Obesity Isn’t Your Fault: Biology, Addiction & Solutions with Dr. David Kessler

16:04Dr. Mark Hyman:But it can be. Like, for example, I don't have, I don't think, an addictive personality. I don't have the dopamine receptor genes that require me to get more dopamine stimulation to feel good. But if, if I go on a rant of sugar, I just going to want more of it. Like, even if I don't have that predilection and most of the time it doesn't bother me, but like occasionally, like if I'm in a stressful situation or whatever, I'll go, Oh God, I'm really like.

16:29Dr. David Kessler:But that past learning, that past experience, that, that exposure, right. I mean, begets, you know, more of that. I mean, it's all that Q-induced wanting. So what is going on biologically? Like, is it the same as heroin or cocaine or nicotine?

16:45Dr. Mark Hyman:Like, what's actually happening?

16:46Dr. David Kessler:So we got to be careful at no doubt there are differences pharmacologically. So if you look at the dopamine hit, I mean, heroin and amphetamine is clearly in a different ballpark as far as the extent of that hit. Nicotine, on the other hand, is probably much closer to food. And how hard is it to quit cigarettes? And again, it's this gating of attention, right? You get, I mean, next time you get hungry, just try to figure out what the cue is. There's always a cue. It could be the time of day. It could be a smell. Something triggered that thought. And that thought created this, you know, that sense of wanting, right?

17:26Dr. David Kessler:I mean, and, you know, that cue-induced wanting, right? is what really I think it's part of all of us. And in the extreme form, I mean, it's food addiction. In many people, you can just call it sort of disordered eating. But, you know, and at the heart of that, we took fat, sugar, and salt, put it on every corner, made it available 24-7, made it socially acceptable to eat anytime. And cheap. Right, and cheap.

17:58Dr. Mark Hyman:And, you know, we created this food circus. What did we expect to have? It's a food carnival out there. It's, yeah, it's a toxic nutritional landscape that we're all exposed to.

18:08Dr. David Kessler:And causing this toxic fat. So that visceral adiposity, right, that you've been studying, right? I mean, is it the heart of much cardiorenal metabolic disease? It starts early in life. I mean, we are seeing it in the liver of our kids, right? I mean, it gets into the heart. 25 % of us are going to develop heart failure, right? I mean, what, 30, 40 % diabetic. Half of us are pre-diabetic. 25 % of us are going to have stroke. And at the cause of that, I mean, there is this, I think, finally, this convergence in medicine and in public health. We know what the problem is.

18:54Dr. Mark Hyman:But you know, David, what's really striking to me is I co-founded a new company called Function Health that allows people access to their personal health data and lab testing. And I asked Quest Labs, who's our lab testing partner, I said, how many labs that get submitted test for insulin? And they're like, oh, less than 1%, less than 1%. And insulin is the first thing to go awry when you actually have this visceral fat. It starts to go up and nobody's checking it.

19:20Dr. David Kessler:Well, not only that, I mean, if you look on a population basis, there has been a doubling in the last 20 years of insulin levels, right? I mean, there is an epidemic of hyperinsulinemia. And it's not being tested. It's crazy to me. Now, you can argue, you know, that assay is not the easiest necessarily, right? These things happen so fast, you know. I mean, there's this cycle. I mean, does the visceral adiposity, this toxic fat, does that cause the hyperinsulinemia or does the hyperinsulinemia cause the toxic fat? I mean, you get caught in this vicious cycle.

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21:49Dr. Mark Hyman:If you're looking to take care of your health at the most fundamental level, supporting your mitochondria is the place to start support your mitochondrial health and save 20 on mitopure visit timeline.com dr hyman to get 20 off today well the david literally talks about does overeating make you gain weight does it gaining weight make you overeat and it's this paradox

22:14Dr. David Kessler:so you have these central you have these central circuits right that focus our attention and our wanting on this, you know, this energy dense, highly palatable, high glycemic index food. And then you have these peripheral, the peripheral biology, I mean, in our gut. You mean the microbiome? I'm just talking about the hyperinsulinemia, right? I mean, the absorption of the belly fat, the biochemistry, what's going on in our liver. And I mean, the absorption of this rapidly absorbable glucose in an increasingly insulin-resistant body. The American body is not well. I mean, only 12.2 % of us are metabolically healthy.

23:01Dr. Mark Hyman:Well, actually, that was the last study. The updated version, it's only 6.8 % from Tufts, the same kind of data. It was like, that's frightening. I mean, that means that 93.2 % of Americans have some degree of insulin resistance. They might not have prediabetes yet, but they're somewhere in that continuum. And in some people, they hear that

23:20Dr. David Kessler:number and go, that just can't be right. Right. I mean, it's very interesting. They go, I mean, 12, only 12 % or 9 % or 6 % of us are metabolically healthy. But the fact is, right. Um, that, I mean, those are, uh, the, the, the numbers.

23:36Dr. Mark Hyman:It's true. I mean, we, we, we tested over 300 ,000 members in our company, and it's shocking. The demographics of what the population-level data on insulin, on glucose, on the metabolic effects on cholesterol of this visceral fat are just...

23:55Dr. David Kessler:So here I am, 40 pounds heavier, right? And the question is, what does it take to reclaim our health. I mean, and I think finally, finally, right? I mean, I think we have the tools, right, to do this. I mean, look, I mean, you know, in the, it's pretty, in some ways, it's very complicated, but it's also very simple. I mean, you have one industry that makes billions of dollars, right, that's causing the problem, and then you You have another industry now that, you know, is making equal profits to reverse what the former industry is doing. It's actually trillion. It's doing, right? The focus, the increasing focus on, you know, we call it, you know, highly processed food or, you know, rapidly absorbable, you know, carbohydrates, ultra processed foods.

