¶ Dr. Weil's Journey to Integrative Medicine
Hello everybody, and welcome to another episode of the Smart Human Podcast. Today I am honored to be joined by Dr. Andrew Weil, physician, author of over 14 books. educator and one of the world's most influential voices in integrative medicine. Today we're talking about the innate ability of the body to heal, food as medicine, mental health,
Ancient healing practices, the tenets of integrative medicine, the rise of infectious disease, AI and the future of medicine, and so much more. So stay tuned.
🎵 Music
Hello everybody and welcome to another episode of the Smart Human Podcast. Today I'm honored to be joined by Dr. Andrew Weil, physician, author of 14 books. Educator and one of the world's most influential voices in integrative medicine. For over six decades, Dr. Weil has helped bridge ancient healing traditions with modern science, reshaping how generations of clinicians and patients
think about food, lifestyle and the body's innate capacity to heal. His work has trained thousands of physicians and helped bring integrative medicine into the mainstream. Doctor Weil, thank you so much for being here. It's truly a privilege to speak with you.
Well, it's a it's wonderful to be with you, Aly, and uh I'm looking forward to our conversation.
Me too. So I want to get right into it. Um, you know, for the audience that that uh you know I speak to, um I wanted them to learn a little bit about your origins. Before medicine, before books. What sparked your curiosity about healing and the body's capacity to heal itself?
Y you know, I think my interests go back as far as I can remember. I as a kid I was fascinated by the mind and consciousness and I wanted to know how that the mind affected the body. I have a lifelong interest in plants, something I got from my mother, which she got from her mother, that led me to be a botany major at uh Harvard as an undergraduate, which is a very fortunate choice.
Uh I had an an aunt, my mother's older sister, who was the kook of the family. She was a vegetarian. She went to chiropractors. And that first sparked my interest in other ways of doing medicine. And uh when I was an undergraduate I began reading about alternative medicine. Uh so you know these interests uh go long very long standing.
Yeah. No, I I know you've had lots of variety of I mean it it reflects in the in the aut in the titles of the books that you've written. Um, you've written books about, you know, The Natural Mind was your first book in nineteen seventy two. And then you also wrote a book about uh, you know, from chocolate to morphine. And also talk a lot about the consciousness and and subconsciousness and even psychedelics. So you know, that was early on. Yeah.
Let me interrupt you for a moment. Between nineteen seventy one and nineteen seventy five I had a wonderful fellowship that allowed me to travel throughout the world looking at
Uh, altered states of consciousness, drugs, plants, healing plants, other traditions in medicine. I spent a lifetime in South America. You know, some in Africa. But that's gave me a much wider perspective and really made me aware of uh other cultures, ways of interpreting reality, including how they looked at healing and medicine.
Yeah, that's that's wonderful. And that was actually I think what after college. So you were a young person at that point and kind of And then h what brought you to Arizona and the story behind how you actually began teaching and training in integrative medicine? I mean that was a big
Jump there. You know, I grew up in Philadelphia. I never imagined that I would live in Tucson, Arizona. My car broke down here in nineteen seventy three. That was after I was finishing these uh travels. and it took six weeks to get fixed. It was February of a warm, wet winter. The desert was in full bloom and met people I liked and I never left. And it turned out that was
a a stroke of good fortune because I don't think I could have done what I've done on either coast or at other universities. The University of Arizona was, you know, very conducive to what yeah, some new ways of thinking.
And you helped define integrative medicine for the world, really, back then. And and in your own words today, how would you describe integrative medicine and how was that evolved?
One way you describe it is just good medicine. I've always said one day we'll be able to drop the word integrate. Um I think one way of defining it is as the intelligent combination of conve of the best ideas and practices of conventional medicine. with those of other systems of healing, traditional systems of healing, with natural uh remedies and with an emphasis on prevention and health promotion. I've also said to people that any rate of medicine attempts to correct
¶ Food as Medicine and Thoughtful Drug Use
the greatest excesses and deficiencies of conventional medicine. I think the greatest excess of conventional medicine is is the misuse and overuse of medication. And I think the greatest deficiency is its neglect of the non physical. Uh that it only looks at us as physical bodies and old treatments are directed toward that. And I think that greatly limits our effectiveness.
