Dhru Purohit Show - How Regular Marijuana Use, Ultra-Processed Food, and Lack of Sleep Are Poisoning Our Mitochondria and What We Can Do To Reclaim Our Energy and Brain Health With Dr. Chris Palmer

Episode Date: June 17, 2024

This episode is brought to you by Maui Nui, BON CHARGE, and Aqua Tru.  Mental health disorders are on the rise at alarming rates. Although access to therapy and medications has increased, the rates continue to grow, leaving millions to suffer. There has to be another approach to treatment, and today’s guest is here to show us what traditional medicine often misses. Today on The Dhru Purohit Show, Dhru sits down with Dr. Chris Palmer to discuss the rise in mental health disorders and how we need to change our approach to treatment. Dr. Palmer dives into the science behind his Brain Energy theory and shares the research surrounding mitochondrial and mental health. He also sounds the alarm about how alcohol and marijuana use can increase the risk of severe mental health disorders in vulnerable individuals. Dr. Palmer shares inspiring stories of his patients who have overcome mental illness and regained their independence by addressing functional imbalances at their roots. Dr. Chris Palmer is a psychiatrist and researcher at the metabolism and mental health interface. He is the Director of the Department of Postgraduate and Continuing Education at McLean Hospital and an assistant professor of psychiatry at Harvard Medical School. For over 25 years, Dr. Palmer has held leadership roles in psychiatric education, conducted research, and worked with people who have treatment-resistant mental illnesses. He has pioneered the use of the medical ketogenic diet in the treatment of psychiatric disorders through research, patient treatment, writing, and speaking around the world on this topic. More broadly, he is interested in the roles of metabolism and metabolic interventions on brain health. In this episode, Dhru and Dr. Palmer dive into (audio version / Apple Subscriber version): What's at stake if we don't rethink our approach to mental health? (00:00:51 / 00:00:51) The impact of alcohol and marijuana on mental health (9:40 / 5:20) How marijuana impacts brain and mitochondrial function (12:40 / 8:20)  Using the Brain Energy theory to help individuals who are vulnerable to the effects of marijuana (22:00 / 17:30) Lifestyle treatment options and the ketogenic diet (27:40 / 23:10) Optimal exercise and how to start implementing it in your life (39:20 / 34:00) Ozempic: the impact on mental health and studies on other addictions (48:00 / 42:50) Ultra-processed foods and the impact on hormones and appetite signals (1:01:00 / 56:20) The common sense truth behind what we eat affects the brain (1:11:20 / 1:06:10) Euthanasia in Europe for younger individuals suffering from mental illness (1:21:40 / 1:15:10) Hope in Dr. Palmer’s work, Brain Energy theory, and final thoughts (1:37:30 / 1:32:00) Also mentioned in this episode: Dr. Palmer’s Twitter Jackson Fyfe, PhD X/Twitter post about weight training reducing all-cause mortality Study on weight training reducing all-cause mortality Magic Pill by Johann Hari  Brain Energy  For more on Dr. Palmer, follow him on Instagram and Twitter or via his websites, chrispalmermd.com and brainenergy.com.  Right now, Maui Nui Venison is offering my community 20% off your first purchase. Just go to mauinuivenison.com/DHRU or enter the code DHRU at check out to get 20% off and up your high-quality protein today. Right now, BON CHARGE is offering my community 15% off; just go to boncharge.com/DHRU and use coupon code DHRU to save 15%. AquaTru is a countertop reverse osmosis purifier with a four-stage filtration system that removes 15x more contaminants than the bestselling water filters out there. Go to dhrupurohit.com/filter/ and get $100 off when you try AquaTru for yourself.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Dr. Chris Palmer, welcome back to the podcast. You know, a year ago, you came on our podcast and shared your groundbreaking brain energy theory that argued that the vast majority of mental disorders are actually metabolic disorders of the brain, that many various mental issues that we all know very well and have heard of. And unfortunately, many people have had a family member or a friend that suffered from them, things like depression, anxiety, bipolar disorder, schizophrenia even. They're not distinct individual diseases or entities necessarily, but they're all related to metabolic dysfunctions within the brain

and, of course, the poisoning of our mitochondria. Just as a reminder, as we start off today's episode, can you tell our audience why this conversation matters so much and what's at stake if we don't fix our mental health challenges that we're experiencing worldwide? The tragic reality is that mental disorders are skyrocketing in prevalence. You know, over the last 25 years, rates of autism spectrum disorder have quadrupleasure. in the United States. Rates of ADHD are up threefold. So they've tripled. Rates of overdose deaths and deaths of despair. So overdose deaths are up exponentially. Deaths of despair have more than

doubled. And that includes statistics on suicide and substance-related deaths. Rates of bipolar. Rates of bipolar disorder, largely thought to be a genetic disorder, have doubled in adults and are up exponentially among children and adolescents, rates of eating disorders, anorexia, the kind where people are starving themselves to death, those are up exponentially over the last 25 years. And at the same time the rates of mental illness are increasing, we are delivering more and more mental health treatments. Antidepressant prescriptions are up. We are doling out more antidepressants. We are doling out more antipsychotics. We are doling out more mood stabilizers. We are offering psychotherapy to more and more people. And the rates are going up and the deaths

are going up. Something is seriously wrong, and we need a better understanding of what exactly is causing these mental illnesses. And more importantly, what on earth are we going to do about it? And how can we not only more effectively treat these disorders, but how can we prevent these disorders from occurring so much? So there is so much at stake for the world. For the world, You know, I share statistics like that. I could get into the finances of that and why the finances matter. But if you or anyone you know has somebody suffering from one of these severe mental illnesses, you know that money is not the main point. These people's lives can be ruined. People are tormented day after day. Their families are tormented, seeing them tormented.