24:51Dr. David Kessler:I think the fact is that that food is engineered in such a way that it goes down in a whoosh. It deprives us of satiety. It is rapidly absorbed. It's causing that metabolic chaos. And so you have this food on the one hand that's depriving us of this satiety, this ultra-processed food. and now for a thousand dollars a month you can go buy a drug to reverse what that food is causing right i mean i mean and it's just if you came from another planet and you saw what was going on you'd say something's wrong with that picture fix the root cause and and just to unpack what

25:38Dr. Mark Hyman:you're saying is is the change in the american food supply over the last 50 years has increased the consumption dramatically of sugar and starch and refined carbohydrates in ways that have activated this ancient survival system, which is to store fat at all costs when we've come across something sweet, because we don't know when we're going to get our next meal. But now we're in a food carnival and it's everywhere and it's hijacked our brains. It's hijacked our brain chemistry, our metabolism, our immune system, our microbiome, and it's created a cascade of effects that cause every almost single chronic disease of aging.

26:15Dr. David Kessler:Sure. If you go back, you know, and I went back in over the last, you know, few months, did the book, and then I filed this petition with HHS, but, you know, went back and looked at the history. Um, and the food industry back in the fifties and forties, fifties, uh, sixties, learned how to take corn, learned how to take starch, right. And was able through chemical processing, chemical and physical processing to create a whole slew of other, um, uh, what they call at the time, nutritive sweeteners, right. These starch conversion products, they have names called maltodextrin or dextrose or amino xylose or maltose, corn syrup and corn solids.

27:12Dr. David Kessler:I mean, and that gave birth to an alternate universe. I mean, you know, it's really not food.

27:22Dr. Mark Hyman:It's not technically food. Actually, if you look up the definition of food in the Webster's Dictionary, it doesn't actually meet the definition of food, which is something roughly that promotes the growth and health of an organism.

27:33Dr. David Kessler:They took out the structure of food, right? They extracted these chemical components, and then they reassembled them in a way without the structure of that food, without the fiber, right? All that slowed down eating, right? And they took the, I look at this ultra processed foods and I say, there are basically, there are four components of this stuff, right? Just when you look at how it's made, there's these refined sweeteners. There are these refined starches made in flours. There's these added fats and oils and there's salt, right? And what the industry did from after it generated all these, you know, chemical ingredients, right, was to reassemble them.

28:22Dr. David Kessler:I mean, find some other chemicals that added to mouth field or texture. And they were able to dial in, right, that palatability. This wasn't an accident. Certainly wasn't an accident. Like the tobacco companies were like, oops, we didn't know it was addictive, but baloney. The tobacco industry did the science. They did exquisite pharmacology. They did all the EEG work, the imaging work. They knew everything about nicotine. secretly hiding the data. Correct. And we went inside, you know, to do the really the big investigation into the tobacco industry. And when I did that, my friends at night, I had to teach me everything about addiction.

29:13Dr. David Kessler:And one of the tests on addiction was whether animals, laboratory animals, self-administered nicotine. Correct. And they pressed the lever for nicotine, whether it was rewarding, whether it set off those reward circuits, right? I mean, of the brain. And they always had a positive control there of sucrose. And I said, well, what about sucrose? Tell me about that. Why are you using that as a positive? And they never paid attention to me. And that's what got me interested. What the industry did was it generated this whole new generation of industrial sweeteners, these starch conversion products, and were able to take those ingredients, right?

29:56Dr. David Kessler:Again, not in the context of food or food structure, that food matrix, right? Which is so key to that absorption and reassemble that and make it highly palatable and energy dense and accessible. And it was cheap. No one went to study it. No one asked what was the effect of destroying that food matrix, leaving that aside and just isolating these energy-dense, I mean, chemical ingredients that you see on that ingredient panel that, you know, you look at and you go, I don't know what half of those mean, right? And to reassemble it. And no one asked, what was the biological effect? So if you take starch and you subject it to, there's these, you know, a number of processing techniques, one's called extrusion.

30:51Dr. David Kessler:I mean, it basically molds that starch into any kind of form. Side-shaped color. It gives you the thousands of products that are in the middle of that grocery. But to do that, you have to take that starch and exert these shear forces and these temperatures to change the molecular structure. And no one asked. What happened? No one asked what was going to be the metabolic consequences of that.

31:20Dr. Mark Hyman:Well, they may not have asked that, but they certainly knew the brain biology and they would do functional MRI imaging about what lights up what. And so they actually, like the tobacco companies, designed these foods to be addictive.

31:33Dr. David Kessler:Absolutely. And we will see. Okay. My guess is some in the food industry may have done that a bit. but my guess is they had their head in the sands deliberately they didn't want to know yeah right they went ahead and they created this alternate universe of you know this food system this ultra processed food i mean of which these refined carbohydrates these processed carbohydrates these added sweeteners were a key component again i mean they had these you know added fats and oils too. They had this salt, right? And it all ended up being very rapidly absorbed, causing this hyperinsulinemia, causing this visceral fat.

32:24And certainly in anyone who is along that path,

32:30Dr. David Kessler:I mean, already, I mean, having, you know, challenges, you know, with that weight, that insulin resistance. If you add these energy-dense, high-glycemic foods, I mean, to somebody who's insulin-resistant, I mean, it's adding, that's where you're at. That's where the real, you're adding that fire exactly. And that's what's going on. And that's why, and again, it's not just the hyperinsulinemia. It's not just the fat. I mean, it's the liver consequences, the consequences in the pancreas, the consequences, I mean, that acopic fat in our heart.

33:11Dr. Mark Hyman:I mean,

33:11Dr. David Kessler:that's heart failure. I mean, that's causing some of this atrial fibrillation.

33:16Dr. Mark Hyman:That's right.

33:17Dr. David Kessler:The fats, that's not where fat's supposed to be. And that fat is metabolically active.

