1
00:00:00,000 --> 00:00:05,840
This episode is sponsored by a company I've used for well over a decade and that is 511.

2
00:00:05,840 --> 00:00:11,120
I wore their uniforms back in Anaheim, California and have used their products ever since.

3
00:00:11,120 --> 00:00:17,440
From their incredibly strong yet light footwear to their cut uniforms for both male and female

4
00:00:17,440 --> 00:00:23,520
responders, I found them hands down the best workwear in all the departments that I've worked for.

5
00:00:23,520 --> 00:00:28,480
Outside of the fire service, I use their luggage for everything and I travel a lot and they are

6
00:00:28,480 --> 00:00:35,280
also now sponsoring the 7X team as we embark around the world on the Human Performance Project.

7
00:00:35,280 --> 00:00:40,720
We have Murph coming up in May and again I bought their plate carrier. I ended up buying real

8
00:00:40,720 --> 00:00:45,760
ballistic plates rather than the fake weight plates and that has been my ride or die through

9
00:00:45,760 --> 00:00:50,640
Murph the last few years as well. But one area I want to talk about that I haven't in previous

10
00:00:50,640 --> 00:00:55,760
sponsorship spots is their brick and mortar element. They were predominantly an online

11
00:00:55,760 --> 00:01:00,960
company up till more recently but now they are approaching 100 stores all over the US.

12
00:01:01,520 --> 00:01:07,040
My local store is here in Gainesville Florida and I've been multiple times and the discounts you see

13
00:01:07,040 --> 00:01:14,640
online are applied also in the stores. So as I mentioned 511 is offering you 15% off every

14
00:01:14,640 --> 00:01:20,640
purchase that you make but I do want to say more often than not they have an even deeper discount

15
00:01:20,640 --> 00:01:31,760
especially around holiday times. But if you use the code SHIELD15 you will get 15% off your order

16
00:01:31,760 --> 00:01:37,840
or in the stores every time you make a purchase. And if you want to hear more about 511, who they

17
00:01:37,840 --> 00:01:44,000
stand for and who works with them, listen to episode 580 of Behind the Shield podcast with

18
00:01:44,000 --> 00:01:50,720
511 regional director Will Ayres. Welcome to the Behind the Shield podcast as always my name is

19
00:01:50,720 --> 00:01:56,240
James Gearing and this week it is my absolute honor to welcome back onto the show author

20
00:01:56,240 --> 00:02:03,520
Johann Hari. Now for those of you who listen to episode 317 we took a deep dive into his books

21
00:02:03,520 --> 00:02:10,240
Chasing the Scream and Lost Connections discussing mental health and addiction. Well Johann has a

22
00:02:10,240 --> 00:02:15,680
brand new book called The Magic Pill where he details his own experience with the weight loss

23
00:02:15,680 --> 00:02:22,800
drug Ozempic and as you will hear we dive into a host of topics from the psychology behind obesity,

24
00:02:23,360 --> 00:02:28,640
how these drugs have the potential to replace gastric bypass surgery thus making weight loss

25
00:02:28,640 --> 00:02:36,080
much safer, deconstructing the health of the food in our stores, some incredible ideas from overseas

26
00:02:36,080 --> 00:02:41,600
and so much more. Now before we get to this amazing conversation as I say every week please just take

27
00:02:41,600 --> 00:02:47,920
a moment go to whichever app you listen to this on, subscribe to the show, leave feedback and leave

28
00:02:47,920 --> 00:02:54,320
a rating. Every single five star rating truly does elevate this podcast therefore making it easier

29
00:02:54,320 --> 00:03:02,960
for others to find and this is a free library of well over 900 episodes now. So all I ask in return

30
00:03:02,960 --> 00:03:08,800
is that you help share these incredible men and women stories so I can get them to every single

31
00:03:08,800 --> 00:03:17,600
person on planet earth who needs to hear them. So with that being said I introduce to you Johann Hari.

32
00:03:17,600 --> 00:03:42,160
Enjoy. Well Johann I want to start by saying I am so so glad to get you back on the show. We were

33
00:03:42,160 --> 00:03:46,720
just talking before we hit record. Ironically I tried reaching out several times and as people

34
00:03:46,720 --> 00:03:52,720
will hear in these conversations there are reason why you away from your devices but you have already

35
00:03:52,720 --> 00:03:58,560
had one great book out Stolen Focus. You're about to release Magic Pill so I just want to start by

36
00:03:58,560 --> 00:04:03,680
welcoming you back onto the Behind the Shield podcast today. Oh I'm so glad to be with you.

37
00:04:03,680 --> 00:04:11,280
Cheers James. So the last time we sat down was May 30th 2020. Interesting time in the last few years.

38
00:04:11,280 --> 00:04:17,840
I can't remember anything that happened in between now and then. Sure there were some world events.

39
00:04:17,840 --> 00:04:22,720
I believe so. I wish I could remember the name. There was a podcast you did I think it was recently

40
00:04:23,440 --> 00:04:29,440
with three Australian hosts. Oh the Imperfix. I love those guys. Great great conversation especially

41
00:04:29,440 --> 00:04:34,160
for three of them. They weren't interrupting or stepping over each other but one of them was

42
00:04:34,160 --> 00:04:40,160
telling a story. I forget who it was they said now but someone went into a oh it's Jared Leto

43
00:04:40,160 --> 00:04:46,240
went into a meditation retreat right when before Covid hit and then came out 30 days later

44
00:04:46,240 --> 00:04:50,080
wondering what the hell had happened to the world because you've been in some monastery for a month.

45
00:04:51,520 --> 00:04:57,360
Yeah I was in Vegas for a lot of Covid because I'm writing a book about a series of crimes that

46
00:04:57,360 --> 00:05:02,800
are happening in Vegas. I've been researching them for god 13 years now. It's the next book in the

47
00:05:02,800 --> 00:05:09,120
queue. It's the next one I'm going to write and Vegas was an absolute headfuck during Covid. It

48
00:05:09,120 --> 00:05:14,480
was completely bizarre. There was a period when everything shut down so Steve Sisolak the governor

49
00:05:14,480 --> 00:05:20,640
shut everything down a few weeks into the pandemic but so in Vegas if you've got a gaming license

50
00:05:20,640 --> 00:05:26,800
by law you have to be open 365 days a year 24 hours a day. You can never close right. I think

51
00:05:26,800 --> 00:05:30,880
you're allowed by law to close for like six hours a year for cleaning and that's it right.

52
00:05:31,760 --> 00:05:36,160
So there was this bizarre thing where when everything had to shut down no one had any

53
00:05:36,160 --> 00:05:42,560
keys to lock the doors. Caesar's Palace opened in 1966 and has never closed right. So there was this

54
00:05:42,560 --> 00:05:47,760
sudden bizarre like anyone seen those keys since 1966. It was completely surreal. There's also a

55
00:05:47,760 --> 00:05:53,840
period when it reopened when they were very strict on the mask mandates in Vegas. There's a period

56
00:05:53,840 --> 00:05:57,200
where it reopened where the strip clubs reopened where it looked like it was going to be that there

57
00:05:57,200 --> 00:06:01,520
there would be strippers and the only thing they would be wearing was going to be face masks

58
00:06:01,520 --> 00:06:06,320
because by law they had to right. So it was a completely surreal I mean I mean it was surreal

59
00:06:06,320 --> 00:06:11,280
everywhere but I think it was Vegas always gives an extra surreal edge to everything in life.

60
00:06:11,280 --> 00:06:17,040
Absolutely well while we're on that topic just for a second Chasing the Scream an incredible book on

61
00:06:17,040 --> 00:06:21,200
addiction actually just sat back down with Zhao Guilao a few months ago for our second interview.

62
00:06:21,200 --> 00:06:25,520
Oh I love Zhao what a great man. Amazing and one of the most impressive people I've ever met.

63
00:06:25,520 --> 00:06:31,040
Yeah really great man. It's so humble as well but then you have they obviously lost connections.

64
00:06:31,040 --> 00:06:38,960
Now we all know what happened and the way it was handled during the pandemic. The way I navigated

65
00:06:38,960 --> 00:06:45,280
those years as I put lots and lots of extra episodes out on health nutrition mental health

66
00:06:45,280 --> 00:06:49,440
etc. So people had autonomy in their homes they had actionable things to do even though they were

67
00:06:49,440 --> 00:06:54,720
being told to you know stay in your house and we'll tell you what to do. That time is already gone

68
00:06:54,720 --> 00:06:59,040
and we had a captive audience and an amazing opportunity to really move the needle on a lot

69
00:06:59,040 --> 00:07:04,880
of wellness issues and they just didn't. So rather than being critical of that time

70
00:07:05,600 --> 00:07:12,080
with all the the areas that you've written about up to this point if everyone listened today

71
00:07:12,960 --> 00:07:17,360
what were the the lessons that you wish people to learn from the last four years

72
00:07:17,360 --> 00:07:18,560
if they were listening right now?

73
00:07:18,560 --> 00:07:29,280
Well everyone knows they have natural physical needs. You need food, you need water, you need

74
00:07:29,280 --> 00:07:34,240
shelter, you need clean air. If I took those things away from you you'd be in real trouble real fast

75
00:07:34,240 --> 00:07:39,040
but there's equally strong evidence that all human beings have natural psychological needs.

76
00:07:39,920 --> 00:07:44,880
You need to feel you belong. You need to feel your life has meaning and purpose. You need to feel that

77
00:07:44,880 --> 00:07:49,920
people see you and value you. You need to feel you've got a future that you understand and that

78
00:07:49,920 --> 00:07:56,880
makes sense and our culture is great at many things. I'm glad to be alive today but we've been

79
00:07:56,880 --> 00:08:01,360
getting less and less good at meeting these deep underlying psychological needs for a very long

80
00:08:01,360 --> 00:08:08,800
time throughout my lifetime in fact and then obviously during the pandemic the ability to get

81
00:08:08,800 --> 00:08:15,920
your psychological needs met just collapsed. We had to physically separate because of the virus.

82
00:08:16,720 --> 00:08:21,360
There's a massive increase in loneliness. We were already the loneliest society in human history.

83
00:08:21,360 --> 00:08:28,400
They had a huge increase in loneliness, huge increase in stress, a huge increase in people

84
00:08:28,400 --> 00:08:36,080
not having a sense they understood the future or had a future. So I think what it shows us

85
00:08:36,080 --> 00:08:40,320
is that being deprived of your underlying psychological needs makes you feel terrible.

86
00:08:40,320 --> 00:08:44,560
It makes you feel anxious. It makes you feel depressed or at the very least it makes you

87
00:08:44,560 --> 00:08:49,360
feel much less good than you otherwise would have and there's all sorts of ways that I write

88
00:08:49,360 --> 00:08:55,040
about in my book Lost Connections that I saw being played out all over the world that we can

89
00:08:55,040 --> 00:09:01,040
together change the way we're living to get our deeper needs met and when you do that it reduces

90
00:09:01,040 --> 00:09:04,400
depression and anxiety massively. It's not the only thing you can do to reduce depression. There are

91
00:09:04,400 --> 00:09:09,520
many things that I talk about in the book and that people will know about. But yes, I guess

92
00:09:09,520 --> 00:09:14,320
the main thing is someone wrote to me, a friend of mine, Andrew Sullivan, the writer, wrote to me

93
00:09:15,280 --> 00:09:20,640
at the height of COVID when it had just been reported that depression had doubled in Britain.

94
00:09:22,160 --> 00:09:30,480
He said, it's like we ran an experiment to see if you were right, if your book was correct.

95
00:09:30,480 --> 00:09:36,800
Now there were bigger things going on in the world than worrying about whether I was right or not.

96
00:09:37,920 --> 00:09:43,200
But I think there's a truth in that. The book is called Lost Connections because we've lost

97
00:09:43,200 --> 00:09:53,840
our connections to many of the things you need in life and in the pandemic we lost our connections

98
00:09:53,840 --> 00:10:00,320
even more and it was a disaster. Now, of course, there was a good reason for us to physically

99
00:10:00,320 --> 00:10:08,080
separate during the pandemic, right? But that can teach us something going forward. Okay, if

100
00:10:09,840 --> 00:10:15,920
massive increase in loneliness and stress and anxiety and loss of a sense of the future was

101
00:10:15,920 --> 00:10:20,800
making us feel terrible during the pandemic, well, that might help us understand why depression and

102
00:10:20,800 --> 00:10:26,960
anxiety were hugely rising before the pandemic and why since the pandemic, if we want to get out of

103
00:10:26,960 --> 00:10:33,280
this spiralling depression and anxiety and addiction, which has very similar causes,

104
00:10:33,280 --> 00:10:37,680
the core of addiction is about not wanting to be present in your life because your life is too

105
00:10:37,680 --> 00:10:42,720
painful a place to be. If we want to get out of that spiral, we've got to do many things,

106
00:10:42,720 --> 00:10:47,600
but one of them is you've got to deal with the deep underlying causes of these problems, right?

107
00:10:47,600 --> 00:10:51,440
Which can sound very fancy, but like I say, I went to places that have done it. I've seen how

108
00:10:51,440 --> 00:10:58,800
it's done in practice. Absolutely. I remember quoting you many times when it came to hearing

109
00:10:58,800 --> 00:11:05,440
about all the mental health elements from the pandemic. And again, ultimately it was about

110
00:11:05,440 --> 00:11:10,800
resilience. And so what should have happened is that we should have fought to make the people in

111
00:11:10,800 --> 00:11:16,320
our own nations as healthy as possible and as happy as possible because the more scared and

112
00:11:16,320 --> 00:11:21,920
isolated they are, the less resilient they are, the more immunocompromised they are. Therefore,

113
00:11:21,920 --> 00:11:27,600
the higher chance there is of having a greater response to the virus. So when you talk about

114
00:11:27,600 --> 00:11:32,400
the opposite of addiction isn't sobriety, the opposite of addiction is connection.

115
00:11:33,200 --> 00:11:40,800
Well, during the pandemic, alcohol didn't get stronger. People just connected less. So I think,

116
00:11:40,800 --> 00:11:46,240
again, underlining your work, this is what I think really need to be brought out of this whole thing

117
00:11:46,240 --> 00:11:51,520
is we've got to make people healthier because another thing is going to come. But also we've

118
00:11:51,520 --> 00:11:56,880
got to understand exactly like you said, that the disconnection, the pigeonholing and dividing of

119
00:11:56,880 --> 00:12:03,120
communities and countries only further adds fuel to the fire of addiction, depression,

120
00:12:04,080 --> 00:12:09,440
suicide, homelessness, and all the other things that we see crushing our men, women, and children.

121
00:12:09,440 --> 00:12:17,760
Well, there's a wonderful couple called Professor Anne Case and Professor Angus Dayton

122
00:12:18,880 --> 00:12:24,240
have done some of the best work looking at the places where addiction is highest in the

123
00:12:24,240 --> 00:12:30,720
United States. And I've been to a lot of them mostly for my research. And they describe those

124
00:12:30,720 --> 00:12:39,600
deaths as deaths of despair. And as you know, we had a lot of addiction in my family. So this really

125
00:12:39,600 --> 00:12:45,600
rings true to me. Yeah. And interestingly, I've been thinking about these issues in a very different

126
00:12:45,600 --> 00:12:53,280
way about health in the last year because I've been writing a book about these new weight loss

127
00:12:53,280 --> 00:13:00,560
drugs that have come along. And I've spent a year traveling all over the world taking these drugs

128
00:13:00,560 --> 00:13:05,520
interviewing the leading experts on them, the scientists who play key roles in designing them

129
00:13:05,520 --> 00:13:10,160
and making them possible, their biggest critics, their biggest supporters all over the world from

130
00:13:11,120 --> 00:13:17,840
Reykjavik in Iceland to Minneapolis to Tokyo. And it's been so interesting because

131
00:13:19,440 --> 00:13:27,520
with my previous books, which we've talked about, I ended up with a very strong sense of,

132
00:13:27,520 --> 00:13:31,120
this is what we should do now. I went to places that I felt had found the answer.

