Johann Hari: They’re Lying To You About The Side Effects Of Ozempic!

We've not spoken for 2 years, but I have. to say you look remarkably different. So, I lost 3 stone in a year and there's. a secret to that, Steven. Johann Hari, the best-selling author. who's using his own body. to unearth the extraordinary benefits. and disturbing risks of the new weight. loss drugs. Ozempic, it is literally the hottest. drug in the country right now. I really worry about the risks of these. drugs. You're nine times more likely to. get this particular condition, which is. excruciatingly painful.

And these drugs are working very hard on. key parts of your brain. In fact, there. are 12 significant risks and we'll get. into that, but it seems extraordinary. that we reached the point where we would. inject ourselves with a potentially. risky drug to stop us from eating. And. we've had 40 years of relentlessly. promoting diet and exercise as the only. solutions and only 10% of people really. do lose huge amounts of weight on diets. and keep it off. But now, we have the. most effective tool for self-starvation. human beings have ever come up with. When I started taking Ozempic, I was. literally 80% less hungry than I.

normally am. These drugs really do. massively reduce or reverse obesity and. a few years from now, we'll have 50% of. the population taking it. It's the new. miracle drug. Now, this is when I go through the 12. big risks, some of which have not really. been explained to the public. So, within. a year of stopping, you regain 70% of. the weight you've lost. Muscle mass loss. is a real problem. There's concern that. it may be causing suicidal feelings and. then there's one of the really big risks. and it's absolutely grim beyond belief. And that is.

Congratulations, Diary of a CEO gang. We've made some progress. 63% of you. that listen to this podcast regularly. don't subscribe, which is down from 69%. Our goal is 50%. So, if you've ever. liked any of the videos we've posted, if. you like this channel, can you do me a. quick favor and hit the subscribe. button? It helps this channel more than. you know and the bigger the channel. gets, as you've seen, the bigger the. guests get. Thank you and enjoy this. episode. Johan,

we've not spoken for 2 years, but I have to say you look remarkably. different. There's a secret to that, Stephen. Really? Which we can dig into, yeah. What is the secret? So, for me it started It's a kind of. weird story. It started in the winter of. 2020. So, it was that weird period when. kind of the world was opening up again. after the pandemic. And I'd gained a lot of weight in. lockdown like loads of people.

And. because of that kind of weird moment of. reopening, I went to a party for the. first time in like, I don't know, a year. and a half, 2 years. And it was a party. thrown by a kind of famous Hollywood. actor. And on the way there, I remember. thinking, oh, this is going to be kind. of funny because. all these Hollywood people are going to. put on weight as well, right? They're. going to have gained weight. What are. they going to look like? So, I remember getting there, looking around and having this really. weird feeling. because it's not just that they hadn't.

gained weight, everyone was gaunt, right? Like everyone. looked like their own Snapchat filter. Like they had like higher cheekbones. They looked cleaner and clearer and. sharper. And I was kind of wandering around. feeling a bit like, oh, [ __ ]. And I bumped into a friend of mine on. the dance floor. And I said to her, wow, it looks like um. looks like everyone really did do. Pilates during lockdown. And she laughed and she looked at me and. I sort of looked at her and she said, well, you know it wasn't Pilates, right? And I sort of looked at her blankly.

And she pulled out her phone and she. showed she'd Googled an image and she. showed me an Ozempic pen. I didn't know what it was. And I said, what are you talking about? And she. said, well, this is a drug. Everyone. here is on this drug, right? Not just. the stars, like their wives, their. agents, their agents' kids, everyone, right? And I'd I've really thrown and then over. the next few days I I read a lot about. these these new weight loss drugs and. I've never I don't remember ever coming. across a topic. where I felt.

so deeply conflicted from the very. beginning and that conflict remained all. the way through, right? The subtitle to. my book is the extraordinary benefits. and disturbing risks of the new weight. loss drugs and that's. even right from the start I was I was. aware that was. that was the the tension. So the. benefits are kind of obvious, right? You. know, I'm older than my grandfather ever. got to be cuz he died of a heart attack. Loads of the men in my family get really. fat and die of heart attacks. My uncle. died of a heart attack. My dad had lot. of heart problems.

Um. there's a lot of evidence that obesity. unfortunately does cause a whole range. of health problems, over 200 diseases. and complications. Uh there's a lot of evidence these drugs. really do massively reduce or reverse. obesity. The average person who uses. them. as in Wegovy loses 15% of their body. weight in a year. With the new. generation of drugs, the next ones that. are coming down the line, the average. person loses 24% of their body weight. It's staggering. It's just below. bariatric surgery. So I could see the.

obvious health benefit. and I could see that the alternatives. that most of us have been pursuing, diets, have not worked well for most. people. But at the same time I thought I mean. just I had so many doubts straight away. I thought well, we've seen this story. before. There've been lots of miracle diet drugs. that have been announced. They cause. dramatic weight loss at first and we. always discover some horrendous side. effect that causes, you know, catastrophic outcomes that mean the.

whole thing has to be pulled. I thought that. I thought. well, we know what causes obesity, right? The reason obesity is massively. increased is because of a complete. change in the food supply. We eat. completely different food to what our. grandparents ate. We need to deal with. that, not kind of drug everyone. I also thought, well, what will happen. to people with eating disorders when. they get hold of this? What will this do. to the kind of positive changes that. were happening in accepting a kind of. broader range of weights? So, I was really.

deeply conflicted. So, to really get to. the bottom of this for my magic pill, I. I spent a year taking the drugs and. going on this big journey all over the. world from Reykjavik in Iceland to. Minneapolis to Tokyo to interview the. leading experts in the world on these. drugs, the biggest supporters, the. biggest critics, all sorts of. kind of alleys and avenues that follow. from them. And at the end of it, it's really weird. I know far more than I did before, and I. know far more about the benefits and. risks, and I know far more about what.

this is going to do to the culture, and. it will be massive. But, I'm still really conflicted. So, if we if we start there then, you're. at the party, someone mentions this. Ozempic thing to you. Can you have you. got the Ozempic. pen on you? it as a a prop. You've got it here, okay. So, it's very simple. Um. you it's just a little pen. It's like a. an EpiPen. So, you take that, you put on. the little lid. I won't take it out cuz. I need this one later, but the although. this one's empty. So, you put a little.

twist a little needle onto there, and you inject yourself with it, and you. inject yourself once a week. And. it's really strange the effect it has. I. remember. the first day I took the injection, couple of days later, I remember waking. up, and I was lying in bed, and I had this. weird feeling. You know actually when. you wake up and you're not quite with. it. You think, "What am I feeling?" And. I was struggling to articulate it. And I. I was like I thought I felt mildly. nauseous, which everyone gets when they. start taking it, but that wasn't the.

thing that was puzzling me. A- And then I realized. I'd woken up and I wasn't hungry. I. don't remember that ever happening to me. before. I mean, I don't mean that as an. exaggeration. I I used to be woken up. every day like really hungry. Often I. would be woken up. by hunger, by my stomach rumbling. And I went on my kind of typical routine. for the day. I went to this cafe just. around the corner from where I live. And I ordered the same thing I would. always order, which was a kind of big. kind of a brown roll with lots of.

chicken and mayo in it. And I had like three mouthfuls. and I was full. I just didn't want to. eat anymore. I remember leaving. I remember Tatiana, the woman who works in the cafe, kind of. shouting after me to see if I was ill or. something. And then for lunch, I went to the same. place I always go or went at the time. Next to my office, there's a Turkish. kind of restaurant. I went there. I ordered a Mediterranean lamb. Again, I. had like. three or four mouthfuls. I wasn't. hungry. It was like the kind of shutters had. come down on my appetite. I was.

literally 80% less hungry than I. normally am. And it basically stayed that way from. then on. It was a very uh physically and. psychologically strange experience. So, on the on the on the pen itself, cuz. I just want to make sure I fully. understand this. Is that that little pen. you have in your hand, for people that. can't aren't watching on video, there's. a pen kind of looks like a big Sharpie. Yeah, exactly. And is that one dose? Yeah, well, there's lots of doses in. there, so you twist the base. Yeah. And um.

the each time you twist it, it would. release with this pen 1 mg. Okay. Yeah. And how many twists you get out of one. pen? Uh I think each one contains four doses, yeah. And how much does that cost? So, it varies massively cuz as you know, I live half in the US, half in Britain a. lot of time. Um so, in Britain, this. cost you at the moment about 250 pounds. a month. In the US, it's way more, like. 800 dollars a month. So, 250 pounds a month, how many sort of. doses do I get for that 250 pounds? You that would cover your whole month. So, each month you'd have to pay 250.

pounds. You get four doses in each one. And you said in the US, it's way more. Way more. How much more? So, it's about 800 dollars, between 800. and 1,200. Bearing in mind there've been. lots of shortages, which I'm sure we'll. talk about. So, the price is kind of. been a bit sensitive to how much is. actually available at any given time. Okay, interesting. And are these drugs. new? Relatively. So, I interviewed the. scientists who played the key role in. the breakthroughs that led to the. development of the drugs and then. scientists who worked on it at every. stage. So, in one sense they're not that.

new. Diabetics have been using them on. license now for 18 years. So, for. obesity they're relatively new. For. diabetes they've been around for nearly. 20 years. And it was fascinating talking. to the scientists involved because one. of the things that's really weird about. this is there's a huge debate about how. they even work. So, there's certain. things that we know for sure. So, if you. now. ate something, right? You It doesn't. matter what it is. After a while a hormone would start to. be produced it in your body called.

GLP-1. And that is one of many gut hormones. that would start to be created. And it's. basically GLP-1 is a natural signal. saying, "Steven, you've had enough. Stop. eating, right? Just stop now, right?". But GLP-1, natural GLP-1, only remains. in your system for a couple of minutes. and then it's washed away. So, if you. sort of push through it, you can carry. on eating, right? Most people do stop. when they get the signal. Um so, what these drugs do. is they simulate GLP-1. They inject into. you an artificial copy of GLP-1. But.

instead of that GLP-1 remaining in your. system for a few minutes and then. disappearing, it stays in your system. for a whole week. So, when I go to that. cafe and I eat the thing I'd normally. eat, my system is filled with signals. that say, "You're already full, Johan. You don't need any more, right?". So, that was initially That is. definitely a key part of how it works. And it was initially thought that these. drugs worked on your gut, right? These GLP-1 is a hormone that's made in. the gut. Um it's thought that the effect. was it slows down your gut. It slows. down gastric emptying.

That is definitely happening, but the. cutting edge science and the kind of. leading neuroscientists that I. interviewed now believe actually it. primarily has an effect on your brain. It changes what you want and how you. want it, which it has brings with it a. huge parallel set of both benefits and. risks. Interesting, so it's once a week and you. basically feel. fuller for a whole week from one. injection. Yeah, not everyone gets to that state. immediately. Some people it takes. longer. Some people the side effects are.

just. intolerable and they can't take it at. all or they can't continue to take it. And I interviewed plenty of people. who are in that position, but for most. people. the best way I can describe it. is imagine you just had Christmas dinner. Yeah. and I came up to you and you're so. you're completely bloated, you're lying. on the sofa and I came up to you and. said, "Hey Stephen, I got you a Big Mac. Here it is.". And you'd be like, I mean, you could. physically force yourself to eat that. Big Mac. You might throw up, but you. probably could eat it. But you just. don't want to. You feel full. So it.

creates a very rapid sense of fullness. in response to far So I used to eat. 3,200 calories a day roughly. I now eat. about 1,800. So there's a huge drop. And the benefits. are kind of obvious of that, but there. are really big costs. I discovered this. in fact 12 really big risks. And there's. all sorts of. Cuz at first when you hear all this, you're like, "Wow, this is just. ka-ching. Win-win, right? Who wouldn't. want this?" But there's a lot of risks. and downsides as well. So I want to go on to all those risks. and downsides, but one of the I think.

rebuttals that some people would have. when they hear this um is kind of. contrary to the reaction I think you. expect, which is. Johan, I really love eating food. I. really really enjoy the process of. eating food. Aren't you losing happiness. because food gives a lot of people. happiness in various ways? So aren't you. a little bit annoyed now that you've. lost your desire to have you know. that roll that you used to have for. breakfast in in morning. Hasn't that. taken something from you? This is a big drawback for lots of. people. I think I'm quite unusual, so.

I'll explain how most people feel about. this, then I'll explain how I feel about. it. Um you're absolutely right. Even. Jens Juul Holst, who was one of the. scientists who developed Ozempic, said, "Look, for most people. it's just a life without pleasure in. food is just unbearable, and after a. couple of years they just give up. because they want to enjoy life, right? And one of the key things that gives us. pleasure throughout the day is eating.". Uh and a lot of people feel that way. If. you look at, for example, Jay Rayner, a. brilliant food critic here in Britain, you know, he just described how he.

started taking it. He would go to the. best restaurants in Paris, places he. loves, and he just. couldn't get any pleasure out of it. So, for him it was just awful. It's a very common complaint that it. drains pleasure from food. Honestly, I I had almost the opposite. experience, but I want to stress I do. think I'm quite unusual. So, I realized when I started taking. these drugs, one of the fascinating things about. these drugs is they will bring to the. surface whatever psychological issues.

you had with food, right? Because it so. radically interrupts your eating. patterns. Um. and that can be very challenging for a. lot of people. I'm sure we'll get into. that, but for me, I realized how much of. my eating, from when I was very young, the pleasure I got from food was not. primarily from like tasting it and. savoring it. The pleasure I got from. food was mostly from kind of a feeling. of stuffing myself. So, stuffing is like. you know what I mean? You do it at. Christmas dinners. We all do it. sometimes. Stuffing is when you sort of. eat deliberately beyond the point at.

which you're full, and you feel it as a. physical sensation. You can feel it sort. of pushing up on your esophagus and out. on your stomach. And I think from when I. was very young, I grew up in a very. violent and crazy environment, I think. one of the ways I learned to cope with. that, there are many productive and positive. ways I learned to cope with that, but. one of the kind of downsides is I. learned to really eat to soothe myself, and I would stuff. And when I started. taking Ozempic, I actually couldn't eat. like that anymore. Like you you can't. stuff yourself. I would literally throw. up if I, you know, tried to stuff.

myself. So, actually for me, it massively slowed down my eating, and. I actually enjoy food a fair bit more. now. I don't want to overstate it. I'm. not a foodie. I'm never going to be that. person. But like I remember going for. dinner with one of my friends. and I know maybe three or four months. after I started taking it, and her saying to me, you know, it's. always been a bit stressful to eat with. you cuz you eat so quickly, but you. don't seem to really enjoy it. And now, you do actually look like you're. enjoying your food. But I stress again, I don't think I'm. typical in that respect. There are far.

more people like Jay Rayner than there. are like me. I really want to go into. why people, you know, people's. relationship with food more generally. Um but I wanted to close off on that. what you were saying about Ozempic's. impact on the brain. You talked about. GLP-1 in the gut and the, you know, the. impact it has on making you feel. satiated, but you also alluded to does. now research that suggests it's doing. something to the brain as well? This is totally fascinating. It opens up. a whole new set of potential benefits. for these drugs in relation to addiction. and a whole set of potential risks for.

these drugs in relation to depression. So, I want to stress there is. very big scientific disagreement about. what is happening in the brain in. relation to these drugs. And it's a bit. like when you need to be people, it's. like it's like looking at a picture. that's just coming into shape. So, a. year from now we'll know much more than. we do now. But. what was discovered, it was actually. discovered in the '90s, um. here in London at Hammersmith Hospital, was that in fact we don't only have GLP.

receptors in our guts, we have GLP. receptors in our brains. In fact, GLP-1. can be made in the brain, right? Which. is fascinating. It can also be made in. your thyroid, which is very significant, I'm sure we'll come back to. Um. so, when you take these drugs, um. as John Wilding, one of the key figures. in the development of these drugs, said. to me, you can tag the drug, which means. that you can sort of dye it, and you can. give it to animals, and then cut open. their brains. Obviously, you can't do. that with humans. And when you do that, when you just give them the drug and you. cut open their brain afterwards, what.

you find is this drug goes everywhere in. the brain. It's going all over the. brain. It is primarily having a brain. effect, right? And it definitely also, much more anecdotally, feels that way. When you take it, it feels like you want different things, right? It doesn't just feel like a. physical sensation of I'm full. It feels I remember taking my godsons to. McDonald's, maybe on a week after I. started taking it, and I didn't want a. McDonald's. And then one of my godsons. saying to me, "Who are you and what have. you done with Johan?" Right? Cuz it was. so contrary to my preferences and my um.

um. one of my low points in life was. Christmas Eve 2009. I went to my local branch of KFC, just. around the corner from where we are now, cuz I used to live near here. And I said to the guy behind the counter. my standard order, which is so gross I. won't repeat it. And the guy behind the. counter said, "Oh, Johan, I'm really. glad you're here. Wait a minute.". I was like, "All right." And he went off. behind where they fry the chicken and. everything. And he came back with a massive. Christmas card and everyone who was. working that day, and they'd written, "To our best customer.".

