# Johann Hari - Beware The Thrill of The Magic Pill

An episode of [The Imperfects](https://invisiblenetwork.ai/podcast/1476501557), 1 Dec 2024, 1 h 25 min.

Audio: https://enrichment.soundstack.com/4vjqq8/episode.flightcast.com/i9hvfb7jz48yu2pdosrgwnr8.mp3

Johann Hari is a prolific author, deep thinker, and seasoned guest of The Imperfects. In this episode, Johann takes the guys on a deep dive into the Western food system, and how processed food has completely derailed our nutritional wisdom. Our relationship with food is a very personal one, and Johann and Josh get vulnerable about how they have used food to manage emotions. They discuss how vanity comes into play, the plethora of risks and benefits to the new weight-loss drug like Ozempic, and if their introduction of could derail any notion of self-acceptance. This episode does discuss eating disorders and suicidal ideation so tread carefully, and only listen to this episode when you’re ready. Johann, it is always a pleasure. This is a big and tricky conversation, and we thank you for having it with us. To watch the full episode on YouTube, follow this link - https://youtu.be/2rcWI8zSOvE 🎧 Things to listen to: • Johann Hari - The Importance of Connection - https://apple.co/4fE5V8n • Johann Hari - Why You Can’t Pay Attention - https://apple.co/4flaoMG • Johann Hari (P1 1) - How Can We Change? - https://apple.co/40liAIJ • Johann Hari (Pt 2) - Why Do We Do What We Do? - https://apple.co/3UokTH2 📖 Things to read: • The Magic Pill by Johann Hari - https://bit.ly/3NHoyw1 • Johann’s other books - https://johannhari.com 💻Things to look into: • Prof. Tracey Mann research into dieting - https://bit.ly/4eKbDEB • Bee Wilson’s research into baby food - https://bit.ly/3ZtpklZ • Dr. Paul Kenny research into the obesity - https://bit.ly/3ZbtZsm The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice, treatment or assessment. The advice given in this episode is general in nature, but if you’re struggling, please see a healthcare professional, or call lifeline on 13 11 14.

## Transcript

[0:00] In today's Academy of Imperfection, we have Johan Hari back in the studio to talk about a lot of things actually.
[0:06] We talk about the westernized food system and how our reliance on processed foods can have serious negative consequences on our physical and mental health, our relationship with food and weight, willpower, diet and exercise, vanity, body shaming, eating to comfort or suppress negative emotions and much more.
[0:23] Johan also discusses the benefits and risks of new weight loss drugs like Ozempic.
[0:28] Although these drugs can be beneficial for people at higher risk of negative health conditions due to living with obesity, they also have significant mental and physical health risks associated with them.
[0:38] And there is a lot we still don't know.
[0:40] So if you're thinking of taking them, weighing up the risks with your doctor for your unique situation, like Johan has, is incredibly important.
[0:47] We also know that many of the topics mentioned in this episode can be challenging for people, especially those who have had a history of disordered eating.
[0:54] So please tread carefully with this episode and only listen when you feel ready.
[1:00] These drugs are so powerful.
[1:02] I think of them as being like fire, right?
[1:05] They're a tool.
[1:06] Fire is a really good tool if I use it to warm up my house.
[1:10] It's a really shit tool if I use it to burn down yours, right?
[1:13] A tool this powerful will be used for great good and great harm.
[1:18] Well, hello darlings and welcome to the Academy of Imperfection, where experts in their field share their wisdom on the subject of imperfection.
[1:30] Today, for the quadruple of time, we welcome best-selling British author, Johan Hari, to talk to us about our problematic food system and what he calls the magic pill.
[1:44] So, pour yourself a pint of Devonshire and join students Hugh, Ryan and Josh learning from the man who says c**t a lot, Johan Hari.
[1:56] Well, how exciting.
[1:58] We are joined by the King of England.
[2:01] Essentially.
[2:02] Yep.
[2:03] Yep, for the fourth time.
[2:04] The fake king is literally in Australia right now.
[2:07] Really?
[2:08] Yeah.
[2:09] Charles, did you not know this?
[2:10] Is he in Australia now?
[2:11] I think so, yeah.
[2:11] I think he's literally here today.
[2:13] I have to say, it is a really bad thing that Britain has a hereditary monarchy, but it's particularly shameful that you have our hereditary monarchy, right?
[2:20] Yeah.
[2:21] Come on, Australia, have some fucking self-respect here, right?
[2:24] Am I being led to believe that there is no one in Australia who could do a better job as your head of state than someone from another country who is there because he emerged from the right vagina 70 years ago?
[2:34] This cannot be correct.
[2:36] So, yeah, fourth time you've been on this podcast.
[2:39] That is a record, I'd say.
[2:41] Hooray.
[2:41] Yeah.
[2:41] So, really, I'm the king of this podcast more than of England.
[2:45] Yeah, you are.
[2:46] You are definitely the king of authors, that's for sure.
[2:49] It's the nicest thing anyone's ever said to me.
[2:51] Stolen Focus, Lost Connection, Chasing the Scream, three books that have had an extraordinary impact on so many people worldwide.
[2:58] The new book, Magic Pill, which we're going to talk to you about today.
[3:01] I mean, there's so much to talk to you about today.
[3:03] Where do we start?
[3:04] Well, I mean, I feel like the magic pill, I guess, so much about that book is about the food system and about how the food system is doing us no favours and how it makes it incredibly hard.
[3:18] But I guess it's just like from what you experienced because, and I'm sure you've got lots to say on it, but I think just starting there, because I think that's the thing that most people face every day.
[3:28] You get up, whether it's how you've grown up, how you've been brought up or whatever it is, but everyone has a different experience with the food system.
[3:36] Most people probably don't even think about it.
[3:38] It's difficult to get your head around how much this has changed in such a short period of time.
[3:44] It's such a funny little moment in the history of Australia.
[3:46] Not funny, a terrible moment, but I think it helps you to understand this.
[3:49] So your Prime Minister drowned in 1968, Harold Holt.
[3:51] Yeah, Harold Holt.
[3:53] Just say to everyone listening, just pause this and Google.
[3:56] You can watch online.
[3:57] When he drowned, there were just a load of ordinary Australians on the beach, right, who helped look for him that day.
[4:03] Just Google it and look at those people on that beach, right, and then just come back.
[4:07] If you look at them or go even later than that, I was born in 1979.
[4:12] Google photographs of any beach in Australia in 1979.
[4:15] Just look at them and then come back, right?
[4:18] You will have noticed something a bit weird, right?
[4:20] The people on that beach don't look like us.
[4:22] They're all what we would call skinny or quite ripped, right?
[4:26] You look at it and go, well, where was everyone else that day, right?
[4:29] Was it like a skinny person convention on the beach that Harold Holt happened to drown off of?
[4:33] And then you look at the figures.
[4:34] So the figures for Australia are pretty similar to Britain.
[4:37] In the year I was born, 6% of British people were obese.
[4:41] It's now 27%.
[4:43] Between the year I was born and the year I turned 21, obesity doubled in the US and then in the next 20 years, severe obesity doubled again.
[4:50] So you've got to understand how unusual this is.
[4:52] Human beings exist in our modern form for about 350,000 years, something between 300,000 and 350,000 years.
[4:58] And obesity exists, but it's unbelievably rare, right?
[5:01] Vanishingly rare.
[5:03] And then essentially in our lifetimes, it has blown the fuck up.
[5:08] I think that's weird.
[5:09] What happened, right?
[5:10] Why did this explosion take place?
[5:13] And we know the answer, the core of the answer, because this change happens everywhere that makes one change.
[5:20] It's where people move from mostly eating fresh whole foods they prepare on the day
[5:24] to eating mostly processed or ultra-processed foods, which are foods that are built in factories out of chemicals in a process that isn't even called cooking, it's called manufacturing food.
[5:35] And it turns out this new kind of food, right, which our great-grandparents never had one mouthful of this kind of food because it didn't exist then, this new kind of food affects our bodies in a completely different way to the old kind of food.
[5:47] And I go through lots of ways, seven ways it affects us differently in the book, but...
[5:52] I think the kind of core of how it affects us differently is really distilled in this quite simple experiment.
[5:57] It was done by a scientist I interviewed called Dr. Paul Kenney, brilliant Irish-American scientist.
[6:02] He's the head of neuroscience at Mount Sinai in New York.
[6:05] It's a very simple experiment.
[6:07] He got a lot of rats and he raised them in a cage.
[6:09] And all they had to eat was the kind of natural whole foods that rats evolved to eat over thousands of years.
[6:13] Yeah.
[6:14] And when that's all they had, the rats would eat when they were hungry and stop when they were full.
[6:19] They had some kind of natural nutritional wisdom that just said when they had enough, hey guys, you've had enough, stop now.
[6:25] So the rats, when they had the kind of food they evolved to eat, never became fat, overweight, obese, just didn't happen.
[6:31] Then Dr. Kenny introduced them to the American diet.
[6:34] He fried up a load of bacon.
[6:36] He bought a load of cheesecake.
[6:37] He bought a load of Snickers bars.
[6:38] And he put it in the cage.
[6:40] God, rats must have been pumped.
[6:41] The rats went fucking apeshit for the American diet.
[6:45] They would literally dive into the cheesecake and eat their way out, which has been one of my ambitions in my life.
[6:52] and emerged just completely smeared with the cheesecake.
[6:56] And the way Dr. Kenny put it to me is they ate and ate and ate and ate.
[7:01] And within a couple of days, they were just different animals, right?
[7:04] This nutritional wisdom that they'd had when they had the kind of food they evolved for disappeared and they all became severely obese.
[7:11] Dr. Kenny tweaked the experiment then, again, in a way it feels quite cruel to me as a former KFC addict.
[7:16] He took away all the American diet and left them with nothing but the healthy food.
[7:20] And he was sure he knew what would happen.
[7:22] They thought they would eat more of the healthy food than they had before, and that would prove that exposure to this kind of food expands the number of calories you eat in a day.
[7:31] That is not what happened.
[7:32] What happened is much weirder.
[7:35] Once they had the American diet and it was taken away, they refused to eat the healthy food.
[7:41] It was like they no longer recognised it as food.
[7:43] They literally starved.
[7:44] It was only when they were actually starving to death that they finally reluctantly went back to eat it quite a while later.
[7:50] Is there, cause like you said before, like, you know, they, it's like they forgot the nutritional wisdom they had before, but before all these processed foods came in and people had no choice, but just to eat whole foods, was there much nutritional wisdom or was it just like, well, this is food.
[8:05] This is just like people were people thinking about why they were eating that food or were they just eating it because that was food?
[8:13] Yeah, it's an innate nutritional wisdom.
[8:15] So it's not like the rats weren't reading complex books about the macros you need, right?
[8:19] Oh, well, then I think I'll balance this with the...
[8:21] But I mean more like people, yeah.
[8:23] Yeah, you're right, because the phrase wisdom we think of is kind of explicit, kind of intellectual wisdom.
[8:28] But it's more...
[8:29] It's linked to...
[8:33] getting signals from your body about you've had enough, you don't need any more satiety.
[8:38] It's been interesting research on this here in Australia, actually.
[8:40] One of the reasons why people eat more, when you've got a diet of processed food, you eat far more calories.
[8:47] There's lots of reasons why, but there's a guy at the University of Sydney called Professor David Raubenheimer, who's done really interesting research on this.
[8:54] One of the reasons, out of many, is that processed food is actually very low in protein.
[8:59] And it turns out, we all know you have hunger for calories, right?
[9:02] You need a cent of more calories in order to stay alive.
