# Ozempic: The Truth About What Happens When You Stop | Weight Loss Doctor | Dr Jack Mosley

An episode of [Live Well Be Well with Sarah Ann Macklin | Health, Lifestyle, Nutrition](https://invisiblenetwork.ai/podcast/1508380100), 8 Apr 2026, 1 h 07 min.

Audio: https://anchor.fm/s/1033d1554/podcast/play/118126103/https%3A%2F%2Fd3ctxlq1ktw2nl.cloudfront.net%2Fstaging%2F2026-3-8%2F421652610-44100-2-d132b50283b71.mp3

Exciting news - pre-order my debut book https://linktr.ee/HealthySBTH?utm_source=linktree_profile_share You've seen the headlines. You've watched the celebrities transform. Maybe you've even wondered, quietly, if it could be for you. But what is the science really saying? This week on Live Well Be Well, I sit down with Dr. Jack Mosley, GP registrar, and author of Food Noise. Jack brings a perspective that is honest, nuanced, and completely free of hype. We get into what these drugs can genuinely do, who they are truly for, and why taking them without lifestyle support is like putting on noise-cancelling headphones without ever learning to listen to yourself. Here's What We Dive Into: - Why up to 40% of weight lost on GLP-1 medications can come from lean muscle, not fat, and why that matters more than the number on the scale. - What "food noise" actually is and why silencing it with medication is only half the story. - The 80% reality: why most people regain all their weight within 20 months of stopping and what the 20% who don't have in common. - Why these are not cosmetic medications, who they are genuinely for, and the real risks of microdosing without clinical need. Love, Sarah Ann 💛 *** Want to put what Jack shared into practice? The Fast 800 combines intermittent fasting, nutrition, and guided lifestyle support in one place. Co-founded by his father Dr. Michael Mosley. Try it free for 7 days: 👉 www.thefast800.com *** This episode is sponsored by: DIOME: Rest deeper. Stay grounded. Rested is available now and Grounded lands later this month. 👉 Get 20% off with code SARAH20 at DIOME.CO *** The Great British Veg Out How to support your gut, energy, and hormones by eating more — not less. 👉 https://sarahmacklin.substack.com/p/the-great-british-veg-out Reset Your Health If your body feels off after stress, travel, or burnout — this is where to start. 👉 https://sarahmacklin.substack.com/s/reset-your-health-in-30-days 👉 Practical beats perfect. Here’s a free 5-recipe PDF I use to support energy and stress during busy weeks. https://open.substack.com/pub/sarahmacklin/p/download-your-free-5-recipes-to-relieve 👉 If this resonates, you can join the thousands who read The Compassionate Cure each week. https://sarahmacklin.substack.com/ *** Let’s be friends! 📷 Instagram: https://www.instagram.com/sarahannmacklin/ *** If You Enjoyed This Episode, You Might Also Like: Fat Loss, Metabolism & The Myth Holding You Back | Dr Andy Galpin https://youtu.be/ZXLWY5HcPXE *** Sign up to Sarah’s Compassionate Cure newsletter: Science Simplified, Health Humanised. Join thousands in exploring actionable insights that prioritise compassion, clarity, and real-life impact. https://sarahmacklin.substack.com/ *** Highlights 00:00:00 Intro00:01:45 The obesity crisis: how we got here and what's driving it 00:04:10 The string test: a simple way to assess your metabolic health 00:06:30 Muscle loss on GLP-1 medications and the stat no one is talking about 00:10:20 Benefits of GLP-1 drugs: heart disease, sleep apnea, and beyond 00:12:00 Food noise explained and how these drugs work like noise-cancelling headphones 00:15:00 GLP-1 and addiction: alcohol, opioids, and the reward system 00:20:30 Side effects, hair loss, and the dangers of unregulated sources 00:23:30 Microdosing Ozempic: what you really need to know 00:35:00 Shame spirals and the role of self-compassion in sustainable change 00:41:00 Managing cravings without medication: urge surfing and habit stacking 00:47:00 Weight regain after stopping: the 20-month reality check 00:50:30 The Mediterranean diet, the 5:2, and the Fast 800 programme 01:05:30 What live well, be well means to Dr. Jack Mosley *** Love what you’re hearing? My small ask is to please rate and review Live Well Be Well. This helps the show expand and allows me to keep producing these with the best quality guests. It means a huge amount to me, so thank you.

## Transcript

[0:00] What are the benefits of taking Ozempic or GRP one?
[0:03] They probably will save many lives through reducing obesity.
[0:07] I like to think of them as noise cancelling headphones.
[0:10] They reduce your food noise, but there are definite issues.
[0:14] Doctor Jack Mosley, weight loss expert and author of Food Noise.
[0:18] Here's what the diet Industry doesn't want you to know.
[0:20] How quickly are people regaining the weight?
[0:22] Quite rapidly actually, 80% of people will regain their weight.
[0:26] Reset shows up to 40% of that weight loss can come from lean
[0:30] muscle, not just fat. This is one of my concerns with
[0:33] the GLP one. What about Ozempic face?
[0:36] Ozempic face is caused when you there's quite a few people who
[0:40] do get hair loss. Some hairdressers say that they
[0:44] can spot the people on the GLP 1 weight loss medications because
[0:47] of that. The risks are really big.
[0:49] They're really amplified when you're getting it off some
[0:52] unregulated source. Now there's something called a
[0:55] triple agonist, and what that means is works with three
[0:58] receptors. So that is as effective as
[1:00] bariatric surgery. So should alarm bars be going
[1:03] off then if people are microdosing these purely for
[1:06] cosmetic reasons? I would say so.
[1:08] Does it outweigh the benefits or does the benefits out raise the
[1:11] risks? For the last two years I have
[1:16] kept a secret from you and it's this.
[1:18] It's my new book. Healthy shouldn't be this hard
[1:22] and I think it is a problem that we are all feeling.
[1:25] And I was feeling it so much that I wrote a book on it.
[1:28] Now, if you've been a guest of this podcast for a while, you
[1:30] know that I am all about kindness, self compassion.
[1:34] But when I dug into the research of this, my mind exploded.
[1:39] The connection between the mind and body is so integral, but we
[1:42] completely miss out on all the conversations on health, on how
[1:46] we speak to ourselves. And that is such a driving
[1:48] factor on how our food responds to what we eat, to the choices
[1:52] that we make. And we are so overwhelmed right
[1:55] now in the $8.5 trillion industry that is the Wellness
[1:58] industry, which is predicted to be by 2027.
[2:02] So if you need a helping hand, if you want a new way to live
[2:06] and be well and buy my new book Healthy shouldn't be this hard
[2:10] out on May the 28th. But you can pre-order it now.
[2:15] I'll pop the link below in the show notes.
[2:17] And I would love if you could support me on this.
[2:20] And I honestly think it will support you too.
[2:22] This is a very timely conversation we're about to
[2:24] have, so we're going to discuss everything.
[2:27] GRP one medications. Now for some people that don't
[2:29] know what that is, people might recognise it through the
[2:32] American brand name such as the Zenpic.
[2:35] And they have become hugely popular, So popular that you've
[2:38] actually written a book on it. So as AGP Registrar, I just want
[2:42] to ask you straight up, where do you stand on these drugs?
[2:45] Are you pro or you against? Start with the heavy hitters.
[2:49] So I would just like to say I'm not necessarily for or against.
[2:53] I would say overall for the general, for the overall
[2:57] population, they probably will save many lives through obesity,
[3:02] through reducing obesity and obesity related diseases.
[3:05] But there are definite issues with these medications, and they
[3:09] really do need to be paired with changes to your lifestyle.
[3:12] Such a scientific answer there. Never give one or the other,
[3:15] always the in between, the nuanced view.
[3:18] Well, we're going to go into why you're for and against.
[3:20] So it's really rare for a drug to have such a large impact so
[3:24] quickly in the rise of medicine. And also not just for one like
[3:29] chronic disease for so many. So before we kind of talk about
[3:34] the for and the against and the pros and the cons, how do we get
[3:37] to this crisis point that we're all now looking at this kind of
[3:40] miracle drug as a cure? Well.
[3:42] We've seen this dramatic rise in obesity over the last 60 years.
[3:48] Really, and there are many factors for this, but we've seen
[3:52] an increase in the UK from around 1 to 2% back in the 1960s
[3:57] to around 30% today in the UK and over 40% in the US And this
[4:03] has led to this tidal wave of obesity related diseases.
[4:06] Everything from heart disease, sleep apnea, high blood
[4:10] pressure, type 2 diabetes, and even things like dementia are
[4:15] significantly increased. So there are obviously a really
[4:19] big range of factors that are responsible for this, but the
[4:23] some of the key ones are this rise in the Western diet.
[4:27] So that's the processed junk food.
[4:29] But there's other, there's other kind of smaller things like
[4:32] snacking has rapidly increased over the last few decades.