And they all clapped me. And one of the. things that was so terrible is I. thought, "This isn't even the fried. chicken shop I come to the most, right? How can this be happening to me?" But. so, when you speak to the the. cutting-edge neuroscientists, and I. interviewed them in great depth, there's. basically three theories about what. these drugs are doing to your brain, right? Very broadly. I mean, they This. is a quite crude way of putting it. Um. so, one is, you have in your brain. something called the reward system. The. reward system is what motivates you to. do anything. So, you know, you have sex, you eat, you meet up with a friend, your.

reward centers hum, right? It's what. makes you feel good when you do. something pleasurable. And one theory about these drugs is they. dampen your reward system. So, the. reason I don't want a Big Mac is that a. Big Mac is not as rewarding to me as it. would have been before I took these. drugs, right? That obviously brings with it. a set of risks, cuz then you go. okay, if it's dampening my reward system. for Big Macs, is it dampening my reward. system for the things I love? Writing, reading. There's a big debate about.

this. There's concern that in some. people, it may be causing suicidal. feelings, and in some people it may be. causing depression. There is a warning. on the drug to that effect it required. by the FDA, the the Food and Drug Agency. in the United States. So, that's one. concern. But, there are other scientists. who say that we don't that that's not. correct. That um. that the suicide risk is not accurate, and that it they don't work by dampening. your reward system. Some people, like. Aurelio Galli, who's at the University. of Alabama in Birmingham, said to me.

what he thinks that it does is it resets. your preferences. It's almost like. taking your phone back to the factory. settings. It resets key elements of the. kind of food you want to a healthier. level. Can I just say on that? Sorry to. interrupt, but um I was thinking. constantly as you were talking about. your trip to McDonald's and not wanting. the McDonald's anymore. I I've come to. see in my life that if I have something. unhealthy, if I have sugar or a cookie. today, I'm I feel like I'm much more. compelled to have another one tomorrow. I feel like I.

I I I look back on certain periods of my. life where. I almost get into a bit of a sugar. spiral. And it could be cuz of stress or. some other factor, but it made me think. that the sugar itself is somewhat. addicting. So, when you were talking, I. was thinking, is it is it not just a. case that you're consuming less sugar. and you know, some of these addictive. food substances, so you want it less the. next day, if you know what I'm saying? Yeah, there's an experiment that proves. you're right in in a complicated way. Um. can I just finish off one thing about. the brain and then I'll come back to. that. You raised a super important and.

and truthful point. The third theory. about how it could be working in the. brain, and this comes from a scientist. called Professor Paul Kenny, who. actually did the experiment. relates to what you just said. He argues that in your brain you don't. just have a reward system, you have. something called the satiety system. And. this is a crucial concept for people who. want to understand these drugs and. what's gone wrong with our diets more. generally to understand. Satiety is just. the feeling of having had enough, right? We've all had the feeling of being. sated, you're like, "Okay, I'm done. I. don't want any more." We get that with. food, sex, all sorts of things, right?

You're just sated. He argues that in your brain this this. basically alongside the reward system, there's also a satiety system. A system. that just says, "Stephen, you've had. enough. Stop now." And he argues that. what these drugs do is they dial up your. satiety system, they don't dial down. your reward system, right? There's a. huge and ongoing debate about that. What. we do know is they're having some really. significant effect on the brain, and. that has all sorts of implications that. we need to think about. When I was. learning about this, I remember thinking,

this is a much more intimate and risky. transformation than when you first hear, "Oh, I'm taking something that affects. my stomach, right?" So, there's a lot. there about the brain and implications. for addiction as well, which we can talk. about. But to come to the thing you. asked about, which is so important, of all the things I learned, there was. an experiment that kind of freaked me. out about this. Um. cuz obviously I was trying to figure. out, well, how did we get to this point? Cuz at first glance I can see how it. seems crazy in a way it did to me.

You know, we gained an enormous amount of weight. in the last 40 years. So, I was born in. 1979. The year I was born, 6% of British. people were obese. It's now 26%, right? Staggering increase, unprecedented in. human history. And. it seems extraordinary that we've. reached the point where we would inject. ourselves with a potentially risky drug. to stop us from eating. It seems so. unnatural and so wrong. And I was trying. to think, well, how did we get here, right? What happened? Which is why satiety is so important.

So, there's this experiment that I think. helps to understand that thing you were. saying about sugar. It's done by this guy, Professor Paul. Kenny, who's the head of neuroscience at. Mount Sinai in New York, and a brilliant. neuroscientist. So, Paul grew up in Dublin. And he moved to the US when he was in. his 20s to do his PhD, I think. And he. moved to San Diego first. And he quickly. clocked. Americans do not eat like Irish people, right? They eat much more sugar, much. more fat. They eat just much more, right? And within being within like a.

year of being there, he'd gained, I. think, a stone and a half or something. Uh so, he gained I think it was 23 lb. So, he gained a lot of weight. And he. started to wonder, sort of like the. question you were asking, does this food, when you consume it, change your brain in ways that compel. you to consume it more? What's going on? So, he designed an experiment that sort. of investigated this, uh which I've. nicknamed Cheesecake Park. That's not. its official name, right? Um. you get a lot of rats, and you raise.

them in a cage. And they've just got the. kind of food that rats evolved to eat. over thousands of years. It's pellets. based on their natural diet. And if you do that, even though they've. got far more pellets than they could. actually eat, they will eat enough to. deal with their hunger, and then they. just naturally stop, right? So, when. they've got the kind of food they. evolved to have, they never become. overweight or obese. They just stabilize. their weight. They've got a kind of. natural nutritional wisdom. Then Professor Kenny introduced the. American diet to them. He fried up some. bacon, he bought some Snickers bars, and.

crucially, he gives them a lot of. cheesecake. And they come along and they. nibble the cheesecake and the other. stuff. And quite quickly, they just go wild for. it. They shun the food they evolved to. have, and they just start obsessively. eating the cheesecake, the fried the. fried bacon, the Snickers bars. He. describes to me how they would like he. would put the cheesecake in, and they. would just hurl themselves into the. cheesecake, and then like eat their way. out, and emerge like completely slicked. with the cheesecake. So, given this kind. of food, all their nutritional wisdom.

disappeared, just went away, and they became obsessed with this new. kind of food. Um and as he put it to me, within a couple of days they were. different animals. Their all their. health indicators were worse. They were. obsessively eating. Within a few weeks. they were their health was really bad. They became extremely obese. And then he. varied the experiment even more, and what it seemed to me as a former. junk food addict a little bit cruel, he took all the American diet away, and. they just have the food they evolved to. have, the food they used to eat, right?

And he was quite sure he knew what would. happen, that they would eat a lot more. of the kind of natural food than they. had before, and this would prove that. junk food expands your appetites. That isn't what happened. What happened. was much worse. They completely shunned the natural. food. It was like they no longer. recognized it as food at all. They just. refused to eat it. They starved, and it. was only when they were really starving. that they went back to eating the. natural food. There's lots of human. examples of this, but there's something. as Professor Gerald Mann, who's a.

nutritionist at Harvard, said to me, there's something about the food we're. eating, which I think you're getting at. in that question, which is undermining. our ability to know when to stop, which. is how we got to the point where we so. many people, 47% of Americans want to. take a drug that will make them stop. I was reading about this um. thing you call the cheesecake park in. your book in chapter two. And the other. sort of step he took the experiment to. was the whole idea of electrocuting the. animals when they ate certain foods. And.

you say in the book that he then um. would electrocute the animals while. shining a yellow light in their eyes, so. that they would eventually become scared. of this yellow light. And in the case of. um the natural food, when he shone the. yellow light in their eyes, they would. run away. But even if he shone the yellow light in. their eyes while they were eating the. junk food, they would stay and continue. to eat the cheesecake, which kind of the. conclusion in chapter two of your book. as I've written it here is and I think. this came from the researcher, if you're. exposed. to this food for a while, Paul concluded.

the desire for it is so great that you. will ignore all sorts of negative. consequences to eat it. As we know, as I know in my own life, right? My KFC obsession had obvious. negative consequences in my life. And. the reason this is so important in. relation to these drugs, so for a long. time I was looking at two things, right? I was looking at why did we so many of. us gain so much weight so rapidly? Obesity has trebled globally in my. lifetime, right? Completely. unprecedented in human history. Why did. that happen and how do these drugs work? And at first I thought they were like.

parallel lines, right? But actually I. realized they were like kind of braided. plats. The answer is completely densely. interconnected. What we know is the kind. of food we eat profoundly undermines our. sense of satiety. It completely. disrupts, just like it did with the. rats, it we don't get that signal you're. full, you've had enough, stop from the. kind of food we're eating. And what these drugs do is they restore. a sense of satiety. Carel le Roux, another one of the key scientists who. developed these drugs, said to me what.

these what these drugs give you is. satiety hormones. They give you back a. sense of being full. And in a way at. first I thought. well that makes the whole thing seem. crazy, right? Because there's a guy. called Michael Lowe, brilliant professor. at Drexel University in Philly. He said. to me, "Look, you've got to understand, these drugs are an artificial solution. to an artificial problem. We've. artificially created this problem. through a catastrophic food system that. is screwing us up from childhood.

And then along come these drugs as the. artificial solution to that. And the. first thing you think is. right, we've got to deal with the food. system, right? And that is absolutely. true and correct. And I remember going. to one of my closest friends, I call her. Judy in the book, it's not her real. name, who. you know, she'd had cancer seven years. before. and so I'd been with her all. through that kind of really grueling. process, and it was a an absolute. nightmare cuz she's a single mom, and. you can imagine how how grim that was. Um. and I said to her. I feel like a complete fraud taking.

these drugs, right? I'm always talking. about how we need to deal with the. causes of social problems. I can see. very clearly the cause of this problem, and this is just sort of dealing with. the symptom. And she said to me. look, Johann, you can stop taking this drug. That's. fine. Do it if you want to. But when I had cancer we know there is. something in the environment that is. triggering breast cancer in women, right? One in seven women in Britain now. get breast cancer. That didn't happen in. the past. It's not happening in Japan,

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

was she said, "If your house is on fire, right? You could say. 'Well, look, we need to build houses. that aren't made of flammable materials, and we should make it the law that. you've got to have sprinklers.' And of. course, I agree. But the first thing you've got to do is. put out the fire in your house, right?". And. and then after that conversation, it was. just after it, I I met a guy called Jeff. Parker. He's in San Francisco. He's a 66-year-old lighting designer who. was about 16 stone when I when when when.

he first started taking weight loss. drugs, and he was in real trouble. He. had heart problems, liver problems, kidney problems. It was very painful for. him to walk. And he got Mounjaro, which. is the next generation up of these. weight loss drugs. And he lost loads of weight. And all his. health problems reversed. And now he. walks. his dog over the Golden Gate Bridge. every day and is really happy and said, "Look, I feel like now I'm going to. enjoy my retirement." And I said to him, "But Jeff, I'm I. don't you feel like we should be dealing. with the environmental causes?" And he. said, "Absolutely. I totally agree with.

you. You start that campaign, sign me. up. But I've got to tell you, by the time we achieve that, I'm going. to be dead. Right? We're not going to. get there in the next few years. And I. want to live.". And I found that. I found it hard to dispute. What what if people say, "Well, you. know, you could um you could just not. choose the roll at the coffee shop in. the morning. You could have just gone. for, I don't know, a salad or something. Yeah. It's a choice you're making, Johan. Yes. Make better choices. So, this was completely the voice in my.

head. I remember another one of my. friends, when I was at dinner and I was doing. this. I've been talking through everything. I've been learning. And I was talking. about, you know, the What you got to weigh here, I. thought, was the risks of obesity, which. are really disturbing when you learn. about them. I was actually surprised. We all know obesity's not good for your. health. But I was actually stunned when. you look at the evidence about how bad. obesity is for you in relation to. not just diabetes, but cancer, dementia, across the board. We can come back to. that. So, I was like, "Well, you got to. weigh. these risks of obesity against the risks.

of these drugs." And I learned there. were 12 significant risks associated. with these drugs. And he said, "What are you talking about? Yeah, I'm. going to weigh those risks at all. There's a third option. Go on a diet. Exercise, right? He said, "I've seen you. do it. You've done it plenty of times, right? Do you that?" And of course, I. had this voice in my head. I thought I. was cheating. Um And I thought, "Well, why don't I do. Why why am I not doing that, right?" Um. And I really began to get an insight. into this when I I went to interview an.

amazing person called Professor Tracy. Mann, who's in Minneapolis, where I met. her. Um who's done some of the most important. research on diet ever. I mean, actually I met her I interviewed. her in a place called Isles Bun, which. is a cinnamon bun shop, famous cinnamon. bun shop in Minneapolis. When I arrived, the guy on the door. said, "Have you ever been here before?". And I said, "No." And he said, "Oh, we'll give you a free cinnamon bun. then." And he gave me this like 2,000. calorie massive cinnamon bun that sat. there the whole time we were talking. about diets. And Professor Mann, she. began to research this in the year 2000.

And she wanted to figure out how much do. diets work, right? Are they effective? And at that time the science was very. clear, diets are really effective. If you go on. a diet, you will lose weight, right? But she's looking at She's looking at. all these studies. It's almost 24,000. studies. And she noticed, as part of. this big It's called a meta-analysis, and she discovered something a bit. weird, which is. most of these studies, the overwhelming. majority, would follow people who were on a diet. for 3 months. So, you you exercise your.

willpower, you go on a diet for 3. months, you lose a load of weight, and. then they just stopped. And the. implication was you stay at that lower. rate forever. She'd be like, "Well, I. know quite a lot of people who are not. in that position. That doesn't happen to. them." So, she looked in more detail and. discovered there were 24 studies that. had followed dieters not just over this. short period, but for 2 years and in a. handful of cases 5 years. And when you look at the longer picture, the picture is really different. After 2 years, the average person on a. diet has lost 2 lb in weight, right? So,

it's not nothing, but it's pretty close to nothing, right? It's It's extraordinarily low. So, what. we know from the research on dieting is. there's a very small number of people, around 10% of people, who really do lose huge amounts of. weight on diets and keep it off. We all. know people like that. I've got someone. in my family like that, right? But for. the vast majority of people it doesn't. work. And I remember saying to Professor. Mann and loads of other scientists. who've looked at this, "Well, how can that be? Because we know.

You only have to know the laws of. physics to know. if you consume fewer calories than you. burn, obviously you will lose weight. To. dispute that, you have to dispute the. laws of physics, right? So, how can it. be that these people are dieting, but. they're not losing weight? And Professor. Mann and other people explained to me um. something that's sort of missing in this. picture that I think really helps us to. understand it and is actually important. for understanding these drugs, I think. So, a lot of the scientists explained. that there are biological changes that. happen as you gain weight, which make it.