[9:04] But he argues, I think, and I think he's proven quite persuasively, you don't just have a hunger for calories in the main, you also have a hunger for protein, because your body needs protein to build bones and do all those things.
[9:16] And so your body knows not just when it's had enough calories, but also when it's had enough protein.
[9:21] So you eat more processed food than you would from non-processed food because to get the right amount of protein, you have to have a lot more because it's so low in protein, right?
[9:30] He's done really interesting experiments proving that.
[9:32] So nutritional wisdom takes all sorts of forms, right?
[9:35] But the way we eat...
[9:37] We're fed food that's actually designed to fuck with that, right?
[9:40] So you think about the circumstances where we evolved.
[9:44] If you found, came across soft, sweet-tasting food, that would be fruit.
[9:51] That would be good for you, right?
[9:52] So we evolved to go, oh, let's eat that, right?
[9:54] Yeah.
[9:55] But now, of course, if you come across soft, you know, sugary stuff, it's more likely fruit loops than fruit, right?
[10:02] So it's like the, it's almost like a malfunctioning GPS.
[10:05] It was designed to tell you how to drive home, but now it actually tells you to drive off a cliff, right?
[10:10] We live in an environment because of the changed nature of food that completely scrambles and fucks with our instincts and gets us to eat in all sorts of, or makes us more likely to eat in all sorts of more dysfunctional ways.
[10:23] But I'm really curious about you guys.
[10:24] So you all look like slightly aged home and away lifeguards.
[10:27] So like you've never had, you know, you couldn't be home and away lifeguards now.
[10:32] I mean, you could in my fantasies, but not in the show.
[10:35] But yeah, you get a feeling this has never been an issue for any of you.
[10:39] It's been an issue for me.
[10:40] Really?
[10:41] Yeah.
[10:41] I've always, I'm probably not as heavy as I've been, but I feel like from the age of,
[10:51] 16.
[10:52] In fact, I remember I was on the beach and someone pointed at my like gut and said I'd like put on some weight and kind of joked about me looking fat.
[11:00] And I reckon from that moment I've had issues with the way I look and I always blame myself for like, like I can't open, I jokingly talk about how I can't have like open a pack of sour worms and not finish them in one sitting.
[11:15] Like I got a pack of sour worms a week ago and managed to finish it in two sittings rather than one.
[11:19] And I was really proud of myself.
[11:21] Um, I, yeah, I've always had issues, body issues since teenage years and, um, yeah, and I've blamed myself for almost solely for the whole time that I'm not disciplined enough to exercise enough.
[11:37] I don't have enough self-control to not eat more healthy.
[11:42] Um, and it's, yeah, and it's, it's my fault is kind of the dialogue that's been going on for me for, yeah, since I was a teenager.
[11:49] Yeah.
[11:49] This is true of so many people, Josh, because it relates to a lot of things we've talked about before.
[11:56] But we live in this environment that has lots of good things about it, but is in some ways a dysfunctional environment.
[12:04] And it produces these negative outcomes like depression, attention problems, being overweight.
[12:09] But because we don't have a kind of systemic analysis, we're always pushed to blame ourselves for these things that are actually the result of much bigger systems, right?
[12:19] The fact that the difference between the beach where Harold Holt drowned and the nearest beach to here now and what people look like there is not that all those people were weak-willed, right?
[12:29] And lazy and didn't get their act together, right?
[12:32] It's not that human beings had willpower for 300,000 years and then it suddenly vanished in our lifetimes, right?
[12:38] It's just ludicrous.
[12:39] That's not the change that happened.
[12:40] Not that willpower isn't real.
[12:41] Willpower is a real thing.
[12:44] There's a brilliant scientist based here in Australia, Professor Roy Baumeister at the University of Queensland, who's done some of the best research in the world on willpower.
[12:51] It's a real thing, but it's a very limited resource, right?
[12:54] And if you're pitching your willpower against...
[12:57] the entire environment that's sabotaging your instincts and your willpower, that's, you know, some people can fight their way through that, just like some people can climb Mount Everest without oxygen, but it rigs the odds against you.
[13:09] I also think, interestingly, it feels like in that time when the food system has changed and this dialogue for many people, I think I wouldn't be alone in blaming yourself and thinking it's your own willpower,
[13:21] But also in that same period of time, the proliferation of beauty standards has changed as well.
[13:29] So as it's gotten harder to look a certain way, looking that way has become more and more prized and idealized.
[13:38] Totally.
[13:39] Yeah.
[13:40] So it's like a, it's a pretty shit combo for a lot of people.
[13:44] Yeah, totally.
[13:45] And it's, it's, I mean, it's bad enough for us, but it's much worse for women.
[13:49] I really pissed off one of my, a female friend of mine, just before magic pill came out, I, um, I was chatting to her and I said, Oh, you know, I feel a bit weird going into these interviews because it's the first time I've felt in interviews that people will be looking at me and going like, Oh, is he gained weight?
[14:04] Is he okay?
[14:04] He's talking about taking his end pick.
[14:06] Is he fat?
[14:07] Is he not fat?
[14:08] Yeah.
[14:08] And she was really pissed off.
[14:09] I said, oh, why are you looking pissed off?
[14:11] She said, the fact that you've got to the age of 45, and this is the first time you're going into a work context and you feel self-conscious about how you look, welcome to the life of every fucking woman in the world from the age of like nine to 90, whatever she does, right?
[14:26] You're constantly thinking about that.
[14:28] And I thought that was really interesting.
[14:29] It's obviously not that I hadn't had body consciousness and things before that, but yeah, I thought that was a really important point.
[14:33] But you're totally right that the...
[14:35] The environment has pushed us to worse outcomes, the physical environment, the food environment, while the cultural environment has venerated a more and more narrow body type.
[14:50] Yeah, I think that's totally, totally right.
[14:52] Can we ask about your journey here with, you know, as a child growing up and all the different stages you've been through and your relationship with food?
[15:01] You know, you write strong focus because you found yourself unable to sit and read books for long periods of time.
[15:06] We used to be able to read for hours, but you found yourself being distracted easily.
[15:08] Your books always have... Lost connections, yeah, about your experience with antidepressants and yeah.
[15:13] Yeah, you always have a very strong motivation, a strong personal motivation, which...
[15:19] which inspires you to explore very deeply this topic.
[15:22] So I'd love to know your journey.
[15:23] Yeah, I mean, I can talk about my childhood, but I remember so clearly the moment when I learned about the existence of these new drugs.
[15:31] So for people who don't know, because there'll be some people listening who don't know, there's been a staggering medical breakthrough.
[15:37] We now have...
[15:39] drugs that produce extraordinary amounts of weight loss relatively effortlessly.
[15:45] If you take Ozempic Wigodi, basically the same thing, you lose on average 15% of your body weight within a year.
[15:51] If you take Munjaro, which is the next in this new class of drugs, you lose on average 21% of your body weight.
[15:57] and the next ones that will be available next year, probably GGG, you lose 24% of your body weight.
[16:02] And I've noticed in the Australian coverage of Bozenpik, it's still quite often referred to as like a fad or a craze.
[16:09] It's really important people understand this is not a fad or a craze.
[16:11] This is a huge scientific breakthrough.
[16:14] As one of the scientists I interviewed said to me, we've cracked the code of what controls human appetite, right?
[16:20] I'm sure we're going to more detail what that is, but...
[16:23] And I remember the moment I learned about this.
[16:25] So clearly it was the winter of 2022.
[16:26] It was that moment when the world was opening up again.
[16:30] And I got invited to a party for the first time in like, since the plague began, right?
[16:35] I thought, so yeah, parties, I remember them.
[16:36] I was like, yeah, I'll go, right?
[16:38] And this party was thrown by an Oscar winning actor.
[16:40] I'm not saying that just to name drop it.
[16:41] It's relevant to what happened next.
[16:43] Is that the person's name, Oscar winning actor?
[16:45] Exactly, exactly.
[16:46] I thought it was weird.
[16:47] It was such a coincidence he then won an Oscar as well.
[16:49] A lot of pressure.
[16:50] Exactly.
[16:52] But I was in this Uber on the way there and I suddenly felt a bit kind of...
[16:58] self-conscious because I was quite fat at the start of the pandemic and I gained quite a lot of weight during the pandemic.
[17:02] I thought, oh, fuck.
[17:04] And then I suddenly remembered, oh, actually loads of people I know gained weight during the pandemic.
[17:08] Most people I know gained weight during the pandemic.
[17:10] Actually, this party is going to be really interesting.
[17:12] It's going to be fascinating to see all these Hollywood stars with a bit of like podge on them, right?
[17:17] And I turned up and it was bizarre.
[17:19] I'm walking around and everyone was markedly thinner.
[17:24] I was like, huh?
[17:26] And I bumped into a friend of mine on the dance floor and I said to her, fuck, it looks like everyone really did take up Pilates during lockdown.
[17:33] And she laughed and I didn't know why she was laughing.
[17:36] And she said, right, well, you know, this isn't Pilates, right?
[17:39] And I had no idea what she was talking about.
[17:41] And she pulled up on her phone and her Zenpik pen.
[17:43] That's when I obviously learned.
[17:44] Then I also learned much more.
[17:46] And I remember when I learned about it, immediately feeling two completely contradictory things.
[17:52] The first thing I thought was, well, shit, this could save my life because I was about to turn 45, which is the age my grandfather was when he died of a heart attack.
[18:00] And loads of the men in my family get fat and die young.
[18:03] My dad had terrible heart problems, they didn't kill him.
[18:05] My uncle died of a heart attack.
[18:06] So, and I knew even then, obviously, we know that obesity makes heart disease much more likely and much worse.
[18:14] In fact, obesity causes or makes worse over 200 known diseases or complications.
[18:18] So I thought, if we've got a drug that can reverse or reduce obesity, well, that could have big effects for my health.
[18:26] But I also thought,
[18:28] Wait a minute, there's no such thing as a free lunch, right?
[18:32] What's the catch?
[18:33] Yeah, it can't be as good as this.
[18:36] So it's why for the book office I went on this big journey all over the world, from you know, Iceland to Minneapolis to Okinawa, to interview the leading experts on these drugs, the biggest critics of these drugs, the biggest defenders of these drugs, to try to figure out what's going on here.
[18:53] And it's a complicated picture that the book is Magic Pills, but subtitle is the extraordinary benefits and disturbing risks of the new weight loss drugs because they really are both here.
[19:02] I would love to hear a bit about why.
[19:05] Obviously, there was the risk of...
[19:09] you've just described how your grandfather died at 45, was that?
[19:12] And there's a risk of this hereditary in your family.
[19:15] But why, particularly for you, this was such a light bulb moment, like your journey with food?
[19:21] Do you mind going into the personal?
[19:22] Yeah, yeah, no, of course, of course.
[19:25] I think my experience with food is distilled by a moment that happened to me just before Christmas in 2009.
[19:31] I lived in East London at the time and I went for lunch into my local branch of KFC.
[19:38] And I said my standard order, which is so disgusting, I will not repeat it.
[19:42] And the guy behind the counter said, oh, Johan, I'm really glad you're here.
[19:46] I was like, all right.
[19:49] And he went off behind where they fry all the chicken.
[19:52] And he came back with every member of staff and a fucking massive Christmas card in which they'd written to our best customer.
[20:00] And one of the reasons my heart sank is I thought, but this isn't the fried chicken shop I come to the most.
[20:06] How can this be happening, right?
[20:08] So, like, from a very young age, my diet consisted of, like...
[20:13] absolute shit, right?
[20:15] And, you know, I was mostly raised by my grandmother who was, you know, a working class Scottish woman who left school when she was 13, had a very hard life, an incredible human being, had a very hard life and the day we got the microwave was like the happiest day of my grandmother's life.
