Ozempic Expert: Ozempic Increases This Disease By A Factor Of 9! They're Lying To You About Ozempic Side Effects & What It's Doing To Our Brains! - Johann Hari

23:40So he gained, I think it was 23 pounds. So he gained a lot of weight. And he started to wonder, sort of like the question you were asking, does this food, when you consume it, change your brain in ways that compel you to consume it more? What's going on? So he designed an experiment that sort of investigated this, which I've nicknamed Cheesecake Park. That's not its official name, right? You get a load of rats and you raise them in a cage. And they've just got the kind of food that rats evolved to eat over thousands of years. It's pellets based on their natural diet. And if you do that, even though they've got far more pellets than they could actually eat, they will eat enough to deal with their hunger and then they just naturally stop, right?

24:19So when they've got the kind of food they evolved to have, they never become overweight or obese. They just stabilize their weight. They've got a kind of natural nutritional wisdom. Then Professor Kenny introduced the American diet to them. He fried up some bacon, he bought some Snickers bars, and crucially he gives them a load of Cheesecake. And they come along and they nibble the Cheesecake and the other stuff. And quite quickly, they just go wild for it. They shun the food they evolved to have. And they just start obsessively eating the Cheesecake, the fried bacon, the Snickers bars. He described to me how they would like, he would put the Cheesecake in and they would just hurl themselves into the Cheesecake and then like eat their way out and merge completely slipped with the Cheesecake.

25:03So given this kind of food, all their nutritional wisdom disappeared, just went away. And they became obsessed with this new kind of food. And as he put it to me, within a couple of days they were different animals. They're all their health indicators were worse, they were obsessively eating within a few weeks. Their health was really bad. They became extremely obese. And then he varied the experiment even more. And it wasn't seem to me as a former junk food addict, a little bit cruel. He took all the American diet away and they just have the food they evolved to have, the food they used to eat, right?

25:36And he was quite sure he knew what would happen. That they would eat a lot more of the kind of natural food than they had before. And this would prove that junk food expands your appetites. That isn't what happened, what happened was much worse. They completely shunned the natural food. It was like they no longer recognized it as food at all. They just refused to eat it, they starved. And it was only when they were really starving that they went back to eating the natural food. There's lots of human examples of this, but there's something as Professor Gerald Mann, who's an nutritionist at Harvard, said to me, there's something about the food we're eating, which I think you're getting at in that question, which is undermining our ability to know when to stop, which is how we got to the point where so many people, 47 % of Americans, want to take a drug that will make them stop.

26:21I was reading about this thing you call the cheesecake park in your book in chapter two. And the other sort of step he took the experiment to was the idea of electrocuting the animals when they ate certain foods. And you say in the book that he then would electrocute the animals while shining a yellow light in their eyes so that they would eventually become scared of this yellow light. And in the case of the natural food, when he shone the yellow light in their eyes, they would run away. But even if he shone the yellow light in their eyes while they're eating the junk food, they would stay and continue to eat the cheesecake, which kind of the conclusion in chapter two of your book, as I've written it here, is, and the other thing that came from the researcher, if you're exposed to this food for a while, Paul concluded the desire for it is so great that you will ignore all sorts of negative consequences to eat it.

27:11As we know, as I know my own life, right, my KFC obsession had obvious negative consequences in my life. And the reason this is so important in relation to these drugs, so for a long time I was looking at two things, right? I was looking at, why did we so many of us gain so much weight so rapidly? Obesity has traveled globally in my lifetime, right? Completely unprecedented human history. Why did that happen? And how do these drugs work? And at first I thought they were like parallel lines, right? But actually I realized they were like kind of braided plates. The answer is completely densely interconnected.

27:42What we know is the kind of food we eat profoundly undermines our sense of satiety. It completely disrupts, just like it did with the rats. We don't get that signal. You're full. You've had enough stop from the kind of food we're eating. And what these drugs do is they restore a sense of satiety. Corel LaRue, another one of the key scientists who developed these drugs, said to me, what these drugs give you is satiety hormones. They give you back a sense of being full. And in a way, at first I thought, well that makes the whole thing seem crazy, right? Because there's a guy called Michael Lowe, brilliant professor at Drexel University in Philly.

28:21He said to me, look, you've got to understand. These drugs are an artificial solution to an artificial problem. We've artificially created this problem through a catastrophic food system that is screwing us up from childhood. And then along come these drugs as the artificial solution to that. And the first thing you think is, right, we've got to deal with the food system, right? And that is absolutely true and correct. And I remember going to one of my closest friends. I call her Judy in the book. It's not a real name. She'd had cancer seven years before. I've been with her all through that kind of really grueling process.

28:55And it was an absolute nightmare. She's a single mom. And you can imagine how grim that was. And I said to her, I feel like a complete fraud taking these drugs, right? I'm always talking about how we need to deal with the causes of social problems. I can see very clearly the cause of this problem. And this is just sort of dealing with the symptom. She said to me, look, you know, hand. You can stop taking the drug. That's fine. Do it if you want to. But when I had cancer, we know there is something in the environment that is triggering breast cancer and women, right? One in seven women in Britain now get breast cancer that didn't happen in the past.

29:34It's not happening in Japan, where it's only one in 38 women. Something is really wrong in Britain in the US in the way we're living. That is triggering breast cancer, right? But she said to me, you didn't say to me when I got breast cancer. Well, fuck me. All this environmental problem has caused this breast cancer. And now you want to inject yourself with another poison, chemotherapy in order to deal with it. No, you said, OK, we've got an environmental problem. Obviously that environmental problem needs to be dealt with. But you've got to stay alive or you can't deal with it, right? The analogy she gave me that really helped me.

30:06Well, she said, if your house is on fire, right? You could say, well, look, we need to build houses that aren't made of flammable materials. And we should make it the law that you've got to have sprinklers. And of course, I agree. But the first thing you've got to do is put out the fire in your house, right? And after that conversation, it was just after it, I met guy called Jeff Parker. He's in San Francisco. He's a 66 year old lighting designer who was about 16 stone when I went when he first started taking weight loss drugs. And he was in real trouble. It heart problems, liver problems, kidney problems.

30:41It was very painful for him to walk. And he got me in gyro, which is the next generation up of these weight loss drugs. And he lost loads of weight and all his health problems reversed. And now he walks his dog over the golden gate bridge every day and is really happy and said, look, I feel like now I'm going to enjoy my retirement. And I said to him, but Jeff, I don't you feel like we should be dealing with the environmental causes. And he said, absolutely, I totally agree with you. You start that campaign, sign me up. But I've got to tell you by the time we achieve that, I'm going to be dead.

31:12Right. We're not going to get there in the next few years. And I want to live. And I found that. I've been hard to dispute. What if people say, well, you know, you could, you could just not choose the role at the coffee shop in the morning. You could have just gone for a salad or something. Yeah. It's a choice you're making your hand. So this was completely the voice in my head. I remember another one, my friends, when I was at dinner and I was doing this, I was talking through everything I've been learning and I was talking about, you know, the what you got away here, I thought was the risks of obesity, which are really disturbing when you learn about them.

31:49I was actually surprised. We all know obesity is not good for your health. I was actually stunned when you look at the evidence about how bad obesity is viewing relation to not just diabetes, but cancer, dementia across the board, been come back to that. So I was like, well, you've got away these risks of obesity against the risks of these drugs. And I learned that there are 12 significant risks associated with these drugs. And he said, what are you talking about? Yeah, I'm going to weigh those risks. Oh, there's a third option. Go on a diet, exercise, right? And he said, I've seen you do it. You've done it plenty of times, right?

32:22Do that. And of course, I had this voice in my head. I thought I was cheating. And I thought, well, why am I not doing that? Right? And I really began to get an insight into this when I went to interview an amazing person called Professor Tracy Mann who's in Minneapolis, where I met her, who's done some of the most important research on diet, ever. I met her, I interviewed her in a place called Iles Bun, which is a cinnamon bun shop famous cinnamon bun shop in Minneapolis. When I arrived, the guy on the door said, have you ever been here before? And I said, no, they said, I will give you a free cinnamon bun, then it gave me this like 2000 calorie massive cinnamon bun that sat there the whole time we were talking about diets.

33:02And Professor Mann, she began to research this in the year 2000. And she wanted to figure out how much to diets work, right? Are they effective? And at that time, the science was very clear. Diet's are really effective. If you go on a diet, you will lose weight, right? But she looking at she's looking at all these studies, it's almost 24 ,000 studies and she noticed as part of this big, it's called a meta analysis. And she discovered something a bit weird, which is most of these studies, the overwhelming majority would follow people who were on a diet for three months. So you exercise your willpower, you go on a diet for three months, you lose a load of weight, and then they just stopped.

33:40And the implication was you stay at that lower rate forever. She'd be like, why don't quite a lot of people who are not in that position that doesn't happen to them. So she looked in more detail and discovered there were 24 studies that had followed diet as not just over this short period, but for two years in a handful of cases, five years. And when you look at the longer picture, the picture is really different. After two years, the average person on a diet has lost two pounds in weight, right? So it's not nothing, but it's pretty close to nothing, right? It's extraordinarily low. So what we know from the research on dieting is there's a very small number of people around 10 % of people who really do lose huge amounts of weight on diets and keep it off.

34:21We all know people like that. I've got someone in my family like that, right? But for the vast majority of people, it doesn't work. And I'm saying to Professor Man and loads of other scientists who've looked at this. Well, how can that be? Because we know you only have to know the laws of physics to know if you consume fewer calories than you burn. Obviously, you will lose weight to speak that you have to dispute the laws of physics, right? So how can it be that these people are dieting, but they're not losing weight? And Professor Man and other people explained to me something that's sort of missing in this picture that I think really helps us to understand it and it's actually important for understanding these drugs, I think.

34:58So a lot of the scientists explained that there are biological changes that happen as you gain weight, which make it harder for you to find your way back in a way that you can sustain. So in the 60s and 70s, there was this theory about weight that was almost universally accepted. It's called set point theory. It sounds a bit complex, but it's pretty simple. You think about your temperature, your body temperature, right? Your body wants you to be at the temperature you and me are at right now, right? And if that temperature goes higher than that, if we get a fever or if we go to the Sahara Desert, our body will work really hard in voluntarily to bring us down.

35:32It'll make us sweat, it'll make us really uncomfortable. And again, if you're and also if your temperature goes below the temperature, we're currently at your body will start to shiver. Again, it will make you really crave heat, right? So your body has a set level at which it keeps your temperature and it works extremely hard to keep you in that zone for your whole life. And it was thought for a long time that your weight was a bit like that, that when you're born or possibly even in the womb, you have a biological set point for your weight that remains the same throughout your life. I think you can go a bit higher or a bit lower, but basically you'll fix there.

36:08But then the obesity crisis happened starting in the late 70s, early 80s. There's a huge weight rise in such a large part of the population, and it looked like our set point theory is just wrong, right? That can't be correct because if it was true, then you couldn't possibly have this. But then Professor Lowe at Drexel and other places and other people discovered what is really happening in my view. I think it produced very compelling evidence for this. As you gain weight, your body set point rises, right? So let's say my body wanted me to be 18 % body fat. As I get to 30 % body fat, my body will then fight very hard to keep me at that higher level, right?

36:48Which seems really weird at first, why would that be? So let's say you gained three stone, right? And then you tried to lose weight. I think of a hypothetical Robert De Niro for the movie Raging Bull gained three or four stone, right? And then tried to cut back. But what you'd find was your metabolism would massively slow down. So you would have to burn far more to get the same number of calories as you do now. You would crave far more sweet and salty foods. You would have lower energy. So you would find it harder to exercise. So your set point has risen and it's trying to keep you there. And I remember saying to Lowe's the scientist, well, that just seems bizarre.

37:26Why would evolution endowers with that? That's such a maladaptation, right? Why would it be? And they explained to me, well, you have to think about the circumstances where we evolved. In the circumstances where humans evolved, in fact, every human circumstance pretty much until like 100 years ago, there was never a situation where you would have completely abundant calories. In fact, hyper abundant calories for your whole life, you'd have far more calories around you than you could ever possibly eat. That never happened. So your body didn't, evolution didn't prepare as we're good instincts for that.

37:59What you did have, what was a big risk was famine, right? There was a big risk that at some point in your life, food would run out and you were being real trouble. And then a famine, the fattest person at the start is going to be the last man standing, right? And John Candy will still be alive at the end of it, all of a sudden, not a great example because John Candy has died, but you get the point, right? So actually, that's why evolution prepared us that, oh, if you gain weight, fight to hold it. Because sooner or later you're going to have to lose it in a famine anyway. So we evolve with this instinct that when we gain weight, we experience these biological changes that make it harder to go back.

38:37It's not impossible. Will power is a real thing. Some people can do it. But when you try, you are fighting against your own biology, you're also fighting against your psychology and your environment for different reasons we can explore. So it's not that dieting doesn't work, but we've got to be honest, at any given time, 17 % of people are on a diet. We've really tried that route, right? We've had 40 years of relentlessly promoting dieting as the O or diet and exercises, the only solutions. And we've gotten fatter and fatter and fatter. So there's something missing in that picture. I think it's partly set point theory.