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

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

you're fixed there. But then the obesity crisis happened. starting in the late '70s, early '80s. There's a huge weight rise in such a. large part of the population, and it. looked like our set point theory is just. wrong, right? And that can't be correct, cuz if it was true, then you couldn't. possibly have this. But then Professor Lowe at Drexel and. other places and other people um. discovered what what is really happening. in my view. I think they've produced. very compelling evidence for this. As you gain weight,

your body's set point rises, right? So, let's say my body wanted me to be 18%. body fat. As I get to 30% body fat, my. body will then fight very hard to keep. me at that higher level, right? Which. seems really weird at first, why would. that be? So, if you if you let's say you. gain three stone, right? And then you. try to lose weight. We'll have to think. of a hypothetical Robert De Niro for the. movie Raging Bull gained, you know, three or four stone, right? And then. tried to cut back. But, what you'd find. was.

your metabolism would massively slow. down. So, it would you would have to. burn far more to get the same number of. calories as you do now. You would crave far more sweet and salty. foods. You would have lower energy, so. you would find it harder to exercise. So, your set point has risen and it's. trying to keep you there. And I remember. saying to loads of scientists, "Well, that just seems bizarre. Why would. evolution endow us with that? That's. such a mal-adaptation, right? Why would. Why would um. Why would it be?" And they explained to.

me, "Well, you have to think about the. circumstances where we evolved. In the. circumstances where humans evolved, in. fact, every human circumstance pretty. much until like 100 years ago, there was never a situation where you. would have completely abundant calories. In fact, hyper-abundant calories for. your whole life. You'd have far more. calories around you than you could ever. possibly eat. That never happened. So, your body didn't Evolution didn't. prepare us with good instincts for that. What you did have, what was a big risk, was famine, right? There was a big risk that at some point.

in your life food would run out and you. would be in real trouble. And in a. famine, the fattest person at the start. is going to be the last man standing, right? Timothy Chalamet will die in week. one of a famine, and you know, John. Candy will still be alive at the end of. it. At least I did not great example cuz. John Candy has died, but you get the. point, right? Um So, actually, that's. why our evolution prepared us that Oh, if you gain weight, fight to hold it cuz. sooner or later you're going to have to. lose it in a famine anyway. So, we. evolved with this instinct that when we. gain weight, we experience these.

biological changes that make it harder. to go back. It's not impossible. Willpower is a real thing. Some people. can do it. But, when you try, you are. fighting against your own biology. You're also fighting against your. psychology and your environment for. different reasons we can explore. So, it's not that dieting doesn't work, but. we've got to be honest. At any given time, 17% of people are on. a diet. We've really tried that route, right? We've had fit you know, 40 years. of relentlessly promoting dieting as the. only or diet and exercise as the only.

solutions. And we've gotten fatter and fatter and. fatter. So, there's something missing in. that picture. I think it's partly set. point theory. It's also important for. the drugs cuz some people argue like the. guy I mentioned before in relation to. the brain, Professor Aurelio Galli, some. of them argue that what the drug may be. doing is actually resetting your. biological set point. Lowering the kind. of temperature which your body tries to. keep your weight. It's bringing your set. point down so that you don't get those. effects like the metabolism slowing and. all the other things that kick in when. you try to lose weight.

I think on average, and this might not. be accurate, but I think on average we. live more stressful lives than we once. did as well. And I wonder the. relationship that our more stressful, more frantic, more busy, notification-filled, social. media-driven, screen time lives are. having on our relationship with food. And if there's a relationship there at. all. You know, more. 100%. More kids have ADHD now than ever. And. you know, cortisol levels seems to to be. skyrocketing and it seems there's a. relationship between stress and. appetite, which is acting as a. gravitational force against our. willpower.

No, you're totally right. And this is. when I go through the 12 risks of the. the drugs in the book, this is one that. I really worried about, one that played. out for me. So, I noticed I had this. weird thing. About 6 months since taking the drug, I. had this realization. So, I I losing a. lot of weight, right? I lost a huge. amount of weight. I lost three stone. Three stone in what period of time? From from now to when I started, so I. just over a year. And how quick how quick was that weight. loss just out of interest before we move. on? Pretty. pretty straight linear line downwards. from from the start. But I had this.

strange sensation. I had a. My friend Danielle was pregnant at the. time. I kept bumping into her and it was. like we had we were on opposite. trajectories. Like she was swelling and. I was shrinking. Um. I remember walking away from her once. and thinking, "This is really weird. I'm getting what I want. Why don't I feel better about this?". Right? I I didn't actually feel that. much better for quite a long time, for. about 6 months. Thinking, "Why is that?". So, what do you mean by better? I felt quite muted in my emotions. I. felt.

I felt I wouldn't say I definitely. wasn't depressed, but I felt. a little bit dulled. I thought, "This is. strange." I thought, "Maybe it's just. other things going on in my life. You. never know when it's just an. individual." But. lots of people are reporting this. Most. people are very happy when they say. drugs, but there's a significant. minority. And so I started looking at exactly this. question, the psychology of eating. And. it turns out there's kind of five the. scientific evidence for five reasons why. we eat. Um and obviously the first and most. important one is sustenance, right? I.

would have thought, if you'd asked me a. year ago, "Why do you eat?" Well, I'd. say, "Well, the main reason is to. sustain my body." But here I am eating. so much less than my body is sustained. So, all those other calories I was. consuming were doing something else, right? And one of the things one of the reasons. we The one is pleasure, which we've. talked about. But another reason why. people eat is comfort, right? People get. a tremendous amount of comfort out of. food. Particularly overeating can be. very comforting. We know this partly. because whenever there's a stressful. event, uh. junk food orders massively go up. After.

9/11, there was a huge increase in. ordering people ordering pizzas and. fried chicken. The night Trump won the. election in blue states on Uber Eats and. the other kind of delivery apps, there. was a massive increase in people. ordering tacos, you know, um shitty. food, right? Um if you if you're you're. a man and you lose your job, your. chances of gaining weight massively. increase, partly because it's so. upsetting and you eat to comfort. yourself. Um and one of the things that. happens when you take these drugs. is your ability to comfort eat is taken. away from you.

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

basically what we think of a stomach. stapling stomach operation. Okay. Okay. That's one form of it, right? And so, I think you have to look at the. evidence from gastric surgery. And in. some ways, it's very encouraging. So, we. know that gastric band surgery and other. forms of gastric surgery massively boost. your health. If you have one of these operations, over the next 7 years, you are 56% less. likely to die of a heart attack, 60%. less likely to die of cancer, and 92%. less likely to die of diabetes-related. causes. In fact, it's so good for your.

health that you are 40% less likely to. die of any cause over the next 7 years, right? So, we know reversing obesity. massively boosts physical health in most. cases, right? Sometimes very. dramatically. But, we also know from bariatric. surgery, there's plenty of downsides to. bariatric surgery. It's a horrendous. operation, and one in a thousand people. die during the operation. It's grim. But, we also know, what I think is. really important to the thing you're. asking about, is that it has an effect on your. psychology. So, a lot of people are much.

happier. Most people who have that. surgery are glad. But, 17% of people who have that surgery. have to have inpatient psychiatric. treatment afterwards cuz they're so. depressed or distressed. Your chances of. committing suicide almost quadruple. after you've had bariatric surgery. And. I think there's lots of reasons why. Some of it must be the grimness of the. operation and the aftermath. But I think a lot of it is. you know, you take away comfort eating. from people, right? If you go through. life, especially people who have a. gastric band surgery or the other. surgeries, you know, those are people.

who were very severely obese, so they. would have had this effect very. powerfully in their lives most of them. If you take away something that is a key. way of soothing people, when that goes well, you can rebuild. your life, you can find other ways to. get that soothing and that's really. valuable and important. But a lot of. people just experience it as profoundly. painful and distressing. And I know a. lot of people like that. When people have those surgeries, I read. in your book in chapter eight that one. in 10 people then pick up a different. type of addiction to alcohol or gambling.

or shopping or drugs or something else. So, that's pretty clear evidence that. there's the psychological soothing is. just moving somewhere else. It's fascinating and and and. distressing. And also I spoke to people. who'd been through those was called an. addiction transfer. Um I spoke to this amazing woman called. Robin Moore who uh had been 303 lb. She'd had um bariatric surgery cuz just. nothing else had worked and she felt she. was really a slave to food. That was how. she put it. And it had this incredible effect. She.

she knew why she had gained her. gained weight so much. In her case, it. was she when she was a child she had. been sexually abused, she'd been raped. and she'd never told anyone. And she quite deliberately gained weight. in order to keep men away from her. She. thought, "Well, if I'm if I'm really. fat, I'm less likely to be attacked.". Um which is surprisingly common. And. she lost all this weight. and she felt great. She felt physically. much better, people were treating her. much better.

But. she had this shift where she. she'd never been much of a drinker. She. had a period when she was at college. where she drank a fair bit, but you. know, she'd never been a heavy drinker. And she just quite rapidly became a very. full-blown alcoholic. She used to work. out by the airport in Toronto. And she would, you know, drink on the. way there, drink on the way back. And. she got fired cuz she was drunk at work. eventually. And um. for her she she kind of realized. you know, I think it's interesting ways to think.

about this in relation to these drugs. I want to stress this is not going to be. everyone. I don't think this is even. going to be a majority of people by any. means. But, when you take these drugs, the underlying psychological reasons. that drove your eating. are profoundly disrupted and in many. cases come to the surface. And for me that was help painful at. first, but helpful. I remember having a. day in Vegas. As you know, I spend a lot. of time in Vegas cuz I'm writing a book. about a series of crimes that have been.

happening there. I had a day where I was. investigating something really grim and. I felt I felt really bad and it was. relating to someone It's a long story, but it was something terrible. And I went to the KFC on West Sahara. It's the grimmest KFC in the whole. world. I have a secret love for it. And I on kind of autopilot, I ordered what I would always have. ordered, you know, like a load of fried. chicken. And I sat there and I'm like thinking, "Oh, [ __ ]. I can't eat this." I remember Colonel. Sanders was on the wall looking down and. he was like he was going to me,

"What happened to my best customer, right?" So, being deprived of comfort eating is is. quite apart from the being deprived of. pleasure, which I think is sort of. related, but a bit different, is is is very difficult. And again, my. friend who I'd spoken to who had cancer, when I told her I said, "This is really. hard, right?" And she said, "Look, it's not that the drug is causing. this problem. The drug is making this. problem visible to you. And now you can. deal do that in other ways, right?" And. that's what I've been trying to do. I. write about how in the book, but yeah, so one of the things that fascinated me.

about all the research for for my book. Magic Pill was. how incredibly complex this is. Every. time you look at one effect, it seems to. have another effect. This is a really complicated, difficult topic. And anyone who's coming. in telling you either rah, rah, these. drugs are great and they're going to. save us all, or these drugs are devils, it's terrible. Um. I don't think he's leveling with people. I think it's complicated. I think. there's risks at every turn. And I think. we need to think through the complexity. together in a way that's honest and and.

and honors the complexity. You talked there about the impact that. early childhood trauma has on our. relationship with food and eating. Um I. remember reading a little bit about that. in your previous book Lost Connections. as well. But what is what what is the. sort of data in the stats that that. prove that trauma can cause us to have. this kind of. excessive comfort-seeking relationship. with food. Is there any particular. studies that stand out for you? Oh, yeah. I mean, a guy that I got to. know quite well when I worked on Lost. Connections and I thought about this. research.

in a different light when I worked on. this book. There's this guy called Dr. Vincent Felitti. And in the early 1980s, he was a doctor in San Diego and he was. contacted by Kaiser Permanente, who are. a big not-for-profit medical provider in. the state. And they said to him, "Look, we've got a. problem. We don't know what to do.". Obesity was massively rising. Actually, it was very low by our standards, but it. was hugely rising. And they were trying giving people diet. plans and exercise plans and nothing was. working. And they said, "Look, we don't.

know what to do. Can we give you a load. of money to just do blue skies research? Go away. Figure out what we can do." And. he said, "Okay." So, he took a load of. money and then he's like, "What can I. do?". And he started working with 200 very, very obese people, people who were. severely obese, who had tried all sorts. of ways to cut back and it hadn't. worked. And he's sitting there working with them. and he's thinking, "What can I do?". And he had an idea that sounds and. actually is quite stupid. He said, "Well, what would happen if really obese. people literally stopped eating and we.

medically supervised it and we gave them. vitamin shots so they didn't get like. scurvy or whatever? Would they Would. they burn through the fat stores in. their body and get back to a healthy. weight?". So, with a shitload of medical. supervision, they did it. And. incredibly, at first, it worked. There. was a woman who I call Susan, that's not. her real name, who went from being more. than 400 lb to 138 lb. It was. incredible, right? And, you know, her family are ringing. the doctor and saying, "You saved. Susan's life. She's really thrilled.". And then one day, something happened. that no one expected.

She cracked. She went to KFC or wherever. it was. She starts obsessively eating. and after a while, she's back where she. was. Not exactly where she'd been, but. similar. And Dr. Felitti called her in. He said, "Susan, what happened?". She looked down. She was obviously. really ashamed. She said, "I don't know. I don't know.". He said, "Well, tell me about that day, right? The day you cracked. Did anything happen. that day that didn't happen any other. day?". It turns out something happened that day.

that had never happened to Susan before. Um she was in a bar and a man hit on. her. Not in a nasty way, in quite a nice. way. But she just felt completely. freaked out and she went and started. eating. And that's when Dr. Felitti said. to her, "Well, Susan, when did you start. gaining weight?" In her case, I think it. was when she was 10. He said, "Well, did anything happen when. you were 10 that didn't happen when you. were nine or 11 or anything happen that. year?". And she looked down and said, "Well, that's That's when my grandfather. started raping me.". Dr. Felitti interviewed everyone in the.

program. He discovered that 60% of them. had made their extreme weight gain in. the aftermath of being sexually abused. or assaulted, which is a staggering. figure, right? Uh 60% of the women. Um. And it was like, "Well, how could this. be?". He was really puzzled. And Susan. explained it to him really well. She. said, "Overweight is overlooked and. that's what I need to be, right?" If. you're severely overweight, you're much. less likely to to be sexually attacked, right? It's obviously it can happen, but. it's it's rarer. Um. and when you understand that, you begin.

to see again in relation to these drugs. um. why some people get really freaked out. when they take these drugs cuz some of. them. experience it as suddenly, "Oh my god, I'm really vulnerable to this traumatic. event being re-enacted to it again and. again." Now, that's one example. There's. lots of We go down the the list of. reasons why people eat like I do in the. book. There's lots of other ones that. get triggered and activated as and. disrupted as well. You talk in the book about this this. word I've never really come across. before, which is um it's a phrase, I. guess. You say the environment is.

obesogenic. I I've only ever heard of that term. carcinogenic. Carcinogenic, yeah. Yeah, carcinogenic, yeah, which. basically means something can give you. cancer, but you're saying that the. environment we live in is. I mean, the way that I read it was like. that it that it's almost contagious. Like, it's going to give me obesity just. by being alive in the modern world. Um. one of the stats that really stood out. to me when you're talking about. processed food is that on average, when. we eat processed food, we we end up. eating 500 more calories every single.

day. And um. that again is startling. You know, I've. had a few guests on this podcast that. have talked about processed food and the. rise of it. And I do wonder to myself. if there's ever going to be a change in. society if we if there's any indication. that at some point, I don't know, government will step in and ban it or. tax it more or something will happen. What's your What's your view on. if we talk about the optimism of the. obesogenic environment changing? Do you. think it can change? Do you think it. will?

So, crucially, I went to a country that. had completely transformed its diet and. as a result has very low obesity, Japan. We can talk about that and I went to. loads of countries that are I'm the. changes you're talking about. So, prompt. me to come back to that. But, I would. start by saying well, A, you're totally. right. We live in an obesogenic. environment. An obesogenic environment. is an environment that primes you to be. obese and where it's hard to be a. healthy weight, right? It's hard to get. healthy food. Healthy food is expensive. and rare, whereas shitty food that makes. you obese is cheap, abundant, and.

constantly promoted to you, right? So, that's an obesogenic environment and. there's loads of evidence that well, as. Professor Michael Lowe put it to me, we. live in as obesogenic an environment as. human possibly design, right? Um and. there's seven ways in which processed. food undermines your ability to stop. eating that I go through in the book. So, if you're feeling pessimistic and. I'm clearly. you're right to feel pessimistic. Someone as charismatic and brilliant as. Michelle Obama could not even get us to. join a campaign to physically move. So,

I get it. There's big obstacles here. But, when you feel pessimistic about it, the first thing I would say is. think about smoking. Right, my mother. smokes 70 cigarettes a day. There's a. photograph of me and her where I'm um. she's breastfeeding me. I'm about 6. months old. She's smoking and resting. the ashtray on my stomach. And when I showed her this photo, I. thought she'd feel guilty. She said, "You were a [ __ ] difficult baby. I. needed that cigarette." Um but, you. think about that. That was normal,

right? When I mean, in Scotland, that. was normal when I was a kid, right? Um. so, you think about smoking. When I was. 7 years old, um more than half of the. population of Britain smoked, right? And. people smoked everywhere. People smoked. on the tube. People smoked on planes. People smoked on game shows. The doctor. would smoke while he was examining you. I'm not joking. I remember that. happening, right? So, if I could take. you back to the Britain of 1987 and you. could walk around, you would just you. would feel sick cuz the smell of smoke. was everywhere, right? And there were.

just ashtrays everywhere. Funnily. enough, I was with my mother when it was. the anniversary of there was a terrible. catastrophic fire at King's Cross. Station here in London in 1987 I think. I was with my mother when it was the. anniversary a few years ago. And uh it was a terrible disaster. There. was a fire. Someone had put out a. cigarette near an escalator and it. killed uh more than 50 people. It was. awful. Uh and my mother said, "Oh, that was the. worst day of my life." And I said, "Oh, were you there? Did you know someone who. died?" She said, "No, that's the day.

they banned smoking on the tube." She. Anyway, the So, if I could take you. back, and I said to you, "Right, however. many years we are on from that now, um. only 12% of British people will be will. smoke. It will be falling and the. British government will be about to. progressively ban smoking. You won't be. able to smoke indoors anywhere except. your own home. The rates will have tanked. Young people. will have There'll be almost no. cigarette smoking among young people and. they're going to progressively ban it by. age." That would have seemed ludicrous,

right? You could have said, "Well, tobacco industry is one of the most. powerful industries in the whole world. Uh you've got a very motivated half of. the population are addicted. It's never. going to happen.". These things can change. That's a huge. public health uh transformation in a. very short period of time. These things. can change and I've seen how it can. change with food so that we're not in. this situation where we have to choose, as we are at the moment, between for. many of us, not all, between the risk of. obesity and the 12 big risks associated.

with these drugs. What are they waiting. for? Cuz the government knows this. The. government knows that processed foods. and the you know, the sugar quantities. that the average person's eating is bad. So, they could presumably get something. done this year. So, But they won't. There's a brilliant writer called. Rebecca Solnit who says politicians are. weather vanes and it's our job to be the. weather. You're a politician, you're. constantly making a calculation, right? If I do this thing, how much praise will I get and how much. [ __ ] will I get for it, right? Cuz And. you know, some Some are good people.