33:22Dr. Mark Hyman:And it's neurochemically active. And it's immunologically active. And it's hormonally active. You know, go back. I mean, what's the cause of this? You know, I just want to double click on what you're saying because it was so important. The way in which food companies have taken commodity crops, soy, wheat, and corn primarily, and deconstructed them. Correct. Broken them part chemically. Authored their chemical structure and composition in ways that are completely new to nature. Correct. They're Franken molecules. Correct. And then they reassemble them into things that look like food, but actually aren't food.

33:55Dr. David Kessler:Bingo. And they were cheap, right? And they dialed in palatability. They dialed in, you know, that, that, that, that, that sugar, that fat, that, that, that sweetness that trigger our reward circuits in many of us. Right. And that caused that, that metabolic harm because when you eat this, it goes down in a wash. It's rapidly absorbed. There's no satiety. There's no feelings of fullness. I mean, it gets, just get so rapidly absorbed. It causes this hyperinsulinemia and it, and it, it, it's the, the, the reason why, uh, You know, we're seeing the chronic disease that we're seeing in this country.

34:33Dr. David Kessler:I mean, we now understand this is the primary call.

34:37Dr. Mark Hyman:A hundred percent. Amen. Hallelujah. I've been saying this for decades. Thank God you and others are figuring this out. I think what I want to now do is kind of dive down a rabbit hole because in America in this moment, there seems to be a rare and unique opening to have a conversation about this, that ultra processed foods has been a part of a national conversation now. It wasn't even a thing 20 years ago. It wasn't even defined. It was just junk food or processed food or fast food. Now we have a term for it. It started out of, you know.

35:04Dr. David Kessler:Not a perfect definition. No, I was going to say that. I mean, you have to be careful. I'm going to get to that. I'm going to get to that.

35:10Dr. Mark Hyman:There was a Brazilian scientist who came up with the NOVA classification, which was an attempt to try to figure it out.

35:18Dr. David Kessler:There were a number of other classifications, right?

35:21Dr. Mark Hyman:But what's happening right now is that the FDA, where you're a commissioner, has requested an RFI, a request for information from scientists and experts around the world. What is ultra-processed food and what should we do about it? How do we think about it?

35:37Dr. David Kessler:It's asking for the definition.

35:38Dr. Mark Hyman:It's asking for the definition because unless you know what the definition is, you can't actually start to regulate or legislate around it.

35:44Dr. David Kessler:Yes and no. So certainly if you want to label something ultra-processed food, you have to come up with a definition. but the industry will challenge. That definition will always include certain things that you can argue, well, is this healthy and it's healthy for process? I mean, there's always gonna be those debates, I mean, at the extreme. But we certainly know what's in the components of this food. It is refined sweeteners. It's refined flours and starches. It's these added fats and oils, right? I mean, it's salt. I mean, and it's these other chemicals that give it texture and mouthfeel, right?

36:19Dr. David Kessler:and this drives in the palatability. So we really do know what these foods are, and we know these foods don't exist in nature.

36:30Dr. Mark Hyman:Yeah, and just to be clear for everybody listening, you submitted a petition to the FDA that was based on their request for information for ultra-positive.

36:39Dr. David Kessler:No, I mean, it actually wasn't for the request. It wasn't because of the request for information. Oh, I thought it was. No, the petition went in separately, right? I mean, it certainly is consistent with that, right? And looks at this food system, looks at this system that got developed in the 40s and 50s of developing these cheap ingredients out of food and reassembling them, right? And creating this food circus. It recognizes that. It recognizes ultra-processed food, right? I mean, and highly processed food. I mean, we can, you know, choose how you want to refer to this. But it's certainly not food, I mean, as we know it, right, as occurs in nature or stuff that we make at home.

37:31Dr. David Kessler:The petition was very specific, right? And let me just, let me back up for one second. Give you a sense of the nation's food law so you understand. I mean, anything, I mean, in fact, the nation's food laws are pretty comprehensive and strict if we were enforcing them well, right? So if you want to add something to food, it's a food additive, and you have to meet the definition of reasonable certainty of no harm. Reasonable certainty of no, you can't add anything to food for which there's not reasonable certainty of no harm. Now, in a drug, you know, safety, no harm, you balance risks and benefits.

38:10Yeah.

38:10Dr. David Kessler:Not in food. The law requires you to be reasonable certainty of no harm, right? But Congress enacted that in 1958, but there was this exception. There was a term called grass, generally recognized as safe. If you were generally recognized as safe, if you were grass, you didn't have to come in and prove that you were reasonable certainty of no harm. You can just go onto the market. And the industry was able to self-determine whether it was grass. And I went back and I found this document, 1988, that it actually had its predecessor documents in the 1970s. And it was the grass evaluation for corn syrup, corn solids, dextrose, maltose, maltodextran, all those starch conversion products.

39:12Dr. David Kessler:Most of those are derivatives of corn. And gave rise to the modern, highly processed food. I mean, go look in the middle aisles, right? Those corn syrups, corn solids, maltodextrans, were the essential items that gave rise to this industrial revolution of all this highly processed food. And back, there's an ADA document where the FDA says that it looked at corn syrups and corn solids and maltodextrin, dextrose, et cetera, and said there is no link between those substances and obesity, no link with diabetes, no link with cardiovascular disease, and therefore that stuff is grass. But they hadn't studied the link.

40:04Dr. David Kessler:Let me just, so understand grass. FDA, right? FDA doesn't have to show that something is unsafe, right? In order to be grass, there has to be a consensus among experts trained in the field, right out there that there's a general consensus that the substance is reasonable certainty of no harm right and and these substances were granted grass status so if i ask you today and i and i lump these these these ingredients into this term called process refined carbohydrates yeah right you know it well you've written about it right before the term ultra processed foods We understood processed refined carbohydrates.