Like, these illnesses throw family life into chaos. They cause divorces. They cause people to disown each other. They cause so much heartbreak and turmoil. We need better solutions. And the reason I get so passionate about this is because I think we have better solutions available today that most people are just completely unaware of. Well, we're going to get into some of those.

solutions, get a chance to build on our last conversation that we had together. Our last conversation had almost a million views. And it just shows how much that people are ready to not only hear this conversation, but how many people are searching for answers. And when it comes to searching for answers, there's a multifaceted approach, as you've shared about in your book and in your many interviews. And last time you were on the podcast, we talked about diet a lot and we'll touch on diet today, but we're going to continue and talk about additional mitochondrial poisons that are out there that have been abused in society that are a factor in this growing mental health epidemic that we're seeing. In particular, I want to start off by

talking about something you write about in chapter 16 of your book, which is alcohol and marijuana. Now, alcohol and drugs, marijuana being one of the biggest components of the drugs are out there. When it comes to alcohol and marijuana specifically, what are those two substances doing to our mitochondria? And why are they so concerning for you when you talk about avoiding this mental health epidemic that we're going through right now? depending on how much science you want to dive into, I can get really nerdy and really scientific fast. But the sound bite overview is that in different ways, both alcohol and marijuana are mitochondrial toxins. They affect different neurotransmitter systems. they impact different cells in different ways.

So yes, all of those things are still true. But if you really look at the hardcore science and what exactly are those neurotransmitter receptors doing inside that cell and what does heavy alcohol use do? What does heavy marijuana use do? At the end of the day, they poison mitochondria. And if you use those substances excessively, you can end up developing a whole whole wide variety of both physical and mental health conditions. That's the easy soundbite, happy to dive into more details or science depending on how much you want. Let's dive into it a little

bit further because there is this movement here in America and increasingly around the world where when it comes to marijuana weed specifically, you're seeing a growing increase of people, especially young people consuming these drugs. And there's all. also a societal level of encouraging, essentially, decriminalization, and as a byproduct of that, states that are making these products legal. Obviously, there's a lot of benefits to the decriminalization component. That's a separate conversation. But is any part of you feel worried that you see more people every day, especially young people,

not only smoking marijuana, but using higher and higher and more consistent levels as part of their daily life. Yeah. It's hard as a psychiatrist to not be concerned about those trends. So as you just pointed out, for anybody who questions it, we have pretty good data that overall, over the last, you know, many decades now, that people who grow marijuana, sell marijuana, are increasingly breeding different strains of marijuana so that they have higher levels of THC in them. So the marijuana that most people are smoking or using today

is not necessarily the same marijuana that people were using 30 years ago. And unfortunately, there is another molecule, CBD, that tends to counteract some of the harmful effects of THC, and those levels are actually going down in these new strains. So, CBD levels are going down. THC is going up. If you want to feel high from marijuana, that's precisely what you want. You want more THC and you don't really care about anything else. You just want more THC.

So the reality is that one of the most complicated things about this conversation is that there are millions of people who will swear on the Bible, that marijuana really helps them. Marijuana was life-saving for them or life-changing for them. Marijuana is the only thing that stops their anxiety. Marijuana helps them calm down. Marijuana does this, that, the other. Marijuana helps them sleep. Marijuana helps their chronic pain.

In extreme cases, marijuana stops seizures. And the reality is that most of those claims on a short-term basis are in fact true. Marijuana does all of those things. Because marijuana is suppressing mitochondrial function. And that means marijuana is slowing brain function. And if you have an overactive anxiety portion of your brain, slowing that down or stopping that can feel amazing. If you are having a seizure, let's take an extreme example, a child or an adult with treatment-resistant epilepsy, they're having a seizure. that's hyper-excitable brain, overactive brain.

Slowing that down can actually be life-saving in some situations. So in the short run, marijuana can produce tremendous benefits for people. And they remember those benefits. And then they become convinced, this is a good thing for me. And I'm going to use it every day. And I'm going to live happily ever after. The problem is that you don't want to suppress brain function on a regular basis over and over again. If you start suppressing brain function, and more importantly, if you start suppressing mitochondrial function over and over again,

those brain cells, the mitochondria can become impaired, damaged, or reduced. However, you want to think about it, that basically you're making those brain cells weaker. It would be like not using your muscles on a regular basis. They will shrink a little bit. We have good evidence that people who smoke a lot of marijuana, their brains are actually shrinking. So I'm not being figurative about this. I'm actually being literal about this. Marijuana, heavy use of marijuana over time will, in fact, not only slow brain function and suppress mitochondrial function, it will shrink brain regions. In people who are vulnerable, that can set off a whole cascade of neuropsychiatric disorders. So people who smoke marijuana regularly are more likely to develop

subsequent anxiety disorders. People who smoke marijuana regularly are about four times more likely to develop something like schizophrenia. That's not a diagnosis you really want, and that's not a diagnosis you want to take the chance of getting. Now, four times the rate of an illness that only occurs in 1% of the population is still only 4% of the population. So what does that really mean? that means the overwhelming majority of people who smoke marijuana are not going to get schizophrenia. So I want to be clear. Not saying that like everybody who smokes regularly is going to get schizophrenia. I want to be clear about that.

But suppressing brain function is a rule of thumb. If you are trying to live your best life, you actually want your best brain. And suppressing your brain function is not going to give you your best brain. It is going to give you a relaxed, impaired brain or potentially a damaged brain that results in a crippling illness like schizophrenia or maybe something more mild like just panic disorder or anxiety or depression or other things. So as a rule of thumb, yes, I'm very concerned about trends of more and more young people in particular. because their brains are vulnerable, and they just have so much more of life to live. So that means they've got a lot more years to be smoking, and that means they've got a lot more years to end up harming their brain.

You know, part of the reason that I and so many families that I know are so interested in this conversation and appreciate you talking about it honestly, and the honesty is that, yes, there may be some short-term benefits, but at what expense and is there a better way to get some of those benefits that people are looking at without sacrificing the long-term damage of our mitochondria. So that's the honest truth. And the reason that we're so appreciative is that I personally in my own network have four to five individuals that have had schizophrenia or something that seems to be similar because when individuals go through this process, it can be very difficult to diagnose them to even get them to get treatment in the first place. And these are people

that previously had not shown any signs of having anything severe in their mental health. These are individuals that largely were functioning citizens of society, were young, very promising, had jobs, were, you know, providing for themselves and often in cases their family. And in every instance with these individuals, and I realize I'm coming into this conversation with a bias where they were smoking heavy, which I want to dig into that in a second of what that means, but often multiple times a day with especially for the men, out of the five, there's mostly men and there's one woman that I know as well, strains that seem to have higher and higher amounts of THC. not only does it seem that their brain had broken in a way that they were completely unrecognizable as themselves. Their families often could not get them treatment. In one case, one individual ended up homeless here in Los Angeles, but they've never been able to get back to who they were. And again, a big part of that is that it's very difficult to get these individuals' treatments.