39:11It's also important for the drugs, because some people argue, like the guy I mentioned before in relation to the brain, Professor Orelio Galli, some of them argue that what the drug may be doing is actually reset in your biological set point, lowering the kind of temperature at which your body tries to keep your weight. It's bringing your set point down so that you don't get those effects, like the metabolism, slowing and all the other things that kick in when you try to lose weight. I think on average, and this might not be accurate, but I think on average, we live more stressful lives than we once did as well.

39:40And I wonder the relationship that are more stressful, more frantic, more busy, notification -filled, social media -driven, screen time lives are having on our relationship with food. And if there's a relationship there at all, more kids have ADHD now than ever. Courtesy level seems to be skyrocketing, and it seems there's a relationship between stress and appetite, which is acting as a gravitational force against our willpower. Now you're totally right. And this is when I go through the 12 risks of the drugs in the book. This is one that I really worried about, one that played out for me, so I noticed I had this weird thing.

40:16About six months since taking the drug, I had this realization. So I was losing a lot of weight, right? I lost a huge amount, I lost three stone. Three stone, what period of time? From now to when I started, so I just over a year. And how quick was that weight loss just out of interest before we moved on? Three. Pretty straight, linear line downwards from the start. But I had this strange sensation. I had it from my friend Danielle was pregnant at the time. I kept bumping into her, and it was like we were on opposite trajectories, like she was swelling and I was shrinking. I'm walking away from her once and thinking, this is really weird.

40:48I'm getting what I want. Why don't I feel better about this? I didn't actually feel that much better for quite a long time for about six months. So why is that? So what do you mean by better? I felt quite muted in my emotions. I felt... I felt... I definitely wasn't depressed, but I felt a little bit dulled. I thought, this is strange. I thought maybe it's just other things going on in my life you never know when it's just an individual. But lots of people are reporting this. Most people are very happy when they say drugs, but there's a significant minority. And so I started looking at this, exactly this question, the psychology of eating.

41:26And it turns out there's kind of five... There's scientific evidence for five reasons why we eat. And obviously the first and most important one is sustenance. I would have thought, if you'd asked me a year ago, why do you eat? I would have said, well, the main reason is to sustain my body, but here I am eating so much less than my body is sustained. So all those other calories I was consuming were doing something else. And one of the things... One of the reasons we... I'm another one is pleasure, which we've talked about. But another reason why people eat is comfort. People get a tremendous amount of comfort out of food, particularly overeating can be very comforting.

41:59We know this partly because whenever there's a stressful event, junk food orders massively go up. Often 9 -11, there was a huge increase in ordering people ordering pizzas and fried chicken. The night Trump won the election in blue states on Uber Eats and the other kind of delivery apps. There was a massive increase in people ordering tacos, you know, shitty food, right? If you're a man and you lose your job, your chances are gaining weight massively increased partly because it's so upsetting and you eat to comfort yourself. And one of the things that happens when you take these drugs is your ability to comfort eat is taken away from you.

42:35You can't comfort eat. And we've got a good analogy, I think, or a good precedent for helping us think about how that affects you. So the best comparison for these drugs if we're trying to figure out their effects, I think is bariatric surgery, right? So up to now, it was very hard to sustainably lose like more than 20 % of your body weight. The only way it was possible to do it very quickly was bariatric surgery. So I think we have to look at the outcomes. That's stomach stapling. There's four different kinds of it. But it's basically what we think of a stomach stapling. Stomach operation. Exactly.

43:07That's one form of it, right? And so I think you have to look at the evidence from gastric surgery. And in some ways, it's very encouraging. So we know that gastric band surgery and other forms of gastric surgery massively boost your health. If you have one of these operations, over the next seven years, you are 56 % less likely to die of a heart attack, 60 % less likely to die of cancer, and 92 % less likely to die of diabetes related causes. In fact, it's so good for your health that you are 40 % less likely to die of any cause over the next seven years, right? So we know reversing obesity massively boosts physical health in most cases, right?

43:48Sometimes very dramatically. But we also know from bariatric surgery, there's plenty of downsides to bariatric surgery. So it's a horrendous operation. And one in a thousand people died during the operation. It's grim. But we also know, where I think it's really important to the thing you're asking about, is that it has an effect on your psychology. So a lot of people are much happier. Most people who have that surgery are glad. But 17 % of people who have that surgery have to have inpatient psychiatric treatment afterwards, because they're so depressed or distressed. Your chances of committing suicide almost quadruple after you've had bariatric surgery.

44:20And I think there's lots of reasons why some of it must be the grimness of the operation and the aftermath. But I think a lot of it is, you know, you take away comfort eating from people, right? If you go through life, especially people with gastric band surgery or the other surgeries, you know, those are people who were very severely obese, so they will have had this effect very powerfully in their lives most of them. If you take away something that is a key way of soothing people, when that goes well, you can rebuild your life, you can find other ways to get that soothing, and that's really valuable and important.

44:53But a lot of people just experience it as profoundly painful and distressing. And it's a lot of people like that. When people have those surgeries, I read in your book in chapter 8, that one in 10 people then pick up a different type of addiction to alcohol or gambling or shopping or drugs or something else. So that's pretty clear evidence that the psychological soothing is just moving somewhere else. It's fascinating. And distressing, and I've also spoke to people who've been through those, it was called an addiction transfer. I spoke to this amazing woman called Robin Moore, who had been 303 pounds.

45:25She'd had bariatric surgery because just nothing else had worked, and she felt she was really a slave to food. That was how she put it. And it had this incredible effect. She knew why she had gained weight so much. In her case, it was when she was a child, she had been sexually abused, she'd been raped, and she'd never told anyone. And she quite deliberately gained weight in order to keep men away from her. She thought, well, if I'm really fat, I'm less likely to be attacked. But she's surprisingly common. And she lost all this weight, and she felt great. She felt physically much better. People were treating her much better.

46:06But she had this shift where she, she'd never been much of a drink. Actually, it appears when she was at college where she drank a fair bit, but she'd never been heavy drinker. And she just quite rapidly became a very full -blown alcoholic. She used to work out by the airport in Toronto, and she would drink on the way there, drink on the way back. And she got fired because she was drunk at work eventually. And the her, she kind of realized, you know, and I think it's interesting ways to think about this in relation to these drugs. And I want to stress this is not going to be everyone. I don't think it's even going to be a majority of people by any means.

46:44But when you take these drugs, the underlying psychological reasons that drove your eating are profoundly disrupted, and in many cases come to the surface. And for me, that was painful at first, but helpful. I remember having a day in Vegas, as you know, I had spent a lot of time in Vegas coming right in a book about a series of crimes that had been happening there. And a day was investigating something really grim, and I felt really bad. And it was relating to someone, it's a long story, but it's something terrible. And I went to the KFC on West Sahara. It's the grimest KFC in the whole world.

47:16I have a secret love for it. And I, on a kind of autopilot, I ordered what I would always have ordered, you know, like a load of fried chicken. And I sat there, I'm thinking, oh, shit, I can't eat this. I remember Colonel Sanders was on the wall looking down and it was like he was going to be, what happened to my best customer, right? So being deprived of comfort eating is quite apart from being deprived of pleasure, which I think is sort of related, but a bit different, is very difficult. And again, my friend who I, I can just had cancer, went to her and said, this is really hard, right? And she said, look, it's not that the drug is causing this problem.

47:55The drug is making this problem visible to you. And now you can deal with that in other ways, right? And that's what I've been trying to do and write about how in the book. But, yeah, so one of the things that fascinated me about all the research for my book, Magic Pill, was how incredibly complex this is, every time you look at one effect, it seems to have another effect. This is a really complicated, difficult topic. And anyone who's coming in telling you either, Rar Rar, these drugs are great and they're going to save us all, all these drugs are devils, it's terrible. I don't think he's leveling with people.

48:28I think it's complicated. I think there's risks every turn. And I think we need to think through the complexity together in a way that's honest and, and, and honors the complexity. You talked there about the impact that early childhood trauma has on our relationship with food and eating. I remember reading a little bit about that in your previous book, Lost Connections as well. But what is, what is the sort of data in the stats that that prove that trauma can cause us to have this kind of excessive comfort seeking relationship with food? Is there any particular studies that stand out for you? Oh, yeah, I mean, a guy that I got to know quite well when I worked on Lost Connections and I thought about this research in a different light when I worked on this book.

49:08So this guy called Dr. Vincent Fili Ti. And in the early 1980s, he was a doctor in San Diego and he was contacted by Kaiser Permanente, who were a big not -for -profit medical provider in the state. And they said to him, look, we've got a problem. We don't know what to do. Obesity was massively rising. Actually, it was very low by our standards, but it was hugely rising. And they were trying, giving people diet plans and exercise plans and nothing was working. And they said, look, we don't know what to do. Can we give you a load of money to just do blue skies research? Go away, figure out what we can do.

49:40And he said, okay, so he took a load of money and they was like, what can I do? And he started working with 200 very, very obese people, people who were severely obese, who had tried all sorts of ways to cut back and it hadn't worked. And he's sitting there working with them and he's thinking, what can I do? And he had an idea that sounds and actually is quite stupid. He said, well, what would happen if really obese people literally stopped eating and we medically supervised it and we gave them vitamin shots so they didn't get like scurvy or whatever. Would they burn through the fat stores in their body and get back to a healthy way?

50:13So with a shit load of medical supervision, they did it. And incredibly at first, it worked. There was a woman who I'll call Susan, that's not her real name, who went from being more than 400 pounds to 138 pounds. It was incredible. And her family, everyone in the doctrine saying, you saved Susan's life, she's really thrilled. And then one day something happened that no one expected. She cracked, she went to KFC or wherever it was, she started obsessively eating and after a while she's back where she was, not exactly where she'd been but similar. And Dr. Flety called her in, he said, Susan, what happened?

50:52She looked down, she was obviously really ashamed, so they don't know, I don't know. He said, well, tell me about that day, right? The day you cracked, did anything happen that day that didn't happen any other day. It turns out something happened that day that had never happened to season before. She was in a bar and a man hit on her, not in a nasty way, in quite a nice way. But she just got completely freaked out and she went and started eating. And that's when Dr. Flety said to her, well, Susan, when did you start gaining weight? In her case, I think it was when she was 10. He said, well, did anything happen when you were 10, that didn't happen when you were 9 or 11 or anything happened that year?

51:28She looked down and said, well, that's when my grandfather started raping me. Dr. Flety interviewed everyone in the program. He discovered that 60 % of them had made their extreme weight gain in the aftermath of being sexually abused or assaulted, which is a staggering figure, right? 60 % of the women. And he was like, well, how could this be? It was really puzzled and Susan explained it to him really well. She said, overweight is overlooked. And that's what I need to be, right? If you're severely overweight, you're much less likely to be sexually attacked, right? It's obviously can happen, but it's rare.

52:03And when you understand that, you begin to see again in relation to these drugs. And why some people get really freaked out when they take these drugs? Because some of them experience it as suddenly, oh my god, I'm really vulnerable to this traumatic event being reenacted again and again. Now, that's one example. There's lots of, we go down the list of reasons why people eat like I do in the book. There's lots of other ones that get triggered and activated and disrupted as well. You're talking the book about this word I've never really come across before, which is a phrase, I guess, you say the environment is a besiegenic.

52:37I've any other heard of that term, carcinogenic. Carcinogenic. Yeah, which basically means something can give you cancer. But you're saying that the environment we live in is, I mean, the way that I read it was like that it's almost contagious. Like it's going to give me obesity just by being alive in the modern world. One of the stats that really stood out to me when you're talking about processed food is that on average, when we process food, we end up eating 500 more calories every single day. And that again is startling. You know, I've had a few guests on this podcast that I've talked about processed food in the rise of it.

53:12And I do wonder to myself if there's ever going to be a change in society. If we, if there's any indication that at some point, I'd know government will step in and ban it or tax it more or something will happen. What's your, what's your view on if we talk about the optimism of the a besiegenic environment changing? Do you think it can change? Do you think it will? So, crucially, I went to a country that had completely transformed its diet. And as a result has very low obesity. Japan, we can talk about that. And I went to loads of countries that are making the changes you're talking about. So, prompt me to come back to that.

53:47But I would start by saying, we're a you're totally right. We live in an a besiegenic environment. An a besiegenic environment is an environment that primes you to be obese and where it's hard to be a healthy way. Right. It's hard to get healthy food. Healthy food is expensive and rare. Whereas shitty food that makes you obese is cheap, abundant and constantly promoted to you. Right. So, that's an a besiegenic environment. And there's loads of evidence that well as professor Michael low put it to me. We live in as a besiegenic environment as human beings could possibly design. Right. And there's seven ways in which process food undermines your ability to stop eating that I go through in the book.

54:24So, if you're feeling pessimistic and I'm clearly. You're right to feel pessimistic. Someone is charismatic and brilliant as Michelle Obama could not even get us to join a campaign to physically move. So, I get it. There's big obstacles here. But when you feel pessimistic about it. The first thing I would say is think about smoking right. My mother smokes 70 cigarettes a day. There's a photograph of me and her where I'm. She's breastfeeding me about six months old. She's smoking and resting the astray on my stomach. When I showed her this photo, I thought she'd feel guilty. She said, you were a fucking difficult baby.