40:47Dr. David Kessler:Processed refined carbohydrates are an essential part of ultra-processed foods. We can agree. You can't have these ultra-processed foods without these processed refined carbohydrates. The machinery, the corn syrup, the corn solids, you couldn't use, in fact, sucrose would gunk up the machines you needed for that viscosity, for that lubricity, et cetera, for these machines to work, to give rise to that moisture. I mean, in all this processed food, you had all these starch conversion products that the industry learned to use. So I ask you, is there general recognition of safety among experts that corn syrup, corn solids, maltodextrin are safe?

41:28Dr. David Kessler:Today, the answer is no.

41:29Dr. Mark Hyman:Then I think they didn't know.

41:31Dr. David Kessler:The thing about grass, just because something is grass, let me give you two other pieces and then we'll put it together. Just because something is grass back in the 70s doesn't get you home free forever. Just because you were grass back then, you have to continue to be grass, right? And the burden is not on FDA. The burden is on industry. So why hasn't the FDA held them to account? Bingo. So that's where the petition goes. So the petition basically looks at these corn strips, corn solids, these refined, what I call these refined process carbohydrates. It's now, I don't deal, I exclude, you know, anything that's made at home, sugar, flour, starch.

42:15Dr. David Kessler:You want to make cookies with flour and sugar. I don't deal with that. But what would you deal with? See, the Food and Drug Act deals in ingredients. It doesn't deal in processing, except, so you have to focus on what the ingredients are. So if you just say, FDA, go deal with ultra-processing, right? So you have to come with what's the ingredient. But the law says, if you have an ingredient, you have to generally recognize safe under the conditions of use. So if you take that carbohydrate or that rapidly absorbable carbohydrate and you subject it to extrusion or certain kind of processing, then you consider that processing.

42:57Dr. David Kessler:And so when you took the refined wheat and the refined starches and subjected it to extrusion technology, is there general recognition of safety? no one studied that, right? So I have these categories of refined processed carbohydrates in the petition, right? It also includes sucrose, refined flours, and starches when used with these humectants, dough conditioners, these stabilizers, I mean, these other chemicals. But they come along with the package. It's bad. These other processing aids, right? I say there's not a general, not generally recognized as same. And as a matter of science and law, these substances can't be grasped today.

43:39Dr. Mark Hyman:You know, it just reminds me of when T.H. Huxley heard of the theory of evolution. He said, how stupid not to have thought of that.

43:46Dr. David Kessler:Right. I mean, so in order to put this together, you know, I had to go to law school. I had to do tobacco. I had to be FDA commissioner. I had to write these books. And then all of a sudden, I mean, it couldn't be more simple.

43:57Dr. Mark Hyman:Yeah. Right?

43:59Dr. David Kessler:We have this huge chronic disease problem. We know the culprit, right? We understand the metabolic harm. We understand the toxic fat in our liver, our heart, and pancreas. We know that our diet is the primary culprit. We know that it's these rapidly absorbable carbohydrates. The FDA said, the industry said it was safe, generally recognized as safe back in the 70s and 80s. If you look at the Dietary Guidance Advisory Committee in 2015 and 2020, you don't have to go look any further. They did the systematic reviews. They have shown that these refined carbohydrates, I mean, they've shown all the adverse events associated with that, that they are linked with obesity, cardiovascular disease, and diabetes.

44:46Dr. David Kessler:So those statements back in the 70s, there was no link between these. Just go look at the dietary advisory, the scientific report, and the evidence is there. And this does not require a new law. It doesn't require an interpretation of statute. It just requires enforcement of existing statute. And the fact that there's one other thing. The industry - Very elegant. It's like, wow, what a brilliant idea.

45:10Dr. Mark Hyman:Because you're putting the onus of proof back on the food industry.

45:13Dr. David Kessler:Where it should belong.

45:15Dr. Mark Hyman:Yeah.

45:15Dr. David Kessler:Right? And the industry will come and say, well, what about one can of this or one teaspoon of that? That is safe. But there was something else about the law that is key. The law requires an evaluation of safety based on the cumulative effect, the cumulative dose. So, I mean, if you go look around, right, you see what the cumulative effect of processed refined carbohydrates, at the doses we're currently consuming them, they are not safe, right? So they got on this market, on the market because they were grass. You can't be grass anymore, right? So in some ways, it's self-executing. The industry does not have a legal basis to be selling these processed refined carbohydrates if they are not grass.

46:00Dr. David Kessler:They're going to throw hundreds of millions of dollars

46:02Dr. Mark Hyman:of legal arguments against this. So how strong do you think this would hold up in court?

46:08Dr. David Kessler:I think that it's easier than tobacco. Easier than tobacco? I think it's much... Tobacco, certainly, I don't want to get early legal, you know, in a post-Chevron world. I mean, for the lawyers, you know... Citizens United. In interpreting the statute. This is the existing law, right, requires that these substances be generally recognized as safe. There has to be an expert consensus, a consensus among experts. The FDA does not have the burden. The industry has the burden. All you have to do is show that there are these questions about the safety, right? Any doubt in your mind that process refined carbohydrates?

46:49Dr. David Kessler:I mean, there's questions about the safety. That's all FDA. That's all. I don't think anyone, I mean, what was striking about it. So I submitted this petition, right? Fair to say that the nutrition community is, has divergent views within the nutrition community. Right. I mean, there, there are all these, you know, I mean, very strong views, very strong. I mean, in some ways we eat our own. I mean, in the nutrition community, right? I mean, you've lived it. You see the effect. The one thing that was striking is when everybody said, I said, process refined carbohydrates are not grass. Everybody looked at that and go, oh, we could agree on that.

47:32Dr. David Kessler:So, again, does this deal with all processed foods, all ultra processed foods? No. I mean, could I have gone after added fats and oils? Could I have gone after salt? Right? I mean, could I have done those? But if you look at that, what's driving this metabolic harm, I think 80, 90 % of the culprit has these processed refined carbohydrates. Maybe it doesn't deal with everything. So how do you thread the needle on the dose question? Because if you have like, you know, a cookie or two once in a while, it's not a big deal.