Many of them are good people, but you're. constantly making that calculation in a. democracy. And right now, if you do the right thing. on food, and there are loads of things. we do. I saw in Japan, we can go down. the list of all the things we need to. do. Um that could transform health, particularly for our children. You'd get some praise, but you'd get a. lot of [ __ ] right? You'd get a lot of. [ __ ] for it. And mhm For many years of. my life, I would have been one of the. people who gave them that [ __ ] right? So, I I I understand it. We have to change that calculation by. help helping people understand.

and make better choices in ways that I. saw happen, so I can explain how they. did it if you want. Please. Japan is really important, I think, for. thinking about how we get out of this. trap, because at the moment um the way. it's often presented is look, we're just. screwed, right? There's just this huge. obese population that's the product of. being rich. If you're a rich country, you've got lots of calories around you. Inevitably, we're going to have loads of. obesity, and inevitably, we're just. going to need to give loads and loads of. people these drugs forever. And you.

know, a few years from now, as many. people predicted to me, we'll have 40%. 50% of the population taking these. weight loss drugs, right? And what Japan. showed us is we don't have to choose. that fate, right? So, if you look at. Japan, Japan is the only country that. got rich without getting fat. 4.5% of. Japanese people are obese compared to. 26% in Britain and 42.5%. in the United States. And it's actually. 42%. 42% 42.5% are obese 70% are obese or.

overweight, right? Jesus. So, it's the norm is to be obese or. overweight, right? Whereas in Japan, it's completely the opposite. It's kind. of weird that when we picture Japan, we. often picture sumo wrestlers. It's a bit. like expecting the average American to. look like a bald eagle or something, right? Sumo wrestlers are completely. atypical. And I learned a huge amount. about what's happening there. So, the. first thing you think when you hear that. is that it must just be genetic, right? They just they won the genetic lottery. That must be what's going on. But we. know that's not true, because in the. late 19th century loads of Japanese.

people went to live in Hawaii, where I. just was. Um and there's now this. settled Japanese population in Hawaii. who've been there for four or five. generations. And they're almost as fat as other. Hawaiians, right? So they're five times. fatter than. they're five times more likely to be. obese than Japanese people in Japan. So. actually when the environment changes, Japanese people become obese like. everyone else. So there's something else. going on. So wanted to understand how did Japan do. it? And one of the really interesting. things is it was very consciously done.

There's a guy called Professor Barak. Kushner. He's a professor of East Asian. history in um in Cambridge University. who's talked about how actually if you. go back to the 1920s, Japanese people. had one of the worst diets in the world. They only ate protein once a week. They. almost never ate fish, right? They only. ate fish once a week. They had a. terrible diet. And the Japanese. government of the time wanted a healthy. population so they could. form armies that would go and invade the. rest of Asia. So they deliberately transformed the. food culture in Japan very consciously.

So I want to see how did they do that. now, right? What's going on? So I went. to a school called Koenji school um. which takes kids from five to 18. And it was totally fascinating. So when. I arrived there, I went with my translator. Uh the first you arrive and all the kids. walk to school on their own. From the. age of five, all Japanese children just. leave the house and walk to school on. their own. So they get a lot of exercise. in the morning and they walk home on. their own as well. And we were greeted at the entrance by a. woman called Harumi Tatebayashi the. nutritionist at the school.

By law, every Japanese school has to. employ a professional nutritionist. It's. a difficult qualification to get. It's. three years of study on top of learning. to be a teacher. And your job is to design and oversee. the creation of the food in the school. All processed food is banned. No one is. allowed to have There's no processed. food in any Japanese schools ever. Every meal has to be prepared from. scratch at the start of the day. um and no one is allowed to bring in a. packed lunch. So, every kid has to eat. the food that's prepared in the school.

Uh her job is also to use those meals to. educate the children about how to eat. healthily. So, they teach them all sorts. of key principles. One of them is in. Japan, this is a very deep cultural. norm, you should only eat until you're. 80% full. So, it it takes a while for. your body to realize you're full. So, if. you get the signal that you're full. while you're still eating, they're like, you've eaten too much, right? So, you. should eat until you're 80% full and. then stop. Um there's all sorts of norms. that are very different to ours. So, if.

you look at a typical Japanese meal, it will have five portions, significantly more than ours, but. they're pretty small, right? So, you. might have some fish, some miso miso. soup, a whole range of things. Um. and you which is important for your gut. health cuz there's a bigger variety of. ingredients which makes your gut much. healthier. But also you you eat it differently. If. you gave us, you know, a meal with three. bits, generally you'd eat all of one, then all of another, then all of. another. You'd have all the lasagna, then you have the carrots or whatever. In Japan, that's regarded as like a.

crazy way to eat. You have a mouthful of. the miso soup, then you have a mouthful of the white. fish, then you have a mouthful of the sashimi. and you you have a mouth This slows your. eating down. massively if you eat that way. Um they're also taught I remember her. standing there. So, the the meals in all. the schools are designed to be. nutritionally balanced through these. five components. And so, she stands in front of the class. and teaches the kids, you know, okay, this is a red rope. This represents. calcium. What does calcium do? And cuz.

you go, "Ah, it makes your bones. stronger." She's like, "Yes, that's this. on your plate. This represents. carbohydrates. What do they do?" And. they give you energy and the kids yell. out. So, they And then she ties the rope. together. She goes, "You see, now it's. all tied together. Now it's a balanced. meal." So, they use this healthy food. to educate the children about how to eat. healthily. It's a very. beautifully designed system and it was. fascinating looking at them. I mean, I've got to tell you Stephen, it. was really weird. This is a school of a thousand children. I walked through that school all day.

There was not one fat child. It it it. was. it's odd. Like it's jarring when you go, right? That they have, you know, they. have extraordinarily low childhood. obesity. And I remember with these kids I was. asking them their favorite foods. The. first kid I asked said, "My favorite. food is broccoli.". It's like, right. The second kid said, "My favorite food is seaweed." And the. third one was like, "I like white rice.". And I said to Chia, my translator, "Are these kids trolling me, right? Like.

what their favorite foods are broccoli. and like white rice?". And she just looked kind of puzzled and. every Japanese person I asked said, "Well, we teach our children to like. healthy food. Don't your children like healthy food?". And I was so taken aback by these kids. I brought up on my phone some pictures. of like typical British school dinners. and showed it to them. And they literally reacted like I had. shown them an ISIS beheading video. They. like screamed. They were like, "What is. this?" And one said, "Did you eat this. every day?" I was like, "Yes." They. said, "Where's the salad?" I said,

"There is no salad." They were just. completely baffled. So, they partly. start with this. very strong culture, creating a very. deliberate culture of how to eat. differently that begins at a very, very. young age. There are some other steps. that are a bit more dodgy that we can. come to, I'm sure, but that that was the. kind of um. first um. that was the first pillar of it that I. saw. And then over here we're in we're in. this sort of craze of injecting. ourselves with this thing called. Ozempic. Can I see the pen actually?

I've never actually seen one before. I. won't open it or anything. Of course. I won't contaminate it. My pen of Ozempic. I've just been so intrigued to see what. these things are like. Once weekly. Novo Nordisk. Novo Nordisk now the most valuable. company in the whole of Europe. What What are they? Give me some context. on Novo Nordisk. They're a Danish pharmaceutical company. So, there's two companies that are kind. of pushing the main drugs in this. Pushing sounds too pejorative there, you. know what I mean? So, Novo Nordisk who. are a Danish company, the entire Danish.

economy has had a massive growth because. of the popularity of these drugs. Since. they came out, they've become the most. valuable company in Europe. Um the. market for these drugs is predicted to. be $200 billion by the end of this. decade. Uh and the other one is Eli. Lilly. And if I. How do I get this? Do I have to go to a. doctor and get a prescription or can I. just go buy this on online or something? So, this is part of the problem and this. leads to one of the really big risks. associated with the drugs which is. eating disorders. I am really, really. worried about this. So, there are lots.

of young girls in particular, some boys, but it's mostly girls who want to starve. themselves, right? We know that. It. hugely rose during the pandemic and this. is the most effective tool for. self-starvation human beings have ever. come up with. So, I interviewed a lot of. eating disorders experts who are. terrified about what's coming down the. line and the truth is it is very easy to. get a hold of it. I went, you know, you. could go online now. You clearly do not. meet the criteria for getting these. drugs, right? You've got to have a BMI. of higher than 27 which is a BMI that. comes from fat mass, not muscle mass.

So, you would not meet the criteria at. all. If you went online, you could go. and see a doctor on Zoom, lie about your BMI and you would get it. in the mail two days later, right? Um. They're meant to check your BMI, but on. Zoom that's very hard to do. If in the unlikely event you were turned. down by a doctor on Zoom, you can just. order effectively counterfeit ones. online very, very easily. So, I'm. extremely worried I think we're going to. have a. There are many downsides to these drugs.

Possibly the worst from my point of. view, one of the two or three worst, is. you're going to have a huge wave. of young women who get hold of these. drugs and and do a lot of harm to. themselves. Now, there is something we. can immediately do to massively limit. that harm. Uh lots of the eating disorders experts. I interviewed, like Dr. Kimberly Dennis, is one of the leading experts in the US, said to me, "These drugs should only be. given by prescription if you go to a. physical doctor, and the doctor you.

physically go to to get them needs to be. trained in detecting eating disorders. and referring people for help with. eating disorders if that's what they. think they've got.". So, these were initially created for. people that had diabetes. They have a dual effect. So, GLP-1, the hormone GLP-1 and this kind. of replica of it, uh stimulates the. creation of insulin, which is obviously what diabetics are. lacking, either type 1 or type 2. diabetics. So, it was the whole thing. was discovered by accident. I. interviewed the guy who discovered it, a.

guy called Daniel Drucker, amazing man. So, they discovered He was just looking. at um So, your whole body is made out of. cells, right? And in the '70s, it was. discovered there were new ways of. looking inside cells that human beings. had never had before. So, by the '80s, 1984 was when he made a breakthrough, they were just going through different. cells in the human body trying to figure. out what they did. And they got to the. glucagon gene, which exists inside your. your pancreas, and they were trying to figure out So, the glucagon gene is a long chain, and. at the end of it is GLP-1. And they were trying to figure out,

"Well, can you break off that little bit. of the chain? Or if you break it off, does it just wither and die?" And he. discovered. Dr. Drucker discovered you can break it. off, and then he was like, "Well, what. does it do?" So, he starts experimenting. in lab dishes in Massachusetts General. Hospital, and he discovered that if you combine it. with insulin, it produces more insulin. So, that's why it's so valuable for. diabetics. And immediately, he was like, "Whoa, that's really significant." So, then other people in the lab, um. Professor Svetlana Mojsov, um gave it to.

rats, put it in rats, and discovered it. in fact produced insulin in rats. A team. in Copenhagen put it into the pancreas. of pigs, discovered it produced insulin. there, and that set in set in train what. later became giving it to diabetics. So, that's the most one obviously greatest. benefit of these drugs that was. initially discovered is they hugely help. diabetics. Then the effects around. appetite were discovered separately. initially here in in London in. Hammersmith Hospital. That was when they. discovered, "Oh, if you inject people.

with GLP-1," this is before they had. copies of it. "If you inject people with. GLP-1, it reduces their appetite." "Oh, okay.". You can see where their thinking went. from there. So, there's dual uses. And. the dual uses are kind of incredible. If. you look at when the effects on. diabetics obvious, but um. if you look at the health effects we are. emerging about these drugs, and this is. very close to my heart, literally, because of the heart problems in my. family, um if you take these drugs, if. you started with a BMI higher than 27, and you take these drugs over the next 5.

years, you are 20% less likely to have a. heart attack or stroke. So, we're. talking about This isn't something where. you're like, "Oh, this is vanity." Yeah, and there's an element of vanity in me. and in most people taking these drugs, I'm sure. But, this is having massive health. benefits for lots of people. How many people are willing to take it? Because as you as we discuss this now, say that there's I don't know, a. million, 10 million people that listen, what percentage of those people on. average would go, "Do you know what? That sounds like the thing I've been. looking for.". If they're Americans and the polling is. right, 47% of Americans have said they.

would be willing to take They want to. take these drugs, actively want to. want to. So, about 50% of this the. audience will be actively wanting to. take it as we sit here now. Yeah. And now tell me. why. they shouldn't. Well, there's a huge array of risks, um. some of which are very, very serious. So, I'll give you a few examples. I go. through lots in the book. There's So, in France called Professor. Jean-Luc Faillie, who works at the. university hospital in Montpellier,

who was commissioned by the French. medicines agency to investigate these. drugs and the safety around these drugs. And one of the reasons lots of people. have felt very happy about the safety of. these drugs, and it's a good reason, is. that in their rollout for obesity, as. people have said, like Daniel Drucker, for example, who I mentioned to you. discovered GLP-1, they say, quite rightly, "Well, look, diabetics have been taking these drugs. for 18 years now. If there was some catastrophic effect, we would know. It would have emerged in. diabetics, right? Now, he would also. add, well, it could affect obese people.

a bit differently than diabetics, so. there's some gaps in the knowledge. But. he said, look, we this drug has been. used by enormous numbers of people all. over the world without some huge safety. concern emerging.". But others have said, "Okay, let's really dig into those. diabetics then." So, that's what. Professor Faillie did. So, they've got a. they've got very good health databases. in France, the best in the world. So, he decided to look at. diabetics who'd taken these drugs for 3. years sometime between 2006 and I think.

2015. So, he looked at loads of the diabetics. who'd taken them, and then he compared. them to a group of other diabetics who. were very similar in every other way, but had not taken these drugs, to see if. there were differences in outcome. And. he was particularly looking for one. outcome. We know that when you give. these drugs to rats, they are much more. likely to develop thyroid cancer. So, he's looking, okay, is there a. difference in thyroid cancer risk. in this population? And what he. discovered was very sobering. It was. published. So, the people who'd taken.

the drugs had a 50 to 75% increase in. their risk of thyroid cancer. Now, when. I first heard that, I was like, what the. [ __ ] But you have to understand what. that doesn't mean. That doesn't mean 50. to 75% of people who take the drug get. thyroid cancer. If if it was that. outcome, they would pull it immediately, and no one would ever take it again. What it means is, whatever your thyroid. cancer risk was at the start, it will go. up by between 50 to 75% if this research. is correct, right? This then is being further investigated. There are some scientists who dispute.

it. The European Medicines Agency Agency. has not been persuaded by the evidence. so far. But that's pretty sobering, right? That's, you know, 1.2% of people. get thyroid cancer in their lifetime. 84% of them, I think, survive. You know, a big increase in people getting thyroid. cancer when you're talking about. millions of people across the world. taking it is is very alarming. What about this thing called Ozempic. face? Yeah, I'm not worried about that purely. for purely for selfish reason. So, Ozempic face is where um.