55:01I needed that cigarette. But you think about that. That was normal. Right. When I mean in Scotland, that was normal when I was a kid. Right. She think about smoking when I was seven years old. More than half of the population of Britain smoked. Right. And people smoked everywhere. People smoked on the tube. People smoked on planes. People smoked on game shows. The doctor would smoke while he was examining you. I'm not joking. I remember that happening. Right. So, if I could take you back to the Britain of 1987 and you could walk around, you would just you would feel sick because the smell of smoke was everywhere.

55:35Right. And there were just ash trays everywhere. I found them up. I was with my mother when it was the anniversary of there was a terrible catastrophic fire at Kings Cross Station here in London in 1987. I think. And I was with my mother when it was the anniversary a few years ago. And so it was a terrible disaster. There was a fire. Someone had put out a cigarette near an escalator and it killed more than 50 people. It was awful. And my mother said, Oh, that was the worst day of my life. And I said, Oh, were you there? Did you know somebody died? She said, No, that's the day they banned smoking on the tube.

56:07Anyway, so if I could take you back and I said to you, Right. How many years we are on from that now? And only 12 % of British people will be will smoke. It will be falling and the British government will be about to progressively ban smoking. You won't be allowed to smoke indoors anywhere except your own home. The rates will have tanked. Young people will be almost no cigarette smoking among young people. And they're going to progressively ban it by age. That would have seemed ludicrous. Right. You could have said, well, the back of industries, one of the most powerful industries in the whole world.

56:39You've got a very motivated half the population are addicted. It's never going to happen. These things can change. That's a huge public health transformation in a very short period of time. These things can change. And I've seen how it can change with food so that we're not in this situation where we have to choose. As we are at the moment between the many of us, not all, between the risk of obesity and the 12 big risks associated with these drugs. What are they waiting for? Because the government knows this. The government knows that processed foods and the, you know, the quantities that the average person's eating is bad.

57:14So they could presumably get something done this year. So, but they won't. There's a brilliant writer called Rebecca Solnett who says, politicians are weather veins and it's our job to be the weather. You're a politician. You're constantly making a calculation. Right. If I do this thing, how much praise will I get and how much shit will I get for it? Right. Because of me, and you know, some of them are good people, many of them are good people, but you're constantly making that calculation in a democracy. And right now, if you do the right thing on food and there are loads of things we do, I saw in Japan where we can go down the list of all the things we need to do.

57:46And that could transform health, particularly for our children. You'd get some praise, but you get a lot of shit, right. You get a lot of shit for it. And for many years of my life, I would have been one of the people who gave them that shit, right. So I understand it. We have to change that calculation by helping people understand and make better choices in ways that I saw happen. So I can explain how they did it if you want. Please. Japan is really important, I think, for thinking about how we get out of this trap, because at the moment, the way it's often presented is, look, we're just screwed.

58:22Right. There's just this huge obese population. That's the product of being rich. If you're a rich country, you've got lots of calories around you. Inevitably, we're going to have loads of obesity. And inevitably, we're just going to need to give loads and loads of people these drugs forever. And, you know, a few years from now, as many people predicted to me, we'll have 40 % 50 % of the population taking these weight loss drugs. Right. And what Japan showed us is we don't have to choose that fate. Right. So if you look at Japan, Japan is the only country that got rich without getting fat. 4 .5 % of Japanese people are obese compared to 26 % in Britain and 42 .5 % in the United States.

59:01And it's actually 42%. 42 %? 42 %? But do you want me to say 70 % of obese are overweight, right? Jesus. So it's the norm is to be obese are overweight. Right. Whereas in Japan, it's completely the opposite. It's kind of weird that when we picture Japan, we often picture sumo wrestlers. It's a bit like expecting the average American to look like a bald eagle or something. Right. It's as if there's a completely atypical. And I learned a huge amount about what's happening there. So the first thing you think when you hear that is it must just be genetic. Right. They're just they won the genetic lottery.

59:29That must be what's going on. But we know that's not true because in the late 19th century, loads of Japanese people went to live in Hawaii where I just was. And there's now this settled Japanese population in Hawaii who've been there for four or five generations. And they're almost as fat as other Hawaiians. Right. So they're five times faster than. There are five times more likely to be obese than Japanese people in Japan. So actually when the environment changes, Japanese people become obese like everyone else. So there's something else going on. So I wanted to understand how did Japan do it?

1:00:01And one of the really interesting things is it was very consciously done. There's a guy called Professor Barack Kushner is a professor of East Asian history in in Cambridge University who's talked about how actually if you go back to the 1920s Japanese people had one of the worst diets in the world. They only ate protein once a week. They almost never ate fish right the only fish once a week. They had a terrible dire. And the Japanese government at the time wanted a healthy population so they could form armies that would go and invade the rest of Asia. So they deliberately transformed the food culture in Japan.

1:00:34Very consciously. So I want to see how do they do that now. Right. What's going on. So I went to a school called Koenji school, which takes kids from five to 18. And it was totally fascinating. So when I arrived there, I went with my translator. The first you arrive and all the kids walked to school on their own from the age of five. All Japanese children just leave the house and walk to school on their own. They get a lot of exercise in the morning and they walk home on their own as well. And we were greeted at the entrance by a woman called Harumi to Tibet, who's the nutritionist at the school.

1:01:05By law, every Japanese school has to employ a professional nutritionist. It's a difficult qualification to get. It's three years of study on top of learning to be a teacher. And your job is to design and oversee the creation of the food in the school. All processed food is banned. No one is allowed to approach. There's no processed food in any Japanese schools ever. Every meal has to be prepared from scratch at the start of the day. And no one is allowed to bring in a pack lunch. So every kid has to eat the food that's prepared in the school. Her job is also to use those meals to educate the children about how to eat healthily.

1:01:41So they teach them all sorts of key principles. One of them is in Japan. This is a very deep cultural norm. You should only eat until you're 80 % full. So it takes a while for your body to realize your full. So if you get the signal that you're full while you're still eating, they're like, you've eaten too much, right? So you should eat until you're 80 % full and then stop. There's all sorts of norms that are very different to ours. So if you look at a typical Japanese meal, it will have five portions, significantly more than ours, but they're pretty small. Right? She might have some fish, some miso soup, a whole range of things.

1:02:15And which is important for your gut health because there's a bigger variety of ingredients which makes your gut much healthier. But also you eat it differently. So if you gave us, you know, a meal with three bits, generally you eat all of one, then all of another, then all of another, you'd have all the lasagna, then you have the carrots or whatever. In Japan, that's regarded as like a crazy way to eat. You have a mouthful of the miso soup, then you have a mouthful of the white fish, then you have a mouthful of the sashimi, and you have a mouthful of the sashimi. So you're putting it down massively if you eat that way.

1:02:49And they're also taught, I remember her standing there. So the meals in all the schools are designed to be nutritionally balanced through these five components. And so she stands in front of the class and teaches the kids, you know, okay, this is a red rope. This represents calcium. What does calcium do? And kids go, oh, makes your bones stronger. So yes, that's this on your plate. This represents carbohydrates. What do they do? They give you energy and the kids yell out. And then she ties the rope together. See, now it's all tied together. Now it's a balanced meal. So they use this healthy food to educate the children about how to eat healthily.

1:03:24It's a very beautifully designed system. And it was fascinating looking at them. I mean, I got taste even. It was really weird. So this is a school of a thousand children. I walked through that school all day. There was not one fat child. It was odd. Like it's jarring when you go, right? That they have, you know, they have extraordinarily low childhood obesity. And I remember with these kids, I was asking them their favorite foods. The first kid I asked them, my favorite food is broccoli. It's like, right, the second kid said, my favorite food is seaweed. And the third one was like, I like white rice.

1:04:00And I said to Chie, my translator. Are these kids trolling me, right? Like what their favorite foods are broccoli and like white rice. And she just looked kind of puzzled. And every Japanese person I asked said, Well, we teach our children to like healthy food. Don't your children like healthy food. And I was so taken aback by these kids. I brought up on my phone, some pictures of like typical British school dinners and showed it to them. And they literally reacted like I had shown them an ISIS -beheading video. They like scream. They were like, what is this? And once I did you eat this every day?

1:04:32I was like, yes, they're saying, where's the salad? I said, there is no salad. They're just completely affled. So they partly start with this very strong culture, creating a very deliberate culture of how to eat differently. The begins at a very, very young age. There are some other steps that are a bit more dodgy that we can come to, I'm sure. But that was the kind of first pillar of it that I saw. And then over here, we're in, we're in this sort of craze of injecting ourselves with this thing called as impact. Can I see the pen actually? I've never actually seen one before I went open or anything.

1:05:07Oh, of course, I don't contaminate it. I've just been so intrigued to see what these things are like. Once weekly, nover, nor disk now the most valuable company in the whole of Europe. What are they giving me some context on nover, nor disk? There are Danish pharmaceutical company. So there's two companies that are kind of pushing the main drugs in this, pushing sounds too pejorative day. You know what I mean? So novo Nordisk or a Danish company. The entire Danish economy has had a massive growth because of the popularity of these drugs. Since they came out, they've become the most valuable company in Europe.

1:05:42The market for these drugs is predicted to be $200 billion by the end of this decade. And the other one is Eli Lilling. And if I, how do I get this? Do I have to go to a doctrine, get a prescription, or can I just go buy this online or something? So this is part of the problem and this leads to one of the really big risks associated with the drugs, which is eating disorders. I am really, really worried about this. So there are lots of young girls in particular, some boys, but it's mostly girls who want to starve themselves. We know that it hugely roams during the pandemic. And this is the most effective tool for self -stabation human beings have ever come up with.

1:06:17So I interviewed a lot of eating disorders experts who are terrified about what's coming down the line. And the truth is it is very easy to get hold of it. I went, you know, you could go online now. You clearly do not meet the criteria for getting these drugs, right? You've got to have a BMI of higher than 27, which is a BMI that comes from fat mass, not muscle mass. So you would not meet the criteria at all. If you went online, you could go and see a doctor on Zoom, lie about your BMI and you would get it in the mail two days later. Right? They're meant to check your BMI, but on Zoom, that's very hard to do.

1:06:50If in the unlikely event you would turn down by a doctor on Zoom, you can just order effectively counterfeit ones online very, very easily. So I'm extremely worried. I think we're going to have a, there are many downsides to these drugs, possibly the worst from my point of view. One of the two or three worst is you're going to have a huge wave of young women who get hold of these drugs and do a lot of harm to them. So now there is something we can immediately do to massively limit that harm. Lots of the eating disorders experts say interviewed like Dr Kimberly Dennis is one of the leading experts in the US said to me, these drugs should only be given by prescription.

1:07:32If you go to a physical doctor and the doctor you physically go to to get them needs to be trained in detecting eating disorders and referring people to help with eating disorders, if that's what they think they've got. So these were initially created for people that had diabetes. They have a dual effect. So GLP1, the hormone GLP1 and this kind of replica event stimulates the creation of insulin, which is obviously what diabetics lacking either type one or type two diabetics. So the whole thing was discovered by accident, I interviewed the guy who discovered it, a guy called Daniel Drucker, amazing man.

1:08:06So they discovered he was just looking at, so your whole body is made out of cells, right? And in the 70s it was discovered there were new ways of looking inside cells that human beings had never had before. So by the 80s 1984 was when he made a breakthrough, they were just going through different cells in the human body trying to figure out what they do. And they got to the glucagon gene which exists inside your pancreas. And they were trying to figure out so the glucagon gene is a long chain and at the end of it is GLP1. And they were trying to figure out, well can you break off that little bit of the chain or if you break it off does it just with or die.

1:08:40And he discovered, Dr Drucker discovered you can break it off and then he was like, well what does it do? So he starts experimenting in lab dishes in Massachusetts General Hospital and he discovered that if you combine it with insulin, it produces more insulin. So that's why it's so valuable for diabetics and immediately he was like, whoa that's really significant. So then other people in the lab, Professor Spetliner, Mosjoy, gave it to rats, put it in rats and discovered it in fact produced insulin in rats, a team in Copenhagen, put it into the pancreas of pigs, discovered it produced insulin there.

1:09:14And that set in, set in train what later became giving it to diabetics. So that's the most one, obviously the greatest benefit of these drugs that was initially discovered is they hugely helped diabetics. Then the effects around appetite were discovered separately initially here in London in the Hammersmith Hospital. That was when they discovered, oh if you inject people with GLP1, this is before they had copies of it. If you inject people with GLP1 it reduces their appetite. Oh okay, you can see where their thinking went from there. So there's dual uses. And their dual uses are kind of incredible.

1:09:47If you look at, when the effects on diabetics, obvious. But if you look at the health effects we that are emerging around these drugs, this is very close to my heart literally because of the heart problems in my family. If you take these drugs, if you started with a BMI higher than 27 and you take these drugs over the next five years you are 20 % less likely to have a heart attack or stroke. So we're talking about, this isn't something we're like, oh this is vanity. And there's an element of vanity in me and in most people taking these drugs I'm sure. But this is having massive health benefits for lots of people.