48:05Dr. Mark Hyman:But it's the cumulative dose and the threshold.

48:07Dr. David Kessler:The law requires you to evaluate under the conditions of use as it's being used. You need look no more than just look around us.

48:19Dr. Mark Hyman:So would you say like if it's more than five grams of sugar, refined carbohydrate, or how do you do that on the...

48:24Dr. David Kessler:But that is going to be... Look, I think FDA has no choice. I mean, I think the secretary and the FDA, you know, I mean, I don't think these things are grasped, right? And once these are not grass, figuring that out on what can be safe shifts to the industry and the industry is going to have to come in and it's going to have to get its act together and say, how do we change this food environment? The ability to remake our food system.

48:55Dr. Mark Hyman:So the FDA enforces and says, this is no longer grass. We missed the boat. We kind of had a blind spot here. Now we get it. And as of tomorrow, it's not grass. And then what happens?

49:12Dr. David Kessler:Then you probably give the industry a certain time.

49:17Dr. Mark Hyman:Two, three years.

49:17Dr. David Kessler:And then they can come in, and they have to figure out how they're going to remake and reformulate food so that Americans can thrive. Basically, the minute the government says it's not grass, it gives them a deadline. I mean, I'm not even sure it's whether the government, the government doing that would certainly be very important, but I actually think it's self-executing. I think under the law, the food lawyers I've talked to, I mean, I don't think you can credibly say it's generally recognized as safe. Certainly if the government does that.

49:46Dr. Mark Hyman:But somebody's got to enforce it, right? Right.

49:47Dr. David Kessler:Well, so you're exactly right. I mean, and the FDA did issue this document in 88 that said these things are grasped. So I think FDA has to say that it is not grasped. People say it will take FDA a long time to study this and to figure out all the answers to these questions. They got it wrong. The burden is on the industry to show that it's safe. I mean, the FDA simply says, hey, just look at the Dietary Guidance Advisory Committee scientific reports, these refined processed carbohydrates, I mean, there is a link with obesity, cardiovascular disease, and diabetes. Maybe we didn't see that link back four or five decades ago.

50:24Dr. David Kessler:Maybe that was an area that we didn't foresee.

50:27Dr. Mark Hyman:But what about the dose question, to be back to that? Because I think that's challenging, because it's like the dose makes the poison according to Paracelsus. Exactly.

50:34Dr. David Kessler:But look at our food environment and then go to the European food environment, where there's much less ultra-processed food. Yeah, much healthier. And so the question is, we're going to have to remake our food environment. And remaking our food environment is going to mean that the dose is going to have to come very substantially down, right? Because no question at current doses, at current consumption level, current cumulative consumption levels, right, we see the harm. I mean, and the harm is demonstrable. Just look at the American body. We see that effect.

51:14Dr. Mark Hyman:According to recent USDA data a few years ago, it was like 152 pounds of sugar and 133 pounds of flour per person in America per year. That's almost three quarters of a pound a day. That's a pharmacologic dose.

51:26Dr. David Kessler:We are consuming, right, about 500 calories a day more. Now, maybe calories aren't everything when it comes to toxic fact, but it's certainly part of that. It's the toxic fact, plus the refined, rapidly absorbable glucose. I mean, it is contributing to the sepatic fat. But certainly those calories plus the refined processed carbohydrates are the toxic. Well, the calories are usually the refined carbohydrates.

51:51Dr. Mark Hyman:That's where they're coming. I mean, exactly. No, it's not like we're eating 500 calories more of meat or chicken or fish.

51:56Dr. David Kessler:So if you look at what it is, it's about 200, 300 calories of these refined grains, right? It's these starches and flours, right? It's more sweeteners, although increasingly the sweeteners, you know, are these artificial sweeteners, right? I mean, it's not the corn syrups. They've been replaced by these newer chemicals. I mean, that sweeten foods. So you have these added fats in oils. You have these refined starches. And you have these added sweeteners. And that's what makes up the additional 500 calories. And you were going to have to rethink the formulation, I mean, of these foods. look well once you open the door what the petition does i think that's the question it opens the door yeah and once you open the door and say say hey it's no longer grass there's no turning it back

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53:45Dr. Mark Hyman:So, David, you're in a room with Secretary Kennedy, FDA Commissioner McCary, you, maybe a couple other scientists, maybe me, I don't know, and we're sitting there a month from now. What are the steps that you're going to tell them to take to actually make this a reality? Because it seems to be like a loophole that you found that nobody's been thought about before that actually could solve the problem.

54:09Dr. David Kessler:It certainly gets the ball rolling and reframes the debate. It gives us the tool. So what did we do? Understand when tobacco started, actually tobacco started with a citizen's petition, 1988, right? The American Lung Association, American Cancer Society, American Heart Association submitted a petition to FDA. It was sitting there when I got there. It said FDA should regulate low tar, low nicotine cigarettes as a drug. Huh. Why low tar, low nicotine cigarettes as a drug? Didn't quite make sense, But it gave the regulatory hook, right? It gave the authority, I mean, to ask those questions. And we reframe the question, not is low nicotine cigarettes a drug?

55:04We reframe the question, is nicotine a drug?

55:08Dr. David Kessler:And once we asked that tobacco, that question, we did the investigation into the industry. We found out what the industry knew, right? We got those hearings. Remember those, the CEOs testifying? They believe in the case. Oh, God, yeah. Right? And then there was all this legislation. Took two, three decades. But once you, what the petition does by saying there's no longer grass, it gives HHS, the regulatory and legal hook to be able to reframe the food supply. But it's going to take decades. I mean, you're sitting with the people who are making decisions in Washington and you

55:47Dr. Mark Hyman:say, okay, you guys have to go back to industry and say, these subs are no longer grass. But that's the easy part. That just gets it started.

