finger shrinks, so loads of people are having to

1567
01:14:04.399 --> 01:14:07.479
have their wedding rings resize because their fingers are so

1568
01:14:07.560 --> 01:14:10.039
much dinner, right, who to gain that one out? So

1569
01:14:10.039 --> 01:14:12.720
we're going to see all sorts of weird, unpredictable things,

1570
01:14:12.720 --> 01:14:13.359
good and bad.

1571
01:14:13.479 --> 01:14:20.079
It's like Perspects Perspects Glass before COVID your hand. This

1572
01:14:20.119 --> 01:14:23.359
has been a fascinating conversation. Always, thank you so much.

1573
01:14:24.199 --> 01:14:25.000
It has been a pleasure.

1574
01:14:25.159 --> 01:14:27.039
I love talking to Cassie sy Joy. And I meant

1575
01:14:27.039 --> 01:14:29.439
to say on my publisher's tasing me that anyone who

1576
01:14:29.439 --> 01:14:31.159
wants to know where to get the book, the ebook,

1577
01:14:31.199 --> 01:14:32.880
the audiobook. You can basically get them anywhere, but if

1578
01:14:32.880 --> 01:14:35.199
you go to my website, it's j O h A

1579
01:14:35.479 --> 01:14:39.399
N N h A r I dot com and you

1580
01:14:39.439 --> 01:14:41.479
can see where to get them and all my other books. Yeah,

1581
01:14:41.960 --> 01:14:43.960
I'll put all ink to your hands website.

1582
01:14:43.960 --> 01:14:46.199
In the show notes, if you enjoyed the episode, please

1583
01:14:46.319 --> 01:14:48.880
think about leaving as a five star rating and review.

1584
01:14:49.279 --> 01:14:51.279
Hit me up on the DMS, on Instagram, cast on

1585
01:14:51.359 --> 01:14:53.760
underscore XO tell me what you think. I'd be really

1586
01:14:53.800 --> 01:14:56.800
interested to know. Obviously, if you enjoy the episode, if

1587
01:14:56.800 --> 01:14:58.960
you think somebody else would enjoy it, feel free to

1588
01:14:59.000 --> 01:15:02.199
pass along help so us to get more listeners. As always,

1589
01:15:02.359 --> 01:15:03.520
appreciate you so much.

1590
01:15:03.720 --> 01:15:04.560
Thank you for being here.

1591
01:15:04.600 --> 01:15:06.479
I can't wait to catch you next week on another

1592
01:15:06.520 --> 01:15:07.760
episode of Crabby to Habby