Johann Hari - Beware The Thrill of The Magic Pill｜The Imperfects

In today's Academy of Imperfection, we have Johann Hari back in the studio to talk about a lot of things actually.

We talk about the westernised food system and how our reliance on processed foods can have serious negative consequences on our physical and mental health.

Our relationship with food and weight, willpower, diet and exercise, vanity, body shaming, eating to comfort or suppress negative emotions and much more.

Johann also discusses the benefits and risks of new weight loss drugs like as empic.

Although these drugs can be beneficial for people at higher risk of negative health conditions due to living with obesity, they also have significant mental and physical health risks associated with them.

And there is a lot we still don't know.

So if you're thinking of taking them, weighing up the risks with your doctor for your unique situation like Johann has is incredibly important.

We also know that many of the topics mentioned in this episode can be challenging for people, especially those who have had a history of disordered eating.

So please tread carefully with this episode and only listen when you feel ready.

My name is George and I edit The Imperfects.

I grew up on Ngunnawal Country, studied on Bundjalung Country and am now living and working on Wurundjeri Country.

On behalf of the Imperfects, we acknowledge the Wurundjeri people of the Kulin Nation as the traditional owners of the land on which this podcast was recorded and we extend our respect to all Aboriginal and Torres Strait Islander peoples.

The rich storytelling history of the world's oldest living culture is what we proudly pay homage to when we share stories on The Imperfects.

Well, hello darlings and welcome to the Academy of Imperfection where experts in their field share their wisdom on the subject of imperfection.

Today, for the quadruple of time, we welcome best selling British author Johann Hari to talk to us about our problematic food system and what he calls a magic pill.

These drugs are so powerful.

I think of them as being like fire, right?

They're a tool. Fire is a really good tool if I use it to warm up my house.

It's a really shit tool if I use it to burn down yours, right?

A tool this powerful will be used for great good and great harm.

So pour yourself a pint of devonshire and join students Hugh, Ryan and Josh learning from the man who says a lot, Johann Hari.

Well, how exciting.

We are joined by the King of England, essentially.

Yep. Yep. For the fourth time.

The fake King is literally in Australia right now.

Yeah. Charles, did you not know this?

Is he in Australia now?

I think so. Yeah. I think he's literally today.

I have to say it is a really bad thing that Britain has a hereditary monarchy, but it's particularly shameful that you have our hereditary monarchy, right?

Come on Australia have some fucking self -respect here, right?

I might be led to believe that there is no one in Australia who could do a better job as your head of state than someone from another country who is there because he emerged from the right vagina 70 years ago.

This cannot be correct.

So yeah, fourth time you've been on this podcast.

That is a record. I'd say.

So really I'm the King of this podcast more than sure.

Yeah, you are. You are definitely the King of authors.

That's for sure. It's the nicest thing anyone's ever said to me.

Stolen focus, lost connection, chasing the screen, three books that have had an extraordinary impact on so many people worldwide.

The new book magic pill, which we're going to talk to you about today.

I mean, there's so much to talk about today.

Where do we start? Well, I mean, I feel like the magic pill I guess so much about that book is, is about the food system and about like how the food system is doing us no favours and how it makes it incredibly hard.

But I guess it's just like from what you experienced because, and I'm sure you've got lots to say on it, but it, I think just starting there, because I think that's the thing that most people like face every day you get up, whether you've, it's how you've grown up, how you've been brought up or whatever

it is, but everyone has a different experience with the food system.

Most people probably don't even such a short period of time.

So such a funny little moment in the history of Australia.

Not funny, a terrible moment, but I think helps you to understand this.

So your prime minister drowned in 1968, Harold Holt.

Harold Holt. Just say to everyone listening, just pause this and Google, you can watch online.

When he drowned, there were just a load of ordinary Australians on the beach, right?

Who helped look for him that day.

Just Google it and look at those people on that beach, right?

And then just come back.

If you look at them, or go even later than that, I was born in 1979.

Google photographs of any beach in Australia in 1979.

Just look at them and then come back, right?

You will have noticed something a bit weird, right?

The people on that beach don't look like us.

They're all what we would call skinny or quite ripped, right?

You look at it and go, well, where was everyone else that day, right?

Was it like a skinny person convention on the beach that Harold Holt happened to drown off of?

And then you look at the figures.

So the figures for Australia are pretty similar to Britain.

In the year I was born, 6 % of British people were obese.

It's now 27%. Right?

Between the year I was born and the year I turned 21, obesity doubled in the US.

And then in the next 20 years, severe obesity doubled again.

So you've got to understand how unusual this is.

Human beings exist in our modern form for about 350 ,000 years, something between 300 and 350 ,000 years.

And obesity exists, but it's unbelievably rare, right?

Vanishingly rare. And then essentially in our lifetimes it has blown the fuck up.

You think that's weird.

What happened, right?

Why did this explosion take place?

And we know the answer, the core of the answer, because this change happens everywhere that makes one change.

It's where people move from mostly eating fresh whole foods they prepare on the day to eating mostly processed or ultra processed foods, which are foods that are built in factories out of chemicals in a process that isn't even called cooking.

It's called manufacturing food.

And it turns out this new kind of food, right?

Which our great grandparents never had one mouthful of this kind of food, because it didn't exist then.

This new kind of food affects our bodies in a completely different way to the old kind of food.

And I go through lots of ways, seven ways it affects us differently in the book, but I think the kind of core of how it affects us differently is really distilled in this quite simple experiment that was done by a scientist I interviewed called Dr.

Paul Kenny. Brilliant Irish American scientist.

He's the head of neuroscience at Mount Sinai in New York.

It's a very simple experiment.

He got a lot of rats and he raised them in a cage.

And all they had to eat was the kind of natural whole foods that rats evolved to eat over thousands of years.

And when that's all they had, the rats would eat when they were hungry and stop when they were full.

They had some kind of natural nutritional wisdom that just said when they had enough, hey guys, you've had enough, stop now, right?

So the rats, when they had the kind of food they evolved to eat, never became fat, overweight, obese, just didn't happen.

Then Dr. Kenny introduced them to the American diet.

He fried up a load of bacon, he bought a load of cheesecake, he bought a load of Snickers bars, and he put it in the cage.

Rats must have been pumped.

The rats went fucking apeshit for the American diet.

They would literally dive into the cheesecake and eat their way out, which has been one of my ambitions in my life.

Eat their way out and merge just completely smeared with the cheesecake.

And the way Dr. Kenny put it to me is they ate and ate and ate and ate.

And within a couple of days, they were just different animals, right?

This nutritional wisdom that they'd had when they had the kind of food they evolved for disappeared and they all became severely obese.

Dr. Kenny tweaked the experiment then, again, in a way that feels quite cruel to me as a former KFC addict.

He took away all the American diet and left them with nothing but the healthy food.

And he was sure he knew what would happen.

He thought they would eat more of the healthy food than they had before.

And that would prove that exposure to this kind of food expands the number of calories you eat in a day.

That is not what happened.

What happened is much weirder.

Once they'd had the American diet and it was taken away, they refused to eat the healthy food.

It was like they no longer recognised it as food.

They literally starved.

It was only when they were actually starving to death that they finally reluctantly went back to eat it quite a while later.

Is there, because like you said before, like, you know, it's like they forgot the nutritional wisdom they had before.

But before all these processed foods came in and people had no choice but just to eat whole foods, was there much nutritional wisdom or was it just like, well, this is food.

This is just like people were people thinking about why they were eating that food or were they just eating it because that was food.

Yeah. It's an innate nutritional wisdom.

So it's not like the rats weren't reading complex books about the macros you need.

Right. Oh, well, then I think I'll balance this with the because the phrase wisdom we think of as kind of explicit, kind of intellectual wisdom, but it's more.

It's linked to getting signals from your body about you've had enough, you don't need any more, satiety, there's been research on this here in Australia, actually.

One of the reasons why people eat more when you when you've got a diet of processed food, you eat far more calories.

There's lots of reasons why.

But there's a guy at the University of Sydney called Professor David Rabinheimer, who's done really interesting research on this.

One of the reasons out many is that processed food is actually very low in protein.

And it turns out we all know you have hunger for calories, right?

You need to send them more calories in order to stay alive.

But he argues, I think, and I think he's proven quite persuasively, you don't just have a hunger for calories in the main, you also have a hunger for protein, because your body needs protein to build bones and do all those things.

And so your body knows not just when it's had enough calories, but also when it's had enough protein.

So you eat more processed food than you would from non processed food, because to get the right amount of protein, you have to have a lot more because it's so low in protein, right?

He's done really interesting experiments proving that.

So nutritional wisdom takes all sorts of forms, right?