133
00:13:32,000 --> 00:13:36,640
Of course, there's a lot we don't know, but a huge sense of this is the way forward. This is what we

134
00:13:36,640 --> 00:13:41,040
should do. With these weight loss drugs, it's been really interesting. The subtitle of the book is

135
00:13:41,920 --> 00:13:45,680
the extraordinary benefits and disturbing risks of the new weight loss drugs.

136
00:13:47,600 --> 00:13:51,360
And right from when I first heard about these drugs, and I can tell you how it happened,

137
00:13:52,080 --> 00:13:55,440
the moment I first heard about them, it was kind of weird experience. But right from the moment I

138
00:13:55,440 --> 00:14:03,360
heard about them, I don't remember ever feeling so conflicted about a subject. I could see the

139
00:14:03,360 --> 00:14:08,800
argument for them. The scientific evidence is very clear that obesity very seriously harms your

140
00:14:08,800 --> 00:14:14,720
health on average, and these drugs reverse obesity for lots of people. And that has incredible

141
00:14:14,720 --> 00:14:20,240
positive effects. If you take these drugs and you started off obese, in the next five years,

142
00:14:20,240 --> 00:14:23,760
you're 20% less likely to have a heart attack or stroke, for example, and that's just one of the

143
00:14:23,760 --> 00:14:29,040
many health benefits. And I could see, we've been torturing ourselves with diets for years,

144
00:14:29,040 --> 00:14:34,480
God knows I have. Someone whose weight has always yo-yoed from underweight to obese

145
00:14:35,040 --> 00:14:39,520
throughout my adult life. And I kind of thought, well, if there's a solution here,

146
00:14:39,520 --> 00:14:45,120
if there's something you can do that's relatively painless and that reverses obesity,

147
00:14:45,680 --> 00:14:50,560
wow, this could be amazing. And lots of the scientists I spoke to really reinforced that.

148
00:14:50,560 --> 00:14:54,320
They were like, no, this is a game changer. One of them described it and said, we found the holy

149
00:14:54,320 --> 00:15:02,480
grail, right? We found a drug that reliably and safely causes weight loss. But there were other

150
00:15:02,480 --> 00:15:09,200
scientists, and honestly, my own opinion, at the start, I thought, well, you know, I felt very

151
00:15:09,200 --> 00:15:14,960
anxious. Every previous miracle diet drug has been announced in similar ways and then pulled from the

152
00:15:14,960 --> 00:15:18,880
shelves because it caused some horrific effect that meant that it had to be removed, usually

153
00:15:18,880 --> 00:15:24,240
in a hail of lawsuits. So I was very conscious of that. But even more, I was conscious, look,

154
00:15:24,240 --> 00:15:29,440
there's been a massive increase in obesity just in my lifetime, right? Extraordinary increase.

155
00:15:29,440 --> 00:15:35,680
The average American weighs 23 pounds more than they did shortly before I was born, right?

156
00:15:37,200 --> 00:15:41,840
That's an extraordinary increase, unprecedented in human history. In the world, obesity has

157
00:15:41,840 --> 00:15:47,360
tripled since 1975. And it didn't increase because there was some biological problem,

158
00:15:47,360 --> 00:15:52,720
that needed to be fixed with a medicine. It increased because the food supply changed in

159
00:15:52,720 --> 00:15:57,040
ways that have really fucked us up and made us sick, right? And of course, I thought, well,

160
00:15:57,040 --> 00:16:01,280
you know, my books are all about, we've got to deal with the causes of problems. That's what

161
00:16:01,280 --> 00:16:06,800
we were just saying in relation to, you know, what COVID has revealed about depression and addiction.

162
00:16:07,840 --> 00:16:10,720
I thought, well, we've got to deal with the causes of this problem. Isn't this just sort of

163
00:16:10,720 --> 00:16:16,000
treating the symptom in what could potentially be a very risky way? So I ended up looking at

164
00:16:16,000 --> 00:16:19,920
the risks of these drugs and the benefits of these drugs. And there are a lot of benefits,

165
00:16:19,920 --> 00:16:23,920
and there are 12 quite big risks that I go through in the book. And then lots of implications for

166
00:16:23,920 --> 00:16:28,720
these drugs in all sorts of directions. You know, Barclays Bank commissioned a very sober-minded

167
00:16:28,720 --> 00:16:35,360
financial analyst called Emily Field to go away and give them guidance for investors on what these

168
00:16:35,360 --> 00:16:38,960
drugs are going to mean for investors, right? The kind of investments people should be making.

169
00:16:38,960 --> 00:16:41,520
And she came back and said, well, you know, I'm going to go through this, you know,

170
00:16:41,520 --> 00:16:46,800
the kind of investments people should be making. And she came back and said, if you want to,

171
00:16:46,800 --> 00:16:51,920
if you want a comparison for something similar in terms of its effect on the economy and the

172
00:16:51,920 --> 00:16:58,080
society, you've got to look back to the invention of the smartphone in 2007, right? This is going

173
00:16:58,080 --> 00:17:05,600
to have massive effects on our society. We've now got a drug that causes you to lose 15% of

174
00:17:05,600 --> 00:17:11,920
your body weight on average over a year. In fact, that's just a Zempic stroke regovi. The

175
00:17:12,960 --> 00:17:18,720
next generation, Monjano, which is also now available, causes 21% body weight loss on average.

176
00:17:18,720 --> 00:17:22,640
And the next generation to come down the line, Triple G, that will probably be available next

177
00:17:22,640 --> 00:17:29,120
year, causes 24.2% body weight loss after a year. I mean, that's only slightly less than bariatric

178
00:17:29,120 --> 00:17:36,720
surgery. This is going to be massive for good, for bad. It's something we really need to, in my view,

179
00:17:36,720 --> 00:17:42,800
deeply, deeply think about and reckon with. When you talk about bariatric surgery,

180
00:17:43,440 --> 00:17:48,240
I'm sitting here now, my wife's in the other room and she lost her best friend just over a year ago.

181
00:17:48,240 --> 00:17:54,960
And the kind of, I would say the cascade of ill health began with bariatric surgery. There's a guy

182
00:17:54,960 --> 00:18:00,480
I went to fire school with who had complications of bariatric surgery. And he was way back 10 years

183
00:18:00,480 --> 00:18:05,760
younger than me when I went to school, I think. And he lost a lot of weight as well. And now he's

184
00:18:05,760 --> 00:18:12,960
no longer with us. How did he die, James? There was something where they ended up, part of his

185
00:18:13,600 --> 00:18:18,240
intestine actually started dying, basically, to put it in layman's terms. So they didn't discover

186
00:18:18,240 --> 00:18:23,280
until it was too late. And I think he literally was gone within days of them figuring out what

187
00:18:23,280 --> 00:18:29,120
was going on. So when I think of bariatric surgery, like you said, and the weight loss

188
00:18:29,120 --> 00:18:36,160
element of it, that absolutely is a thing. But as you said, there are 12 startling things about

189
00:18:36,160 --> 00:18:40,480
these pills. It's the same with bariatric surgery and it terrifies me because when you think about

190
00:18:40,480 --> 00:18:47,040
what you're doing to the human body, it's extremely unnatural. I think that's really important,

191
00:18:47,040 --> 00:18:53,280
James, because what bariatric surgery shows in an extreme and heightened form is a dilemma. Because

192
00:18:53,280 --> 00:19:00,160
why would anyone have bariatric surgery? Bariatric surgery is horrific, physically horrific surgery.

193
00:19:00,720 --> 00:19:04,560
About one in a thousand people die during the operation. So why would they do it?

194
00:19:05,440 --> 00:19:08,640
And the reason is, and the reason why many doctors recommend it for people who are

195
00:19:09,280 --> 00:19:14,480
severely obese and have tried other ways and they haven't worked, is because you get... Because

196
00:19:14,480 --> 00:19:20,560
bariatric surgery reverses or hugely reduces obesity. And that leads to, for the people who

197
00:19:20,560 --> 00:19:25,040
don't die and the people who don't have the horrific complications, and that's a big caveat,

198
00:19:25,040 --> 00:19:29,920
but for the people who don't, it leads to staggering improvements in health. So if you have

199
00:19:29,920 --> 00:19:36,640
bariatric surgery, over the next seven years, you're 56% less likely to die of a heart attack,

200
00:19:36,640 --> 00:19:43,680
you're 60% less likely to die of cancer, you're 92% less likely to die of diabetes-related causes.

201
00:19:43,680 --> 00:19:49,120
And in fact, the effect is so powerful, you're 40% less likely to die of any cause. Now, I'm

202
00:19:49,120 --> 00:19:52,400
not waving a flag for bariatric surgery. Bariatric surgery is horrible. I don't think I would do it.

203
00:19:53,280 --> 00:20:00,000
But what that shows us in a very extreme way is the dilemma, right? Because if you just look at

204
00:20:00,000 --> 00:20:03,520
the harms of bariatric surgery, you'd be like, well, this is insane. Why would anyone ever do this?

205
00:20:03,520 --> 00:20:07,600
Right? You're having part of your stomach remediated. I mean, there's different forms

206
00:20:07,600 --> 00:20:11,920
of bariatric surgery, but you're having an extraordinarily invasive form of surgery.

207
00:20:11,920 --> 00:20:18,640
It's very painful. As I say, a negligible number of people die during the surgery, one in a thousand.

208
00:20:18,640 --> 00:20:25,760
Why would you do it? It's because severe obesity is sadly, on average, catastrophic for human

209
00:20:25,760 --> 00:20:29,520
health. Now, what these drugs do is they take that dilemma and slightly alter it. Obviously,

210
00:20:29,520 --> 00:20:35,920
most people taking these drugs are not severely obese. But as I say, you've now got these drugs,

211
00:20:35,920 --> 00:20:39,920
which come with a whole series of risks, but everyone, I think, would agree the risks are

212
00:20:39,920 --> 00:20:43,520
significantly less than for bariatric surgery, right? No one is claiming that these drugs kill

213
00:20:43,520 --> 00:20:49,840
one in a thousand people. Even the worst critics don't claim that. So what you've got is drugs that...

214
00:20:54,080 --> 00:20:57,200
And there's a lot of other downsides to bariatric surgery that I think are interesting to think

215
00:20:57,200 --> 00:21:01,440
about in relation to these new weight loss drugs as well. Perhaps we can come back to that. But

216
00:21:01,440 --> 00:21:06,800
the good news in that respect is, okay, you're going to be able to get bariatric surgery type

217
00:21:06,800 --> 00:21:14,080
weight loss without the operation. I mean, I can't see why once GGG is available, unless you were

218
00:21:14,080 --> 00:21:19,520
someone who, for some reason, couldn't take these drugs, I can't see why anyone would have bariatric

219
00:21:19,520 --> 00:21:23,680
surgery once the next generation of the drugs, which have already been tested in clinical trials,

220
00:21:23,680 --> 00:21:29,760
are available. I think what really breaks my heart about this is that it's not just the

221
00:21:29,760 --> 00:21:33,600
drugs that are available. What really breaks my heart about these two is neither of them,

222
00:21:33,600 --> 00:21:39,520
I would argue, were even probably labeled obese, certainly not severely obese. I mean, one,

223
00:21:39,520 --> 00:21:43,600
my wife's friend was just overweight. She was overweight, but not even obese. And then the

224
00:21:43,600 --> 00:21:50,640
other one, he might have been scraping it, but he was kind of a big boned lad anyway. So I think

225
00:21:50,640 --> 00:21:56,000
this is the problem is, like you said, I agree. I have been on literally a thousand pound patient

226
00:21:56,000 --> 00:22:01,600
with a fire paramedic that was the pancake on the bed that we see in the reality shows. That

227
00:22:01,600 --> 00:22:07,440
gentleman, who I'm sure is no longer with us now, that would be his only option, lying in a bed,

228
00:22:07,440 --> 00:22:13,520
not able to move, the only thing that maybe would save his life. But just like cesarean sections

229
00:22:13,520 --> 00:22:19,200
with pregnancy, now fast forward in America in 2024, I'd like to have my baby on Tuesday at

230
00:22:19,200 --> 00:22:23,360
7.30 in the morning, please. All right, yeah, we'll just slice you open and off you go. Right,

231
00:22:23,360 --> 00:22:29,120
to me is an abuse of that surgery. CSEC is absolutely pertinent in certain areas. There's

232
00:22:29,120 --> 00:22:35,760
a dangerous birth or very, very petite mother and that application is warranted, but we have

233
00:22:35,760 --> 00:22:41,840
allowed it to devolve to all these CSEC births now. They're not getting the bacteria that the

234
00:22:41,840 --> 00:22:47,520
baby should be getting from a vaginal birth. And so that's, I think what really I struggle with is,

235
00:22:47,520 --> 00:22:53,840
as a last resort, I understand bariatric, but I don't think it's being used like that in 2024.

236
00:22:53,840 --> 00:22:58,400
I mean, the good thing is that that dilemma is, people aren't going to be worrying about that

237
00:22:58,400 --> 00:23:03,200
dilemma in a couple of years because of the extraordinarily potent effect of these drugs.

238
00:23:03,200 --> 00:23:07,920
And I think it's worth thinking about how these drugs work. And we now know much more, even than

239
00:23:07,920 --> 00:23:15,520
we did a year ago, about how these drugs work. So when you eat, you get a, so let's say you had a

240
00:23:15,520 --> 00:23:21,040
meal now while we were talking, your gut would produce, would release a hormone called GLP-1.

241
00:23:21,760 --> 00:23:25,760
And that is one of the natural signals in your body that would just say, James,

242
00:23:25,760 --> 00:23:32,800
you've had enough, stop eating, right? Just stop now. And most people, when they get that signal,

243
00:23:32,800 --> 00:23:37,440
they do stop. But that signal only remains in your body naturally for less than 10 minutes.

244
00:23:37,440 --> 00:23:42,160
It washes away. So if you kind of power through it, you can carry on eating. And obviously then

245
00:23:42,160 --> 00:23:47,840
you'll overeat, right? So what these drugs do, and I interviewed the scientists who made all

246
00:23:47,840 --> 00:23:52,160
the breakthroughs that made this possible, is they, and they're mostly not pills at the moment,

247
00:23:52,160 --> 00:23:59,040
they're mostly injections. They inject into your system a copy of the, of GLP-1, a kind of

248
00:23:59,040 --> 00:24:03,680
artificial replica of it. But instead of being washed out of your system in 10 minutes, it stays

249
00:24:03,680 --> 00:24:08,720
in your body for a whole week, which means that I can tell you from my own experience,

250
00:24:08,720 --> 00:24:14,480
you, when you start eating, you know, remember the couple of days after I started taking a

251
00:24:14,480 --> 00:24:23,520
Zempik, I woke up and I had this weird feeling. I wake up and thinking, what do I feel? There's

252
00:24:23,520 --> 00:24:28,240
something strange here. And I could, I lay there for like five minutes and I couldn't place it.

