Johann Hari: Uncovering if Ozempic is a Miracle Drug or Health Hazard & 3 Things They Do Not Want To Tell About Ozempic

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time and I can't believe he's finally, finally here. And this new book is one of the ones that I really hope that you take the time to read, because I promise you you, your friend, a family member is having to deal with the challenges that come with this theme and concept in their daily, weekly, and monthly life. Today's guest is none other than Joan Hari. His new book is called The Magic Pill The Extraordinary Benefits and Disturbing Risks of the new weight loss Drugs, and I can't

wait to dive into it with them. If you don't have a copy of the book already, make sure you go and grab one. We'll put the link in the comments and caption below. Please welcome to On Purpose. Johann Hiri Johanne, thank you for being here.

their life, which is so hard hard to do. So thank you so much for all the work that you do and the experiments you do on yourself.

What do you mean? Right? So, I'm very conscious that, you know, we sound like weird refugees from downtown Abbey. I'm going to try and americanize slightly.

the world was opening up again. And I got invited to a party for the first time and god knows how long, and I decided to go, and I was in an uber on the way there, and the party was thrown by an Oscar winning actor I think someone you know actually, And I'm not saying that just a name drop. It's relevant to what I had the next And on the way there, I was feeling gained quite a lot of weight during Lockdown. I was feeling kind

of schlubby. I was quite fat start a lockdown, I was fatter then and I and I was thinking, Oh, this is gonna be awkward. And then I suddenly realized that kind of everyone I knew had gained some weight during Lockdown, and I thought, oh, this is going to be fascinating to see all these Hollywood stars with a bit of chub on them. Right, And I arrived and I started walking around, and it wasn't just that no

one had gained weight. Everyone was gaunt, right. Everyone looked at their own Snapchat filter them they were like clearer

and cleaner and sharper. And I was kind of wandering around a bit of a daze, and I bumped into a friend of mine on the dance floor and I said to her, WHOA, looks like everyone really did take up pilazas during lockdown, And she laughed, like, you just said, I must have looked puzzled, and she said, well, you know it's not Pilata's right, And I had no I did what she was talking about, and she pulled up on her phone and a zenpic pen And that was

when I learned. I guess in the next couple of days, that we now have a new formal weight loss drug that works in a completely new way that causes the average person who uses it to lose fifteen percent of their body weight. In fact, with Munjiro, the next in this class of drugs, you lose twenty one percent of your body weight. And for the next, which will be available next year, Triple G, you lose twenty four percent

of your body weight on average. And I remember, as soon as I heard that, just feeling this tremendous division in my own mind between. On the one hand, I could obviously see the benefits. I'm older now than my grandfather ever got to be. He died when he was forty four of her heart attack. Loads of the men in my family get heart problems. My dad had terrible heart problems. My uncle died of a heart attack. My

other uncle had a heart attack that survived it. And I knew that Sadly, the evident scientific evidence is very clear that obesity makes it much more likely you'll have heart problems along with many other medical problems. So I thought, Okay, if there's a drug that can reverse or really reduce obesity, that could have really big health benefits. I also thought,

wait a minute, wait a minute, I've seen this story before. Right, Every twenty years or so, a new miracle weight loss drug is announced, We're told it's going to save us, all loads of people take it. They always discover it has some horrendous side effect that you know, means it has to be pulled from the market, leaving a wave of terribly damaged people in its way. So I thought, are we going to see that again? I also thought, what about the progress we've made with body positivity, what

about the what about people with eating disorders? There were just so many doubts that came into my mind. So to really get to the bottom of this, I ended up going on this big journey all over the world, from Iceland to Minneapolis to Okinawa in the south of Japan to interview the leading experts in the world on it. The biggest defenders of the drugs, the people who made the breakthroughs that made them possible. The biggest critics of the drugs, and I learned a huge amount about the

extraordinary benefits of these drugs. The disturbing risks of these drugs is twelve quite disturbing risks. How it's going to try transform the culture in all sorts of ways that even people who don't want to take these drugs, it's going to change the world around you in really fascinating ways. But at the end of all that, it's a slightly

weird feeling. I still feel quite conflicted about it. So I guess the misconception is that we should be so sure, right, this is complicated, and we have to think through the complexity.

ruin your life. What did you discover about people's binary types of thinking through the research of this drug.

other things. And now, you know, to do the book. I've been taking a zempic for a year. There's been lots of ups and downs, but you know, now that problem has largely gone away. I've lost an enormous amount of weight forty two pounds. But also I've lost these a lot of these destructive habits. So you know, it could be magic in the sense of just like WHOA, the problem solved. The second way it could be magic, and I think this is a real possibility, is it

could be like a magic trick. It could be like, you know, the conjurer who shows you a card trick while secretly picking your pocket. It could be that, in addition to giving you these benefits, the risks, and there are really significant risks here, are so substantial that they undo the good. I don't rule that out. In fact, I think it's a significant possibility. But the third way is actually the most likely, and I think it's the one that gets us out of that kind of binary thinking.

And it's the think about the stories of magic that we grew up with as kids. Right, think about it, I'll add in, Right, you find the lamp, you rub it, the genie appears, and he grants your wishes, and your wish comes true, but never quite in the way you expected. Right, You get what you wanted, but always at some weird right angle that you never anticipated. And we're already seeing that with these drugs. You've got to get out the

binary good or bad to think about that. But you know, Barclay's Bank commissioned a really interesting, sober minded financial analyst called Emily Field to just look at these drugs to figure out, Okay, what's this going to mean for our investment decisions going forward? What should be investing in, what should be not investing in as she came back and said, if you want a comparison for the effect of these drugs,

you've got to look at the invention of the smartphone. Right. So, if you and me had been speaking in whatever it was two thousand and seven when Steve Job's On veiled the iPhone, we would not have been able to game out, you know, door tod ash and TikTok and all these things that have transformed our lives that flowed from that. I think we're already beginning to see outside that kind of narrow binary, such an array of things that happening as a result of these forty seven percent of Americans

want to take these drugs. They are going to change all our lives for better and for worse in a way that I think we need to take a moment, as this extraordinary transformation happens all around us, to really think through the benefits, the risks, and what it's going to mean for all of us and what we should do about it. Now.

I was born, nineteen seventy nine. Just take a look at them. Right. If you look at them, they seem really weird to us, because almost everyone is what we would call skinny or jacked. Right, and you look at it and you think that's really weird. Where's everyone else? Was it like a skinny person convention in Atlantic City

that day? And then you look at the population figures, No, that's what people look like in the year I was born, We basically humans have a bit more than three hundred thousand years in which obcity is extremely rare, and then essentially in your lifetime and mind, it absolutely blows up. Between the year I was born and the year I turned twenty one, obesity doubled in the United States, and then in the next twenty years severe obesity doubled again.

And it seems really weird. What's going on? What would what could possibly explain this unprecedented transformation in our bodies where we got to the point where now forty two percent of Americans are obese, right, seems really weird. What happened? We know what happened. This change takes place everywhere where one thing happens. It's not where people become weak willed or lack will power, or become lazy or all the

other cruel, stigmatizing things we say about overweight people. It always happens where people move from mostly eating fresh, whole foods that they prepared on the day to mostly eating processed and ultra processed foods which are constructed in factories out of chemicals in a process that actually isn't even

cool cooking. It's called manufacturing food, and it turns out this new kind of food, which never existed before in human history, affects our bodies in a completely different way to the old kind of food that all humans before. And there's loads of ways that's true. I go through seven reasons in the book. But there's an experiment that was actually done here in New York that to me

just totally distills what happened to us. Right. So it's done by a brilliant Irish scientists called Professor Paul Kenny, not just up the road from where we are. So he's the head of neuroscience at Mount Sinai here in New York. And he grew up in Dublin in Ireland, and when he was in his twenties he moved to

San Diego in California to continue his scientific research. And he quickly clocked, WHOA, Americans don't eat like Irish people did at the time, much more process and ultra process food, much more sugary, salty food, right, And like many a good immigrant, he quickly assimilated. Within a year, he'd gained like thirty pounds and he was like, why, what's going on? And he felt like this new kind of food he was eating wasn't just affecting his gut, it was affecting

his brain. It was changing what he wanted. So he designed this experiment to test it, which I have nicknamed a cheesecake Park. It's not the official name of it. It's very simple. He got load of rats and he raised them in a cage, and they had nothing to eat but the kind of healthy thing that rats evolved to eat over thousands of years, right in pellet form.