55:55Dr. David Kessler:Then the question is, how are you going to fix it? The great public health success of our lifetime, tobacco, fair, right? What in the end worked? litigation go ahead uh labeling labeling advertising taxation focus on our kids all all that work but what really worked what what what did what did those things what those were all tools right if you go back and you look at um certainly in my parents generation or my great parent, great, my grandparents' generation, right? How'd they view tobacco, right? Tobacco was sexy. It was adventuresome, right? It was positively valence. The industry in the early 1900s, they had that march down Fifth Avenue.

56:45Dr. David Kessler:It was associated with emancipation. It was, they hired the psychoanalyst A.A. Brill to come up with the phrase, torches of liberty, symbols of freedom. That was something you wanted. That's something you desired, right? It was cool, right? They made it cool to kids. What did we do? What did we do? What did it take us 75 years?

57:05Dr. Mark Hyman:You made it a pariah. Right.

57:07Dr. David Kessler:So we took something, an addictive substance, a reinforcing substance, a powerful substance, biologically active that affected our brains, affected our metabolism, right? Affected our bodies. And we changed the valence. The industry made it positively valence. What do you do if something's positively valence? You want it. right? You need it. I mean, I can't live without it. What did we do? We made it negatively. We had this critical perceptual shift as a society. I don't want that. So are we going to have to label these? Are we going to have to show people, right? That these chemically engineered, these foods that have these refined starches and grains, refined sweeteners, these added fats and These are not foods, right?

57:50Sure, they make, you know, in the moment, may they get me past the next 20 minutes, right?

57:56Dr. David Kessler:May it give me energy for two hours, but how is it going to make me feel over the long term? Is it cheap? No question it's cheap. For the short term, not the long term. But the long term, look at the devastating cost. So we're going to have to change. We're going to have to have this critical perceptual shift. We understand what the problem is, right? Now there needs to be the coming together, and we just have to execute this. So do you think it's like a public health education like we did with cigarettes? It's everything, right? It's everything you name. HHS has to act. Congress has to hold that hearing, right?

58:32Dr. David Kessler:Who should be the first witness? Secretary has to go in and explain that this stuff is no longer grass and is no longer a legal basis. Next panel is going to be the industry CEOs. And how are they going to fix this? Right? And the question is, is the industry going to just take the position, defend, defend, defend? Or is the industry going to understand? I mean, when tobacco, you know, when we started, the industry was defend, defend, defend.

59:03Dr. Mark Hyman:This is great. This is great. I love this idea. Yeah. I'm actually good friends with the chair of the subcommittee on health and the Ways and Means Committee who wants to have hearings on these things. So I think since Medicare is overseeing the health of America in many ways, it would be an interesting place to have these hearings.

59:23Dr. David Kessler:FDA has to do, HHS has to do its part. We have these hearings. The food industry has to come in with its solutions. And it's going to take, is it just going to be the revocation of grass that's going to solve this? No. But it's going to have to put together that comprehensive package.

59:38Dr. Mark Hyman:But I love the idea of having industry experts and CEOs held to account. I love the idea of scientists and people in the government actually testifying.

59:47Dr. David Kessler:And government doing what it can do. And FDA now has, in this petition, it has the regulatory hook. I mean, I have shown this to the best food lawyers, I mean, in the country. This is straightforward.

1:00:01Dr. Mark Hyman:I mean, I read it and my jaw was on the floor and I, we're going to link to it in the show notes. So if anybody wants to read it, I encourage you, or you can just read the New York Times about it, a article that you were featured in, which is also quite good. Or just throw it in chat. You can ask you to summarize it to summarize.

1:00:18Dr. David Kessler:And if you go back to the book, you go back to the book, there's a chapter. Yeah. I think it's chapter 23 that said you could not have designed a better weapon to blow up the American body. Meaning the petition or you mean the food industry?

1:00:35Dr. Mark Hyman:If you look at what we did, okay? I think it's like lead in the pipes in Rome. It's like the end of the Roman Empire. You know, it's the end of the American Empire. And it's something we bring on ourselves by the permissive nature of how we allow the food industry to run roughshod over American people, how we don't properly regulate it, how we allow things like advertising of junk food to kids that are banned in most countries, how we don't have clear warning labels on food that's harmful for you.

1:01:04Dr. David Kessler:Up until now, the industry has been able to do this with impunity, put this out, and say, it's not my food. I mean, it's the dietary patterns, right? But it's these industrial foods that created the current dietary pattern. Right? So there is, and we need just a complete full picture here. Right? So the question is, what do you do if you're the individual? How do you protect yourself from this environment? Because clearly we've been talking a lot about the public health interventions, which have to happen, but also - But it's absolutely true. Yeah. So again, I left warp speed, 40 pounds heavier, right?

1:01:53Dr. David Kessler:And metabolically, my body - Busted. It was not good. I actually, I started losing weight, you know, and I went on my typical, you know, low carb kind of diet. I lost a couple of pounds, right? It wasn't going as quickly, I mean, as I wanted. I mean, interestingly. And I threw a, I had a kidney stone, you know, losing weight. I mean, you know, I was at risk for kidney stones. I found myself in the ER. I was just dehydrated and had the kidney stone. They drew blood and I had this elevated calcium level. Why didn't I have an elevated calcium level? It just didn't make sense. So I went to an endocrinologist, right?

1:02:39Dr. David Kessler:And parathyroid hormone was that? It was a spurious result. It was a spurious result, but the endocrinologist happened to be doing some of the clinical trials on the GLP-1 drugs, right? And I said I was losing weight. and he said, do you want to try to go on the GLP-1 drugs? You qualify. My BMI was greater than 27 with a comorbidity. And I'm writing this book and I said, hey, I wanted to experience it, right? Diet, drugs, and dopamine. And dopamine, right? I mean, the dopamine I had, right? Those, you know, and there is, when you look at the biology, and I think this is key. I think, first of all, the one thing the drugs show, right, is they're highly effective.