253
00:24:28,240 --> 00:24:36,320
And then I realized, oh, I'm not hungry. But my whole life, I don't remember a day when I didn't

254
00:24:36,320 --> 00:24:40,480
wake up hungry, right? I would often be woken up by my stomach rumbling. I woke up and I wasn't

255
00:24:40,480 --> 00:24:46,160
hungry. I thought, this is a bit weird. And I went to the cafe, the road from here, where I used to

256
00:24:46,160 --> 00:24:50,240
always go for breakfast. And I ordered my standard breakfast, which was a chicken roll with lots of

257
00:24:50,240 --> 00:24:58,240
mayonnaise, a brown bread, huge roll with lots of mayo. And I had a couple of bites, you know, a

258
00:24:58,240 --> 00:25:02,160
little bit, you know, I had maybe three or four bites, which is quite, actually quite a lot when

259
00:25:02,160 --> 00:25:08,800
it's a big thing. And then I just felt full. It was the strangest sensation. And I left, I remember

260
00:25:08,800 --> 00:25:13,440
Tatiana, the Brazilian woman who runs the cafe, sort of saying, are you sick, you're okay? And then

261
00:25:13,440 --> 00:25:18,160
I went for lunch to this Turkish restaurant I used to go to for lunch most days, up the road,

262
00:25:18,160 --> 00:25:23,920
next to my office, which, and I had my standard order, which was the Mediterranean lamb. And again,

263
00:25:24,800 --> 00:25:29,920
had like a third of what I would normally have. And then I just wasn't hungry. And it was like

264
00:25:29,920 --> 00:25:33,840
the kind of shutters had come down on my appetite. So one of the things these drugs do is they make

265
00:25:33,840 --> 00:25:37,840
you fuller, faster. We now know, it used to be thought that was primarily because of an effect

266
00:25:37,840 --> 00:25:42,080
on your gut and your stomach. It's not, it's primarily because of an effect on your brain,

267
00:25:42,080 --> 00:25:49,440
which I'm sure we can explore and talk about. But it was, it was a, I was fascinated by how

268
00:25:49,440 --> 00:25:54,080
rapid the transformation was in my appetite. There was certainly unpleasant side effects as well.

269
00:25:54,080 --> 00:26:01,840
But I remember just being really quite shocked by how dramatic the, dramatic the effect was on my

270
00:26:01,840 --> 00:26:08,160
appetite and how rapid the weight loss was, right? I've lost three stone in just over a year. I'm

271
00:26:08,160 --> 00:26:11,760
terrible at converting to pounds. I need to memorize this before some of the other interviews,

272
00:26:11,760 --> 00:26:14,080
but what's that three stone in pounds for American listeners?

273
00:26:14,080 --> 00:26:15,840
46, I think, 46 pounds.

274
00:26:15,840 --> 00:26:20,480
46, something like that. Yeah. So it's a huge amount of weight loss. I was 14 and a half stone

275
00:26:20,480 --> 00:26:24,880
when I started, I'm 11 and a half now. And actually, and I'm unusual in this respect,

276
00:26:25,760 --> 00:26:32,240
all of my weight loss has been fat. I was 33% body fat when I started. I'm now, I haven't done

277
00:26:32,240 --> 00:26:38,480
it in about a month, but I was, I think it was 23 when I last checked. So, you know, I've gone from

278
00:26:38,480 --> 00:26:44,240
33, which is only slightly below the body fat composition of a whale to, I mean, I gained a

279
00:26:44,240 --> 00:26:49,120
lot of weight during COVID, like a lot of people to now, you know, in the BMI charts, I'm in the

280
00:26:49,120 --> 00:26:53,680
BMI charts. I'm in the nice soothing green zone, the middle of the, the slightly upper end of the

281
00:26:53,680 --> 00:27:00,160
green zone, which is a nice place to be. 42 pounds, I correct myself. I'm not good at

282
00:27:00,160 --> 00:27:06,480
doing maths on the department. Spontaneous maths is my, my like stress stream.

283
00:27:07,920 --> 00:27:10,480
Well, you touched on, you know, on the effects on their brain as well,

284
00:27:11,040 --> 00:27:15,920
just to reverse engineer for a second, you talked about the kind of yo-yo weight struggles that you

285
00:27:15,920 --> 00:27:20,480
had. I think it was an amazing part of, I think it was chasing the screen when you talked about the,

286
00:27:21,120 --> 00:27:27,920
the woman in the weight loss study who was on the IV nutrition and then discovered that she was abused

287
00:27:27,920 --> 00:27:32,240
by her grandfather when she was young. And that was a psychological reason for the weight gain.

288
00:27:32,240 --> 00:27:37,200
I thought that was such a powerful, you know, anecdote because we always kind of chastise

289
00:27:37,200 --> 00:27:42,080
the overweight. When I say we, some, some people in the fitness industry, well, if you just, you

290
00:27:42,080 --> 00:27:46,080
know, ate salad and go for a run every day, then you'll look like me. And obviously there's a,

291
00:27:46,080 --> 00:27:51,200
there's a whole psychology behind our eating as well. So when you look back with this lens now

292
00:27:51,200 --> 00:27:56,640
at your journey, what psychologically do you think contributed to you struggling with,

293
00:27:56,640 --> 00:28:01,680
with your weight and body dysmorphia? I wouldn't say I have body dysmorphia, but the,

294
00:28:02,560 --> 00:28:09,520
I definitely didn't, but the, well, for obesity, there's three kinds of cause,

295
00:28:09,520 --> 00:28:15,920
as with many conditions, there's biological causes, the psychological causes and their social causes.

296
00:28:15,920 --> 00:28:20,640
Right. So biological causes are things like your genes, changes that happen in your brain,

297
00:28:20,640 --> 00:28:25,920
psychological causes are how you feel about yourself and the world. And environmental causes are

298
00:28:25,920 --> 00:28:32,240
things like in this case, the food supply system. Right. So I would say all three of them in different

299
00:28:32,240 --> 00:28:36,480
ways were playing out with me, but you've asked about the psychological ones. So let's home in

300
00:28:36,480 --> 00:28:40,240
on that for a sec. And it was one of the strangest things that happened to me during the,

301
00:28:43,680 --> 00:28:52,640
during the working on the book, a kind of surfacing of these issues. Right. So if you'd

302
00:28:52,640 --> 00:28:58,080
asked me when I started working on the book, magic pill, when you'd asked me, if you'd asked me,

303
00:28:58,880 --> 00:29:04,880
you know, your home, why do you eat? I would have said, well, I eat to sustain my body. Right. I

304
00:29:04,880 --> 00:29:11,040
eat to keep going. Obviously that's why I eat. But you know, before I took these drugs, I was

305
00:29:11,040 --> 00:29:18,400
taking about, I was eating about 3,200 calories a day. And now I eat about 1,800 sometimes between

306
00:29:18,400 --> 00:29:24,480
1,800 and 2,000 a day. So that's a lot fewer calories. Right. So, and here I am, my body is

307
00:29:24,480 --> 00:29:28,640
sustained. It's alive. In fact, it's healthier than it was. So something else was going on with a

308
00:29:28,640 --> 00:29:33,040
huge amount of my eating. And I looked a lot at the evidence about why people eat. Right. And

309
00:29:33,040 --> 00:29:38,720
obviously sustenance is the primary or rather the most important one, but there's lots of other

310
00:29:38,720 --> 00:29:44,800
psychological reasons why people eat. One of them is pleasure, right? Huge numbers of people get a

311
00:29:44,800 --> 00:29:52,000
lot of pleasure out of food. And one of the issues around these drugs is for a lot of people, not me,

312
00:29:52,000 --> 00:29:57,200
I have to say, but I can explain why if you want, but it really strips the pleasure out of foods.

313
00:29:57,200 --> 00:30:01,600
For example, there's a British food critic called Jay Rainer, brilliant food critic, who, you know,

314
00:30:01,600 --> 00:30:06,400
has talked about, he went on these drugs, goes to like some of the best restaurants in Paris and

315
00:30:06,400 --> 00:30:10,480
just cannot enjoy the food. Even one of the scientists involved in designing the drugs,

316
00:30:10,480 --> 00:30:15,840
Jens Jolls-Holst said in an interview with Wired magazine that, you know, for a lot of people,

317
00:30:15,840 --> 00:30:19,440
they take these drugs and it just strips the pleasure out of food. And after a year or two,

318
00:30:19,440 --> 00:30:23,760
life is so boring. They just can't go on. They have to say, it didn't have that effect on me.

319
00:30:25,280 --> 00:30:30,800
But I don't think for particularly good reason. One of the things I realized, so I grew up in a

320
00:30:30,800 --> 00:30:39,520
working class family and I grew up eating absolute shit. I mean, I ate nothing but junk food for my

321
00:30:39,520 --> 00:30:45,200
entire childhood and teenage years. I mean, that's an exaggeration, right? The day the microwave,

322
00:30:45,200 --> 00:30:49,920
I was mostly raised by my grandmother, who was an amazing woman. And the day the microwave was

323
00:30:49,920 --> 00:30:57,360
invented was the happiest day of my grandmother's life, right? And it's funny, I remember the first

324
00:30:57,360 --> 00:31:03,360
time I took a Zempik, you know, like a lot of people when they're about, a lot of people who've

325
00:31:04,240 --> 00:31:10,000
nearly died and, you know, been revived describe near death experiences. I feel like I had a sort

326
00:31:10,000 --> 00:31:15,360
of near death experience with food where I could picture all the food I'd ever, as I was injecting

327
00:31:15,360 --> 00:31:19,600
myself, I was pictured all the food I'd ever eaten in my life, right? And I pictured, you know,

328
00:31:19,600 --> 00:31:28,080
so much shit, like so many like, you know, there's little foam sugary bananas you used to get when

329
00:31:28,080 --> 00:31:36,560
you were a kid, I pictured like, loads of just in staggering amounts of KFC and McDonald's,

330
00:31:36,560 --> 00:31:40,720
there's 38,000 branches of McDonald's in the world, and I felt like I could see them all flicking

331
00:31:40,720 --> 00:31:48,960
through my mind. And I realized, when it comes to pleasure, partly because I grew up in a very violent

332
00:31:48,960 --> 00:31:55,920
and crazy environment when I wasn't with my grandmother. For me, the primary pleasure I got

333
00:31:55,920 --> 00:32:01,440
from food was actually from kind of stuffing myself. I would sort of, I wouldn't have thought about

334
00:32:01,440 --> 00:32:04,640
it this way, but looking back, I would sort of deliberately overeat. So everyone would have been

335
00:32:04,640 --> 00:32:08,640
stuffed at some point in their life, Thanksgiving dinner or something, you know, and stuffing is a

336
00:32:08,640 --> 00:32:11,520
particular kind of pleasure, it is a kind of physical pleasure when you're stuffed, it's

337
00:32:11,520 --> 00:32:16,080
uncomfortable, but it's also pleasurable. You know, it's where you feel, you can feel sort of

338
00:32:16,080 --> 00:32:20,880
pressure outwards on your stomach and upwards on your esophagus. And I think most of the pleasure

339
00:32:20,880 --> 00:32:25,920
I got from food was sort of stuffing, I would overeat to stuff myself. And when I was on a

340
00:32:25,920 --> 00:32:30,320
Zempik, I couldn't, you can't really do that when you're on a Zempik, you would just throw up if

341
00:32:30,320 --> 00:32:37,680
you did that. So for me, I actually had to slow down my eating when I started taking these drugs,

342
00:32:37,680 --> 00:32:42,000
which actually for me meant that I kind of tasted my food a bit more. And actually, I think I enjoy

343
00:32:42,000 --> 00:32:45,280
food slightly more, I don't want to claim I'm some great foodie now, I'm never going to be

344
00:32:45,280 --> 00:32:49,360
now, I'm never going to be that guy. But I think I've actually had an increase in pleasure from

345
00:32:49,360 --> 00:32:53,120
food admittedly from a very low base. Of course, if you're someone like Jay Rayner, the food critic,

346
00:32:53,120 --> 00:32:56,880
is coming from a different direction with a different relationship with food, he's going

347
00:32:56,880 --> 00:33:00,400
to have a different experience. And I think more people are like Jay than they are like me, I

348
00:33:00,400 --> 00:33:05,600
suspect, on these drugs. But that's one thing is pleasure. But another thing, which is a big thing

349
00:33:05,600 --> 00:33:11,760
that we're playing out for loads of people, is just comfort. We eat to comfort, to stabilize our

350
00:33:11,760 --> 00:33:18,560
emotions, to lift our moods if we're feeling down. There's lots of evidence about this. There's a

351
00:33:18,560 --> 00:33:27,680
brilliant study of 475 NFL games. And it found that if the home team wins in a town, sales of shitty

352
00:33:27,680 --> 00:33:35,360
junk food go down by 9% in that town over the following week. And if they go down, if they win,

353
00:33:35,360 --> 00:33:39,360
and if they lose, the sales in shitty, comforting junk food go up by 16%.

354
00:33:39,360 --> 00:33:46,560
And this is true of all traumatic events. There was a massive increase in shitty junk food after

355
00:33:46,560 --> 00:33:52,560
9-11. There was a massive increase in shitty junk food purchases in blue states after Trump won.

356
00:33:52,560 --> 00:33:58,400
So comfort eating is a very common thing. If you lose your job, you're very likely to gain a lot

357
00:33:58,400 --> 00:34:02,960
of weight, partly through a big increase in comfort eating. And of course, that's another

358
00:34:02,960 --> 00:34:10,000
thing that's taken away when these drugs kick in. Your ability to comfort eat is much more limited.

359
00:34:10,000 --> 00:34:15,280
I remember one day about six months into taking them, probably a bit less actually,

360
00:34:16,240 --> 00:34:20,720
I had a bad day. Nothing terrible. Not an awful day, but I had a bad day. And kind of on autopilot,

361
00:34:20,720 --> 00:34:31,120
I was in Vegas, I went to KFC, a particularly rough KFC in Vegas that I love. And I remember

362
00:34:33,280 --> 00:34:37,120
sitting there with this bucket of fried chicken in front of me, which a year before I would have

363
00:34:37,120 --> 00:34:44,640
just eaten on autopilot and felt comforted by, and just thinking, shit, I can't eat this.

364
00:34:45,280 --> 00:34:49,280
Like, I mean, I just literally couldn't eat it. And I remember seeing Colonel Sanders staring down

365
00:34:49,280 --> 00:34:54,080
at me from the wall. And it's like he was going, hey, buddy, what happened to my best customer?

366
00:34:55,680 --> 00:35:02,560
So one of the things that happens when you take these drugs is the underlying psychological

367
00:35:02,560 --> 00:35:11,200
components that drive your eating are disrupted and therefore come to the surface. Now that can

368
00:35:11,200 --> 00:35:15,840
be a good or bad thing. I remember going to one of my best friends and just saying, yeah,

369
00:35:15,840 --> 00:35:20,960
this is making me feel like shit, I can't come for eat. I'm going to stop taking them. And her

370
00:35:20,960 --> 00:35:26,320
saying to me, you know, this isn't creating this issue. These drugs are not creating this issue,

371
00:35:26,320 --> 00:35:31,120
right? This is an issue that's there the whole time. What these drugs are doing is making it

372
00:35:31,120 --> 00:35:35,840
visible to you. So yeah, you can stop taking the drugs and go back to that. And you'll incur all

373
00:35:35,840 --> 00:35:41,200
sorts of health costs in the long term, and you'll be comforted in the short term. Or you can try to

374
00:35:41,200 --> 00:35:44,560
change your relationship. You can try to understand these feelings and change your relationship with

375
00:35:44,560 --> 00:35:50,880
food and try to see food, begin to see food as something you use to feed your body and make you

376
00:35:50,880 --> 00:35:56,800
healthy, not something you use primarily to manage your emotions. And that's what I decided to do.

377
00:35:56,800 --> 00:36:00,720
And I think it was a very conscious effort and it's been hard work, but I think I've made

378
00:36:01,440 --> 00:36:07,040
a huge amount of progress in that. I did notice when I was writing the book, I kept mistyping

379
00:36:07,040 --> 00:36:12,640
fried chicken as a friend chicken. And I thought, you don't need to be Freud to figure out that one,

380
00:36:12,640 --> 00:36:17,920
right? But yeah, so I would say to anyone who's thinking about taking these drugs,

381
00:36:19,920 --> 00:36:26,240
think about your relationship with food, because whatever your emotional relationship with food is,

382
00:36:26,240 --> 00:36:31,760
these drugs will lay it bare in ways that can be quite challenging and ultimately,

383
00:36:31,760 --> 00:36:36,800
for many people, quite positive. That's really interesting to hear. I'm so glad that we went

384
00:36:36,800 --> 00:36:42,240
down that road because when I listened to that, it reminds me of a Dutch model I had on Doris

385
00:36:42,240 --> 00:36:49,360
Maus and she was an alcoholic and then ended up literally like cold turkey in her sobriety.