But the way we eat with fed food that's actually designed to fuck with that, right?

So you think about the circumstances where we evolved, if you found came across soft, sweet tasting food, that would be fruit, that would be good for you, right?

So we evolved to go, let's eat that, right?

But now, of course, if you come across soft, you know, sugary stuff, it's more likely fruit loops than fruit, right?

So it's like the, it's almost like a malfunctioning GPS, it was designed to tell you how to drive home, but now it actually tells you to drive off a cliff, right?

We live in an environment, because of the changed nature of food that completely scrambles and fucks with our instincts, and gets us to eat in all sorts of, or makes us more likely to eat in all sorts of more dysfunctional ways.

But I'm curious about you guys.

So you all look like slightly aged home and away lifeguards.

So like, like you've never had, you know, you couldn't be home and away lifeguards now.

I mean, you could in my fantasies, but not in the show.

But yeah, you got a feeling this has never been an issue for any of you?

It's been an issue for me.

Really? Yeah, I've always, I'm probably not as heavy as I've been, but I feel like from the age of 16, in fact, I remember I was on the beach and someone pointed at my like gut and said I'd like put on some weight and kind of joked about me looking fat.

And I reckon from that moment, I've had issues with the way I look.

And I always blame myself for like, like, I can't open up, I jokingly talk about how I can't have like open a pack of sour worms and not finish them in one sitting.

Like I got a pack of sour worms a week ago and managed to finish it in two sittings rather than one.

And I was really proud of myself.

I yeah, I've always had issues body issues since teenage years.

And yeah, and I've blamed myself for almost solely for the whole time, that I'm not disciplined enough to exercise enough.

I don't have enough and it's yeah, it's my fault is kind of the dialogue that's been going on for me for yes, since as a teenager.

This is true. So so many people, Josh, because the it relates to a lot of things we've talked about before, but we live in this environment that is has lots of good things about it, but is in some ways a dysfunctional environment.

And it produces these negative outcomes like depression, attention problems being overweight.

But because we don't have a kind of systemic analysis, we're always pushed to blame ourselves for these things that are actually the result of much bigger systems, right?

The fact that the difference between the beach where Harold Holt drowned and the nearest beach to here now and what people look like there is not that all those people were weak willed, right?

And lazy and didn't get their act together, right?

It's not that human beings had willpower for 300 ,000 years and then it suddenly vanished in our lifetimes, right?

It's just ludicrous.

That's that's not the change that happened.

The willpower isn't real.

Willpower is a real thing.

There's a brilliant scientist based here in Australia, Professor Roy Baumeister at the University of Queensland, who's done some of the best research in the world on willpower.

It's a real thing, but it's a very limited resource, right?

And if you're pitching your willpower against the entire environment that's sabotaging your instincts and your willpower, that's, you know, some people can fight their way through that just like some people can climb Mount Everest without oxygen, but it rigs the odds against you.

I also think interestingly, it feels like in that time when the food system has changed and this dialogue for many people, I think I wouldn't be alone in blaming yourself and thinking it's your own willpower, but also in that same period of time, the proliferation of beauty standards has changed as

well. So like, as the it's gotten harder to look a certain way, looking that way has become more and more prized and idealized.

Totally. Yeah. So it's like a, it's a pretty shit combo for a lot of people.

Yeah, totally. And it's, it's, I mean, it's bad enough for us, but it's much worse for women.

I really pissed off one of my, a female friend of mine just before magic pill came out.

I, I was chatting to her and I said, Oh, you know, I feel a bit weird going into these interviews.

Cause it's the first time I felt in interviews that people will be looking at me and going like, Oh, is he getting way, is he okay?

He's talking about taking his Epic.

Is he fat? Is he not fat?

And she was really pissed off.

I said, Oh, why are you looking pissed off?

She said, the fact that you've got to the age of 45, and this is the first time you're going into a work context and you feel subconscious about how you look, welcome to the life of every fucking woman in the world from the age of like nine to 90, whatever she does, right?

You're constantly thinking about that.

And, um, I thought that was really interesting.

It's not that I hadn't had body consciousness and things before that, but yeah, I thought that was a really important point, but you're totally right that the, the environment has pushed us to worse outcomes while the physical environment, the food environment, while the cultural environment has venerated

a more and more narrow body type.

Um, yeah, I think that's totally, totally right.

Yeah. Can we ask about your journey here with, you know, as a child growing up in a team, all the different stages you've been through you and your relationship with food, you know, you, you write strong focus because you found yourself unable to sit and read books for long periods of time.

We used to be able to read for hours, but you found yourself being distracted easily.

Your books always have lost connections.

Yeah. About your experience with antidepressants and yeah, yeah, you always have a very strong motivation of strong personal motivation, which, um, which inspires you to explore very deeply this topic.

So I'd love to know your journey.

Yeah. I mean, I can talk about my childhood, but I remember so clearly the moment when I learned about the existence of these, these new drugs.

So for people who don't know, because there'll be some people listening, you don't know, um, there's been a staggering medical breakthrough.

Uh, we now have drugs that produce extraordinary amounts of weight loss, relatively effortlessly.

If you take osenpik, we'll go the, the basically the same thing.

You, you lose on average 15 % of your body weight within a year.

If you take manjaro, which is the next in this new class of drugs, you lose on average 21 % of your body weight.

Um, and the next ones that will be available next year, probably triple G, you lose 24 % of your body weight.

And I've noticed in the Australian coverage of osenpik is still quite often referred to as like a fad or a craze.

It's really important people understand this is not a fad or a craze.

This is a huge scientific breakthrough as one of the scientists I interviewed said to me, we've cracked the code of what controls human appetite, right?

I'm sure we're going to more detail on what that is, but, um, and I remember the moment I learned about this so clearly, it was the winter of 2022.

It's that moment when the world was opening up again and I got invited to a party for the first time in like, since the plague began.

Right. I thought, so yeah, parties.

I remember them. I was like, yeah, I'll go.

Right. And this party was thrown by an Oscar winning actor.

I'm not saying that just to name drop.

It's relevant to happen next.

Um, and I was in the person's name Oscar winning actor.

I thought it was with, it was such a coincidence.

He then won an Oscar as well.

But the, um, a lot of pressure, but I was in this Uber on the way there and I suddenly felt a bit kind of self -conscious cause I was quite a fat at the start of the pandemic and I gained quite a lot of weight during the pandemic.

I thought, Oh, fuck.

And then I suddenly remembered, I'm actually loads of people.

I know gain weight during the most people I know, gain weight during the pandemic.

Actually, this party is going to be really interesting.

It's going to be fascinating to see all these Hollywood stars with a bit of like, podge on them.

Right. And I turned up and it was, it was bizarre.

I'm walking around and everyone was markedly thinner.

I was like, huh. And I bumped into a friend of mine on the dance floor and I said to her, fuck, it looks like everyone really did take up pilates during lockdown and she laughed and I didn't know why she was laughing.

And she said, right, well, you know, this isn't pilates, right?

And I had no idea what she was talking about.

She pulled up on her phone and I was unpicked pen.

That's when I obviously learned then, obviously I learned much more to follow.

And I remember when I learned about it immediately feeling two completely contradictory things.

The first thing I thought was, well, shit, this could save my life because I was about to turn 45, which is the age of my grandfather was when he died of a heart attack.

Um, loads of the men in my family get fat and die young.

My dad had terrible heart problems.

He didn't kill him.

My uncle died of a heart attack.

So, and I knew even then, obviously we know that obesity makes heart disease much more likely and much worse.

In fact, obesity causes or makes worse over 200 known diseases or complications.

So I thought if we've got a drug that can reverse or reduce obesity, well, that could have big effects from a health.

But I also thought, wait a minute, there's no such thing as a free lunch, right?

What's the catch? Yeah.

It can't be as good as this.

So it's why for the book, obviously I went on this big journey all over the world, um, from, you know, Iceland to Minneapolis to Okinawa to, to interview the leading experts on these drugs, the biggest critics of these drugs, the biggest defenders of these drugs to try to figure out what's, what's going

on here. And it's complicated picture that the book is magic pills, but subtitle is the extraordinary benefits and disturbing risks of the new weight loss drugs.

Cause they're, they're really are both here.

I would love to hear a bit about why obviously there was the risk of, uh, you've just described how your grandfather died at 45.

Was that, and there's a risk of this hereditary in your family, but why particularly for you, this was such a light bulb moment, like your journey with food.

Do you mind going into the course?

Of course. The, um, I think my experience with food is distilled by a moment that happened to me just before Christmas in 2009.

I lived in East London at the time and I went for lunch into my local branch of KFC.