[4:35] That's become the norm. We even have bigger plate size
[4:39] and we're definitely more sedentary than before.
[4:42] So modern society does not help with any of this.
[4:47] I find that really interesting about the snacking because I
[4:50] think, you know, my mum used to always say little and often, but
[4:54] actually that kind of sues us to potentially eating more.
[4:57] And I know there's a lot of really interesting research now
[4:59] coming out that people that do snack more obviously have a
[5:02] higher weight gain and and are more likely to be obese, which
[5:05] is really interesting. I don't know if you've seen that
[5:07] when you were researching your book.
[5:09] Yes, completely. So the, yeah, the stats say like
[5:13] 9095% of our snack at least once a day and it's something like
[5:17] 70% have at least a couple of snacks a day.
[5:20] Now the you can have healthy snacks, things like nuts and
[5:24] fruit, that sort of thing. But realistically the vast
[5:27] majority of the snacks that we do eat are many of these kind of
[5:31] processed junk foods like crisps, chocolate, sweets, all
[5:34] of these sort of things. So they're often packed with
[5:37] sugar and they are packed with refined carbs, salt,
[5:43] flavourings, all of these sort of things.
[5:44] And these are, they are burnt off really quickly, but they
[5:48] also keep us wanting more and more.
[5:51] These dopamine hacks, aren't they?
[5:53] Yes, exactly. So the many of these foods are
[5:58] developed by food scientists to literally hack your brain and
[6:04] and like you say, dopamine that is that the chemical that it's
[6:09] involved in wanting. So it teaches your brain that
[6:12] was a nice tasty treat and keeps you coming back for more.
[6:16] Yeah, we actually had, he's given you a quote in your book,
[6:18] but Chris Van Talliken, who wrote Process People, he came on
[6:22] this podcast when he released his book.
[6:24] And I mean, our listeners absolutely loved that episode.
[6:28] We we dissected lots of different foods live so people
[6:32] could start to understand. And it shocked me just, you
[6:34] know, how much that we don't really foresee in our day-to-day
[6:37] that is process because it's such a confusing landscape.
[6:40] Now you talk about something really interesting because I
[6:42] think there's a bit of a debate about BMI, you know, does it
[6:45] take into account muscle health or not?
[6:48] But you talk about the string test.
[6:50] Can you tell us about that? So the string test is really
[6:54] simple and it's a good way to assess your overall metabolic
[6:58] health. Like you said, the issues with
[7:01] BMI is that they it doesn't account for muscle mass.
[7:06] So you might have a rugby player who's carrying a lot of muscle
[7:09] but have a high BMI and they may actually be relatively healthy.
[7:13] The other thing it doesn't account for is that distribution
[7:16] of fat. So there's, there are lots of
[7:18] different types of fat. The two important ones are this
[7:21] so subcutaneous fat and this is a fat around your hips, your
[7:24] arms. It's not dangerous, but the fact
[7:27] that we are concerned about that affects your metabolic health is
[7:30] a visceral fat and that's typically around your belly.
[7:34] So what the string test involves is it's essentially your your
[7:40] height to waist ratio really. And it's quite a crude test, but
[7:44] all you have to do is you get a piece of string, you extend it
[7:49] to your full height, then you fold it in half and see if you
[7:52] can fit it around your, your abdomen.
[7:55] And if you can't, it may be a sign that you're you're you're
[7:59] not quite as metabolic healthy as you might like to be.
[8:03] Quite interesting. I wonder how many people now are
[8:04] going to be going to pick up string and standing up and
[8:08] measuring themselves if I should have done that.
[8:10] I mean, you're definitely going to pass.
[8:12] You're very lean and tall, but I think 1 big concern around
[8:18] around this is that it can feel like a quick answer.
[8:23] And I think for some it's really needed.
[8:27] And it's, you know, very much looked at when we had the
[8:29] gastric band. You know, there are certain
[8:32] measures that some people really do need help with.
[8:34] But I guess when we look at the landscape of this, it's also can
[8:38] be quite dangerous. Now, the thing that I think is
[8:40] really important to talk about here when it first comes to GLP
[8:42] ones is muscle. So people can lose 15% of their
[8:47] body weight, but research shows up to 40% of that weight loss
[8:51] can come from lean muscle, not just fat.
[8:54] So I think that's where people maybe aren't quite understanding
[8:58] how quickly this weight is dropping and where it's
[9:00] dropping. You just mentioned there are two
[9:01] really interesting types of fat, but then also we have muscle on
[9:05] top. So what does that mean for
[9:07] people that are losing weight quickly and up to 40% of that is
[9:12] muscle? This is, yeah, this is one of my
[9:15] concerns with the GLP 1 weight loss medications that like you
[9:20] say up to 40. So it's between kind of 25 and
[9:22] up to 40% of that weight you lose is lean body mass.
[9:25] And the main component of that is muscle.
[9:29] And what, and the, the reasons for this are primarily when you
[9:35] go through any rapid weight loss, you can lose muscle, which
[9:39] is why it is so important to, to do certain things to prevent
[9:43] that. And that kind of includes
[9:44] increasing your protein intake whilst you're taking these
[9:47] weight loss medications and doing some basic strength
[9:50] training. So why, why is muscle so
[9:53] important? Well, it's actually very
[9:54] strongly associated with longevity.
[9:57] When you look at some of the studies you they find that both
[10:00] grip strength and leg strength is actually very strongly
[10:03] correlated with a long lifespan. The other really important
[10:07] reason and part of why this could be the case of things like
[10:11] your future frailty. If you have enough muscle to do
[10:15] simple things that we take for granted right now, getting off
[10:18] the chair and reducing your risk of future falls, future hip
[10:23] fractures, all these sorts of things.
[10:26] It's also a really important sink for your glucose.
[10:30] So it's soaks up a lot of the sugar in your blood.
[10:33] And I think finally, it's very important for your metabolism.
[10:36] It burns much more calories than fat.
[10:39] So this could also be one of the reasons why when you've lost,
[10:44] when you're taking these weight loss medications, you may have
[10:46] lost a significant amount of fat, but also muscle.
[10:48] But when you stop these medications, you will be what we
[10:53] see in the studies is you, you do rapidly regain that weight.
[10:56] And again, one of my concerns here is that, and we do need
[11:00] more studies look into this, that fat is more easy to regain
[11:05] than muscle. Yeah.
[11:06] I mean, we know how hard it is to gain, especially as you get
[11:08] older. We know how hard it is to gain
[11:10] muscle. We talk about this a lot with
[11:13] perimenopausal and menopausal women.
[11:16] Also, how important it is to to make sure they're maintaining
[11:19] their muscle during especially this phase because that's when
[11:22] estrogen becomes, you know, drastically reduced and there
[11:26] are much higher risks of things like, you know, osteoporosis and
[11:29] things like that later on. So that's really important for
[11:32] them, but then also with the rise of Ozempic, it puts us in
[11:35] this really interesting dynamic. So let's talk about the risks.
[11:40] Does it outweigh the benefits or does the benefits out raise the
[11:43] risks? Risks.
[11:45] So what are the let's start with the positives.
[11:48] What are the benefits of taking Ozempic or GLP one?
[11:52] So for people who are living with obesity and potentially
[11:56] poor metabolic health, and what I mean by that is they may have
[11:59] high blood pressure, high cholesterol, their risk up
[12:02] ischemic heart disease or strokes or sleep apnea.
[12:07] For some of these people, it can have a massive benefit.
[12:10] And especially people who have tried many other types of diet.
[12:16] Like I say, the food environment we do live in, there are
[12:19] temptations. Everyone.
[12:20] I understand it's very hard for certain people to lose weight.
[12:24] So just looking at some of the studies with heart disease, it
[12:29] reduced the risk of heart disease by around 1/4.
[12:31] As with chronic kidney disease with with sleep apnea, this is a
[12:37] condition where people are carrying often too much weight
[12:40] around their tongue and their neck and they actually stop
[12:43] breathing multiple times throughout the night.
[12:46] And this is much more common than we think.
[12:47] Well, that it reduces it reduced the number of these APNIC
[12:51] episodes where they stop breathing by about half
[12:54] massively reduces the risk of type 2 diabetes because we know
[12:57] that's so strongly associated with with weight and again,
[13:00] weight around the middle. What is very interesting as well
[13:03] is we're looking at its role in addiction.
[13:08] So part of the way these weight loss medications work, they
[13:12] reduce your physical hunger, but they also reduce some of your
[13:16] your food noise. So that's your cravings I.
[13:18] Love that word. Yeah, and I think it's something
[13:21] that a lot of people can relate to, this food noise.
[13:24] So it reduces those cravings. And when you see that chocolate
[13:29] bar, you can potentially resist more than you could before with
[13:32] these weight loss medications. So this appears to impact your
[13:37] reward centres and that's why they're also looking at how it
[13:42] could affect things like alcohol consumption.