386
00:36:49,360 --> 00:36:55,200
And she made a comment, it's like, when you are sober, you have to face all your emotions.

387
00:36:56,480 --> 00:37:00,960
I mean, that's a very obvious statement, but it's also very pertinent because I mean, I myself,

388
00:37:00,960 --> 00:37:08,560
I went to this ball with my wife last night and I drank. So I'm always very, very clear about my

389
00:37:08,560 --> 00:37:13,600
reliance on alcohol in some areas. I don't drink binge drink or anything, but I drink frequently.

390
00:37:14,720 --> 00:37:20,880
But when you remove that crutch, and you wouldn't have thought of that for a weight loss drug,

391
00:37:20,880 --> 00:37:26,160
but the way you've described it when you remove that crutch, and you hopefully couple it with

392
00:37:27,520 --> 00:37:32,880
an understanding of the toolbox that you actually have at your disposal to start unpacking what it

393
00:37:32,880 --> 00:37:38,880
is behind the eating, that then becomes another positive element of this drugs I wouldn't have

394
00:37:38,880 --> 00:37:48,080
thought of before. Yeah. And I think so most people who take these drugs, it seems, experience

395
00:37:49,440 --> 00:37:54,160
improvement in health and I really needed that. I'm older now than my grandfather ever got to be.

396
00:37:54,160 --> 00:38:00,480
I'm 45. He died when he was 44 of a heart attack. My dad had bad heart problems. My uncle died of

397
00:38:00,480 --> 00:38:06,800
a heart attack. I was conscious that particularly with my family's history, it would be a very bad

398
00:38:06,800 --> 00:38:12,480
idea to carry on carrying excess weight given what we, the overwhelming evidence about heart

399
00:38:12,480 --> 00:38:17,840
disease and weight gain. For every 3.6 inches you gain on your waist, you increase your chances of

400
00:38:17,840 --> 00:38:26,160
having a heart attack by 27%. It's a big increase. So I was very conscious of that. And most people

401
00:38:26,160 --> 00:38:31,440
experience a kind of boost in health. There does seem to be a significant minority who are

402
00:38:31,440 --> 00:38:37,040
experiencing distress, right? I think there's a range of reasons why. In fact, there's even a

403
00:38:37,920 --> 00:38:45,040
much debated safety signal around suicide. So a safety signal is where doctors notice that some

404
00:38:45,040 --> 00:38:48,960
of their patients who were on a particular drug appear to be getting a particular reaction.

405
00:38:50,240 --> 00:38:55,440
And so some doctors notice that some of their patients appear to be developing suicidal

406
00:38:55,440 --> 00:39:00,880
feelings after taking these drugs. So they raised a signal about it. Now, most safety signals turn

407
00:39:00,880 --> 00:39:05,680
out to be nothing, just like most times your smoke alarm goes off, your house is not on fire. So the

408
00:39:05,680 --> 00:39:09,600
fact that there's a safety signal doesn't mean that it's happening. But there's a big debate

409
00:39:09,600 --> 00:39:14,640
about this and the FDA requires a warning on these drugs that it may cause suicidal ideations. The

410
00:39:14,640 --> 00:39:21,760
European Medicines Agency is looking into it. Now, that would be for a small minority. Stress,

411
00:39:21,760 --> 00:39:26,320
stress, that's important. Obviously, it's a big risk for a small minority. And there's a big debate

412
00:39:26,320 --> 00:39:31,440
about why that might be. So some of it might be the psychological components that we've just talked

413
00:39:31,440 --> 00:39:37,760
about. Some of it may be something else, which I spent a lot of time discussing with the leading

414
00:39:37,760 --> 00:39:42,480
scientists who are doing some of the kind of cutting edge research on this, which is when these

415
00:39:42,480 --> 00:39:49,920
drugs were first developed, people thought, oh, this is a gut hormone. We're injecting people

416
00:39:49,920 --> 00:39:55,440
with the simulation of a gut hormone. These drugs are mainly having an effect on your gut. They

417
00:39:55,440 --> 00:40:00,000
must be slowing down gastric emptying and all sorts of other things. And they do indeed clearly

418
00:40:00,000 --> 00:40:05,600
have an effect on the gut. But there is a growing scientific consensus. In fact, these drugs

419
00:40:05,600 --> 00:40:11,040
primarily do not work through an effect on your gut, real though the effect is, they primarily

420
00:40:11,040 --> 00:40:16,320
work on your brain. So it was discovered that in your brain, it was discovered by scientists here

421
00:40:16,320 --> 00:40:23,920
in London at Hammersmith Hospital that in your brain, you have GLP-1 receptors. So GLP-1 is that

422
00:40:23,920 --> 00:40:28,080
hormone that the drug simulates. You don't just have receptors for it in your gut. You have them

423
00:40:28,080 --> 00:40:35,280
in your mouth, in your thyroid, and most crucially in your brain. And so when you tag a Zempic,

424
00:40:35,280 --> 00:40:40,240
for example, and then you give it to an animal, and then you cut open the animal's brain to see

425
00:40:40,240 --> 00:40:43,440
where it went, you obviously can't do this with humans, but if you do it with an animal,

426
00:40:43,440 --> 00:40:49,520
a non-human animal, what you see is that the drug goes everywhere in the brain. As Professor

427
00:40:49,520 --> 00:40:55,280
Robert Kushner said to me, this drug goes everywhere in the brain. This affects everything in the brain.

428
00:40:55,280 --> 00:41:01,280
It seems to affect some brain regions most importantly. And slightly disconcertingly,

429
00:41:01,280 --> 00:41:07,600
scientists do not really understand what the brain effect is yet. So there's different theories,

430
00:41:07,600 --> 00:41:10,160
and I go through the different theories, and I'm happy to talk about them because they all have

431
00:41:10,160 --> 00:41:16,160
potentially different risks and benefits. But when you take these drugs, you are taking a drug that

432
00:41:16,160 --> 00:41:26,880
changes your brain, and that feels like a deeper change and a more potentially disturbing one.

433
00:41:26,880 --> 00:41:32,320
It may help explain some of the extraordinary benefits as well. So yeah, it's one of the

434
00:41:32,320 --> 00:41:37,600
fascinating things about these drugs. The more you look, the more complex and interesting the

435
00:41:37,600 --> 00:41:43,760
picture becomes, both biologically, in terms of the effect on the culture, in terms of the effect

436
00:41:43,760 --> 00:41:49,600
on your psychology. I just found this such a fascinating subject with so many weird alleyways

437
00:41:49,600 --> 00:41:54,640
and corners and different things that I think we really need to know. And we really need to know

438
00:41:54,640 --> 00:42:01,440
this because there was a poll recently, 47% of Americans want to take these drugs, right?

439
00:42:01,440 --> 00:42:08,880
And the price is going to come down relatively soon. I can explain why. So that is a staggering

440
00:42:08,880 --> 00:42:14,400
number of people who want to take this drug. And due to the staggering levels of obesity and

441
00:42:14,400 --> 00:42:21,120
overweight in the United States, very recent problem, very recent. Essentially, it's in my

442
00:42:21,120 --> 00:42:26,160
lifetime that the obesity crisis has happened. It essentially did not exist prior to my lifetime

443
00:42:26,160 --> 00:42:33,680
or ever in human history. And so you might even be thinking, well, I'm not really interested in

444
00:42:33,680 --> 00:42:39,440
these drugs for myself. Okay, but go back to what that Barclays analyst said, comparing it to the

445
00:42:39,440 --> 00:42:43,840
birth of the smartphone. In 2007, you might not have wanted to have a smartphone either,

446
00:42:43,840 --> 00:42:47,760
the year Steve Jobs launched it, but the iPhone changed the society all around you,

447
00:42:47,760 --> 00:42:51,920
even if you never bought one, right? If we were talking in 2007, we could never have predicted

448
00:42:51,920 --> 00:42:59,200
the effects on attention or Trump or TikTok or anything, all the crazy different things that

449
00:42:59,200 --> 00:43:05,680
flowed from the invention of the iPhone. And this is going to really revolutionize our societies in

450
00:43:05,680 --> 00:43:12,800
complex ways. And I think we can begin to see some of the threads of how this is going to affect us

451
00:43:12,800 --> 00:43:15,440
now. And we're going to see it more and more as time goes by.

452
00:43:16,880 --> 00:43:20,480
What is the philosophy? And it might be different in different countries as you're having this

453
00:43:20,480 --> 00:43:27,280
conversation with people on the prescription of these meds. And the reason I ask that,

454
00:43:27,840 --> 00:43:35,360
I am a huge believer in the body's incredible innate ability to heal. So for example, if someone

455
00:43:36,240 --> 00:43:44,320
has the psychological ability to really dive into a plant-based diet for six months, I truly believe

456
00:43:44,320 --> 00:43:48,880
that they would see their blood chemistry improve, some of the inflammation in the body would improve,

457
00:43:48,880 --> 00:43:53,280
do they need to be on that the rest of their life? Of course not. But you're giving the body all the

458
00:43:53,280 --> 00:43:58,800
tools it needs to start healing itself and you're removing all the toxins and carcinogens and

459
00:43:58,800 --> 00:44:03,920
processed foods that were causing the issue in the first place. When as a firefighter and a

460
00:44:03,920 --> 00:44:10,800
paramedic, I see a lot of people here in the US, which is what I know now. What I see and even in

461
00:44:10,800 --> 00:44:14,480
my fellow firefighters is, oh, you've got high blood pressure, you're going to be on this the

462
00:44:14,480 --> 00:44:19,840
rest of your life. Here's the statin, here's a beta block or whatever it is. And so there's not

463
00:44:19,840 --> 00:44:27,440
an application of a medication being used simply as a bridge between where you are and where we

464
00:44:27,440 --> 00:44:34,560
want you to be through exercise, diet, sleep, meditation, et cetera. So I see with these

465
00:44:34,560 --> 00:44:41,200
pills as a phenomenal application of, all right, Stephanie or Steve, you're at this weight now,

466
00:44:41,200 --> 00:44:45,280
you're at this body composition, we're worried about these things, these disease processes.

467
00:44:46,000 --> 00:44:51,760
We're going to give a two-year plan to get you with this pill down to here, but then we're also

468
00:44:51,760 --> 00:44:57,040
going to work on getting you off the pill and now hopefully getting you to the point where you can

469
00:44:57,040 --> 00:45:02,960
self-stabilize with a healthy, holistic diet. What worries me with any application of pharmaceuticals

470
00:45:02,960 --> 00:45:08,320
in a profit-based system like America is economically you want people to be taking your

471
00:45:08,320 --> 00:45:13,200
pills the rest of their life. So what have you seen as far as the nuances in different countries

472
00:45:13,200 --> 00:45:19,360
with the application of this incredible medication? I think there's a few different questions there

473
00:45:19,360 --> 00:45:26,080
and you raised some really interesting points, James. So I would start with that question about

474
00:45:26,080 --> 00:45:32,960
how long do you need to take them for? So I noticed with myself, the first six months I was taking them,

475
00:45:32,960 --> 00:45:41,280
to put it crudely, I was eating smaller portions of the same shit, right? So I would, you know,

476
00:45:42,400 --> 00:45:48,240
go to the same place that I always went, but I would eat a little bit, you know, and that's

477
00:45:48,240 --> 00:45:52,480
clearly was an improvement, right? As we see from the fact that I lost loads of weight and all sorts

478
00:45:52,480 --> 00:46:02,080
of health indicators improved, but it didn't feel like I was... Well, one of the things we don't know

479
00:46:02,080 --> 00:46:06,240
is whether you develop tolerance to these drugs, right? So it's possible if you look at, for example,

480
00:46:06,240 --> 00:46:10,640
there are 60 months, the longest term studies we have go a little bit longer than 60 months.

481
00:46:10,640 --> 00:46:17,280
And if you look at the graph of weight loss over 60 months, basically, a bit more than 60 months,

482
00:46:17,280 --> 00:46:27,360
basically what happens is you lose an enormous amount of weight, then you plateau, you stop losing

483
00:46:27,360 --> 00:46:29,840
weight, which is of course what we'd want. You wouldn't want a drug that would make people

484
00:46:29,840 --> 00:46:35,840
literally waste away, that has to plateau, has to happen. And then at the very end of the 60 months,

485
00:46:35,840 --> 00:46:40,320
it starts to slightly tick up again. Now I want to be clear, it's ticking up a little bit, so

486
00:46:40,320 --> 00:46:44,240
you're still vastly lower than you were at the start. And then the studies stop and the studies

487
00:46:44,240 --> 00:46:47,520
were always designed to stop at that point, but nonetheless, you're a bit like, oh, what's going

488
00:46:47,520 --> 00:46:54,320
on there? And as with so many things in relation to these drugs, the scientists involved just do not

489
00:46:54,320 --> 00:46:58,480
agree on the question of tolerance. So some scientists said to me, well, it does seem quite

490
00:46:58,480 --> 00:47:03,280
likely there'll be some tolerance that will be developed. Some drugs people never develop

491
00:47:03,280 --> 00:47:07,360
tolerance to, antihistamines, for example, you can take them your whole life, you'll never develop

492
00:47:07,360 --> 00:47:14,720
tolerance to them. So there's a debate about that. The biggest argument that we won't develop

493
00:47:14,720 --> 00:47:22,320
tolerance is that diabetics have been taking these drugs now for more than 18 years, because they,

494
00:47:22,320 --> 00:47:28,320
in addition to having these effects we've been talking about, GLP-1 in your pancreas stimulates

495
00:47:28,320 --> 00:47:34,560
the creation of more insulin. So obviously for diabetics, it's great, both type 1 and type 2

496
00:47:34,560 --> 00:47:38,800
diabetics. So they've been taking it for 18 years and they don't seem to be developing tolerance.

497
00:47:38,800 --> 00:47:42,560
If they were developing tolerance, they would need higher and higher doses to achieve the same

498
00:47:42,560 --> 00:47:46,560
benefits for their blood sugar, and that isn't happening. So I mean, it could be that it has

499
00:47:46,560 --> 00:47:50,800
different effects for diabetes compared to obesity. There's a big debate about this,

500
00:47:50,800 --> 00:47:55,120
but all of which is to say, given that we don't know that about tolerance, we don't know yet about

501
00:47:55,120 --> 00:48:00,880
tolerance, it's possible that this is just opening a window of change that will close,

502
00:48:00,880 --> 00:48:05,600
right? That eventually the effects of the drug will wear off, in which case there's a strong case

503
00:48:05,600 --> 00:48:09,280
for doing what you're saying. And even if there isn't tolerance, there's a strong case for doing

504
00:48:09,280 --> 00:48:13,360
what you're saying, because there are significant risks to taking any drug, and particularly a drug

505
00:48:13,360 --> 00:48:18,160
where we don't know the long-term effects. And actually there are some effects we do know that

506
00:48:18,160 --> 00:48:21,360
we should be worried about in relation to these drugs that I'm sure we'll talk about.

507
00:48:21,360 --> 00:48:26,720
So given that, yeah, it makes more sense, most sense to do what you're saying, which is

508
00:48:26,720 --> 00:48:31,920
use it as an opportunity to interrupt your unhealthy patterns and build a load of change

509
00:48:31,920 --> 00:48:35,680
into your life. So I did that to some degree. I should stress I'm still taking the drug, but

510
00:48:35,680 --> 00:48:40,960
I learned how to cook. Embarrassingly, I was in the middle of my 40s, I'd never learned how to cook.

511
00:48:40,960 --> 00:48:45,680
I started learning how to dance, which is really good fun, it turns out. I made all sorts of

512
00:48:45,680 --> 00:48:55,200
changes in my own life. So what we know about when you stop is at the moment, the studies that look

513
00:48:55,200 --> 00:48:59,760
at when you stop, and we should stress these studies are funded by the drug companies who

514
00:48:59,760 --> 00:49:03,600
have a vested interest in encouraging people to take the drugs forever. So take them with a pinch

515
00:49:03,600 --> 00:49:09,760
assault, but they were done by reputable scientists. What those studies found is if you take the drugs,

516
00:49:09,760 --> 00:49:15,520
lose weight, and then stop taking the drugs, you regain 70% of the weight you've lost within a year.