Um, and I, I said my standard order, which is so disgusting.

I will not repeat it.

And, um, the guy behind the counter said, Oh, yeah, I'm really glad you're here.

Was that right? And he went off behind where they throw all the chicken and he came back with every member of staff and a fucking massive Christmas card in which they'd written to our best customer.

And one of the reasons my heart sank as I thought, but this isn't the fried chicken shop I come to the most.

How can this be happening?

Right? So like from a very young age, my diet consisted of like absolute shit, right?

Um, and you know, I was mostly raised by my grandmother who was, um, yeah, a working class Scottish woman who literally left school when she was 13 had a very hard line, incredible human being had a very hard life.

And, um, the day we got the microwave was like the happiest day of my grandmother's life.

It was like, you get food, but you don't have to fucking cook.

So, yeah, from a very young age, you know, me, my brother, my sister, our diets were, you know, almost entirely processed food.

Which I now realize had all sorts of effects on me.

Um, and also because, because I grew up in this environment, um, cause fellow members of my family was a lot, we've talked about before, as a lot of addiction and craziness.

Uh, I realized now, partly I learned it through some weird things that happened when I took these drugs, how much of my eating from when I was very young was, you know, when you're in a chaotic environment, you're a child, you don't have that much control, right?

But one thing you can control is what you eat most kids.

Um, and I realize now how much of my eating was driven not by tasting food or like some people who overeat is because they actually love food.

Do you know, it gives them a huge amount of pleasure.

Um, they think about food a lot.

That is not, that was not me.

For me, I would, I would feel soothed by stuffing myself, stuffing is when you deliberately overeat, right?

You know, and you feel like a pressure outward on your stomach and upward on your esophagus.

And I realized how much of my relationship with food was about getting that sort of stuffed feeling.

Um, uh, so from, from when I was very young, that was my primary relationship with food.

And yet, so I just ate, um, huge amounts of shit that feeling you described as like wanting to feel stuffed when you're a kid, did that last into your adult years?

Like, was that until I took these drugs all the way up until then.

It wasn't the only thing going on.

But yeah, it was, I would say that was the primary determinant of my relationship with food.

Now, in retrospect, now cause these drugs are so profoundly changed my relationship with food.

Um, I now see how much was, was that.

Yeah. And had you before doing the research for this book, had you done much research, like was it an interest or?

I mean, I knew a fair bit, but I think it's an interesting thing.

And it's nothing about these drugs.

One of the things we know, there's a huge amount of research on this, like professor Michael Low at Drexel university and Philly have done work on this.

Um, increasing people's intellectual insights into their eating into health and food has all sorts of benefits.

They feel less shame for example, but it doesn't change their eating psychological therapy for overeating.

I mean, we've now got 50 years of research and it couldn't be clearer.

It doesn't work. Right.

To the point where I actually think it's cruel to refer people now for psychological therapy to say to them, this will reduce your overeating.

Now it's not cruel to refer them for therapy.

I'm a big fan of therapy.

It can help with all sorts of things.

But, but we know very clearly that intellectual, increasing intellectual insight onto these things alone does not solve the problem.

Um, and I would say I probably had a high level of intellectual insight onto these things.

Um, like sort of awareness of what's good and what's bad and stuff like that.

Actually, you know what?

I've said that and I don't think that's actually true.

And I tell you why I think why I realized it's not true.

I'm really embarrassed to say I learned a huge amount for this book, obviously.

The thing that most shocked me is something I thought I'd known since I was a little boy.

Uh, and I realized I really didn't understand fully, which is just how bad for you.

Obesity is how bad for your health.

On average, speaking to the leading expert, no, it doesn't mean, you know, a hundred percent.

We all need to oppose stigma against people who are overweight and obese, um, which I'm passionately in favor of posing, but the science of evidence is shocking.

If you're obese, you are much more likely to get basically every medical condition that we fear.

A dementia, I didn't know there was a huge increase in dementia risk.

Cancer is one of the biggest causes of cancer in Australia is obesity.

Um, uh, it throws off your inflammatory responses, which means that you don't heal as well from anything.

Um, even think about diabetes.

So I definitely knew from when I was a kid that obesity causes type two diabetes or makes it much more like if you're obese, when you're 18, you've got a 70 % chance of becoming diabetic in your lifetime.

But I think I thought I'm really embarrassed to say this.

I think I thought, well, if you're diabetic and you live in a country like cows and you get insulin, you know, you're fine, right?

You're basically like everyone else.

It's not true at all.

Type two diabetes knocks 15 years off your life on average.

It's the biggest preventable cause of blindness in this country and in Britain.

Um, more people in the U S have to have a limb or extremity amputated because of diabetes than because they got shot.

And you so I was taken aback and I suppose intellectually I knew some of it, but I had not really absorbed it partly because if you don't feel there's a solution, you just don't want to know the truth.

Right? Like you just don't want to hear about it.

Right. And diet and exercise only work in maintaining weight loss over time for a small minority of people.

It's not no one, uh, this a small minority, we go into why.

Um, so do you, do me as in people who decide to go on a diet and exercise to fix the problem.

It works, but they don't maintain that.

It's just a small amount of people that it works for.

It's the research and this is really interesting.

There's a brilliant woman called professor Tracy Mann, right into she's at the university of Minnesota in Minneapolis where I interviewed her.

So she started researching this when she was still, I think a grad student in Stanford in 1999.

So she wanted to look at the evidence about the efficacy of dieting, right?

Does it work? How does it work?

And so on. And she looked at, at that time the scientific evidence was very robust.

Dieting works, right?

For a very simple reason.

You only have to understand the laws of physics to understand it.

If you burn more calories than you, um, take in, you will lose weight, right?

That's beyond dispute.

Um, and there were thousands of studies demonstrating this effect, but she looked at them and she noticed something, which is almost all the studies that were done were done for three months.

So you reduce your calorie consumption burn more over three months.

The graph will be very clear on average.

It goes right now. There were some for six months, but she listened.

So, huh. And so the implication in all these studies was, well, you, you, the graph goes down for six months and then you either continue going down or you remain at this lower weight forever.

Right. Um, but we all know people who've gone on diets, press some answer that wasn't their experience, right?

You lose weight for a while, you regain most of it.

Sometimes you go back to more than you had before.

Like she looked. And at that time there had only been that she could locate 26 studies ever that looked at dieting over two years, which is a much more meaningful timeframe.

And for there, the results were very different.

The average was only two pounds of weight loss over two years.

And, and we now have a lot more evidence that demonstrates this effect that, um, diets usually don't work in the longterm.

Right. Now there are certainly people for whom it does.

Someone in my family lost a huge amount of weight purely through diet and exercise.

Incredibly. Um, Professor Mam was discovering this and I was really curious about, well, how can that be?

Because we know the laws of physics, right?

We know that if you burn more calories than you consume, you lose weight.

And there's a huge debate about this, but there's a really important theory, um, which is broadly accepted now, not entirely, but broadly accepted, which also relates to one debate about how these new drugs work.

So if you go back to the sixties and seventies, scientists generally thought that your weight was, uh, had a, what's called a metabolic set point.

So you think about your body temperature, right?

From when you're born, your temperature has an innate set point at 36 degrees centigrade.

36 .6, I think. And if you go, if you go higher, your body will work really hard to bring you back down your sweat, your crave shelter.

And if you go lower than that, your body will bring you work really hard to bring you back up your shiver, you know, your crave warmth.

So your, your body temperature is fixed.

It's got a set point, right?

And you can go outside it, but it's really hard on your body fights to bring you back.

So it was thought that, that the fat percentage body weight was basically like that, right?

That you've got a set, uh, body weight fat level that your, that your body wants you to be.

And yeah, you can go above or below, but your body will try to keep you at this.

And then the obesity crisis happened in the late seventies, the early eighties.

It's been spiking up ever since.

And they thought, well, that, that theory must've been wrong, right?

It can't be because it'd be like, imagine if you, you went to the Sahara desert, you got really hot and then your body tried to stay at that higher temperature, right?

It wouldn't, how could that be right?

So that must be wrong.

You don't have an innate, um, body weight, um, set point, but then the theory actually evolved in a way that I think is more accurate.

So it turns out you do have a set point for the fat percentage of your body wants you to be, but as you gain weight, your, your set point rises.

So let's say that you gained like three stone.

Now you would have to eat fewer calories than you do now to stay at the exact weight you are now because your metabolism would slow down.

Your body would change, right?

So your body would, that's your body fighting to bring you back up to that higher weight.

So as you gain weight, your body tries to hold that weight and it's harder to go back.

And there's a lot of evidence for this.