[20:30] It was like...
[20:31] You get food, but you don't have to fucking cook.
[20:33] She was like so happy.
[20:36] So yeah, from a very young age, you know, me, my brother, my sister, our diets were, you know, almost entirely processed food.
[20:47] Which I now realise had all sorts of effects on me.
[20:50] And also because I grew up in this environment, because of other members of my family, we've talked about before, there was a lot of addiction and craziness.
[21:01] partly I learned it through some weird things that happened when I took these drugs.
[21:06] How much of my eating from when I was very young was, you know, when you're in a chaotic environment and you're a child, you don't have that much control, right?
[21:13] But one thing you can control is what you eat, most kids.
[21:18] And I realise now how much of my eating was driven not by tasting food or like it.
[21:22] Some people who overeat, it's because they actually love food.
[21:25] You know, it gives them a huge amount of pleasure.
[21:28] They think about food a lot.
[21:29] That is not, that was not me.
[21:31] For me, I would feel soothed by stuffing myself.
[21:35] Stuffing is when you deliberately overeat, right?
[21:37] You know, and you feel like a pressure outward on your stomach and upward on your esophagus.
[21:41] And I realised how much of my relationship with food was about getting that sort of stuffed feeling.
[21:47] Mm-hmm.
[21:49] So from when I was very young, that was my primary relationship with food.
[21:52] So I just ate huge amounts of shit.
[21:57] That feeling you described as wanting to feel stuffed when you were a kid, did that last into your adult years?
[22:03] Oh, yeah, until I took these drugs.
[22:05] All the way up until then, really?
[22:06] Yeah, it wasn't the only thing going on.
[22:07] But yeah, I would say that was the primary determinant of my relationship with food.
[22:11] Now, because these drugs have so profoundly changed my relationship with food,
[22:17] I now see how much was that.
[22:23] And had you, before doing the research for this book, had you done much research?
[22:28] Was it an interest?
[22:30] I mean, I knew a fair bit, but I think it's an interesting thing and it's another thing about these drugs.
[22:38] One of the things we know...
[22:41] There's a huge amount of research on this.
[22:43] People like Professor Michael Lowe at Drexel University in Philly have done work on this.
[22:49] Increasing people's intellectual insights into their eating, into health and food, has all sorts of benefits.
[22:58] They feel less shame, for example...
[23:01] but it doesn't change their eating.
[23:03] Psychological therapy for overeating, I mean, we've now got 50 years of research and it couldn't be clearer, it doesn't work, right?
[23:11] To the point where I actually think it's cruel to refer people now for psychological therapy to say to them, this will reduce your overeating.
[23:17] Now it's not cruel to refer them for therapy, I'm a big fan of therapy, it can help with all sorts of things.
[23:22] But we know very clearly that increasing intellectual insight onto these things alone does not solve the problem.
[23:31] and I would say I probably had a high level of intellectual insight onto these things.
[23:38] Like a sort of awareness of what's good and what's bad and stuff like that?
[23:41] Actually, you know what?
[23:42] I've said that and I don't think that's actually true.
[23:45] And I tell you why I realise it's not true.
[23:49] I'm really embarrassed to say, I learned a huge amount for this book, obviously.
[23:55] The thing that most shocked me
[23:59] is something I thought I'd known since I was a little boy.
[24:01] And I realised I really didn't understand fully, which is just how bad for you obesity is, how bad for your health on average.
[24:12] Speaking to the leading expert, no, it doesn't mean, you know, 100% we all need to oppose stigma against people who are overweight and obese, which I'm passionately in favour of opposing.
[24:23] But the scientific evidence is shocking.
[24:28] If you're obese, you are...
[24:30] much more likely to get basically every medical condition that we fear.
[24:34] Dementia, I didn't know, there was a huge increase in dementia risk.
[24:37] Cancer, it's one of the biggest causes of cancer in Australia is obesity.
[24:42] It throws off your inflammatory responses, which means that you don't heal as well from anything.
[24:49] Even think about diabetes.
[24:50] So I definitely knew from when I was a kid that obesity causes type 2 diabetes, what makes it much more likely.
[24:54] If you're obese when you're 18, you've got a 70% chance of becoming diabetic in your lifetime.
[25:00] But I think I thought, I'm really embarrassed to say this, I think I thought, well, if you're diabetic and you live in a country like ours,
[25:08] and you get insulin, you know, you're fine, right?
[25:11] You're basically like everyone else.
[25:12] It's not true at all.
[25:13] Type 2 diabetes knocks 15 years off your life on average.
[25:18] It's the biggest preventable cause of blindness in this country and in Britain.
[25:22] More people in the US have to have a limb or extremity amputated because of diabetes than because they got shot.
[25:29] And you will have noticed, a fuckload of Americans get shot, right?
[25:33] So I was taken aback,
[25:37] And I suppose intellectually I knew some of it, but I had not really absorbed it, partly because if you don't feel there's a solution, you just don't want to know the truth, right?
[25:46] Like you just don't want to hear about it, right?
[25:48] And diet and exercise only work in maintaining weight loss over time for a small minority of people.
[25:57] It's not no one.
[25:59] But it's a small amount of people who can go into why.
[26:02] Sorry, do you mean as in people who decide to go on a diet and exercise to fix the problem, it works, but they don't maintain that?
[26:10] Or it's just a small amount of people that it works for?
[26:14] The research on this is really interesting.
[26:15] There's a brilliant woman called Professor Tracy Mann, who I interviewed.
[26:18] She's at the University of Minnesota in Minneapolis, where I interviewed her.
[26:22] So she started researching this when she was still, I think, a grad student in Stanford in 1999.
[26:27] So she wanted to look at the evidence about the efficacy of dieting, right?
[26:31] Does it work?
[26:32] How does it work?
[26:33] And so on.
[26:35] And she looked at, at that time, the scientific evidence was very robust.
[26:40] Dieting works, right?
[26:42] For a very simple reason.
[26:43] You only have to understand the laws of physics to understand it.
[26:45] If you burn more calories than you take in, you will lose weight, right?
[26:50] That's beyond dispute.
[26:53] And there were thousands of studies demonstrating this effect.
[26:55] But she looked at them and she noticed something, which is almost all the studies that were done were done for three months.
[27:02] So you reduce your caloric consumption, burn more.
[27:06] Over three months, the graph will be very clear on average.
[27:09] It goes right down.
[27:10] There were some for six months.
[27:12] But she looks and sort of...
[27:14] So the implication in all these studies was, well, the graph goes down for six months and then you either continue going down or you remain at this lower weight forever, right?
[27:26] We all know people who've gone on diets.
[27:29] Press and Manz certainly did.
[27:30] That wasn't their experience, right?
[27:31] You lose weight for a while.
[27:32] You regain most of it.
[27:33] Sometimes you go back to more than you had before.
[27:35] She's like, oh.
[27:36] So she looked, and at that time, there had only been that she could locate 26 studies ever that looked at dieting over two years, which is a much more meaningful timeframe.
[27:46] And for there, the results were very different.
[27:48] The average was only two pounds weight loss over two years.
[27:52] And we now have a lot more evidence that demonstrates this effect.
[27:55] That...
[27:57] diets usually don't work in the long term, right?
[28:01] Now, there are certainly people for whom it does.
[28:04] Someone in my family lost a huge amount of weight purely through diet and exercise, incredibly.
[28:10] Professor Mann was discovering this, and I was really curious about...
[28:13] Well, how can that be?
[28:14] Because we know the laws of physics, right?
[28:16] We know that if you burn more calories than you consume, you lose weight.
[28:21] There's a huge debate about this, but there's a really important theory which is broadly accepted now, not entirely, but broadly accepted, which also relates to one debate about how these new drugs work.
[28:34] So, if you go back to the 60s and 70s,
[28:37] Scientists generally thought that your weight had what was called a metabolic set point.
[28:43] So you think about your body temperature, right?
[28:46] From when you're born, your temperature has an innate set point at 36 degrees centigrade.
[28:51] 36.6, I think.
[28:51] Brilliant.
[28:52] And if you go... Get you.
[28:54] And if you go higher...
[28:56] Your body will work really hard to bring you back down.
[28:59] Your sweat, your crave shelter.
[29:01] And if you go lower than that, your body will work really hard to bring you back up.
[29:05] Your shiver, you know, your crave warmth.
[29:08] So your body temperature is fixed.
[29:10] It's got a set point, right?
[29:11] And you can go outside it, but it's really hard and your body fights to bring you back.
[29:16] So it was thought that the fat percentage body weight was basically like that, right?
[29:22] You've got a set point.
[29:24] body weight, fat level that your body wants you to be.
[29:28] And yeah, you can go above or below, but your body will try to keep you at this.
[29:32] And then the obesity crisis happened in the late 70s, the early 80s.
[29:35] It's been spiking up ever since.
[29:36] And they thought, well, that theory must have been wrong, right?
[29:39] It can't be because...
[29:42] Imagine if you went to the Sahara Desert, you got really hot, and then your body tried to stay at that higher temperature, right?
[29:47] How could that be, right?
[29:49] So that must be wrong.
[29:50] You don't have an innate body weight set point.
[29:55] But then the theory actually evolved in a way that I think is more accurate.
[29:59] So it turns out you do have a set point for the fat percentage your body wants you to be.
[30:05] But as you gain weight...
[30:07] your set point rises.
[30:09] So let's say that you gained like three stone now.
[30:12] You would have to eat fewer calories than you do now to stay at the exact weight you are now because your metabolism would slow down, your body would change, right?
[30:21] So your body would... That's your body fighting to bring you back up to that higher weight.
[30:25] So as you gain weight, your body tries to hold that weight and it's harder to go back.
[30:30] And there's a lot of evidence for this.
[30:32] We know that if you gain weight and then try to go back, your metabolism slows down.
[30:35] The evidence for that is very clear.
[30:37] But I actually didn't really believe that for a long time because I thought, well, given that obesity is really bad for you on average...
[30:47] Why would nature, why would evolution endow us with that, right?
[30:53] That seems really odd.
[30:54] But then it was explained to me, so you've got to think about the circumstances where human beings evolved.
[30:59] In the circumstances where human beings evolved on the savannas of Africa, the situation we live in now where there's infinite abundant calories all around you your whole life, that never existed, that never happened, right?
[31:10] What did happen quite a lot was a very different situation, which is famine, right?
[31:14] You were quite likely in your life to face a period when you starved.
[31:19] And if you think about what you would evolve to do in that situation...
[31:24] if a famine came along, you know, me at my fattest would stay alive quite a long time and Timothee Chalamet and Kate Moss would die in week one, right?
[31:32] And I would cry over Timothee Chalamet's body, bury him, and, you know, I'd probably eat him to be fair.
[31:37] But the, I want to be clear, that's not for sexual reasons.
[31:41] Sorry, that sounded creepy.
[31:42] It would be to survive the famine, right?
[31:46] To be clear.
[31:47] Throwing in disclaimers in this ridiculous...
[31:49] I don't want to creep out of Chalamet in this scenario.
[31:52] Exactly.
[31:53] He was so close to
[31:54] meeting up with you.
[31:55] I know.
[31:55] It's like, oh, well, you've fucked up.
[31:57] I've fucked it again.
[31:58] But the, so you think about that situation, right?
[32:02] Actually, that would make perfect sense to, if you get calories, gain as much weight as you can and hold them as long as you can because when the famine comes, that will get you through it, right?
[32:13] So nature is effectively preparing us for a famine that will never come.
[32:17] This is one reason why if you think about processed food drives up obesity, because it makes us consume more calories on average, but also why we then get locked into that is as you gain weight, your body tries to get you to hold that weight.