517
00:49:15,520 --> 00:49:20,400
It's a pretty dramatic effect right now. What those studies didn't look at is, well, what if

518
00:49:20,400 --> 00:49:25,280
you combine them with lifestyle changes and all sorts of other things, right? And I suspect,

519
00:49:25,280 --> 00:49:31,920
although I don't know this, I can't prove this, that the people who didn't regain the weight,

520
00:49:31,920 --> 00:49:39,440
in those studies, made some other changes, right? I suspect that's what happened, it seems like,

521
00:49:39,440 --> 00:49:46,640
common sense. So yeah, that's a broad overview. In terms of different countries,

522
00:49:46,640 --> 00:49:51,600
so different countries are more strict or more relaxed about how easily you can get these drugs.

523
00:49:51,600 --> 00:49:57,440
So in Australia at the moment, you can only get them if you've got diabetes. In Britain,

524
00:49:57,440 --> 00:50:03,840
you can get it for obesity, but in theory, at least, you're meant to have a BMI over than 27,

525
00:50:03,840 --> 00:50:12,880
which wouldn't actually even be obese, that's overweight. And you've got to see a doctor and

526
00:50:12,880 --> 00:50:19,360
all sorts of things. In the US, it's pretty lax. I mean, as I say, I'm in Vegas a lot of the time,

527
00:50:19,360 --> 00:50:23,600
can basically go to any beauty spa in Vegas and get a compounded version of these drugs.

528
00:50:23,600 --> 00:50:28,080
They don't really check anything. I suspect if I went in and I was bone thin and I asked for it,

529
00:50:28,080 --> 00:50:32,720
they would give it to me. I mean, I had actually started taking it in Britain and I had to get it

530
00:50:32,720 --> 00:50:38,880
a few times in Vegas. And yeah, I went in, by the time I went in, because I'd taken the drug and

531
00:50:38,880 --> 00:50:42,880
I'd lost a load of weight, I was not obese. If I had been at that weight when I was starting,

532
00:50:42,880 --> 00:50:46,080
the clinical guidance is to not take the drug, right? Obviously, I was taking it to maintain

533
00:50:46,080 --> 00:50:52,160
that lower weight, which a clinical guidance does allow. And they didn't even ask me anything,

534
00:50:52,160 --> 00:50:56,720
and they didn't ask me anything, I don't care. They also charge you an absolute fortune in the

535
00:50:56,720 --> 00:51:03,120
US. In Britain, you pay 200 pounds a month, which is what about $260, something like that.

536
00:51:03,120 --> 00:51:09,360
In the US, it's like $800 to $1,200 a month. So yeah, different countries are adopting different

537
00:51:09,360 --> 00:51:14,560
strategies with different risk levels, obviously. Yeah. I mean, I think that's, we won't dive into

538
00:51:14,560 --> 00:51:20,880
this too deeply, but I'm a huge fan of the philosophy of the national health system. I mean,

539
00:51:20,880 --> 00:51:26,240
I really am. I think that everyone chipping in to take care of the people who need it at that time

540
00:51:26,240 --> 00:51:33,040
is, in my opinion, the most Christian, Hindu, you know, whatever philosophy you subscribe to,

541
00:51:33,040 --> 00:51:36,400
it's the most kind, compassionate way to do it. Take care of everyone, just like you would in an

542
00:51:36,400 --> 00:51:41,040
ancient tribe. I don't think they were asking for insurance cards and, you know, the Incas back in

543
00:51:41,040 --> 00:51:46,400
the day when Inca Steve got sick and needed, you know, attention. So I love that philosophy.

544
00:51:46,400 --> 00:51:49,360
And I always- I mean, to be fair, the Incas are probably not the best example, because they

545
00:51:49,360 --> 00:51:53,360
probably were sacrificing them to the gods. Maybe that's what it was. Yeah. Super sticks.

546
00:51:57,200 --> 00:51:58,960
The wider point you're making, but I totally agree.

547
00:52:00,480 --> 00:52:04,880
But yeah, but you know, and I try and get people to understand, like when you have a profit-based

548
00:52:04,880 --> 00:52:12,160
system, just economically at its base, you want your customers to keep buying. So where are the

549
00:52:12,160 --> 00:52:19,920
checks and balances for making the nation healthy? If the NHS was run the way it really is supposed to,

550
00:52:20,880 --> 00:52:27,600
the taxpayer contributes a certain amount. The absolute emphasis should be on making the British

551
00:52:27,600 --> 00:52:32,000
as healthy as possible. So we use as little taxpayer's money. And then the elderly,

552
00:52:32,000 --> 00:52:38,080
the newborns, whatever group that needs our money collectively, we have the facilities, the beds,

553
00:52:38,080 --> 00:52:44,000
the doctors, the nurses for them. This is a kind of interesting segue, because I want to get your

554
00:52:44,000 --> 00:52:51,200
take on this. I moved to the US 22 years ago now, and it breaks my heart because I feel like every

555
00:52:51,200 --> 00:52:58,960
time I go home, my, you know, original countrymen and women and children seem to be getting more

556
00:52:58,960 --> 00:53:02,720
and more overweight and obese, something that I don't remember seeing when I was young. And if

557
00:53:02,720 --> 00:53:09,600
you did, it was an anomaly really. What have you seen as far as the UK specifically and the overweight

558
00:53:09,600 --> 00:53:16,400
slash obesity epidemic? Well, the year I was, how old are you, James? I am about to be 50 on Friday.

559
00:53:16,400 --> 00:53:22,720
Wow, you're looking good for it. So I'm slightly older than me. I'm 45. So I was born in 1979.

560
00:53:22,720 --> 00:53:29,600
Year I was born, 6% of British people were obese. It's now 26%. It's a staggering increase,

561
00:53:29,600 --> 00:53:33,600
literally unprecedented, not just in the history of this country, but the entire history of the

562
00:53:33,600 --> 00:53:41,600
human species. And we know, and interestingly, the answer to this question is key to understanding

563
00:53:41,600 --> 00:53:47,120
something at the heart of these drugs. So we know why this happened. And there's an experiment that

564
00:53:47,120 --> 00:53:53,680
I think distills it down. There's a brilliant guy called Professor Paul Kenny, who is from Dublin

565
00:53:53,680 --> 00:53:58,240
in Ireland. He's a brilliant neuroscientist. He's now the head of the Department of Neuroscience at

566
00:53:58,240 --> 00:54:05,360
Mount Sinai in New York. And Professor Kenny moved when he was in his 20s to do his PhD from Dublin

567
00:54:05,360 --> 00:54:12,080
to San Diego in California. And within, I think a year, he gained 30 pounds, right? Quickly noticed,

568
00:54:12,080 --> 00:54:19,440
huh, American people eat differently, right? Like there's different food, a lot more of it,

569
00:54:19,440 --> 00:54:23,920
and it seems to work differently, right? And he really was finding it very hard to control what

570
00:54:23,920 --> 00:54:28,640
he ate. And he started to wonder if this different American diet with foods that just at the time did

571
00:54:28,640 --> 00:54:36,160
not exist in Ireland, like cheesecake, or were extremely rare, if that diet in some way affected

572
00:54:36,160 --> 00:54:41,440
your brain and your body to make you eat more. So he designed an experiment, which I have nicknamed

573
00:54:41,440 --> 00:54:49,280
Cheesecake Park. Very simple experiment. Exactly. So very simple experiment. You get a load of rats

574
00:54:49,280 --> 00:54:55,680
and you raise them in a cage. And the only food source they have is pellets that are based on the

575
00:54:55,680 --> 00:55:00,000
kind of natural food, the kind of whole foods that rats evolved to eat over many thousands of years.

576
00:55:00,000 --> 00:55:04,880
And they've got way more of these pellets than they could ever possibly eat. In that cage,

577
00:55:06,000 --> 00:55:12,160
they'll eat when they're hungry, and then they stop. They never become overweight or obese.

578
00:55:12,160 --> 00:55:16,720
They have a kind of nutritional wisdom. When they've got the kind of food that they evolved to eat,

579
00:55:16,720 --> 00:55:20,880
they'll eat enough of it to keep their bodies going, and then they just stop and do something

580
00:55:20,880 --> 00:55:27,600
else, right? Then he introduced into the cage the American diet. He gave them cheesecake,

581
00:55:27,600 --> 00:55:34,640
he gave them Snickers bars, he fried up some bacon, and very quickly something changed in the rats.

582
00:55:34,640 --> 00:55:40,640
The kind of wisdom they had had, knowing when to stop eating, seemed to disappear. He would put down

583
00:55:40,640 --> 00:55:45,280
the cheesecake and they would hurl themselves into the cheesecake, and they would like eat their way

584
00:55:45,280 --> 00:55:52,720
out of it. They would emerge just absolutely slicked with cheesecake, with their whiskers

585
00:55:52,720 --> 00:56:00,000
thick with it, and they would just eat and eat and eat and eat. And very quickly they were extremely

586
00:56:00,000 --> 00:56:05,280
obese. The way he put it to me is within a couple of days, they were physically and psychologically

587
00:56:05,280 --> 00:56:09,600
different animals, right? They're all sorts of indicators of poor health were starting to shoot

588
00:56:09,600 --> 00:56:15,040
up, and they just did not stop, right? And the whole way they had this junk food, they also had

589
00:56:15,040 --> 00:56:19,600
their old diet, but they just shunned it. They just stopped eating it almost entirely. Only 5% of their

590
00:56:19,600 --> 00:56:24,240
diet came from the pellets once they had the cheesecake and all this other stuff. And then

591
00:56:24,240 --> 00:56:29,760
Paul, Professor Kenny, tweaked the experiment again in a way that seemed a bit cruel to me as a former

592
00:56:29,760 --> 00:56:36,720
junk food addict. He took away all the shitty junk food, and again they only had the healthy whole

593
00:56:36,720 --> 00:56:43,040
foods they'd evolved to have. And he was sure he knew what would happen. What he believed would happen

594
00:56:43,040 --> 00:56:48,080
is that they would now eat far more of the pellets, so the junk food would have expanded their

595
00:56:48,080 --> 00:56:57,120
appetites. That's not what happened. What happened is once they loved the junk food, they'd eaten it

596
00:56:57,120 --> 00:57:02,800
for a long time and it was taken away, it's like they didn't even recognize the old food as food

597
00:57:02,800 --> 00:57:08,960
at all. They shunned it, they wouldn't eat it, they just starved. And it was only when they were

598
00:57:08,960 --> 00:57:15,200
really literally starving that they started to eat the pellets again. To me this is like a parable

599
00:57:15,200 --> 00:57:19,520
about, and there's lots of evidence about this happening to humans, as Gerald Mand, who's a

600
00:57:19,520 --> 00:57:24,080
professor of nutrition at Harvard who designed the food label that's on all American food,

601
00:57:24,080 --> 00:57:30,320
said to me, there is something about the food we're eating that is undermining our ability to

602
00:57:30,320 --> 00:57:35,440
know when to stop. I actually go through the evidence that there's seven ways in which

603
00:57:35,440 --> 00:57:40,240
processed and ultra-processed food profoundly undermines our ability to know when to stop.

604
00:57:42,000 --> 00:57:46,640
And so we become like those rats, right? We just stop recognizing healthy food as food and we

605
00:57:46,640 --> 00:57:50,560
gorge and gorge. It's funny, Professor Kenny said to me, ever since he did that experiment,

606
00:57:50,560 --> 00:57:54,160
he's never been able to eat cheesecake again. Every time he looks at it, he just gets this

607
00:57:54,160 --> 00:58:03,440
mental picture of the rats literally eating their way out of the cheesecake. And this really

608
00:58:03,440 --> 00:58:10,640
importantly loops us back to the drugs because for a long time I was researching why we gained

609
00:58:10,640 --> 00:58:14,080
weight and the effects of these drugs. And at first I thought, oh, these are kind of,

610
00:58:14,880 --> 00:58:18,560
there's obviously a connection at the end, right? But these are sort of parallel lines,

611
00:58:18,560 --> 00:58:24,560
they're sort of different topics. But there was a word that kept coming up when I researched both

612
00:58:24,560 --> 00:58:30,080
topics. And it's a word we don't often use in everyday English, but it's a word we all know,

613
00:58:30,080 --> 00:58:36,000
satiety, right? So the feeling of being sated is the feeling of just having had enough and not

614
00:58:36,000 --> 00:58:39,120
wanting anymore, right? And we get it with food, we get it with sex, we get it with all sorts of

615
00:58:39,120 --> 00:58:43,680
things. You might have, you've just had sex and the hottest person in the world might walk into

616
00:58:43,680 --> 00:58:48,800
the room and you'd be like, oh, I just don't want it right now, right? I mean, I'm sure if Keanu

617
00:58:48,800 --> 00:58:54,240
Reeves came in, I would find a way, but in general, right? We've all had that feeling of being sated.

618
00:58:54,240 --> 00:58:59,920
And you can be sated with food, right? And what this food is doing, this ultra-processed food,

619
00:58:59,920 --> 00:59:05,680
and 78% of all the calories consumed on an average day by an average American child come from

620
00:59:05,680 --> 00:59:12,640
ultra-processed food, which is horrifying, and certainly would have been true of my childhood.

621
00:59:15,200 --> 00:59:22,160
That profoundly undermines your satiety. And what these drugs do is they boost your sense of

622
00:59:22,160 --> 00:59:25,600
satiety. In fact, one of the scientists who developed them played a key role in developing

623
00:59:25,600 --> 00:59:30,480
them. Karel LaRue, a South African psychiatrist, said to me what these drugs really are is they're

624
00:59:30,480 --> 00:59:36,880
giving you satiety hormones. They're giving you your sense of satiety back, right? And once you

625
00:59:36,880 --> 00:59:41,200
see it that way, of course, you begin to see the connection between processed food and these drugs

626
00:59:41,200 --> 00:59:45,600
is very clear. As Michael Lowe, who's a professor at Drexel University and one of the leading

627
00:59:45,600 --> 00:59:50,720
experts in the world on hunger, put it to me, these drugs are an artificial solution to an

628
00:59:50,720 --> 00:59:55,680
artificial problem, right? We could put it differently, a man-made solution to a man-made problem,

629
00:59:55,680 --> 01:00:02,560
right? These foods undermine our satiety and these drugs give us back our satiety, which of course

630
01:00:02,560 --> 01:00:07,840
begs the question, why the fuck are we accepting these being the two choices, right? Why aren't we

631
01:00:07,840 --> 01:00:12,080
changing the food system so that our kids don't face those choices? And I went to countries that

632
01:00:12,080 --> 01:00:17,280
have done that, like Japan, I can talk about how they did it. But yeah, you begin to see what's

633
01:00:17,280 --> 01:00:23,120
going on here is deeply connected to the change in food that is very big and very recent. We eat

634
01:00:23,120 --> 01:00:28,880
foods that our grandparents would not have recognized as food, right? And this has happened very

635
01:00:28,880 --> 01:00:33,760
rapidly. And it's why when you come back to Britain, when we were kids in Britain,

636
01:00:36,160 --> 01:00:41,440
obesity was very rare. Childhood obesity was extremely rare. It's now, you know, not quite

637
01:00:41,440 --> 01:00:47,440
the norm, but it's very, very common, right? So yeah, that's a huge change in a very short

638
01:00:47,440 --> 01:00:52,720
period of time because overwhelming, it's a few other factors, but overwhelmingly because of this

639
01:00:52,720 --> 01:00:58,000
change in our diet. Yeah. Yeah. I'm going back to the NHS and this is the problem. So the bigger

640
01:00:58,000 --> 01:01:03,120
people get, the sicker people get, the more we drain the resources, the more 999 calls there are.