I'm not worried about it for other. people. Ozempic face is where you lose so much. weight that your face looks really gaunt. and you look kind of hollow and a bit My. face is so naturally round. Like babies. always smile at me. I think it's they. think I'm their king. I'm just like a. baby that inexplicably got to walk. around. Um I'm not I could lose so much. weight in my face and not look gaunt. that I not worried about that myself. It's there's no um. health problem with Ozempic face. It's. just, you know, It's a vanity thing. Well, no, vanity's too negative a word. It's, you know, people don't want to. look gaunt and ill.

That's fair enough. Pancreatitis. Pancreatitis is a rare side effect, but. it's very, very unpleasant. So, um. pancreatitis is basically. where uh your pancreas just goes haywire. as a result of taking these drugs. I. need to be a woman called Michelle. Stesney Atkins who's in Myrtle Beach in. North Carolina. She she started taking these drugs and. her doctor said to, you know, there's a. few side effects. One of them is. pancreatitis. And she said, "God, no me, like I'll probably get it." She starts. taking it. Was really happy with the. weight loss. Six weeks later, she went.

to Pittsburgh to visit her daughter. She woke up in the worst agony she's. ever been in. She had this excruciating. pain running all from below her breasts. around to her back. She was vomiting. She was [ __ ] herself. She was. screaming in pain. And her son-in-law. phoned for an ambulance. He thought she. was about to die. She was in such state. of distress. She arrives at the hospital and they. discover something gone really wrong. with her pancreas. They said, "Are you a. heavy drinker?" She said, no. Then they. said, "Are you taking Ozempic?" This.

kind of revealing that was the second. question they asked. So, we know that. if you take Ozempic, there's a study by. the University of British Columbia that. found it increases your risk of. pancreatitis by a factor of nine. So, you're nine times more likely to get it. It's still rare. You're very unlikely to. get pancreatitis even when you times it. by nine, it's still a very rare outcome. But, you know, doctors often compare it. to the pain of being stabbed. Michelle. said to me it was much worse than the. pain of childbirth, right? They had to.

give her fentanyl to take the pain away. So, if you get medical care, you recover. But, so it's worth people knowing that. is a significant risk of just an. excruciatingly painful condition. One of my friends has started taking. Ozempic, you know. There's this word on the side of this. pen in front of me, semaglutide. Semaglutide, yeah. What did I say? It's. It's You said it the way that isn't. intuitive, the way the scientists say. it. I think it's. It says it looks like semaglutide. Exactly, that's how I said it until all. the scientists kept correcting me in a. slightly patronizing way. But, yeah.

What's the actual word? Semaglutide. And is that the chemical and is Ozempic. the brand? Yeah, exactly. So, semaglutide So, there's there's several brands. So, there's semaglutide which is the. drug which has this GLP-1 agonist. effect. Ozempic is the one for diabetes, Wegovy is the one for obesity. They're. exactly the same drug. They're made in. the same factory. They're identical. It's just that Wegovy is marketed for. obesity and you can in the US, not here. yet, prescribe Wegovy for higher doses. than you would for diabetics. And then.

there's other drugs that are coming. along the line. So, there's Mounjaro. which is made by Eli Lilly. So, Ozempic or Wegovy produces an average of. 15% loss of body weight over a year. Mounjaro causes a loss of 21% on. average. And the next one that will come. down the line, it's probably going to. come out next year, triple G, causes. 24.2%. The reason Mounjaro works differently, so this only works on GLP-1. Mounjaro. adds another gut hormone, GIP. So, it. works on two gut hormones, not just one.

And triple G works on three gut. hormones. And there's going to be more. and more drugs. I mean, there's 37 gut. hormones that can affect appetite, they. think. So, there's going to be lots of. variants of these drugs with different. side effect profiles, different risks, different benefits. So, yeah, this is, you know, one of the a South African. psychiatrist called Carel le Roux, who's. been at the absolute forefront of the. developments in this, said to me, you. know, when a baby starts to walk, it's. been crawling for ages, and then it just. stands up, and it walks. And we are at.

that point. And it was striking how how. much the scientists kept describing it. as a game-changer. You know, one of. them, Tim Spector, who I think you might. have had on, described as, um, it's like. they found the holy grail. They found. the thing that causes weight loss, right? Uh, Robert Kushner said that to. me, who's another one of the scientists. been at the heart of it, said, "We. cracked open the treasure chest. We. found the thing that controls weight. It's your gut hormones." So, I worry about the parallels with. previous diet drugs, and we can talk.

about that. These are new drugs working. in a new way, and the. overwhelming feeling in the science is, "No, this really is different.". My friend is, um, a biotech billionaire, and, um, when I I saw him last, I'd say. he's at the very forefront of all of. these things. He takes so many different. things to optimize his life. One of them. he started taking is a Zempic, and last. time I saw him, he was, um, we're in the. gym together, and he was significantly. weaker. He was significantly skinnier, but I noticed when we did our exercises, he was significantly weaker, as well.

And that strikes me as a bit of an. unspoken And side effect is muscle loss. It's one of the 12 big risks that I. write about in the book. So, muscle mass. loss is a real problem. People who don't. know, muscle mass is the total amount of. soft tissue that you have in your body. and it's essential for doing anything. that requires movement and strength, basically. And any form of weight loss causes a. reduction in muscle mass. So, if you if. someone's very overweight and they lose. a huge amount of weight on a diet, they lose a lot of muscle mass. Hopefully, you lose more fat mass than. muscle mass, but you lose a lot of.

muscle mass. control that, right? You just. There's no way to lose a lot of weight. that doesn't involve some muscle mass. loss unless you're very, very lucky, right? Um. So, obviously, this triggers a huge. amount of muscle mass loss and there's. real worries with that, right? Um. If you lose muscle mass, so you. naturally lose muscle mass from when. you're 30 onwards anyway. You lose quite. a lot every year. It's incredibly. depressing when you look at the figures. You lose muscle mass naturally every. year anyway. Um. But if you lose too much muscle mass, you won't You'll be a bit weaker now,

but the real risks are when you're. older. So, if you. have really low muscle mass when you're. older, you're at risk of a condition. called sarcopenia, which is Greek for. poverty of the flesh. Basically, just. means you'll really struggle to climb. the stairs, do any kind of physical. activity. You're more likely to fall. If. you do fall, you're more likely to die. It's It's quite a serious thing and this. I think is particularly going to be an. issue for. people who are already skinny, like the. people at that party we were talking. about right at the start. None of them.

were fat at the start, right? People who. were already skinny, who are taking it. to be super skinny, they're going to see. they're going to have real issues with. their muscle mass likely when they're. older. So, this is a very serious. problem. We could be building up a time. bomb of more frail older people further. down the line. You lose up to 20 to 30% of your lean. muscle mass when you start taking. Ozempic, it says in your book as one of. the risk profiles. That's That's for some people, yeah, not. for everyone. Actually, weirdly, I was. 33% fat mass when I started and I went. down to 22% I think it is now. So, I. lost nothing but fat mass, but I suspect.

that might be for the slightly. humiliating reason that I had no muscle. to start with, but I'm not sure. And then on on the psychology, the. mental health side of things, suicidality is some cases where. suicidality, things like feelings of. anxiety and depression increase. Is that. because of the underlying reasons why. we're eating, the self-soothing stuff, or is that a separate side effect? So it's hugely debated. There isn't even. agreement that it the drugs cause that. effect in a minority of people. You've. got to bear in mind. at any given time some of the population. becomes suicidal, some of them will be.

taking these drugs. So you it's very. hard to disentangle that, especially. early on. Uh so some scientists would say there. isn't even any evidence they cause. suicidality. Among the scientists who. fear that it may cause suicidality, there's a big debate. Some of it will be you're deprived of. comfort food, uh or pleasure. Some of it. will be, as Corrine Rupp put it to me, a lot of people who are overweight for a. long time say, "You know, the reason my. life is [ __ ] is cuz I'm overweight. If I. finally lose weight, my life will be.

good." And then they lose weight, and. they've still got the same [ __ ]. husband, and they've still got the same. job they don't like, and they suddenly. go into this crisis where they're like, "Oh, it wasn't the weight that was. blocking me. It was everything else, right?". They say, don't they, that the. difference between like happiness is. your expectations and reality. So you. can imagine if you have that expectation. that losing this weight's going to make. me happy, and you fall short of the. expectation because it doesn't, the. anticlimax. can cause so much psychological. discomfort.

Yeah, and I spoke to people who've been. through that, and I think that's that. that can be a really a really big issue. There's also with suicidality, so some other people who would say, "Well, okay, the psychological effects. are probably real, but it might come. back to what we were saying about. dampening the reward system in the. brain, right?" There were people like, um Professor Patricia Grigson, who's. done some of the really cutting-edge. research on effects with addiction in. this, who said to me, you know, that's a. real concern. Now, she stressed we don't. know yet. No one definitively said. "Yes, it is causing these problems and. we know how.".

It was weird. It was like a um. Like I said before, it's you're seeing. this picture form. It was fascinating. that you're There's so much we don't. know, which makes it kind of. disconcerting. It's like, "Oh, so this. is an experiment on millions of people. and I'm one of the guinea pigs. Great, right?" So, it's disconcerting how much. we don't know. Um. but yeah, that is a big worry. And we've been here before with diet. drugs as you were alluding to. Where we kind of rush in to the party. and then everyone rushes out of the. party cuz we realize that. The history of diet drugs, Stephen, is.

absolutely grim beyond belief. So, the. first kind of modern diet drug was. something called dinitrophenol. So, there were a load of um people in France. who were working in ammunitions. factories during the First World War. And people noticed that they lost loads. of weight, right? Not that they had They. didn't have weight problems at the. start, but they lost a huge amount of. weight. And it turned out they were ingesting. this explosive powder, you know, through. their skin and breathing it in. So, after the war, a load of scientists at. Stanford were like, "Oh, maybe this can. be a weight loss treatment." So, they. made it into a pill called reducols, uh.

which were very popular. There was. 100,000 people taking them in 1934, which when you consider there was very. low obesity back then, that's a huge. number of people. And then they discovered just. I mean, it's it it is almost. unbelievably terrible what happened. So, loads of the people taking them went. blind. And then they went into this horrific. fever where their bodies were burning. up. So, it's an explosive, right? So, it. was discovered that the way it works is. it massively speeds up your metabolism. But when you take a high dose, it gives.

you cataracts, makes you go blind, and. then your body goes into a fatal fever. And the way one person put it is you. become cooked from the inside. So, they stopped marketing that one. It. continued to be used as a pesticide for. like years and years cuz it is so good. at killing anything it comes across. So, then there was a craze for. amphetamines. So, during Again, during. the a war, during the Second World War, radar, um, people had to watch radars, soldiers who had to watch radars. were extremely bored. So, they gave them. amphetamines to sort of keep them on the.

job, keep them active, mentally alert. And it was discovered they lost loads of. weight, as well. So, after the war, they. started marketing amphetamines as a. weight loss drug, right? And they became. hugely popular. They were described as. "Mother's Little Helper." By the time. you get to 1970, 8% of all the. prescriptions in the United States were. for amphetamines for weight loss. But, it was discovered that. when you take amphetamines, you develop. tolerance to them. Your body gets used. to them. So, you need higher and higher. doses to get the same effect. But, if.

you take really high doses of. amphetamines, you just lose it. I mean, you can become psychotic. You it has a. really bad effect on you. You don't. sleep. It's terrible. So, then there was. a real rolling back of amphetamines. And then there were some real horror. shows, like jaw wiring, where they would. wire up the jaws of obese people so that. they could They literally couldn't get. any food into their mouths, but then it. was discovered if you vomit while your. jaw is wired, you can choke to death. I. mean, just like nightmarish, horrifying, humiliating solutions. And then we get. to a the worst of them all,

and also the most popular of them all. until these new drugs, which is called. fen-phen. So, this was in the 1990s, early 1990s, a group of scientists decided to combine. two diet drugs that had existed until. then. One was called fenfluramine. It's. an appetite suppressant. But, it was. never very popular cuz it makes you very. drowsy. So, they combined it with. phentermine, which is an the kind of it counteracted. the drowsiness, and it had an additional. weight loss effect. And it worked. incredibly well. People taking it lost. as much weight as they lose on Ozempic.

And it's actually eerie when you go back. and look at the coverage. Front page of. Time magazine, "The New Miracle Drug". was the headline, you know. By the time. you got to the mid-90s, there were 18. million prescriptions for fen-phen. every year in the US. And then a group of ordinary doctors in. Fargo in North Dakota were like, "A lot of our patients are getting. really ill. when they take this." And raised a. safety signal. Turned out the drug. company had known about this risk all.

along. So, it was discovered that when. you take these drugs, they cause. something called primary pulmonary. hypertension. It's where the blood. vessels in your lungs massively contract. and you can't breathe properly. They. also damage your heart. I mean, the. stories were just horrendous. There was. a. a young woman in Massachusetts called. Mary Linen who was about 28, wanted to. lose weight for her wedding day, starts. taking fen-phen. Couple of weeks later. is trying to climb a hill and just gets. really breathless. And it's like, "Something weird here.".

Goes home, is really breathless, goes to. the doctor, he takes her off the drug, but by then she had the problem. Um she. needed oxygen her whole life. She was. told she could never have children. And. then one day she she couldn't breathe. and she died. This happened to lots and. lots of people. It led to the largest. payout in the history of the. pharmaceutical industry up to that. point. They had to pay 12 billion. dollars to the people whose hearts and. lungs were harmed. And that is not that. long ago. Now, I want to stress again, that was given to people with a very.

poor There was a single study of 120. people of fen-phen at the point at which. it was marketed to people, which is. staggering. This has a much bigger body. of evidence. So, this is not going to be. in the short term fen-phen. But when I. looked at the 12 big risks associated. with these drugs, some of which have not. really been explained to the public, one of the ones that was most. disconcerting, and was explained to me. by a brilliant scientist called Greg. Stanwood who's at Florida State. University and is researching these. drugs, the biggest risk is what he called.

unknown unknowns. So, you remember that. Donald Rumsfeld thing, right? So, when. he was talking about the invasion of. Afghanistan, but um. when he was the US Secretary of Defense, says, "You know, when it comes to these. things, there are things there are what. are called known unknowns. There are. things we know we know. There are known. unknowns. There are things we know we. don't know. Where is Osama bin Laden? And there are unknown unknowns. Things. we don't know we don't know that might. hit us out of the blue. And with these drugs, there's a big. worry about longer-term unknown.

unknowns. So, for example, we know very little about what happens. to pregnant women when they're taking. these drugs, right? We know that in the. animal studies, um when animals are. other non-human animals are exposed to. these drugs, they're much more likely to. get birth defects. So, one thing Dr. Stanwood said that we should think. about, and he stressed this is. speculative, we don't know, was think about antipsychotics, right? In the 1950s, doctors started giving. people antipsychotics. They were judged. to be safe. Lots of people dispute that, but park that for a second. And people.

took them for many, many decades. And. then it was discovered really late in. the day that when you get into your 70s. and 80s, if you've been taking. antipsychotics, you are much more likely. to get Alzheimer's disease and other. forms of dementia, like much more. likely. Now, there's no way you could have known. that at the start. It was an unknown. unknown, right? You couldn't have known. that. You had to have people taking it. for a really long time before you could. find that out. Now, one of the concerns. about these drugs is that there will be. unknown unknowns that we can't know. about. These drugs are working on your. brain. They are working very hard on key.

parts of your brain. Parts that relate. to memory processing, taste processing, um gut motility, right? We don't know, but. there's at least some risk there. Now, again, you have to weigh that against. the risks of obesity. As Dr. Shawn. O'Leary, who's at Tulane School of. Medicine, put it to me, we don't know. the long-term risks of these drugs. We. do know the long-term risks of obesity, and they are horrific. Really horrific. And much worse than I thought at the.

start. You know, for example, I'm just quite embarrassed to say this. Diabetes, right? Okay, I knew that you. were more likely to become diabetic if. you were obese. Um figures on that are kind of shocking. If you were obese when you were a. teenager, your your chances of. developing diabetes are 70% in your. life, right? Shocking. But I thought, all right, diabetics, they get insulin, and then they're. basically like the rest of us, right? As. long as you've got health care, you're. fine. Interviewing doctors, they were like, "No, no, no. Lots of people think that. If you get diabetes, it it knocks on.