So when the rats have got the kind of natural food they used to they would eat when they were hungry, and they would stop when they were full, and they never became overweight or obese. Given their kind of natural food. They had a kind of innate nutritional wisdom that meant they were gone, I've had enough now. Then Professor Kenny introduced them to the American diet. He fried up some

baker and he bought a load of Sneakers' bars. Crucially, he bought a load of cheesecake and he put it in the cage alongside the option of the healthy food, and the rats went crazy for the American diet. They would literally hurl themselves into the cheesecake and eat their way out, just completely slicked with cheesecake, right, and they ate and ate and ate and ate, and all that nutritional wisdom they'd had before disappeared. They just rapidly became obese.

In fact, the way Professor Kenny put it to me was within a couple of days they were different animals, and so this nutritional wisdom that they'd had before with their natural food just disappeared. The brakes were off right. Then Professor Kenny tweaked the experiment, and again in a way that to a lifelong junk food adict seems to be a bit cruel. He took away the American diet and left them with nothing but the healthy food they've grown up with. And he was pretty sure he knew

what would happen. That they would you eat more of the healthy food than they had before, and this would prove that junk food expands the number of calories you eat in a day. That is not what happened. Something much weirder happened. Once they'd had the American diet and it was taken away, they refused to eat anything at all. It was like they no longer recognized the healthy food as food. It was only when they were really starving

that they finally went back and ate it. Now, what this tells us, and there's loads of evidence in humans, is the diet we're eating is profoundly undermining our ability to ever feel full and to In fact, the key word here both in explaining the rise of obest and how these drugs work is satiety. It's not a word we use that often in every day English, but it's the feeling of being stated, the feeling of having had enough and not wanting any more. And this kind of

food we eat profoundly steals our satiety. Right. And what these drugs do is they give you back your sense of society. They give you back your sense of being full, but with a potential cost. Right.

into Orlando to go to Disney World. Yeah yeah, I was going to get you to sing Theozenbic. So going a second. But we come to Orlando, and I remember like getting one of those you could get like this jumbo size coke, like which was refillable at the gas station, and then if you wanted, you could get the double jumbo size coke, which is refill about every gas station. And I couldn't believe. And that's all I wanted as a kid, right, I was like, that's the coolest thing ever.

My parents got it for me, and then I was drinking refillable cokes the whole time.

what happened though, was I still had bad habits. So I got through university having a sprite and a chocolate bar every single day, and it wouldn't show up as fat physically, but it would show up as you know now, I see it as glucose spikes. Now I see it as an increase in the chances of having diabetes. And it had in that direction. And my wife has been the one to coach me more on the side of

self control and discipline and finding alternatives. And I've seen a huge shift in my life ever since I've stopped refined sugars, ever since I've switched my diet to whole foods less processed foods, and I've done it in a very self controlled way. And how hard that is, I know, how pro and I still am to having craving sometimes and at the same time, I've lost taste for certain things. Anyway, I'm saying all of that to ask you the question

of portion sizes have increased. We're eating fake foods that are making us want them more. We don't feel satiated when we're consuming. How does the drug actually make you feel satiated, because I think it's important for people to understand that what is happening in order for you to feel satiated.

grew up in a working class family. We ate constant process and junk food. And I was in a bit of a daze and I went to there's a cafe just around the corner from where I live, and I went in and I ordered what I used to order every morning for breakfast when I'm in London. It was a big brown roll with loads of chicken and loads of mayo in it, and I I had like three or four mouthfalls, and I just didn't want anymore. I was full. I was following a way that I never

normally felt full. I thought, that's really weird, and I went for lunch that day. I went to there's a Turkish cafe next to my office, and I went in and I ordered what I used to order every day when I went there, which was a Mediterranean lamb. Again, I had three or four mouthfuls and I was just full. It was. It was so strange. It was like kind of shutters had come down on my appetite. I can't think of another way to describe it. Or it was

more like when I ate. So imagine you had just had Thanksgiving dinner or Christmas dinner and you were stuffed, and then I came along and said, hey, j great news, I've got your KFC bucket. Right You'd just be like, oh no, But you get to that level really really quickly. So obviously, I interviewed the people who made the breakthroughs for the drug, scientists who'd worked on the key stages of developing the drug. One of the weird things about the drug is we don't actually know how it works,

but there's some things we know for sure. There's a big amount of indeterminacy. But there's some things we know for sure. If you ate something now, it doesn't matter what it is, something healthy unhealthy. After a little while, your pancreas would produce a hormone called GLP one, and GLP one, we now know, is just part of the natural signaling in your body saying hey, j it had enough. Stop. It's like the breaks, right, But that natural GLP one only stays around in your system for a couple of

minutes and it's just washed away. So what these drugs do is they inject you with an artificial copy of GLP one that, instead of being washed away in a few minutes, stays around your system for a whole week. It's why when I go to the cafe, I only want three off our mouths because I'm already so close to form my GLP one or this artificial beasting of

GLP one makes me feel full so quickly. So initially it was thought when they were developing these drugs that because this hormone is made in the gart, it has an effect primarily on the gut. This must be a drug that's changing your gut in some way. And it clearly is right. And there's all sorts of ways. We know that, but from interviewing the cutting edge scientists working on this, particularly neuroscientists, it's increasingly clear that in fact,

these drugs work primarily on your brain. You don't just have GLP one receptors in your gut. You've got them in your thyroid, which is important for something else, and your brain. And these drugs are profoundly changing your brain.

We know that if you give these drugs to rats and then you kill them and cut their brains open, which obviously you're not allowed to do with humans for very good reasons, what you see is the drug go everywhere in the rat's brain, everywhere, Right, So I remember when I learned that, and I learned it quite a while into, you know, a few months into taking the drugs. It's just a concerting thing to learn it. You've reads, how would I put it, It's a much more intimate transformation.

debate about what it's actually doing in your brain. But for me, it just sort of made me realize, Oh, this is a, like, I say, a much more intimate change than a lot of people realize, I think when they start taking it.

lowest moment in my life as an overweight person. That the worst was the time that I was fat shamed by the Dalai lamos, But no, there was this moment where it's not even a joke, by the way, the horror of the dilarma another time. But so I'd had this very intimate relationship with this food all all my life, and to have it one of the There were many good things that flowed from takeo ZMP for me, and there are many benefits to it, as well as some

significant risks. But the weirdest moment for me actually was another moment that happened in KFC. In fact, one of my nephew said to me, a lot of the key moments in your life seemed to happen in bright She's a KFC I heard. I like that, good point. But the I had a real epiphany about this because what these drugs do is they profoundly interrupt your underlying eating patterns. Right, you can't eat the way you did before. And this is something I think people are not being warned about.

And I tried to take people through in a lot of detail in the book, is you need to be prepared that because of that, a lot of the underlying emotional issues that drive your eating may well come to the surface. So I had this moment for me. I was in Vegas. I was, as you know, I'm writing a book about a series of crimes that have been happening in Vegas that I've been researching for a long time.

And I was researching the murder of someone that I knew and loved, and it was obviously very painful, as you can imagine, he was an incredible person. I was working on this and I just, you know, felt bad, and I went to this branch of KFC on West Sahara, which is one of the grimmest KFCs in the world, and believe me, I could write a book about all of them. And I went in. I'm reading on autopilots. It was like seven eight months into taking the drugs. I I went in and I ordered what I would

have ordered a year before. Right. I ordered a bucket of fried chicken, and I had a chicken and I wasn't even really thinking about the eating or anything. I was and I had a chicken drumstick. And I looked at this bucket and I thought, I can't eat this right, Like I would throw up if I tried to eat. I remember Colonel Sanders was on the wall, and it's like he was looking at me, going, hey, what happened

to my best customer? And I were thinking, Oh, you're just going to have to feel your feelings right, And it's interesally if you look at the scientific evidence, there's scientific evidence for five reasons why we eat. One of them is the obvious one, to sustain our bodies. And I would have told you before I started taking this drug that was why I ate, right, But here I am. Then I ate maybe three thousand, two hundred calories a day. Now I ate around a thousand eight hundred, So all

that other eating was doing something else right. And I go through the four psychological reasons why we eat, they don't obviously applies differently to different people, and those things kind of get surfaced. And I remember going to one of my closest friends when I got back from Vegas and saying to hey, I've got to stop taking this. I can't take it. This is too upsetting. And she said to me, go hand, stop taking it. If you want to, that's fine, but you need to know these

drugs are not causing this issue. This issue was there all along. In this case, what they're doing is giving you an opportunity to deal with those issues in a better way than drowning your feelings in saturated fats. Right, And that's been a bumpy transitional that I'm glad. I'm glad I stuck with it, although lots of people respect the fact.

about the benefits. And I think some of the answer to your question. So, and it's barioatric surgery. Right up to now, it's been very hard without some kind of external intervention to lose huge amounts of weight and keep it off. Clearly, you did it. There are lots of people who do it, but it's actually a surprisingly small percentage of the people who try it succeed. I go through why in the book, and that reasons are really important.