641
01:01:03,120 --> 01:01:07,520
I mean, it's all these areas that they're just getting dismantled along with, you know, budget

642
01:01:07,520 --> 01:01:12,240
cuts and all those things. And to me, all these conversations, whether it was you and I talking

643
01:01:12,240 --> 01:01:18,240
about addiction before, or now this, it's the proactive solution and the false economy of,

644
01:01:18,240 --> 01:01:22,640
for example, the war on drugs, thinking that we're going to arrest our way out of addiction,

645
01:01:22,640 --> 01:01:28,880
you know, all the money wasted there versus like Portugal did pouring resources into helping people

646
01:01:28,880 --> 01:01:33,600
with their mental health challenges in the first place and job creation, all these things. It's the

647
01:01:33,600 --> 01:01:39,680
same with this. And this is what was so disgusting about COVID is we came out and I don't know how it

648
01:01:39,680 --> 01:01:45,440
was in the UK, but here in the US, there was no boosting of PE programs. There were no real food

649
01:01:45,440 --> 01:01:50,080
being cooked in schools again and getting rid of soda machines. And we didn't do anything to fix

650
01:01:50,080 --> 01:01:56,880
this crisis. We just furthered it. What's interesting about, you know, the obesity crisis,

651
01:01:56,880 --> 01:02:01,200
and I've heard people say this phrase before as well, is that we are overfed yet malnourished.

652
01:02:01,200 --> 01:02:07,440
And so I think one of the other maybe underlying elements that a lot of people have when they keep

653
01:02:07,440 --> 01:02:12,960
eating is I wonder, and this is just simply my hypothesis, is the body also still craving

654
01:02:12,960 --> 01:02:18,480
nutrition and say, no, you got to keep eating. I go through, there's really good evidence for this.

655
01:02:20,320 --> 01:02:24,320
There's a brilliant guy called Professor David Rabenheimer, who's at the University of Sydney,

656
01:02:24,320 --> 01:02:28,240
who's done really important work on this. I interviewed him. So he came up with this

657
01:02:28,240 --> 01:02:34,160
theory. So actually, I should say before that, one of the things we know, and there's loads of evidence

658
01:02:34,160 --> 01:02:40,480
for that, is that processed and ultra processed food contains far less protein than whole foods,

659
01:02:40,480 --> 01:02:44,880
right? It's really chronically lacking in protein, partly because of the nature of food processing,

660
01:02:44,880 --> 01:02:52,080
right? This processed and ultra processed food is assembled in factories, right, from chemical

661
01:02:52,080 --> 01:02:57,360
components, many of which are disgusting when you look into them. Almost everyone listening has eaten

662
01:02:57,360 --> 01:03:02,480
an artificial flavouring called Vanillin in the last week. It's one of the most common

663
01:03:03,120 --> 01:03:08,800
products in our food. Vanillin is made, is a fake form of vanilla. It's in loads of food we eat

664
01:03:08,800 --> 01:03:13,120
that is made out of petrochemicals and sawdust. It's pretty gross when you look at it.

665
01:03:13,120 --> 01:03:18,480
But Professor Rabenheimer developed this theory. So obviously, we are hungry for food in general,

666
01:03:18,480 --> 01:03:24,480
right? No surprises there. But also, we need protein, right? We need protein to build our

667
01:03:24,480 --> 01:03:32,240
bones. It's essential for all sorts of things. And he began to wonder, does the fact that we are

668
01:03:32,240 --> 01:03:38,880
lacking in protein, that this food we're eating is lacking in protein, mean that we overeat to get

669
01:03:38,880 --> 01:03:42,960
the amount of protein we have? So his kind of theory was, what if we don't just have a hunger

670
01:03:42,960 --> 01:03:49,440
for calories in general, but we have a hunger for protein in particular? And if we don't get enough

671
01:03:49,440 --> 01:03:54,640
protein, we'll eat more and more until we've got enough protein. And he designed a series of

672
01:03:54,640 --> 01:03:59,680
experiments which prove that that is in fact the case, right? That if you're eating food that's

673
01:03:59,680 --> 01:04:04,880
low in protein, you'll eat much more of it to get the daily amount of protein that you need

674
01:04:05,280 --> 01:04:09,520
for your body to function and for your bones to function. So you're absolutely right. If you're

675
01:04:09,520 --> 01:04:14,560
eating food that is chronically lacking in key nutrients, your body will make you eat more of it

676
01:04:14,560 --> 01:04:19,600
to at least get up to some level of those nutrients that you need. It's one of the seven

677
01:04:19,600 --> 01:04:24,560
reasons that I go through in Magic Pill for why processed food and ultra processed food

678
01:04:24,560 --> 01:04:30,480
make us overeat so much. Yeah, I think this is the thing. And I talk about this quite a bit as well.

679
01:04:30,480 --> 01:04:35,040
Again, with that kind of, why don't you just get up at five, go for a run and eat a salad, kind of,

680
01:04:35,040 --> 01:04:40,480
you know, rhetoric that's out there is say you grew up in, you know, the Bronx or somewhere and

681
01:04:40,480 --> 01:04:45,360
the local, you know, park is just a concrete basketball court and, you know, you've only got

682
01:04:45,360 --> 01:04:50,080
bodegas around you. That's a very different environment than I grew up. I grew up on a

683
01:04:50,080 --> 01:04:54,160
farm in England, you know, but we had vegetables and we had animals on, you know, that we would

684
01:04:54,160 --> 01:05:01,840
butcher. And so my understanding of food as a young English boy in 1980s was very, very different.

685
01:05:01,840 --> 01:05:05,520
If I wanted an apple, I went to the orchard and grabbed one off the tree. I knew what it was and

686
01:05:05,520 --> 01:05:10,880
where I could get it. And it wasn't sprayed with chemicals. And so we have created an environment

687
01:05:11,520 --> 01:05:15,440
for failure the same way in addiction, you know, the same way. I mean, this multi-generational

688
01:05:15,440 --> 01:05:21,280
trauma and the way that we view mental health and addiction and the gang membership and all these

689
01:05:21,280 --> 01:05:25,680
things, we have created an environment for people to fail. And I think this is a really important

690
01:05:25,680 --> 01:05:30,480
part of this whole conversation. And again, that's why it's so disappointing when it was

691
01:05:30,480 --> 01:05:35,520
disregarded during COVID is, as you said, I mean, these are tools that we're talking about, you know,

692
01:05:35,520 --> 01:05:40,160
with these pills. And it sounds like the application could be extremely promising,

693
01:05:40,160 --> 01:05:45,440
but we also have to fix the environment. And if we're not having that food source conversation,

694
01:05:46,000 --> 01:05:50,880
then that, as you pointed out, is why you'll gain 70% of it back when you come off the pill.

695
01:05:51,920 --> 01:05:57,680
Well, you've raised a really important thing that's something I was asking myself a lot.

696
01:05:57,680 --> 01:06:03,280
As I was working on the book and had to really dig deeply into, which is, you know, so I was

697
01:06:03,280 --> 01:06:08,800
learning about the negative health effects of obesity, which are really significant, right?

698
01:06:08,800 --> 01:06:13,920
There was one study in Britain that followed 2500 government bureaucrats over many years.

699
01:06:14,720 --> 01:06:19,920
And at the start, the obese people in the study were no more like when they were younger,

700
01:06:19,920 --> 01:06:25,840
were no more likely to develop health problems than the non-obese people. But as the years went on,

701
01:06:25,840 --> 01:06:29,920
the obese people were in the end, eight times more likely to develop health problems than the

702
01:06:29,920 --> 01:06:34,240
non-obese people, right? For all sorts of reasons that we can go into. So I was learning about that

703
01:06:34,960 --> 01:06:42,080
and the risks of continuing to be obese, which I am sure I would have been had I not taken these

704
01:06:42,080 --> 01:06:47,120
drugs versus the risks of obesity, sorry, versus the risks of these drugs, right? Which are really

705
01:06:47,120 --> 01:06:53,280
significant, I go through 12 big risks from these drugs in the book that I'm worried about. And

706
01:06:53,280 --> 01:06:57,680
they're pretty broad and there's, you know, a mixture of evidence for them. And some of them

707
01:06:57,680 --> 01:07:02,560
are really worrying. And when I talked to my friends about it, I remember one night going out

708
01:07:02,560 --> 01:07:07,680
for dinner with one of my friends and I ate almost nothing but and him saying, but what the fuck

709
01:07:07,680 --> 01:07:11,360
are you talking about, Joha? And you keep saying, are you weighing these two sets of risks? Why

710
01:07:11,360 --> 01:07:14,400
don't you just choose the third option? Why don't you just lose weight like everyone else? Why don't

711
01:07:14,400 --> 01:07:19,440
you just go on a diet, right? And I did a lot of research on this because in my life, I had, you

712
01:07:19,440 --> 01:07:25,360
know, many times in my life, I'd gone on diets and I'd often lost a significant amount of weight. And

713
01:07:25,360 --> 01:07:29,200
then I kind of gained it all back. And I think it's particularly relevant to your podcast because

714
01:07:29,920 --> 01:07:32,560
when I was looking at willpower, one thing really stood out to me.

715
01:07:34,320 --> 01:07:38,160
I think we would all agree that firefighters have staggering levels of willpower.

716
01:07:38,160 --> 01:07:41,680
There's nothing in the world that could make me run into a burning building, right? And I'm sure

717
01:07:41,680 --> 01:07:46,240
most people are like me. Nothing, I mean, maybe if someone I loved was there and, you know, it was

718
01:07:46,240 --> 01:07:50,800
the only thing, but short of that, you could not get me to run into a burning building.

719
01:07:50,800 --> 01:07:52,400
What if Keanu Reeves was in that building?

720
01:07:53,680 --> 01:07:59,920
A shirtless Keanu Reeves as he was on speed crying my name. All right, you've thought of the second

721
01:07:59,920 --> 01:08:07,440
scenario, but it's got to be speed Keanu, right? Or possibly point break Keanu. But anyway,

722
01:08:10,160 --> 01:08:14,560
so I think we'd all agree firefighters have unusually high levels of willpower. And yet also,

723
01:08:14,560 --> 01:08:18,160
as you'll know better than me, firefighters are disproportionately more likely to be overweight

724
01:08:18,160 --> 01:08:24,320
and obese, right? So if just having high levels of willpower protected you, that would make no

725
01:08:24,320 --> 01:08:28,480
sense, right? There's something if, because they've definitely got willpower and yet they're more

726
01:08:28,480 --> 01:08:33,200
likely to be overweight than the general population. So I think we've got to think about willpower in a

727
01:08:33,200 --> 01:08:38,720
slightly different way. And willpower is very real, right? Willpower is a real phenomenon. There's

728
01:08:38,720 --> 01:08:42,560
lots of scientific evidence for it. And everyone in their lives will have experienced willpower,

729
01:08:42,560 --> 01:08:47,040
right? But the way I began to think about willpower when I looked at the evidence for it in

730
01:08:47,040 --> 01:08:54,240
the relationship to weight at the moment, is I think willpower is a bit like having a pretty

731
01:08:54,240 --> 01:09:00,720
strong umbrella in a really, really bad storm, right? Some people using that umbrella are going

732
01:09:00,720 --> 01:09:04,960
to be able to get through the storm and get where they're going and not get soaking wet, right?

733
01:09:04,960 --> 01:09:09,200
But for most people, the storm is so bad, it'll just break the umbrella and they're going to get

734
01:09:09,200 --> 01:09:16,400
soaked, right? So willpower is real, but it exists in a context, a context that is beyond your will,

735
01:09:16,400 --> 01:09:20,560
right? So I think it becomes clearer if you look at some of the science around dieting, for example.

736
01:09:21,200 --> 01:09:25,840
So there's a very simple fact about dieting, is you have to dispute the rules of physics in order

737
01:09:25,840 --> 01:09:33,840
to dispute. If you consume fewer calories than you burn, you will lose weight, right? So you hear that

738
01:09:33,840 --> 01:09:39,120
and you're like, oh, the answer's obvious, right? And it's true. It will work if you can do that.

739
01:09:40,080 --> 01:09:43,600
But I spent a lot of time interviewing a brilliant woman called Professor Tracy Mann,

740
01:09:43,600 --> 01:09:48,080
who's at the University of Minnesota in Minneapolis. Actually, we met in a bakery

741
01:09:48,080 --> 01:09:53,600
called Buns Inn. And the first thing that happened, I was there before her. First thing that happened,

742
01:09:53,600 --> 01:09:57,360
as I walked in, they said, have you been here before? I said, no. They said, here's a free

743
01:09:57,360 --> 01:10:03,920
cinnamon bun, a cinnamon bun, absolutely caked in sugar. That must have been like 2000 calories. And

744
01:10:03,920 --> 01:10:09,680
even on the ozempic, I was able to eat some of it. But Professor Mann has been studying, has done,

745
01:10:09,680 --> 01:10:13,760
I think, the most important research on diet in the world, which is why I went to see her.

746
01:10:14,480 --> 01:10:18,720
So when she started doing this research in the year 2000, at that time, there were lots of studies

747
01:10:18,720 --> 01:10:27,040
of dieting and the results were very clear. Diets work, right? Use your willpower, eat less, exercise

748
01:10:27,040 --> 01:10:32,960
more, you'll lose weight. But she noticed something in these studies. Almost all the studies looked at

749
01:10:33,600 --> 01:10:39,200
dieters for three months or six months, right? So what these studies seem to assume is you lose

750
01:10:39,200 --> 01:10:43,520
weight over three months or six months, and then you just stay at that lower weight for the rest

751
01:10:43,520 --> 01:10:47,200
of your life. That didn't seem to fit with most of the people that Tracy, the professor Mann knew.

752
01:10:48,400 --> 01:10:51,600
So she then said, well, okay, let's look at the longer term, right? So she starts to look for

753
01:10:51,600 --> 01:10:56,480
studies of longer term weight loss on diets. And at that time, there were only, I think it was 24

754
01:10:56,480 --> 01:11:02,960
studies that had ever been done that looked at diets, weight loss on a diet over two years,

755
01:11:02,960 --> 01:11:07,120
or there were a handful of studies that looked at five years. And what they found was very different.

756
01:11:08,560 --> 01:11:15,360
Almost everyone relapsed when they were dieting. And the average weight loss for a diet after two

757
01:11:15,360 --> 01:11:19,840
years was two, the average person lost two pounds. The average is slightly misleading because some

758
01:11:19,840 --> 01:11:24,320
people, a very small minority did lose a lot and keep it off. And we'll all know people like that.

759
01:11:24,320 --> 01:11:28,720
But for the vast majority of people, they regain weight over time. And I'm thinking, well, why would

760
01:11:28,720 --> 01:11:33,680
that be, right? Even if you stayed on the diet in general, you restricted number of calories,

761
01:11:33,680 --> 01:11:39,440
in general, you regained weight. And it turns out that if you gain weight and then lose it,

762
01:11:40,160 --> 01:11:44,480
there's strong evidence that a series of biological changes happen in your body

763
01:11:45,200 --> 01:11:50,720
that make it really hard to keep that weight off. So one of the ways to understand this is there

764
01:11:50,720 --> 01:11:56,800
used to be a theory about weight, which sounds a bit fancy, but it's actually pretty simple to

765
01:11:56,800 --> 01:12:01,360
understand, which is called biological set point theory. Basically what it is, is they used to

766
01:12:01,360 --> 01:12:07,760
think in the sixties and even the seventies, that when you were born, your body, or even in the womb,

767
01:12:08,320 --> 01:12:15,600
your body has a sort of innate level of body fat that it wants you to be. And it'll basically work

768
01:12:15,600 --> 01:12:19,600
really hard to keep you there. You might get a little bit more, you can drop a little bit more,

769
01:12:19,600 --> 01:12:23,840
but think about temperature and you get, you start to understand it. Your body has a set point for

770
01:12:23,840 --> 01:12:29,280
temperature, right? I think it's whatever, it's 39 degrees centigrade. If you, and your body will

771
01:12:29,280 --> 01:12:35,680
work really hard to keep you at that temperature. If you get hotter than that, you'll involuntarily

772
01:12:35,680 --> 01:12:41,680
sweat, you'll pant, you'll be really physically uncomfortable. If you get below that, you'll

773
01:12:41,680 --> 01:12:46,880
shiver, you'll feel horrible, you know, shivering makes you a bit warmer. So your body works very

774
01:12:46,880 --> 01:12:51,840
hard to keep you in that sweet spot of temperature. And it used to be thought that there was something

775
01:12:51,840 --> 01:12:56,240
like that for weight, but then the obesity crisis happened. And for a while, the theory just fell

776
01:12:56,240 --> 01:13:01,360
apart. They were like, well, obviously that isn't right because look how, if your body has a set

777
01:13:01,360 --> 01:13:08,000
point, how come so many people have gained so much weight so fast? But then actually a lot of the

778
01:13:08,000 --> 01:13:12,560
scientists who looked at it figured out you do have a biological set point, but there's a twist.