They're adults. Often sometimes they might be better. sometimes they might get worse. And that's why so many families wrote to me after your first episode asked me to go a little bit deeper into this topic because most people actually don't know the facts that you shared, that it's not for them super clear that marijuana is shrinking their brain. That's why I feel so scared about this for many people, especially young people, who actually don't know that it's that damaging.

to their brain and body. So I just wanted to share that with you there. Have you seen with the brain energy theory and all the practitioners that are out there that are now starting to get educated about all the different ways of the mitochondria can say, ouch, and get damaged, marijuana, alcohol, being one way overuse of them,

but diet, sleep, other factors you talked about on our last episode, have you seen families or individuals get better, who seem to have gotten completely worse from heavy marijuana usage. Have you seen hope and people get better through following the brain energy theory and the repair process that would ensue? Yes, absolutely. I, you know, as a psychiatrist, I have seen countless cases like you just described.

So again, I'm biased. I'm a psychiatrist, so people come to me when they're not in good shape. I'm not seeing all the people who are smoking and are fine. They don't come to psychiatrists. So my bias is that I see the patients who aren't doing well. But this theme with marijuana in particular has played out countless times for me. I had one patient who had bipolar disorder and was using every drug under the sun, opioids, alcohol, stimulants, cocaine, everything.

He could tolerate those other medicines, but every time he smoked marijuana, he would get psychotic and paranoid. And, I mean, that just gives you a flavor. And I'm not trying to say that marijuana is more dangerous than opioids. It's a lot easier to die from opioids than it is from marijuana. Let me be clear about that. But for this particular patient, he could use low doses of opioids and not have as catastrophic consequences as what marijuana did to him.

So what I'm saying is that some people are particularly sensitive or vulnerable to the harmful effects of marijuana. But one of the patients that actually went to a conference and spoke with me, she went to a public conference, shared her story openly. She had a history of substance use, including marijuana and opioids and other substances, had developed schizoaffective disorder. It became chronic and unrelenting. She became disabled from it. It was really a nightmare. She was in an abusive relationship. She and her boyfriend were homeless at one point. And she went on a ketogenic diet. We got her to stop using opioids. We used medication assisted therapy for a while. She's now off that medication assisted therapy.

doing phenomenally well. She's off all the drugs of abuse. Other than smoking, she still smokes a little bit. But her illness is in full remission. Full remission. She's in graduate school, getting straight A's, top student, is in a healthy, good, new relationship, has a new home. Like, people would not recognize her.

compared to when she was ill. And what her story and numerous others tell me is that although we often see people with schizophrenia as having irreparably damaged brains, and a lot of clinicians think about it in that way, they think that these patients, these people's brains are damaged forever and that there's no hope of recovery, what I am here to tell you is that that may not always be true. And what I really believe is that that mostly isn't true for most people. Now, am I being 100%? No, I'm not saying that people can't have permanent brain damage.

I think they can have permanent brain damage. But I think the majority of people who are diagnosed with psychotic disorders like schizophrenia and bipolar disorder can in fact recover. And the only thing standing in the way is knowledge, information, support, and clinicians who can help them on that journey to recovery. Let's zoom out for a second and talk about that approach of repair. You know, you shared on our podcast last time that when there is a persistent mitochondrial, quote unquote, poison like heavy usage of substances, could be heavy usage of alcohol, could be heavy usage of marijuana or some other form. But that also includes mitochondrial poisons like heavy usage of ultra-process foods that are driving insulin resistance and are driving poor metabolic health. the first step in the process is obviously limiting and reducing those inputs, right? Walk us through that process.

Obviously, we're talking about alcohol, marijuana, but that's in the grand scheme of all the different levers that make our mitochondria either healthy or worse off. So what are the different levers that are out there that you look at? If the first one is reducing alcohol, reducing marijuana, potentially cutting it out, getting somebody in a right treatment program if there's an addiction component that's there. What are the next things that you look at? So the biggest ones that I'm going to look at in terms of treatment strategies are the basic lifestyle medicine interventions. And that includes diet, exercise or movement, sleep.

as we've talked about managing substance use, it also includes stress reduction or relaxation, if needed, and it also includes connection and relationships. So those are the basics. And the way I think about it is that those are the basic ingredients for human health. And if a human being is not healthy, it's best to start. with those basic ingredients and figure out is something missing? Is something too much, too little? Like, what's happening here? And obviously, the devil is sometimes in the details, especially with diet. I'm just going to say that up front. So many people ask me, so what is the one diet that I should

do, Dr. Palmer, to cure whatever I've got? I really don't have a one-size-fits-all diet. for all human beings with all different health conditions. I just don't. It's not that I'm trying to be stingy. It's not that I'm holding out. It's not that I'm trying to be mean. It's that different humans are different. Some people are allergic to nuts. Nuts can be a really healthful kind of food to include in your diet if that's something you like. But if you're allergic to them, no. Some people are allergic to gluten and could have very horrible reactions to gluten. Other people can tolerate it. Some people really want to be more plant-based, more vegetarian or vegan. I will work with those people. I myself am not vegetarian or vegan. I myself am an omnivore. I eat both animal-sourced

and plant-sourced foods. But again, so lots of ways to think about it. Devils in the details. And at the same time, this information isn't that shocking. Clean, like real food diet. That's the one prescription that I'm usually willing to give. Real food. Eat things that are real food. So stay away from the processed, ultra-process. If something has more than four or five ingredients in it, and especially if you can't

pronounce some of those ingredients, maybe stay away from that food. Maybe try to go with single or two or three ingredient type food. foods. That's diet. I'd ask you one question about the diet before we go to exercise and sleep. Would you say that another principle along with it is that, yes, eat real food, stay away from ultra-processed foods, stay away from things that have too many ingredients, especially the ingredients you can't pronounce, and largely depending on the spectrum of maybe how severe your situation is and what people are going through, but that generally eating a diet that is going to be, you

keeping your blood sugar and improving your metabolic health, especially from an insulin level, right? Which now that may not, that might be very complicated for people to hear, but if they're working with somebody or they're generally getting a sense, they're tending to move towards more of a diet that is not constantly throwing their blood sugar on a roller coaster. Is that another part of it? 100%. So the general rule of thumb is that I would say if you are not mentally healthy and metabolically healthy,

so we're looking for good mental health. So you're not having hallucinations or delusions. You're not having manic episodes. You're not having unrelenting depression and suicidality. You're not having panic attacks. Like all of the absence of those things, you're generally happy. be reasonably calm, feel reasonably safe. So if you have good mental health and you have good metabolic health. So blood sugar is absolutely part of that. Blood pressure is two. Lipids, triglycerides,