1:03:30Dr. David Kessler:No question you lose weight on the GLP ones for the vast majority of people. 95 % of people lose weight. They are not the be-all and end-all. They're not the whole story. They are only one tool. They have real adverse events, right? But if you look at those drugs, certainly those drugs work through biology. So it's proof that it's not willpower. We can agree on that, right? But with the pharmaceutical, how do these drugs really working, right? Why are they so effective? You know, we talked about the, um, the, the sedonic, this reward, this addictive circuit in our brains, this dopamine circuits in our brain, the reward circuits, right?

1:04:16Dr. David Kessler:There's another set of circuits, right? In our, in our biology, you mentioned it when you talked about bitter, there are these aversive circuits, right? And And so what do these drugs do, right? I mean, these drugs delay gastric emptying, right? They slow down the movement. Highly processed foods increase the speed of the food. It slows your gut down. It slows your gut down. And we've all experienced it. We've had the flu. Our gut slows down. You're not hungry. You're not hungry. But how do you also fear it? When you have the flu and you don't want to put anything else in your stomach, right? They're nauseous.

1:04:51Dr. David Kessler:So what these drugs do is they delay gastric emptying and they push you to that edge of nausea, right? What's strong enough to overcome the addictive circuits? Wanting to puke. No, so you laugh. Now, the great thing about these drugs is they titrate the dose.

1:05:09Dr. Mark Hyman:I'm not kidding. I'm just saying.

1:05:09Dr. David Kessler:No, no, no, but that's exactly how this is work. So what happens, the way these drugs work is they have this spectrum of satiety. There is fullness, right? There's, you know, I'm satiated. And then there's Thanksgiving Eve fullness, right? I mean, where you push it up. And then there's the, you know, I push you over to the vert GI, you know, effects of that nausea, right? I mean, the acute effects. If I push you over the edge. So what these drugs do is they stimulate that circuit, right? The gut and the brain, I mean, it's working on the area per stream of the hind rate and the gut. You delay gastric dent and you push people to that edge of nausea.

1:05:53Dr. David Kessler:Now, everybody feels this differently. And what do you do? If you know you're going to put food in your stomach and it's going to make you feel ill, what do you learn to do? Not eat. Or eat less.

1:06:05Dr. Mark Hyman:Or eat less.

1:06:05Dr. David Kessler:So that's, I mean, my guess is that's the primary thing. It's like a gastric bypass without the bypass. Now, how long are people on these drugs? Well, often after a year, 50 % stop. Even more. Okay. The vast majority are off these drugs eight, nine. And then they gain back 65 % of the weight or more. So what's going to happen? In three, four years, we're going to go back and look. And the average person's on this drugs for eight to nine months. They gain back the weight. And what are we going to say? Is one big, these are highly effective drugs. Well, you're on them. but if you go off them, right?

1:06:38Dr. David Kessler:And if you go off them, you know, understandably they don't work when you're off them, but while they're on them, they delightfully, there's this gastric empty and you need this seesaw, this is reward circuits that's gonna make me feel better. And this is gonna, you know, increase the tide and make me feel full. I don't want this, right? Just because I was born without the genes to have this satiety and I need this drug, there shouldn't be no shame associated with using these drugs, right? But we got to figure out how to use these drugs wisely, right? They are an important tool, but they are not the only tool in the toolkit, right?

1:07:14Dr. David Kessler:So can you use these drugs to change, you know, your relationship with food? To condition yourself to eat less? Sure. To give you this is high to take, to want to eat real food, to eat, not eat. I mean, people change. It's very interesting how these drugs change tastes. They change what people want to eat. For the first time, people say they want to eat healthy. They don't want this, you know, highly, high glycemic fat and sugar. Because if that's just going to sit there in their stomach, how is it going to make them feel?

1:07:46Dr. Mark Hyman:Right.

1:07:47Dr. David Kessler:Right? But we have very powerful tools that are highly effective, but we don't know how to use that in the long term. Right?

1:07:57Dr. Mark Hyman:What's your sense of these drugs long term? Because, you know, we're talking about covering Medicare. I mean, they - People should have that.

1:08:04Dr. David Kessler:I mean, imagine struggling with your weight for your whole life, right? And you have real, this real, I mean, that be your belly, right? Let's, right. That be your belly. I mean, the average male in this country who's 50, 60, 70 pounds overweight, and where is that fat? Belly fat. And what did we, we actually, you know, that dad bod or whatever people refer to it. I mean, but we made it cool in this country. But in fact, what's going on with that beer belly? I mean, we got to help. I mean, that beer belly translates into heart failure, into achial fibrillation. These are a tool to get us there.

1:08:42Dr. Mark Hyman:But if people, more than 50 % of people are off them.

1:08:45Dr. David Kessler:But we got to give people care.

1:08:46Dr. Mark Hyman:I mean, you got to marry with nutrition and exercise and coaching and support.

1:08:54Dr. David Kessler:And it's not your fault. Right. Okay. But the one thing you can decide to do is to do something about it. but you have to be, but then we have to give people help. I mean, personally,

1:09:05Dr. Mark Hyman:I think it's malpractice to prescribe these drugs without a nutrition consultation, without higher protein intake, without exercise training and building muscle.

1:09:13Dr. David Kessler:And if we're just going to put people back into an environment, right? With all this ultra processed foods, what's going to happen when they're off the drugs?

1:09:21Dr. Mark Hyman:Yeah.

1:09:21Dr. David Kessler:So we got to change the food environment, but we got to give people the tools and give people the care. I mean, this is what you've always stood for. fair? This is what you've cared about. People talk about longevity. What's longevity? Let's really talk. What's longevity? I mean, if I could prevent heart failure, if I can prevent atrial fibrillation, if we can prevent certain forms of these cancers, I mean, we are at the point,

1:09:50Dr. Mark Hyman:right?