[13:45] And this is with people living with obesity and also alcohol
[13:50] addictions, alcohol use disorders.
[13:53] And they did find that it did significantly reduce the number
[13:55] of heavy drinking days and the overall alcohol consumption, but
[13:58] only in people who also not only had a alcohol problem but also
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[15:01] Wow, I mean, even here. So this is the book your book
[15:04] food Noise, which is I have to say, like one of the best titles
[15:07] I've seen of a book. The opioid crisis is a really
[15:09] big thing in America right now and I've watched things like
[15:13] dope sick and all of the programmes are great, great
[15:16] programmes. It's amazing.
[15:17] And you don't quite realise just like how strong the opioid
[15:21] crisis is. But you said here, a study
[15:23] examining the medical records of over 1,000,000 people in the USA
[15:27] found that those that were taking GLP one medications had a
[15:29] 40% reduced this change of overdosing on opioids and then
[15:33] with those of an alcohol addiction, they were 50% less
[15:37] likely to get drunk. That's quite amazing, isn't it
[15:39] it? Is absolutely fascinating and
[15:43] that that is an observational study.
[15:45] So we can't say for certain this is going.
[15:47] To reduce and. But it's, but it's a really
[15:50] interesting study for sure. And I think it does highlight
[15:54] the fact that this could have some role in, in our reward
[15:58] centres and in, in managing addiction.
[16:02] And even with some of these other studies, they've seen
[16:05] people taking these weight loss medications.
[16:07] They are they're smoking less. As well so.
[16:10] And like you say, the the opioid crisis, is it still a massive
[16:14] problem today in the UK as well, but but more so in the US where
[16:18] there's massive access to. Fentanyl.
[16:21] Fentanyl and and prescription drugs and that's kind of where
[16:24] it all all originates really, to be honest.
[16:27] It's interesting because it's kind of like another
[16:28] prescription drug going against another prescription drug when
[16:31] you look at it at the horizon like that.
[16:33] And there are all these interesting kind of interplays
[16:36] there because then you've also got Big Pharma against Big Food.
[16:40] So Big Pharma trying to solve a problem created by Big Food at
[16:45] the end of the day. Exactly.
[16:47] So it's kind of this arms race. I think the thing that when we
[16:50] first heard about GLP ones, it was so connected to type 2
[16:54] diabetes and weight loss. I think that's like where it
[16:56] started to spark, but then you were hearing, oh, it helps with
[16:59] longevity. I mean, even in here we've got
[17:02] bipolar, schizophrenia, depression.
[17:04] We've got, you know, it's mood disorders, you know, as well as
[17:07] obesity being one of the biggest killers of today, mental health
[17:11] issues and problems of people suffering with their mental
[17:13] health illnesses is also rising so rapidly.
[17:17] So we've got like these two sectors that this drug seems to
[17:20] be able to treat quite well and quite quickly.
[17:25] Do you feel that because there's now been such like a huge wave
[17:29] of this discussion, you know, there's headlines everywhere.
[17:32] We're seeing celebrities from people like Kelly Osbourne to
[17:35] Oprah to Rebel Wilson all talking about their experiences
[17:40] on this. And we see, we see the outcome,
[17:42] right? We see them looking thin and
[17:46] full of life and like they've got their glow back.
[17:50] Is there a worry that this is too good to be true?
[17:54] I think this is where some of the problems I've mentioned
[17:57] about that are these some of these incredible effects of
[17:59] these medications and there is this crisis of obesity that we
[18:04] are trying to solve. And but this is where we do come
[18:08] to some of the yeah, some of the issues of these medications.
[18:11] So you do have a lot of a lot of celebrities who are using these
[18:16] medications. I think it was all the rage in
[18:19] in Hollywood before it kind of hit the mainstream market.
[18:23] And I do really have concerns that although these medications
[18:27] are definitely helpful for certain people living with
[18:31] obesity, not for everyone because there are some risks and
[18:33] they're definitely not for everyone.
[18:35] So I'm not saying everyone with obesity should take it, but
[18:38] people who are the healthy BMI or even of kind of a lower
[18:41] weight, I think this is when that risk to reward benefit
[18:45] really starts to mount up in the opposite direction.
[18:48] And actually for some people, those risks really start to
[18:51] mount. And I think this is from several
[18:55] reasons for some people like we've mentioned some of this
[19:00] these other issues which I could go into in a bit later, but like
[19:02] things like muscle mass, nutrient deficiencies start to
[19:07] mount up, but also people who are at maybe a risk of an eating
[19:12] disorder, then this could definitely exacerbate that.
[19:15] And we we know that is the case. Well, it's interesting because
[19:18] do you remember that term? I don't know if it's officially
[19:20] being put in the DSMV 5, which is the manual where different
[19:25] type of mental health disorders are put into and characterised
[19:28] orthorexia. It was a very big term about 10
[19:31] years ago when the clean eating came out and I'm not sure if it
[19:34] was ever officially coined, but it was basically the fear of not
[19:37] eating anything clean. And I feel like this again could
[19:41] start another new wave of this type of thing.
[19:44] And I was thinking about this today before you came on the,
[19:47] you know, a cultural message I from the modelling industry for
[19:50] anyone that has no idea of my previous background, if you
[19:52] haven't listened to the show. And I was very much in that wave
[19:56] of the orthorexia movement very much the thin is beautiful and
[20:02] the ideal body weight and the pressure as a woman to be thin
[20:05] and, you know, you're skinny and strong or whatever.
[20:08] Instead of, you know, now the message feels like it's about
[20:11] more about muscle and feeling strong in yourself.
[20:13] It's more about your mental health, which I think is a
[20:15] really amazing transition. But the cultural message a few
[20:19] years ago was very strong in body positivity.
[20:21] And I've seen this rise of GLP ones come up and a lot of
[20:25] celebrities drop weight very quickly.
[20:28] Do you think this is also revealing something about how
[20:31] we're looking at society with weight and health?
[20:34] Yes, I, I think it does have the potential to do that on a kind
[20:39] of quite a major way. Like you, you said the we have
[20:44] started to move into kind of some better directions with it's
[20:48] not just about weight and it's more about overall health is
[20:53] about all of these lifestyle interventions from, you know,
[20:57] eating well to exercise. This can really improve your
[21:00] mood. And, and yeah, it's not about
[21:03] just the numbers on the scale, but you know, also things like
[21:06] muscle and, and overall well-being is much more
[21:09] important. And that's what I, yeah, that's
[21:11] what I'm really passionate about.
[21:14] So you're right then maybe and we are potentially seeing this
[21:19] move towards, you know, going back to skinny is, is great
[21:23] again. And I don't think that is
[21:24] necessarily the best message. And you mentioned, yeah, you've
[21:28] obviously been in the modelling industry where there are
[21:31] undoubtedly these incredible pressures to be skinny.
[21:34] So it would not surprise me if there is quite a lot of GLP, one
[21:40] Ozempic and Manjara use within the modelling industry already
[21:43] and that's again a bit of a concern.
[21:45] Well, I want to get onto that. Actually, I want to get onto the
[21:47] micro dosing in a second because I think this is a huge way.
[21:49] But before we get onto the micro dosing, we've got to talk about
[21:51] the risks because as we just touted, you know, a lot of
[21:54] people are putting longevity onto these drugs.
[21:56] And I'd love to know like what the research is there Like do we
[22:00] really know if they if they have an impact long term or do we
[22:03] know that it's quite short term? But what are the risks first
[22:07] associated with this? Because I think this is maybe
[22:09] what we aren't hearing as much. So some of the immediate, so
[22:14] starting off with the side effects, so some of the side
[22:17] effects appear because of the way it slows down your overall
[22:19] digestive tract. So you've got those immediate
[22:22] side effects that are quite common really actually.
[22:24] So nausea, some people actually vomiting, especially if you
[22:28] continue to eat what you ate before, things like Constipation
[22:32] or diarrhoea, some of these are fairly, fairly common.
[22:36] And then you've got some of these other more dangerous side
[22:40] effects like, and so you've got things like pancreatitis.
[22:44] So that's inflammation of the pancreas, bowel obstructions.
[22:49] So that's a blockage of the bowel because it slows very
[22:52] serious, really down. It's very, yeah, exactly a very
[22:54] serious problem. And things like gold stones as
[22:56] well, some of these things like pancreatitis, they do get a lot
[23:00] of the headlines. Overall the risks are still
[23:04] fairly low, but but it's something to be to be aware of.
[23:09] Well, I think I had a call from somebody that I used to know
[23:12] that worked in the fashion industry and he'd been on
[23:15] Olympic. I don't actually, that's wrong.
[23:17] He might not be in Olympic, but he'd been on a GR P1 and I can't
[23:20] remember which brand it was. So I don't want to demonize the
[23:22] brand be being on a GR P1 drug. And fair to say, he said to me,
[23:27] it's changed my life. I went from chronically obese to
[23:32] now having a healthy weight and it has totally changed the way I
[23:37] see life and how I can move and all of these things.