[32:29] It's why it's so hard to go back.
[32:31] It's not impossible.
[32:32] People can do it.
[32:34] But yeah, so I think that's a kind of important part of the picture.
[32:40] The thing that I keep thinking about is, and sort of like going back to what you were saying before about the Harold Holt Beach and how things have changed since then and how all this new food has been introduced to us.
[32:53] It sort of reminds me a little bit of the more convenient our digital lives become, the worse off we are.
[33:02] And it almost seems like the more convenient food became, the worse off we are.
[33:07] We are.
[33:08] And I think a lot of the reason for that is like it feels good.
[33:14] It's like a quick dopamine hit that we ultimately know will not fulfill us, like the dopamine hit of calling someone or speaking to someone in person.
[33:24] But we continue to do it because it's like it's just enough.
[33:29] And then we scroll again.
[33:30] It's like just enough.
[33:31] It's like we're always just like it's like going to the petrol station and refilling one liter.
[33:35] You know, and then be like, oh, cool, just drive a bit.
[33:37] Then I'm going to go into a petrol station again.
[33:39] It's just like a nightmare.
[33:40] I agree.
[33:42] The only twist I would pull on what you've said is... Wouldn't have mentioned the petrol station.
[33:47] It's more that that's...
[33:49] I think you're a bit like what Josh was saying before about weight.
[33:53] I think everything you've said is true.
[33:54] I would try to expand the frame because there's a risk...
[33:57] then of saying, oh, it's just that I'm choosing it and it's on me.
[34:00] Whereas the truth is we've got a very sophisticated machinery that is designed to manipulate and shape you to make that choice.
[34:07] And that's true, by the way, not just this, but of food.
[34:10] More three-year-old children know what the McDonald's M means than know their own last name.
[34:14] So from the moment we're born, we're moulded in this environment to make choices that leave us with that feeling of dissatisfaction.
[34:24] And it was so interesting to me.
[34:25] Except for the kids whose last name is McDonald's.
[34:29] them.
[34:29] Exactly.
[34:30] That ruins the research.
[34:31] But yes.
[34:33] But no, but I think about what you're saying in relation to one of the ways you really begin to see this so clearly is when you go to places that did not allow the environment to fuck with people.
[34:40] Right.
[34:41] So for magic pill, I went to Japan.
[34:43] So sometimes you'll hear people say obesity is just the result of modernity.
[34:48] Right.
[34:49] If you've got a society where there's surplus calories, right.
[34:52] People are going to eat them.
[34:53] It's going to fuck with your biology, you know, and you're just going to inevitably have a really large part of your population who are obese, right?
[34:59] So it's a product of wealth, development, modernity, right?
[35:02] Japan shows that's not true because Japan has almost no obesity.
[35:07] 4% of Japanese people are obese.
[35:09] It's barely risen, you know, ever.
[35:13] So Japan has the same level of obesity as Somalia, even though Japan is the third richest economy in the whole world, right?
[35:18] They have literally almost no childhood obesity.
[35:21] I was like, huh, this is interesting.
[35:23] What did they do in Japan, right?
[35:24] Because with these drugs, with these weight loss drugs, we're in a really difficult choice.
[35:32] Someone like me.
[35:34] between continuing with a risky medical condition or taking a potentially risky drug, right?
[35:38] It's a difficult choice.
[35:39] We're in a trap.
[35:40] Here's a trap door.
[35:41] Should we go through it?
[35:43] And obviously, I agonise a lot about that in the book.
[35:46] But actually, Japan shows, wait a minute, we don't have to let our kids grow up in this trap, right?
[35:51] It's just like, okay, what did they do in Japan?
[35:53] So I went to Japan to research this.
[35:57] And I've got to tell you, it is a really strange experience to go to a school with thousands of pupils
[36:05] walk around and realise there's not one overweight child.
[36:09] So the person who greeted me at the door is a woman called Harumi Tatibe, who's one of the schools I went to in Tokyo, big kind of middle-class school.
[36:17] So she's the school's nutritionist.
[36:19] By law...
[36:20] Every school in Japan employs a professional nutritionist.
[36:23] They design the meals, which have to be made fresh every day.
[36:25] No processed food is allowed at all.
[36:27] Even the paste they use on that food has to be made fresh that day.
[36:31] And the nutritionist uses that healthy food, which is prepared in the school, to educate the children to love healthy food and to learn how to eat healthily, right?
[36:40] So I'm chatting to these kids.
[36:41] So it was so interesting seeing Harumi in front of this class.
[36:44] So it's so cute.
[36:47] The kids dress as chefs and they go and collect the food and the kids serve the food.
[36:50] It's so adorable.
[36:51] And the kids like dole out the food and the kids read out this.
[36:55] So they're given this thing to read out where the kids then explain the healthy food today.
[36:58] We're eating this because it comes from there and it does this for you.
[37:01] And Harumi holds it.
[37:02] She had these...
[37:03] Coloured ropes.
[37:04] And she stands in front of the kids.
[37:05] She goes, okay, this is the red.
[37:07] This is red.
[37:07] This means calcium.
[37:09] You're eating the calcium.
[37:10] And this, because the dish is like six different things.
[37:12] And the food is fucking, it's more like nobu than anything I ever ate at school, right?
[37:16] And she says, what does the calcium do?
[37:18] And the kids yell out, oh, it makes your bones strong.
[37:20] And then they go, now you're eating carbs.
[37:22] What do they do?
[37:22] They give you energy.
[37:23] So anyway, I had my brilliant translator, Chie, with me.
[37:27] And I started talking to the kids, right?
[37:28] So I started talking to kids who were nine and 10 first.
[37:32] And I said to her, I'll never forget, the first kid I interviewed, I said, what's your favourite food?
[37:37] And she said, broccoli.
[37:39] And I was like, right, he's this little freak.
[37:41] Go on to the next one.
[37:43] Now while the teacher's on here.
[37:44] No, no, the teacher wasn't there.
[37:46] And I was like, and the next kid, I said, what's your favourite food?
[37:49] He said, white fish.
[37:51] I was like, this is weird.
[37:52] The next kid, he's like, oh, boiled white rice.
[37:55] And I turned to Chia and I was like, are these kids fucking trolling me, right?
[37:58] They're taking the piss.
[38:00] And Chie, like all Japanese people I ever talked to about this, just looked puzzled and said, well, no, I mean, we teach kids to like healthy food.
[38:08] They didn't.
[38:09] So I pulled up on my phone.
[38:10] I couldn't help myself.
[38:11] I pulled up British school meals and American school meals to show to the kids.
[38:15] Right.
[38:16] They almost couldn't believe what they were saying.
[38:17] And they said, but you ate this at school.
[38:19] I said, yeah, we ate this at school every day.
[38:21] And they would look.
[38:22] And one little girl put out of my mouth and said, yeah.
[38:24] I'm really worried about you.
[38:25] She said it was so cute.
[38:27] They were like, where are the vegetables?
[38:29] There were no vegetables.
[38:30] They were like, they just couldn't believe it, right?
[38:32] So there's all sorts of things they do in Japan, some things that we couldn't imitate and I wouldn't want to.
[38:36] I can tell you about some of the weird things.
[38:39] So I go around and I see how this society has just built in all these ways of protecting themselves and their children from their bodies being fucked by this processed food.
[38:47] Like there are sections in, you go to our supermarkets and it's mostly processed food.
[38:52] In Japanese supermarkets, there's a section called processed food.
[38:55] And it's like a little bit and it's got a few tins in it, right?
[38:58] Everything else is built on the premise that you will prepare fresh food on the day, right?
[39:03] And the result of this is unbelievably inspiring.
[39:05] So I went to this place that almost sounds mythical.
[39:08] There's a village in Okinawa called Ogimi, which is the oldest village in the world by many measures.
[39:14] So Japan has the longest life expectancy in the world.
[39:17] But even more amazingly, it has the longest healthy life expectancy.
[39:20] So Australia and Britain, people are ill for quite a long time before they die on average.
[39:24] In Japan, you're only ill for, I think the figure is in the book, it's like two years on average you're in poor health before you die, right?
[39:30] Which is amazing, much less than a year.
[39:33] So I went to this village where there's 400 households and more than 120 of them have someone over the age of 90 living in them, right?
[39:40] So I went to their little community centre and the first person I met was a 103-year-old woman called Matsu Fukuchi who walked there on her own.
[39:53] And the first thing she said to me was, oh, I can't stay for long because I'm looking after my son who just fell off the roof fixing it the other day.
[39:58] I was like, how old is your fucking son?
[40:00] What's this about?
[40:00] But anyway...
[40:01] So we sit there and we're chatting and there's all these like hundred year olds who have good lives.
[40:05] She's like, oh, it was volleyball season.
[40:07] They were chatting about how much they love watching volleyball with their great grandchildren.
[40:11] And then at some point, someone put on some Okinawan folk music and they put on these, what are they called?
[40:16] Kimonos.
[40:18] And they all started dancing.
[40:19] And I danced with these like 103 year old women.
[40:21] And I sit there and I thought...
[40:24] God, you were born before they started doing radio broadcasts in Japan.
[40:28] And here I am recording us dancing on an iPhone.
[40:31] This is what you get if you sort out the obesity crisis, right?
[40:34] Obviously not everyone is 103.
[40:36] But you get more years of life.
[40:38] You get more years of joy.
[40:39] You get more years of dancing, right?
[40:40] That's what the fight is for.
[40:42] And...
[40:44] Japan is not a fictional place.
[40:46] It can feel like it a bit, but it's not a fictional place.
[40:48] It's a real country that got to be rich and avoided this.
[40:51] And it's not just innate to Japanese culture.
[40:54] If you go back to the 1920s, Japan had some of the most unhealthy people in the world.
[40:58] They had a terrible diet.
[41:00] They only ate protein once a week, right?
[41:02] And it was a concerted effort by the Japanese government to make the population healthier.
[41:07] Not for good reason.
[41:08] It's because they wanted an army to invade the rest of Asia.
[41:10] But yeah, we've all got our own weight loss motives, right?
[41:14] And then obviously when the country's in ruins after the Second World War, the one thing they've got is their population.
[41:18] They want to make it healthy.
[41:20] So they, you know, there's this very deliberate effort to make the population healthier.
[41:27] We can do that if we want, right?
[41:29] There's all sorts of things.
[41:30] I went to so many countries.
[41:32] Mexico imposed a sugar tax, reduction in obesity.
[41:35] In the Netherlands, obese kids, they give them personal coaches that go and meet with their families and help them change their lives.
[41:44] They get the sugary drinks out of the schools.
[41:46] Again, big reduction in obesity.
[41:48] Finland, they had a concerted programme.
[41:49] There's places that have done this, right?
[41:51] We can do it, but we've got to understand what's happening.
[41:54] Although, can I tell you about a really weird aspect of Japan that we can't import?
[41:57] Yes, please.
[41:58] So this was so really fucked with my head.
[42:01] So in 2008, they had a massive like national debate about obesity because obesity went up by one percent.
[42:08] Right.
[42:08] It's still like basically no one was obese, but they were adorable.
[42:13] Oh, my God.
[42:13] We can't go on like this.
[42:15] We've got to deal with it.
[42:16] Right.
[42:16] So they made all sorts of changes.
[42:17] We've got to help John.
[42:21] So one of the changes they made is they introduced a thing called the Metabo Law.
[42:26] It's named after metabolic syndrome, which is kind of a nasty combination of conditions you can get if you become obese.
[42:32] And the law they'd made was...
[42:35] Every single person in Japan over the age of 40, every year on a specific day has to be weighed by their boss.