So actually the most effective way up to now has been bariatric surgery, things like you know, stomach stapling, gastric sleeves. Baratric surgery is a horrific operation. It's really grueling. You know, one in a thousand people die during operation. It's no joke, right, But the reason people put themselves through that is because

of the extraordinary benefits to their health. Afterwards if you have back Now bear in mind they were severely obese at the start, otherwise you wouldn't qualify for the surgery. But if you have this surgery, in the seven years that follow, you are fifty six percent less likely to die of a heart attack, you are sixty percent less likely to die of cancer, you are ninety two percent less likely to die of diabetes related causes. In fact, it's so good for your health that you're forty percent

less likely to die at all in that seven year period. Right. And we know similarly that these drugs are moving us in a similar direction. So if you take these drugs and your BMI is higher than twenty seven at the start, you are twenty percent less likely to have a heart attack or stroke right in the years that follow. That's very that's gonna that. It's close to my heart. It

is literally close to my heart. Right. But you also, when you look at bariatric surgery, begin to see some of the drawbacks, and I think the key to what you're asking might be there. So one of the things that I think is really shocking is if you have bariatric surgery, your suicide rate quadruples in the years that follow right, it's still quite a low risk. Most people are baratric surgery. Glad they did it quadrupling. That's that's a big effect, right, Just think why would that be?

What's going on I think there's lots of things going on there. Some of it is actually the after effects of the surgery are pretty onerous. Some of it is you can't comfort in it anymore, so that pain comes to the surface. Some of it is a lot of people who are overweight kind of think well, if only I was thin, my life would be really great, exactly, and they lose the weight, and you know, your husband's

still an asshole, and you'll hate your job. And I think there's also some give an example of a really deep psychological issue that I think is surfaced in some cases by these drugs and baratory surgery. Something I learned about from a wonderful man who should have on actually called Dr Vincent Feliciti. It was really hard for me

to learn about this. So Dr Feliti was a doctor in San Diego in the early nineteen eighties and he was approached by Kaiser Permanente, the big not for profit medical provider in California, and they said, look, we've got a problem. We don't know what to do. Please help us. A problem they had was that obesity was hugely rising. In fact, it was very low by our standards, but it was rising. And they said, look, nothing we do work. So we give people, you know, diet plans, we give

them personal trainers. It's not working. Can we give you a load of money and just do Blue Sky's research figure out what the hell we should do. So doctor Felti took the money and was like, oh, what can I do? So he started working with two hundred severely obese people, people who weighed more than three hundred pounds and had for a long time, and it's like what could I do? And he had an idea that sounds

and in fact is kind of done. He said, what would happen if really obese people literally stopped eating and we gave them like, you know, vitamin sea shots so they didn't get scurvy or whatever. Would they just burn through the fat supplies in their body and get down to a healthy weight. So, with a ton of medical supervision, they did it, and incredibly, at first it worked. There was a woman, hard core Susan not her real name, who went down from being more than four hundred pounds

to one hundred and thirty eight pounds, staggering transformation. And you know, her family are calling the doctor and saying you saved her life. She's thrilled. And then one day she cracked. She went to KFC or actually think that's projection. She went somewhere and you know, started hugely of eating again and quite quickly got back to a dangerous way. And Dotte Feltti called her in. He said, Susan, what happened? What happened? As she looked down, she was really ashamed.

She said, I don't know, I don't know. He said, well, tell me about the day you cracked. Did anything in particular happen that day? They didn't happen some other day. It turned out something had happened that day that had never happened to Susan. She was in a bar and a man hit on her, not in a nasty way, in a nice way, and she felt completely freaked out and went and started eating. That's when Dr Felti asked hers something he'd never thought to ask her before. He said, Susan,

when did you gain your weight? In her case, it was when she was eleven. He said, well, did anything happen when you were eleven that didn't happen when you were nine or when you were fourteen, anything in particular happened that year and she looked down and she said, well, that's when my grandfather started raping me. Dr Fillitti interviewed

everyone in the program. He discovered that sixty percent of the women had made their extreme weight gain in the aftermath of being sexually abused assaulted, And at first he was like, what's going on. It doesn't make any sense, and Susan explained it to him really well. She said, overweight is overlooked and that's what I need to be right. Clearly,

obesity for women has a protective sexual function. You are somewhat it can still happen, of course, but you are less likely to be sexually assaulted if you're goin a lot of weight. And so for Susan, losing a huge amount of weight made her really frightened and feel really vulnerable and brought her back to that terrified place of abuse.

That there's lots of psychological things that go on. That's only one of many, but I think and of course it can give you an opportunity to deal with those feelings, right, But again, it gives you a sense of like the incredible psychological complexity of what's really going on here can kind of come to the surface in complicated ways.

found ways to cope with them. This is something that you've been able to kind of put aside for ten twenty thirty years, and all of a sudden, now that this is blocking something which is giving rise to that, it almost feels like, Wow, I haven't learned how to deal with this for a long time.

And I really wanted to think this through because I was very conscious that we've made so much progress in this culture. I mean, we were nowhere near where we need to be. What we've made some progress. I think about this in one of the things I really worry about in relation to these drugs. But I think it's really distilled in a moment, probably the worst moment in

the whole writing of the book for me. So, I've got a niece called Erin, who's nineteen now, but in my head she's fixed as a six year old, like she's the baby of my family, she's the only girl. She's the youngest of my brother's sister's children. But one day I was facetiming with her. I'veter be taking the drug for a while, and she was sort of praising me in a teasing way. She was like, oh, I

never knew how to draw. Yeoh, I ne't ever knew how to neck and I was kind of preening, and then she looked down and she said, will you buy me some mozampic and I laughed because I thought she was kidding, and I realized she wasn't. And she's like

a perfectly healthy weight she always has been. And I thought, I've undone all the messages I've ever tried to give her right about valuing yourself about and I thought, you know, she's grown up seeing a broader range of body types and female celebrities than we ever grew up with, of course, and now all of those women pretty much are boned thin, right. And I really wanted to think this through because I

think this two categories here, which are quite different. There's overweight and obese people who are taking these drugs to get down to a healthy weight. Right now, they're still incurring the twelve big risks that I write about in Magic Pill. There's still a lot to discuss there, but I think there's a lot to defend there. Then you've got people who were already a healthy weight or indeed skinny, who are taken them to be super skinny. Now I

don't judge those people. We live in a culture that makes women feel shit about their bodies whatever they do, and there are tremendous pressures on them and I don't judge where those women are coming from at all, but they're incurring all the all the twelve risks for none of the benefits, right, I mean, well, rather for esthetic benefits, but not health benefits. And in fact they're endangering their

own health in all sorts of complicated ways. To give an obvious example, as you age, you naturally lose muscle mass. Muscle mass is the total masts soft tissue in your body that you need to like get out of a chair, walk the walk up the stairs, whatever it might be. So as you age, you naturally lose muscle mass from

the age of thirty depressingly. So if you're going going into the aging process already with quite low muscle mass, which people who have taken the drugs to be super skinny likely will be, it could cause you real problems. When you're older. You know you'll be much less mobile, You'll find it harder to walk up the stairs. You're at risk of a condition called sarcopenia, which means poverty of the flesh. It's where basically you just can't do

much because you're quite physically weak. So I think we've got to sing which between those two things and then we've got to think about also what this means for body positivity and how we think about it in relationship. That was a particular person who helped me to think about that. I could tell you a bit about her if you.

want to think this through with her. She's seventy six now and her story, I think really helps her to think through the complexity of this. So she grew up in a kind of big working class town in Britain called Port Talbot. I guess the equivalent in the US would be like Scranton. She would put it the only fat girl at her school. This was the nineteen sixties and one day after class, her teacher said to her, Bovy,

stay behind, I need to talk to you. So she's sort of sitting there thinking, hey, what did I do? And she goes up to the teacher and the teacher said, you're much too fat. It's disgusting. Go see the school nurse. She'll sort you out. So completely thrown, she goes to see the school nurse and then I says, why are you here? She said, well, the teacher saysn't too fat, and then I said take off your clothes. I'm going

to look at you. And the nurse looked at her and said, oh disgusting, you're too fat and just berated her, said you're greedy, you're a pig eat less, and Shelley completely throwing kind of leaves. And she was soaking up this kind of abuse the whole time. Right, girls were constantly saying to her, thank God, I don't look like you. And really, her whole life she soak up this abuse. When she got pregnant. She went to the doctor. First thing the doctor said was shouldn't be pregnant when you're

as fat as you are. When she gave birth, she had a very painful birth, difficult birth. She's lying there covered in blood, and the midwife said to you know, you really need to lose some weight. And when her baby wouldn't attach he wasn't feeding properly, she went to the doctor. The doctor said, what are you trying to do? Make the baby as fat as you are? Over and abest people are soaking this up all the time, and

most of them just internalize it. Shelley told me she had never looked to her body naked, even in the shower. She would sort of wash herself but not look because she felt such hatred for her own body. And one day she learned in the US there was this movement which at the time called itself fat pride. There's still some people who use that term. Now we would probably call it more body positivity. Who just said, why are we taking it? This is like, this is just cruelty,