[23:40] So it had huge benefits, but, and I say with a but he's like,
[23:45] I've lost all my hair from being on this drug and I had no idea
[23:49] that hair loss was a thing. Again, I've had really bad like
[23:52] GI problems. But for him the risks versus the
[23:56] benefits, the benefits outweigh the risks because he actually
[24:00] really, he was somebody who was very much suited to go onto this
[24:03] drug. And we look at it from vanity
[24:05] reasons, I guess on the longevity side, or when people
[24:09] are micro dosing to lose a little bit before the beach
[24:13] holiday comes up, or maybe they feel pressure from their
[24:16] community that they're in. I know the gay community fills
[24:19] us a lot. I think we forget that also, you
[24:22] know, hair loss is a significant thing from a vanity metric and
[24:26] it's not spoken about enough. So when you were interviewing
[24:28] people for this book, did you come across any of these
[24:30] stories? I I did and there are quite a
[24:35] few, yeah, there's, there's quite a few people who do get
[24:39] hair loss and hairdressers are even commenting on it.
[24:42] Some hairdressers say that they can spot the people on the GOP 1
[24:47] weight loss medication is because of that.
[24:49] And part of that is because of this, the fact that you are
[24:52] losing weight more quickly, some of it may also be lack of
[24:57] nutrients. So we do know there's lots of
[24:59] different nutrients that are really important in your hair,
[25:02] things like iron, zinc, some of the B vitamins, they're all
[25:06] really important and protein as well.
[25:09] So there are there is a range of factors there.
[25:13] But yeah, unfortunately that is a is a side effect of the
[25:15] medications. And just back to what you said
[25:19] about the beach body, people get it using it for beach body,
[25:23] getting beach body ready or a wedding.
[25:26] These ultimately they're not cosmetic medications and I don't
[25:29] think they should be used as such.
[25:31] These really are for people who are living with obesity and
[25:33] obesity related diseases really. What's the risks of people that
[25:37] are going on these more that aren't on the the natural
[25:40] selection because I know still here you can get them.
[25:44] I don't know, but I call it black market.
[25:45] You, you wouldn't go to AGP and and get them unless you kind of
[25:49] met the the category of basically what you would, what
[25:52] you'd have to meet at being a certain weight to go on these
[25:55] drugs. But people are still accessing
[25:57] them, whether it's via the dark web or beautician or I don't
[26:01] know what they're getting them from, but people are still
[26:03] getting them and they're still micro dosing.
[26:05] What are the risks associated with those types of people?
[26:08] The risks are are really big. They're really amplified when
[26:12] you're getting it off some unregulated source, for
[26:15] instance, some of. So we kind of just mentioned
[26:19] some of the medications. So there's Ozempic, Ozempic,
[26:22] which is semaglutide, Ninjaro, which is tazepatide.
[26:25] Now there's, there's a third, well, there are other
[26:28] medications coming through, but those.
[26:32] So Ozempic is a single agonist, so it works on one receptor.
[26:35] Then Ninjaro is more effective because it works on 2 receptors.
[26:39] Now there's something called a triple agonist and what that
[26:42] means is works on three receptors.
[26:44] So that is as effective as as bariatric surgery, but it's not
[26:50] yet released this medication. But at the same time, people can
[26:54] still access counterfeit versions, which are often coming
[26:57] from kind of labs in China. And and it's not often the
[27:02] correct version they're made. There's horror stories of people
[27:06] who have been given three times recommended dose things like
[27:10] insulin instead of instead of the medications and they've been
[27:15] hospitalized with their blood sugars dropped really, really
[27:19] low and they, you know, they felt very unwell.
[27:20] And it's life threatening thing. So I think when you're getting
[27:24] it from a unregulated source, that's when the that's when the
[27:27] risks really ramp up. And we're also seeing that
[27:30] happen quite a lot in things like gyms and, and beauticians
[27:35] actually. But it can be, it can be
[27:37] anywhere. So it's it's very important that
[27:39] if if you do make the choice to pursue these weight loss
[27:42] medications and it is a very individual choice, you really
[27:46] should get them for a regulated source.
[27:49] I'm laughing because it actually is a peptide.
[27:52] The GRP 1 is a peptide and there's a lot of conversations
[27:54] on the rise of peptides as well, just on how regulated they are
[27:58] and we don't really know what these long term effects are yet.
[28:01] So what about people that are micro dosing with it?
[28:04] What would you say if anyone's listening to this wanting to
[28:07] micro dose or micro dosing, what is the thing that they really
[28:10] need to know? So with micro dosing, people are
[28:13] doing it for a range of different reasons.
[28:15] You mentioned things like longevity, some people may be
[28:19] micro dosing just at lower level to keep their appetite just
[28:23] slightly reduced and keep that weight off for a longer period
[28:26] of time. But one of the things we really
[28:28] don't know is this the long term effects on people.
[28:32] If you're micro dosing and you are of a healthy BMI, as I
[28:36] mentioned, there's no, there's no long term studies on that.
[28:39] And that's when potentially the risks do start to increase.
[28:41] So, so it's not definitely not something I would be
[28:44] recommending as a doctor because we just don't have the studies
[28:47] to know. I suspect that these medications
[28:51] are linked to longevity, but again, there's not really much
[28:58] evidence on this yet. It would not surprise me if they
[29:01] do improve longevity for certain people, but this is really for
[29:05] those people with those obesity related diseases who are at
[29:09] massive increased risk of, of heart disease.
[29:13] Again, one of the reasons people another reason some people are
[29:17] thinking of micro dosing is that role in inflammation, which they
[29:21] do seem to dampen down. But again, that is far more
[29:25] pronounced in people living with obesity.
[29:27] And we know when you're living with obesity that that slowly
[29:31] burning fire that some people can get when they have obesity
[29:35] and poor metabolic health that can be ramped up.
[29:38] So, so we know when you're living with obesity and you
[29:40] reduce your weight, then that is reduced.
[29:42] So I suspect most of the impact is from just losing weight.
[29:45] Have you found that since you wrote this book on food noise
[29:48] and obviously like, you know, half of this is about the rise
[29:51] of the GRP one medications like Ozempic, Do you feel that you're
[29:55] now more aware online of seeing people talk about this from a
[29:59] point of the miracle cure? Because when I was researching
[30:01] this podcast, I'd go down, I listen to lots of other
[30:04] podcasts, I'll read lots of other books.
[30:05] I want to see where the landscape is like what's what we
[30:08] were talking about right now. And that was just these like big
[30:11] claims from, you know, doctors are being like, it's cured my
[30:14] daughter's PCOS. It's totally changed this part
[30:17] of inflammation. And I think, you know, you, we
[30:21] can look at it as in like, OK, well, actually I'd, I'd much
[30:24] rather not have inflammation or PCOS.
[30:27] So I'm just going to, I'm just going to take it.
[30:28] And it can just feel too good to be true.
[30:31] It's really interesting. So you mentioned, yeah, PCOS, so
[30:34] polycystic ovary syndrome now that that again is quite
[30:37] strongly, not for everyone, but it can be quite strongly linked
[30:41] to being overweight or living with obesity.
[30:44] So then and we do actually know that things like PCOS, it can
[30:50] improve with weight loss. So, so that I don't think as of
[30:54] now that it's studies to directly say GLP ones reduce
[30:56] PCOS, but there is definite reasons to believe that it
[31:00] definitely could improve those things.
[31:02] Because again, with, with people who are living with obesity, who
[31:06] have PCOS in it and may be struggling to get pregnant,
[31:09] sometimes when they lose a bit of weight, they find it much
[31:11] more easy. So there is some evidence to
[31:13] support some of those things. I think seeing as this fits all
[31:17] medication, that's where it's, it's not not clear.
[31:20] And I, I'm, I'm quite sceptical of some of the, the miracle
[31:24] cures that people are suggesting, but there, there are
[31:28] many and diseases that are associated with, with obesity.
[31:32] So like I say, losing that weight can make a big difference
[31:36] for some people, but there are obviously many other routes to
[31:40] that. And, and it's still so important
[31:42] to write have the right nutrition on the lifestyle
[31:44] strategies when you're on these medications.
[31:46] Definitely. What I think what's really
[31:48] interesting is that so in the UK, if you're listening in
[31:52] America, you will have no idea what this means, but there is a
[31:56] famous shop here called Marks and Spencer's that have a food
[31:58] range. They're actually quite known for
[32:00] their adverts around Christmas time and they've they've
[32:04] announced this year in 2026 that they have released a nutrient
[32:08] dense range. So basically you mentioned very
[32:11] earlier that one of the many reasons that we might be in the
[32:15] state that we are today with our obesity is because of our food
[32:17] environment. We're eating on bigger plates,
[32:20] we have bigger portion sizes, there's less nutrient density in
[32:23] our foods, so it's more ultra processed, which is like 2/3 of
[32:27] our shopping baskets. That never seems to blow my
[32:30] mind. That's that.