We know that if you gain weight and then try to go back, your metabolism slows down.

The evidence for that is very clear, but I actually didn't really believe that for a long time because I thought, well, given that obesity is really bad for you on average, why would nature, why would evolution endow us with that?

Right. That seems really odd.

But then it was explained to me.

So you've got to think about the circumstances where human beings evolved in the circumstances where human beings evolved on the savannahs of Africa, the situation we live in now where there's infinite abundant calories all around you your whole life.

That, that never existed.

That never happened.

Right. What did happen quite a lot was a very different situation, which is famine, right?

You were quite likely in your life to face a period when you starved.

And if you think about what you would be, what you would evolve to do in that situation, if a famine came along, you know, me at my fattest would stay alive quite a long time.

And Timothy Chalamet and Kate Moss would die in week one.

Right. And I would cry over Timothy Chalamet's body, bury him, and you know, I'd probably eat him to be fair.

But I want to be clear, that's not for sexual reasons.

So that's not a creepy, it would be to survive the family.

Right. To be clear.

Throwing in disclaimers in this ridiculous, I don't want to creep out Chalamet in the scenario, but see, exactly.

It was so close to meeting up with you.

Oh, well, you've fucked up here.

I've fucked it again.

But the, so you think about that situation, right?

Actually that it would make perfect sense to, if you get calories gain as much weight as you can to hold and hold them as long as you can.

Cause when the famine comes, that'll get you through it.

Right? So nature is effectively preparing us for a famine that will never come.

Right. This is one reason why if you think about processed food drives up obesity, it makes us consume more calories on average.

But also why we then get locked into that is as you gain weight, your body tries to get you to hold that weight.

It's why it's so hard to go back, right?

It's not impossible.

People can do it. But yeah, so I think that's a kind of important part of the picture.

It's sort of like the thing that I keep thinking about is, and sort of like going back to what you were saying before about the Harold Holt beach and how things have changed since then, and how all this new food has been introduced to us.

It sort of reminds me a little bit of the more convenient our digital lives become, the worse off we are.

And it almost seems like the more convenient food became, the worse off we are.

And I think a lot of the reason for that is like it feels like there's a, it feels good.

It's like a quick dopamine hit that we ultimately know will not fulfill us.

Like the dopamine hit of calling someone or speaking to someone in person, but we continue to do it because it's like, it's just enough.

And then we scroll again.

It's like just enough.

It's like we're always just like, it's like going to the petrol station and refilling one liter, you know, and then we're like, Oh, cool, I'll just drive a petrol station again.

It's just like a nightmare.

I agree. The only twist I've said is wouldn't have mentioned the petrol station.

It's more that that's, I think you're a bit like what Josh was saying before about weight.

I think everything you've said is true, but I would try to expand the frame because there's a risk then of saying, Oh, it's just that I'm choosing it.

And it's on me. Whereas the truth is we got a very sophisticated machinery that is designed to manipulate and shape you to make that choice.

And that's true, by the way, not just this bit of food, like more three year old children know what the McDonald's M means they know their own last name.

So, you know, from the moment we're born, we're molded in this environment to make choices that leave us with that feeling of dissatisfaction.

And it was so interesting to me, except for the kids whose last name is McDonald.

That would fuck with them, that ruins the research, but yes.

But no, but I think about what you're saying in relation to one of the ways you really begin to see this so clearly is when you go to places that did not allow the environment to fuck with people.

Right. So for magic pill, I went to Japan.

So sometimes you'll hear people say.

Obesity is just the result of modernity, right?

If you've got a society where there's surplus calories, people are going to eat them.

It's going to fuck with your biology, you know, and you're just going to inevitably have a really large part of your population who are obese, right?

So it's a product of wealth, development, modernity, right?

Japan shows that's not true because Japan has almost no obesity.

Four percent of Japanese people are obese.

It's barely risen. You know, ever.

So Japan has the same level of obesity as Somalia, even though Japan is the third richest economy in the whole world.

Right. They have literally almost no childhood obesity.

I was like, huh, this is interesting.

What did they do in Japan?

Right. Because with these drugs, with these weight loss drugs, we were in a really difficult choice, someone like me, between continuing with a risky medical condition or taking a potentially risky drug.

Right. It's a difficult choice.

We're in a trap. It's a trap door.

Should we go through it?

And obviously I agonize a lot about that in the book.

But actually, Japan shows, wait a minute, we don't have to let our kids grow up in this trap.

It's just like, OK, what did they do in Japan?

So I went to Japan to research this.

And I've got to tell you, it is a really strange experience to go to a school with thousands of pupils, walk around and realize there's not one overweight child.

So a person agreed to me at the door as a woman called Harumi Totebe, who's the one of the schools I went to in Tokyo, big kind of middle class school.

So she's the school's nutritionist.

I law every school in Japan employs a professional nutritionist.

They design the meals which have to be made fresh every day.

No processed food is allowed at all.

Even the paste they use on that food has to be made fresh that day.

And the nutritionist uses that healthy food which is prepared in the school to educate the children to love healthy food and to learn how to eat healthily.

Right. So I'm chatting to these kids.

So it was so interesting seeing Harumi in front of this class.

So it's so cute. The kids dress as chefs and they go and collect the food and the kids serve the food.

It's so adorable. And the kids like dole out the food and they and the kids read out this.

So they're given this thing to read out where the kids then explain the healthy food.

Today we're eating this because it comes from there and it does this for you and Harumi holds it.

She had these colored ropes and she stands in front of the kids and goes okay this is the red.

This is red. This means calcium.

You're eating the calcium and this because the dish is like six different things and the food is fucking it's more like Nobu than anything I ever ate at school, right?

And she's what is what is the calcium do and the kids yell out all right it makes your bones strong and then go you now you're eating carbs.

What do they do? They give you energy.

So anyway, I had my brilliant translator Chie with me and I started talking to the kids, right?

So I started talking to kids who were nine and ten first and I said to never forget the first kid I interviewed I said what's your favorite food?

And she said broccoli.

I was like right, this is a little freak.

I'm going to the next one.

Now what the teachers aren't here?

Teacher wasn't there.

And the next kid, I said what's your favorite food?

He said white fish.

I was like this is weird.

The next kid, I said he's like oh boiled white rice.

And I turned to Chie and I was like are these kids fucking trolling me right?

And Chie like all Japanese people I ever talked to about this just looked puzzled and said well no I mean we teach kids to like healthy food.

They didn't so I pulled up on my phone, I couldn't help myself.

I pulled up British school meals and American school meals to show to the kids, right?

They almost couldn't believe what they were saying.

And they said but you ate this at school.

I said yeah we ate this at school every day and one little girl said I'm really worried about you.

That was so cute. They were like where are the vegetables?

There were no vegetables.

They were like they just couldn't believe it.

So there's all sorts of things they do in Japan, some things that we couldn't imitate and I wouldn't want to.

I could tell you about other weird things.

So go around and see how this society has just built in all these ways of protecting themselves and their children from their bodies being fucked by this processed food.

Like there are sections in you go to our supermarkets and it's mostly processed food.

In Japanese supermarkets there's a section called processed food and it's like a little bit and it's got a few tins in it, right?

Everything else is built on premise that you will prepare fresh food on the day, right?

And the result of this is unbelievably inspiring.

So I went to this place that almost sounds mythical.

There's a village in Okinawa called Ogimi which is the oldest village in the world by many measures, right?

So Japan has the longest life expectancy in the world but even more amazingly it has the longest healthy life expectancy.

So Australia and Britain, people are ill for quite a long time before they die on average.

In Japan you're only ill for I think the figure it's in the book, it's like two years on average you're in poor health before you die, right?

Which is amazing, much less than here.

So I went to this village where there's 400 households and more than 120 of them have someone over the age of 90 living in them, right?

So I went I went to their little community center and the first person I met was a 103 -year -old woman called Matsufukuchi who walked there on her own and she said the first thing she said to me was, oh I can't stay for long because I'm looking after my son who just fell off the roof fixing it the other

day. I was like how old is your fucking son?

What's this about? But anyway, we're chatting and there's all these like 100 -year -olds who have good lives, so she's like oh it was volleyball season, they were chatting about how much they love watching volleyball with their great -grandchildren and then at some point someone put on some Okinawan folk

music and they put on these um what they call kimonos and they all started dancing and I danced with these like 103 -year -old women and I sit there and I thought God you were born before they started doing radio broadcasts in Japan and here I am recording us dancing on an iPhone.