HDL cholesterol, should at least be looked at, abdominal obesity. All of those things play a role in your mental and metabolic health. They are markers of metabolic and mental health. If there are problems in those areas, I want you to assess these basic lifestyle strategies. If those things are not all perfect or in decent shape, you probably have some opportunities to optimize your health, if you want to optimize your health, if you're really struggling and suffering, if you have low energy, if you do have mental health symptoms, you have an opportunity to dramatically improve your life by focusing on some of these lifestyle interventions to see if you can get them better. So one of the reasons that I'm unwilling to kind of give a one-size-fits-all

prescription. As we discussed in the last episode, we don't need to go in a lot of details. The ketogenic diet, the epilepsy-grade version of the ketogenic diet, which is different than the weight loss version of the ketogenic diet, that can be an extraordinarily powerful intervention for patients with severe brain disorders. The friends and colleagues and acquaintances, that you just mentioned, who are all struggling with severe mental illness and haven't returned to their baseline, I would absolutely want to at least consider the option, consider whether they are a candidate for a ketogenic diet, and then talk with them about whether they might be willing to do it, and then help them, coach them, support them, in their ability.

to do it, but the ketogenic diet can have a profound impact when the brain is harmed and malfunctioning. But does that mean I'm recommending the ketogenic diet to every human being on the planet? Absolutely not. I'm not. If you are following a diet and it is generally consisting of real food and you are generally healthy in terms of mental health and metabolic health, please, by all means, keep doing what you're doing. You are in the select elite group of people who are healthy. You know, 93% of Americans have poor metabolic, at least one of the metabolic health markers, meaning metabolic syndrome, meaning they've got high blood pressure or poor lipids or, you know, high glucose levels or insulin resistance,

or abdominal obesity. They have at least one of those, 93% of Americans. So we have an epidemic of poor metabolic health. And oh, coincidentally, at the same time, we have an epidemic of poor mental health too. You know, I interrupted you while you were going through the different levers that you have as a psychiatrist who understands and came up with this brain energy theory to help patients move in the right direction. And you started off with diet. And you shared something, again, very powerful that I want to reiterate is that diet is, there's no one size fits all. And yet the core pillars and themes around diet is something that truly everybody can embrace. So you can embrace the core pillars and themes, regardless of who you are. And then you might need to

contextualize it. There's been individuals that have come on. this podcast who were in a very severe mental health situation. Hannah Warren, who's written on your website previously, shared her story of her psychotic episodes and her alcohol abuse disorder that she was facing as well as not sleeping and a few other things that were there. Somebody like her, she shared that she had to be very strict because she was dealing with a lot. And there's other individuals, many people, I love your Twitter, your X, and you're always retweeting stories and testimonials for people. If anybody wants inspiration or is looking for guidance in the space, I would highly recommend they follow you on X.com. We'll link to it in the show notes.

You've shared stories of people who simply tweak their diet a little bit, increase their exercise, doubt in their sleep, which are the next things that we're going to get into, and felt a significant improvement in their mood in a way that they had never anticipated that they would feel. And I love seeing all those examples. So it's almost in a way, the sicker you are, sometimes the stricter you have to be. And then the less sicker you are and the less issues you're dealing with, the more flexibility that there might be that's there. And it could be your diet is pretty good, but there's a few other areas to dial in. So let's walk through those few other areas you were dialing in. I think the next one you were planning on going into was exercise. So exercise,

everybody already knows. Yep, exercise is good for you. And you have to start somewhere. So if you're already exercising, you may actually have optimized your health as much as possible through exercise. So if you are exercising at least three or four days a week for at least 30 minutes a day and doing moderate to high intensity exercises, I'm not sure that. what I'm going to say necessarily applies to you. You may actually be getting close to the maximal benefit of exercise for yourself. There's a fallacy that doing more is going to be better and actually you can actually overdue exercise. So doing more people who exercise excessively actually have been found to have reduced lifespan. They can sometimes be at higher risk for

health conditions, like even heart attacks, believe it or not. Because exercise is a stress. Exercise takes energy and calories. And we actually have some hardcore cell biology data to suggest that low to moderate levels of exercise are really, really good for your mitochondria. They will improve mitochondrial function, improve the production of new. healthy mitochondria so that your cells are more resilient, have better, more healthy mitochondria. But if you overexercise, it actually can harm and impair your mitochondrial health. You can overdo it. So I just point that out.

So if you are somebody who doesn't exercise at all, start low, go slow. Start with something that you can do. take a walk, take a walk around the block after dinner. Like, that's a great place to start, right after dinner. Help digest your food. It might get you to stop eating because a lot of times people like to snack and have desserts and then turn on the television after they eat dinner. And whenever you're watching, if you're just sitting watching television,

everybody wants a snack. And so nobody just wants to sit there and just watch. You got to be eating something while you're watching because that's the way to relax or you're drinking something like alcohol or you're smoking some weed to wind down at the end of a stressful day. So usually when people are sitting on a comfortable sofa or lounge chair or whatever they've got, watching television at the end of a hard day, usually some bad habits are happening at the same time. So instead, go for a walk around the block and just get, get things moving. If nothing else, even if you then go sit down and watch TV and start snacking, at least you didn't do that for 15 extra minutes. You got a little bit of a walk in instead.

If you're already doing that, if you're already walking, you want to work your way up. The two types of exercise I would most promote for mitochondrial health, the best evidence that we have. So one is strength training. So muscle is muscle-centric medicine. We've all heard that. And so the more muscle you have, the more mitochondria you have. And muscle is an endocrine organ. And actually, mitochondria are playing a powerful role in a lot of those endocrine functions

from your muscle cells. So if you grow your muscle size, you will grow mitochondria because they have to support those larger muscles. and then that serves as a sink for blood glucose. That helps maintain glucose levels and insulin signaling. And it's good to be strong. It's good to be strong. So in order to do that, you just need to stress your muscles.

You really need to, you don't need to do a lot, but you need to do enough. Ideally, if you're trying to grow muscles, you want to go to failure. So you want to just do a heavy enough weight that you can do anywhere between eight and 20 reps, but you're going to do enough reps until you literally cannot do another one.