[32:31] And So what they've done is made the meals smaller, but they've
[32:34] made them more nutrient dense. They're packed with more
[32:36] protein, more fibre, more vegetables to trying to give
[32:40] people a smaller but more kind of nutrient filled meal, which I
[32:46] find really interesting. And they've kind of done this in
[32:48] conjunction with the rise of GLP ones.
[32:51] I mean, I think it's quite good for everybody because it means
[32:53] that we're actually eating more foods that are nutrient dense.
[32:56] But it's so interesting how it's even shaping now certain
[32:59] landscapes and then our food environment.
[33:01] It really is, isn't it? And it definitely is.
[33:03] It's a step in the right direction.
[33:05] Some of these moves and making these nutrient dense meals for
[33:09] instance, like you said, you mentioned kind of protein and
[33:12] fibre having because your appetite is so restricted every
[33:17] bite really does count when you're on these medications,
[33:20] eating those nutritious foods is more important than ever.
[33:23] For instance, eating enough protein to reduce your muscle
[33:25] loss, because again, as we get in that calorie deficit, you're,
[33:31] you are at increased risk of muscle loss.
[33:34] Eating enough fibre I think is also really important because it
[33:36] can also mitigate some of those side effects I mentioned and
[33:41] exactly so reduce your risk of things like Constipation.
[33:44] And it's generally good for our, our gut health and our overall
[33:48] body. And then just making sure you do
[33:51] have all this right range of, of, of nutrients as well,
[33:55] because we are eating these foods a lot of the time that are
[33:59] calorie dense but nutrient poor. So many people living with
[34:04] obesity may also similar simultaneously have a kind of
[34:08] micronutrient deficiency. Yeah, I think that's a big one,
[34:11] right. And I think also it's not just
[34:14] people that are on GLP ones. When I was in studying
[34:17] nutrition, we'd also see this with people that work over
[34:19] consuming processed foods. So they're still gaining the
[34:22] calories, but they were very undernourished.
[34:25] So we had this kind of skew where you're overnourished but
[34:27] undernourished at the same time, which is like a really
[34:29] interesting definition to look at.
[34:32] When you were speaking to people for this, your book Food, Food
[34:35] Noise, and you were kind of going and there's a lot of
[34:37] different case studies in there. What was kind of like your
[34:40] understanding of like speaking to to people who are exploring
[34:43] this, whether they needed the drug or not?
[34:46] Like what were your interactions?
[34:48] It was a mix of people actually. So it was really interesting to
[34:51] see those different range of people.
[34:55] So there were some people who had just really struggled with
[34:58] weight a lot of their lives and were significantly overweight.
[35:03] And, and it was giving them a lot of, yeah, it was giving them
[35:07] some benefits. But there, there also were, were
[35:10] certain people who were kind of of a normal BMI.
[35:14] And, and, and this is where there potentially does need to
[35:17] be more regulation on this because they were just able to
[35:20] send AI can't remember exactly what they did, but some people
[35:24] are sending AI photos or, or photos in strange positions to
[35:29] make themselves or photos of someone else.
[35:31] So it's quite easy to trick the system where I think at the very
[35:34] least there should be a, you know, video consultation or
[35:37] ideally an in person consultation because it's kind
[35:40] of like the Wild West out there of online pharmacies.
[35:42] It is, I think what, what was their emotional connection to
[35:46] all of this when you spoke to them?
[35:47] Because I think that's such a big thing that weight loss is
[35:50] such an emotional topic. You know, whether it's weight
[35:53] gain, weight loss. I felt like I spent a lot of my
[35:57] life growing up around weight. And you know, whenever we do a
[36:01] podcast on Wait, it does really well because I do think it's a
[36:03] pain point for so many people, but it's also so emotional.
[36:07] So like emotionally, how were these people with you?
[36:10] Like, were they relieved? Did they feel overwhelmed?
[36:14] Like what was your landscape understanding that with them?
[36:17] Well, I completely agree that it is such an emotional issue for
[36:20] many people and kind of understandably with the, with
[36:24] the stigma we kind of have in society around obesity, which is
[36:28] a real, which is a real problem. But the one of the things they
[36:32] definitely did notice is this reduction in, in food noise.
[36:38] So and. Talk to me about that, like what
[36:43] is Food Noise? Because that is the title of the
[36:45] book. I do have to say you will not
[36:46] know this. When we were looking for the
[36:48] title of my book, yours came up and I was like, I want that
[36:50] title. Yeah, and I'm quite happy with
[36:53] the title. Like it's a genius thank.
[36:57] You So food noise is your cravings.
[37:00] It's for some people that incessant chatter about food.
[37:03] Some people wake up thinking about food.
[37:05] They may be planning food whilst they're currently eating.
[37:08] For some people, it may just pop up as a craving during the day,
[37:12] you know, in that afternoon slump or, or when they're
[37:14] stressed, tired or bored. And emotions play a massive role
[37:18] in not just how we think about our, our weight, but also how we
[37:22] think about food. And actually, they do drive us
[37:25] to eat these sugary, salty snacks as well.
[37:28] So one of the ways these weight loss medications, I like to
[37:32] think of them is they're like noise cancelling headphones.
[37:36] So you put them on, you put them on, you can go about your day,
[37:41] you're less tempted by these sugary snacks.
[37:44] But when you take them off again, that food noise does come
[37:47] rushing back with a vengeance. So for some people it can create
[37:51] this opportunity to try and build in the sustainable habits
[37:55] and eating patterns and lifestyle changes without that
[38:00] distraction of food noise. But clearly when you stop the
[38:03] medications, there is an issue that that that food noise comes
[38:06] back. I'm interrupting for one moment
[38:09] to ask one small favour. Please subscribe to the show.
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[38:20] But you know, my goal was 100,000 to get to on YouTube and
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[38:32] Do you think that GPS or physicians or whoever is
[38:37] prescribing this is giving those lifestyle interventions?
[38:41] Because I think that's been the biggest conversation that I've
[38:44] seen going on right now with GLP ones is, yes, it's producing
[38:49] rapid weight loss, but it has to be administered with lifestyle
[38:54] interventions such as high protein, such as weight training
[38:58] to keep your muscles intact, which is the one thing that we
[39:00] keep talking about. Like all of these making sure
[39:02] that the nutrient density is in check.
[39:06] But like, are people doing that or are people being told that,
[39:09] or are people kind of being left on their own devices to figure
[39:12] it out? Again, it is it is a mix, but on
[39:14] the whole it's a kind of a bit of an afterthought to be honest.
[39:17] These lifestyle changes and I think it should be at the
[39:21] forefront of everything you do around these weight loss
[39:23] medications, making sure you are eating these nutrient dense
[39:26] foods with plenty of you know, protein, fibre, healthy fats,
[39:31] vitamins, minerals. We know the Mediterranean style
[39:33] diet is one of the best studied and is the one of the ultimate
[39:39] health bullets and doing these extra things like basic strength
[39:43] training is is so important so that you do preserve that muscle
[39:48] loss and even do it looking at it in a more kind of more
[39:51] holistic way. We kind of mentioned how stress
[39:53] and emotions play such a big role.
[39:55] So addressing some of those things and doing even things
[39:58] like mindfulness and, and looking at reasons why you are
[40:02] eating certain things. I think that's all really
[40:06] important whilst you're on these weight loss medications.
[40:09] And I don't think the online pharmacies are necessarily doing
[40:13] a great job at that because they're.
[40:15] Their key goal is just to really ship off as much of this product
[40:19] as possible, I think. Well, I don't know if you saw
[40:22] this, and this is no kind of force against GPS, obviously,
[40:25] but the BBC reported the GP practices would receive bonuses
[40:29] prescribing weight loss injections eligible to patients
[40:32] this year and next year of up to 3000 lbs.
[40:35] I think people hear that they might feel uncomfortable.
[40:39] Like, how do we think about that?
[40:40] It's quite an interesting thing that I, I, I had, I read that as
[40:45] well. And I, I don't know where to
[40:50] begin with that because firstly, these weight loss medications, I
[40:55] think they could be very beneficial as I've talked about.
[40:58] But even at the moment, the way it's rolled out on the NHS is
[41:02] going to be very, very slow. So, so they are still only
[41:05] actually available for a very, very small number of people on
[41:08] the NHS and those are typically people who are living with
[41:11] really severe obesity and kind of four or five obesity related
[41:14] diseases. And, and it will be a kind of
[41:18] slow roll out over 10 years. I'm not sure how that is going
[41:21] to impact things. And maybe that does give the
[41:23] wrong motivation. Many GPS will be happy to
[41:26] prescribe it and they already are for things like type 2
[41:28] diabetes. Lots of GPS are very happy to
[41:31] prescribe it for that because it does make a big difference
[41:33] there. But we still don't so many of
[41:38] these trusts around the country, they don't have that wrap around
[41:41] service in in place yet. And because it is this new
[41:44] medication and because the extra funding has not really been
[41:48] provided for all of that as well alongside it.