[42:43] If you've gained weight, you have to drop a plan with your boss to bring your weight down.
[42:49] And if...
[42:51] And if the company has to declare the weight of its employees to the government, and if your company's overall has gained weight, you get fined by the government, right?
[43:01] So it's like, whoa, so I thought I have to go and see this.
[43:03] So I went to some workplaces to go and see this in practice.
[43:07] And it just fucked with my head because you're like, you're seeing all these people being literally weighed by their boss.
[43:12] Right.
[43:13] And they're all going, even when the boss is like, oh, this is really, yeah, this is really helpful.
[43:17] You know, it helps me not gain weight.
[43:19] And I was like, OK, if you did this in Britain or, you know, the US, we would fucking burn the office down.
[43:25] Right.
[43:26] And they would just be like, they were genuinely puzzled.
[43:28] Why?
[43:29] Like it was such a, that's a really big cultural difference.
[43:33] So is it as simple as, cause we mentioned the nutritionist at the schools.
[43:38] I'm just like, well, let's just get nutritionists at schools.
[43:40] Like surely that is it, is it as simple as doing that?
[43:44] Like that seems like a really great idea.
[43:46] It's a really big component.
[43:48] I mean, it's one of many, but it's a really big component of what they do.
[43:51] And yeah, absolutely.
[43:52] I mean, you compare that, we literally, you know, you think about the really good work Jamie Oliver has done on this.
[43:56] Like, you know,
[43:59] It's not just that we don't have nutritionists in our school.
[44:02] We actively pump our kids with shit.
[44:05] You know, if I think about the school dinners that I ate, right, they were a world away.
[44:10] They were, you know, so even though in my home environment, I wouldn't have had healthy food.
[44:14] You think, oh, the one place you could have had healthy food would have been at school.
[44:18] But even there, it was as unhealthy as anything I was eating at home.
[44:20] Right.
[44:21] So, yeah, absolutely.
[44:22] That's one way we can break the cycle among many.
[44:25] Because you do, because I mean, I don't have kids, but my sister does.
[44:29] And lots of people I know do, pretty much everyone I know does.
[44:32] And often I hear like, well, you can teach them really good lessons at home.
[44:37] But as soon as they go to school, they discover all these new things.
[44:41] Like you can pretend that ice cream doesn't exist for five years.
[44:44] But then as soon as they get to school, they'll go to their friend's house and see.
[44:47] And it becomes like, oh, I want that thing that my friend and all the work you've done in the first five years maybe doesn't matter.
[44:54] Yeah.
[44:55] So, yeah, I wonder if it's like... Yeah.
[44:59] Well, just to jump in on that, I find that getting my kids to eat well is probably the hardest thing as a parent and it's probably my biggest source of guilt.
[45:11] That and screen time, but I think I'm moving to being on top of screen time and I'm able to shrink it and all this kind of stuff.
[45:18] But when you get to a meal time and my two-and-a-half-year-old just refuses to eat anything...
[45:24] And I'm like, well, all he wants is fruit.
[45:26] And that's pretty – like fruit is better than processed food.
[45:29] But I'm like, you've got to have some protein or something.
[45:31] And then it's so hard to get him to eat anything.
[45:35] And I feel so guilty that I'm not doing better as a parent.
[45:40] But the options are – it's fucking hard when you're busy and you get home.
[45:44] You don't have much time to – like I don't have time to prepare –
[45:48] Well, I might have a bit of time to prepare a meal.
[45:51] I really enjoy cooking.
[45:52] Like last night I made like a sort of tuna pasta with all, like I made it from scratch.
[45:58] But the two-year-old was, I knew he would not eat a single bit of it.
[46:02] So I'm like, well, I can't give him that.
[46:03] So I've got to try and think of another idea that he might eat.
[46:07] I tried something that was mildly healthy and he still didn't go for that.
[46:10] Yeah, we have the exact same battles.
[46:13] Yeah.
[46:13] I think you're right.
[46:14] And what we've got to do is there's a whole combination of things there, I think.
[46:17] It's very difficult.
[46:18] First thing is do what they did in Greece.
[46:20] Ban advertising of junk food to children.
[46:23] Because you are running up a down escalator in the environment.
[46:26] Just walk around Melbourne.
[46:28] Look at the number of junk food ads you see, right?
[46:29] You walk your kid for a mile and try to protect them from seeing ads, right?
[46:34] They go on to watch Peppa Pig on YouTube and what do you see?
[46:36] You see immediately you'll be flooded with ads for junk food.
[46:38] Or when you go in a shop.
[46:39] Like if you go to try and buy a healthy thing, you've got to walk past like...
[46:43] 60,000 terrible things that are bright-coloured and attractive.
[46:47] Exactly.
[46:47] So there's all sorts of things that can be done with regulation.
[46:51] Effectively, in our societies, we subsidise shitty food, not healthy food, right?
[46:55] So there's all sorts of things you can do there.
[46:58] Also, just anything that reduces stress and gives parents back time, reduces the ability to –
[47:05] I think about my grandmother, you know, someone actually funny enough said a quite snooty, irritating thing to me at one of the events I did where they were like, oh, well, you talk about it, wasn't it your grandmother's responsibility to feed you better?
[47:17] And I'm like, my grandmother worked every fucking job she could.
[47:20] She woke up at four in the morning to go and clean toilets.
[47:22] Then she did like my grandmother got home.
[47:25] She was fucking exhausted, you know, and she wanted kind of carby treats.
[47:31] Yeah.
[47:32] And also, she genuinely experienced it as a form of love.
[47:34] So, yeah, anything that gives people back...
[47:37] I mean, we've talked about a four-day week before.
[47:39] One of the reasons I'm in a four-day week, you've got to give people back time to do other things in their life.
[47:43] So, you know, we can't live in a culture where no one has any time.
[47:46] And then say, by the way, we've got this whole other half-hour-a-day thing we want you to do, right?
[47:51] Also, we should look at...
[47:54] baby food.
[47:55] Like baby food that we give babies, it crafts their palates when they're very young.
[47:59] There's an excellent food writer called B. Wilson who's written a lot about this.
[48:04] You know, baby food is like mostly sugar.
[48:09] So yeah, there's all sorts of things we can do.
[48:10] Giving more maternity pay and more maternity leave so mothers can breastfeed.
[48:15] So all sorts of things we can do that kind of help deal with that and don't
[48:22] load the odds against the kids from when they're very young.
[48:25] Absolutely.
[48:26] I wanted to go back for a moment and pick up on the exercise and diet conversation.
[48:31] I feel like there's an insensitive thing to say to you and to Josh, but there'll be people out there listening like me going, I feel like exercising and eating really well is the other solution.
[48:43] And we can't ignore the incredible mental health benefits you get from doing both these things.
[48:48] I get that it's a lot more nuanced and I get that there is so much that happens and so much background and context to everyone's journey.
[48:54] But for me, it's been eat well and exercise and that is the other option.
[48:59] It's not take the pill or don't take the pill.
[49:02] It's like exercise, eat well.
[49:05] That's been my experience for me.
[49:07] Yeah, and so the research on this shows really clearly that people who try diet and exercise, about 20% have your experience, which is a huge number of people, right?
[49:16] One in five people, it works really well and it's transformative, not just physically, but for their mental health.
[49:23] So absolutely every person who's overweight or obese should be helped to try what you tried.
[49:31] And for a significant number of them it will work.
[49:32] But that leaves us with four out of five for whom it doesn't work.
[49:35] The complicated reasons partly to do the metabolic set point, but there's a lot of other factors as well, environmental sabotage, psychological factors, all sorts of things going on.
[49:43] And for them we've got to have other options.
[49:44] And these drugs expand the menu of options that are available.
[49:50] Yeah.
[49:51] So, if you want to think about the benefits and risks, it helps to look at a parallel area of science.
[49:59] So for the reasons we've been talking about, it's quite hard to keep off weight for a long time, lose it quickly and keep it off for a long time.
[50:05] Up to now, the most reliable way for really overweight people to do that has been bariatric surgery.
[50:10] So we've got very good research on bariatric surgery now going back many years, whereas these new drugs have only been available for weight loss for a couple of years, right?
[50:18] So the evidence is evolving.
[50:20] So we look at the evidence from bariatric surgery.
[50:22] We know lots of things.
[50:23] First thing, it's a fucking horrible operation.
[50:26] What is bariatric surgery?
[50:27] Things like stomach stapling, gastric bands.
[50:31] So it's where you physically alter the person's insides to make it impossible for them to continue eating as they have before through an invasive form of surgery.
[50:39] And you know, it's grim.
[50:40] One in a thousand people die in the operation.
[50:42] It's no joke.
[50:44] But the reason people go through that risk is because of the staggering physical benefits if you reverse obesity or reduce it.
[50:54] So if you have bariatric surgery in the seven years that follow, you're 56% less likely to die of a heart attack.
[51:00] you're 60% less likely to die of cancer, you're 92% less likely to die of diabetes-related causes.
[51:06] In fact, it's so good for your health, you're 40% less likely to die at all in those seven years after bariatric surgery.
[51:12] So it's a really enormous health benefit, which fits with everything we know about how bad for you obesity is.
[51:20] And we now know that these drugs take you in a similar direction.
[51:23] Like I mentioned before,
[51:26] If you start with a BMI higher than 27, you take these drugs for two years, you've got a 20% lower risk of having a heart attack or stroke, which is extraordinary.
[51:34] And we're now seeing remarkable benefits across the board, huge reductions in inflammation.
[51:41] The scientific evidence is building up that there are really remarkable benefits.
[51:47] So you've got to weigh them against the significant risks.
[51:51] And there's quite a lot.
[51:54] There's kind of ones that I'm worried about for the society and ones that I'm worried about for myself.
[51:59] I'll tell you what I'm most worried about for the society, but not for myself first, if that's okay.
[52:04] And this is something I think is really important for Australia because this drug has not really arrived here yet.
[52:09] So you can get this right in a way that we haven't got it right in Britain and the US.
[52:14] I'm really worried about what happens, what is happening when people with eating disorders are getting hold of these drugs.
[52:22] So anyone who knows someone with, let's say, anorexia, there's obviously many forms of eating disorders, but let's say anorexia, I'm sure we've all known someone with anorexia.
[52:30] You know that there's a conflict going in within that person.
[52:33] There's the biological part of them that wants to live and therefore wants to eat.
[52:37] And then there's the psychological part of them that for complicated reasons we can go into wants to starve themselves.
[52:43] And what these drugs do is they make you not want to eat very much.
[52:48] And they're really good at that.
[52:51] It's not like dieting.
[52:52] It's not like where you're hungry, but you're denying yourself.
[52:54] You just don't want to eat very much.
[52:55] And if you take a high dose, it can just amputate your appetite.
[52:59] You just do not eat, right?
[53:03] What we know, people like Dr. Kimberly Dennis, who I interviewed, is one of the leading eating disorders experts in the United States.
[53:09] Dr. Dennis is in Chicago.
[53:11] She said to me, look, these drugs are rocket fuel for eating disorders.
[53:16] She's seeing this a lot in her practice.
[53:19] So I'm really worried that in addition to the huge benefits of people like me,
[53:26] there's huge risks for people with eating disorders.
[53:30] So what people like Dr. Dennis say, I think completely rightly, is do not allow Zoom prescriptions of these drugs.
[53:35] You should have to go and see a doctor in person who actually checks your BMI and also is qualified in spotting people with eating disorders.
[53:43] And if you don't match the criteria, you shouldn't be given it.
[53:47] This is a really big debate about BMI.
[53:48] If people don't know, body mass index is a very simple measurement.