They don't have to be jerky movements. You don't have to super load your weight. You can avoid injuries, especially if you're older like me. you can avoid injuries, take it slow, but you just want to take it slow to the point of muscle failure. And then as long as you eat enough protein after that and some calories to sustain muscle growth, you will likely build muscle and you'll have more muscle and that will be good for your metabolic and mental health. The other type of exercise that I highly recommend is zone two cardio.

We've got the best evidence for that. So zone two cardio is where you're doing cardio, moderate intensity. You can probably still talk while you're doing it. But that is pretty good for improving mitochondrial health. So if you want to mix it up, you know, a few times a week you're doing some muscle strength training. A few times a week you're doing some zone two cardio. that would be a pretty optimal exercise plan. And if I could just add something to that,

in both the case of zone 2 cardio, which obviously links into if people want to formally measure their capacity for aerobic endurance, they could get like VO2 max testing. It's pretty intricate. You know, the test itself sometimes can be a little bit challenging for people. It's not always available. And there's obviously different proxies that are out there.

But the most important thing to know, you know, we've had on individuals like Andy Galpin on the podcast, an expert in this area, is that the most significant return on investment is when people who are in the, let's say, zero to 10 percent tile of cardio, cardio health and lung capacity as, as, you know, measured by VO2 max, if they just got to 10 to 10 percent, they saw massive gains that are there. And why I'm bringing this up is that sometimes people will hear this and think that they have to be perfect, but any amount of physical activity, any amount of walking that you can add in, you know, vigorous walking in the case of zone two, any amount of resistance training you can add in, those things make a huge difference. In fact, there was a study that was just published in the International Epidemiological Association, and it was talking about a big cohort of, I think, like, 200,000 American adults that were followed between 2004 up to 2019.

And they saw that those who did any amount of weight training, and we'll link to the study in the show notes below, any amount of weight training, any amount of resistance training, compared to those who did none, like did none at all, the individuals who did a little bit of weight training had a 6% lower risk of all-cause mortality and 8% lower risk of cardiovascular disease and mortality and a 5% lower risk of cancer mortality. And of the people that they studied, 75% of the people in that cohort of 200,000 that they followed over those years, they were doing nothing. So you went from nothing to just a little bit and you got all those benefits that were there.

And so just a reminder for anybody who's listening, even a little bit makes a huge difference. It does. Yeah, as you said, especially if you're not doing anything, you don't have to be a bodybuilder or a slim model or whatever it is you think you're trying to strive for. All you got to do is just move a little bit to get massive, massive. gains. I want to talk about sleep, but because we're talking about exercise and diet, I want to ask you about something that I haven't seen you talk about yet, but maybe I've missed it on a couple of episodes that are out there. There have been a lot of anecdotal accounts that have been showing up of individuals who are severely overweight or obese, who have been using these GLP1 and agonists that are

out there, Wagovi, Ozempic, etc. That have seen a significant improvement in their mental health. And I want to get your commentary. I'm sure there's a lot of layers to it about the role of these drugs, not just in, you know, weight loss, which a lot of people are debating and talking about and having conversations on. but specifically as potentially one tool in the toolbox as it's related to mental health. Would you mind chiming in on that?

Yeah. So, you know, this is a really controversial area. There are a lot of fitness gurus and diet gurus who are really kind of against the GLP1 receptor agonists. And for a wide range of reasons, there are some people who express concerns about, oh, people might be losing more muscle than fat or maybe a higher percentage of muscle when they're losing weight from these medications. And those concerns are there. Those concerns are true.

And I want to just be the first to say, I have gotten patients with schizophrenia to lose 160 pounds and keep it off for seven years without any medication assistance. So my first go-to is not to put people on medications to help them lose weight. My first go-to is lifestyle strategies because I know they can work. And if I can get patients with schizophrenia to do it, guess what? You can probably do it too. And it's nothing. I'm not trying to disparage or put down people with schizophrenia, but that is a pretty profound disorder that comes with heavy medication burden that causes weight gain, that causes sedation, that causes cognitive impairment. And so they really are, they really are in a disadvantage when it comes to weight loss. That's just a fact. And I'm

I am a champion for people with schizophrenia. I just want to put that out there. If the way I said that turned you off or made you feel like I'm putting people with schizophrenia down, I'm not. I'm a champion for them. And if they can do it, you can do it too. With that said, you know, so the FDA and the European Union have raised concerns about anecdotal case reports of people saying they.

went on weight loss drugs like Weigabe and other Zempec and they developed suicidal thinking. And so there's since that time, so these are a handful of case reports. Obviously there's a concern that, well, maybe that's just the tip of the iceberg and maybe this is a really concerning area. there's been one meta-analysis that I saw that looked at patients with type 2 diabetes who used GLP-1 receptor agonists versus something else, some other medication to treat their type 2 diabetes. And they looked at the signal for both depression and suicidal thinking.

And in fact, in that meta-analysis, Patients who were prescribed GLP-1 receptor agonists had lower rates of depression and lower rates of suicidal thinking than patients who were prescribed other medications for their type 2 diabetes. So that meta-analysis says it doesn't say that these anecdotal cases aren't true. You know, patients can use antidepressants, and 90% of patients who use antidepressants might say, is really helping me and it has reduced my suicidal thinking. But other patients using antidepressants can say this caused all sorts of horrible psychiatric symptoms in me. It caused suicidal thinking in me. And both of those statements can be true. Some people can benefit from medications even though

other people might be harmed by them. And I think that we need to remember these nuanced kind of perspectives when we're talking about medications. Again, everybody wants the simple answer. Like, give me a yes or no, Chris. Is it yes or is it no? And I'm like, well, really depends. I can't give you a yes or no. And if you go on this medication and start having suicidal thoughts, stop it.

Let's just use some common sense, maybe. These medications are most, the biggest area of interest is these medications. for addiction. So substance use disorders, alcohol use disorder, but cocaine, smoking cigarettes, marijuana dependence, opioid dependence. We actually have clinical trials underway for all of those right now because there are animal models showing the GLP1 receptor agonists reduce, reward cravings for substances of abuse. Some think that might be how they are reducing weight, is that they are reducing the rewarding effects of food

and or the craving for food. And at the same time they're doing that, it's the same pathways in the brain. At the same time they're doing that, they might also reduce cravings for nicotine or alcohol or cocaine, or cocaine or other substances. So those trials are underway. We have lots of anecdotal case reports.