This is like racism or homophobia or sexism. Just no, we're not going to be treated like this. You're not going to get to talk to us like that. And so she wrote the first ever book advocating for body positivity still stands up now, brilliant book call the Forbibven Body, in which she argued against this stigma. And when I tracked Shelly down, she stressed to me she's really proud of everything she said about stigma, and I think she's

one hundred percent right to be. Stigma A is just a form of bullying, and b makes the problem much worse. Lindy West, is a brilliant body positivity advocate, said people don't take good care of everything they hate. If you make people hate their bodies, it doesn't make them take better care of them. But something happened to Shelley next. I think if we're going to be truthful and compassionate, we

have to talk about Shelley was very overweight. She was not yet fifty, and she was losing the ability to walk and so she had to be in a wheelchair. And she went to her doctor and a doctor said, well, because of your weight, because the strain that's putting, you've got problems with your heart. And Shelley felt this profound dilemma because she was so proud of everything she said about stigma. At first she thought, well, I want to

talk about these health challenges, but is this contradictory. There was at the time a newsletter in Britain called fat News, which is like a body positivity newsletter, and she wanted to write about this and they said, no, that's not what we want. We're here to tell the positive news. And she said, but if we love ourselves, don't we

want to tell the whole truth. She felt really conflicted about this and for a long time she felt like it was either or either you're again stigma or you're in favor of reducing a b CD where you can. But you know, she then and she's the first to acknowledge this is extremely hard to do. But she lost a lot of weight through dieting. She went from being unable to walk to being able to run. Her health

massively improved. Her heart problems went away, which tends to happen when you're reverse obesd like when we talked about with the bariotric surgery and Shelley I thought put it to me in a really way. She said, it's not either or, it's both. And if you love someone who's obese, as everyone watching will. I'm pretty sure you want to

protect them from two things. You want to protect them from cruelty and bullying, and you want to protect them if you possibly can, from the more than two hundred diseases and health complications that are made much more likely by being overweight or obese. And I was kind of shocked when I looked at the science of this with an open mind. I'm very happy to challenge scientific consensus.

I've done it before in my previous books. But when you look at the scientific evidence, and I was trained to assess scientific evidence at Cambridge University, I was kind of taken aback by how bad obesity is for your health on average. Of course, there are exceptions. My mother smokes seventy cigarettes a day. She's alive and well at

there just seventy eight. But she's an outlier. I mean, if you think about something as simple as diabetes, right, I'm really embarrassed to say this, but I thought if you'd asked me a couple of years ago, Okay, I knew that obesiently makes diabetes much more likely. If you're obese when you're eighteen, you have a seventy percent chance of becoming diabetic in your life. But I thought, okay,

that's not good. But as long as you've got good health insurance and you get insulin, you're basically like everyone else. A diabetic with insulin is like me or you. That's not true at all when I a'ter feed the leading you know doctors who are leading people who treat diabetics. When you look at the scientific evidence, diabetes knocks fifteen years off your life on average. It's the biggest preventable

cause of blindness in this country. More people have to have a limb or extremity amputated because of diabetes in the US than because they got shot. And you will have noticed a lot of us get shot right. In fact, it's the effects are so bad that one of the leading doctors in Britain who treats diabetics, Dr Max Pemberton, said to me, if you gave me a choice between becoming diabetic or becoming HIV positive, I would choose to become HIV positive because if you're HIV positive and you

get treatment, you live as long as everyone else. That is not true of diabetics. Type two diabetics. You have a shorter life and you're much more likely to have a terrible last few years where you're blind or you're horribly you know, your body is mutilated. And I found that so frightening to take on. And I'm conscious that loads of people hearing that will experience that and as

very painful. It is extremely painful to hear, and it's an extremely painful truth, and we have to communicate it with great compassion and love and not as concern trolling. And I hate even saying it because you can see how it gives ammunition to the bullies in a way because they use that. It's like, oh babe, I'm just worried about your health. I get that. But Shelley really taught me. Yeah, she put it. We have to live in reality and we have to be as compassionate as

we can within that reality. We have to do both right. And I'm conscious this is a long answer about you. Give an example. One other person helping to think about this as a brilliant guy interview called Jeff Parker's a sixty seven year old retired lighting engineer in San Francisco, and Jeff a couple of years ago was very severely overweight. He was finding it painful to walk. He had doubt,

He had liver problems, kidney problems. He was taking fistfuls of pills every day, and he started to take Munjaro, which is one of the new weight loss drugs, and he lost a lot of weight. All his health problems went into remission, and doctor almost took him off the pills. Now he walks his dog over the Golden Gate Bridge every day. He said, you know, I feel like I'm gonna enjoy my retirement. Now. I don't think we can

say to someone like Jeff that that improvement is not meaningful. Right, there are many Maybe the risks of the drugs will outweigh that benefit to him and for others. That's a real possibility. It's why I put a lot of weight on the twelve risks of these drugs in the book. But I do think we have to acknowledge that a lot of people who do successfully reverse their OBESTI, which is much easier to do now than it's been before, do experience a massive improvement in the quality of their life.

I do think we're not being honest with people if we don't explain that as well.

appear different visually. How is she now perceived and how does she feel about reconnecting with that community and talking about it with them?

positivity advocates. Well, they have many good arguments, and it's worth stressing. So if we think about the history of diet drugs, think about the seventies. One of the things that one of the first things the Fat Private movement did was point out, so there were diet drugs in the seventies that were in fetamins. Right, They're hugely popular. There were staggering figures like more than ten million and fetamine prescriptions were written in nineteen seventy in this country

for weight loss, right. And it turns out taking loads of speed to lose weight not a good idea. Who knew, and they had to be taken off the market because it screws you up, right, partly because you developed tolerance to these drugs. You have to take higher and higher doses to get the same effect. And if you're taking really high doses of speed, as anyone who knows any recreational drug users well know, don't end so well for you. You know, skinny but psychotic is not a great trade off.

I hope for some people it is, but not for me. And so a lot of the Fat Private movement very presciently warned at the time, you know, this is really good to screw people up, don't do it right. And they've been entirely vindicated by that. And it may be and I think there's a significant chance of this. I don't think it's the most likely option, but I do think it's a significant chance that they'll be vindicated on

these drugs as well. Going Look, this is a big risk right for me, especially with the history of my own family. What I felt I had to do was waigh two risks, and I think that's what most people watching and listening, this will be the position they're in. Realistically, I was going to remain obese. I'd tried dieting many times. I always ended up fatter than I was at the start. I tried insane and tense diets. I'd gone to diet camps in Austria where they give you tea for I

done it all right. Realistically, I was going to carry on being obese to some level. So for me, the choice was what are the risks of continuing to be obese versus what are the risks of these drugs? That is not an easy calculation. There's a lot we don't know. We're learning more and more. There's a lot of detail in the book that I think people don't know about. It's a hard calculation, and I don't know if I've

made the right choice for myself. It may well be there's a significant chance that they will that their caution about this will be vindicated, and they're right that they're also right to say it's clearly not the case that we're only taking this to deal with health problems, right, And that's true to me as well. There's a significant amount of just relief from the stigma being fat, vanity. I like being thinner, right, because of the culture we

live in. Some of that is the health benefits and the risk to my heart, of course, but some of that isn't a big part of it isn't. We've got a level with people about that, so it's possible that they'll they'll be vindicated, and even if they aren't, we've really got to understand where it comes from. If you are soaking up abuse your whole life, that cruelty, that bullying, I totally get. You know, there's an analogy I always think of, which is I'm gay the height of the

age crime. When doctors explained to gay men, look, because of the nature of anal sex and because gay men tend to have a lot more sexual partners than other sexual combinations, this is going to affect gay men much worse than other communities. So they wanted to you know,

shut down the bath houses in San Francisco. Really warm people say while we don't know, you shouldn't have sex, right, and a lot of gay men were like, our whole lives, we've been told our sexuality is disgusting, we're diseased, we're evil, and now you come along and tell us this as well. We're going to carry on going to the bath houses. We're going to carry on. And I get where they're coming from. I might well have been like that myself at the time, but now we realize looking back where

you have to separate the stigma from the scientific advice. Right, there was I'm sure there were lots of homophobes picking up those arguments and fullying gay people exactly, but equally there was the scientific reality, which is it was much more likely to affect gay people, and lots of those people who refuse that advice. Tragically, I'm not here now because they refused it, so I think. And that doesn't mean I stand over those people people and go what fools.