[41:50] So it's a it's a difficult one now.
[41:53] For the people that are listening to this and they're
[41:56] like, OK, I'm understanding it. He's mentioned it in there
[41:59] really interesting called food noise.
[42:01] And I love the sound of putting noise cancelling headphones on
[42:04] and just not being able to have the interruptions of day-to-day
[42:07] and feel like I can just go through without the drug.
[42:11] How come we approach this food environment?
[42:13] Because the amount of messages that I get on, you know, binge
[42:17] eating and intense cravings and all of the different things
[42:21] that, you know, food is so nostalgic and it can really help
[42:25] heal the pain for certain people.
[42:27] Like how can people navigate that without taking GRP ones?
[42:31] Well, there are there are so many temptations everywhere.
[42:35] So I think the first thing would be when you are going on these
[42:40] weight loss journeys, really to kind of prepare like you go for
[42:44] an expedition trying to control that food environment.
[42:47] You can control and try to fill your covers with like nutritious
[42:51] foods and, and reducing some of those kind of processed junk
[42:55] foods. Really, I think planning your
[42:57] meals ahead of time is really, really important.
[43:00] What I mean by that is you can go shopping on a Sunday so you
[43:03] don't revert to those default patterns and you know, planning
[43:08] even making your lunches for the day.
[43:09] So you don't just go to whatever fast food place there is around
[43:13] the corner. I've kind of mentioned about
[43:15] helping control your stress and that can be through exercise,
[43:18] things like meditation as well. I'd say fourthly, making sure
[43:24] you are eating these really filling foods that do have
[43:27] protein, healthy fats and fibre. And I think, I think another
[43:32] like what one thing some people do use is something called urge
[43:37] surfing. So it can be quite an effective
[43:41] technique for some people. So the thing with cravings is
[43:45] often they like a wave, they they peak and then they pass.
[43:49] It's, it's different to physical hunger, which slowly builds over
[43:52] time. So First off, naming what you
[43:56] are feeling and that often is a craving, noticing how it feels
[44:02] in your body. And then, and then one thing
[44:06] some people do is, you know, they, they do a couple of
[44:09] minutes of deep, deep breathing or they take themselves off for
[44:13] a walk or, or listen to some music or read a book or that
[44:16] sort of thing. And just and they will often
[44:18] notice that those cravings do do pass over time.
[44:21] Yeah, I think it's about activating the self soothing
[44:24] system because I think that's what food does, right?
[44:26] It activates something where you start to feel safe and it's an
[44:29] immediate effect of feeling safe.
[44:31] And then all of a sudden that's that feeling goes again because
[44:34] that kind of hit that you had is now has now gone.
[44:37] And then that's when the feelings of shame creep in.
[44:41] And so, you know, creating some type I, I talk a lot about self
[44:45] compassion on the show because I really believe it's missing from
[44:47] so much. And, you know, really crap foods
[44:51] can make us feel really shit about ourselves.
[44:54] You know, that's what the chance that they can have.
[44:56] They can unbalance our chemicals and make our, you know, our
[45:00] glucose go crazy and make us feel heavy and all of those
[45:03] things. And so I think, you know,
[45:05] actually trying to build some self compassion in yourself is
[45:09] really important during this time too.
[45:11] I think, I think it's completely vital really, because we're even
[45:14] looking at the studies when you associate, say you've been to a
[45:19] party and you're eating a cake. If you associate that cake with
[45:21] guilt, then it actually has been shown to lead to further weight
[45:25] gain because you, you know, you punish yourself really.
[45:28] And then you go, oh, well, what's the, what's the point?
[45:30] And then you, you may get in these vicious cycles of
[45:33] overeating. So I think just going easy on
[45:35] yourself and saying, oh, I'm, I'm moving in the right
[45:38] direction overall, having a little bit of cake here and
[45:41] there, that's not going to harm my overall process progress that
[45:45] I've made. So I think it's, yeah, it's so
[45:47] important. It's so important and even the
[45:49] people that are stuck in, you know, binge eating cycles to
[45:52] give yourself a bit of a break is really important because you
[45:54] kind of can't undo what's already been done.
[45:57] So it's about like what is the next step forward?
[45:59] That's a way that I always try to speak to to clients that kind
[46:03] of come and see me on like, what's the next best step that
[46:06] would be correct right now? Like what advice would you give
[46:09] to me? That's always quite helpful
[46:12] because we can quite, we can offer advice quite freely to
[46:13] others. It's quite easy.
[46:15] Offering it to ourselves is is pretty hard.
[46:18] No, exactly. I think being your your inner
[46:21] coach rather than the inner inner critic, which we are all
[46:24] our inner critic. But would you treat a friend
[46:26] like that? No, you probably wouldn't.
[46:28] You would say you would be reassuring and you would say
[46:30] don't worry about it. But but that's not often what we
[46:33] do to ourselves, is it so? It's true.
[46:35] I kind of think if we speak to ourselves, I speak to our
[46:38] friends. We wouldn't have any friends.
[46:39] No, exactly. It's so, and everyone's just
[46:42] living this internal monologue, like, oh, why can't you do this?
[46:45] You're useless. And like, yeah, it's it's not,
[46:48] unfortunately. It's not like beneficial in the
[46:51] long term. And yeah, like you say, you
[46:52] would be pretty lonely if you spoke to everyone else.
[46:56] Exactly. So I'm thinking about, you know,
[46:58] how long are these people? Because This is why it's coming
[47:01] into my brain. How long are these people on
[47:02] these drugs? Typically for 10 months.
[47:06] Well, it's a, it's a real range and they're definitely not a
[47:10] short term medication. We've mentioned they're not for
[47:14] to get beach body ready. They what we do find is so the
[47:21] studies at least show after a year half of people have stopped
[47:24] the weight loss medications. And this could be for a range of
[47:27] factors and including the kind of quite high price that a lot
[47:30] of people are paying at the moment.
[47:31] Because how much they're like 2500 a month or something.
[47:35] In the US, they are a lot, a lot more than. 4 1/2.
[47:38] So, so, yeah, no, so they're similar like around that.
[47:41] So they, they have come down actually quite considerably.
[47:44] So when they first came out, they were up to 2000 a month
[47:47] exactly. Now they are coming right down
[47:49] even in the US and in the UK you're kind of looking at maybe
[47:52] £200 a month. OK, well.
[47:55] That has dropped. That still is, you know, that's
[47:57] an expensive amount of someone's daily, so monthly costs.
[48:03] So, so some people are coming off them because of how
[48:07] expensive all sorts of things, how expensive they are.
[48:09] Some of the side effects and, and the problem, the problem
[48:12] with this is that as we've mentioned, when you stop these
[48:16] weight loss medications, that that weight regain is actually
[48:19] much more rapid than if you were doing what's a kind of a
[48:23] conventional, what you call as a conventional diet without weight
[48:26] loss medications. So.
[48:27] How quickly so say people go on it for 10 months, a year, year
[48:30] and a half, How quickly are people regaining the weights?
[48:34] They are regaining the rate quite rapidly actually.
[48:38] So with this new generation you may have lost 15% of your body
[48:42] weight, but within around 20 months typically on the studies
[48:47] you have regained it all. And this is around 4 to up to 8
[48:52] times faster than than the weight regain you would see
[48:55] after a a diet where you're not taking the weight loss
[48:58] medication. So it's much more rapid.
[49:01] The other thing is those cardio metabolic markers which come
[49:05] down when you take the weight loss medications, when you lose
[49:08] that weight. So your blood pressure, you
[49:10] know, your cholesterol, your blood sugars, all of these again
[49:13] return to that baseline after around 1 1/2 years, so around 20
[49:17] months again. So, so they do return and there
[49:20] is a concern, especially if you're taking them, say if
[49:22] you're taking them later in life.
[49:24] And this is where things are like thinking about your muscle
[49:27] is so important when you're taking it later in life.
[49:30] We've already lost a lot of muscle when you by the time you
[49:32] hit your 70s, if you're then losing muscle, you might regain
[49:35] some of that fat if you stop the weight loss medications.
[49:38] So it's so important to think of your muscle and do some of these
[49:42] things that can improve it. Yeah, that's really important.
[49:44] OK, so that's So what percent to help?
[49:47] What did you say? What was the percentage of
[49:48] people that regain their weight? So it's something like the
[49:53] actual number of people who regain their weight.
[49:55] So on average, people will regain all that weight after
[49:58] about 20 months. But.
[49:59] All of the people. But not all of the people.
[50:01] So when you actually break it down, it's something like 80% of
[50:05] of people will will regain their weight.