The New York Times did like a front page story of people went on Wegeve for weight loss and they kicked their alcoholism. They overcame their alcoholism. They hadn't planned to. They didn't intend it. But they just noticed, wow, I'm not really wanting to drink that much anymore. What happened? I used to be such a heavy drinker.

And there are trials of GLP1 receptor agonists for severe mental illnesses, bipolar and schizophrenia. I think a lot of people are really interested in them more from can they prevent the weight gain and the other metabolic side effects of the medications that we commonly prescribe patients with those disorders. But increasingly there's reason to believe that if the GLP1 receptor agoninists, are in fact helping to improve metabolism that they may actually improve brain function as well. These medications are unequivocally impacting mitochondrial function, and that might be a way to help us understand why would one medication treat type 2 diabetes and weight loss and cardiovascular

disease and all of these different mental illnesses. There are trials underway for Alzheimer's disease, GLP1 receptor agonists to prevent Alzheimer's disease or potentially slow it. Why would one medication do all of those things? Brain energy ties all of those things together and says that they are all metabolic and or mitochondrial related. So if I'm hearing from you correctly, it's that we have to keep an open mind that just like other interventions that might be there, that this could be one tool in the toolbox to help us deal with this sort of very advanced stage we're in where people have all sorts of different addictions. It could be traditional drugs, alcohol, substances. But of course, the number one addiction is the sort of process food movement that's out there. And if the

appropriate dosing, along with all the other lifestyle, factors that you encourage, and many of the people that come on this podcast encourage, you know, resistance training, eating healthy, et cetera, are incorporated, then maybe these medications, which are peptides, these peptides, if they can help people in that direction across this whole landscape, we should be keeping an open mind. We don't want to throw them out completely and yet we also don't want to have a society that thinks that they're the magic pill for everything without these lifestyle interventions. Is that an accurate description of how you feel? A hundred percent, especially that last one. So it's not that people get to inject themselves

with GLP1 receptor agonist and then go out and eat bags of Doritos and drink milk. milkshakes and all of that. So the GLP1 receptor agonists are definitely a tool in the toolbox. I don't think it's fair to anyone to say that we should not use them ever. Again, my bias as a clinician is, I have one patient on them prescribed by his endocrinologist for his type 2 diabetes, but as a rule of them, I'm not using it for my other patients. And I'm helping most of my patients lose weight and keep it off and do it pretty effectively. So I'm not a huge fan of jumping out and putting everybody on GLP1 receptor agonists, but I also don't want to stand in the way of people having access to them.

And if they don't have the support or education, or if they're just, if they, if they feel like they've tried to do the work and it's just they're not capable of it, it's too hard, they're too stressed. It just isn't working out for them. If these medications, if these peptides can give them the edge they need to start making progress, I almost want to say who would be opposed to that? But obviously, there are a lot of people opposed to it. But let's promote human health with whatever tools, resources people need.

Yeah, I would say that I'll go on record and say, you know, I've asked a few different people about this question to get their honest thoughts about it. I came in initially when I had heard about this and I felt very much my wellness bias, which is, oh, wait for the other shoe to drop. Is this another, you know, Vioxx or some sort of other thing where we find all these hidden issues that were covered up by clinical trials or hidden? And as I started to go into it further and talk to more practitioners who actually were using, in some cases, microdosing of these.

items or super low doses of them combined with lifestyle factors. I've been reading the book, Magic Pill by the journalist whose name I'm blanking. I'll put in the show notes. I started to realize that, you know, one, these drugs have been used for a long period of time with diabetes, individuals who have been facing diabetes. They are first and foremost peptides, no different than a lot of other peptides that the wellness community might be excited about for their potential therapeutic usages in some instances. And that, you know, we don't have to have the extremes. One extreme being, you know, lobbyist and drug companies saying,

we need to have kids on this from the time that they're young. And then never take them off because when people go off, they gain back all the weight when it comes to, let's say, the obesity, you know, crisis if they're not doing all the other lifestyle factors. And then the other extreme being, you know, know, you should never touch them at all. It's cheating or there's going to be all these other risks that are going to come up. And the truth seems to be somewhere in between. So I appreciate you sharing your honest thoughts on it because I think a lot of our audience is trying to figure

things out and is just paying attention to make sure that they're educated. And, and no to ask the right questions if they are an individual that's potentially seeking some of the usage of these things out. But like you said, there's so many layers that are there and finding practitioners that are open-minded that would work with you. And most importantly, that would never forget to make the lifestyle factors a primary focus to actually give them the best shot. Yeah. So especially when it comes to kids, let me let me give one obvious kind of qualifier to this. So I am of the belief that ultra-processed foods contain ingredients, chemicals, something. They contain something that is probably not good for human health.

And probably a lot of things. It can't be narrowed down to one thing, and that's what makes it so difficult to tease apart and figure out. But that is just, it's a belief. Do I feel like I can say that with certainty and back it up with scientific evidence? Nope, I can't. We can back it up with epidemiological evidence that people who consume more ultra-processed foods have worse health outcomes, both physical health and mental health outcomes.

So that's about the strongest evidence we've got right now. We've got some animal model data that says that when you expose animals to certain ultra-processed foods, they can gain massive amounts of weight. pretty rapidly, they can develop all sorts of problems, including Alzheimer's like plaques and all sorts of things. But then again, you know, the hardcore scientists will say, well, that's an animal. That's not the same thing as a human. So I'll just say my belief is that ultra-processed foods contain things that are harmful to human health. And the best way to avoid those diagnoses, whether it's obesity, diabetes, cardiovascular disease, or mental illness, is not to go on a GLP1 receptor agonist

and keep eating your ultra-processed food. The best way to avoid it is to avoid ultra-processed foods. And so the way that I would stage the intervention in particular with a child is step one is we're getting rid of the ultra-processed foods. They're going out of the house. I'm going to do all the other lifestyle stuff. Are you getting enough sleep? Are you on your screen all day? Are you playing video games all day?

Do you have any real friends? Do you ever see these real friends? I'm going to do all those things as well. So it's not just diet. I'm going to do the comprehensive, common sense, lifestyle intervention, which I say it's common sense. not saying it's easy. When you have families who've been doing this for years or decades, these are hard changes to make. I get it. But that's where I'm going to start.