This is what you get if you sort out the obesity crisis right obviously not everyone is 103 but you get more years of life you get more years of joy you get more years of dancing right that's what the fight is for and you know Japan is not a fictional place it can feel like it a bit but it's not a fictional

place right it's a real country that got to be rich and avoided this and it's not like just innate to Japanese culture if you go back to the 1920s Japan had some of the most unhealthy people in the world they had a terrible diet they only ate protein once a week right and it was a concerted effort by the Japanese

government to make the population healthier not for a good reason it's because they wanted an army to invade the rest of Asia but yeah hey we've all got our own weight loss motives right and then obviously when the country's in ruins after the second world war the one thing they've got is their population they

want to make it healthy so they um you know there's this very deliberate effort to make the population healthier we can do that if we want right there's all sorts of things i went to so many countries mexico imposed a sugar tax reduction in obesity in the netherlands um obese kids they give them um

uh personal coaches that go and meet with their families and help them change their lives they get the sugary drinks out the schools again big reduction in obesity finland they'd have a concerted program there's places that have done this right we can do it but we've got to understand something although can i

tell you about a really weird aspect of japan that we can't import so um this was so it really fucked with my head so in 2008 they had a massive like national debate about obesity because obesity went up by one percent right just like basically no one was obese but they were like oh my god we can't

go on like this we've got to deal with it right so they made all sorts of changes we're going to help john and the one so one of the changes they made is interesting called the metabol law um it's named after metabolic syndrome which is kind of nasty combination of conditions you can get if you become

obese and the law they've made was every single person in japan over the age of 40 every year on a specific day has to be weighed by their boss if you've gained weight you you have to drop a plan with your boss to bring your weight down and if um and if the company's the government the company has to

declare the weight of its employees to the government and if your company's overall has gained weight you get fined by the government right so it's like why so i thought i have to go and see this i went to some workplaces to go and see this in practice and it just fucked with my head because you're

seeing all these people being literally weighed by their boss right and they're all going even when the boss they're through like oh this is really yeah this is really helpful you know it helps me not gain weight and i was like okay if you did this in britain or you know the us we would fucking burn

the office down right like and it and they would just be like they would genuinely puzzle it why like they would it would be such a that's a really big cultural difference so is it as simple as because you know we mentioned the nutritionist at the schools i'm just like let's just get nutritionists at schools

like surely that is it is it as simple as doing that like that seems like a really great idea it's a really big component i mean it's one of many but it's a really big component of what they do and yeah absolutely i mean you compare that we literally you know you think about the really good work jamie

oliver has done on this like you know it's not just that we don't have nutritionists in our school we actively pump our kids with shit you know if i think about the school dinners that i ate right they were a world away they were you know so even though in my home environment i wouldn't have had healthy

food you think oh the one place you could have had healthy food would have been at school but even there it was as unhealthy as anything i was eating at home right so yeah absolutely that's one way we can break the cycle among many because you do because i mean i don't i don't have kids but my sister

does and you know lots of people i know do pretty much everyone i know does and often i hear like well you can you can teach them really good lessons at home but as soon as they go to school they discover all these new things like you can pretend that ice cream doesn't exist for five years but then

as soon as they get to school they'll go to their friend's house and see and it becomes like oh i want that thing that my friend and all the work you've done in the first five years maybe doesn't matter um so yeah i wonder if it's like yeah i just well just to jump in on that i find that getting my

kids to eat well is probably the hardest thing as a parent and it's probably my biggest source of guilt that in screen time but i think i'm on getting moving to being on top of screen time and i'm able to shrink it and all this kind of stuff but when you get to a meal time and my two and a half year

old just refuses to eat anything and i'm like well all he wants is fruit and that's pretty like fruit is better than processed food but i'm like you've got to have some protein or something and then it's so hard to get him to eat anything um and i've so i feel so guilty that i'm not doing better as

a parent but the options are it's hard when you're busy and you get home you don't have much time to like i don't have time to prepare well i might have a bit of time to prepare a meal actually i really enjoy cooking like last night i was i made like a sort of tuna pasta with all like i made it from scratch

but the two -year -old was i knew he would not eat a single bit of it so i'm like well i can't give him that so i gotta try and think of another idea that he might eat i tried something that was mildly healthy and he still didn't go for that yeah it's attempt me to have the exact same battles i think

you're right and what we've got to do is there's a whole combination of things there i think it's very difficult first thing is do what they did in Greece ban advertising of junk food to children because you are running up and down escalator in the environment just walk around Melbourne the number of look

at the number of junk food ads you see right you walk your kid for a mile and try to protect them from seeing ads right they go on to watch Peppa Pigger on youtube and what do you see you see immediately you'll be flooded with ads for junk food or when you're going to shop like if you go to try and buy

a healthy thing you've got to walk past like 60 ,000 un like terrible things that are bright colored and attractive and exactly so there's all sorts of things that can be done with regulation effectively in our societies we subsidize shitty food not healthy food right so you can there's also things you

can do there also just anything that reduces stress and gives parents back time reduces the ability to like you know i think about my grandmother you know someone actually funny enough said a quite snooty irritating thing to me at one of the events i did but they were like oh well you talk about it

wasn't it your grandmother's responsibility to feed you better and i'm like my grandmother worked every fucking job she could she woke up at four in the morning to go and clean toilets then she did like my grandmother got home she was fucking exhausted you know and she wanted kind of carb treats um

and also it was genuine experience as a form of love so yeah the anything that gives people back i mean that one of the i mean we've talked about a four day week before one of the reasons i'm in a four day where you've got to give people back time to do other things in their life so you know we can't

live in a culture where no one has any time and then so by the way we've got this whole other half hour a day thing we want you to do right um also we should look at um baby food like baby food that we give babies crafts their palates from the very young is an excellent um food writer called b wilson who's

written um a lot about this you know baby food is like mostly sugar so yeah there's all sorts of things we can do giving you know more maternity pay and more maternity leave so mothers can breastfeed so yeah all sorts of things we can do then that kind of help deal with that and don't load the the odds

against the kids from when they're very young absolutely um i wanted to go back for a moment and pick up on the exercise and diet conversation i i feel like there's an insensitive thing to say to you and to josh but there'll be people out there listening like me going i feel like exercising and eating

really well is the other solution and we can't ignore the incredible mental health benefits you get from doing both these things i get it's a lot more nuanced and i get that there is so much that happens and so much background and context to everyone's journey but for me it's been eat well on exercise

and that that is the other option it's not take the pill or don't take the pill it's like exercise eat well that's been my experience for me yeah and so the research on this shows really clearly that people who try diet and exercise about 20 percent have your experience which is a huge number of people

right one in five people it works really well and it's transformative not just physically but for their mental health so absolutely every person who's overweight or obese should be helped to try what you tried um and for a significant number of them it will work but that leaves us with four out of five

for whom it doesn't work for complicated reasons partly to do the metabolic set point but there's a lot of other factors as well environmental sabotage psychological factors all sorts of things going on and for them we've got to have other options and these drugs um expand the menu of options that are available

so if you want to think about the benefits and risks it helps to look at um a parallel area of science so for all the reasons we've been talking about it's quite hard to keep off weight for a long time lose it quickly and keep it off for a long time um up to now the most reliable way for really overweight

people to do that has been bariatric surgery so we've got very good research on bariatric surgery now going back many years whereas these new drugs have only been available for weight loss for a couple of years right so the evidence is evolving so we look at the evidence from bariatric surgery uh we

know lots of things first thing it's a fucking horrible operation what is bariatric?

Things like um stomach stapling gastric bands yes it's uh it's where you physically alter the person's insides to make it impossible for them to continue eating as they have before through an invasive form of surgery and you know it's it's grim one in a thousand people die in the operation it's it's

no joke but the reason people go through that risk is because of the staggering physical benefits if you reverse obesity or reduce it um so if you have bariatric surgery in the seven years that follow you're 56 less likely to die of a heart attack you're 60 less likely to die of cancer you're 92 less

likely to die of diabetes related causes in fact it's so good for your health you're 40 less likely to die at all in those seven years after bariatric surgery so it's a really enormous health benefit which fits with everything we know about how bad for you obesity is um and we now know that these drugs

take you in a similar direction like I mentioned before um if you start with a BMI higher than 27 you take these drugs for two years you've got a 20 lower risk of having a heart attack or stroke which is extraordinary and we're now seeing remarkable benefits across the board huge reductions in inflammation the scientific

evidence is building up that there are really remarkable benefits um so you've got to weigh them against the significant risks and there's quite a lot um there's kind of ones that i'm worried about for the society and ones that i worried about for myself i'll tell you what i'm and this thing so i think

is really important for australia because this drug has not really arrived here yet so you can get this right in a way that we haven't got it right in britain in the us i'm really worried about what happens what is happening when people with eating disorders are getting hold of these drugs so anyone