average 15 years off your life." There's. a doctor here, Dr. Max Pemberton, a. close friend of mine and a brilliant. doctor, who said this thing to me, it. seemed really shocking when he first. said it. But then he went through the evidence. He said, "If you gave me a choice. between getting diabetes or becoming HIV. positive, I would choose HIV every time. If you become HIV positive, as long as. you get medical treatment, you live as. long as everyone else. If you get. diabetes, you know, not only does it. knock 15 years off your life, your. chances of all sorts of catastrophic.

complications in your life are really. high. It's the biggest single cause of. blindness in Britain, preventable cause. of blindness. It's a massive cause of leg amputation. More people get an extremity cut off in. the US cuz of diabetes every year than. because of being shot, right? I mean, it's And you go down the list of all the. harms associated with obesity, diabetes isn't even number one, right? So, every time I talk about the risks of. these drugs, I really worry about the. risks of these drugs, right? There is a.

lot of them. People should go through it. very carefully. If you have thyroid. cancer in your family, for example, I. would strongly recommend you don't take. them. If, you know, you're already um. worried about your muscle mass, don't. take them. There's a whole range of. caveats and clauses. But we have got to be honest about the. risks of obesity. And for me, if I'm being honest, I think. the choice was ongoing obesity or these. drugs. And so, for me personally, I have. made the judgment call after looking at. all of this evidence, that I'd rather take the risks of those.

than pick them the risks of going obese, especially given my family's history and. how many men die young of heart attacks. But, loads of people will look at the. evidence that I present in Magic Pill. and take totally the opposite point of. view. And they they may well turn out to. be right and I might well turn out to be. wrong, right? I wouldn't debar that. there's a fen-phen like scenario down. the road, right? I don't It's not. likely, but you'd be a fool to dismiss. it. I am in a different camp and I have to. say before I express my own opinion that. I understand there's a lot of people out.

there where drugs like this will. literally save their life. And if they. don't take these drugs, then, you know, you've gone through some of the stats, but they I mean. they will probably die from something. with you know, some kind of form of. you know, we talk about all cause. mortality a lot. Like something will. kill you in the next couple of years, whether it's cardiovascular issue or. something related to. another element related to obesity. My thing, and this is I think developed. over time with doing this podcast and. speaking to so many experts in health.

and fitness and wellness and psychology. and psychiatry, is I just have this really deep innate. belief that. there's no such thing as a free lunch. in life. And I just the more I've done these. interviews, the more I've come to learn. that everything is a trade-off. And I almost see life as like a scale. So, if you if you if you if you put a. weight on one end, there's going to be. an equal and an opposite force somewhere. else. You know, like the What's the law. of physics? Is it Einstein that said.

that that you can't like. destroy energy, you can just move it? And I think about the same with like. drugs often and other things that seem. like miracles or shortcuts. You're. you're moving the set of issues. somewhere else. You've talked about some. of those movements today, like the. psychological transfer of. soothing behavior to an addiction, for. example. That's always been my like. belief that whenever one of my friends. says, "Steve, I'm taking this. uh pill, modafinil, and it's making me. super productive and it's fixed all my.

problems in life and I'm killing the. game now. I go, "What's the cost?". Yeah. And my friend said to me, I remember. when it he started taking it, he was. like, "There's no cost. There's no side. effects." And my brain goes, "Mhm, history shows if you wait long enough, there's always a cost. It's just being. conscious of the cost. And when you. balance up, as you've done in your life, the pros and cons, you say, "Okay, I'm. willing to take the cost." Now, when I. see things like Ozempic and people say. to me, "There is no downside.". I get more scared cuz I can't run the.

numbers to see whether the cost is worth. the upside for me. So, I don't know what. the. the big obvious downsides of Ozempic and. these magic drugs are, but I feel like. logically there must be one. We do know there are some medications. where pretty dependably the benefits. outweigh the risk. Think about statins, right? If you have a problem with your. cholesterol, what statins do is they. block. part of your body that makes. cholesterol, right? So, it's the most. commonly prescribed drug in the US. It's.

pretty close to it in Britain. Almost every doctor would agree there. are some downsides to statins, but. sometimes they're just like. And you have to stay on them for life, right? have to stay on them like with these. drugs, right? Even the minute you stop. taking them, so within a year of. stopping, you regain 70% of the weight. you've lost, right? This is one of the. big questions around these drugs. Now, that's not 100% of the people regain it, but it's most people seem to regain. their weight. So, I think there are. sometimes when a drug, a medication, I'm. not saying these drugs are that, definitely not, but there are some.

medications which do seem to be just. not that there's no cost, but the. benefits are really unambiguous and. massively outweigh the cost. This is a. much more finely judged thing. And it's. interesting to me, it's been funny. talking to people who've read the book. because. when we were talking to the marketing. teams at both my publishers, cuz some people. who were the first people to read the. book apart from my friends, so some of them came up to me and said, "Oh, Johann, I loved your book. It made. me really want to take Ozempic.". Some of you came up to me and said, "Johann, I loved your book. It made me. think convinced that you'd have to be.

completely insane to take Ozempic." And. it was a bit like, you know, the dress, the uh some people saw it as gold, some. people saw it as blue. And I I felt like that meant I'd done my. job because. unlike pretty much everything else I've. ever written, I've ended this feeling as conflicted. almost as I was at the start, right? This is. a huge thing. It's going to change, and we've talked a. lot about the personal dilemmas. It's. going to have a huge social effect. Barclays Bank commissioned a very.

sober-minded analyst named Emily Field. to um. make predictions that could guide. investment based on these drugs. And she. said, "If you want an analogy, you have. to think of the invention of the. smartphone.". Right? I mean, this is going to have so. many unpredictable effects. Um already, Krispy Kreme donut stocks have been. tanking. The head of Nestlé, Mark. Schneider, has said we're they're. worried about their ice cream and. confectionery ranges. Um. Jefferies Financial did a report for the. airlines in the US saying they're going.

to have to spend much less on jet fuel. pretty soon because it costs takes so. much less jet fuel to fly a much thinner. population. What I was fascinated by is. um. companies that manufacture hinges for. knee and hip replacements. are seeing their stocks tank. because people are going to need far. fewer knee and hip replacements cuz. that's overwhelmingly that's driven by. obesity, right? So, not entirely, but. overwhelmingly, um. So, yeah, if we were talking in 2007, when the day Steve Jobs unveiled the. iPhone,

I don't think we could have gained out, you know, 1/10 of what was about to hit. us. And I kept having these moments. traveling all over the world. interviewing these experts. Remember one. day, I was in a cafe I was interviewing one. of the key neuroscientists. at Cambridge University who was working. on this. We were in a cafe. and there were loads of people walking. past us, you know, just random British. people, a lot of whom are overweight or. obese like I was. And I was thinking, "Wow, you don't know.

what's about to hit us all.". It was a slightly weird, unreal feeling. I mean, this is is for better and for. worse, and I think there will definitely. be positive effects and there will. definitely be negative effects. And I think we can see early on what. quite a lot of them are. This will change the lives of all of us. in one way or another. How do you guys manage your stress? This. month is stress awareness month and it's. a topic that I'm super passionate about. and we talk about a lot on this podcast. I personally manage my stress by.

prioritizing my health and well-being. Going to the gym is my number one form. of therapy and I couldn't be without. those two things. As you guys know, Whoop is a sponsor of this podcast and. I'm an investor in the company as well. For those of you that don't know, Whoop. actually created a stress monitor within. this device. Not only does this help me. to identify periods of high stress in. real time throughout the day, but it. also provides me with the tools I need. to deal with stresses as they come up. throughout the day and it's based on. scientifically backed breathing. exercises and research that's been.

developed by leading neuroscientists. It's a feature that has been. game-changing for me and I highly. recommend, if you're someone that's. looking to manage your stress levels, then head over to join.whoop.com/ceo. where we'll give you 30 days risk-free. and zero commitment to try Whoop. Let me. know how you get on. I'm just I was thinking as you were. speaking there about a bunch of. statistics that I've read recently. Humans are getting more and more. sedentary, which means we're moving a. lot less. Um obviously obesity's going.

up across the sort of western world um. most obviously. Uh and then you've got this rise in. Ozempic which allows us to stay skinny. basically and suppress our appetite. I. was just wondering there's going to be. it feels like there's going to be two. groups of people when these drugs drop. in cost and they become really. accessible. And I I saw you say in the. book that the next sort of iteration of. these drugs is going to be a pill. A lot. of people won't want to inject. something. I'm one of the people that. just I'd get too squeamish about having. to inject myself. So the minute. something becomes a pill it brings down. one of the psychological barriers. It's.

cheap, it's a pill, a lot of people are. doing it. If you're not doing it. in the obesogenic whatever that long. word was environment we live in. It's almost like you're going to be a an. inferior human to some degree. Like. there's going to be two parts of. society. The 50% that are down to take. the pill and they're going to be skinny. and they're going to be whatever. And. then the 50% that are struggling in this. this difficult food environment we live. in with the ultra-processed food. Um I can't I almost can't play out a. scenario where most people aren't taking.

this magic pill. So there's a few assumptions in what. you've said. Um I think I'm probably. right but there's a few assumptions. So. in a way what you're saying. there's sort of few different dystopias. that could emerge. One is actually that we don't even get. to where you are because it's restricted. to a tiny number of rich people, right? So let's start with the first like. dystopian vision we could have. The. first is that we never even get to that. point. Let's imagine we basically we.

have a situation at the moment where the. real housewives of New Jersey get to be. super super skinny and the real school. children of New Jersey get diabetes at. the age of 12, right? So we could have a. situation where these drugs exist and. they work very well but they are. restricted to a tiny elite of rich. people which is. kind of where we are, But it's not it's not going to stay like. that though, is it? In the longer term it won't and it's not. that far off. So in 2032 the patent on. Ozempic passes. So then it's not. actually that expensive to make these. drugs. It's $40 a month to actually make.

them. It's the rest is profits for Novo. Nordisk who argue understandably, you. you look we took all the risk of. developing this, we should cash in now. Um you can see that argument, although I. don't think they need to cash in quite. as much as they are. Uh so, one scenario. is it go it will go out of patent in. 2032. By then, it looks like the main. way of taking semaglutide will be pills. anyway. So, you can well imagine a. situation where you've got $40 a month. to take a daily pill that will make you. much thinner. I think in that scenario, you're right. Now, what I most hope.

is that A, the drugs don't have a. catastrophic side effect, obviously. B, the people who want them get them. And C, it wakes us up and we go. how did we get to this point? How did we. get to the point where we're looking at. potentially drugging our children. forever, not knowing the long-term. effects? Who did this to us and how can we be. more like Japan and all the other. countries that are making these changes? Now, that's optimistic. That requires a. lot of uh.

raising of consciousness between now and. then, but that's the most optimistic. scenario. I think you're You're totally. right. There could be a a scenario, it's. probably the most likely scenario if. there isn't some big risk that emerges, that we'll just have staggering amounts. of the population taking these drugs. Unless the government intervene, that. feels like the most likely scenario. Unless the government introduce some. laws that put restrictions on what. children can eat at school and all those. kinds of things in a more severe way. I. can't see a scenario where. especially with this younger generation,

you know, you hear all these stats. around young girls on TikTok being more. anxious than ever before, the. suicidality going up. Men are struggling. more than ever with body dysmorphia, which no one's talking about. Um I was. reading some stats about that yesterday. Yeah, shocking the figures on that. And the antidote appears to be. I mean, this. It's not a good solution, right? And. perfectly normal, healthy people. who just have a little bit of belly fat. And they hear this, you know, they hear. about this stuff. They go, you know,

I've got to the gym is hard and I do. love those burgers, and that KFC is. really nice. It just tastes really good. So, I could eat my KFC. and I could stay skinny." Well, if they. think that last bit, then they're wrong. You you if you take it, you won't want. to eat the KFC and the burgers. And. believe me, I've been the king of KFC. Just three bites. I've got a couple of. bites, though. Well, but you don't get you actually. don't even want that particularly, right? And huge numbers of people are. saying that. I mean, for most of the time I have been eating. smaller portions of similar [ __ ] but um. actually, you even your taste for that.

tends to kind of wane over time, right? So, the last bit's wrong, but I think. yeah, you. it's one of the things it's funny I. didn't. it's one of the things that made me. really angry in Japan. I was thinking, all this agonizing I've done, all this worrying, and I worry even more about the fact. we're almost certainly about to start a. mass wave of drugging children with. Ozempic. It's already begun in the US. I. interviewed parents who are drugging. their kids. because their children are obese.

And I thought this whole dilemma never. had to happen, right? This happened. because the food industry screwed us. over, and we didn't regulate them, and. we didn't stop them. And we can start to. do that. And I went to places that have. done it. I went to Mexico where they. introduced a sugar tax. It hugely. reduced the amount of sugar that people. consume. I went to Minneapolis where. they prescribe healthy food for poorer. people who can't afford it. It has a. really positive effect. I went to. Finland where they had a huge. transformation in the food supply. I. went to Japan. There's load Here in. Britain, there's a really interesting.

experiment. Bread used to have far more salt in it. And a really heroic guy called Professor. Graham McGregor, who I interviewed, persuaded the government to just. to get the food companies to sort of. lure them. I mean, they would have they. threatened regulation, which meant that. the companies gave in before they did. it. To just massively reduce the amount of. salt in bread. No one even noticed, and it reduced. strokes every year in Britain by between. 6,000 and 9,000, right? And a stroke is. one of the worst things that can ever. happen to you. Now, we could do It's called. reformulation. There's loads of other.

things we can do like that. We could. reformulate loads of foods in ways that. aren't even painful to us, right? There's so much we can do. There's so. much we can do to be like Japan. I mean, it was a bit weird in Japan though. because there were things. they did. that we can't do, right? So, I'll give. you an example. This was one of the. weirdest days of the research for the. book. In 2008, obesity very slightly went up in Japan, but it was still like laughably low. And they had a real panic, and they. introduced this new law. It's called the.

Metabo Law. Um it's named after metabolic syndrome, which is a really nasty combination of. like diabetes, obesity, and other. problems you can get when you're when. you're very overweight. And um the law is very simple. Every single company in Japan on a. particular day every year has to weigh. every single person who works there. And if their weight has gone up, they. have to draw up a plan with their. employer to bring their weight down. And. as a company overall, if your weight. goes up, you can be fined by the. government. And I said, "How could this.

possibly work?" So, I went to a company. that does it, Tanita. They They all do. it, but a company that let me go and see. how it works. And it's really weird, right? You At. this workplace, you arrive, you show. your face to a video screen, and it. says, "Hi Stephen, you walked 14,000 steps. yesterday. You're number 121 in the. company in terms of steps taken." cuz. everyone has to wear like a Fitbit or. the equivalent to a Fitbit. Everyone uploads pictures of every meal. they have to this system where you can. see it. It was bizarre, right? Um.

And yeah, explain to the Japanese people. who kept going, you know, every morning in this office. when we'd all be having donuts and. coffee, they do aerobics together. It was. bizarre. And I would sort of explain to these. Japanese people, right, if you try to do. this in Britain, we would burn the. [ __ ] office down, right? Like And. they were just going, "Well, why?". "Why?". They couldn't understand why I was so. affronted by it. And that okay, that's a. big cultural chasm. And we can't do that. and I wouldn't want us to do that, but.

if you look at so many of the other. changes in Japan, I started to see like what you win if. you get this right. So, Japan has the. longest life expectancy in the whole. world. And one of the best things I did for the. book, one of the most moving things for. me, is I went to the oldest village in. the whole world. It's in Okinawa in the. deep south of Japan. And there's a village called Ogimi where. there's 215 households and 190 of them. have someone who's over the age of 90. living there, right? So, it's the oldest. place on earth. Um Japan has the by far the longest life.

expectancy in the world and not just. that, um you're far less likely to get. sick as you age. So, they have not just. more life, but more healthy life. And I went to their little community. center. And the first person I met was a. 102-year-old woman called Matsu Fukuchi, who was this like almost like this kind. of perfect crumple of wrinkles, right? And she was so cheerful and we were. chatting to her. She was like, "I can't. stay for long cuz I'm looking after my.

son who fell off the roof the other day. fixing it." I was like, "Jesus, how old. is your son?" Um and she was like, "Oh, I I love you know, she she was so full. of joy. She was like, "I love life. I. spent all of yesterday watching. volleyball with my grandchildren. It's. so great." She was so happy. She'd walk. there on her own. And then there was this moment where. they put on some music. She put on this. red kimono and she started dancing and. all these old these women as old as a. century start dancing, right? And I. danced with her.