[50:08] So on average everyone has but but there is there is some 2025%
[50:13] of people who haven't. Yeah, I think it's actually a
[50:16] little bit less. It's around 20%, and many of
[50:19] these people are people who have also made these significant
[50:22] lifestyle changes as well and really focused on improving
[50:27] their nutrition, improving the exercise, all these kind of
[50:30] things we've talked about. Wow, OK, so if it's interesting,
[50:33] right, we started off with, you know, how rapid and life
[50:36] changing this can be. But then within 20 months with
[50:39] 80% of people are regaining back the weight and regaining back,
[50:44] you know, the the factors that lead to chronic disease like
[50:48] your blood pressure, your cholesterol, all of those
[50:50] things. It kind of just feels like a
[50:53] little bit like a plaster. Yeah.
[50:55] So that's what it exactly that that's what it has been
[50:59] described as or a Band-Aid for. Yeah, yeah.
[51:03] Thank you for making sure my American audience knows what a
[51:05] plaster is. It's like when I say the word.
[51:07] Napkin they probably. They.
[51:08] Probably know what plaster is, to be fair.
[51:11] Yeah. But yeah, it is it has been
[51:15] described by some people as this, this plaster, a pretty
[51:18] effective plaster to be fair. But again, when that plaster
[51:23] comes off sometimes, well, quite a lot of the time you can get
[51:27] that rebound in your in your weight and you can regain that
[51:29] weight. So that that is that is an
[51:32] issue. So how do people sustain their
[51:36] way? Like, how does one stop to say,
[51:38] well, like, it would be honest for you and now we're going to
[51:40] stop. We're going to come off it.
[51:42] What does one do? There are there are definitely
[51:45] different options of of what people do there is.
[51:51] So I think when you're on these weight loss medications, I
[51:53] mentioned the Mediterranean style diet that is the ultimate
[51:57] health bullet and it does help keep off that that weight.
[52:03] So that's like lots of whole grains, good protein, tons of
[52:06] olive oil, legumes, beans, all of that type of stuff.
[52:10] That's it. Nut seeds, oily fish.
[52:13] Yeah, like you say, lots of olive oil, which is.
[52:17] Yeah. So it's not a low fat diet and
[52:19] it's kind of dispelled the myth of it just has to be low fat,
[52:23] actually. And this was compared to to a
[52:27] lower fat diet which had kind of starchy carbs.
[52:29] And they found with all of these good, good ingredients and these
[52:32] complex carbs, that's what's important.
[52:34] The things like the whole grains and the beans, it was associated
[52:38] with much lower risk of heart disease, all of these things.
[52:42] So that's, that's one thing you can do.
[52:44] My dad's, he popularised the the 52 diets.
[52:49] How? Many years ago was that.
[52:50] Now that was back in 2012, so long time ago, 14 years ago, and
[52:55] that was really when lifestyle medicine was in its infancy.
[52:59] So the concept of that is five days a week you eat normally,
[53:05] then two days a week you, you really cut your calories down to
[53:08] between 800 calories and 1000 calories.
[53:11] And he was able to lose, he was, he was pre diabetic and he had
[53:16] kind of gradually put on weight as lots of, many people do as he
[53:19] approached middle age. And he was, he was approached
[53:21] the diabetic range and he managed to lose 9 kilos and kind
[53:25] of keep that off for the long term doing that.
[53:28] And there's actually a really interesting recent meta
[53:31] analysis. So that's pooling over 20
[53:33] studies together that found it was significantly more effective
[53:36] than the kind of traditional diet at reducing body weight and
[53:40] some of these cardio metabolic markers too.
[53:42] So that was really interesting and.
[53:44] What the 52 diet the. 52 diet was so one yeah, that could be
[53:49] an option for even, you know, throwing in a few fast days here
[53:52] and there to kind of keep that weight off for, for the longer
[53:55] term. And he, he set up with my mum
[53:59] the the fast 800. So that was this digital
[54:02] lifestyle program that really helped support people with
[54:05] eating their, you know, following these healthy habits
[54:09] and cooking the right sort of foods that are really beneficial
[54:13] to keep that weight off with lots of filling nutrition, as
[54:15] well as kind of guided exercises and guided meditation.
[54:19] And it's a kind of really holistic approach.
[54:22] So I think in general a digital lifestyle program, whatever that
[54:26] is, I think it because, you know, we do have limited
[54:30] resources. I think it is a, it's been shown
[54:32] to be a valid option to do it. I mean whether it is the Fast
[54:35] 800 or whatever else you want to use that that works for you.
[54:40] I think in general, that is a very with, you know, limited
[54:45] budget, limited money, this is a really, really beneficial way to
[54:49] do it. Well, I, I think one of the
[54:51] reasons some people find it really helpful things like the
[54:53] five two is, is because, you know, it's not like this kind of
[54:59] permanent calorie restriction. And with many people are on this
[55:02] kind of living this life of this kind of permanent calorie
[55:05] restriction. I can't have that.
[55:06] I can't have this. So they can kind of eat a bit
[55:07] more normally on the other days. So it gives some people a bit
[55:11] more control and it, you know, it also makes you think about
[55:15] what foods are filling. So you kind of fill your your
[55:19] food with some of these more, more filling, yeah, more filling
[55:22] foods. What would be some examples that
[55:23] you would give on the lower calories for people to get their
[55:26] head around? What are those foods that you
[55:28] could have in the day? What I would say is things like,
[55:33] yeah, so having, having enough, having enough protein.
[55:36] So things like, yeah, chicken with chickpeas and a bit of
[55:40] garlic and lots of, yeah, lots of beans I think is really
[55:46] important because that has plenty of protein and, and
[55:49] fibre. So if you're a veggie, having a
[55:51] kind of bit more of a veggie, veggie chili and yeah, just
[55:57] eating things like, you know, oily fish, all of these sorts of
[56:04] things can make a big, big difference actually.
[56:07] And they contain all of these, yeah, protein, but healthy fats
[56:10] as well. And we do know, yeah, quite a
[56:16] lot of these areas where people live a lot longer, that is in
[56:19] areas like the Mediterranean where they do eat more of this
[56:23] sort of diet, whereas in the UK, not so much.
[56:26] Yeah. Do you worry about the kind of
[56:28] male nutrition if it's on the 800 calories a day or not?
[56:31] Do you worry more about like the nutrient density that you're
[56:34] talking about or do you think that doesn't affect it if you're
[56:37] really being aware of the calories that you're eating?
[56:40] So once again, it's so that's why it's so important to kind of
[56:44] make every every bite count in these circumstances.
[56:48] So, you know, eating these kind of really nutrient dense foods
[56:52] is so important. Yeah.
[56:54] So I guess if people are looking at that, I'm trying to get
[56:56] people to get their head around what that looks like.
[56:58] So would that mean that they would be skipping a meal
[57:01] potentially? Not necessarily.
[57:03] Sometimes it might just be slightly smaller meals.
[57:06] And yeah, so it's not necessarily about skipping
[57:09] meals, but having like slightly smaller meals on those days.
[57:14] Some people might be, you know, skipping certain meals.
[57:17] But on the whole, it's it's just about eating those kind of
[57:20] filling, nutrient, nutrient dense foods.
[57:23] Yeah, and in smaller portions, I guess.
[57:25] Yes. No, exactly.
[57:26] Yeah. And so do you see a lot of
[57:27] people come to the program from GLP One Drugs?
[57:31] There, there is, yeah, there are lots of people who are who are
[57:34] doing that. And I think it just does provide
[57:38] that extra support really for for a lot of people.
[57:42] And I think it is just so important to have that extra
[57:45] nutritional support, whatever it is.
[57:48] And I think also in my in my book Food Noise, I kind of talk
[57:52] about some of these nutritional strategies.
[57:54] But yeah, whether whatever that extra support is, I think it's
[57:58] so important to make sure you are very, you know, well
[58:00] informed on the right nutritional and, and lifestyle
[58:04] strategies and ingrain some of those habits for for the long
[58:08] term. Yeah, I guess I think it's so
[58:11] important to just understand the landscape of food because.
[58:14] Yeah. I don't know, do I say this?
[58:17] Maybe I should say this. I don't know if I fully agree
[58:19] with it, but I think exercise is important for your mental health
[58:22] and your muscles and your longevity, but it's not as
[58:26] effective as weight loss as looking at the food itself.
[58:28] And so there's a very famous slogan that you can't outrun a
[58:30] bad diets, which, you know, can be seen either side.
[58:34] But I do think that like understanding the food landscape
[58:38] is really important when it comes to weight loss, like
[58:42] understanding. And I think a lot of people
[58:43] might think what if I go for a run, I can kind of out balance,
[58:47] but actually understanding the ratios of the foods that you're
[58:50] having is really key. Yeah.
[58:51] And exercise is just so vital for your overall health, whereas
[58:57] as you mentioned, you can't outrun a bad diet unfortunately.
[59:01] So you can't go eating loads of extra cookies really, if, if
[59:06] you're doing a bit more exercise.
[59:09] But we're now learning exercise and strength training.