I totally get it, But I do think we have to, as Shelley says, we have to separate out two things. We have to separate out the stigmatizing, cruel things that are said from things that are just physic Think about cancer, right, The leading cancer group in Europe, Cancer Research UK, explain, if you carry excess weight in your body, it doesn't

just sit there. It's not inert it's active. Right. It sends signals through your body, and one of those signals is for your cells to divide more rapidly, which can cause cancer. This is why obst is one of the biggest causes of cancer in the developed world. Right. That's true. Even if we've got rid of all the stigma in the world, which we passionately should fight to do, it's still going to make you more like to get cancer. Right. We can't. That's not something we can undo with an argument,

and therefore we do need to think about this. Also, though I'm very conscious the most important thing we've got to do, so people like me are in a shitty trap. Right. You've got to choose risky medical condition, risky drug. But that is not inevitable and we should not tolerate that being the choice for our children. Right Japan, for example. Right, I can explain how they did it, but the key thing to understand is the way one expert put it.

For me, A brilliant man named Professor Michael Lowe at Drexel University in Philly is processed and ultra process feeds dug this hole. They stole our satiety and the drugs fill it. In the way he put it was, so you've got to see that these drugs are an artificial solution to an artificial problem. Right, So we've got to

pull back. In addition to the dilema about the drugs for people like me, we've got to pull back and go how did we get here and how do we make sure the next generation of kids are not in that position? And absolutely this is the dilemma a lot of ours face, but it doesn't have to be the dilemma for our children and grandchildren. And I went to places that have solved this dilemma that show us the way out. So that's the kind of broader argument which I think is so important to stress as well.

or is shrinking? And while I see the rise of organic vegetables, while I see but still expensive, while I see the rise in people proposing a largely plant based diet, if not not not full, but a larger plant based diet, again more expensive, harder to access, maybe maybe difficult to know what to do. I don't see fast food shrinking as an industry. Did you see that? Are you seeing that through your research where you seeing investment shift and redirect or is that a myth as well?

a dollar a day. I would anticipate forty seven percent as an underestimate for how how many people will take it. Provided some of the twelve big risks that I write about in the book don't blow up, which is a real problem. I think about Jeff Parker, the guy I just talked about in San Francisco. Everyone like Jeff becomes a walking advertisement for the drug and goes what happened to Jeff? He looks completely different. My god, he's so much healthier. So you can see how it creates a

huge growth, growth effect. So you're right, at the moment, we've got two trends. We've got the ongoing explosion of fast food, which is, you know, blowing up and blowing up and is implanted in us from the moment we're born. More three year old children in this country know what the McDonald's M means and know their own last name. More people, yeah, more people in the world recognize the McDonald's M as a symbol of McDonald's than recognize the

cross as a symbol of Christianity. Right, So this is really deep at out of consciousness. So you've got that huge explosion in fast food, which is growing and growing and growing, and you've got huge numbers of people who want to take these drugs. Now, one of those trends is going to win, right, So as more and more people take the drugs, we're already seeing effects. And I think, in a way, the best some of the best predictors

are the financial markets. Jeffrey's Financial just a big report for the US airlines saying you're going to have to spend a lot less money on jet fuel pretty soon because a lighter population takes less jet fuel to fly. There's even just like crazy little things, there's been a huge run on duelers in Los Angeles because people's fingers have shrunk so much that they need their wedding bands refitted. Or think about you mentioned the hip and knee replacements.

Companies that manufacture knee hip replacements, the joints for them, their stock is going down because the main driver of ne and hip replacements is obesity. And if there's a lot less obesity, there's going to be a lot fewer knee and hip replacement operations. So I do think we're we're You're right. The trend you're seeing, which is the growth of fast food, which any more and more, I mean,

thank god, when I was a child. You couldn't just push a button on a device and they bring that good olds to you, right yet to actually leave your house at least I imagine however, I would have become of that have been the case. That trend is driving the other trend as well, right, so that they're they're densely interconnected.

twelve which I want to dive into. The big twelve risks and the issues with the drugs are a lot of them more long term than short term, and based on your own personal experience, are the short term ones tolerable and the long term ones the ones that we would consider intolerable and complicated.

to vomit the whole time. That's rare but not unheard of. I mean, in the clinical trialst about five percent of people did just stop because the nausea was so bad. For me, it was like it was mild. It was like when I would get on the bus or something, I would get a little bit of exaggerated travel sickness. But like if I'd got that feeling just randomly on a normal day, it wouldn't have stopped me going about my day. It just would have been a bit unpleasant.

And after a few months you generally you get it worse the day you take it or the day after, and then you're okay for the rest of the week, and then again you ject yourself and it gets.

I mean it's it's literally like the tiniest scratch. It's like a mosquito bite. That are their different doses in Everyone starts at zero point two. Five milligrams is to get you used to the nausea, and the effect is quite mild, and most people go up and up and up, so generally you go up to one milligram you can go as high as two point four milligrams. It would depend on your level of obesity. I think a lot of people are on two higher dose.

young girls. You're interviewing my friend Jonathan Hight. He can tell you much more about that, and everyone should read his brilliant, amazing work. Then during the pandemic he just sort of went up even further, which is mind blowing. And what these drugs do is they give you an unprecedented tool to amputate your appetite. Right, And anyone who knows anyone who's got eating disorders, imagine, I'm sure you do.

Pretty much everyone does. They're in a conflict. There's the psychological part of them that wants to starve themselves for complex reasons created by the sick culture we have mostly and then there's the biological part of them that wants to live and wants to eat. And what these drugs do is they, you know, if you take them and you're in that position, they massively empower the part of

you that wants to starve yourself. So I am and people like doctor Kimberly Dennis, who's one of the leading eating disorders experts in Britain, another person you should interview, a very wise and brilliant person, are really worried about this. My biggest fear is that we could have an opioid like death toll of huge numbers of young girls. And unfortunately, these disorders do mostly affect young girls, or there are of course some young men and boys. I mean, I'm

really really worried about that. Now there are things we could do right, now, as Dr Dennis says, we need to I got them on zoom, you know when I got them in Britain, initially in Vegas had to go in person. They're meant to check you'll BMI on zoom. I mean, good luck with that. Yeah, Basically, you are very visibly not eligible for these drugs, right, You clearly have a BMI lower than twenty seven, and yet I

have no doubt you could go on zoom. Literally, your lovely team here could arrange in half an hour we get a Zoom call and you would get it delivered in the you know, biked over to you today. Right. We need to stop that, As Dr Dennis says, we should only have in person prescription, and the in person prescription should be done by doctors who are given clear guidance about how to spot eating disorders and how to prevent the prescription of these things to eat disorders. It's

not perfect. People might still buy it online, but it would put at least some barrier between these drugs and people who should not be getting them. At the moment, there is basically no barrier.

key parts of your brain. So a brilliant expert called Dr Greg Stanward, who works on these drugs at Florida State University, said to me, Now he's stressed to me, he's broadly in favor of these drugs. He's considering taking them himself, but as a responsible scientist, he has to warn people. So he gave an analogy. I want to be clear, he's not suggesting these drugs will have this effect, but it's an analogy that helps us to think about it.

If you look at antipsychotic drugs, if you go back to when they were first given to people in the late nineteen fifties, at the time, doctors judged that the benefits outweighed the risk. It's always been controversial, but they judge that. So loads of people will give an antipsychotics for really long periods of time, and it was only what forty to fifty years later that they discovered if you take these drugs for decade after decade, you are much more likely to get dementia or some In fact,

all forms of dementia are much more likely. It's not that the doctors were being negligent in the nineteen fifties. You couldn't know that, right. You had to have people take it for a really long time to know that. What could these drugs do over the long term, We don't know right now. Against that, Dr Shaan O. Levy, a brilliant obesity specialist at at Tulane University School of Medicine in New Orleans, said to me, well, look, we

don't know the long term effects of these drugs. We do know the long term effects of obesity, and they are very serious. But you know, I'm forty five, right If you stop taking the drugs, for almost everyone they stopped, you just go back to where you were before. And there's a big debate about that, but for most people that seems to be happening. So I'm assuming I'm going to be taking these drugs for forty years. That's anxiety provoking.