And I was thinking, "God, this is. this woman was born before radio started. broadcasting in Japan and here I am. recording an interview with her on my. iPhone. This is what you get if you get this. right. If you sort out the obesity. crisis, you get to have more years of. health and joy and dancing, right? That's what we're fighting for here. I. think about. how many people I know. who died young.

because of complications related to. obesity. Everyone listening and watching. will know someone who would be alive now. if we had sorted out the obesity crisis. but has died. Everyone, right? And. it doesn't have to be this way. You know, now part of that solution in. the short and medium term is going to be. these drugs. In the longer term, it. doesn't have to even be that, right? Japan is a real country. It exists. They. solved this problem. There are other. countries in the world that are solving.

these problems. We don't have to. tolerate this being done to our. children. We don't have to accept us. being made sick and our children being. made sick. But it requires an awakening. around what's really happening, who's. doing this does at the moment. You know, whenever I. my weight goes up and down, right? It. has gone up and down throughout my life. And whenever I was fatter, I would blame. myself, right? I wasn't angry with the. forces that have done this to us, right? More three-year-old children know what. the McDonald's M means than know their. own last name, right? I didn't choose.

that world. I didn't choose to live in a. world where we were, you know, constantly promoted and fattened and. physically changed such that it's hard. to come back, right? I don't mean I had. no responsibility in that, I did. But. we don't have to continue like this. Do you think you could stay at the. weight you are now. without this, Ozempic? It's funny you're holding this. I feel. like we're in a weird dystopian version. of QVC, right? Um. do I think uh. Honestly. Well, if I'm typical, we know from the.

clinical trials 70% of people regain the. weight within a year. No, I don't think. so. If I'm being really honest with. myself, I don't think so. I think I have. made lots of changes in my life that. mean I don't think I would go back to. quite where I was. But I think I would very rapidly regain. a lot of weight. So you have to take this for life now to. stay at the way you're at therefore. Yeah, and there's a big debate about we. mentioned before with the amphetamine. based um. diet drugs from the past that people. develop tolerance. One of the big question marks around.

this is do people develop tolerance? Does it mean that over time it will have. less of an effect, right? Now some. scientists the scientists asked about. this just were wildly all over the. place. Some said no, we do know. diabetics don't seem to develop. tolerance. They because if they did they. would need higher and higher doses to. get the same level of control for their. blood sugar. So that's a point against. tolerance, but others said. it would seem quite likely we'd develop. tolerance. We develop tolerance for most. drugs. It would be surprising if we. didn't. Probably what's most likely. again Carel le Roux the South African.

psychiatrist said to me. again probably the best comparison is. bariatric surgery. You have bariatric surgery. you lose an absolute [ __ ] ton of weight. and then you regain a little bit of it. over the next few years and then you. sort of plateau at that higher point. But we don't know. Truth is no one. knows. I'm also concerned that if you is there. a world where if you stopped taking this. your body had become reliant on your. GLP-1 coming from this so your body. makes less GLP-1 itself?

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

problem with it and it had to be. withdrawn would I then. have a slower metabolism and be fatter. than I was the start. Yeah. No one knows that's a significant risk. And the other big sort of risk here is. you've talked about a few times is this. eating disorder um epidemic. It seems as. I think you talk about in your book that. since March 2020 rates of anorexia and. bulimia were 42% higher than they would. be expected for teenage girls aged 13 to. 16. I think that's cuz of lockdown to be. fair. That's not that's not a result of. the drugs. That's cuz of the massive.

stress of lockdown, yeah. some research in the Lancet journal. and 32% higher for those aged 17 to 19. What I'm saying here is that we we do. have an issue with eating disorders in. the in the Western world especially. Um. they they skyrocketed after the the. pandemic. But when I think about eating. disorders and bulimia and anorexia, I. think about this. and what it might. mean for those eating disorders, I feel. somewhat concerned, especially when kids. get their hands on them. Go beyond concerned. And we don't have.

to speculate about this. We've been here. before. So in the early '90s, there was. a very popular amphetamine-based diet. drug that was marketed in the United. States. And it was huge. And lots of teenage. girls used it and it led to a. catastrophe. There was a guy called Rob. Wiener who was a congressman for Ohio at. the time who held congressional hearings. on this. And they are really chilling to. read cuz they show what happens. when a popular diet drug combines with. eating disordered young women, right? So. there was a a woman called Jessica.

McDonald who testified at the hearing. She was a she was in her early 20s at. the time. So she was a ballet dancer. Obviously we know about the horrendous. pressures on body shape for ballet. dancers. And she would take this drug like this. amphetamine-based drug until she passed. out to be thin. She would take it to. starve herself cuz she wanted to be that. that ballet shape. There's a guy called. Tony Smith from State Center in Iowa. who testifies that his daughter Noel. from when she was very young became. obsessed with the idea that she was fat.

She would go and look at these fashion. magazines and say, "Daddy, do you think. I'm fat? Why don't I look like these. women?". And she got hold of these diet drugs, massively starved herself, and died of a. heart attack. And he read out this. heartbreaking poem. where she describes, like, you know, "I'm hungry. I want to eat, but not yet. Not yet.". Right? So, we know that when a diet drug. combines with eating disorders, it leads. to catastrophic outcomes. We don't have. to speculate. So, yeah, that's one of my. three or four biggest concerns. Now,

like I say, we can introduce regulation. now to mean you only get it from a. doctor. The doctor has to see you. That. will cut some of that. But I don't see. how it And And that's really important. And anyone we save is worth saving. But. yeah, I'm very, very concerned about. that. I'm also concerned about a more. subtle effect in relation to that. So, the worst moment I had in writing. the book was not any of the physical. side effects for me, although there were. some grim moments there early on. It was a moment when um. So, my I've got a niece called Erin, and.

she's 18 now, although she's 19, actually. But in my head, she's sort of. 6 years old all the time, like cuz she's. the baby in my family. She's the only. girl. She was the youngest. So, no one. makes me more protective. And one day, a. few months into taking these drugs, I. was FaceTiming with her. She was in a. pub in Liverpool. And she was like, "Oh, Johann, you've. lost so much weight." And I was all. preening. She's like, "Oh, look, I can. see your jaw. I never knew you had a. jaw." And I was like, "Oh, yeah, I was. thinking you're happy." And then. she looked down. and she said,

"Will you get me some Ozempic?" She's a. perfectly healthy weight. She always has. been. And I thought, "What the [ __ ] am I doing?". All her life, I've been trying to give. her this message, "Don't be judged by how you look. Don't. worry about that, you know?" And I. thought, "Oh, I've counteracted. everything I wanted to communicate.". And we know. And And she decided not to take it. And. it all And And it fine with her, but. when I was a kid, there were no fat.

people on television except just the. butt of the joke. And I think about my. niece, she's grown up seeing actually. quite a lot of women who are a broader. range of body shapes in the public eye. And in the last 2 years, almost all of those women have massively. shrunk. Now, they're not talking about Ozempic, but. unless there's been some kind of. outbreak of dysentery in Malibu, I think. we know what's happening, right? Some of. them are talking about it, but most are. not. Can I just ask on that? Cuz we've seen a. lot of very famous faces suddenly shrink. over the last couple of years. And when you read their autobiographies, they talk about like going to the gym.

and eating getting their lifestyle. right. Do you think they're lying? I mean, obviously. Yes. It does appear I wasn't sure if it was. just me, but I look at I look at think. about a lot of people that were a little. bit bigger, and it seems that suddenly everybody's. kind of cracked. weight loss. And it's rapid, and it's super fast. I. don't want to name any particular names. cuz it's not my place to talk about. individuals like that, but it really. does seem like Hollywood. has found a a great personal trainer.

And I'm I'm just like I'm wondering if. um. if this is what it is. Yes. Although I think I would say. the people who you and I think about are. almost all women. And. I do think we should bear in mind Now, you would agree with this. I'm not. making this as a point against you. Women get so much more [ __ ] than men for. this sort of thing, right? Like actually. social one of my editors said to me, you. know, I was saying, "Why has no one else. written a book about Ozempic yet? Why am. I the only one?" And they said, "Cuz.

only a man could write this cuz a woman. would be crucified for writing it, right? She would be monstered." And if. you look, whenever even someone as. unbelievably popular and amazing as. Oprah, who slightly surreally is my. friend, um. gets savaged for it, right? And there's. lots of deep underlying reasons for. that. That came out for me as well, actually. That I I I projected towards myself. I. mean, for a long time taking the drug, I felt like I mean, I mentioned this a.

little bit before, but. I felt like I was cheating. I felt like. I was sinning almost. And I started to look at the kind of. deep ideas that are so deep in our kind. of. collective unconscious. If you look at. So, for example, in the 6th century, the. Pope, Pope Gregory the 1st, draws up the. seven deadly sins, right? And one of. them is gluttony. And it's this image. It's always depicted with an image of. some hugely fat person looking like a. pig, you know, and it's horrible. It's very deep in our culture, the idea. that being obese is a sin, right? If you.

look at the forms of weight loss we. admire, they follow the pattern of sin, right? The kind of classic Catholic pattern of. sin. You sin, then you have to suffer, and redeem yourself, and then we forgive. you, right? So, if you look at the forms. of weight loss we admire, they're ones. where people are humiliated and suffer. terribly. You starve yourself, you um. you know, you Think about that show, The. Biggest Loser, which I hate. Uh you. know, where. severely obese people are made to sort. of compete in grueling, horrific forms.

of exercise. Then we're like, "Okay, Jabba, we forgive you now." Do. you know what I mean? We use this kind. of stigmatizing way of thinking. But cheating is a bit more subtle. Cuz I kept thinking, "I'm cheating as I. do this." And I was like, "Well, that's. really weird. If I If I had a heart. problem and I took statins, I would not. think I was cheating, right?" So, why is. that? I think it's partly So, people put. in a huge amount of effort to be thin, right? Loads of women watching this, and. it's disproportionately women, will suffer some privation and.

deprivation in their life cuz they are. really trying to be thin. And then they hear, "Oh, this [ __ ]. just injects himself once a week, and he. gets to be thin like me." It's like they. feel the way I imagine cyclists do when. they look at Lance Armstrong, right? And. the only way out of those. that negative conversation where we turn. on each other like rats in a sack. is to realize oh there is a sin and. there are people who are cheating but. it's not Oprah. it's not someone who Jeff Parker that.

guy I mentioned who you know didn't want. to die young. it's the food industry that [ __ ] all. of us that's why we're in that race. right that's why you're starving. yourself that's why we feel we're. sinners. okay well we can collectively come. together and challenge that shared. opponent if we want but if we're just. going to. get into look it's very hard in this age. of social media madness to not have. every conversation turn into a toxic. conversation and it's not surprising. that something is charged as a debate. about Ozempic. and weight has become so toxic so.

quickly. but again we don't have to do that that. the toxicity isn't going to get us out. of this right we're in a shared crisis. everyone watching has someone they love. who is on course to die young because of. the problems associated with obesity. obesity is so widespread in this society. in a very recent amount of time look at. a picture of a beach in Britain. in 1975 not a million years ago. everyone is thin by our standards right. this happened in the blink of an eye in.

human terms right. again we don't have to tolerate that. part of it is also we don't like when. people lose weight some of us because it. shines a light on us and I think about. someone like Adele who dropped a ton of. weight very quickly and the shocking. thing when she when she dropped that. photo I think it was at like a birthday. party cuz she went from like being you. know a certain weight to then. dropping weight very quickly so we cuz. we don't see Adele's private life life. much it was just this this selfie she. dropped and if you look online at the. reaction people were betrayed.

they felt betrayed by Adele's weight. loss not because of the the assuming she. used Ozempic or anything but the fact. she's now not. the way she was in terms of her weight. people were like almost angry about it. and the same happened with Rebel Wilson. When Rebel Wilson dropped a ton of. weight cuz in her book she talks about, you know, she wanted to increase her. chance of having a kid. So, her doctor. advised her to lose lose the weight. People were angry like almost angry. that they lost. someone they could maybe relate to or. that made them feel a certain way about.

themselves, which I find to be really. interesting that we actually don't like. it when someone. loses weight. We've got to understand where that's. coming from. Obviously, I don't support. anyone being cruel to people online and. it's good for both Adele and Rebel. Wilson that they've improved their. health. Um. but I think where it comes from and a. lot of these things that can seem a. little bit odd that that are kind of. said. we've got to realize how much shame. people are soaking up on this issue. You.

know, if you have a BMI higher than 35. and you're a woman. 45% of women in that position get. insulted every single day in public. Every day, right? So, you're walking. through the world constantly being made. to feel there's something wrong with. you, being treated like [ __ ]. Um and I can see how people in that. position develop a sort of parasocial. relationship with Rebel Wilson or Adele. They're like, "Oh, look, we can look to. Adele." And they feel trapped. They feel. they can't lose weight and then they see. Adele and Rebel Wilson and they're just.

like, "Oh, et tu Brute? [ __ ] you." You. know, I get it. Now, it's not the right. response. I would want to talk to them. more about, "Okay, well. we want to think deeper about this, but. I can see where it comes from and I can. see why some people look at me and go. "You fucker." Right? I totally get it. I. suspect I would have felt that anger. were I not me looking at me, right? So, I get where the anger and this comes. from. From the moment we're born. in this culture, we are primed to be. overweight and we are primed to feel. tremendous amounts of shame about being.

overweight, right? And. anything that comes along and brings up. those stories and forces us to think to. them, brings them to the surface, like. these new weight loss drugs, just leeches out of all of us. so many negative and angry and hurt. feelings. And I felt it myself, right? I felt so much self-doubt all the way. through this. I still feel self-doubt. about it. I still have days where I. wonder, am I doing completely the wrong.

thing? So, I do think we have to understand. where it's coming from and not just sort. of I know you're not doing this, you're. always interested in understanding where. people come from, but it's tempting to. just condemn people and go, "Look at. this bad behavior." And I'm always more. interested when people are behaving. badly and it is cruel to say to Adele, "You [ __ ] you betrayed us.". I mean, I would never say anything bad. to Adele anyway cuz I love Adele, but. I saw her in Vegas, she's incredible. But, um. I do think we always have to try to. understand and it comes from a place of.

profound pain, and that's not a pain. that those people deserved, right? That. And that's a pain they should never have. been subjected to. One of the really surprising things you. talk about in your book is the. relationship that Ozempic has on. addiction. And I couldn't quite figure. out why there'd be any impact on. addiction if we start taking Ozempic. drugs. You talk about the how it eases. the food chatter in our brains and the. sort of food cravings we have, but then. there's a lot of research you go into. that shows. Ozempic and these kinds of drugs can. actually have an impact on our. addiction to things like cocaine and.

alcohol. So, this is much disputed and there are. serious scientists on both sides. But, I found it mind-blowing and totally. fascinating. So, for example, a woman called Elizabeth Jerlhag, who's. a professor at the University of. Gothenburg in Sweden, has done some of. the pioneering work on this. So, I. interviewed her a lot. They get a lot of rats and they put them. in a cage. and they give them loads of alcohol. And. rats will like alcohol and they get. hammered like the rest of us and they. wobble about and they love it, right?

So, they put them in this cage for a. while, they've plenty of alcohol, they. get drunk over many weeks, and then once. it starts to resemble like a dive bar in. Vegas, they do an intervention. They. come along and they inject them with. GLP-1 agonists, exactly the drug you've. got in front of you, semaglutide. Um and then they watch. And what they. discovered, what Professor Yieldhall and. her colleagues discovered, is afterwards. the rats drink about 60% less than they. did before, and the rats who drank most. heavily are the ones who cut back on. their drinking the most. Like, what? What's going on there?

Uh but then they thought, okay, maybe. it's cuz alcohol's got a caloric. content. It's like they they want the. calories less, right? So then there were. experiments done with drugs that don't. contain any calories. So Professor. Patricia Grigson, who's at Penn State. University, gets rats heavily using. heroin and fentanyl, gives them GLP agonists, again finds the. same thing. 50% reduction in the rats using the. heroin self-administering the the heroin. and the fentanyl. Then Greg Staner, who. I mentioned before, who's at Florida. State University, does it with cocaine.