[53:53] And it's just your height divided by your weight.
[53:55] And it comes up with a number.
[53:57] The reason it's controversial as a way of measuring obesity is that there's a small number of people who have a high BMI who are not obese.
[54:06] So if you picture Arnold Schwarzenegger at his most like jacked and ripped in like The Terminator, sorry I got so distracted picturing that then.
[54:11] But he would have had a very high BMI but also obviously he had very low body fat, he wasn't obese, right?
[54:18] So sometimes we'll say we shouldn't use BMI.
[54:22] The truth is there are many ways of measuring obesity.
[54:25] There's lots of other ones.
[54:26] The body adiposity index, you can measure people's body fat percentages, and they all come to pretty much the same outcome, which is, unfortunately, obesity correlates with much higher negative outcomes for health.
[54:40] So the reason doctors still use BMI is it's just it's the quickest one, it's really easy to do.
[54:44] And your doctor can look at you and can see if you've got a high BMI because you're jacked or because you're obese.
[54:52] It's not hard to tell.
[54:53] So in practice, I think it's a defensible and still usable one.
[54:58] But we could move to the other ones.
[54:59] We could do body fat percentages.
[55:00] They're fairly easy to measure as well.
[55:02] They don't get us out of, unfortunately, the underlying problem, which is that obesity does, on average, correlate with much worse health outcomes.
[55:08] Yeah.
[55:09] So, yeah, this sounds slightly hyperbolic.
[55:12] It is slightly hyperbolic, but it's only slightly over the top.
[55:15] The way I think about these drugs is someone who's taken them, and I can tell you more about how they feel when you take them, but these drugs are so powerful...
[55:24] I think of them as being like fire, right?
[55:26] They're a tool.
[55:27] Fire is a really good tool if I use it to warm up my house.
[55:32] It's a really shit tool if I use it to burn down yours, right?
[55:35] In the same way, this tool is incredible.
[55:37] If you're obese, I've lost a staggering amount of weight, right?
[55:42] I'm much healthier.
[55:44] And
[55:46] A tool this powerful will be used for great good and great harm.
[55:51] And we're not going to go back.
[55:53] We're not going to put this back in the box.
[55:55] There are some predictions that 10 years from now, half of the people of Australia will be taking these drugs.
[55:59] That is not implausible.
[56:02] The invention of these drugs, I believe, will be as significant a moment as the invention of the contraceptive pill.
[56:06] When you consider that obesity, unless some of the 12 risks that I write about turn out to be worse than we think, which they might, so it might get yanked from the market, but...
[56:14] I don't rule that out.
[56:15] I don't think it's likely, but you can't rule it out.
[56:18] Given that obesity is the biggest killer in our societies, and given we now have a drug that can reliably reduce or reverse obesity, this is a huge moment, right?
[56:31] And we shouldn't underestimate that, but we do have to weigh the risks.
[56:34] I'm going to tell you about more of them if you want the risks.
[56:36] I wouldn't mind a couple more of the risks.
[56:38] I'm so fascinated by... Because to me, the benefits are so visibly obvious and appealing to people.
[56:48] I also feel like we should know a lot of the risks involved.
[56:50] So in terms of the risks... You don't have to go through all 12.
[56:52] So in terms of some of them...
[56:54] Some scientists believe these drugs may increase the risk of thyroid cancer in people who are vulnerable to it.
[56:59] I interviewed Professor Jean-Luc Fayy, who's at the University Hospital in Montpellier in France, who's been warning about this.
[57:05] So it's why, I mean, obviously I stress to everyone listening, I'm obviously not a doctor.
[57:09] People should talk to their doctors.
[57:10] But it's why people who have thyroid cancer in their family or who have had it before are advised to not take these drugs.
[57:18] The one that most worries me, there was one that I experienced that I'll tell you about in a minute, but the one that most worries me...
[57:25] It's just really simple.
[57:26] We don't know the long-term effects of these drugs.
[57:28] No one's been taking them that long.
[57:29] Diabetics have been taking them for 19 years now.
[57:35] And given that we know these drugs primarily work by changing your brain, taking a drug that chronically changes your brain for a very long period of time is inherently concerning.
[57:47] There's an analogy, and I want to stress...
[57:49] I'm not suggesting these drugs will have this specific effect.
[57:52] But there's an analogy that was explained to me by Dr. Greg Stanwood at Florida State University.
[57:58] Let's really stay with me.
[57:59] If you go back to the late 50s and the early 60s, scientists, doctors started to give people antipsychotic drugs.
[58:06] Because they judged at the time that the benefits outweigh the risk.
[58:09] That was always controversial, but that was the judgment they made.
[58:12] 40 years later, they discovered if you take antipsychotics for a really long time, you're way more likely to get dementia.
[58:19] It hugely increases your dementia risk.
[58:22] Now, it's not that the doctors were being irresponsible in the 50s and 60s.
[58:24] There was no way you could have known that, right?
[58:27] How could you have known?
[58:28] You just had to have people take it a long time.
[58:30] Now, there's no reason to think these drugs, the weight loss drugs, cause dementia, obviously.
[58:34] But I'm just raising that as like...
[58:35] It could be something like that.
[58:37] We're particularly worried about...
[58:38] pregnant women, right?
[58:40] So we don't know the effect.
[58:42] Obviously, you're told to come off these drugs when you're pregnant, but a lot of people don't know they're pregnant for quite a long time.
[58:48] We don't know.
[58:49] Could it negatively affect their unborn children?
[58:52] So there's all sorts of things.
[58:55] The one that played out for me, and it relates to what we were talking about much earlier, it's really surprised me.
[59:01] And I wish I'd known about it in advance.
[59:05] So the first six months I took Ozempic,
[59:07] I got everything I wanted.
[59:08] I lost a shitload of weight.
[59:10] I felt much better.
[59:11] My back pain went away.
[59:12] My neighbour's hot gardener hit on me.
[59:14] Loads of good shit happened, right?
[59:16] But weirdly, I didn't actually feel better.
[59:21] Like, I felt physically better, but psychologically, if anything, I felt slightly worse.
[59:27] I thought, oh, that's a bit weird.
[59:28] And there's been some scientists who've warned that their concern these drugs may cause depression or even suicidal feeling, and some people didn't have that.
[59:35] It wasn't as bad as that for me, obviously.
[59:37] I did feel quite a bit down.
[59:39] And there's a big debate about why that is.
[59:40] Maybe it's a brain effect.
[59:41] There's a serious debate about that I go through in the book, but I had a real epiphany about this in a branch of KFC in Las Vegas.
[59:49] My nephew said to me recently that it's weird how many of your epiphanies in your life have happened in branches of KFC, but like, so I was in, for anyone listening who knows Vegas, it was the KFC on West Sahara, which is one of the roughest KFCs in the whole world.
[1:00:02] I love it.
[1:00:03] And I was in Vegas, it was seven months into taking a Zen pic.
[1:00:07] And I was in Vegas, as you guys know, I've been working on a book about Las Vegas for a long time, a series of crimes that have been happening there.
[1:00:13] And I was investigating the murder of someone that I knew and really loved, who died and been killed.
[1:00:20] So it was obviously a difficult thing to do.
[1:00:26] I'd had a rough day researching it.
[1:00:28] And I just really on autopilot, I went to this branch of KFC and I did what I would have done before I was on a Zen pick.
[1:00:33] I ordered a bucket of fried chicken.
[1:00:35] And I've been into this KFC a million times.
[1:00:38] Although they haven't given me a Christmas card yet.
[1:00:43] And I had this bucket of chicken in front of me and I had one chicken drumstick.
[1:00:47] And I suddenly thought, oh fuck, I can't eat this, right?
[1:00:51] When you're on a Zen pick, you can't overeat.
[1:00:53] You would vomit if you tried to overeat.
[1:00:55] Did you want to eat it?
[1:00:57] I physically did not want to eat it and indeed couldn't, but I psychologically wanted to eat it.
[1:01:02] Yeah.
[1:01:03] And I had a real kind of epiphany.
[1:01:05] You know when you have a realisation that almost feels like someone else is talking to you?
[1:01:10] And I remember thinking, oh, you're just going to have to feel like shit then, right?
[1:01:13] And I realised in that moment, oh...
[1:01:18] So much of my relationship with eating was about managing my emotions, calming myself down, soothing myself.
[1:01:24] It's why I did that stuffing that we were talking about earlier.
[1:01:28] And when you're on these drugs, you can't do that.
[1:01:30] I go through in the book, there's scientific evidence for five reasons why we eat.
[1:01:36] Only one of them is the obvious physical one, right?
[1:01:38] But...
[1:01:39] get nutrition to keep your body going.
[1:01:41] All the rest is psychological.
[1:01:43] And for me, and for everyone who takes these drugs, what these drugs do is they interrupt your eating patterns, right, you can't eat very much.
[1:01:52] But they also interrupt the deep underlying psychological reasons why you eat.
[1:01:55] And I realized deprived of that soothing mechanism that was so deeply ingrained,
[1:02:02] I was less able to regulate my anxiety, right?
[1:02:05] And I remember Colonel Saunders staring at me from the wall and it was like he was looking at me going, hey, what happened to my best customer?
[1:02:11] But I remember thinking then as well, well, obviously there are better ways for me to deal with anxiety and distress than a bucket of fried chicken, right?
[1:02:24] But that was a difficult, I'm still in a difficult adjustment from that.
[1:02:27] It was hard.
[1:02:29] So yeah, that was the downside that I really wasn't, that these drugs, if you're going to take them,
[1:02:36] these drugs will really challenge, they will profoundly change your relationship with food and that will, it's a rare person that doesn't bring up some emotional issue for.
[1:02:46] Do you know what I mean?
[1:02:46] It's such a comfort for so many people, yeah.
[1:02:48] Yeah, it reminds me a bit of something you've talked about before on this podcast, I believe, or maybe I heard you say it somewhere else, about addiction and how that was doing a job for you.
[1:02:58] It was, I can't remember the doctor who you interviewed who said that that did a job for you at a time in your life and it saved your life.
[1:03:05] Funny enough, it wasn't the doctor, it was Mara...
[1:03:06] Well, she should be a doctor.
[1:03:07] Oh, no, it was Marianne Faithfull.
[1:03:08] Yeah, yeah.
[1:03:09] The legendary rock singer.
[1:03:11] She'd been homeless in the 60s and she had a heroin addiction at the time.
[1:03:14] And she says in her memoir, saying this is very challenging, but really important.
[1:03:19] She said heroin saved my life because if it wasn't for heroin, I would have killed myself at that point.
[1:03:23] Now, Marianne is not saying heroin is a good solution to despair, obviously.
[1:03:26] But she's saying it's the best solution anyone offered her at that point.
[1:03:29] Yeah, so in the case of taking away your desire to your satiation...
[1:03:35] It's a really weird word, though.
[1:03:37] Yeah, yeah.
[1:03:38] It feels like these drugs could take out a safety net a lot of people have that they didn't know was there in the first place, and then you're left...
[1:03:48] Yeah, out in the open exposed to all these things that you've never dealt with or realised were there in the first place and no mechanism, like your mechanism's gone.
[1:03:59] It sounds exactly like what you experienced.
[1:04:01] That's a really good way of putting it.
[1:04:04] There's all sorts of dynamics that emerge, all sorts of underlying psychological dynamics, all sorts of things we do with food that begin to kind of emerge.
[1:04:16] It's funny because the book is called Magic Pill because there's three ways these drugs could be magic.
[1:04:20] The first way is the most obvious.
[1:04:22] They could just solve the problem of obesity, right?
[1:04:24] I've got to tell you, there are days when it feels like magic in that sense.