who knows someone with let's say anorexia there's obviously many forms of eating disorders but let's say anorexia i'm sure we've all known someone with anorexia you know that there's a conflict going in with that within that person there's the biological part of them that wants to live and therefore

wants to eat and then there's the psychological part of them that for complicated reasons we can go into wants to starve themselves and what these drugs do is they make you not want to eat very much and they're really good at that it's not like dieting it's not like where you're hungry but you're denying

yourself you just don't want to eat very much and if you take a high dose it can just amputate your appetite you just do not eat right what we know people like dr kimberly dennis who i interviewed is one of the leading eating disorders experts in in the united states um dr dennis is in chicago she said

to me look these drugs are rocket fuel for eating disorders uh she's seeing this a lot in her practice so i'm really worried that in addition to the huge benefits for people like me there's huge risks for people with eating disorders so if you if you went online now and you pretended to be in britain you

could get a zoom consultation with a doctor i guarantee you could all get an assembly prescription it'd be shipped to an address in britain the next day right um so doctors are meant to check on zoom your bmi but obviously how do you do that you can't right um so this is a huge kind of loophole so what people

like dr dennis say i think allows zoom prescriptions of these drugs you should have to go and see a person a doctor in person who actually checks your bmi and also is qualified in spotting people with eating disorders and if you don't match the criteria you shouldn't be giving it um this is a really

big debate about bmi if people don't know body mass index it's very simple measurement um and uh it's just a height divided by weight and it comes up with a number um the reason it's controversial as a way of measuring obesity is that there's a small number of people who have a high bmi who are not obese

so arnold schwartz if you picture arnold schwartz and i go at his most like jacked and ripped in like the terminator so i got so distracted picturing that then but the um he would have he would have had a very high bmi but also obviously he had very low body fat he wasn't obese right um so sometimes

we'll say we shouldn't use bmi but the truth is there are many ways of measuring obesity there's lots of other ones the body add opacity index you can measure people's body fat percentages and they all come to pretty much the same outcome which is unfortunately obesity correlates with much higher negative

outcomes for health um so the reason people doctors still use bmi is just it's the quickest one it's really easy to do and your doctor can look at you um and can see if you're you know if you've got a high bmi because you're jacked or because you're obese it's not hard to tell so um in practice i think

it's it's a defensible and still usable one but we could move to the other ones we could do can do body fat percentages they're fairly easy to measure as well they don't get us out of unfortunately the underlying problem which is that obesity does on average correlate with much worse health outcomes

yeah so yeah i'm this sounds slightly hyperbolic it is slightly hyperbolic but it's only slightly over the top the way i think about these drugs as someone who's taken them and i can tell you more about how they feel when you take them but these drugs are so powerful i think of them as being like fire

right they're a tool fire is a really good tool if i use it to warm up my house it's a really shit tool if i use it to burn down yours right in the same way this tool is incredible if you're obese it will you know i've lost a staggering amount of weight right i'm much healthier um a tool this powerful

will be used for great good and great harm right and we've got it and we're not going to go back we're not going to put this back in the box right there are some predictions that 10 years from now half of the people of australia will be taking these drugs that is not implausible right the invention of these

drugs i believe will be a significant moment as the invention of the contraceptive pill when you consider that obesity unless some of the 12 risks that i write about turn out to be worse than we think which they might so it might get yanked from the market i don't rule that out it's likely but it's

you can't rule it out um given that obesity is the biggest killer in our societies and given we now have a drug that can reliably reduce or reverse obesity this is a huge moment right um and and we shouldn't underestimate that but we do have to weigh the the risks i'm gonna tell you about more of them

if you want the risks you know wouldn't mind a couple more of the risks i just i'm so fascinated by because to me the benefits are so visibly obvious and appealing to people i also feel like we should know a lot of the risks involved so in terms of the yeah so in terms of some of them some scientists

believe these drugs may increase the risk of thyroid cancer in people who are vulnerable to it um interviewed professor Jean -Luc Fayy he's at the university hospital in Montpellier in France who's been warning about this so that's why i mean obviously i stressed everyone listening i'm obviously not a doctor people

should talk to their doctors but it's why people who have thyroid cancer in their family or who have had it before are advised to not take these drugs um the one that most worries me there was one that i experienced that i'll tell you about in a minute but the one that most worries me it's just really

simple we don't know the long -term effects of these drugs no one's been taking them that long diabetics have been taking them for 19 years now um and given that we know these drugs primarily work by changing your brain taking a drug that chronically changes your brain for a very long period of time

is inherently risky concerning right there's an analogy and i want to stress i'm not suggesting these drugs will have this specific effect but there's an analogy was explained to me by dr greg stanwood at um florida state university that's really stay with me if you go back to the late 50s and the scientists

doctors started to give people anti -psychotic drugs because they judged at the time that the benefits out with the risk that was always controversial but that was the judgment they made 40 years later they discovered if you take anti -psychotics for a really long time you're way more likely to get dementia it

hugely increases your dementia risk now it's not that the doctors were being irresponsible in the 50s and 60s you just there was no way you could have known that right how could you know you just had to have people take it a long time now there's no reason these drugs the weight loss drugs cause dementia obviously

but i'm just raising that as like it could be something yeah yeah we're particularly worried about pregnant women right so we don't know the effect obviously you're told to come off these drugs when you're pregnant but a lot of people don't know they're pregnant for quite a long time um we don't know

could it negatively affect their their um unborn children uh so there's all sorts of things like the one that played out for me and it relates to what we were talking about much earlier it's really surprised me and i wish i'd known about it in advance so the first six months i took ozem pick i got everything

i wanted i lost a shit load of weight i felt much better my back pain went away my neighbor's hot gardener hit on me loads of good shit happened right but weirdly i i didn't actually feel better like i felt physically better but psychologically if anything i felt slightly worse i thought i was a bit

weird and there's been some scientists who warned that their concern these drugs may cause depression or even suicidal feeling and some people didn't have that it wasn't as bad as that for me obviously i did feel quite a bit down and um there's a big debate about why that is maybe it's a brain effect

there's a serious debate about that i'll go through in the book but i actually had a real epiphany about this in a branch of kfc in las vegas my nephew said to me recently that um it's weird how many of your epiphanies in your life have happened in branches of kfc but like videos are so boring but um

so i was in um if anyone listening who knows vegas it was the kfc on west sahara which is one of the roughest kfc's in the whole world i love it and i was in vegas it was seven months since taking ozem pick and i was in vegas as you guys know i've been working on a book about las vegas for a long time

a series of crimes that have been happening there and i was investigating the murder of someone that i knew and really loved uh who died and um been killed so it was obviously a difficult thing to do and i i'd had a rough day researching it and i just really on autopilot i went to this branch of kfc

and i did what i would have done before i was on ozem pick i ordered a bucket of fried chicken and i've been into this kfc a million times um although they haven't given me a christmas project and um and i had this bucket of chicken in front of me and i had one chicken drumstick and i suddenly thought

oh fuck i can't eat this right when you're on ozem pick you can't over eat you would vomit if you tried to overeat did you want to eat it i physically did not want to eat it and indeed couldn't but i'm psychologically wanted to eat it yeah and and and i had a real kind of a picking at my you know when you

have a realization that almost feels like someone else is talking to you and i remember thinking oh you're just gonna have to feel like shit then right and i realized in that moment oh so much of my relationship with eating was about managing my emotions calming myself down soothing myself it's why

i did that stuffing that we were talking about earlier and when you're on these drugs you can't do that i go through in the book there's scientific evidence for five reasons why we eat only one of them is the obvious physical one right to get nutrition to keep your body going all the rest are psychological

and for me and for everyone who takes these drugs what these drugs do is they they interrupt your eating patterns right you can't eat very much but they also interrupt the deep underlying psychological reasons why you eat and i realized deprived of that soothing mechanism that was so deeply ingrained

i was less able to regulate my anxiety right and i remember colonel sander staring at me from the wall and think it's like he was looking at me going hey what happened to my best customer but i remember thinking then as well well obviously there are better ways for me to deal with anxiety and distress

than a bucket of fried chicken right but but that was a difficult i'm still in a difficult adjustment from that it was it was hard so yeah there were that was the downside that i really wasn't that the these drugs if you're going to take them these drugs will really challenge they will profoundly change

your relationship with food and that will it's a rare person that doesn't bring up some emotional issue for do you know comfort for so many people yeah yeah it reminds me a bit of something you've talked about before on this podcast i believe or maybe i heard you say it somewhere else about addiction and how

that was doing a job for you it was i can't remember the doctor who you interviewed who said that that did a job for you at a time in your life and it saved your life um funny enough it wasn't a doctor it's mar - well she should be a doctor oh no it was marion faithful yeah the uh legendary rock singer