Yeah, I mean there's such an a desire to learn other tools outside the conventional Western toolbox. I mean, I know that drove me to get involved with your fellowship, which was the first fellowship in integrative medicine training, I think back in two thousand, was it? Yep. Um and um, you know, since that time you've you've trained countless numbers of mostly physicians, but certainly some other um healers um from Allied Health.
You know, in staying the course, I mean you basically came at a time in in the sixties and seventies when this is not really welcomed into the you know, the conventional Western establishment of medicine.
Just really.
To say the least, tell me a little bit about what you had to encounter that most of us take for granted actually.
There was a growing consumer movement that w built through the nineteen seventies, nineteen eighties. uh people wanting this kind of medicine, but the institutions were very close to it. And uh I was paid really no attention by my medical colleagues, you know, and if if I did get any attention it was very negative. And that didn't change until the early nineteen nineties. And I think what happened then, that was when the economics of healthcare really began to deteriorate.
And the conclusion that I draw is that no amount of ideological argument moves anything. It's only when the pocketbooks of institutions get squeezed that they open to new ways of thinking. So I I uh my best friend from Harvard Medical School, Joe Alpert, uh cardiologist, came to be chief of medicine at the University of Arizona. This was in um uh I think it was around nineteen ninety one and he came to the new dean, both from the University of Massachusetts Medical School and um
¶ Healthy Aging and Societal Perspectives
you know, this was a chance to make change and uh I went to the dean and said I wanted to start a fellowship in this field that I was c calling in the rate of medicine. and uh he gave me a blessing to think about designing a fellowship and that was the origin. We now have, as you know, a wonderful physical centre and it is the first dedicated academic integrative medicine center to open in the heart of medical campus of the major university. And it's embraced by
all the uh units of the the Arizona Health Sciences Center and by many of the uh colleges on the main campus as well. So that really represents a milestone.
Yeah, I mean and to think that as a pioneer to start that program there's been successive, you know, programs to train other physicians, allied healthcare workers, um, you know, there's many offshoots and I think so it shows you the ripple effect of what you created at that time, which was sort of an uphill battle.
Um, you've long championed food as medicine. I know we talked about medication by the way. I wanna make a uh a quick comment that that is one of the key things that I think about quite a bit as a rheumatologist who deals with so many medications at this point. But you you've made comments, you know, use the least amount over the shortest period of time. Do you want to elaborate on that piece?'Cause I think
Yeah, I mean any raid metaphone certainly doesn't reject medication, but I feel that when we use it we should as you said, start with the lowest dose of the least potent agent as demanded by the circumstances of illness and then work up from there. And also I think medication should only be used in the context of an integrative treatment plan. that begins with lifestyle modification, including dietary change. Um
But it should not be the sole or or primary treatment. And I think most people have no idea of the harm caused by the medications that we give out so freely. You know, first in terms of adverse reactions. I mean I mean many of them fatal. I mean the numbers of people it's just staggering. And the other is that I think long term reliance on these
suppressive counteractive medications can actually get you into worse trouble, that they can intensify or prolong uh diseases. They're okay for short term management, but then you want to find other methods to maintain improvement.
And in fact integrative medicine teaches a lot of, you know, it not to simplify, but the hacks of Western medicine in many ways. If people conventional people, you know, i it's a way of having alternative options for the some of the same common ailments that we experience, whether it's reflux, whether it's, you know, hypertension, whether or not it's managing sugars.
Um, but the idea that you you know, that you've championed food as medicine is just so critical because it's talking about how food in and of itself has the ability to heal.
Yeah, not a not a new idea. Hippocrates, the you know, the fifth century BC said, Let food by th be thy medicine and medicine be thy food. In my four years at Harvard Medical School, the total instruction I got in nutrition was thirty minutes, which we're grudgingly all out to a dietitian at one hospital I worked at to tell us about special diets we could order for patients.
That hasn't changed substantially since I've been out of medical school. Oh, it is now beginning to change. You know, and there have been calls even from leading medical institutions for curriculum and nutrition to be developed and included. Um, but I think still most doctors are are ignorant about the effects of of dietary change and it's not their fault. They weren't taught it and there was not even any place you could go to
You don't learn that for medical credit and as you know, the food served in medical institutions is generally awful. Um the last I checked I think something like forty eight percent of American hospitals have fast food restaurants on their premises.