779
01:13:12,560 --> 01:13:20,480
As you gain weight, your set point rises. So let's say you were 11 stone and you go up to 15 stone.

780
01:13:21,280 --> 01:13:27,600
Your body will then take that 15 stone weight as your new set point and it will work very,

781
01:13:27,600 --> 01:13:32,880
very hard to keep you at that set point. As Giles Yeo, Dr. Giles Yeo, who's one of the leading obesity

782
01:13:32,880 --> 01:13:37,840
experts at Cambridge University put it to me, your brain hates it when you lose weight and it will

783
01:13:37,840 --> 01:13:42,800
fight to take you back to the highest weight you could have been. So when you initially lose weight,

784
01:13:42,800 --> 01:13:49,040
your brain then fights to bring you back. So how does it do that? It slows down your metabolism.

785
01:13:49,040 --> 01:13:54,320
It makes you crave far more sweet, sugary food that would bring your weight back up. It makes

786
01:13:54,320 --> 01:13:58,240
you more lethargic so you want to exercise less. And I remember when I learned this and there's

787
01:13:58,240 --> 01:14:05,440
loads of scientists who put forward evidence for this theory, I remember thinking, well, that

788
01:14:05,440 --> 01:14:11,200
doesn't make sense. Why would evolution have equipped us with that? Why would evolution give

789
01:14:11,200 --> 01:14:15,760
us this thing that makes us so unhealthy? And people like Professor Michael Lowe kept explaining

790
01:14:15,760 --> 01:14:21,440
to me, took me a while to get it, you've got to understand the context in which we evolved.

791
01:14:22,160 --> 01:14:26,240
So in the circumstances where human beings evolved, in fact, in every situation until like

792
01:14:26,240 --> 01:14:34,800
50, 60 years ago, there was no situation where you were going to just have x-rayed your body

793
01:14:34,800 --> 01:14:40,960
and excess abundant calories forever. That just never happened. Human beings were never in a

794
01:14:40,960 --> 01:14:46,080
situation where they had far more than they could ever eat for their whole lives. When would that

795
01:14:46,080 --> 01:14:51,360
ever happen? So evolution didn't prepare our bodies for that scenario because it didn't ever occur.

796
01:14:52,000 --> 01:14:57,040
What evolution did prepare our bodies for was a very different scenario, which happened a lot,

797
01:14:57,040 --> 01:15:03,520
which was famine. Very often, human beings would have food and then it would go away.

798
01:15:03,520 --> 01:15:08,400
And in a situation of famine, the fattest guy at the start of the famine will be the last man

799
01:15:08,400 --> 01:15:14,400
standing at the end, right? Timothy Chalamet is going to die very quickly in a famine and John

800
01:15:14,400 --> 01:15:19,280
Candy is going to be the last guy standing, right? So there's, I mean, sadly, John Candy no longer

801
01:15:19,280 --> 01:15:24,000
with us. That's not a great example, but you know what I mean, right? So actually there's a huge

802
01:15:24,000 --> 01:15:29,120
evolutionary advantage in a situation where famine happens quite often. If you get food,

803
01:15:29,120 --> 01:15:33,200
keep consuming it and stay as fat as you can for as long as you can because sooner or later a

804
01:15:33,200 --> 01:15:38,720
famine is going to come along. But what our evolution has done is prepare us for a famine

805
01:15:38,720 --> 01:15:44,480
that ain't coming, right? When you and I, barring some horrific event, are never going to be in a

806
01:15:44,480 --> 01:15:49,200
situation where there's a famine. What we are in is a situation of calorie excess all the time or

807
01:15:49,200 --> 01:15:54,000
potential calorie excess all the time, right? So you can see how this is a kind of quirk of our

808
01:15:54,000 --> 01:16:00,880
biology that has ill prepared us for this environment. Also leads us back to the drugs,

809
01:16:00,880 --> 01:16:05,760
because what some people think, and this is contested, it's certainly not a settled scientific

810
01:16:05,760 --> 01:16:13,040
view, is that possibly what these drugs do is they lower your set point in your brain. They lower the

811
01:16:13,040 --> 01:16:18,320
weight your brain is trying to keep you at. That may be actually the primary mechanism by which

812
01:16:18,320 --> 01:16:20,640
they work, although it may not. And there's a debate about that.

813
01:16:20,640 --> 01:16:23,680
That's so interesting to think about. And I'm to circle around to what you're saying about the

814
01:16:23,680 --> 01:16:30,240
fire fires. The one other factor that a lot of people don't understand in fire, especially in

815
01:16:30,240 --> 01:16:35,360
America, we do 24 hour shifts. But if you look at police and doctors and nurses and a lot of

816
01:16:35,920 --> 01:16:40,960
life-saving occupations that actually end up being, you know, struggling with their own health,

817
01:16:41,760 --> 01:16:46,640
is the shift work and the sleep deprivation. So going back to your umbrella analogy, now imagine

818
01:16:46,640 --> 01:16:51,920
there's holes in the umbrella as well. That's another reason why their willpower is even more

819
01:16:51,920 --> 01:16:59,200
diminished. But in that conversation, there's a term called circadian scarring. Yeah. And so,

820
01:17:00,000 --> 01:17:04,800
I worked for 14 years and when I transitioned out, it literally took me about five years to be able

821
01:17:04,800 --> 01:17:09,440
to sleep properly again. And that's only 14 years, a short career compared to some people.

822
01:17:09,440 --> 01:17:14,720
So to parallel that, that seems to be what's happening with people that have been in the

823
01:17:14,720 --> 01:17:18,400
world for a long time. And that seems to be what's happening with people that have gained a lot of

824
01:17:18,400 --> 01:17:23,280
weight. There's almost a kind of scarring of, as you said, that baseline, because that should be

825
01:17:23,280 --> 01:17:28,400
dynamic, really, you know, the feast and the famine, the John Candy caveman should then be

826
01:17:28,400 --> 01:17:34,720
able to come down, you know, I want to see that movie, but you know, it should, it should be a

827
01:17:34,720 --> 01:17:39,600
sliding scale, but obviously it gets locked in because like you said, it's, it's an abnormal

828
01:17:39,600 --> 01:17:45,360
artificial, you know, feast versus, you know, an actual feast before a winter in some European

829
01:17:45,360 --> 01:17:51,600
country. And one of the reasons we know that is actually a study of, you know, that horrific

830
01:17:52,160 --> 01:17:58,400
game show, the world, the world's biggest loser. So people haven't seen it. I hate it. It's a

831
01:17:58,400 --> 01:18:02,560
fucking evil show as far as I'm concerned, but it's, they get severely obese people

832
01:18:02,560 --> 01:18:09,520
and they compete to lose weight throughout the show. And they lose very dramatic amounts of weight,

833
01:18:10,240 --> 01:18:14,800
often through going through horrifying ordeals, which are actually not at all wise ways to lose

834
01:18:14,800 --> 01:18:23,040
weight. So what there was a very good study done that went back and looked at these, the previous

835
01:18:23,040 --> 01:18:29,360
contestants on the world's biggest loser. And one of the things they discovered is these people,

836
01:18:29,360 --> 01:18:35,120
and obviously that's a very dramatic weight loss, but even years later, they had to consume far

837
01:18:35,120 --> 01:18:41,360
fewer calories in a day to stay at the same weight as someone who had never been obese, right?

838
01:18:41,360 --> 01:18:46,080
Because their metabolism works so differently. So the way Dr. Giles Yeo described it to me,

839
01:18:46,080 --> 01:18:49,680
and there's a brilliant British doctor called Chris Van Tullaken who's written about this as well.

840
01:18:50,720 --> 01:18:57,040
Imagine two identical twins, right? They're both 75 pounds, but one of them has always been 75

841
01:18:57,040 --> 01:19:05,040
pounds as an adult. And the other one went up to 95 pounds and came back down. The twin who went to

842
01:19:05,040 --> 01:19:11,440
95 and came back will have to eat far, far fewer calories per day to stay at the same weight as

843
01:19:11,440 --> 01:19:17,280
then his brother does, right? Because his metabolism will be so damaged and so much slower. And because

844
01:19:17,280 --> 01:19:24,320
his body is fighting through that set point to bring his weight back up. So yeah, I think what

845
01:19:24,320 --> 01:19:30,880
is that? And you're totally on the money about sleep, James. The figures on this are incredible.

846
01:19:30,880 --> 01:19:37,360
The National Sleep Foundation says that on average we sleep 20% less than people did a century ago.

847
01:19:37,360 --> 01:19:43,280
In Britain, children sleep 85 minutes less a night than they did in 1945, which is, I mean,

848
01:19:43,280 --> 01:19:52,080
staggering. And I interviewed lots of experts about this. And, you know, lack of sleep makes

849
01:19:52,080 --> 01:19:59,440
you crave sugary shitty food, right? To give you energy. So lack of sleep is a huge factor in weight

850
01:19:59,440 --> 01:20:05,120
gain and disturbed and interrupted sleep. There's a lot of evidence on our shift workers really

851
01:20:05,120 --> 01:20:10,480
screws with your brain and partly has these food effects as well. So I think you're absolutely

852
01:20:10,480 --> 01:20:13,440
right. There's a brilliant woman who should interview. I'll give you an intro to her if you

853
01:20:13,440 --> 01:20:18,480
want. Professor Roxanne Prishad, also in Minneapolis at the University of Minnesota,

854
01:20:18,480 --> 01:20:24,320
who's done really shocking work on this and is a great person. Beautiful. Yeah, that would be

855
01:20:24,320 --> 01:20:27,440
amazing. Thank you so much. I've, people have listened to the show for a long time. Sleep

856
01:20:27,440 --> 01:20:32,560
deprivation comes up all the time because it's the elephant in the room for the mental health side.

857
01:20:32,560 --> 01:20:36,960
I mean, you think about not sleeping every third day and the inability to process, you know,

858
01:20:36,960 --> 01:20:41,840
anything that we see and do. The cancer conversation, if you listen again to all the

859
01:20:41,840 --> 01:20:48,240
greats in the sleep medicine world, I mean, shift work is a known carcinogen. So, but we shy away

860
01:20:48,240 --> 01:20:53,520
from that because that involves staffing. That involves getting more human beings to become

861
01:20:53,520 --> 01:20:58,240
first responders to give them more rest and recovery. And a lot of people in leadership,

862
01:20:58,240 --> 01:21:03,040
and I use that term loosely, positions, you know, they just don't want to talk about that

863
01:21:03,040 --> 01:21:08,080
because that's going to involve them actually being courageous and advocating for their people. So

864
01:21:08,080 --> 01:21:12,720
I think it's a very important topic. Yeah, I totally agree with you. And it also, you know,

865
01:21:12,720 --> 01:21:17,760
it involves taking on power, right? I mean, actually firefighters are pretty good at this

866
01:21:17,760 --> 01:21:22,000
because it's one of the most unionized parts of the United, one of the few unionized parts of the

867
01:21:22,000 --> 01:21:25,440
United States. So they're in a stronger position to do that than a lot of other people. But yeah,

868
01:21:26,240 --> 01:21:30,240
I totally agree with you. And there's been enormous rising people working through the night

869
01:21:31,200 --> 01:21:34,080
in the US and Britain, enormous rise in the last few years.

870
01:21:34,960 --> 01:21:40,880
Well, I know where we're running out of time. I, you touched on Japan finding solutions to some

871
01:21:40,880 --> 01:21:48,560
of the food issues. Now I lived there 22 years ago for about 15 months as a stunt man. And even then,

872
01:21:50,080 --> 01:21:56,720
such a glamorous statement. It was pretty cool. But, you know, I, when I was there, there were

873
01:21:56,720 --> 01:22:01,120
some fast food, but it was probably at a transition, you know, there was still mostly traditional

874
01:22:01,120 --> 01:22:06,960
Japanese, you know, restaurants in Osaka. So what were you, what were they seeing in Japan? And then

875
01:22:06,960 --> 01:22:13,520
let's talk solutions. What were they bringing to the table? So really often we're told there's

876
01:22:13,520 --> 01:22:20,080
basically a choice here. It's just weight loss drugs forever or being obese forever. And at an

877
01:22:20,080 --> 01:22:23,680
individual level for a lot of people are obese, that is actually the dilemma they're facing,

878
01:22:23,680 --> 01:22:28,320
but that does not have to be the choice for our children, our grandchildren and future generations.

879
01:22:28,320 --> 01:22:34,000
And one of the ways we know that is because of Japan. So Japan got rich without getting fat.

880
01:22:34,000 --> 01:22:40,240
In the United States, 42.5% of people are obese. In Japan, it's 4.5% and projected to fall

881
01:22:40,800 --> 01:22:45,200
without these drugs. And obviously wanted to understand, well, how did they do it? Right?

882
01:22:47,120 --> 01:22:50,960
So I went to Japan, spent a lot of time there, it was riveting, it was totally fascinating.

883
01:22:51,600 --> 01:22:56,960
And there's lots of answers, but you might think, oh, it's just their genes, right? They must just

884
01:22:56,960 --> 01:23:01,120
have, they've won the genetic lottery. Actually, we know that's not true because in the late 19th

885
01:23:01,120 --> 01:23:07,760
century, lots of Japanese people went to go and live in Hawaii. And Japanese Hawaiians now,

886
01:23:07,760 --> 01:23:13,760
all these generations later, they can be studied and they're almost as overweight as other Hawaiians.

887
01:23:13,760 --> 01:23:18,080
So we know that it's not their genes, because obviously their genes didn't radically mutate

888
01:23:18,080 --> 01:23:23,520
in the space of a hundred years. So something else going on. We also know it's a relatively

889
01:23:23,520 --> 01:23:27,920
recent invention, because actually Japanese people did not have the diet we think of as

890
01:23:27,920 --> 01:23:33,440
the Japanese diet until really quite recently, until the 1920s, the Japanese diet and their

891
01:23:33,440 --> 01:23:38,160
attitude towards it was actually deliberately invented by the Japanese government and kind of

892
01:23:39,120 --> 01:23:45,920
encouraged in the people. So there's lots of reasons why Japan has this very different

893
01:23:47,280 --> 01:23:51,760
level of obesity and very different health outcomes. I remember the first day I went,

894
01:23:51,760 --> 01:24:00,640
I took one of my god-sons and we were staying in a hotel and in the center of Tokyo. And it was a

895
01:24:00,640 --> 01:24:05,280
kind of tourist hotel, but it was about half the people there were tourists from other parts of

896
01:24:05,280 --> 01:24:11,760
Japan and half were Western tourists. And they had two breakfasts laid out, right? There was the

897
01:24:11,760 --> 01:24:17,360
Western breakfast, which was like piles of pancakes and scrambled eggs and everyone could

898
01:24:17,360 --> 01:24:23,760
put bacon and sausages. And there was the Japanese breakfast, which was like tiny little bits of

899
01:24:23,760 --> 01:24:30,080
white fish, like little bowls of miso soup. And my god-son came up to me, I'd already got my

900
01:24:30,080 --> 01:24:34,640
breakfast, and I had the Japanese breakfast. And my god-son who went to get both came up to me and

901
01:24:34,640 --> 01:24:38,080
said, I just saw the weirdest thing. And I was like, what? And he said there was a Japanese

902
01:24:38,080 --> 01:24:45,120
woman and he pointed to her, not very discreetly. She went and she got breakfast from their kind of

903
01:24:45,120 --> 01:24:50,880
food and then she came over to the Western section and she took one French fry and put it on her

904
01:24:50,880 --> 01:24:55,280
plate. And then she came back a minute later and put that French fry back and took a smaller

905
01:24:55,280 --> 01:25:00,560
French fry. And he's like, did you even know the concept of French fry existed in the singular?