she she'd been homeless in the 60s and she she had a heroin addiction at the time and she says in her memoir saying this is very challenging but really important she said heroin saved my life because if it wasn't for heroin i would have killed myself at that point now marion is not saying heroin is a good

solution to despair obviously but she's saying it's the best solution anyone offered her at that point yeah so in in the case of taking away your desire to your satiation yeah um it feels like these drugs could take out a safety net a lot of people have that they didn't know was there in the first place

and then you're left um yeah out in the open exposed to all these things that you've never dealt with or realized were there in the first place and no mechanism like your mechanism's gone it just sounds exactly like what you experienced that's a really that's a really good way of putting it there's

all sorts of dynamics that emerge all sorts of underlying psychological dynamics all sorts of things we do with food um that begin to kind of emerge um you know it's funny because the book is called magic pill because there's three ways these drugs could be magic the first way is the most obvious they

could just solve the problem of obesity right i've got to tell you there are days when it feels like magic in that sense once a week inject myself in the leg it's a tiny little injection barely feel it's an epi pen i don't eat very much anymore i'm not fat it feels like magic the second way it could be

magic is more disturbing it could be like um could be like a a conjurer who who plays a trick on you it could be like a magic trick like he shows you a card trick while he picks your pocket it could be that over time the 12 significant risks that are describing the book outweigh the benefits there will certainly

be some people for whom that's true there are definitely are people whom that's true and not an negligible number either and it could be that in time that turns out to be the actually the balance of risks for everyone right um the third way it could be magic is i actually think the most likely think

about the stories of magic that we all grew up with uh what would be a good example think about Aladdin you find the lamp you rub it the genie appears he grants your wish your wish comes true but it never quite comes true in the way you expect it right there's always some way and i think that's already

happening with these drugs right there's all sorts of ways our wishes are coming true now but in ways that are slightly off right that are slightly unexpected so yeah that's a really interesting analogy you've chosen Aladdin because i feel like the the the underlying message of Aladdin if i remember

correctly or at least the takeaway is a really interesting analogy to put over over reading and obesity and that isn't the lesson of Aladdin although one of the key points is that you can't fake it you need to be yourself and earn the success is that right that's right yeah because to me i feel like

that was literally like a genie's voice behind the curtain as well so to me that is a really interesting analogy because i feel like there's a lot of um feeling in the air and discussions when related to obesity that you need to earn your way to be thin yeah i mean this relates to a you're totally you're

absolutely right and there's i'm not saying that that's good by the way i'm just i don't judge that voice because i i felt that about myself so there's a big discourse around these drugs um that people who take them are cheating right and i remember the first few months i was taking them thinking that about myself

like i was doing something wrong and i'm thinking one of my best friends takes statins to control his cholesterol and i've never once looked at him and gone you fucker getting ahead of me on the cholesterol race fuck you right isn't that if i said that back to you about someone taking status you would think

i was mad right so what's going on there why why do we why do we think this if any celebrity loses where anyone loses weight now and they post a picture on instagram you there they'll just be flooded with people raging at them saying you know fuck you i then pick your cheat um and see what's going on there

this is a topic that's so weight and weight loss drugs are topics that are so encrusted with shame i think it's just starting looking a lot at the history of how we think about weight and obesity and it's very interesting if you look at um if you look at the history of this it's very deep in our culture

the idea that being overweight is a sin if you go back to pope gregory the first in the sixth century the first person to formulate the seven deadly sins one of them is gluttony it's always depicted with some hugely fat person you know stuffing their vase um and you know that we still have this kind

of deep um prototype in our heads because what are the forms of weight loss we admire that ones that actually follow the kind of christian pattern of sin punishment hell redemption right think about that game showed the world's biggest loser did you guys get that here i was just i was thinking about the other

day but i was talking to someone about it and someone just said can you believe there was a show called the biggest loser and it was about people like overweight people getting like and that wasn't that long ago no like that same as bonkers yeah i actually met with the some of the people who worked

on that and so people who haven't seen it it was a show where they got very overweight people and they got them to engage in dangerous levels of starvation and extreme forms of exercise and the one who lost the most weight became the biggest loser and therefore the winner um we admire them it's like

are you sinned but we've seen you cry and sweat and beg and how we've seen that you've suffered okay good job right you deserve it exactly in that prototype if that's your framework i totally understand why you look at me and go well you fucker you got out of jail for free what these guys suffered and screamed

and begged and you just injected you stuff in the leg once a week and now you're the same size as them fuck you i think there's another frame that we apply to to weight which is that it's a race right so you think about in this environment that makes the kind of fancy term for it is an obesogenic environment

we live in an environment where it's easy to become obese and hard to remain a healthy weight in an obesogenic environment lots of people make quite painful sacrifices to not be fat right particularly women they go hungry they work out really hard they do all these things and again in that if that's

your frame then i look like Lance Armstrong it's like what we fucking we do all the training we run the race right you again you just jab yourself you get you get all the benefits we get but you don't put in the effort and i think what we need to do is replace those frames firstly not judge people for feeling

those frames because there's a very deep in our culture none of us chose that right deep deep in none of us is pope gregory the first right we this has been handed down to us um and then offer a better frame which is i would argue we are in a race but it's not me against you where we're competing and scrambling

and tearing each other down it's us all of us against these the food industry in this dysfunctional environment right and when you reframe it that way you know hopefully we can move beyond these ideas of the you know sixth century pope or rage -based nihilistic kind of scramble to tear each other down

it almost becomes like a i mean within reason or whatever it takes like it's it's for some people that the stakes are so high that i think like for some people it is like well my risks my health risks are so high that it is worth the it is worth the whatever the risks are yeah that's where i think it

gets interesting and that like i i think i'm an interesting case study of where the drug becomes problematic i'm on that borderline of like always being very self -conscious about the way i look and feeling shame about the way i look the the what i'm trying to say is the equation because my risks of um

diabetes and heart disease and all these things are there but i'm not in an obese category but i'm borderline but i feel like i'm at this dangerous level where a lot of people would be where it's not a clear um equation it's not a clear thing but the temptation to take an easier route physically easier

is there but i feel like i don't want to take the risk because i don't know what those risks are going to be long term i think there'd be millions of people who are on that cusp on that line i think that's true it's definitely the case that the more obese you are the stronger the case for taking the drug

is i would say i mean people with bmi lower than 27 don't take it i would say in fact that would be the firmest piece of advice i would give is don't take it if you if you're not overweight or obese because you're incurring all the risks yeah without without with only an aesthetic benefit and you and you

and you're actually building in more risk than other people because for example one of the other risks is um as you age you naturally lose muscle mass just generally incredibly depressing from the age of like 29 you start losing muscle mass um and when you lose weight through any way you generally lose

muscle mass as well as fat mass so when you take these drugs um you generally have a few days on a show with one of the real housewives of new jersey she's on it she was i mean she was not fat at the start she was already both she was thin and she's taking it to be bone thin the risk that she's not judging

her for a second because women are made to feel like shit about their bodies no matter what they do so this is not said in the spirit of like scorn or judgment but i i would urge her to to reconsider because for her own health because if you are going into the aging process with artificially low muscle

mass because of these drugs you're at real risk um you won't particularly feel it in your the 40s but when you get into your 60s and 70s um you're at real risk of a condition called sarcopenia which is quite a lot of people get anyway but is basically where you've got very low muscle mass you your muscle

mass is the total amount of soft tissue in your body it's necessary for movement you'll really struggle if you've got the stairs get out of a chair you there's a risk that we're building up a time bomb of people who will be more impaired as they get older because they've taken these drugs to be really

really thin so yeah i would really urge caution on that i think for me there's something problematic in the idea of taking the drugs because i'm not sure i could honestly say that if i was to get on them that it was purely for health outcomes i think that would be a heavy vanity part to it that i just

wanted to look hotter if i'm being frank i don't acknowledge that would be possible but no but it's like but even on that josh i think like separate to the drugs i feel like that's the same with me in like uh eating healthily or like exercising yeah it's like even though i like i feel like the secondary

benefit is that it's good for me but if i was honest it's like i feel better about myself when i can i'm happy with how how i look as opposed to how i feel because it's sort of like a you you're not judged on how you feel you're judged on how you look unfortunately no you're totally right and how do

we difficult moment on this um so as you you know because you know me like i learn stuff by reading a lot and interviewing experts but i process it by talking with my friends right and so i've got i'm lucky i've got a little group of friends where we you know they're interested in the show i'm interested