1:10:20How many people are willing to take it? Because as we discuss this now, say that there's a million, 10 million people that listen. What percentage of those people on average would go, do you know what? That sounds like the thing I've been looking for. If there are Americans and the polling is right, 47 % of Americans have said they would be willing to take. They want to take these drugs actively wanted. Oh, they want to. It's about 50 % of this audience will be actively wanting to take it as we sit here now. Yeah. And now tell me why they shouldn't. Well, there's a huge array of risks, some of which are very, very serious.

1:10:55So I'll give you a few examples. I go through lots in the book. There's a professor in France called Professor Jean -Luc Feille, who works at the University Hospital in Montpellier, who was commissioned by the French medicines agency to investigate these drugs and the safety around these drugs. And one of the reasons lots of people have felt very happy about the safety of these drugs. And it's a good reason is they in their rollout for obesity. People have said like Daniel Drucker, for example, who I mentioned who discovered JLP one. They say quite rightly, well, look, diabetics have been taking these drugs for 18 years now.

1:11:28If there was some catastrophic effect, we would know it would have emerged in diabetics, right? Now he would also add, well, it could affect obese people a bit differently than diabetics. So there's some gaps in the knowledge. He said, look, this drug has been used by enormous numbers of people all over the world without some huge safety concern emerging. But others have said, okay, let's really dig into those diabetics then. So that's what Professor Feille did. So they've got very good health databases in France, the best in the world. So he decided to look at diabetics who've taken these drugs for three years sometime between 2006 and I think 2015.

1:12:08So he looks at loads of the diabetics who've taken them and then he compared them to a group of other diabetics who were very similar in every other way but had not taken these drugs to see other differences in outcome. And it was particularly looking for one outcome. We know that when you give these drugs to rats, they are much more likely to develop thyroid cancer. So he's looking, okay, is there a difference in thyroid cancer risk in this population? And what he discovered was very sobering, it was published. So the people who've taken the drugs had a 50 to 75 % increase in their risk of thyroid cancer.

1:12:39Now when I first said that, what the fuck? You have to understand what that doesn't mean. That doesn't mean 50 to 75 % of people who take the drug get thyroid cancer. If it was that outcome, they would pull it immediately and no one would ever take it again. What it means is whatever your thyroid cancer risk was at the start, it will go up by between 50 to 75 % if this research is correct, right? This then is being further investigated. There are some scientists who dispute it. The European medicine's agency has not been persuaded by the evidence so far. But that's pretty sobering, right? That's, you know, 1 .2 % of people get thyroid cancer in their lifetime.

1:13:1684 % of them, I think, survive. You know, a big increase in people getting thyroid cancer when you're talking about millions of people across the world taking it is very alarming. What about this thing called a Zampic face? Yeah, I'm not worried about that purely for a selfish reason. So a Zampic face is where I'm worried about it for other people. A Zampic face is where you lose so much weight that your face looks really gone and you look kind of hollow. And my face is so naturally round. Like, babies always smile at me. I think because they think I'm their king. I'm just like a baby that inexplicably got to walk around.

1:13:51I could lose so much weight in my face and not look good. I'm not worried about that by myself. There's no health problem with a Zampic face. It's just, you know, vanity thing. Well, vanity is too negative a word. It's, you know, people don't want to look gone and ill. That's very enough. Pancreatitis. Pancreatitis is a rare side effect, but it's very, very unpleasant. So pancreatitis is basically where your pancreas just goes haywire as a result of taking these drugs. I need a little woman called Michelle Stesney -Akkie, who's in Mertle Beach in North Carolina. She started taking these drugs and her doctor said, you know, there's a few side effects.

1:14:27One of them is pancreatitis and she said, no, my luck. I'll probably get it. She starts taking it was really happy with the weight loss. Six weeks later, she went to Pittsburgh to visit a daughter. She woke up in the worst agony she's ever been in. She had this excruciating pain running all from below her breast round her back. She was vomiting. She was shitting herself. She was screaming in pain. And her son -in -law, phone for an ambulance. He thought she was about to die. She was in such a state of distress. She arrives at the hospital and they discovered something really wrong with her pancreas.

1:15:01They said, are you a heavy drinker? She said, no. Then they said, are you taking ozampic? It's kind of revealing. That was the second question they asked. So we know that if you take ozampic, there's a study by the University of British Columbia, that found it increases your risk of pancreatitis by a factor of nine. So you're nine times more likely to get it. It's still rare. You're very unlikely to get pancreatitis. Even when you're time is at by nine, it's still a very rare outcome. But doctors often compare it to the pain of being stabbed. Michelle said to me, it was much worse than the pain of childbirth.

1:15:34They had to give a fentanyl to take the pain away. So if you get medical care, you recover. It's worth people knowing that is a significant risk of just an excruciatingly painful condition. One of my friends has started taking ozampic. There's this word on the side of this pen in front of me, semagglutide. Semagglutide, yeah. What did I say? You said it in the way it's in curiously. The way the scientists say it's semagglutide. It looks like semagglutide. Exactly. That's how I said it until all the scientists kept correcting me. It was slightly patrodized away. But yeah. What's the actual word?

1:16:06Semagglutide. And is that the chemical? And is the Zampic? Yeah. Yeah. Exactly. So there's several brands. So there's semagglutide, which is the drug, which has this GLP1 agonist effect. Ozampic is the one for diabetes. Wagovies are the one for obesity. They're exactly the same drug. They're made in the same battery. They're identical. It's just that Wagovies marketed for obesity. And you can in the US, not here yet, prescribe Wagovie for higher doses than you would for diabetics. And then there's other drugs that are coming along the line. So there's Minjaro, which is made by Eli Lilly. So Ozampic are Wagovie produces an average of 15 % loss of body weight over a year.

1:16:47Minjaro causes a loss of 21 % on average. And the next one that will come down the line, it's probably going to come out next year, triple G causes 24 .2%. The reason Minjaro works differently. So this only works on GLP1. Minjaro adds another gut hormone, GIP. So it works on two gut hormones, not just one. And triple G works on three gut hormones. And there's going to be more and more drugs. I mean, there's 37 gut hormones that can affect appetite, they think. So there's going to be lots of variants of these drugs with different side effect profiles, different risks, different benefits. So yeah, this is one of the South African psychiatrists called Corellaroo, who's been at the absolute forefront of the developments in this said to me.

1:17:28You know, when a baby starts to walk, it's been crawling for ages and then it just stands up and it walks. And we are at that point. And it was striking how much the scientists kept describing it as a game changer. You know, one of them, Tim Specter, who I think you might have had on, described as, it's like they found the Holy Grail. They found the thing that causes weight loss, right? Robert Kushner said that to me, who's another one of the scientists spend at the heart of it said, we cracked open the treasure chest, we found the thing that controls weight. It's your gut hormones. So I worry about the parallels with previous diet drugs and we can talk about that.

1:18:06These are new drugs working in a new way. And the overwhelming feeling in the science is, no, this really is different. My friend is a biotech billionaire. And when I saw him, I saw he's the very forefront of all of these things. He takes so many different things to optimize his life. One of them he started taking us as an impact. And last time I saw him, he was, we're in the gym together and he was significantly weaker. He was significantly skinnier. But I noticed when we did our exercises, he was significantly weaker as well. And that strikes me as a bit of an unspoken about side effect is muscle loss.

1:18:41It's one of the 12 big risks that I write back in the book. So muscle mass loss is a real problem. People who don't know muscle mass is the total amount of soft tissue that you have in your body. And it's essential for doing anything that requires movement and strength basically. And any form of weight loss causes a reduction in muscle mass. So if you, it's someone's very, very overweight and they lose a huge amount of weight on a diet, they lose a lot of muscle mass. Hopefully you lose more fat mass than muscle mass, but you lose a lot of muscle mass. You can't control that, right? You just, there's no way to lose a lot of weight that doesn't involve some muscle mass loss, unless you're very, very lucky, right?

1:19:13So obviously this triggers a huge amount of muscle mass loss. And there's real worries with that, right? If you lose muscle mass, so you naturally lose muscle mass from when you're 30 onwards anyway. You lose quite a lot every year, it's incredibly depressing when you look at the figures. You lose muscle mass naturally every year anyway. But if you lose too much muscle mass, you won't, you'll be a bit weaker now, but the real risks are when you're older. So if you have really low muscle mass when you're older, you're at risk of a condition called sarcopenia, which is Greek for poverty of the flesh.

1:19:46Basically, it just means you're really struggled to climb the stairs, do any kind of physical activity. You're more likely to fall if you do fall, you're more likely to die. It's, it's quite a serious thing. And this I think is particularly going to be an issue for people who are already skinny, like the people at that party, we were talking about right at the start. None of them were fat at the start, right? People who were already skinny, who were taking it to be super skinny, they're going to see, they're going to have real issues with their muscle mass likely when they're older. So this is a very serious problem.

1:20:15We could be building up a time bomb of more frail older people further down the line. You lose up to 20 to 30 % of your lean muscle mass when you start taking a Zen pick, it says in your book as one of the risk profiles. For some people, yeah. For some people. Actually, weirdly, I was 33 % fat mass when I started and I went down to 22 % I think it is now. So I lost nothing but fat mass, but I suspect that might be for the slightly humiliating reason that I had no muscle to start with. But I'm not sure. And then on the psychology, the mental health side of things, a suicidality as some cases where suicidality, things like feelings of anxiety and depression increase, is that because of the underlying reasons why we're eating the self -soothing stuff or is that a separate side effect?

1:20:55So it's hugely debated. There isn't even agreement that the drugs cause that effect to an minority of people. You've got a bare mind. At any given time, some of the population becomes suicide or some of them will be taking these drugs. So it's very hard to disentangle that, especially early on. So some scientists would say there isn't even any evidence they cause suicidality. Among the scientists who fear that it may cause suicidality, there's a big debate. Some of it will be your deprived of comfort food or pleasure. Some of it will be, as Corellaroup had it to me, a lot of people who are overweight for a long time say, you know, the reason my life is shit is because I'm overweight.

1:21:33If I finally lose weight, my life will be good. And then they lose weight and they've still got the same asshole husband. And they've still got the same job they don't like. And they suddenly go into this crisis where they're like, oh, it wasn't the weight that was blocking me. It was everything else, right? They say, don't they, the difference between happiness is your expectations and realities. You can imagine if you have that expectation that losing this weight is going to make me happy. And you fall short of the expectation because it doesn't. The anti -climax can cause so much psychological discomfort.

1:22:04Yeah, and I spoke to people who've been through that. And I think that can be a really big issue. There's also a suicidality. So some other people would say, well, OK, the psychological effects are probably real. But it might come back to what we were saying about dampening the reward system in the brain, right? There were people like Professor Patricia Griggsen, who's done some of the really cutting edge research on effects with addiction in this, who said to me, you know, that's a real concern. Now she's stressed we don't know yet. No one definitively said, yes, it is causing these problems.

1:22:34We know how it was weird. It was like, hey, like I said before, it's you're seeing this picture form. It was fascinating that there's so much we don't know, which makes it kind of disconcerting. It's like, oh, so this is an experiment on millions of people. I know one of the guinea pigs. Great, right? So it's disconcerting how much we don't know. But yeah, that is a big worry. And we've been here before with diet drugs as you're alluding to where we kind of rush into the party. And then everyone rushes out of the party because we realized that history of diet drugs. Stephen is absolutely grim beyond belief.

1:23:07So the first kind of modern diet drug was something called dionetrofinal. So there were a load of people in France who were working in ammunition factories during the First World War. And people noticed that they lost loads of weight, right? Not that they didn't have weight problems at the start, but they lost a huge amount of weight. And it turned out they were ingesting this explosive powder through their skin and breathing it in. So after the war, a load of scientists at Stanford were like, oh, maybe this can be a weight loss treatment. So they made it into a pill called reduce souls, which were very popular.

1:23:37There was 100 ,000 people taking them in 1934, which when you consider there was very low obesity back then, that's a huge number of people. And then they discovered just, I mean, it's almost unbelievably terrible what happened. So loads of the people taking them went blind. And then they went into this horrific fever where their bodies were burning up. So it's an explosive, right? So it was discovered that the way it works is it massively speeds up your metabolism. But when you take a high dose, it gives you cataracts, makes you go blind, and then your body goes into a fatal fever. And the way one person put it is you become cooked from the inside.

1:24:14So they stopped marketing that one. It continued to be used as the pesticide for like years and years, because it is so good at killing anything it comes across. So then there was a craze for amphetamines. So again during the war, during the Second World War, radar, people are to watch radars. Soldiers who had to watch radars were extremely bored. So they gave them amphetamines to sort of keep them on the job, keep them active, mentally alert. And it was discovered they lost loads of weight as well. So after the war, they started marketing amphetamines as a weight loss drug, right? And they became hugely popular.