¶ Holistic Approaches to Mental Wellness
So you know, we have a long way to go. When I write an integrative treatment plan, almost always the first step is about dietary change and often I've seen that alone uh produce remarkable improvements over time, and certainly in rheumatological conditions.
And and do you feel the same way about drinking water now that that's sort of come in more into focus in terms of what our pollution level is in this country? Yeah, and you are
The whole issue of environmental causation of illness, another subject that was neglected in my medical education. I think is getting a lot more attention now. And uh but, you know, what we do about that, there you know, it's not so easy to protect yourself from all this stuff. And even looking at water, um, I think it's a very good idea to get your water tested to find out what's in it.
uh and to think about you know purifying it. I there have been increasing numbers of articles about dangers of bottled water, um, in terms of of pollutants that it can contain, of leaching plastics into the water and so forth. So I don't know that that's the best solution.
Yeah, it's uh it's it's int it's a big topic, but it it but now with reverse osmosis and some of the newer technologies being more affordable, it's really kind of brought the ability to manage at least that one particular issue.
That's clear, yeah.
Yeah. Question for you. You you wrote a book called Healthy Aging, one of your many books and publications that you've been involved with in two thousand and five.
Um
Twenty years ago, before we had longevity medicine and anti aging medicine, uh, before those became a thing, right, in the health and wellness world. What are your thoughts on that and how do you feel that you've handled your aging process over these last twenty years?
Okay, first of all, I I I really am bothered by the whole concept of anti aging. You know, what I started out in that book to say was that aging is a natural process. Everything in the universe ages. You know, plants age, animals that age, mountains that age, stars that age. If you make your goal anti-aging,
you're putting yourself in a very wrong relationship with nature and that's not a good place to be. And also I think if you're obsessed with anti aging and longevity, that can distract you from what I think is most important, which is learning how Uh what learning what you can do to ensure that you age in a healthy way, that you maintain health as long as possible, and compress the time of
disability and decline at the end of life into sh as short a period as possible. So I'm now eighty three. I can't believe how I got here. Uh I think I'm doing pretty well. And uh, you know, I live by my own uh advice. So, you know, it's aging is really interesting. And also in that book I wrote about we have such negative ideas about aging. Um and I asked people to think about what in our experience gets better as you age.
You know, and I used examples like uh old violins and trees and wine and whiskey. Uh but you know, there are aspects of aging that I think
¶ Psychedelics, Policy, and Public Health Controversies
are really interesting. Mm many older people that I've talked to say that they have greater equilibrium, emotional equilibrium now than they did when they were younger, that things don't throw them off balance as easily.
Um although many people think memory declines with age, there are actually some aspects of memory that I think improve. Um you know, one scientist I talked to said that You know, when something new comes along, i it's easier for him now to to place it in the right context because he has more in his filing system to compare it to. Um so you know, and not not everything deteriorates with age.
That is for sure and I'm I'd like to believe that as I you know, am aging myself. And in fact you actually are the same age my my you went to school with my dad back uh but you didn't know him. But you went to the same high school, so there's kind of a fun connection there and I feel very um connected to you and your work. Um but yeah, aging is a phenomenon and you know, there is such a battle to to kind of control it, to constrain it, to to mask it.
And um I find that must be very unique for you to observe over these
Not only that, Ali, I think that in our culture particularly, we don't want to see old people. You know, we wanna put them out of the way. Uh and all marketing efforts are directed at a young demographic Um, you know, I I spent time in Okinawa which was famous for no long lived people. They had a very high concentration of centenarians. And one thing that struck me there is that the very old people were included in all cultural activities and were considered
you know, living treasures and they felt valued and included. They're very different from what I see here.
Yeah, and and we don't live with our parents and our grandparents and have those set of hands on site. It's often, you know, visiting and and that kind of thing and that's kind of changed even the dynamic of the family. in some respects, you know. So um interesting how that's changed. We've also tried to live longer with technology, you know, be it, you know
dialysis, you know, my dad was involved with, but y things that, you know, medications and living longer but not necessarily living healthier. Well do you see that there I mean, what is your thoughts on the distinction of that?