I asked Dr Clements Blue, who's one of the leading obesity specialists at Cambridge University, So, what brain areas do these drugs activate? And she taught me through it at the he and so on. I said, well, what else do those areas of the brain do? She said, oh, were they memory? Processing, taste processing, got motility like not this is me speaking now, but not trivial things, right, So for me that was of the twelve, that was

the one where I thought shit. So I'm trying to a more eloquent way to say shit, but that was yeah, yeah.

want you to carry on buying the drugs forever. It would not be good news for them if they discovered that actually you can take the drugs for a short time stop and then you'd stay at the lower way some people. This is anecdotal because we don't have any research on it yet. Other people are studying it, so

we'll know in a while. Like I give an example, someone I know, Tukman Jarro, lost loads of weight, interrupted their relationship with junk food, started exercising a lot in a way they felt too embarrassed to do when they were obese, and has now stopped and seems to be maintaining that lower weight. So how many people will there be like that? We don't know. I mean, the early studies we have we're just looking at if you take it and then stop. But what about motivated people who

change use it as a tool to promote change. We just don't know.

really good scientist, and that's a good point. Actually, we know loads about the medium term effects of these drugs because diabetics have been taking them for eighteen nearly nineteen years, right, So for people who don't know, these drugs, in addition to having this effect on your appetite, also stimulate the creation of insulin, which is what diabetics, by type one anti two diabetics are lacking. It's why it's a diabetes treatment.

And so actually we've got eighteen years of data on diabetics, so I mean, I'm putting it more crudely than they would. But if the drugs made you grow horns, the diabetics would have grown horns by now, right. And that's a good and important point, and it should give people some degree of security that some other people say, some other leading experts say, well, hang on, if we're going to base a lot of our confidence on these drugs on the diabetics, let's dig a bit deeper into the diabetics.

So give an example. There's a brilliant scientist call Professor Jean luc Faye, who's at the University Hospital in Montpellier in France, and he was commissioned by the French Medicines Agency to look at the safety of these drugs for the French market. As we started looking at what's called the preclinical research, which is on animals, and something really took him aback, which is, if you give these drugs to rats, they're much more likely to get thyroid cancer.

And it's like, huh, okay, let's do some digging. So what he did is they have very very good medical databases in France. He compared a large number of diabetics who'd been taking these drugs between I think twenty six and twenty twelve with a large number of diabetics who were similar in every other way but hadn't taken these drugs. And what he calculated with his colleagues was, if he's right, and it's highly contested, these drugs increase your thyroid cancer

risk by between fifty to seventy five percent. And he said to it, we've got to understand what it doesn't mean. Doesn't mean if you take the drugs you have a fifty to seventy five percent chance of getting thyrocncer. If that was the case, we'd be having bonfires of ozenpic all over the world. What it means is, if he's right, whatever your thyroid cancer risk was at the start, these drugs increase it by fifty to seventy five percent. Now,

thyro cancer is an overall low risk. One point two percent of people get it in their lives, eighty two percent of them survive, so it's a relative, but it's a big increase in a small risk, right, And I'm very conscious a that you got to weigh that against just the cancer risk of continue to be abast But also one of the things that really worries me about that is, so you think about the history of diet drugs, very often they began to unravel based on small warnings.

So if you think about it, there was a diet drug in the nineties called fenfen, the most popular diet drug ever before a zenpic. So if you look at how it was a combination of two drugs. It was an appetite suppressant called flex fluoramine and an a fetamine called fentromine, and it really worked. People who took it got the same level of weight loss as people get on a zenpic and people talked about it in a very similar way. Front page of Time magazine was the

new miracle weight loss drug, right, very similar. In nineteen ninety five, there were eighteen million Fenfen prescriptions in this country. It was huge. It was discovered a small group of doctors in a practice in Fargo in North Dakota noticed, huh, a lot of people using this drug in our practice seemed to be having trouble breathing. Wow, And so they raised what's called a safety signal. It was then investigated.

It turned out these drugs caused in a lot of people something called primary pulmonary hypertension, a horrific condition where the blood vessels and your lungs contracted and you can't breathe. It it kills you. It can kill you. If not, you're an oxygen the rest of your life. It's horrendous. So it obviously got withdrawn from the market, led to the biggest pay out in the history of the pharmaceutical industry twelve be and it does actually emerge the drug

companies had known about this risk all along. You look at the stuff the drug companies, you know. One of the one of the documents that was presented at the civil case was just someone saying one of the people at the drug company saying, oh am, I going to have to spend my retirement writing check compensation checks for silly, fat women with lung brew can't breathe. I mean horrendous. Right now, I want to stress Eli Lilly and Novo Nordous. I'm very happy to criticize drug companies. I do it

a lot. But they are not shysters like those people were. They are reputable drug companies. There's no reason to believe that they're like that. But I'm conscious that small things could lead to the whole thing unraveling. We need to be vigilant. I'm alert to that. It's why if you have thyroid cancer in your family, I mean, I'm gonna say I recommend it. Don't really matter why I recommend. The FDA recommends don't take the drugs. It's not a good idea.

you might get pregnant. So one of the things that really worries me is we have really no data on what it does to people are pregnant. Obviously you're told to not take it if you think you might get pregnant, but people get pregnant and all sorts of ways that you don't expect. So we know rats when they're given some agualatide the active component. I'm much more like to

have children with birth deformities fetuses with birth deformities. Dr Stamward, who I mentioned before a Florida State said to me again stressed he's broadly confident, but has to alert people to potential concerns because he's a very responsible scientist. He said, to think about this, you might want to look at the long term research on mothers who are exposed to contaminants when they're pregnant. So think about, for example, mothers

who are exposed to lead. This happens scandalously frequently in this country because a lot of poor people still live in housing that still has a lending it and still get water from We know about Flint, Michigan, but actually lots of places get water from pipes that are made of lead. It's insane that in the richest country in the world we allow that the poisoning of children. But anyway, if you look at the if you look at mothers who are pregnant and get exposed to lead during pregnancy,

actually their babies look like all the other babies. There's no it seems like there's no difference. But when those kids get to be twelve thirteen, we know that they have less impulse control, they're more likely to have attention problems. So it seems to have affected their developmental trajectory, even though that wasn't immediately obvious at first. Could that happen with these drugs, Yes, I mean it might not in might effect their trajectory in a positive way. We don't know.

Maybe they'd be less likely to become obesie kind of a protective effect on that. But it's just disturbing when you when you look it's a really weird feeling to go all around the world into feel these leading experts, sit with them and to realize, oh, this is an experiment on millions of people, and I'm one of the guinea pigs. Shit right, it's a weird feeling, right, and it makes me angry that we've been put in the

position where we have to make these choices. Like I say, there are countries that don't have to make these choices because they didn't allow their population to be put up with process and ultra process food in the first place. And that pissed me off.

I interviewed a woman called Michelle Sterziak, who lives in Myrtle Beach in South Carolina, which is a place I only thought existed in country songs until I interviewed her. And Michelle said to me, you know, she went for a zmpic for weight loss. The doctor said, oh, this is rare side effects, one of those pancreatitis. She said, no, my life, I'll probably get it. She started taking it, lost loads away. Six weeks later, she went to visit a daughter in Pittsburgh and she woke up, she said,

in the most excruciating angony she'd ever been in. She felt like she like she was being stabbed all over her body, and she was rushed to hospital and they hadn't know if I pancreatics. In the first thing they said was are you an alcoholic? She said no. Then they said are you taking her zempic? She was like yes, So that was probably the person. Michelle said to me, you know I've had children. It was much worse than the pain of childbirth, right so, which thank god you

and I will never have to go through. But unless you've got something you want to announce, Jay, But there's some real horror stories, and most people are not having these horror stories. Most people are having I want to be responsible. Most people's experience is more like Jeff Parker or Oprah than it is like you know, Michelle. Yeah, but that's now twenty years from now, thirty years from now,

forty years from now. We don't know what the picture will be, which which puts us in this difficult position.

stuff your face with our shit. Right. The first thing I want to say is this is a crisis created by them, and we need to stop them doing that, and we can do that, and I went to places that have done it. But given that's where we are, I think people are in a really tough position because there's so I'm very sympathetic to both sides of that debate. So, for example, I interviewed a really lovely woman called Deborah

Tyler who's a nurse in Connecticut. Her daughter was very severely obese from when she was very young, and she took a daughter to the doctor when I think she was eight, and the doctor said she had liver problems, and she's like, can you imagine when you've been told your child is of the problems at the age of eight, And she faced this agonizing decision about whether to put her daughter on ozm PIC And in the end she decided to do it, and her daughter's liver problems have

gone away. So I have a lot and she's still very agonized about it. All the problems are accentuated when it comes to children. I mean, there are benefits. Dr Charles you, who's one of the leading experts at Cambridge University on obest, explain to me if you are obese when you're a child. It is very hard to become unobese. I mean, you're unusual, right, it happens. You'll proof of that. There are other people approve that. Most people don't. Right.