1:24:45They were described as mothers little helper. By the time you get to 1970, 80 % of all the prescriptions in the United States were found fetamines for weight loss. But it was discovered that when you take amphetamines, you develop tolerance to them. Your body gets used to them. So you need higher and higher doses to get the same effect. But if you take really high doses of amphetamines, you just lose it. I mean, you can become psychotic. It hasn't really bad effect. When you don't sleep, it's terrible. So then there was a real rolling back among amphetamines. And then there were some real horror stories, like jaw wiring, where they were wire up, the jaws of obese people so that they could, they literally couldn't get any food into their mouths.

1:25:24But then it was discovered if you vomit, while your jaw is wide, you can choke to death. I mean, just like nightmare -ish, horrifying, humiliating solutions. And then we get to the worst of them all. And also the most popular of them all until these new drugs, which is called FENFAM. So this was in the 1990s. Early 1990s, a group of scientists decided to combine two diet drugs that had existed until then. One was called Flex Flora -Mean. It's an appetite suppressant. But it was never very popular because it makes you very drowsy. So they combined it with ventramine, which is an amphetamine. So it had the kind of counteracted the drowsiness and it had an additional weight loss effect.

1:26:00And it worked incredibly well. People taking it lost as much weight as they lose on ozampic. And it's actually eerie when you go back and look at the coverage. From page of Time magazine, the new miracle drug was the headline. You know, by the time you got to the mid -90s, there were 18 million prescriptions for FENFAM every year in the US. And then a group of ordinary doctors in Fargo in North Dakota were like, a lot of our patients are getting really ill. When they take this and raise the safety signal, turned out the drug company had known about this risk all along. So it was discovered that when you take these drugs, they caused something called primary pulmonary hypertension.

1:26:41It's where the blood vessels in your lungs massively contract and you can't breathe properly. They also damaged your heart. I mean, the stories were just horrendous. There was a young woman in Massachusetts called Mary Linnon, who was about 28, wanted to lose weight for her wedding day, starts taking FENFAM. A couple of weeks later, she was trying to climb a hill and just gets really breathless. And it's like, so weird here. Goes home. It's really breathless. Goes to the doctor. He takes her off the drug. But by then she had the problem. She needed oxygen her whole life. She was told she could never have children.

1:27:15And then one day she couldn't breathe. And she died. It's happened to lots and lots of people. It led to the largest payout in the history of the pharmaceutical industry up to that point. They had to pay $12 billion to the people whose hearts and lungs were harmed. And that is not that long ago. Now, I want to stress again, that was given to people with a very poor... There was a single study of 120 people, a FENFAM at the point at which it was marketed to people, which is staggering. This has a much bigger body of evidence. So this is not going to be in the short term FENFAM. But when I looked at the 12 big risks associated with these drugs, some of which have not really been explained to the public, one of the ones that was most disconcerting, and was explained to me by brilliant scientist Greg Stamwood, who's at Florida State University, and is researching these drugs, the biggest risk is what he called unknown, unknown.

1:28:05So you remember that Donald Rumsfeld thing, right? So when he was talking about the invasion of Afghanistan, but when he was the US Secretary of Defense, he said, you know, when it comes to these things, there are things... We're called known, known, known. There are things we know we know. There are known unknowns. There are things we know we don't know, where is our summer bin Laden? And there are unknown unknowns. Things we don't know we don't know that might hit us out of the blue. And with these drugs, there's a big worry about longer term unknown unknowns. So for example, we know very little about what happens to pregnant women when they're taking these drugs, right?

1:28:41We know that in the animal studies, when animals are other non -human animals are exposed to these drugs, they're much more likely to get birth defects. So one thing Dr. Stamwood said that we should think about, and he stressed this is speculative, we don't know, was think about antipsychotics, right? In the 1950s, doctors started giving people antipsychotics. They were judged to be safe. Lots of people were to speak that, but park that for a second. And people took them for many, many decades. And then it was discovered really late in the day, that when you get into your 70s and 80s, if you've been taking antipsychotics, you are much more likely to get Alzheimer's disease and other forms of dementia, like much more likely.

1:29:19Now there's no way you could have known that at the start. It was an unknown, unknown, right? You couldn't have known that. You had to have people taking it for a really long time before you could find that out. Now one of the concerns about these drugs is that they will be unknown, unknown, that we can't know about. These drugs are working on your brain. They're working very hard on key parts of your brain, parts that relate to memory processing, taste processing, gut motility, right? We don't know, but there's at least some risk there. Now again, you have to weigh that against the risks of obesity.

1:29:52As Dr. Shawna Levy, who's at Tillane School of Medicine, put it to me, we don't know the long term risks of these drugs. We do know the long term risks of obesity, and they are horrific, really horrific. And much worse than I thought at the start. For example, I'm much quite embarrassed to say this. Diabetes, right? I knew that you were much more likely to become diabetic if you were obese. Figures on that are kind of shocking. If you're obese when you're a teenager, your chances of developing diabetes are 70 % in your life, right? Shocking. But I thought, all right, diabetics, they get insulin, and then they're basically like the rest of us, right?

1:30:28As long as you've got health care, you're fine. Interviewing doctors, they were like, no, no, no. Lots of people think that if you get diabetes, it knocks on average 15 years off your life. There's a doctor here, Dr. Max Pemberton, a close friend of mine, and a brilliant doctor, who's just saying to me it seemed really shocking when he first said it. But then he went through the evidence. He said, if you gave me a choice between getting diabetes or becoming HIV positive, I would choose HIV every time. If you become HIV positive, as long as you get medical treatment, you live as long as everyone else.

1:30:59If you get diabetes, you know, not only does it knock 15 years off your life, your chances of all sorts of catastrophic complications in your life are really high. It's the biggest single cause of blindness, in Britain preventable cause of blindness. It's a massive cause of leg amputation. More people get an extremity cut off in the US because of diabetes every year than because of being shot, right? I mean, it's, and you go down the list of all the harms associated with obesity. Diabetes isn't even number one, right? So every time I talk about the risks of these drugs, I really worry about the risks of these drugs.

1:31:34There is a lot of them. People should go through it very carefully. If you have thyroid cancer in your family, for example, I would strongly recommend you don't take them. If you know, you're already worried about your muscle mass, don't take them. There's a whole range of caveats and clauses. But we have got to be honest about the risk of obesity. And for me, if I'm being honest, I think the choice was ongoing obesity or these drugs. And so for me personally, I have made the judgment call off looking at all of this evidence that I'd rather take the risk of those and pick them the risk of ongoing obesity, especially given my family's history and how many men die young of heart attacks.

1:32:11But loads of people will look at the evidence that I present in Magic Pill and take totally the opposite point of view and that they will turn out to be right and I might well turn out to be wrong, right? I wouldn't be barred that there's a fan fan like scenario down the road, right? It's not likely, but you'd be a fault to dismiss it. I am in a different camp and I have to say before I express my opinion that I understand there's a lot of people out there where drugs like this will literally save their life. And if they don't take these drugs, then you've gone through some of the stats, but they will probably die from something, some form of more, you know, we talk about all cause mortality a lot, like something will kill you in the next couple of years, whether it's a cardiovascular issue or something related to another element related to obesity.

1:32:59My thing, and this is, I think, developed over time, we're doing this podcast and it's being just so many experts in health and fitness and wellness and psychology and psychiatry is I just have this really deep innate belief that there's no such thing as a free lunch in life. And I've just the more I've done these interviews, the more I've come to learn that everything is a trade off and I almost see life as like a scale. So if you, if you, if you put away on one end, there's going to be an equal and an opposite force somewhere else, you know, like the what's the law of physics? Is it Einstein that said that that you can't like destroy energy?

1:33:37You can just move it. And I think about the same with like drugs often and other things that seem like miracles or shortcuts. You're moving the set of issues somewhere else. You've talked about some of those movements today, like the psychological transfer of soothing behavior to an addiction, for example. That's always been my like belief that whenever one of my friends says, Steve, I'm taking this limitless pill, my daffonil and it's making me super productive and it's fixed all my problems in life. And I'm killing the game now. I go, what's the cost? Yeah. And my friend said to me, I want to, he started taking it.

1:34:11He was like, there's no cost. There's no side effects. And my brain goes, hmm, history shows. If you wait long enough, there's always a cost. It's just being conscious of the cost. And when you balance up as you've done in your life, the pros and cons, you say, OK, I'm willing to take the cost. Now, when I see things like a Zempek and people say to me, there is no downside. I get more scared because I can't run the numbers to see whether the cost is worth the upside for me. So I don't know what the big obvious downsides of a Zempek and these magic drugs are, but I feel like logically there must be one.

1:34:47We do know there are some medications where pretty dependably the benefits that way, the risk, think about statins, right? If you have a problem with your cholesterol, what statins do is they block part of your body that makes cholesterol, right? So it's the most commonly prescribed drug in the US. It's pretty close to it in Britain. Almost every doctor would agree. There are some downsides to statins, but sometimes they're just like... You have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right?

1:35:14Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? Yeah, you have to stay on them for life, right? I'm not saying these drugs are that, definitely not. But there are some medications which do seem to be just... I'm not that there's no cost, but the benefits are really unambiguous and massively outweigh the cost. This is a much more finely judged thing. And it's interesting to me, it's been funny talking to people who read the book because...

1:35:48When we're talking to the marketing teams at both my publishers, because some people who were the first people to read the book apart from my friends, so some of them came up to me and said, oh, yeah, I love your book. It made me really want to take a Zen pick. Some of you came up to me and said, yeah, I love your book. It made me think convinced that you'd have to be completely insane to take a Zen pick. And it was a bit like, you know, the dress, the... Some people saw it as gold, some people saw it as blue. And I felt like that meant I'd done my job, because unlike pretty much everything else I've ever written, I've ended this feeling as conflicted almost as I was at the start, right?

1:36:24This is a huge thing. It's going to change, and we've talked a lot about the personal dilemmas. It's going to have a huge social effect. Barclay's Bank commissioned a very sober -minded analyst named Emily Field to make predictions that could guide investment based on these drugs. And she said, if you want an analogy, you have to think of the invention of the smartphone, right? I mean, this is going to have so many unpredictable effects. Already, Krispy Kreme Donart stocks have been tanking the head of nest. And then, I said, I'm going to have to go to the West Lane Mark Schneider. He said, we're worried about their ice cream and confectionery ranges.

1:36:59And Jeffery's financial did a report for the airlines in the US saying they're going to have to spend much less on jet fuel pretty soon, because it costs, takes so much less jet fuel to fly a much thinner population. What I was fascinated by is companies that manufacture hinges for neon -hit replacements are seeing their stocks tank, because people are going to need far fewer neon -hit replacements, because they're overwhelmingly that's driven by obesity, right? So not entirely, but overwhelmingly. So yet, if we were talking in 2007, when the day Steve Jobs unveiled the iPhone, I don't think we could have gained out, you know, one -tenth of what was about to hit us.

1:37:40And I kept having these moments, traveling all over the world, interviewing these experts. Remember one day, I was in a cafe, I was interviewing one of the keen neuroscientists at Cambridge University who was working on this. We were in a cafe, and there were loads of people walking past, and it's, you know, just random British people, a lot of him overweight or obese, like I was. And I was thinking, wow, you don't know what's about to hit us all. It was a slightly weird, unreal feeling. I mean, this is for better and for worse, and I think there will definitely be positive effects, and there will definitely be negative effects.

1:38:17And I think we can see early on what quite a lot of them are. This will change the lives of all of us in one way or another. Q1 is often when businesses start implementing new systems and processes in hopes of creating efficiencies for the year ahead. And over the course of my career, I've learnt just how crucial having the right systems in places, one which has helped me across many of my investments is NetSuite. They're also a sponsor of this podcast. NetSuite is the number one cloud financial system through their streamlined platform you'll find all of your accounting financial management inventory and HR in one place.

1:38:52Their technology has been a real game changer, especially for my team at Flight Studio. As over the last year, we've moved out of startup mode and into scale at mode. We no longer have to juggle multiple systems and having everything together has reduced the number of manual tasks and errors. Over 41 ,000 businesses have chosen to future -proof their business with NetSuite. So if you'd like to learn how it can help your business, head to NetSuite .com slash Bartlett and free download the CFO's guide to AI and machine learning. That's NetSuite .com slash Bartlett. I'm just thinking as you were speaking there about a bunch of statistics that I've read recently.

1:39:27Humans are getting more and more sedentary, which means we're moving a lot less. Obviously, obesity is going up across the Western world most obviously. And then you've got this rise in a Zempec, which allows us to stay skinny, basically in suppressor appetite. I was just wondering, there's going to be, it feels like there's going to be two groups of people. When these drugs drop in cost and they become really accessible, and I saw you say in the book that the next sort of iteration of these drugs is going to be a pill. A lot of people won't want to inject something. I'm one of the people that just, I'd get too squeezy about having to inject myself.

1:39:58So the minute something becomes a pill, it brings down one of the psychological barriers. It's cheap, it's a pill. A lot of people are doing it. If you're not doing it in the obesity, a genic, whatever that long word was, environment we live in, it's almost like you're going to be an inferior human to some degree. There's going to be two parts of society, the 50 % that are down to take the pill, and they're going to be skinny and they're going to be whatever. And then the 50 % that are struggling in this difficult food environment we live in with the ultra -process food, I almost can't play our scenario where most people aren't taking this magic pill.