Now, if the kid, the family are really putting their best effort forward, they're trying to eat real foods, they're doing their best, and they just cannot seem to do it. They just keep, you know, they make progress, but then they fall off the wagon. They make some more progress and fall off the wagon and make progress. The GLP1 agonist might be the thing that gives them the edge to stay on the wagon, but they still have to get on the wagon. And that wagon is you're avoiding all this bad food. You're including these other lifestyle interventions.

You're getting good sleep. You're trying to reduce your screen time. You're getting some movement or exercise in. And that's where I would start. But I do want to say that for the record. I do not at all endorse people taking GLP1 receptor agonists and keeping their diet just the same and simply eating less of it. The food itself actually matters. It's not just calories.

It's more than, yes, calories are a part of it, but it is more than calories. You know, Kevin Hall did a study people, when people were given ultra-processed foods, they ate like on average 500 more calories. It's not because the foods are so delicious. I think it's because the foods are disturbing normal hormone signaling and other metabolic signaling and brain function. it is throwing off your appetite set point, your satiety set point. It is throwing those things off. And that is why they're consuming 500 more calories. It's not that they're glutton's and they just can't resist the delicious taste of the ultra-processed foods.

Is that the ultra-processed foods are influencing human biology. And the solution to that is to avoid them, not eat less of them. That's well said. And in this conversation, I feel like the thing that often gets missed is just the will that societies can have to encourage change in the right direction, especially when it comes to to the kids. Mr. Hari, the gentleman that wrote the book, The Magic Pill, inside of there, one of the chapters

he talks about what happened in Japan in, I believe it was like 2008 or some of around there. There was an uptick in obesity rates amongst the population, but in particular about kids. And in society, we wrote a whole news about this, but I may have the statistics wrong, but it's something like this. The obesity rates went from like 3.8% to 4%. Like a very slight increase. And Japan as a country had a national.

freak out. They said, holy smokes, this is heading in the wrong direction. We did do something about this. So there was all these laws that were passed. And one of the first things they did is they banned processed foods in all schools.

All schools in Japan. Process foods were banned. And they mandated and said every school has to have a dedicated nutritionist on staff and all meals must be provided to students from scratch every day, not from ultra-processed foods. Along with that, there was a few other controversial laws they ended up passing.

One of the laws that they ended up passing was that companies at a certain size and level had to support their staff and their employees in making sure that their weight did not increase over a pit of time. Something like this probably wouldn't fly in the United States. And if an employee's waist circumference and weight headed in the wrong direction, they had to assign them a nutritionist and give them, you know, kind of like a coach to help them move in the right direction. And as controversial as it sounds, and again, I'm not necessarily recommending this. I'm just saying the will of the people. A lot of employees in surveys said that they appreciated these efforts of the companies helping them because if they were left to their own devices, they might have felt like they would have headed in the.

wrong direction. So it just shows that if we used some of this energy from our industrial war machine that seems to have endless budgets every single year, and we actually supported kids at an early age with the right food and education, what would be possible for us as a society? I think it's worthwhile to at least have that debate here in this country. Absolutely. I agree. And I'm, I'm, I'm actually friends with a few people who have been doing that. You know, Robert Lustig has supported a nonprofit organization called Eat Real, which is actually focused on getting real whole foods in school lunches and school programs

across the country. And they're making a dent. They're actually getting it done. There's the Shaw Family Foundation. here in Boston got all of the Boston inner city schools to go from processed foods to made from scratch real whole food lunches. They hired a chef, they did a documentary. And it's pretty impressive the way they managed that. It turns out that schools actually do have the option of purchasing real whole food.

They usually just don't because it's a little, it's like one or two extra steps. You mean we actually have to cook that as opposed to put it in the microwave and heat it up? Wow, that's two extra steps. And we don't have time for that. Well, they went out of their way to figure out a way for the school lunch programs to have enough staff.

to be able to do those one or two extra steps and make real food. So although these feel like monumental problems and it feels like we're all pushing this big boulder uphill and we'll never get there, people are making progress. There are real things that we can do and to change this kind of tide. It doesn't have to be this constant downhill downward trajectory for human. health. You know, I want to read a tweet that you had that a lot of people retweeted that were out there just so fitting for this topic. And you wrote, what we eat affects the brain, what we eat affects the brain even when we're young. Someday, we'll look back in disbelief at how this obvious statement was met with skepticism by many mental health professionals. What's fueling

this skepticism that's still there for some of these most basic common sense statements that we all know to be true. You know, so I put out that tweet because when I say what we eat impacts our brain, most people will say, well, yeah, of course. How could it not? That's obvious. Tell me something I don't know, Chris. And yet, when people go to a mental health professional, whether it's a psychiatrist, a psychologist, a social worker therapist, a counselor therapist, well over nine times out of ten, those mental health professionals don't even ask you about diet or exercise or nutrition and vitamins and possible vitamin deficiencies. and when most, you know, there's been kind of fledgling nutritional psychiatry movement for decades, with psychiatrists and neuroscientists trying to get the mental health profession to take seriously, that diet can actually play a role in something like depression or anxiety.

And by and large, that's been met with tremendous skepticism. Diet doesn't play a role in that. You know, Linus Pauling, you know, some consider him kind of the father of functional medicine, really proposed that vitamin, nutrient deficiencies might be a core root cause of mental disorders. And for the most part, most mental health professionals think that is either laughable or those are just extraordinarily rare cases, Chris. Those are really rare cases and the majority of people don't have vitamin or nutrient deficiencies. And that has nothing to do with schizophrenia or bipolar or ADHD or autism. That these are brain disorders.

these are neurodevelopmental disorders. These are chemical imbalances. These are genetic. These are built into the genes of the human genome. They are inheritable. They must be genetic. And stop blaming diet. Diet's not going to do anything.

And that is really where we're still at as a field right now. Everything that I just said, most psychiatrists, mental health professionals, would say, yeah, that pretty much sums it up, Chris. Sounds like you got your head on your shoulders and you at least get it. So I think that some of the ways that I want people to think about it, I want them to think about it in much more complex, nuanced ways. I want them to think about what impact does food have on inflammatory biomarkers? because inflammatory biomarkers are causing inflammation. That's what they do.