Cocaine in it was mice, not rats, for. him. Again, 50% reduction in them using. cocaine. We don't know why. Again, it comes Some. of the theories come back to that. question about the reward system. Could. it be dampening the reward system? One. of the things a lot of the scientists. find fascinating. is these drugs appear to have what they. call selectivity. So selectivity is. where. the drug makes you want less of the Big. Mac, but not less of a salad, right? So. it seems to It doesn't just generally. dampen You don't just not eat at all.

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

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

she'd never wear. She was doing a lot of. skin picking, um and obsessive eating. She goes on as. Mounjaro and all these addictions like. disappeared. So, there's now this. debate, okay, is it going to have this. effect more widely? The early research. is kind of mixed. So, there's only very, very small studies on humans so far. Uh. it found that it does reduce smoking, but only if you pair it with a nicotine. patch. They found that it does reduce alcohol. consumption, but only if you were a. heavy drinker at the start. So, we're.

going to know a lot more. We're going to. get a lot of results actually this year. and definitely a lot next year. But, it's a very promising. So, some people. argue, so the most extreme, I want to. stress this is speculative, the biggest cheerleaders for the drug. would say, "Actually, we haven't found a. drug that causes appetite regulation. What we found is a drug that boosts. self-control across the board, right?". Now, that's very contested. I'm always. conscious of, you know, of the overselling of drugs generally.

We want to be careful about it, but it's. a possible scenario. And the animal. research is mind-blowing and really is. highly, highly exciting, and you don't. normally see this, right? There's no. other drug that I'm aware of, I'm pretty. sure there isn't, um that just reduces. addiction across the board in animal. studies, right? It is remarkable. I. mean, there's a debate about whether you. can even call it addiction in animals, but you know what I mean, heavy. compulsive use. What impact has this impact had on your. weight loss journey? How much have you. lost? I mean, I just lost a huge amount of. weight. So, I lost three stone across a.

year. And actually what was even more. dramatic was the percentage of body fat. that I lost. So, at the start, I was 33%. body fat. I remember the day Josh, my. trainer, measured that. And I don't know. he sort of looked sort of winced as he. saw it. And um I said, "Oh god, if you. if I was a sandwich, you wouldn't want. to eat me." I later looked up whales. that are only 35% body fat. So, it's. slightly disconcerting. So, I went from. 33% body fat to 22% body fat. So, it's a. really dramatic fall. And did you increase your dose? Yeah. So, everyone starts at 0.25 mg. Partly because the most common side.

effect by far is nausea, right? Almost. everyone feels nauseous a bit when they. start taking it. For some people, the. nausea is unbearable. I interviewed. someone called Sunny Newton in Vermont. who said, you know, it felt like an. alien had entered her body and was. thrashing and trying to get out. Yeah, a. significant minority experience such. extreme nausea they just have to stop. For me, the nausea has now totally gone. away. Um and Carell Leroux, one of the. scientists who worked on this, said, "Look, when it comes to nausea, you've. got to level with people. There are two. kinds of drugs. There are drugs that have side effects.

and there are drugs that don't work, right?" And he's right about that. But. yeah, the nausea is pretty bad, but but. for me, it's all gone away now. I really do admire Oprah. I've watched. it she's kind of like a role model of. mine for how she's kind of conducted. herself throughout her career. And as. you say, she's a friend of yours. And. she's I think recently come out and. admitted to using Ozempic. She's talked. about how she struggled with weight for. her life. Um and Ozempic has been a bit of a magic. bullet, it seems, for her in her weight. loss journey. Um you know her as a person.

I've not been paying enough attention to. her describing her decision to know why. she decided to take Ozempic versus I. don't know some other form of dieting. Has she explained that? Yeah, she talks about it very movingly. Um she talked about it in an interview. with People magazine and then in a. brilliant special for ABC, I think. Um. I mean, nobody has publicly tortured. themselves with diets more than Oprah. There's this famous clip that you've. probably seen. where she comes on stage on her show and. she's.

wheeling a a huge bucket of fat and. that's the amount of fat she'd lost on. this diet and she describes very. movingly in the special. She says it. much better than I can. How she had starved herself to get that, right? And you think about So, she had tried. all the extreme. diet and exercise options that were. available and they'd always yo-yoed back. for the reasons that we talked about. before. So, and you know, and she had to have a. knee operation. I'm not giving away. anything. She's she's disclosed this. Yeah, she had to have a knee operation.

and she was very worried about her. health. And so, for those reasons she's made. this this choice. There are lots of reasons to be worried. about these drugs, but I have found it. very hard. when you talk to people. who've really struggled with this, like. that guy Jeff Parker I mentioned before. in San Francisco, like Oprah. People who've made the decision to do it. and seen the benefits of the weight. loss, staggering benefits. Whatever the other arguments are, I've. never I don't want to argue against.

them, right? If if you are taking these drugs and. experiencing an enormous improvement in. your in your health. as they both have and as lots of other. people have, then that's been the right. choice for you. Now, that won't be right. for everyone. I met people who really. regretted taking the drugs for all sorts. including many of the terrible side. effects and risks. But, I think we have to be truthful to. the complexity of these drugs, right? I. mean, one of the reasons it's called. Magic Pill, the book, is cuz there's. three different ways you could think. about this as magic. Loads of people who.

take the drug go, "This is magic, right?" So, the first form of magic is. obvious. It seems to solve a problem so quickly, so effectively that you're like, "Wow, it's like a miracle, right?" That's one. way. The second way is it could be magic. like a. conjurer's illusion, right? It could be. like a magic trick. It seems to solve. the problem but doesn't or sets up and. trains something else. Or the third way. is think about almost every fable about. magic is you get what you want.

but then you get what you want in a way. you didn't quite expect. You You make a. wish with the genie and you get what you. want but the wish doesn't quite work out. how you thought. Most famous story about. magic is Fantasia, you know, the magic. can spiral away from you. So, I think. one of the things we're still trying to. figure out is what kind of magic is. this? Is it a magic solution? Is it a. magic trick or is it a magic solution. that's going to spiral in all sorts of. unpredictable directions. I have to say. when you know when you were holding that. pen and looking at me, I got weird like. you were doing slightly judgmental. Dragon's Den eyes and I was like I was.

like, "Shit, how do I persuade him to. invest in me, right?". I I was I was just thinking. I was. thinking. I was having a conversation with myself. and I was staring at thinking, "God, this would be easier than going. cuz after you leave here, I I haven't. eaten yet today so I'm going to have my. lunch and then I'm going to go to the. gym for about an hour and a half. And. much of the reason why I go to the gym. is to try and stay in shape. You know, I. want to keep my I want to keep my belly. fat off. I want to keep my muscles. strong. I want to be strong. I want to. look good. That's the That's the reasons. I go to the gym. Also, the positive consequence of me going to.

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

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

270 hours a year, you add 3 years onto. your life, even if it doesn't cause. weight loss, right? So, the. benefits in terms of preventing disease, slowing down aging, mental health are. just enormous from exercise. And I think. you've gone to a really important. drawback, which is yeah, if you can get. the benefit. in the short to medium term just from a. jab, but that calculation you were thinking. through as you were holding the pen in. the slightly sinister Dragon's Den way,

is a calculation lots of people are. going to make and there's. there's a lot of things I'm not sure. about in these drugs, but there's a few. bits of advice which I am very sure. about. If you are not overweight or. obese, you definitely shouldn't take. these drugs, right? You are incurring. all the risks for none of the benefits. So, that I'm certain of and there are. lots of people who are not overweight or. obese who are taking the drugs to be. super thin. My friend, Alisa Loenan, who. used to be the chief content officer at. Goop, said she won't even go out for. dinner in LA with people we know now. because. no one eats anything. She's like, "Why.

do we come out for dinner? You're all. starving." She says, you know, "Dieting. is out, elimination is in." The way she. put it. So, I'm confident about that. I'm also fairly confident, although. slightly less, but fairly confident, if. your BMI is higher than 35. or your body fat percentage is very, very high, and you're not someone with thyroid. cancer in your family, and you're not. trying to get pregnant, I would recommend taking the drugs. I. think for you the balance of risk.

And assuming you've tried diet and it. didn't work, I I think for you the balance of risk is. is more towards the benefits of taking. the drug. I'm not as confident about. that, but I'm pretty sure the people I. love who have a BMI higher than 35, who. are in that position, I have recommended. the drug to them. For people between. with a BMI between 27 and 35, I think. it's much more. um you've got to just go down the list. of the benefits and drawbacks um and. really think it through for yourself and. reasonable people will reach completely. different conclusions.

It can be quite interesting to see that. people who do decide to do exercise and. they change their diet and they start. running marathons, when they lose. weight, every everybody is going to say, "No, you didn't.". That's so funny. Everyone's going to say it was Ozempic. If some celebrity now drops, I don't. know, three stone or four stone and they. did it, you know, in the gym and with a. dietary change, no one is going to. believe them. No one. That's very funny and I think think. certainly I think you're right there. I. hadn't thought of that actually. You wouldn't believe them. Of course you. wouldn't believe them. No, you're right. One of the big rebuttals online is that.

because people are now taking these. drugs, people like you are taking them. to lose weight, diabetics can't get. their hands on these drugs anymore and I. saw some articles that said the um. the drugs have been in such high demand. that diabetics who really really need. them to save their lives now can't get. access to them. I think those people have a really good. point and I interviewed some of them for. the book and it was a very painful. conversation. I think the solution is what we should. have done right from the start and what. we should do now is what we did in. Britain with the COVID vaccine. So, we. should um ration the drug and the people.

with the greatest need should be given. it first. And everyone agrees. Severely obese people and diabetics. together would be the people who most. need the drug. and they should be given it first. People like me who've got heart disease. in my family, but we're not hugely obese. would probably be around the middle and. you know, people who don't have heart. disease and are just sort of overweight. would be at the bottom. We didn't have. that system. What we had, unfortunately. because the government didn't set up. that system was a scramble. which meant that you know.

some diabetics didn't get the drug they. needed had to go on insulin earlier. which poses a real threat to their. health. That's awful and I feel a bit. ashamed about it because of course if. people like me hadn't hadn't all. together bought it that wouldn't have. happened. In practice for me personally. I was worried about my own heart risk. you know I'm a year older than my. grandad was when he died. Um. but that's not much of an excuse and. when I met the diabetics in that. position like for example a guy called. Zami Jalil.

who was exactly in that position. He. could as musician 41 couldn't get the. the Ozempic he needed for his diabetes. for his type 2 diabetes. I felt um. ashamed you know clearly his need was. greater. Johann thank you. Thank you for a few things. I think it's. worth saying that the first time you. came on my podcast I had basically no. listeners. You were like a tiny little baby podcast. star. I remember it really clearly you. came to my flat. I showed up at your flat in London and. I'd read your book Lost Connections. I.

was so fascinated by it so I reached out. to you and asked you if you'd come on. and you said yes when I was when no one. was listening to the podcast. I don't. even I wasn't even videoing it back. then. Um and it was an incredible. conversation. The audio was terrible. It. was we had loads of issues and stuff. like that but you were one of the first. people to really give me a chance so. it's so wonderful that that we can still. stay in touch and that I get to cover. your work still to this day. So thank. you for giving me a chance back in the. day. I really appreciate it. Oh my pleasure. And thank you for writing this book. because one of the the most sort of. popular things that our audience have. been asked seeking to understand is. Ozempic. We've seen that in all the data.

and the way that you approach this even. though you are someone that's taking it. so it's easy to see how you would be. biased in various ways to defend it or. whatever. That's not the approach you. take and in the book Magic Pill you're. able to. be incredibly nuanced in how you look at. the pros and the cons in a way that I. was not expecting from someone who is. taking it themselves and I think that's. really important because you're right. you've finished the book and. in a weird way you. you have more information but I can. understand how the decision still.

remains with the individual. And I think that's really what any book. on this subject should should aim to. achieve. It should kind of not have a. dog in the fight but present you both. sides of the trade-off so that you can. make a decision for yourself. And that's. what you do so skillfully. And the real. thing, you know, as an author that. you've taught me over the years is. you're just remarkably good at writing. And it's really your your your. storytelling is phenomenal. It's. influenced me profoundly as an author. myself. And uh whenever I read a book. now, I often wish that they'd written it.

like one of your books. Oh. Because you take a you take a concept. that's difficult and widely discussed. and you take us on a journey. And that journey is so much more. enjoyable than just reading like a. science book. So, I recommend everybody. to go and get Magic Pill right now. It's. um it's obviously a huge point of. conversation at the moment, these these. magic pills. Um and this is the book to. read on them. Magic Pill, The Extraordinary Benefits. and Disturbing Risks of the New Weight. Loss Drugs. It's due to be released on. the 2nd of May, 2024. So, we're a couple. of days away from that now. And um yeah,

I would just highly highly recommend. this book. Thank you so much, Johan. Oh, I'm really touched by that, Stephen. Thank you so much. I almost forgot. We have a tradition on. this podcast. Oh, yes, the question. What is the. question? Who who posed this question? I'm not going to tell you who who this. is. Okay. But the question that's been left for. you is. it's a really interesting one. Why should. humanity. continue to exist? So, as you know, I've been writing for. God, 12 years now, 13 years, a book.

about a series of crimes that have been. happening in Las Vegas that I'm not. allowed to talk about, but it will come. out next year and I promise we'll. finally talk about it. I think you're just saying this so you. can hang out in Vegas and every time I. see you say you're just in Vegas to. writing a book, I'm like, "Well, where's. the book, Johan?". Yeah, there are people many people in. Vegas have said to me, "Yeah, your. book's been a long time [ __ ] coming, Jeremy, but. So, um. I know two people called Rob Banghart. and Paul Boutin who. who um. a lot of people won't know, but there's. many thousands of homeless people who. live in the drainage tunnels beneath Las.

Vegas. And Rob and Paul used to live in the. tunnels. And Rob lived in a particular set of. tunnels that I know very well and have. spent a lot of time in. And. in 2017. So, Rob was known as Hobo Santa. He. would steal things and give them to. people. And um. he was also kind of low-level dealer, very low-level. And there was a uh group. of uh. rival Cuban dealers who didn't like him. And one day in 2017, they hit him in the head with an axe,

split his skull open, dragged him onto. the railway tracks, and left him there. for a train to run him over. But fortunately, someone spotted him, pulled him off the tracks, and he. survived. And he. in the next 6 months as he recovered, he um. turned his life around. And he began to volunteer for a group. that my friend Paul runs. uh called Shine a Light, which is a. group of people, overwhelmingly people. who used to live in the tunnels, who. managed to get out, turn their lives. around, who now help the people who are.

still down there. They give them loads. of practical things from tampons to. flashlights, and they most importantly. give them support when they want to. leave and have got lots of people out. and every month get people out of the. tunnels, and I've seen them do it with. some people I really love who were down. in there. And one day. a few years ago, I was I was with Rob, and um. um. So, one day a few years ago, I was with. Rob. when he got word that uh.

a friend of his from the tunnels called. Pickit had died. He'd OD'd in in the tunnel he used to. live in. So, we went straight down there. And um Pickit's stuff was still there. They'd taken away his body. And we bumped into a woman who also. lives down there. And whenever Rob goes to the tunnels, even in a situation like that, he always. brings supplies, you know, food and. stuff. And he said to her, "Who's in the tunnel over there?" And. she said, "You don't want to go there.". And he said, "Why?" And she named some.

people. And he said, "No, I'll go there. I'll give them some stuff." And he went. and gave them some stuff. Anyway, I. didn't really think about it very much. I was thinking about Pickett and what. had happened. And a few days later, I said to Rob, "What did she mean when she said you. don't want to go there?" And he said, "Oh, it's just these guys." And I said, "What guys?" He said, "Oh, well, they're the guys who hit me in the head. with an axe. They're the guys who tried. to kill me.". And I said, "Well, why did you go and. help them?". And he said, "Cuz they're human beings, and they're. suffering, and they need help.".

And um. I thought a lot about Rob. Every day, him and Paul. go back into those tunnels. You know, they could do anything. They could leave. and do a million things, right? They're incredibly intelligent and. talented people. Every day, they go back and they help. the people who got left behind. And they don't make no money doing it, and they don't have great lives doing it. in any material sense. And I say to them, "Why do you do it?". And they just.

they say it's cuz it's the right thing. to do. And if you said to me, "Why should human beings continue to. exist?" I could give you a lot of. abstract answers. I could talk to you. about philosophy, and I could talk to. you about art, and. I'd just say, "Come and meet Rob and. Paul.". They're why humans should continue to. exist. Thank you. Cheers, Steven.

Oh. Oh. Oh. Oh.