1:40:35So there's a few assumptions of what you've said. I think I'm probably right, but there's a few assumptions. So in a way, what you're saying, there's sort of few different dystopias that could emerge. One is actually that we don't even get to where you are because it's restricted to a tiny number of rich people. So let's start with the first dystopian vision we could have. The first is that we never even get to that point. Let's imagine, basically we have a situation at the moment where the real housewives of New Jersey get to be super, super skinny, and the real school children of New Jersey get diabetes at the age of 12.

1:41:10So we could have a situation where these drugs exist and they work very well, but they are restricted to a tiny elite of rich people, which is kind of where we are. So you're maxing on a stand like that, there is it. In the longer term, it won't, and it's not that far off. So in 2032, the patent on a Zempic passes. So then it's not actually that expensive to make these drugs. It's $40 a month to actually make them. It's the rest is profits from over Nordisk. Who argue, understandably, you know, look, we took all the risks of developing this. We should cash in now. You can see that argument, although I don't think they need to cash in quite as much as they are.

1:41:44So one scenario is it will go out of patent in 2032. By then, it looks like the main way of taking some agglotide will be pills anyway. So you can well imagine a situation where you've got $40 a month to take a daily pill that will make you much thinner. I think in that scenario, you're right. Now what I most hope is that a, the drugs don't have a catastrophic side effect, obviously. B, the people who want them get them. And C, it wakes us up. And we go, how do we get to this point? How do we get to the point where we're looking at potentially drugging our children forever, not knowing the long term effects?

1:42:24Who did this to us? And how can we be more like Japan and all the other countries that are making these changes? Now it's not domestic. That requires a lot of raising of consciousness between now and then. But that's the most optimistic scenario for you. But you're totally right. There could be a scenario. It's probably the most likely scenario if there isn't some big risk that emerges that we'll just have staggering amounts of the population taking these drugs. Unless the government intervene that feels like the most likely scenario. Unless the government introduced some laws that put restrictions on what children can eat at school and all those kinds of things in a more severe way.

1:42:58I can't see a scenario where, especially with this younger generation, you know, you hear all these stats around young girls on TikTok being more anxious than ever before, the suicidality going up. Men are struggling more than ever with body dysmorphia, which no one's talking about. I was reading some stats about that yesterday. Yeah, shocking the figures on that. And the antidote appears to be, I mean, this is not a good solution, right? And perfectly normal healthy people who just have a little bit of belly fat. And they hear about this stuff. They go, you know, going to the gym is hard and I do love those burgers and that care of season is really nice.

1:43:35It does taste really good. So I could eat my KFC and I could stay skinny and I could eat it. I think that last bit, then they're wrong. If you take it, you won't want to eat the KFC and the burgers. And believe me, I've been the king of KFC. Just three bites. I've got a couple of bites though. Well, but you don't get, you actually don't even want that particularly, right? And it's huge numbers of people are seeing that. I mean, for most of the time, I had been eating smaller portions of similar shit. But actually, even your taste for that tends to kind of wane over time, right? So the last bit's wrong.

1:44:05But I think, yeah, it's one of the things it's funny. I didn't. It's one of the things that made me really angry in Japan. I was thinking all the sagging I've done, all this worrying, and a worry even more about the fact we're almost certainly about to start a massive wave of drugging children with those M -PIC. He already begun in the US. That interviewed parents who were drugging their kids because their children are obese. And I thought this whole dilemma never had to happen, right? This happened because the food industry screwed us over and we didn't regulate them and we didn't stop them. And we can start to do that.

1:44:42And I went to places that have done it. I went to Mexico where they introduced a sugar tax, hugely reduced the amount of sugar that people consume. I went to Minneapolis where they prescribe healthy food for poorer people who can't afford it. It has a really positive effect. I went to Finland where they had a huge transformation in the food supply. I went to Japan. There's here in Britain, there's a really interesting experiment. Bread used to have far more salt in it. And a really heroic guy called Professor Graham McGregor who I interviewed persuaded the government to just get the food companies to sort of lure them.

1:45:13I mean, they threatened regulation which meant that the companies gave them before they did it. To just massively reduce the amount of salt in bread. No one even noticed. And it reduced strokes every year in Britain by between 6 ,000 and 9 ,000. And a stroke is one of the worst things that can ever happen to you. Now, it's called reformulation. There's loads of other things we can do like that. We could reformulate loads of foods in ways that aren't even painful to us. There's so much we can do. There's so much we can do to be like Japan. I mean, it was a bit weird in Japan though because there were things they did that we can't do.

1:45:47So I give you an example. This was one of the weirdest days of the research for the book. In 2008, obesity very slightly went up in Japan. It was still like, laughably low. And they had a real panic and they introduced this new law. It's called the Metabolic Syndrome, which is a really nasty combination of like diabetes, obesity, and other problems you can get when you're very overweight. And the law is very simple. Every single company in Japan, on a particular day every year, has to weigh every single person who works there. And if their weight has gone up, they have to drop a plan with their employer to bring their weight down.

1:46:26And as a company, overall, if your weight goes up, you can be fined by the government. And I was like, how could this possibly work? So I went to a company that does it, Anita, but they all do it, but a company that let me go and see how it works. And it's really weird, right? In this workplace, you arrive, you show your face to a video screen. It says, Hi, Stephen, you walked 14 ,000 steps yesterday. Your number 121 in the company in terms of steps taking, because everyone has to wear like a fit bit, or the equivalent to a fit bit. Everyone uploads pictures of every meal they have to this system where you can see it.

1:46:59It was bizarre, right? And yeah, explained to the Japanese people who kept going, you know, every morning in this office, when we would all be having donuts and coffee, they do aerobics together. It was bizarre. And I sort of explained to these Japanese people, right? If you tried to do this in Britain, we would burn the fucking office down, right? And they would just go, well, why? Why? They couldn't understand why I was so affronted by it. And that, okay, that's a big cultural chasm. And we can't do that. And I wouldn't want us to do that. But if you look at so many of the other changes in Japan, I started to see like what you win if you get this right.

1:47:38So Japan has the longest life expectancy in the whole world. And one of the best things I did for the book, whether it's moving things for me, is I went to the oldest village in the whole world. It's in Okinawa, in the deep south of Japan. And there's a village called Ogimi, where there's 215 households, and 190 of them have someone who's over the age of 90 living there, right? So it's the oldest place on Earth. And Japan has, by far, the longest life expectancy in the world. And not just that, you're far less likely to get sick as you age. So they have not just in more life, but more healthy life.

1:48:13And I went to their little community center. The first person I met was a 102 -year -old woman called Matsu Fukuchi, who was this like, almost like this kind of perfect crumple of wrinkles, right? I should have so cheerful chatting to her, she was like, I can't stay for long, because I'm looking after my son who fell off the roof the other day, fixing it. I was like, Jesus, how old is your son? And she was like, oh, I love, you know, she was so full of joy. She was like, I love life. I spent all of yesterday watching volleyball with my grandchildren. It's so great. She was so happy. She'd walked out on her own.

1:48:47And then there was this moment where they put on some music. She put on this red kimono. And she started dancing. And all these old women as old as the centuries start dancing, right? And I danced with her. And I was thinking, God, this is... This woman was born before radio started broadcasting in Japan. And here I am recording an interview with her on my iPhone. This is what you get if you get this right. If you sort out the obesity crisis, you get to have more years of health, and joy, and dancing, right? That's what we're fighting for here. I think about how many people I know who died young.

1:49:30Because of complications related to obesity, everyone listening and watching will know someone who would be alive now if we had sorted out the obesity crisis, but has died. Everyone, right? And it doesn't have to be this way. You know, now part of that solution in the short and medium term is going to be these drugs. In the longer term, it doesn't have to even be that. Right? Japan is a real country. It exists. They solved this problem. There are other countries in the world that are solving these problems. We don't have to tolerate this being done to our children. We don't have to accept us being made sick, and our children being made sick.

1:50:09But it requires an awakening around what's really happening, who's doing this, does at the moment. You know, whatever I... My weight goes up and down, right? It has gone up and down throughout my life. And whenever I was faster, I would blame myself, right? I wasn't angry with the forces that have done this to us, right? More three -year -old children know what the McDonald's M means than know their own last name, right? I didn't choose that world. I didn't choose to live in a world where we were, you know, constantly promoted and fattened and physically changed, such that it's hard to come back, right?

1:50:40I don't mean I had no responsibility in that, I did. But we don't have to continue like this. Do you think you could stay at the weight you are now without this, as I'm hooked? It's funny you're holding this. I feel like we're in a weird dystopian version of PVC. Do I think, honestly? Well, if I'm typical, we know from the clinical trials, 70 % of people regain the weight within a year. No, I don't think so. If I'm being really honest with myself, I don't think so. I think I have made lots of changes in my life. I mean, I don't think I would go back to quite where I was, but I think I would very rapidly regain a lot of weight.

1:51:17So you have to take this for life now to stay at the way you're at, therefore? Yeah, and there's a big debate about we mentioned before with the M. Fettemaine -based diet drugs from the past that people develop tolerance. One of the big question marks around this is, do people develop tolerance? Does it mean that over time it will have less of an effect? Now, some scientists asked about this just wildly all over the place. Some said, no, we do know diabetics don't seem to develop tolerance. Because if they did, they would need higher and higher doses to get the same level of control for their blood sugar.

1:51:49So that's a point against tolerance. But others said it would seem quite likely we develop tolerance. We developed tolerance for most drugs. It would be surprising if we didn't probably what's most likely again, Correll LaRue, the South African psychiatrist, said to me, again, probably the best comparison is bariatric surgery. You have bariatric surgery, you lose an absolute shit ton of weight, and then you regain a little bit of it over the next few years, and then you sort of plateau at that higher point. But we don't know. The truth is no one knows. I'm also concerned that if you, is there a world where if you stopped taking this, your body had become reliant on your GLP1 coming from this, so your body makes less GLP1 itself.

1:52:31Don't you think it's so much, I don't think that's the concern? I think there is, I think you've gone to a really important point. We know all forms of diet slow down your metabolism, right? That's a reality about diet, which is why often people end up fat at the end than they were at the start. I'm worried about, and again, I asked lots of scientists and people just said, we don't know, I'm worried about, is my metabolism slowing down as I take this drug? If I, let's say they discovered some terrible problem with it and it had to be withdrawn, would I then have a slower metabolism and be fatter than I was at the start?

1:53:09No one knows, that's a significant risk. And the other big sort of risk here is you've talked about a few times as this, eating disorder epidemic, it seems. I think you talk about in your book that since March 2020, rates of anorexia and bulimia were 42 % higher than they would be expected for teenage girls aged 13 to 16. I think that's because I locked down to be fair, that's not the result of the drugs, that's because of the mass of stress. Yeah, this is locked down. Some research in the Lancet Journal, and 32 % higher for those age 17 to 19. What I'm saying here is that we do have an issue with eating disorders in the Western world especially.

1:53:45They skyrocketed after the pandemic, but when I think about eating disorders and bulimia and anorexia, and I think about this and what it might mean for those eating disorders, I feel somewhat concerned, especially when kids get their hands on them. Go beyond concerned, and we don't have to speculate about this. We've been here before. So in the early 90s, there was a very popular and fetamine -based diet drug that was marketed in the United States. And it was huge, and lots of teenage girls used it, and it led to a catastrophe. There was a guy called Rob Wyden, who was a congressman for Ohio at the time, who held congressional hearings on this, and they are really chilling to read, because they show what happens when a popular diet drug combines with eating disordered young women.

1:54:29So there was a woman called Jessica McDonald who testified at the hearing. She was in her early 20s at the time. So she was a ballet dancer, so we know about the horrendous pressures on body shape for ballet dancers. And she would take this drug, like this fetamine -based drug, until she passed out to be thin. She would take it to staff herself, because she wanted to be that ballet ship. It was a guy called Tony Smith from State Center in Iowa who testified that his daughter Noelle, from when she was very young, became obsessed with the idea that she was fat. She would go and look at these fashion magazines and say, Daddy, do you think I'm fat?

1:55:05Why do I look like these women? And she got hold of these diet drugs, massively starved herself and died of a heart attack. And he read out this heartbreaking poem, where she describes, like, you know, I'm hungry, I want to eat, but not yet, not yet, right? So we know that when a diet drug combines with eating disordered as it leads to catastrophic outcomes, we don't have to speculate. So yeah, that's one of my three or four biggest concerns. Now, like I say, we can introduce regulation now to me. You only get it from a doctor. The doctor has to see you. That will cut some of that. But I don't see how, and that's really important.

1:55:41And anyone we save is worth saving. But yeah, I'm very, very concerned about that. I'm also concerned about a more subtle effect in relation to that. So the worst moment I had in writing the book was not any of the physical side effects for me, although there were some grim moments there early on. It was a moment when some might, I've got a niece called Ernie. She's a young girl, she's a young girl. And she's 18 now, although she's 19 actually. But in my head, she's sort of six years old all the time. Like, she's the baby in my family. She's the only girl. She was the youngest. So no one makes me more protective.