1:09:51Dr. David Kessler:If we can reduce this visceral adiposity, this toxic fat, right? That's longevity, fair? I mean, that's what's killing us. That's what's in our senior years, how many years of chronic disease of that health span is going to be taken up by disability because of this heart, this cardiac, I mean, it may be cardiac disease, it may be renal disease, it may be metabolic disease, but it's going to manifest itself, that toxic fat. And we could do something about that. We know how to change the, we know we have to change the environment, right? We have these tools. We just now have to put it together.

1:10:27Dr. Mark Hyman:This is incredible. I think between the public health focus and the clinical focus and the structural changes that have to happen in our society to allow people to make better choices where the default choice is the healthy choices and most of the bad choice, it's going to take a minute. I don't know if it's hopefully. Tobacco? Yeah. How long did it take us? 30 years.

1:10:49Dr. David Kessler:All right. This is as big as tobacco.

1:10:50Dr. Mark Hyman:I think it's bigger, but the question is everybody eats. Not everybody has to smoke. But you don't have to eat. ultra processed food.

1:10:58Dr. David Kessler:You don't have to eat in this alternate food universe.

1:11:02Dr. Mark Hyman:Yeah, it's true. It just requires a whole restructuring of everything from field to fork. And that is really important because it's not just a policy issue. It's not just a personal choice issue. It's like how we grow our food. And it goes back to right.

1:11:18Dr. David Kessler:But it's how we're making this food. Soil and how we're processing it. But look at how this ultra processed food is coming together. It's not food. No, no. Right? I mean, they're taking, right, these supercharged ingredients and putting that together in some kind of mixture, and then they're adding back that palatability. That's not food.

1:11:40Dr. Mark Hyman:Yeah, I agree. I mean, I think if there was one sweeping policy that the U.S. government could make that would change everything, it would be like, if you're eating something, does it promote or detract from your health? And if it's something that detracts from your health, it shouldn't be covered by any government policy. you can make your own choice to drink soda.

1:11:56Dr. David Kessler:We certainly shouldn't give it a pass and say it's generally recognized.

1:12:00Dr. Mark Hyman:No, it's sort of like, imagine with SNAP, with the food stamp program, imagine we were paying for$125 billion

1:12:07Dr. David Kessler:of cigarettes for Americans.

1:12:08Dr. Mark Hyman:That's essentially what we're doing.

1:12:09Dr. David Kessler:So an incredible opportunity to get this done? There's an incredible opportunity. Yeah. Right? Yeah. We understand what we need to do medically. There's finally a convergence.

1:12:18Dr. Mark Hyman:So what's going to tip this point? Like, you wrote this petition. It was brilliant. It was like this insight that I was like, oh my God, why didn't I think of that? It's so good. And it makes sense. And it seems straightforward. So how do we get this over the finish line?

1:12:30Dr. David Kessler:Because you and I and a few others - There's not one finish line. In tobacco, there wasn't just one finish line. It was a series of chapters. We got to get HHS to act on the petition and simply say, get the ball rolling. I'm on it. Okay.

1:12:46Dr. Mark Hyman:I'm on it.

1:12:46Dr. David Kessler:All right. I mean, if you do that, right, then you open up the, you have the hearings, right i'm on that too okay and and you bring in the food industry right and help that and and they got to be able to part of the solution we're going to have to give people care we can't just wait to change our food environment people need care today right these drugs are one they're powerful they're not the whole answer okay but we have to give people access to real food we have to give people access to care. I mean, and finally, finally, what you've always wanted to do,

1:13:23Dr. Mark Hyman:I think we can reclaim our health. I love this. This is beautiful. And what a wonderful place to end. We can reclaim our health. And, you know, you've been a pioneer in this space for a long time. I have huge respect for you. I followed your work from the days back when you were the FDA commissioner under Clinton and Bush. And the fact that you took on tobacco and won, I think, you know it would be a beautiful bookmark to your life to take on the ultra processed food industry and create a win for america and i'm going to do whatever i can to help you because i i i have little levers i can pull i know people you know people we can we can we can pull this together and i i have elevated this this petition to a bunch of people in the administration i'm also So, you know, wanting my community of listeners to also talk about this to their congressmen, their senators to start to socialize this idea because it is a powerful idea.

1:14:19Dr. Mark Hyman:There's sometimes these ideas that happen once in a while that catalyze some shift. And I think this is one of those ideas. It's simple. It's clear. It's irrefutable. It's time to come. Like, let's go. Thanks for having me. Yeah. Thanks for being here, David. When it comes to supplements, you only want the best for your body. the kind with the highest quality, cleanest, and most potent ingredients you can get. That's exactly what you'll find at my supplement store, where I've hand-selected each and every product to meet the most rigorous standards for safety, purity, and effectiveness. These are the only supplements I recommend to my patients, and they're also what I use myself.

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1:15:41Dr. David Kessler:This podcast is separate from my clinical practice at the Ultra Wellness Center,

1:15:45Dr. Mark Hyman:my work at Cleveland Clinic, and Function Health, where I am Chief Medical Officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests. This podcast is for educational purposes only and is not a substitute for professional care by a doctor or other qualified medical professional. This podcast is provided with the understanding that it does not constitute medical or other professional advice or services. If you're looking for help in your journey, please seek out a qualified medical practitioner. And if you're looking for a functional medicine practitioner, visit my clinic, the Ultra Wellness Center at ultrawellnesscenter.com and request to become a patient.

1:16:21Dr. Mark Hyman:It's important to have someone in your corner who is a trained, licensed healthcare practitioner and can help you make changes, especially when it comes to your health. This podcast is free as part of my mission to bring practical ways of improving health to the public. So I'd like to express gratitude to sponsors that made today's podcast possible. Thanks so much again for listening.