[59:12] It's good for not just your heart health, you know, your
[59:15] bones, but also your, your brain health too.
[59:18] Is some of these exercises for instance, especially some of
[59:24] these muscle building exercises, for instance squats, they
[59:28] release so-called BDNF, which is brain derived neurotrophic
[59:33] factor. So this is like fertilizer for
[59:35] your brain. And we do know now, and many
[59:38] people obviously will feel that after doing exercise that they
[59:40] may have a bit more energy, they may have better concentration.
[59:44] But we do know actually the science shows that it even can
[59:47] grow different parts of our brain.
[59:48] If you started from a very sedentary lifestyle and even
[59:53] start walking, for instance, then areas of our brain actually
[59:56] do can grow over time. So, so we know just, it is so
[1:00:01] important to ingrain these things in and just make, make
[1:00:05] these. And it can for, especially for
[1:00:08] things like exercise, it can be very simple changes.
[1:00:11] So for instance, get out of bed and do 5 body weight squats if
[1:00:15] you're really like, you know, starting from a lower, lower
[1:00:17] base and you haven't done much. Because there's a lot you can
[1:00:20] really do from home as well. And I think, you know, gyms are
[1:00:23] intimidating for a lot of people.
[1:00:25] Yeah, but we don't want people to be intimidated by gyms.
[1:00:27] No, no. We want people to be able to
[1:00:29] walk in there, pick up the big weights and be like, move out
[1:00:32] the way. Exactly.
[1:00:34] They've got to shut their stuff. Yeah, I think it's important.
[1:00:36] I think I used to be that person that was terrified of the gym,
[1:00:38] and then I got Doctor Stacey Sims on and she'd totally get
[1:00:41] back out of my head. And she was like, don't you pick
[1:00:44] up those pink dumbbells, Go to the proper one.
[1:00:47] And it's changed my relationship to it.
[1:00:49] I think it's important. So if someone is wanting to
[1:00:53] improve their metabolic health in the next three months, what
[1:00:58] are the practical steps you're going to give to somebody?
[1:01:00] What I would say is I think it does depend kind of what what
[1:01:07] base they're kind of coming from.
[1:01:08] So there there is a lot of way different ways to lose weight
[1:01:11] and you know, GOP ones for some people might be an option for
[1:01:15] some people living with obesity. We also know, and it's not not
[1:01:19] for everyone, but rapid, rapid weight loss via kind of a bit of
[1:01:21] a lower calorie diet. We know that the weight you
[1:01:26] actually lose in the 1st 10 weeks or so of the of your
[1:01:30] weight loss journey can predict your longer term weight.
[1:01:35] But things like incorporating activity into your routine is so
[1:01:41] important. So things and even thinking
[1:01:44] about simple things like instead of instead of getting the train,
[1:01:48] the tube driving to work, thinking about cycling to work
[1:01:52] do. You want to know a good one that
[1:01:53] my friend did. This is one that has never
[1:01:56] ceased to amaze me and I think I wish I did this, but I don't
[1:01:59] have the space for it in my kitchen.
[1:02:01] But they had cups and he was all about mobility.
[1:02:04] He was very into calisthetics. You know, where you like, hold
[1:02:06] yourself on a bar and you can do all these crazy things.
[1:02:10] He was like, you really want to be mobile, so he would put his
[1:02:13] cups at the bottom of the kitchen so we'd have to bend and
[1:02:17] squat. Every.
[1:02:18] Time to get there. And he was like, yeah, every
[1:02:21] time I had to make like a cup of tea, I would bend, pick up my
[1:02:24] cuff. And I was like, that's actually
[1:02:26] such a good point. I should do that.
[1:02:28] I never did it. But like, making things in your
[1:02:31] household, you know, they're like, that's what I think about
[1:02:34] with people in Japan, how mobile they are.
[1:02:36] They all sit on the floor and they're all kneeling.
[1:02:39] And my friend went to Japan recently and she was like, it
[1:02:42] was great. But my gosh, I had to constantly
[1:02:45] keep kneeling down to eat food because there's no furniture.
[1:02:48] But they maintain this type of mobility.
[1:02:51] I think this form of like habit stacking like you mentioned is
[1:02:54] so is so vital. So pairing you having you're
[1:02:59] putting the kettle on and pairing it with an activity.
[1:03:01] So that could just be a few squats in your in your kitchen.
[1:03:05] It could be stretching. To be honest, I'm quite, I'm
[1:03:10] quite inflexible. I'm quite tall, but I, so I've
[1:03:14] actually started, I have actually started doing some yoga
[1:03:17] recently to kind of help with that flexibility.
[1:03:19] And, and I was told by the, the instructor, so when I'm putting
[1:03:24] on a cup, when I, when I'm putting on the kettle to, to
[1:03:28] just sit down in the kitchen and, and bend over and touch
[1:03:30] your touch my toes exactly to get that, that flexible movement
[1:03:35] or whatever. Exactly.
[1:03:36] My, my hinge is I, I'm flexible in some ways, but my hinge is
[1:03:40] just terrible. So I have started doing that.
[1:03:44] But even you can pair things like you're brushing your teeth,
[1:03:47] you're going to do that anyway. You've ingrained the habit.
[1:03:49] So you can pair that with after I brush my teeth, I, I meditate
[1:03:53] for 5 minutes. And these simple changes can
[1:03:55] make a huge difference. And they can help with your
[1:03:58] overall health for sure. Yeah, I think it's the key.
[1:04:01] I've started to do mindfulness when I brush my teeth because
[1:04:04] normally I'm scrolling or like trying to reply to Whatsapps.
[1:04:08] But actually if you're meant to be brushing for two minutes,
[1:04:11] which I'm not sure if everyone listening to this is, but if you
[1:04:14] do, it's actually really good space because you're like, you
[1:04:16] can't, you're not meant to be doing anything else.
[1:04:18] So I try and feel the sensations when I'm brushing my teeth and,
[1:04:23] and I think, you know, it's like mindfulness is like going to the
[1:04:27] gym for your brain, similar to how you brush your teeth.
[1:04:30] So that's how I try to make that connection.
[1:04:32] No, that's a really good idea. I'll I'll try that out.
[1:04:34] Give that one a go. My dad's kind of famously
[1:04:36] suggested standing on one leg while you're brushing your teeth
[1:04:39] to improve your balance. So just a couple of minutes of.
[1:04:42] Yeah, balance is a predictor of. Longevity, it is exactly.
[1:04:45] So yeah, within longevity health, there's even within
[1:04:50] exercise, there's quite a lot of different, unfortunately
[1:04:51] different things to think about that it can keep things
[1:04:54] interesting at least. So you're doing, you know,
[1:04:57] you're doing your walking, you're doing your, your cardio,
[1:04:59] maybe a bit of stroke training and then maybe you're doing a
[1:05:02] bit of balance exercises as well.
[1:05:03] So yeah, just trying to try to incorporate that to make it easy
[1:05:10] like like your friend did with the the stretching and.
[1:05:13] Isn't that amazing with the cops?
[1:05:15] Yeah. I mean, he's so flexible that it
[1:05:17] did make me want to start. It's such an interesting
[1:05:20] landscape that we are finding ourselves in.
[1:05:23] I find GRP ones one of the most fascinating medical moments that
[1:05:30] I've ever obviously lived through, that many of us have
[1:05:31] ever lived through. I, you know, you wrote in your
[1:05:34] book that it's going to reach $100 billion by 2030, which is
[1:05:39] wild. Like it's such an exploding
[1:05:42] industry. I look forward to seeing the
[1:05:44] update of your book coming. But Jack, it leaves me with my
[1:05:48] final question, which is what does live well be well mean to
[1:05:52] you? It's yes, it's, it's not about,
[1:05:55] we've talked a lot about, about weight here, but you know, it's
[1:05:57] not about how much you weigh the numbers on the scale at all.
[1:06:00] It's about your overall health, your, your, your well-being, you
[1:06:04] know, your, the quality of your life and that a lot of that can
[1:06:07] come from your, your social relationships are so important.
[1:06:12] Keeping up with friends, loved ones, your family, you know,
[1:06:16] doing all these extra things like things like mindfulness,
[1:06:20] exercise and eating well, all of these things can be so important
[1:06:23] for your overall, overall well-being.
[1:06:26] So I think weight weight is by far is not the only thing we
[1:06:32] need to think about. Well, yeah, I definitely think
[1:06:34] it's not. The thing is on everyone's eyes
[1:06:36] and ears and front pages. But it's true.
[1:06:38] I think such a personal topic as well, isn't it?
[1:06:43] Such a personal, But thank you coming on, spreading your
[1:06:44] knowledge about GLP ones and the food noise and you know your
[1:06:49] Fast 800 programme. We'll pop it all in the show
[1:06:52] notes so people can go and check it out if they want to.
[1:06:56] But thanks so much for coming on.
[1:06:57] No voice. Thank you so much.

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