[1:04:28] Once a week, I inject myself in the leg.
[1:04:30] It's a tiny little injection.
[1:04:31] Barely feel it.
[1:04:31] It's an EpiPen.
[1:04:32] I don't eat very much anymore.
[1:04:34] I'm not fat.
[1:04:35] It feels like magic.
[1:04:37] The second way it could be magic is more disturbing.
[1:04:39] It could be like a conjurer who plays a trick on you.
[1:04:45] It could be like a magic trick.
[1:04:46] He shows you a card trick while he picks your pocket.
[1:04:49] It could be that over time, the 12 significant risks that I describe in the book outweigh the benefits.
[1:04:54] There will certainly be some people for whom that's true.
[1:04:55] There definitely are people for whom that's true.
[1:04:58] And not a negligible number either.
[1:04:59] And it could be that in time that turns out to be actually the balance of risk for everyone, right?
[1:05:05] The third way it could be magic is I actually think the most likely.
[1:05:09] Think about the stories of magic that we all grew up with.
[1:05:11] What would be a good example?
[1:05:13] Think about Aladdin.
[1:05:15] You find the lamp, you rub it, the genie appears, he grants your wish, your wish comes true.
[1:05:20] but it never quite comes true in the way you expected, right?
[1:05:23] There's always some way.
[1:05:24] And I think that's already happening with these drugs, right?
[1:05:27] There's all sorts of ways our wishes are coming true now, but in ways that are slightly off, right?
[1:05:32] That are slightly unexpected.
[1:05:33] So, yeah.
[1:05:35] That's a really interesting analogy you've chosen, Aladdin, because I feel like the underlying message of Aladdin, if I remember correctly, or at least the one I take away,
[1:05:49] is a really interesting analogy to put over overeating and obesity.
[1:05:52] And that isn't the lesson of Aladdin, although one of the key points is that you can't fake it.
[1:05:58] You need to be yourself and earn the success.
[1:06:02] Is that right?
[1:06:03] That's right.
[1:06:03] Yeah, because to me, I feel like that was literally like a joke.
[1:06:06] genie's voice behind the curtain as well so to me that is a really interesting analogy because i feel like there's a lot of um feeling in the air and discussions when related to obesity that you need to earn your way to be thin
[1:06:24] Yeah, I mean, this relates to a... You're absolutely right.
[1:06:27] And there's...
[1:06:28] I'm not saying that that's good, by the way.
[1:06:30] I'm just saying... No, no, I don't judge that voice because I felt that about myself.
[1:06:34] So there's a big discourse around these drugs.
[1:06:38] that people who take them are cheating, right?
[1:06:42] And I remember the first few months I was taking them, thinking that about myself, like I was doing something wrong.
[1:06:48] And I remember thinking, one of my best friends takes statins to control his cholesterol.
[1:06:52] And I've never once looked at him and gone, you fucker, getting ahead of me on the cholesterol race, fuck you.
[1:06:58] If I said that to you about someone taking statins, you would think I was mad, right?
[1:07:01] It's like, what's going on there?
[1:07:02] Why do we...
[1:07:04] Why do we think this?
[1:07:04] If any celebrity loses, or anyone loses weight now, and they post a picture on Instagram, they'll just be flooded with people raging at them, saying, you know, fuck you, I Zenpick, you cheat.
[1:07:15] And I was thinking, what's going on there?
[1:07:19] This is a topic that's so...
[1:07:21] Weight and weight loss drugs are topics that are so...
[1:07:25] encrusted with shame.
[1:07:26] I started looking a lot at the history of how we think about weight and obesity.
[1:07:32] It's really interesting.
[1:07:34] If you look at...
[1:07:36] If you look at the history of this, it's very deep in our culture, the idea that being overweight is a sin.
[1:07:44] If you go back to Pope Gregory I in the 6th century, the first person to formulate the seven deadly sins, one of them is gluttony.
[1:07:50] It's always depicted with some hugely fat person, you know, stuffing their face.
[1:07:57] And you know that we still have this kind of deep,
[1:08:03] prototype in our heads because what are the forms of weight loss we admire?
[1:08:08] that ones that actually follow the kind of Christian pattern of sin, punishment, hell, redemption, right?
[1:08:13] Think about that game showed the world's biggest loser.
[1:08:15] Did you guys get that here?
[1:08:16] I was just, I was thinking about the other day, but I was talking to someone about it and someone just said, can you believe there was a show called the biggest loser?
[1:08:22] And it was about people like overweight people getting, like, and that wasn't that long ago.
[1:08:26] Nah.
[1:08:27] Like that seems bonkers.
[1:08:29] Yeah.
[1:08:29] I actually met with the, some of the people who worked on that and the,
[1:08:34] So people who haven't seen it, it was a show where they got very overweight people and they got them to engage in dangerous levels of starvation and extreme forms of exercise.
[1:08:43] And the one who lost the most weight became the biggest loser and therefore the winner.
[1:08:48] With Maya then, it's like, oh, you sinned, but we've seen you cry and sweat and beg and howl.
[1:08:55] We've seen that you've suffered.
[1:08:56] Okay, good job.
[1:08:57] Right?
[1:08:57] You deserve it.
[1:08:58] Exactly.
[1:09:00] In that prototype, if that's your framework, I totally understand why you look at me and go, well, yeah, you fucker, you got out of jail for free.
[1:09:09] What?
[1:09:10] these guys suffered and screamed and begged and you just injected yourself in the leg once a week and now you're the same size as them.
[1:09:16] Fuck you.
[1:09:17] I think there's another frame that we apply to weight, which is that it's a race, right?
[1:09:24] So you think about in this environment that makes the kind of fancy term for it is an obesogenic environment.
[1:09:28] We live in an environment where it's easy to become obese and hard to remain a healthy weight.
[1:09:33] In an obesogenic environment, lots of people make quite painful sacrifices to not be fat, right?
[1:09:38] Particularly women, they go hungry, they work out really hard, they do all these things.
[1:09:42] And again, if that's your frame, then I look like Lance Armstrong.
[1:09:47] It's like, well, we fucking, we do all the training, we run the race, right?
[1:09:51] You, again, you just jab yourself, you get all the benefits we get, but you don't put in the effort.
[1:09:57] And I think what we need to do is...
[1:10:00] replace those frames.
[1:10:02] Firstly, not judge people for feeling those frames because this is very deep in our culture.
[1:10:05] None of us chose that, right?
[1:10:06] That's deep, deep.
[1:10:08] None of us is Pope Gregory I, right?
[1:10:10] This has been handed down to us.
[1:10:13] And then offer a better frame, which is I would argue we are in a race, but it's not me against you.
[1:10:19] where we're competing and scrambling and tearing each other down, it's us, all of us, against the food industry and this dysfunctional environment, right?
[1:10:29] And when you reframe it that way, hopefully we can move beyond these ideas of the 6th century Pope or rage-based nihilistic kind of scramble to tear each other down.
[1:10:39] Mm-hmm.
[1:10:40] It almost becomes like a, I mean, within reason or whatever it takes, like it's for some people, the stakes are so high that I think like for some people it is like, well, my risks, my health risks are so high that it is worth the, it is worth the, whatever the risks are.
[1:10:57] Yeah, that's where I think it gets interesting in that like I think I'm an interesting case study of where the drug becomes problematic.
[1:11:06] I'm on that borderline of like always being very self-conscious about the way I look and feeling shame about the way I look.
[1:11:12] What I'm trying to say is the equation because my risks of diabetes and heart disease and all these things are there, but I'm not in an obese category, but I'm borderline, but I feel like I'm at this dangerous level where a lot of people would be.
[1:11:27] where it's not a clear equation, it's not a clear thing, but the temptation to take an easier route, physically easier, is there, but I feel like I don't want to take the risk because I don't know what those risks are going to be long term.
[1:11:42] I think there'd be millions of people who are on that cusp, on that line.
[1:11:48] I think that's true.
[1:11:48] It's definitely the case that the more obese you are, the stronger the case for taking the drug is.
[1:11:56] I would say, I mean, people with a BMI lower than 27 don't take it.
[1:12:00] I would say, in fact, that would be the firmest piece of advice I would give is don't take it if you're not overweight or obese, because you're incurring all the risks.
[1:12:07] Risk without the... Yeah, without, with only an aesthetic benefit.
[1:12:11] And you're actually building in more risk than other people, because for example, one of the other risks is as you age, you naturally lose muscle mass, just generally.
[1:12:20] Incredibly depressing, I think, from the age of like 29, you start losing muscle mass.
[1:12:27] when you lose weight through any way, you generally lose muscle mass as well as fat mass.
[1:12:31] So when you take these drugs, you generally lose muscle mass.
[1:12:37] So if you're skinny and you start taking these drugs, like I was on a show with one of the Real Housewives of New Jersey, she was on it.
[1:12:45] She was...
[1:12:46] I mean, she was not fat at the start.
[1:12:48] She was already, but she was thin and she's taken it to be bone thin.
[1:12:52] The risk that she's, I'm not judging her for a second because women are made to feel like shit about their bodies no matter what they do.
[1:12:56] So this is not said in a spirit of like scorn or judgment.
[1:12:59] But I would urge her to reconsider for her own health because...
[1:13:04] if you are going into the aging process with artificially low muscle mass because of these drugs, you're at real risk.
[1:13:14] You won't particularly feel it in your 40s, but when you get into your 60s and 70s, you're at real risk of a condition called sarcopenia, which is quite a lot of what people get anyway, but is basically where you've got very low muscle mass.
[1:13:28] Your muscle mass is the total amount of soft tissue in your body.
[1:13:30] It's necessary for movement.
[1:13:31] you'll really struggle if you've got low muscle mass as you age to climb the stairs, get out of a chair.
[1:13:36] There's a risk that we're building up a time bomb of people who will be more impaired as they get older because they've taken these drugs to be really, really thin.
[1:13:46] So yeah, I would really urge caution on that.
[1:13:50] I think...
[1:13:52] For me, there's something problematic in the idea of taking the drugs because I'm not sure I could honestly say that if I was to get on them, that it was purely for health outcomes.
[1:14:04] I think there would be a heavy vanity part to it that I just wanted to look hotter.
[1:14:09] If I'm being frank.
[1:14:10] I don't acknowledge that would be possible.
[1:14:13] No, but even on that, Josh, I think like separate to the drugs, I feel like that's the same with me in like eating healthily or like exercising.
[1:14:22] Yeah.
[1:14:22] It's like, even though I feel like the secondary benefit is that it's good for me.
[1:14:27] Mm-hmm.
[1:14:28] But if I was honest, it's like I feel better about myself when I'm happy with how I look as opposed to how I feel.
[1:14:35] Because it's sort of like you're not judged on how you feel.
[1:14:38] You're judged on how you look, unfortunately.
[1:14:41] No, you're totally right.
[1:14:41] And I had a really difficult moment on this.
[1:14:45] So as you know, because you know me, like I learn stuff by reading a lot and interviewing experts, but I process it by talking with my friends, right?
[1:14:55] And so I've got, I'm lucky, I've got a little group of friends where we, you know, they're interested in the shit I'm interested in.
[1:15:00] And I've got one friend who, for my previous three books, we talked so much about what I was learning.
[1:15:06] And with this one, she just was really...
[1:15:10] pissy about it.
[1:15:11] She's not herself overweight, so it wasn't like a personal sensitivity.
[1:15:14] And while working on the book, she came, she was in London, we were both in London, and we went out for dinner.
[1:15:20] And I'd just been doing some stuff about, you know, weighing the health benefits and let's talk about that.
[1:15:25] And she wasn't leaning into it.