Well, I ch I think as I said that what the what the goal should be healthy aging, to maintain health as long as possible. Uh rather than the number of years that you live.
How do you think new technology coming through now, AI? How is I mean, we're seeing this with mammography. I you know, they're look running my breast, you know, mammography results through AI, which is making it better in many ways. What are your thoughts on AI and?
¶ The Future of Healthcare and Dr. Weil's Legacy
I think the line is gonna change everything. And I think we've just beginning to see how it's gonna change. I think some things I don't know, I worry about some aspects of it, but I think in general in medicine it might be uh a great boon to us. It m it might make diagnosis much easier. It might make uh
some treatments much better. Um, so I think on the whole it's gonna im improve medical care and I'm not anti technology. I think uh, you know, that properly used technology can Uh, have great benefits and I look forward to seeing what you know, what we come up with.
Uh in terms of mental health and the mental health kind of uh you know epidemic we're having, um how what are your thoughts on on that and how that's evolved in the world.
Uh to me, s uh psychiatry is uh is really in a sad state because it is completely dominated by the materialistic paradigm, uh, which says that all emotional disturbance is a result of disturbed brain biochemistry and therefore the only uh intervention is by giving medication. And the fact is that
Except in certain instances like treatments for bipolar disorder, I think the psychiatric drugs are not very good. You know, they're not very effective. I think they have very significant adverse effects. Uh and there are many other methods available for managing common conditions. You know, for anxiety, the commonly used t medications, the benzodiazepines, are just terrible drugs. You know, highly addictive, interfere with cognitive function.
And don't work very well, whereas the m breathing techniques that I recommend, like the four seven, eight breath, are incredibly effective and free and take very little time. For depression there are so many um things you can do, increasing physical activity, using cognitive therapy. you know, um practicing gratitude. I mean it just goes on and on and on. And the antidepressant drugs are not very good.
Yeah, and there's been a lot of controversy over that. Uh you know, if you start them some of these antidepressant medications and if they're not giving you some type of benefit within a month or so, then likely they're not necessarily going to work at least that particular choice.
And not only that, we're likely if you continue them, they're likely to prolong or intensify depression. That is, you know, what I referred to earlier. You know, if you give
a drug that increases serotonin at neural junctions, over time the body is gonna try to counteract that. That's uh the homeostatic reaction. So it will it will drop serotonin levels and drop serotonin receptors and then if you stop the drug, say after six months, a year, often depression is worse than it was to begin with and prolonged.
And you speak of serotonin, which eighty five percent is in the gut. What what are your thoughts about what we're seeing now with all these uh, you know, not only gut methods of helping the gut work better with the microbiome, which has advanced over the decades, but also now these medications. What are your thoughts on that?
I think the gut brain connection is very firmly established. And the fact that neurotransmitters are produced in the gut, I mean, that's fascinating. And also all the research on the vagus nerve and this as a mate connection. Uh I I think m this is a a a real frontier area of research that's gonna open up new treatments.
By the way, I've never been that much convinced by the serotonin hypothesis of depression. I think the inflammatory hypothesis of depression to me is more compelling. You know, that that depression is one consequence of um uh uh upregulated inflammation.
And by getting to the root cause of where that inflammation stems from is how you get to maybe some, if not all, of the root of mental health.
Uh, true. And that again again comes back to diet. As you know, I I have an anti inflammatory diet that I recommend. I think the the mainstream, the standard American di uh diet, which is abbreviated SAD. Uh you know, is strongly pro inflammatory. It gives us the wrong kinds of fats, the wrong kinds of carbohydrates and not enough of the protective elements that are mostly found in fruits and vegetables and herbs and spices.
And mushrooms.
And you're
Yeah, you love your mushrooms. Tell us a little bit how mushrooms play a role in mental health but also in lots of different other areas of health.
Well, you know, I became interested in medicinal mushrooms long, long ago, originally from I I was first interested in magic mushrooms and then in edible mushrooms. But as I began reading about traditional Chinese medicine I was struck by the fact that mushrooms are very prominent in in uh in them in it. And uh
Uh many of these medicinal mushrooms uh have effects that we don't have medications for in the West. And some of them are specifically useful for mental and brain function. I suppose the main one is lion's main mushroom. that many people know it's a it's a delicious mushroom and now is available as a food mushroom in many places, in many stores, but you can buy also extracts of it.