1:56:11And one day, a few months into taking these drugs, I was face timing with her. She was in a pub in Liverpool. And she was like, oh, yeah, Hannah, you've lost so much weight. And I was like, oh, look, I can see your jaw. I never knew you had a jaw. And I was like, oh, yeah, I was thinking you're happy. And then she looked down and she said, will you get me some ozampic? She's a perfectly healthy weight she always has been. And I thought, what the fuck am I doing? All her life, I've been trying to give her this message. Don't be judged by how you look. Don't worry about that. And I thought, I've counteracted everything I wanted to communicate.

1:56:54And we know. And she decided not to take it. And if I'm with her. But when I was a kid, there were no fat people on television except just the butt of the joke. And I think about my niece, she's growing up seeing actually quite a lot of women who have broad, a range of body shapes in the public eye. And in the last two years, almost all of those women have massively shrunk. Now, they're not talking about ozampic, but unless there's been some kind of outbreak of dysentery in Malibu, I think we know what's happening, right? Some of them are talking about it, but most are not. Can I just ask on that?

1:57:23Because we've seen a lot of very famous faces, suddenly shrunk over the last couple of years. And when you read their autobiographies, they talk about going to the gym and getting their lifestyle right. Do you think they're lying? I mean, obviously. Yes. I wasn't sure if it was just me, but I look at, I look at, think about a lot of people that were a little bit bigger. And it seems that suddenly everybody's kind of cramped. Weight loss. And it's rapid and it's super fast. I want to name any particular names, because it's not my place to talk about individuals like that. But it really does seem like Hollywood has found a great personal trainer.

1:58:03And I'm wondering if this is what it is. Yes. Although I think, I would say the people you and I think you're about are almost all women. And I do think we should very much know you would agree with this. I'm not making this as a point against you. Women get so much more shit than men for this sort of thing. Like, actually, it was one of my editors said to me, you know, I was saying, why has no one else written a book about a Zen pick yet? Why am I the only one? And they said, because only a man could write this, because a woman would be crucified for writing it. Right? She would be monster. And if you look, whenever even someone as unbelievably popular and amazing as Oprah, who's slightly surrealist, my friend, gets savaged for it.

1:58:46Right? And there's lots of deep underlying reasons for that. That came out for me as well, actually, I projected towards myself. I remember a long time taking the drug. I felt like, I mentioned this a little bit before, but I felt like I was cheating. I felt like I was sinning almost. And I started to look at the kind of deep ideas. They're so deep in our kind of collective unconscious. If you look at, so for example, in the sixth century, the Pope, Pope Gregory I draws up the seven deadly sins, right? And one of them is gluttony. And this image is always depicted with an image of some hugely fat person looking like a pig, you know, and it's horrible.

1:59:28It's very deep in our culture, the idea that being obese is a sin, right? If you look at the forms of weight loss we admire, they follow the pattern of sin, right? The kind of classic Catholic pattern of sin you sin, then you have to suffer and redeem yourself and then we forgive you. Right? So if you look at the forms of weight loss we admire, they're ones where people are humiliated and suffer terribly. You starve yourself, you, you know, you think about that show, the biggest loser, which I hate, you know, where severely obese people are made to sort of compete in grueling horrific forms of exercise.

2:00:03Then we're like, okay, Jabba, we forgive you now. Do you know what I mean? We use this kind of stigmatising ways of thinking. Cheating is a bit more subtle, because I kept thinking I'm cheating as I do this. And I was like, that's really weird. If I had a heart problem when I took statins, I would not think I was cheating, right? I said, why is that? And I think it's partly, so people put in a huge amount of effort to be thin, right? Loads of women watching this, and it's disproportionately women, will suffer some privation and deprivation in their life, because they are really trying to be thin.

2:00:35And then they hear, oh, this fucker just injects himself once a week, and he gets to be thin like me, it's like they feel the way I imagine cyclists do when they look at Lans Armstrong, right? And the only way out of those, that negative conversation, where we turn on each other like rats in a sack, is to realise, oh, there is a sin, and there are people who are cheating, but it's not Oprah, it's not someone who, Jeff Parker, that guy I mentioned, who, you know, didn't want to die young, it's the food industry that fucked all of us. That's why we're in that race, right? That's why you're starving yourself.

2:01:09That's why we feel we're sinners. Okay, well, we can collectively come together and challenge that shared opponent if we want. But if we're just going to get into, look, it's very hard in this age of social media madness, to not have every conversation turn into a toxic conversation. And it's not surprising that something has charged as a debate about a Zampic and weight has become so toxic so quickly. But again, we don't have to do that. The toxicity isn't going to get us out of this, right? We're in a shared crisis. Everyone watching has someone they love who is on course to die young because of the problems associated with obesity, because obesity is so widespread in the society in a very recent amount of time.

2:01:50Look at a picture of a beach in Britain in 1975, not a million years ago. Everyone is thin by our standards, right? This happened in the blink of an eye in human terms, right? Again, we don't have to tolerate that. Part of it is also we don't like when people lose weight, some of us, because it shines a light on us. And I think about someone like Adele who dropped a ton of weight very quickly and the shocking thing when she dropped that photo, I think it was like a birthday party, because she went from like being a certain way to then dropping weight very quickly. Because we don't see Adele's private life much.

2:02:26It was just this selfie she dropped. And if you look online at the reaction, people were betrayed. They felt betrayed by Adele's weight loss, not because they're assuming she used a Zempec or anything. But the fact she's now not the way she was in terms of her weight, people were almost angry about it and the same happened with Rebel Wilson. When Rebel Wilson dropped a ton of weight, because in her book she talks about, you know, she wanted to increase her chance of having a kid, so her doctor advised her to lose the weight. People were angry, like, always angry that they lost someone they could maybe relate to or that made them feel a certain way about themselves, which I find to be really interesting, that we actually don't like it when someone loses weight.

2:03:09We've got to understand where that's coming from. Obviously, I don't support anyone being cruel to people online and it's good for both the Dail and Rebel Wilson that they've improved their health. But I think where it comes from, and a lot of these things that can seem a little bit odd, that kind of said, we've got to realize how much shame people are soaking up on this issue. You know, if you have a BMI higher than 35 in your woman, 45 % of women in that position get insulted every single day in public every day, right? So you're walking through the world constantly being made to feel there's something wrong with you, being treated like shit.

2:03:48And I can see how people in that position develop a sort of parasocial relationship with Rebel Wilson or a Dail. I'm like, oh look, we can look to a Dail and they feel trapped, they feel they can't lose weight and then they see a Dail and Rebel Wilson. And they're just like, oh, at two Brute, fuck you, you know, I get it. Now, it's not the right response. I would want to talk to them more about, okay, what we want to think deeper about this, but I can see where it comes from and I can see why some people look at me and go, you fuck her, right? I totally get it. I suspect I would have felt that anger where I'm not me looking at me, right?

2:04:21So I get where the anger and this comes from. From the moment we're born in this culture, we are primed to be overweight and we are primed to feel tremendous amounts of shame about being overweight, right? And anything that comes along and brings up those stories and forces us to think to them, brings them to the surface like these new weight loss drugs, just leeches out of all of us, so many negative and angry and hurt feelings and I felt it myself, right? I felt so much self -doubt all the way through this. I still feel self -doubt about it. I still have days where I wonder, am I doing completely the wrong thing?

2:05:03So I do think we have to understand where it's coming from and not just sort of, I know you're not doing this, you're always interested in understanding where people come from, but it's tempting to just condemn people and go, look at this bad behaviour and I'm always more interested when people are behaving badly and it is cruel to say to Adele, you bit, she betrayed us. I mean, I would never say anything bad to Adele anyway, because I love Adele, but I saw her in Vegas, she's incredible. I do think we always have to try to understand it. It comes from a place of profound pain and that's not a pain that those people deserved, right?

2:05:34And that's the pain they should never have been subjected to. One of the really surprising things you talk about in your book is the relationship that a Zempec has on addiction. And I couldn't quite figure out why there'd be any impact on addiction if we start taking a Zempec drugs. You talk about how it eases the food chatter in our brains and the sort of food cravings we have, but then there's a lot of research you go into that shows as Zempec and these kinds of drugs can actually have an impact on our addiction to things like cocaine and alcohol. So this is much disputed and there are serious scientists on both sides, but I found it mind blowing and totally fascinating.

2:06:10So, for example, a woman called Elizabeth Yellhag, who's a professor at the University of Gothenburg in Sweden, has done some of the pioneering work on this site, interviewed her a lot. They get a load of rats and they put them in a cage and they give them loads of alcohol, and rats will like alcohol and they get hammered like the rest of us and they wobble about and they love it, right? So they put them in this cage for a while, they've got plenty of alcohol, they get drunk over many weeks, and then once it starts to resemble like a dive bar in Vegas, they do an intervention. They come along and they inject them with GLP1 agonist, the exact drug you've got in front of you, some agglotide, and then they watch.

2:06:47And what they discovered, what Professor Yellhag and her colleagues discovered, is afterwards the rats drink about 60 % less than they did before, and the rats who drank most heavily are the ones who cut back on their drinking the most. Like, why? What's going on there? But then they thought, okay, maybe it's because alcohol's got a caloric content, it's like they want the calories less, right? So then there were experiments done with drugs that don't contain any calories. So Professor Patricia Griggsson, who's at Penn State University, gets rats heavily using heroin and fentanyl, gives them GLP agonist, again finds the same thing.

2:07:2150 % reduction in the rats using the self -administering the heroin and the fentanyl, then Greg Stammer, who I mentioned before, who's at Florida State University, does it with cocaine? It was mice, not rats for him. Again, 50 % reduction in them using cocaine. We don't know why. Again, some of the theories come back to that question about the reward system. Could it be dampening the reward system? One of the things a lot of the scientists find fascinating is these drugs appear to have, what they call selectivity. So selectivity is where the drug makes you want less of the Big Mac, but not less of a salad, right?

2:07:57So it doesn't just generally dampen, you don't just not eat at all. Some people do, the malnutrition is a risk, but most people don't, right? So given that, it's some of them argue, again, it's highly speculative at this point. It seems to be activating, downgrading your desire for things that are bad for you, but not things that are good for you, right? And I'm thinking, how can that be? That seems so weird. Let's imagine I'm Elton John, right? And I get my pleasure from playing music. How can it know to tell me to eat fewer jam sandwiches, but not to engage in jamming, right? How can it do that?

2:08:32And they kept saying, we don't know. There does seem to be a mechanism that does that. We're trying to explore it. So obviously hugely encouraging results in animal studies with addiction. So now there's lots of experiments going on. We're giving these drugs to humans to see if they reduce addiction there. There's been a huge amount of anecdotal evidence, interviewed a nurse in Canada called Tracy, who had a bad relationship break up and just became completely addicted to shopping. She would just obsessively buy books she'd never recloed, she'd never wear. She was doing a lot of skin picking and obsessive eating.

2:09:08She goes on her Zen pick and all these addictions like disappeared. So there's now this debate, okay, is it going to have this effect more widely? The early research is kind of mixed. So there's only very, very small studies on humans so far. It found that it does reduce smoking, but only if you pair it with a nicotine patch. They found that it does reduce alcohol consumption, but only if you were a heavy drinker at the start. So we're going to know a lot more, we're going to get a lot of results actually this year and definitely a lot next year. But it's a very promising. So some people argue, so the most extreme, I want to stress this is speculative.

2:09:43The biggest cheerleaders for the drug would say, actually, we haven't found a drug that causes appetite regulation. What we found is a drug that boosts self -control across the board. Now that's very contested. I'm always conscious of the overselling of drugs generally. We want to be careful about it, but it's possible scenario. And the animal research is mind -blowing and really is highly, highly exciting. And you don't normally see this, right? There's no other drug that I'm aware of, pretty sure there isn't. That just reduces addiction across the board in animal studies, right? It is remarkable.

2:10:18I mean, there's a debate about whether you can even call it addiction in animals, but heavy, compulsive use. What impact has his impact had on your weight loss, Jenny? How much have you lost? I've just lost a huge amount of weight. So I lost three stone across a year. And actually, it was even more dramatic. It was the percentage of body fat that I lost. So at the start, I was 33 % body fat. I remember the day Josh Martreina measured that. I sort of looked at wins to see saw it. And I said, I've got, if I was a sandwich, you wouldn't want to eat me. I let you look at whales, not only 35 % body fat, so it's slightly disconcerting.

2:10:50So I went from 33 % body fat to 22 % body fat. So it was a really dramatic fall. And did you increase your dose? Yeah. So everyone starts at 0 .25 milligrams, partly because the most common side effect by far is nausea, right? Almost everyone feels nauseous a bit when they start taking it. For some people, the nausea is unbearable. I interviewed someone called Sunny Newton in Vermont, who said, you know, it felt like an alien had entered her body and was thrashing and trying to get out. Yeah, a significant minority experienced such extreme nausea. They just have to stop. For me, the nausea has now totally gone away.