It's really partly because as you become obese, all sorts of changes happen in your brain that make it very hard to go back that I go through in the book. So there's a case for dealing with it early. Right, And we know childhood obesity, I mean has really devastating impacts on your health throughout your life and radically shortens your life on average. There are other people who have a lot of sympathy for like Professor Dan Cooper who's at UC Irvine, who say, well, A and I can't

believe anyone would disagree with this. We need to deal with the underlying causes, but the environmental factors. But be children are not miniature adults, right. This could affect children in different ways. For example, of one of the things children use calories for is bone mineralization, and if you don't have enough calories, maybe your bones don't form it properly. Maybe they'll become austereoporotic as they get older, So it's

really complicated. Novo Nordisk is currently doing a trial on giving these drugs to chill as young as six years old. It turns my stomach. It's a sign of a six society that we've reached this point. We need to fix the society. But if you're trapped in the choice that Debra Tayler is trapped in, honestly, I think I would probably do what she's done and I would feel as anguished as she does about it.

on at five pm on Channel four. Right, and no one in Britain when we were kids spoke like Oprah, Right, no one spoke about their no one spoke about their emotions, no one spoke about in this extraordinary and profound way that Oprah does. And I really think one of the reasons I get on well with Oprah, I think is because I've I've so entitalized her voice that I sort of I mean, clearly, as a British person, you can't talk like Oprah, but like, well, clearly no one can

talk like Oprah, but you know what I mean. So I can't think dispassionately about it because I love her so much and I'm weirdly friends with her, which is like still to me the most surreal, whether she emails me or texts me. And my friend I was like, shut up, everyone Oprah needs us. But I thought her special was incredible and I cried a lot for the

minute it started. I cried, and my friend said, thank God Oprah has not brought her show back, because if you had this emotional reaction every day, you've been a psychiatric hospital because of seeing op profront of an audience may be emotional, but I thought it was amazing, and I think part of it made me really sad, because you think about how much Oprah has given us, right, how much she's given to the culture, people forget, you know, I mean even just think about the incredible work she

did on breaking the taboos around sexual abuse right where. What she's done is incredible. And I could list like fifteen things like that that Oprah has done transform the culture. And you think, all that time she was doing that and rising, she was being bullied in the most hateful ways. I really recommend people watch. And this is someone else who I admire and was a damaged person. So I don't want to say this in a spirit of judgment,

but you can watch it on YouTube. There's an interview between Oprah and Joan Rivers from I think nineteen eighty five, and I'll preface this by saying, a Joan Rivers was the funniest comedian I've ever seen, and be Joan Rivers was someone who hated her own body and was at war with her own body. So she's externalizing something that's an internal, horrifying battle. But it's viscerally shocking when you

watch it now. She says to Oprah something like, I haven't watched it in a long time, so I'm going to be get the exact wording wrong. But she says something like, you can't be this fat, you need to lose weight. And it's not said as a joke. It's not framed as like I mean, it would be would be acceptable as a joke, but it's not even framed as a joke. And you can see just looks really thrown and make some joke about herself because what else

could she do? But you think, God, that's the Tonight Shows. They're on the Tonight Show, right, that's because Joan was the guest host. How many people watch that? Twenty five million people? That's been brutally shamed in front of twenty five million people. You think Oprah's carrying that the whole time she's torturing herself. You know that famous the famous image of her with the you know, the thing that

represents as much fat as she's lost. And you think, God, I feel so sad if you, even if your Oprah, you get tortured about it, right, you just realize. So to see her overcome that and see her looking so well, and to see her given a space beyond that stigma, I found incredibly moving. But that's tied up for me with so many other feelings about Oprah that I can't really you know.

to take statins right to lower's cholesterol. I've never once thought cheating to get lower cholesterol than me. You think I was crazy if I said that, Right, that's really weird what's going on here? And I think it lies with that. It looks a lot into the history of

obesity and how we talk and think about it. So if you look back in the sixth century, the pope Pope Gregory the First was the first one to lay out the seven Deadly sins, and one of them is gluttony, and it's always depicted with like some hugely fat person picking out It's very deep in our kind of psychees to think of obesity as a sin, right, And one of the ways you know that is what are the

forms of weight loss we had? There's basically only one form, and it follows the classic Catholic pattern of like the sinner, you're sinner. You've got to be tormented, you've got to go through hell and purgatory, and then we'll forgive you. So think about that game show the world. It's called the Biggest Loser, repulsive and wicked show in my view,

but it's where people haven't seen it. People are very unwell, very seriously overweight, are humiliated, made to take part in very extreme and in fact dangerous forms of exercise and starve themselves, and whoever loses the most weight is the biggest loser and therefore wins. It's like, oh yeah, if you torture yourself and go through agony, then we'll forgive you for your sin. Then we'll go, well done, good job, Joe. Right. But I think one of the things that's weird with

those sen because it's so easy, right. So it's like I think a lot of people look at it and go, well, you haven't paid for your sin, right, you haven't suffered. If you suffer, we might forgive you suffer with bariatric surgery. I also think it underlies can you think about right in this culture which makes it so easy to be to over eat and be obese, and so hard to be healthy, lots of people are making daily sacrifices to

not gain weight, particularly women. They're starving themselves, they're denying themselves, they're going hungry, they're doing extreme forms of exercise, and I think to them, people like me must look a bit like Lance Armstrong looks to a cyclist. It's what you, you, bastard. I work so hard for this and you just inject yourself once in the leg a week and you get

the same benefit as me. Screw you. I can see where that impulse comes from, and I think we have to re I think we have to acknowledge those feelings are there. They were there in me, they're in everyone. I think it's you can't live in this culture and not absorb those ideas at some level. But then we have to say, okay, well, A, I don't think of these people are sinners. I think we're typical products of this environment, and i'd hope we can move beyond the

ideas of with sixth century pope. But also in terms of being in a race and competing against each other, well, we are competing, but it's not me against you. It's all of us against the forces driving up obesity, which are the processed food industry. If we reframe it that way,

we can get out. Look, we live in, as you know very well, a toxic age where you know, every conversation turns toxic very quickly, partly because of social media algorithms which prioritize negativity, all sorts of factors that are going on. If we want to have a non toxic conversation about obesity and about a zenpic, I think we've got to acknowledge those ideas about sin and cheating are there, and then we've got a move beyond them.

so I don't want to get it wrong. But if I remember rightly, I suspect I don't know this, but I suspect the fast food industry will soon be funding antio zen pic propaganda, just like the tobacco industry used to fund, you know, claims that smoking isn't bad for you for yearsnars, or like the oil industry still funds claims that global warming isn't happening or is actually a good thing, or you know, over amazed if that isn't.

I mean, they're going to lose a lot of money, and they are some of the most profitable companies in the whole world, so i'd be I suspect they're already doing it.

do that? Or when, as you said, we're trying to find artificial solutions to artificial problems, and now that we're living in an artificial world, it's like, well, where did we allow that to happen? And I want to talk about Japan in that vein, because that was a place where you found that at least tried to deal with this in a much healthier, smarter way.

and therefore these drugs become inevitable. But actually, Japan is the third richest country in the world in the history of the world, and now is the third rich country in the world, and they have almost no obesity at all. Forty two point five percent of Americans are obese. It is four percent of people in Japan. Right, there's almost no childhood obesity in Japan. I went to a school

in Tokyo, typical middle class school. When several schools, it's the weirdest thing walking around a school with a thousand children and they're being not one overweight child anywhere. It's as weird if you're used to going to British and American schools. So I wanted to understand how did Japan do it because I remember at first I read about you know, a zepic has been approved in Japan and are in any sales because there's no one to take it, right,

almost nobody. It's a tiny, tiny market for it. And it's kind of weird that we expect Japanese people to look like sumo wrestlers. It would be like expecting an American to look like a bald eagle. And at first I thought it must just be that Japanese people won the genetic lottery, right, But that's not true. We know that because in the late nineteenth century lots of Japanese people moved to Hawaii. I was just there and they've been there ever since, and Japanese Hawaiians are almost as

overweight as other Hawaiians. So and it's not that their genes suddenly mutated in one hundred and twenty years since. So something else is going on, right, There's something in the environment that's that's driving up obesity in our societies and hasn't in Japan. And there's so many fascinating things about this. I went to. The most important to understand is Japan deliberately created an environment in which it is

hard to get fat and hard to eat badly. If you go back to the nineteen twenties, Japanese people had one of the worst diets in the world. They only ate protein on average once a week. Right, they were quite unwell. They had poor life expectancy, and the Japanese government at the time deliberately transformed the society. Not for a good reason, it's because they were They wanted to have an army to go and invade the rest of Asia.