I think this increases um nerve regeneration and stimulates nerve growth and looks as if it may protect uh cognitive function, so very useful and completely non-toxic.
And when they commercialize mushrooms into powders and shakes and all these things, do you think that that in some way diminishes the the potency or is there is there
Not necessarily. You know, in traditional Chinese medicine th um these medicinal mushrooms well, some of them are eaten'cause they're good food mushrooms, like shiitake and Flying's mane, but others are too woody or bitter to eat and they're commonly made um as hot water extracts. Uh, and that's been used in Chinese medicine for a long time. So I think you can preserve the effects of these mushrooms if they're handled in the right way.
Okay.
And tell me a little bit about psychedelics and how far we've come since we're talking a little bit about mental health and and mushrooms.
Well I think this is a very interesting time. You know, it's taken years for there to be reopening of interest in psychedelics as therapeutic agents. I think that was uh established back starting in the nineteen fifties. Uh we began to see the potential their potential usefulness and they have They're so safe. On a physical level I think they're among the safest of all substances. And the main dangers are psychological and that's related to set and setting, to expectation and environment.
So there has been I think now uh enough research to document the benefits of psychedelic therapy in in mental emotional conditions, especially depression, anxiety, PTSD.
O C D and so forth. Um, but I'd love to see them used in physical medicine as well. I've seen some very dramatic um remissions or cures In including of rheumatological conditions with psychedelics, I have one a friend, a former patient, who had uh pretty severe rheumatoid arthritis, a lot of surgeries for it, um, which disappeared after an N DMA.
uh experience and he was able to maintain that uh by taking M DMA occasionally. So that should be that should be explored. You know, it's not these are not just useful for physic for mental emotional conditions.
Yeah, I was gonna say, I mean I I agree with you and I was wondering if you think the FDA and regulation should play a role.
Well the first step is, you know, we've gotta get them out of schedule one under federal law. You know, it sc things go into Schedule One, they never get out. And uh, you know, Schedule One is defined as high abuse potential and no therapeutic potential. Again, that's absurd. But that will take, you know, a an act of Congress to change that and that's not happening yet. However, the momentum for this is uh tremendous.
Um I think probably before COVID I was um going around a lot giving lectures and it didn't matter what I was talking about, whether it was nutrition, healthy aging, integrative medicine.
I would get questions on psychedelics, you know, how can we find and how can we find people trained to use them? The interest in the general public in this subject is enormous and building. And um, you know, a number of states, New Mexico being the most recent one, uh has just o authorized the use of psilocybin uh for uh def a number of defined mental conditions, including end of life care, which I think is tremendous.
And speaking of regulations, I'm gonna ask you something a little controversial, but what do you think in terms of what we're seeing now with the rise in measles and, you know, commentary on uh vaccines? Just wanted to know your thoughts.
That's the same. polarizing subject that I hesitate to even talk about it in public. Um and I'm I'm you know, when I was in medical school and I was growing up, the people who didn't vaccinate were uneducated people. You know, poor people. Um today it's highly educated people who are rejecting vaccination. And I th I think that's just completely misguided. without risk, but I think the risks of the diseases that they prevent are much, much greater than the risks of the vaccines. And if people
lived with diseases like diphtheria and tetanus and polio, nobody would be questioning this. And you know, we're seeing, you know, it it is certain that these diseases will come back as people stop vaccinating. We're already seeing that with Uh with hooping cough and with measles now very dramatically.
It's coming back. So I I I know I mean I find it very disturbing. Es especially two two things bother me, particularly. One is that I hear you at n doctors, some doctors now getting on this anti vax campaign. I can't imagine that. And the other is there's an anti vax movement among pet owners. Uh that there are people not vaccinating dogs for conditions like uh parvo and distemper and most alarmingly rabies, you know, a really, really terrible disease. And I just uh that bothers me very much.
Yeah, and it's going to potentially affect the, you know, the thoughts and the training of future healthcare workers and future doctors, which um kind of brings me to my next question for you. You've created your integrated medicine training program. You've had such a ripple effect. Um what's the most important quality you hope physicians will carry into their practice?