2:11:23And Correll LaRue, one of the scientists who worked on their said look, when it comes to nausea, you've got a level with people. There are two kinds of drugs. There are drugs that have side effects, and there are drugs that don't work. Right? And he's right about that. But yeah, the nausea is pretty bad, but for me, it's all gone away now. I really do admire Oprah. I've watched her. She's kind of like a role model of mine for how she's kind of conducted herself throughout her career. And as you say, she's a friend of yours. And she's, I think, recently come out and admitted to using a Zempec. She's talked about how she's strong with weight for her her life.

2:11:54And a Zempec has been a bit of a magic bullet. It seems for her in her weight loss journey. You know her as a person. I've not been paying enough attention to her describing her decision to know why she decided to take a Zempec versus, I don't know, some other form of dieting. Has she explained that? Yeah, she talks about it very movingly. She talks about an interview with People magazine and an brilliant special for ABC, I think. I mean, nobody has publicly tortured themselves with diets more than Oprah. There's this famous clip that you've probably seen where she comes on stage on her show. And she's reeling a huge bucket of fat.

2:12:34And that's the amount of fat she'd lost on this diet. And she describes very movingly in the special. She says it much better than I can. She had starved herself to get that, right? And you think about, so she had tried all the extreme diet and exercise options that were available. And they'd always yo -yoed back for the reasons that we talked about before. And you know, and she had to have a knee operation. I'm not giving away anything. She disclosed this. She had to have a knee operation. And she was very worried about her health. And so for those reasons, she's made this, this twist. There are lots of reasons to be worried about these drugs.

2:13:10But I have found it very hard when you talk to people who've really struggled with this. Like that guy Jeff Parker, I mentioned before in Summer, is this going like Oprah? People have made the decision to do it and seen the benefits of the weight loss, staggering benefits. Whatever the other arguments are, I don't want to argue against them, right? If you are taking these drugs and experiencing an enormous improvement in your health, as they both have and as lots of other people have, then that's been the right choice for you. Now that won't be right for everyone. I met people who really regret taking the drugs for all sorts of reasons, including many of the terrible side effects and risks.

2:13:51But I think we have to be truthful to the complexity of these drugs, right? I mean, one of the reasons it's called magic pill, the book, is because there's three different ways you could think about this as magic. Those people who take the drug go, this is magic, right? So the first form of magic is obvious. It seems to solve the problems so quickly, so effectively that you're like, whoa, it's like a miracle, right? That's one way. The second way is it could be magic like a conjure resolution, right? It could be like a magic trick. It seems to solve the problem but doesn't or sets up in train something else.

2:14:25Or the third way is think about almost every fable about magic is you get what you want. But then you get what you want in a way you didn't quite expect. You make a wish with the genie and you get what you want, but the wish doesn't quite work out how you thought. Most famous story about magic is fantasia, you know, the magic can spiral away from you. So I think one of the things we're still trying to figure out is what kind of magic is this? Is it a magic solution? Is it a magic trick? Or is it a magic solution that's going to spiral in all sorts of unpredictable directions? I have to say, you know when you were holding that pen, you know what I mean?

2:14:57I got weird like you were doing slightly judgmental dragons, Den. I was like, shit, how do I persuade him to invest in this? I was thinking, I was thinking, I was having a conversation with myself and I was staring at it, thinking, God, this would be easier than going because after you leave here, I haven't eaten yet today. So I'm going to have my lunch and then I'm going to go to the gym for about an hour and a half. And much of the reason why I go to the gym is to try and stay in shape. You know, I want to keep my belly fat off or when I keep my muscles strong, I want to be strong, I want to look good.

2:15:26That's the reasons I go to the gym. Also, the positive consequence of me going to the gym later on after this conversation is it will make my brain feel really good. Now I was looking down at the 10 hours thinking I could take this and then the belly fat you know, wouldn't be there. But then I would lose the positive upside of the exercise that I'm going to get from going to the gym as well. So I was wondering to myself, are people going to exercise less? And is there a consequence to us not exercising as much to our mental health and our feelings of you know happiness and all the things that exercise does for us?

2:16:01Yeah, the answer to both your questions is yes, people will exercise less and it will have negative effects. So we know I want to add to that the point that I alluded to earlier on. People are getting more and more sedentary. We're living in like a vision pro headset don't need to move well. Well, you know what I mean? So we're going to be able to inject to keep the weight down but we're still going to be moving less and there's a lot of upsides to moving and exercise. Yeah, so we know that there are enormous benefits to exercise which exists quite separate to the question of weight loss, right?

2:16:30If you exercise for 270 hours a year, you add three years onto your life, even if it doesn't cause weight loss, right? So the benefits in terms of preventing disease, slowing down aging, mental health are just enormous from exercise. And I think you've gone to a really important drawback which is yeah, if you can get the benefit in the short to medium term just from a jab. But that calculation you were thinking through is you were holding the pen in the slightly sinister drag and stone weight. It's a calculation lots of people are going to make and there's a lot of things I'm not sure about in these drugs.

2:17:06But there's a few bits of advice which I am very sure about. If you are not overweight or obese, you definitely shouldn't take these drugs, right? You are incurring all the risks for none of the benefits. So that I'm certain of and there are lots of people who are not overweight or obese who are taking the drugs to be super thin. My friend Elise Loner who used to be the chief content officer at Goop said she went even got up for dinner in L .A. with people we know now because no one is anything. Why did we come out for dinner? You're all starfish. She says you know dieting is our elimination is in the way she put it.

2:17:37So I'm confident about that. I'm also fairly confident, although slightly less but fairly confident. If your BMI is higher than 35 or your body fat percentage is very very high. And you're not someone with thyroid cancer in your family and you're not trying to get pregnant. I would recommend taking the drugs. I think for you the balance of risk and assuming you've tried dieting it didn't work. I think for you the balance of risk is more towards the benefits of taking the drug. I'm not as confident about that but I'm pretty the people I love who I be at my higher than 35 who are in that position.

2:18:15I have recommended the drug to them. The people between with a BMI between 27 and 35 I think it's much more. You've got to just go down the list of the benefits and drawbacks and really think it through for yourself. And reasonable people will reach completely different conclusions. It can be quite interesting to see that people who do decide to do exercise and they change their diet and they start running marathons when they lose weight. Everybody is going to say no you didn't. That's so funny. Everyone's going to say you as impact. If some celebrity now drops I don't know three stone or four stone and they did it in the gym and with a diet to change, no one is going to believe them.

2:18:52No one. That's very funny. And I think certainly I think you're right there. You wouldn't believe them. Of course you wouldn't believe them. No you're right. One of the big rebuttals that I see online is that because people are now taking these drugs people like you are taking them to lose weight. Diabetics can't get their hands on these drugs anymore and I saw some articles that said the the drugs have been in such high demand that diabetics who really really need them to save their lives now can't get access to them. I think there's people have a really good point and I interviewed some of them for the book and it was a very painful conversation.

2:19:24I think the solution is what we should have done right from the start and what we should do now is what we did in Britain with the COVID vaccine. So we should ration the drug and the people with the greatest need should be given it first and everyone agrees. These severely obese people and diabetics together would be the people who most need the drug and they should be given it first. People like me who've got heart disease in my family but were not hugely obese would probably be around the middle and you know people who don't have heart disease and are just sort of overweight would be at the bottom.

2:19:54We didn't have that system what we had unfortunately because the government didn't set up that system was a scramble which meant that you know some diabetics didn't get the drug they needed had to go and insulate and then I was just thinking about how I was feeling earlier which poses a real threat to the health. That's awful and I feel a bit ashamed about it because of course if people like me hadn't had all together bought it that wouldn't have happened in practice for me personally. I was worried about my own heart risk you know I'm a year older than my granddad was when he died. But that's not much of an excuse and when I met the diabetics in that position like for example a guy called Zammage a Leo who was exactly in that position he could his musician 41 couldn't get the the ozampic he needed for his diabetes for his type to diabetes.

2:20:40I felt ashamed you know clearly his need was greater. You hand thank you thank you for a few things I think it's worth saying that the first time you came on my podcast. I had basically no listeners you were like a tiny little baby podcaster remember it really clearly you can't see my flat I showed up at your flat in London I read your book lost connections I was so fascinated by it so I reached out to you and asked you if you come on and you said yes. When I was when no one was listening to the podcaster I was even videoing it back then. And it was an incredible conversation audio was terrible there was loads of issues and stuff like that but you're one of the first people to really give me a chance so it's so wonderful that we can still stay in touch and that I get to cover your work still to this day so thank you for giving me a chance back in the day really appreciate it.

2:21:23Oh my pleasure and thank you for writing this book because one of the most popular things that audience have been asking to understand is a Zampic we've seen that in all the data and the way that you approach this even though you are so. And I think that's the only thing that's not the most important thing is that you're not going to be able to see someone that's taking it so it's easy to see how you would be biased in various ways to defend it or whatever that's not the approach you take and in the book magic pill you're able to be incredibly nuanced and how you look at the pros and the cons in a way that I was not expecting from someone who is taking it themselves and I think that's really important because you're right you finish the book and in a weird way you.

2:21:55You have more information but I can understand how the decision still remains with the individual and I think that's really what any book on this subject should aim to achieve it should kind of not have a dog in the fight but present you both sides of the trade off so that you can make a decision for yourself and that's what you do so skillfully and the real thing you know as an author that you've talked me over the years is you just remarkably good at writing and it's really your your storytelling is phenomenal it's influenced. I think it's really important to me profoundly as an author myself and whenever I read a book now I often wish that they'd written it like one of your books because you take a you take a concept that's difficult and widely discussed and you take us on a journey and that journey is so much more enjoyable than just reading like a science book so I recommend everybody to go and get magic pill right now it's obviously a huge point of conversation at the moment these these magic pills and this is the book to read on a magic pill the extraordinary benefits and disturbing risks of the new weight loss drugs.

2:22:55It's due to be released on the second of May 2024 so a couple of days away from that now and yeah I just highly highly recommend this book thank you so much your hand. Oh I'm really touched by that Stephen thank you so much. I will miss forgot we have a traditional in this podcast. Oh yes the question. Yes who posed this question. I'm not going to say who the question is but the question that's been left for you is it's a really interesting one. Why should humanity continue to exist? So as you know I've been writing for 12 years now 13 years a book about a series of crimes that have been happening in Las Vegas.

2:23:34I'm not allowed to talk about but it will come out next year and I promise we'll finally talk about it. I think you're just saying this so you can hang out in Vegas. I remember every time I see you say you're just in Vegas to writing a book I'm like, I'm like, where's the book you had? There are people in Vegas that said to me, yeah your book's been long time fucking coming. So I know two people called Rob Banghart and Paul Bo Trinhoe who a lot of people won't know but there's many thousands of homeless people who live in the drainage tunnels beneath Las Vegas. And Rob and Paul used to live in the tunnels and Rob lived in a particular set of tunnels that I know very well and I've spent a lot of time in.

2:24:12And in 2017 so Rob was known as Hobo Santa he would steal things and give them to people and he was also kind of low level dealer very low level and there was a group of rival Cuban dealers who didn't like him. And one day in 2017 they hit him in the head with an axe split his skull open dragged him onto the railway tracks and left in there for a train to run him over. But fortunately someone spotted him pulled him off the tracks and he survived and he in the next six months as he recovered he turned his life around and he began to volunteer for a group that my friend Paul runs called Shiner Light, which is a group of people, overwhelming people who used to live in the tunnels who managed to get out turn their lives around who now help the people who still down there they give them loads of practical things from camp ons to flashlights and they most importantly give them support when they want to leave and I've got lots of people out every month get people out of the tunnels and I've seen them do it with some people I really love who were down there.

2:25:17And one day a few years ago I was with Rob and so one day a few years ago I was with Rob when he got word that a friend of his from the tunnels called picket had died he did Odin in the tunnel he used to live in so we went straight down there and picket stuff was still there they've taken away his body. And we bumped into a woman who also lives down there and whenever Rob goes to the tunnels even in a situation like that he always brings supplies you know food and stuff and he said to her. Who's in the tunnel over there she said you don't want to go there and he said why and she named some people and he said no I'll go there I'll give them some stuff and he went and gave them some stuff I don't really think about it very much I was thinking about picket and what happened.

2:26:08And a few days later I said to Rob what did she mean when she said you don't want to go there and he said it's just these guys and I said what guys he said I will. They're the guys who hit me in the head with an axe the guys who try to kill me. And I said well why did you go and help them. And he said because they're human beings and they're suffering and they need help. And I thought a lot about Rob every day him and Paul go back into those tunnels you know they could do anything they could leave and do a million things right. They're incredibly intelligent and talented people every day they go back and they help the people who got left behind and they to make no money doing it and they don't have great lives doing it in any material sense.

2:26:59And I've said to them why do you do it and they just they say it's because it's the right thing to do. And if you said to me why should human beings continue to exist I could give you a load of abstract answers and could talk to about philosophy and I could talk to about art and I just say come and meet Rob and Paul. They're why humans should continue to exist.

2:27:22Thank you. Cheers Steven.

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