906
01:25:00,560 --> 01:25:06,720
Has anyone ever eaten one French fry in the entire history of the United States? Right, never. So

907
01:25:06,720 --> 01:25:12,720
they eat very differently. I spent a lot of time in the Tokyo School of Sushi, the great

908
01:25:12,720 --> 01:25:19,920
chief chef there, the head of it, Masaru Watanabe, gave me some really great lessons there. So

909
01:25:19,920 --> 01:25:27,760
obviously they eat much simpler food. They eat a lot of fish. They eat in a much simpler way.

910
01:25:27,760 --> 01:25:32,400
The way he put it to me is, you know, he was grilling a mackerel and I was watching this

911
01:25:32,400 --> 01:25:39,760
oil drip out of the mackerel. And he said, what you have in the West is an addition cuisine.

912
01:25:39,760 --> 01:25:46,080
When you want to eat something, you add more to it. You add salt, butter, sugar, all sorts of things.

913
01:25:46,080 --> 01:25:53,360
We have a minus cuisine. We subtract from our food to make it taste more like itself, which was a

914
01:25:53,360 --> 01:25:58,560
really interesting way of thinking about it. And he said, because our food is so simple, you have

915
01:25:58,560 --> 01:26:05,120
to put even more care into preparing it because you have to make every flavor fire. So in every

916
01:26:05,120 --> 01:26:10,080
meal, Japanese people actually eat a much more diverse range of ingredients than us. You know,

917
01:26:10,080 --> 01:26:17,040
we might have like a lasagna, but they'll have five small dishes. And actually you're meant to

918
01:26:17,040 --> 01:26:21,680
eat them, I'm sure you saw this when you were there, James, in a triangle shape. So if you gave me,

919
01:26:21,680 --> 01:26:27,600
you know, a lasagna, some cabbage and some French fries, I would eat probably all the French fries

920
01:26:27,600 --> 01:26:30,720
first, then I'd eat all the cabbage, then I'd eat the lasagna, right? But we eat them in one after

921
01:26:30,720 --> 01:26:35,440
the other. In Japan, you don't do that. You have a little bit of the fish, then you have a little bit

922
01:26:35,440 --> 01:26:39,600
of the next dish, a little bit of the next dish, and you eat them in a triangle shape, which slows

923
01:26:39,600 --> 01:26:45,120
down your eating. Also Japan, Japanese people are taught from when they're very young that you're

924
01:26:45,120 --> 01:26:52,640
meant to eat until you're 80% full. So if you get the feeling of being full when you're still eating,

925
01:26:53,520 --> 01:26:58,640
you've eaten too much because it takes a while to get the signals. Actually, we now know the GLP

926
01:26:58,640 --> 01:27:04,800
one that tells you you've had enough, right? So you teach me all these different ways in which

927
01:27:04,800 --> 01:27:09,680
Japanese people think about food. I was thinking, God, how would we ever integrate this into our

928
01:27:09,680 --> 01:27:15,680
thinking? But crucially, this is taught from a very young age to children. I went to a school

929
01:27:15,680 --> 01:27:20,640
called Koenji Middle School. Actually, I went to the whole school, but I spent most time in Koenji

930
01:27:20,640 --> 01:27:27,840
Middle School. A school in Tokyo in a middle-class neighborhood, they showed me how to eat

931
01:27:27,840 --> 01:27:35,200
and how they create this food culture, some of the key ways. So I was greeted at the door, me and my

932
01:27:35,200 --> 01:27:41,760
translator, by the school nutritionist. His name is Harumi Tatebe. Every school by law has to have

933
01:27:41,760 --> 01:27:46,400
a nutritionist. It's a really serious qualification. It's three years even after your teacher training,

934
01:27:46,400 --> 01:27:53,600
and your job is to design the food, oversee the food. Everything every child eats in Japan in school

935
01:27:53,600 --> 01:28:00,400
has to be completely non-processed, made from fresh on the day. And your job is to use this

936
01:28:00,400 --> 01:28:06,080
fresh food to teach the children what a healthy diet is, and also to counsel any kids who might be

937
01:28:06,080 --> 01:28:12,480
under-eating or overeating. So going to this school, I've got to tell you it was the weirdest

938
01:28:12,480 --> 01:28:19,360
thing. There's a thousand kids at that school. I spent all day there. I didn't see one overweight

939
01:28:19,360 --> 01:28:28,240
child. It was weird. So you're going through, so they have this delicious, amazing fresh food.

940
01:28:28,240 --> 01:28:33,440
I mean it was probably more like Nobu than like anything I ever ate at school. And I'm sitting

941
01:28:33,440 --> 01:28:39,440
talking to the kids and Harumi, while they're eating, she uses the food to teach them. So she'll

942
01:28:39,440 --> 01:28:44,320
hold up like a red rope and she'll go, okay, this is calcium. What does calcium do? And they'll go,

943
01:28:44,320 --> 01:28:49,120
ah, it makes your bones strong. She'll go, right, this blue rope, this is carbohydrates. What does

944
01:28:49,120 --> 01:28:53,920
that do? It gives you energy in there. And every time she adds a rope, she'll tie the rope together.

945
01:28:53,920 --> 01:28:57,920
And then she holds the rope up and go, you see, you need all these things to have a healthy meal.

946
01:28:57,920 --> 01:29:03,840
She's constantly telling the kids, you have to eat with your brain. What you eat makes your

947
01:29:03,840 --> 01:29:08,560
brain. You have to eat with your brain, right? And it was so weird speaking to these kids,

948
01:29:08,560 --> 01:29:14,320
because I talked to them, it's like, I spent the most time with kids who were about nine or 10.

949
01:29:14,320 --> 01:29:17,120
And I'd say to them, what's your favorite, one of the kids said, what's your favorite food? He said,

950
01:29:17,120 --> 01:29:21,440
broccoli. I love broccoli. Another kid, I'm like, what's your favorite food? He's like salmon.

951
01:29:21,440 --> 01:29:25,680
And after a while, I turned to Chie, who's my translator, and I said, are these kids taking

952
01:29:25,680 --> 01:29:30,320
the piss out of me? Right? Like, well, their favorite food is broccoli. And Chie just looked,

953
01:29:30,320 --> 01:29:33,520
every Japanese person I discussed it with just looked puzzled when I said that. I was like,

954
01:29:33,520 --> 01:29:38,880
they were like, what do you mean? We teach our kids to like healthy food, they like healthy food.

955
01:29:38,880 --> 01:29:44,720
They just couldn't. And at one point, I was like getting so vexed by how healthy these kids were,

956
01:29:44,720 --> 01:29:49,840
that I took out my mobile phone, and I googled British school dinner, right? I just pictures of

957
01:29:49,840 --> 01:29:54,880
a typical British school meal, the kind of thing I ate at school, and I showed it to them. And these

958
01:29:54,880 --> 01:29:59,760
kids literally reacted like I'd showed them an ISIS beheading video, right? They began to scream,

959
01:29:59,760 --> 01:30:05,520
they looked like horrified and disgusted, like where's the salad? I said, there is no salad.

960
01:30:05,520 --> 01:30:10,480
Where's the vegetables? I was like, there are no vegetables. They looked like, ah, they were like

961
01:30:10,480 --> 01:30:15,440
completely, and they were like, what, you would eat this every day? I was like, yeah, this little

962
01:30:15,440 --> 01:30:21,040
10 year old girl put a hand on my arm, very sympathetic, she said, I'm worried about you.

963
01:30:23,040 --> 01:30:26,400
So it was fascinating. I mean, there's lots of things they do in Japan, some of which we would

964
01:30:26,400 --> 01:30:31,680
not approve of, and I wouldn't want to import as well. I'll give you an example of one of them,

965
01:30:33,200 --> 01:30:38,800
which is quite hard to get your head around. So in 2008, they had a panic in Japan because

966
01:30:38,800 --> 01:30:44,960
their obesity rate went up by like 0.2%. It was still like laughably low by our standards.

967
01:30:44,960 --> 01:30:49,760
And they introduced something called the Metabolor, which is called that because when you're,

968
01:30:49,760 --> 01:30:52,800
when you develop obesity, you're at risk of something called metabolic syndrome,

969
01:30:52,800 --> 01:30:57,120
which is a combination of a whole series of really unpleasant problems. And

970
01:31:00,320 --> 01:31:07,680
under the Metabolor, every business in Japan, every year on a certain day, has to weigh

971
01:31:07,680 --> 01:31:12,320
all of its workers. And if your weight has gone up, you have to drop a plan with your employer

972
01:31:12,320 --> 01:31:17,200
to bring it down. And if the overall weight of the company goes up, you can be fined by the

973
01:31:17,200 --> 01:31:21,280
government, right? So it's pretty hard to get your head around. And so they introduced this

974
01:31:21,280 --> 01:31:25,360
to the government, right? So it's pretty hardcore. So I went to a Japanese business to see how they

975
01:31:25,360 --> 01:31:31,120
do this. And it's pretty intense, right? I went to one called Tanika. I mean, okay, so they make

976
01:31:33,280 --> 01:31:36,000
health equipment. So they have a particular investment in, you know,

977
01:31:37,200 --> 01:31:42,800
they're the most enthusiastic edge of this. But when you arrive at work, you stand in front of

978
01:31:42,800 --> 01:31:48,320
video screen and it says, Hi, James, you walked 12,000 steps yesterday, because everyone has to

979
01:31:48,320 --> 01:31:52,400
fit bit. These are the meals you ate, because everyone takes a photo of their meals and shows

980
01:31:52,400 --> 01:31:57,760
them. Bob, who sits two desks down from you, hasn't weighed himself yet this week. Why don't

981
01:31:57,760 --> 01:32:03,040
you remind him? Like, Whoa. So I go up every morning, they do collective exercise together,

982
01:32:03,040 --> 01:32:07,760
they do yoga together at the time when everyone in an American office is eating bagels and donuts.

983
01:32:09,840 --> 01:32:15,920
And it's, it's pretty intense, right? And, I mean, when I explained to people

984
01:32:15,920 --> 01:32:19,600
at this workplace, you know, if you did this in Britain or the US, we would burn the office down.

985
01:32:20,000 --> 01:32:25,520
And they were just like, baffled. They were like, why? They just didn't, you know, so there's some

986
01:32:25,520 --> 01:32:29,440
aspects of Japan that are really different, but many which are not. And a lot of people will be

987
01:32:29,440 --> 01:32:32,480
listening and thinking, okay, that's very nice for Japan, but we're never going to do that.

988
01:32:33,520 --> 01:32:38,640
And it's a big change. I went to lots of places that have made changes. But I would just give an

989
01:32:38,640 --> 01:32:43,120
example to anyone our age who, who thinks we're never going to make that change. Think about

990
01:32:43,120 --> 01:32:49,280
smoking, right? When I was a kid, half of British people smoked. My mother smokes 70 cigarettes a

991
01:32:49,280 --> 01:32:56,400
day. There's a photo of me and her when I'm a baby, she's breastfeeding me, um, smoking and resting

992
01:32:56,400 --> 01:33:00,640
the ashtray on my stomach. Right. When I discovered this photo a few years ago, I thought,

993
01:33:00,640 --> 01:33:05,040
or she'll feel guilty. I'll show it to her. She said, you were a fucking difficult baby. I needed

994
01:33:05,040 --> 01:33:10,240
that cigarette. That was like typical Scottish parenting at the time. This should be a birthday

995
01:33:10,240 --> 01:33:15,520
card. That was beautiful. Exactly. I was going to put the photo in my book and she said, you're not

996
01:33:15,520 --> 01:33:20,960
putting my tits in your book. Um, but the, uh, she was very pissed off about it, but the, um,

997
01:33:21,840 --> 01:33:27,520
so you think about how big that changes when we were kids, people smoked everywhere. They smoked

998
01:33:27,840 --> 01:33:33,840
on trains, on buses, on planes. My doctor used to smoke while he was examining me when I was a kid.

999
01:33:33,840 --> 01:33:37,840
I remember it right. And we've gone from that, obviously we have issues around vaping, but

1000
01:33:37,840 --> 01:33:44,080
you know, very few young people smoke now it's gone from, you know, 50% to 12% and enormous fall.

1001
01:33:44,080 --> 01:33:49,680
Right. So we can make these big changes if we want to. I believe we can, I believe we should,

1002
01:33:49,680 --> 01:33:57,120
I believe we will, if we band together and fight for it. Um, so we're not trapped in the choice

1003
01:33:57,120 --> 01:34:01,440
between these weight loss drugs and the 12 big risks that they cause that I go through in the book.

1004
01:34:01,440 --> 01:34:07,200
And the risks of obesity forever, we can make different choices. Um, but that requires bigger

1005
01:34:07,200 --> 01:34:11,760
social changes. So what I'm hoping at the end of the book, I go through five possible scenarios

1006
01:34:11,760 --> 01:34:16,800
for what might happen now with these drugs from the worst case scenario, which is that we find

1007
01:34:16,800 --> 01:34:21,760
out they cause some catastrophic health problem to the best case scenario. For me, the best case

1008
01:34:21,760 --> 01:34:27,040
scenario is that lots of people benefit from these drugs. And I think that's a good thing.

1009
01:34:27,040 --> 01:34:32,320
For me, the best case scenario is that lots of people benefit from these drugs, but they also

1010
01:34:32,320 --> 01:34:38,080
wake us up to say, how the fuck did we end up with this choice? But this, we shouldn't have to drug

1011
01:34:38,080 --> 01:34:44,160
ourselves to be healthy. Why don't we learn from Japan, change how we live and get to a point where

1012
01:34:44,160 --> 01:34:49,760
our kids don't face this risky and dangerous choice. Well, that is a beautiful place to round

1013
01:34:49,760 --> 01:34:55,360
off this conversation. I want to be mindful of your time. So the, the book is magic pill for

1014
01:34:55,360 --> 01:35:00,560
everyone listening out on May 7th. So it will be out by the time this drops. Where can people

1015
01:35:00,560 --> 01:35:04,720
around the world find it? If you want to know where to get the audio book, the ebook or the

1016
01:35:04,720 --> 01:35:13,120
physical book, you can go to my website. It's J O H A N N H A R I.com. And you can see where to get

1017
01:35:13,120 --> 01:35:17,760
that book or my previous books. Um, can see where to follow me on social media, though I don't look

1018
01:35:17,760 --> 01:35:23,760
at it that much. Um, and you can see a load of other things as well. Hooray. Beautiful. Well,

1019
01:35:23,760 --> 01:35:27,440
I want to thank you so much. I'd love to get you back on and talk about stolen focus one day,

1020
01:35:27,440 --> 01:35:32,880
because we dove into the magic pill and rightly so. Um, but it's been another amazing conversation.

1021
01:35:32,880 --> 01:35:37,840
I know how busy you are normally. So I want to be so thankful for you. Oh my God. I can't even

1022
01:35:37,840 --> 01:35:42,320
spit out my last, my last closing. So I want to thank you for being so generous with your time

1023
01:35:42,320 --> 01:35:46,960
and coming on the behind the shield podcast today. I always love talking to James. What a pleasure.

1024
01:35:46,960 --> 01:35:56,800
Thank you so much.