You know, w so many of the people who've come to us for training have said they were on the verge of dropping out of medicine because they had become so disillusioned with the nature of healthcare today. And uh they said that
um coming into this training program restored their faith in medicine and and they were able to join a community of like minded people. So that's w I wanna see that that happen on a much wider scale. And also No but if I get on my political soappox, you know, the as dysfunctional as our healthcare system is, it's generating rivers of money.
that are flowing into very few pockets. It's the pockets of the big pharmaceutical companies, the manufacturers of medical devices, the for profit healthcare systems. for big insurers. Those vested interests have total control of our elected officials. You know, you can't get elected to office in this country unless you've made deals with that. And it's one big tangled mess that also involves in medical journals
and what research they publish. Um it's taken autonomy away from doctors, you know you're now told what treatments you can prescribe and what you can't. And I I the only way that's gonna change is if there is a grassroots social political movement in which enough people get angry enough about the situation that we begin electing different kinds of representatives. I don't see that happening yet.
And every time uh we have a graduating class at our center, I tell them, you know, my hope is that you will be, you know, the catalyst of this social political movement and you can help you know, people, your colleagues and patients see, you know, how dysfunctional and and counterproductive this is.
and the whole system has to change. So that would be my greatest hope is that, you know, what I've started will become a movement that will transform the nature of healthcare. I think the great promise of integrative medicine and why it is now
you know, becoming mainstream is that it can lower healthcare costs and improve outcomes. And it can do that in two ways. One is by shifting the whole focus to health promotion and disease prevention, which now don't pay, uh, and also by bringing into the mainstream treatments that aren't dependent on expensive technology.
Yeah, well said. Um, so let's hope that things move in a different way. You know, it's it's just it's very daunting. I know there's a big burnout, as you said, burnout rate and you know, there's a lot of um I wanna say distrust, but I you know, the question is where's that distrust being, you know, focused?
Not focused. Yeah, it needs to focus. I think the uh uh I think time is on our side, Ellie, because um you know the the health the economics of health care are only gonna get worse and worse. and the outcomes are not getting better. You know, we have these this epidemic of lifestyle related diseases that we are not managing well. And y I s I said that, you know, in my early career, the nineteen seventies, nineteen eighties,
This was a consumer led movement. But now I think it's it's that it's driven economically and that that's only gonna get worse and the worse it does the m the greater the more people will see the wisdom of what we're doing.
Yeah. Yeah. I mean integrated medicine just always made sense to me. And um, you know, in a very logical way that employs as many, you know, brings in as many tools, including ancient healing. Um
And uh now there's there's a big push even by the World Health Organization. There's a meeting even this week on bringing in traditional medicines from around the world and different cultures. So I'm hoping to share that on this podcast as well. Stuff that I don't know very well. You know, I'm I'm trying to learn as well. So we're coming to an end of our conversation. I know you're a busy person. Um what questions about health and healing still fascinate you actually?
uh that it focuses on the innate healing capacities of the organism. I I think most people I meet do not have great confidence in their body's own healing abilities. And I think that's one of the things I've always tried to convey in my writings and
And teachings and I would love to see that w really begin to be researched. You know, what is the body's healing system? What are the mechanisms? I think the whole first year of medical school should be devoted to that, to the healing system of the human organism.
Yeah, it's great. I think anthropology and evolution should be really emphasized. How did we get here? Why how did we get here? And what are we playing with here? Um, this has been a lovely, lovely conversation and I appreciate you taking time. Um You know, you're at a point in your life where you get to enjoy things like grandfatherhood and you have your I know you love your dogs. That's one thing I I feel very connected to you with is is being an animal lover and a dog lover.
Um, are you still working on projects now or w what do you have your hands in and what do you
No, I've I don't feel like writing anymore. I think I've I've written everything that I have to say. Uh I enjoy teaching, so uh that will continue to be, you know, a an active part of my life and uh you know, I love teaching medical students, doctors, other kinds of health professionals. Um And um I spending more time in my garden and uh cooking and with friends and uh so I'm I'm enjoying life.
That's great. As well as well you should and well deserved. I will say that on personal note that your simple kindness, your warmth, your mentorship over the years have been really wonderful and I've I feel very honored to have this conversation. So thank you again for being here and for taking the time. And I wish you very well, Dr. Andrew Weil.