[1:15:27] And then after a while, she just said, I can't listen to another fucking word of this.
[1:15:31] And I was like, what?
[1:15:33] And she said,
[1:15:35] You keep telling me it's about all these health benefits, you're weighing these risks.
[1:15:39] It's fucking bullshit.
[1:15:40] Don't give me that.
[1:15:42] You want to look better, right?
[1:15:43] She said, I think you've always looked good.
[1:15:45] All the time I've known you, we've been friends for like 20 years.
[1:15:48] You've never felt good about how you look.
[1:15:49] Just admit that's what's driving you, right?
[1:15:51] Just don't give me this.
[1:15:54] And I really thought about it because she knows me very well.
[1:15:56] And I think she was underestimating that I do have a genuine health concern here.
[1:15:59] Like, you know, my granddad did die when he was younger than I am now.
[1:16:02] And this does massively reduce heart concerns.
[1:16:05] But there's definitely a truth in what she said as well.
[1:16:08] Like, yeah, there's an element of vanity.
[1:16:13] And it's interesting, isn't it?
[1:16:14] Even that word vanity is so loaded.
[1:16:17] Like wanting to feel better about how you look is...
[1:16:21] I don't think is a disreputable thing, right?
[1:16:24] I mean, the word vanity so implies a kind of...
[1:16:31] Sin?
[1:16:31] Narcissism, sin, yeah.
[1:16:33] Although, you know, I also think about the worst moment for me in writing the book by far
[1:16:39] was I've got lots of nephews and godsons, but I've only got one niece.
[1:16:44] So I feel very, no one makes me more protective.
[1:16:46] She's the only girl in my family.
[1:16:48] She's amazing.
[1:16:49] And in my head, she's always like a six-year-old.
[1:16:51] She's actually just turned, she had her 20th birthday yesterday.
[1:16:53] So whenever she has a boyfriend, I'm all like, get away from her, you fucking paedophile.
[1:16:57] And then I'm like, oh no, wait, she's an adult woman.
[1:17:00] But about six months into taking the drugs, I was in Vegas and I was FaceTiming with her.
[1:17:08] And she's like, oh yeah, and you've lost so much weight, you know.
[1:17:11] She's like teasing me, like I didn't know you had a neck before, things like that.
[1:17:16] And I was sort of preening and she looked down and she said, will you get me some Ozempic?
[1:17:20] And she's a completely healthy weight, right?
[1:17:22] And so I laughed.
[1:17:24] And then I realised she wasn't joking.
[1:17:26] And I was like, oh, fuck, have I undermined every message I've ever given her, right?
[1:17:31] Like since she was little.
[1:17:33] So I do think that the danger with the vanity thing is that it's hard to say, I feel better looking like this.
[1:17:42] without implying an aesthetic judgment on people who don't, right?
[1:17:46] And that, to me, is the difficult... Do we set in race, particularly for women, but also for men, a kind of aesthetic arms race where, you know, already there's so much...
[1:17:58] I mean, in a social media age, there's so much fucking pressure on people to look...
[1:18:01] particular way just this ramp that up even more so it's not like if you call it my vanity well okay the only person you could go well what's up to me but if that has consequences for other people that becomes a more complicated conversation it's difficult one i don't know the answer to it but i think you're right to raise it is there like i just wonder and maybe there's research on this but one of my fears would be that
[1:18:22] If these drugs become a normal part of society and 50% of the country are on them and it becomes something that we can rely upon, I worry that our nutritional wisdom will decline because we feel like, well...
[1:18:39] I won't be obese so I can eat what I want.
[1:18:41] So I actually don't need to eat whole foods and I don't need to go on, you know, do all the things that we've all been told.
[1:18:48] Yeah.
[1:18:48] And then why, why fix the food system?
[1:18:50] And then why do we need the nutritionists in the schools where it's like, that's okay.
[1:18:53] We can just give, there'll be kids versions of them at some point and it doesn't matter.
[1:18:57] Like, has there been any research on that or thinking about that?
[1:19:00] Oh yeah.
[1:19:01] I'm very worried about this.
[1:19:02] The, the,
[1:19:04] Professor Michael Lowe said to me, these drugs are an artificial solution to an artificial problem, right?
[1:19:09] Processed food dug this hole of hunger in all of us, which undermine our ability to ever feel full.
[1:19:15] And what these drugs do is give you back your sense of fullness, but at a cost, right?
[1:19:19] So clearly the better solution is let's deal with the environmental problems so that we don't have this hole of hunger or we don't need to fill with the drugs.
[1:19:27] And for a while, I considered stopping taking the Ozempic for that reason.
[1:19:30] I remember going to one of my best friends a few months into taking them and saying to her,
[1:19:36] I've got to stop taking this drug.
[1:19:37] This is completely fraudulent, right?
[1:19:39] I write all these books about how we've got to deal with the deep underlying social problems that cause these symptoms, not just deal with the symptoms, right?
[1:19:47] I've done that with all these topics.
[1:19:48] And here I am, clearly with a problem that has a social cause, and I'm just treating the symptom.
[1:19:53] And this friend, she got eight years ago, nine years ago now, she got very bad breast cancer and she nearly died.
[1:20:00] And...
[1:20:02] She's a single mom.
[1:20:03] It was a terrible time.
[1:20:05] And I was with her all through the, you know, the double mastectomy, the hysterectomy and everything.
[1:20:10] And she said to me, when I got breast cancer, you could have said to me, well, there's something really wrong with our environment.
[1:20:19] One in seven British women get breast cancer now.
[1:20:21] It's one in 38 in Japan.
[1:20:25] This is a very recent thing.
[1:20:26] 30 years ago, one in seven British women weren't getting breast cancer.
[1:20:29] There's something in our environment that's really wrong.
[1:20:33] And she said to me, you could have said, well, fuck me.
[1:20:36] The environment's caused this terrible thing, but now you're injecting yourself with all this poison and chemo.
[1:20:40] It's crazy.
[1:20:41] Don't do that.
[1:20:42] Let's fix the environment.
[1:20:43] She said to me, you didn't say that.
[1:20:45] Because if I'm dead, I can't fix the environment.
[1:20:48] And she gave me a really good analogy.
[1:20:49] She said, if your house is on fire...
[1:20:52] You could make a very good argument for saying we should change the building code and make buildings out of less flammable materials, right?
[1:20:59] Really good idea.
[1:21:00] Let's make it the law.
[1:21:01] You've got to put sprinklers in the apartment hallways.
[1:21:03] Good idea.
[1:21:05] But when your house is burning down, that's no fucking use to you.
[1:21:07] You've got to phone the fire brigade, douse the house in water, and then you can campaign for the better thing.
[1:21:13] And she was then sort of flipping this logic back to me, she said, if you die of a heart
[1:21:19] what there's no use to us to then go, well, you know, or think about another analogy.
[1:21:23] Think about gun control.
[1:21:24] My friend who I was in Vegas for was murdered by someone with a gun.
[1:21:28] I'm passionately in favor of gun control.
[1:21:30] I'm sure you are as well.
[1:21:31] Um, but I wouldn't have stood over him and sit while he's bleeding to death and gone, you know, we need to close the gun show loophole and we need to ban bump stocks.
[1:21:39] I phoned a fucking ambulance, right?
[1:21:41] Yeah.
[1:21:41] And I wasn't there when he died.
[1:21:42] So I didn't, I would have phoned an ambulance.
[1:21:43] Right.
[1:21:44] Um, so I don't think dealing in the short term, um,
[1:21:49] When you've got a problem caused by big environmental factors, you want to, in the medium to long term, change the environment.
[1:21:56] And the short term, you make the best choice you can make for yourself with the limited options the environment provides you.
[1:22:01] So both things need to happen.
[1:22:02] But I don't think that gets us out of the very difficult point you've just put, which still worries me, which is, does it undermine the momentum for dealing with the environmental problems?
[1:22:15] Right.
[1:22:16] If you could look, these drugs at the moment are mostly injectables, but eight years from now, there'll be a daily pill.
[1:22:21] They'll be out of patent.
[1:22:21] It'll be a dollar a day.
[1:22:24] I really do think half of Australians will be taking them.
[1:22:27] At that point, will it be harder to get momentum going for a movement to change the food system?
[1:22:36] But, you know, one of my friends, the same friend, actually, I just mentioned said...
[1:22:40] when I put that to her, said, let's be really honest here, what momentum?
[1:22:47] Hard to think of a more charismatic and brilliant person than Michelle Obama.
[1:22:50] Even she couldn't when she tried to be president.
[1:22:52] She started a campaign saying, let's move.
[1:22:54] And she couldn't get a fucking traction around saying, let's help children to move around, right?
[1:22:58] Now, I don't believe it's impossible to build a movement on this.
[1:23:00] I absolutely believe it is possible.
[1:23:01] I believe we can and must do it.
[1:23:03] But I do think the doubt you've raised is a really important one.
[1:23:07] There is a risk...
[1:23:09] that the widespread adoption of these drugs will undermine the momentum or sort of smother in its cot the momentum to deal with the deeper environmental problems.
[1:23:18] I do think there's a risk of that and I don't know what to do about it other than, I mean, you could put it another way, it could wake us up, right?
[1:23:24] It could be.
[1:23:26] It makes people go, how do we get to the point where half of us need to fucking drug ourselves?
[1:23:30] What happened to us, right?
[1:23:31] It could be an awakening moment.
[1:23:33] It depends partly about how we communicate it.
[1:23:36] If we talk about it in a more truthful way, look, artificial solution to an artificial problem.
[1:23:40] This shouldn't have been done to you.
[1:23:41] We're in a trap, but we don't have to let our kids be raised in a trap, right?
[1:23:45] Right.
[1:23:46] If we communicate it that way, I hope we can get to a better answer.
[1:23:50] This didn't have to happen.
[1:23:51] This absolutely didn't have to happen, right?
[1:23:53] We could have avoided this.
[1:23:54] Japan avoided it.
[1:23:55] We could have avoided it.
[1:23:56] And we can make a choice now for our children and grandchildren to not have to make this choice.
[1:24:02] Well said.
[1:24:03] Yeah, well said.
[1:24:03] Yeah.
[1:24:04] Hooray.
[1:24:06] You are the most gifted storyteller.
[1:24:09] I love listening to you talk.
[1:24:10] I've listened to all your books because I just love your voice.
[1:24:12] I always talk about how much I love your voice and your storytelling, but I also love your brain a lot.
[1:24:18] You get a great brain.
[1:24:19] You're slightly aroused now, Hugh.
[1:24:20] And on that note...
[1:24:23] It reminds me of that line, I was going to say, like, I admire your brain, but it reminds me of that terrible, you know, the film Indecent Proposal, and you've seen it, where people haven't seen it.
[1:24:31] Robert Redford meets Demi Moore and Woody Harrelson and says, and he's a rich guy, he meets them in Vegas, and he offers Demi Moore a million dollars to spend one night with her.
[1:24:42] And when Woody Harrelson and Demi Moore are debating this, she says to him, you know, he's not offering a million dollars for my brain, he's offering a million dollars for my body.
[1:24:50] And this film critic wrote, this begs the question, what would you offer for a night with Demi Moore's brain?
[1:24:56] But yeah.
[1:25:01] So Hugh, I would offer a lot for your brain.
[1:25:03] Well, likewise.
[1:25:04] Thank you so much for joining us.
[1:25:05] It's been an absolute pleasure once again.
[1:25:07] What a joy.
[1:25:07] Thank you, mate.

Shows are listed from Apple Podcasts' charts and directory, and Podcast Index where it is used. Every show and episode belongs to its publisher and plays from the publisher's own feed; this site hosts none of them.