So we all got our motives for weight loss. Not the best run, but you know whatever, it worked, right they and they deliberately created this new new diet in this new way being which is now continued in policy in Japan. So I went to school, like I say, in Tokyo to see how does it begin. There's lots of layers at which they do this. And I was greeted at the door by a woman called Harumi to t Bay who's the nutritionist at this school, Coenji School. Every school, by law in Japan has to employ a

professional nutritionists. It's a difficult qualification to get. It's three years. On top of your teaching qualification. Your job is to design the food that the kids eat. By law, the kids can't bring back lunches. They have to eat what's prepared there, and they can only that food has to be fresh, prepared on the day and have no processed

ingredients at all. And then they use this healthy food which has to contain all the food groups every day to educate the kids about how to make their bodies healthy. So still, you know, they're eating this food. And Japanese people love food. It's not a place people deny themselves food. They love it. Right, So with these group of kids, they're eating the school lunch, which literally is more like something from Nobu than like anything we ever ate at school, right,

and they're eating it. And I say to these kids through my translator Chier, I said to these kids and never forget it the class I think of in particularly we're nine ten year olds. I said, what's your favorite food? The first kid said broccoli. I love broccoli. I was like, okay, little freak. So to the next kid, what's your favorite food? She said white fish. I said to the next kid, and she said, I boiled white rice. And I turned to cheer and I said, are these kids trolling me?

do they do give you energy? And she ties the ropes together in every lesson and that surrounded meal that you should have in every meal. Right, So they teach kids from a very young age how to nuture their bodies. And I was with these kids, and I couldn't help. I couldn't resist the temptation. I pulled up on my phone videos of British and American school meals, and these kids reacted like I had shown them an Isis beheading video. They like screamed, they were like what are They said

to me, where are the vegetables? Said, there are no vegetables. Where's the salad? I said, there is no salad. They were just complete and it was very touching. My little girl put her hand on my shoulder and said, I'm worried about you. Well it like it was completely adorable. Right. It begins there and then all through the society. There are measures taken to make processed food. You can buy it if you want to, but it's very much a minority pursuit. It exists, but it's a tiny part of

the Japanese diet, overwhelming the fish, fresh food, vegetables. Most people eat fresh food that's prepared on the day. And I think probably the most moving conversation I had for the whole book was in Okinawa, which is an archipelago of islands in the south of Japan, where I really saw what you win if you get this right. So Japan has the longest life expectancy in the world. Women live to be eighty eight. Men I think it's eighty two. But not just that. They have the healthiest lifespan in

the world. So the average British person is in poor health. I think it's sixteen years before they die. In Japan, it's like a few years. So it's a very different relationship. And so I went to this place that sounds almost mythical. It's called Ogeemi. It's the oldest village in the whole world. It has two hundred and fifteen houses and one hundred and ninety two have someone older than the age older

than the age of ninety living there. And I went there and I went to they' got this little community center. And the first person I met, the first woman who walked through the door, was the one hundred and two year old woman called Matsufakucci, who walked there on her own from her home down the hill. And she said, I can't stay long because I'm looking after my son who fell off the roof fixing it the other day.

I was like, Jesus, how old is your son? But okay, and we sat down and we talked and she talked about how much she loved life. It was volleyball season. She's been watching a great grandchildren play volleyball. I actually loved volleyball. You could see how much joy she took in life. Two into all these old women. And then someone put on some older Okinawan music and she put

on a kimono and she started dancing. And so I start dancing with this one hundred and two year old woman, and I thought, wow, you were born before they started doing radio broadcasts in Japan. And here I am dancing with you and recording it on my iPhone. That's what you get if you solve obesity. You don't get destroyed.

Clearly not everyone will live to one hundred and two, but you don't get your knees destroyed and your heart destroyed and your you know, you get to live, and you get more years of joy and more years of laughter, and more years of dancing. That's what we get if we solve this crisis, and it is within our grasp to solve it. These drugs are one tool. They are a difficult and controversial tool, and I'm not sure I've made the right decision to carry on taking them. It

was the heart benefits. That did it for me. But we absolutely can deal with this wider crisis. They've done it in Japan. Think about smoking. Right, when we were kids, people smoked everywhere. People smoked on the subway, people smoked on the bus, people smoked on the plane. Doctors to smoke while they examined you. I remember it happening. There's a photo of me and my mother where she's breastfeeding me when I'm a baby, obviously smoking and resting the

ashtray on my stomach. When I found this photo a few years ago, I thought she'd feel guilty. I showed it to She said, you were a difficult baby. I needed that cigarette. Right. If you think about how normal that was then. Right now, if you saw that, you'd call the police. Right, we've gone from you know, more than fifty percent of people with smokers when we were kids, it's now twelve percent. You very rarely see a young persons smoking cigarettes now, Ka, we've gotn issue with vaping.

But you know that's an enormous transformation that's happened in our lifetimes through concerted action. Right, we can do the same with food. We can free future generations from this shitty choice. Japan showed me you can do it with joy. Right, Japanese people aren't sitting there being miserable. They love food. Their food is grabbed, never eaten, better than in the two and a half weeks I was in Japan. Right,

literally never right. It's not about depriving yourself. It's about making better choices and empowering everyone to be in an environment where we can make better choices.

was like this huge debate intopad. It was from like you know, I can't remember, it's literally for it saying like three percent to three point four percent or like saying that like we wouldn't even notice it in the US if that happened, right, And there's a huge debate, and they introduced something that I, frankly just when I read about it, thought this can't be true. It's so called the Matabo law. It's named after metabolic syndrome, which is a kind of combination of problems you can get

when you're obese. This has very bad health effect. The introduced this rule. I actually kin'd even say it without like it decided insaid in Japan, every single employee once a year has to be weighed by their employer. If your weight has gone up, you have to, by law drop a plan with your employer to bring your weight down. And a company overall has to report its weight levels to the government, and if your overall workforce got fatter, you can be fined by the government. Right, So it's like,

how can this work? So I went to this company that does it. I mean every company does it, but this is a company that agreed to show me, partly because they manufacture products to keep you healthy, so they can't want people to know about it, and they're super nice people, but it was freaky. So you arrive the first thing you see when you arrive at work is

a face recognition thing. It says, hij you walked one three hundred steps yesterday whatever, because you have to wear a fitbit equivalent and a fitbit, and then it says you were number one hundred and twenty one in the company. By the way, Susie who said two deaths away from you hasn't weighed herself this week. Tell her to weigh herself.

You're like, ohh And then so every you're encouraged. It's not required, but you're encouraged to take a photograph of every meal you take and post it so you can literally go, oh, I wonder what Bobby sits next to me eight yesterday and you can look at it all. It's just bizarre. And I was interviewing people there, so in to be the boss, who's this fifty eight year old man, I have to say, incredibly hot boss? And he was like talking about yeah, this is you know,

it's great, it's really good for everyone. And I was interviewing the employees and they would go, yeah, this really helps me be healthy, and I would kind of go, right, So if you did this in the US or Britain, we would burn the office building down. And they genuinely didn't understand we're saying. They would kind of go, well, why they just it was. It really was a moment I thought I could profound cultural chasm, right, I thought, this is you're not like us.

insides of the book. But there's one thing that stayed with me, and it's this idea of even after being on a zebig, if people are unable to change their eating habits even though they're satiated quicker, does that not necessarily double up on the health problems too?

So for me, it made me realize I had to do it. I'm super embarrassed to say it, but I didn't know how to cook. I didn't know how to do really basic things. I learned that partly because I realized I had to make that change. But you could I could have just carried on eating smaller portions. And frankly, I'm on the road at the moment, I am eating

smaller portions of the same shit. This morning I had travelers travel is really tough, or even try living in Las Vegas, no idea, But you're worried about portion size in this country, generally you want to try Vegas. But yeah, so, yeah, the issue A pointed to is real. I mean, you're still moving in a positive direction, but it can leave you, yeah, far from from the ideal position.

And I feel your analysis, research and thought through it is actually so so so helpful in that if people are confused in their decision making for themselves their family, I think you've at least given them every angle possible to think about, which is I think sometimes what's missing, right, Sometimes we are just presented a binary angle, which is where we started and now we're ending today feeling like we can look at this from twelve different angles and

twelve different points of view. We end every episode of On Purpose with a fast five or a final five. These have to be answered in one word to one sentence maximize.

to reflect on as they're making their own decision. What would they be that are not related to be am I or or some of those more tactical elements and not attactical those tangible elements you shared with us earlier.

is these drugs might be significantly reducing addiction. This is hugely contested, but there are serious scientists who think they are, and that's the whole dimension when need to think about not just food addiction, but actually like cocaine addiction, ventimal addiction across the board. Those would I guess be the three things that we haven't covered that would be the things I mean, there's about one hundred things from book.

helping them, addiction massively fell. Deaths massively fell. We could do the same and we'd get the same results. So it would be I guess, take the current law on criminalizing addiction and drug use more generally and transfer all that money to helping people instead.

second time. But I really believe that this book is so significantly important at this time, especially and especially for the younger generations to follow, so highly highly recommend Magic Pill that I really mean it.

And so if you're living with that for your whole life and it was created by a system, that that needs to be addressed, and I think you're addressing it in a really deep and profound way. So thank you.

with all the stretch marks. Now I'm looking at myself like I've been hacked. But day three, when I did it, I was like, you know what, her thighs are cute