in and i've got one friend who for my previous three books we talked so much about what i was learning and with this one she just was really pissy about it and she's not herself overweight so it wasn't like a personal sensitivity and then while into working on the book she came she was in london we

were both in london and we went out for dinner and i'd just been doing some stuff about you know weighing the health benefits and i was talking about that and and she wasn't leaning into it and then after a while she just said i can't listen to another fucking word of this and i was like what and she

said um keep telling me it's about all these health benefits you're weighing these risks it's fucking bullshit don't give me that you want to look better right she said i think you've always looked good all the time i've known you we know we've been friends for like 20 years you've never felt good about how

you look just admit that's what's driving you right just just don't give me this and i really thought about it because she knows me very well and i think she was underestimating that i do have a genuine health concern here like you know my granddad did die when he was younger than i am now and this does

massively reduce heart concerns but there's definitely a truth in what she said as well like yeah the there's an element of vanity and it's interesting even that word vanity is so loaded like wanting to feel better about how you look i don't think is a disreputable thing right um i mean the word vanity

so implies a kind of uh sin narcissism sin yeah although you know i also think about the the worst moment for me in writing the book by far was i've got um i've got lots of nephews and god sons but i've only got one niece so i feel very she's no one makes me more protective she's the only girl in my

family she's amazing and um in my head she's always like a six -year -old she's actually just turned twitch her 20th birthday yesterday so um whenever she has a boyfriend i'm all like get away from her you fucking pedophile and then i'm like oh no wait she's an adult woman but um but the about six months

into taking the drugs i was in vegas and i was facetiming with her and uh she's like oh yeah and you've lost so much weight you know she's like you know she's like teasing me like i didn't know you had a neck before things like that and and i was sort of preening and she looked down and she said well

you get me some osenpik and she's a completely healthy weight right and so i laughed and then i realized she wasn't joking and i was like oh fuck have i undermined every message i've ever given her right like since she was little so i do think that the the danger with the vanity thing is that it's hard

to say i feel better looking like this without implying an aesthetic judgment on people who don't right like and that to me is the difficult do we set in in in race particularly for men but also for men a kind of aesthetic arms race where you know that you create already there's so much i mean in a social

media age there's so much fucking pressure on people to look particular way just this ramp that up even more so it's more like if you call it my vanity well okay the only person you could go well what's up to me but if that has consequences for other people that becomes a more complicated conversation it's

difficult and i don't know the answer to it but i think you're right to raise it is there like i just wonder and maybe there's research on this but one of my fears would be that if uh if these drugs become a normal part of society and 50 percent of the country are on them and it becomes something that we

can rely upon i worry that our nutritional wisdom will decline because we'll we feel like well i won't be ob so i can eat what i want so i actually don't need to eat whole foods and i don't need to go and you know do all the things that we've all been told yeah and then why why fix the food system and then

why do we need the nutritionist in the schools where it's like that's okay we can just give there'll be kids versions of them at some point and it doesn't matter like has there been any research on that or thinking about that yeah i'm very worried about this the the professor michael lowe said to me

these drugs are an artificial solution to an artificial problem right processed food dug this hole of hunger in all of us and that which undermine our ability to ever feel full and what these drugs do is give you give you back your sense of fullness but at a cost right yeah so clearly the better solution is let's

deal with the environmental problems so that we don't have this hole of hunger or we don't need to fill with the drugs and for a while i consider stopping taking the ozone pick for that reason i remember going to one of my best friends a few months into taking them and saying to her i've got to stop

taking this drug because this is completely fraudulent right i write all these books about how we've got to deal with the deep underlying social problems that cause these symptoms not just deal with the symptoms right i've done that with all these topics and here i am clearly with a problem that has a social

cause and i'm just treating the symptom and this friend she got um eight eight years ago nine years ago now she got very bad breast cancer and she nearly died and um she's a single mom it was a terrible time and i was with her all through the you know the double mastectomy the hysterectomy and everything

and she said to me when i got breast cancer you could have said to me well there's something really wrong with our environment one in seven british women get breast cancer now it's one in 38 in japan this is a very recent thing 30 years ago one in seven british women weren't getting breast cancer there's

something in our environment that's really wrong and she said to me you could have said well fuck me the environment's caused this terrible thing but now you're injecting yourself with all this poison and chemo it's crazy don't do that let's fix the environment she said to me you didn't say that because if i'm

dead i can't fix the environment right and she gave me a really good analogy she said if your house is on fire you can make a very good argument for saying we should change the building code and build and make buildings out of less flammable materials right really good idea let's make it the law you

got to put sprinklers in the apartment hallways good idea but when your house is burning down that's no fucking use to you you've got to phone the fire brigade douse the house in water and then you can campaign for the better thing she said to me if and she was then sort of flipping this logic back

to me said if you die of a heart attack what there's no use to us to then go well you know or think about another analogy think about gun control my friend who i was in vegasville was murdered by someone with a gun i'm passionately in favor of gun control i'm sure you are as well but i wouldn't have stood

over him and said while he's bleeding to death and gone you know we need to close the gun show loophole and we need to ban bump stocks i phoned a fucking ambulance right and i wasn't there when he died so i didn't i would have phoned an ambulance right um so i don't think dealing in the short term when you've

got a problem caused by big environmental factors you want to in the medium to long term change the environment and the short term you make the best choice you can make for yourself with the limited options the environment provides you so both things need to happen but i don't think that gets us out

of the very difficult point you've just put which still worries me which is does it undermine the momentum for dealing with the environmental problems if you could look these drugs at the moment they're mostly injectables but eight years from now there'll be a daily pill they'll be out patent it'll

be a dollar a day i really do think half of australians will be taking them at that point will it be harder to get momentum going for a movement to change the food system but you know one of my friends the same friend actually i just mentioned said when i put that to her said let's be really honest

here what momentum hard to think of a charismatic and brilliant person than michelle obama even she couldn't when she tried to present she stopped the campaign saying let's move and she couldn't get a fucking traction around saying let's help children to move around right now i don't believe it's impossible

to build a movement on this i absolutely believe it is possible i believe we can and must do it but i do think the doubt you've raised is a really important one there is a risk that the widespread adoption of these drugs will undermine the momentum or or sort of smothering it's caught the momentum to

deal with the deeper environmental problems i do think there's a risk of that and i don't know what to do about it other than i mean you could put it another way it could wake us up right it could be it makes people go how do we get to the point where half of us need to fucking drug ourselves what happened

to us right it could be a awakening moment it depends partly about how we communicate it if we talk about in a more truthful way look artificial solution to an artificial problem this shouldn't have been done to you we're in a trap but we don't have to let our kids be raised in a trap right if we communicate

it that way i hope we can get to a better a better answer yeah this didn't have to happen this absolutely didn't have to happen right we could have avoided this japan avoided it we could have avoided it and we can make a choice now but our children and grandchildren to not have to make this choice well

said yeah well said hooray you are you are the most gifted storyteller you're just i love listening to your talk i've listened to all your books because i just love your voice and um i always talk about how i love your voice and your storytelling but i also love your brain a lot you get a great brain you're

getting slightly aroused now here on that note it reminds me of that line i was gonna say like i admire your brain but it reminds me of that terrible you know the film indecent proposal and you've seen it where people haven't seen it robert redford meets dummy moor and woody harrelson and says uh and he's

a rich guy he meets them in vegas and he offers dummy moor a million dollars to spend one night with her and when woody harrelson and dummy moor are debating this she says to him you know he's not offering a million dollars for my brain he's offering a million dollars for my body and this film critic

wrote this begs the question what would you offer for a night with dummy moor's brain so here i would offer a lot for your brain a lot of thank you so much for joining us it's been an absolute pleasure once again so what a joy.

Thank you. The Imperfects is hosted and produced by Hugh van Carlenburg, Ryan Shelton and Josh van Carlenburg our executive producer is Bridget North East assistant producer Bella North East this episode is edited by George Martin.

The Imperfects is not a licensed mental health service and is not a substitute for professional mental health advice treatment or assessment the advice given in this episode is general in nature but if you're struggling please see a healthcare professional or call Lifeline on 13 11 14.

[마법의 알약인가, 현대의 함정인가: 요한 하리가 분석하는 현대 음식 시스템과 비만 치료제의 양면성]-[Johann Hari - Beware The Thrill of The Magic Pill]

📋 Summary

현대 음식 시스템의 역설과 비만의 폭발적 증가

오젬픽(Ozempic)과 새로운 비만 치료제의 등장: 축복인가 저주인가

일본의 사례: 환경 개선을 통한 비만 해결

결론: 시스템을 변화시키기 위한 각성

🎯Key Sentences

📝Key Phrases

📖 Transcript