And when inflammation occurs in the brain, it can cause the brain to malfunction and result in symptoms of neuropsychiatric disorders. When I talk to them about that, then they start to get it. And when I say, you know the food we eat can actually cause inflammation. The often say, well, it's hard to disagree with that. I guess maybe that's true. And well, you know that inflammation might be affecting the brain. Huh, I never thought about that way.

And, huh, nobody's ever said it that way. So I feel like the science is there. We have the science. We have the evidence. It's just that we have to draw from so many different fields. And most professionals do not understand metabolic science. They don't understand diabetes, biology, and pathophysiology. They don't understand the pathophysiology of obesity.

They don't understand the pathophysiology of cardiovascular disease. We need to put it all together. And when we put it all together, it starts to come together. And we start to see that actually what we put in our mouths does influence metabolism broadly. It influences not just inflammation, but insulin signaling and glucose levels, nutrient deficiencies or nutrient, you know, just balanced nutrients. There are so many ways that diet can go wrong. So again, I don't have the simple, easy, okay, everybody follow this one strict diet that I'm going to outline for you and everybody will be fine. No, it does. Humans don't work that way. And let me give you an easy example of why that is infants need breast milk. They do best on breast milk. Young children don't necessarily need breast milk anymore. Adults should not be drinking breast milk. They all need different diets. They're all

humans still. And then again, as I mentioned before, different people have different sensitivities, allergies, they have different health conditions. They do come to the table with different genetic predispositions. So we need a little bit more nuanced. But at the end of the day, it's as simple as what we talked about before. Look at your mental health, look at your metabolic health biomarkers, some basic ones. If those things are all in a good place, then whatever you're doing, is great. Just keep doing it. And if those things are in a bad place, you're getting an alarm. It's kind of like you're in a car and the light is on. The warning light is on. Warning you. It's trying, your body is trying to warn you. Danger, danger. Something you're doing is not good for

human health. Pay attention to that warning light. Do something about it. Figure out what is wrong. fix it. It's not always, it's usually not rocket science. It usually isn't. And usually common sense lifestyle strategies will solve the problem for most people. You know, at the beginning of this episode, I asked you what's at stake? If we don't get to the root of this, and if we're not paying attention to this movement, that brain energy is a huge part of, And you talked about the increasing statistics of people suffering, increased rates of autism spectrum diagnoses, severe mental health issues like depression, schizophrenia, et cetera. And to go one step further, there's this troubling, limited and very early movement,

but very troubling of individuals who feel that they've gotten the message from their health care practitioner that this disease, which is part of their identity, has not gotten better. And often in these situations, you might have a young person who feels like I cannot go on living like this. And in particular, there's been a few very viral stories, one that you wrote about on Twitter and how it broke your heart about a young woman in, I believe, in Europe and how she felt that no medication was making a difference and had sought out for essentially the support of state assisted suicide, euthanasia.

and I wanted you to get, I wanted to get a chance for you to just talk about this. Again, I want to share with the audience that these accounts are limited, but do seem like they might be having an uptick of young, you know, individuals in particular. In this case, this woman had kids who are seeking out to end their life because they feel like there's not a chance of them getting better. Can you chat about this? Yeah. It's, as you said, some will argue it's a small issue right now.

There aren't that many people dying. I'm actually really concerned about what message this sends and what the precedent means. and how much do we let this grow to its full capacity? So right now, it's primarily, this is mostly happening in the Netherlands, where they have legalized assisted dying or euthanasia for patients with mental illness. And there have been, you know, increasingly news outlets,

the free press, the telegraph just the other day published an article, highlighting some of the cases and what it means. And, you know, there was a woman who I think she was 29 who self-identified as autistic and then potentially also had depression, anxiety, a personality disorder. And the Free Press did a story on her before she died, and she's dead now. And she's dead through medical-assisted euthanasia. The Telegraph in the UK, this story talked about how this might be coming to the UK. A 17-year-old, I can't vouch for the truthfulness of this, but I hope they didn't publish it if it wasn't true. A 17-year-old girl, girl with borderline personality disorder was put to death.

That is an outrage, as far as I'm concerned. A 17-year-old? my God, what are we doing? And then this woman that you described, who's a mother of two young children, the two young children don't even know she's planning on assisted suicide. She's being told,

try one more psychiatric pill, and if that doesn't work, then we will give you euthanasia. The heartbreak, you know, it's a heart. I will declare my bias up front and then I'm going to go into a lot of nuance. But as a rule of thumb, I have hope for people with mental illness. I think they can get better.

I think it is a travesty that we are giving up on them. I think it is a travesty. It is unconscionable. I believe it is unethical that we are killing them. And even if it's at their request, we are helping them die. And so now the nuance of this discussion, there is no doubt mental illnesses can torment people. Mental illnesses can make their lives unbearable, can make their suffering unimaginable to people to people who have never experienced it.

And that suffering when it occurs day after day, week after week, year after year, can become intolerable. And I fully understand how people can be pushed to the decision that I would be better off dead than alive. So I get that. That's one perspective. A second perspective, though, is that the illnesses themselves, depression in particular, but also substance use disorders, schizophrenia, all sorts of others. The illnesses themselves can make people lose all hope, can make people feel suicidal.

I've had patients even say to me, I don't know why I keep thinking about. death. On the surface, I have a decent enough life, but I just am plagued by thoughts of dying and wanting to kill myself. Patients with schizophrenia may say, I don't want to die, but the voice keeps telling me to kill myself. The voice is doing it. So in some cases, the symptom of the illness itself is hopelessness and suicidality. And I want to be clear, we should never confirm that belief. We should never collude with that. We should never enable that belief.

That is a wrong belief. Their brain is malfunctioning. Their brain is tormenting them. And we, society, people who love them, people who care about them, people who are trying to help them, we should make very clear and unequivocal, this is your illness. This is your brain doing this to you. This is not you. This is not a rational decision.

This is not a good decision. I can't, you know, I can understand how you're tormented by it. But I'm not going to collude with this. I'm going to get you better instead. And I'm not saying we're just going to ignore them and turn them out to the street and tell them to suffer relentlessly and leave them alone. No, they desperately need help and we need to provide good interventions. The great news is that we've got a lot of interventions available today. So one, standard treatments do work for people.

People can get standard treatments. But we've got new cutting edge transcranial magnetic stimulants. therapy, like the Saint Protocol out of Stanford, which does very focal targeted transcranial magnetic stimulation. You're still awake while they're doing it, but it's specifically targeting one brain region. People can go from suicidal to not suicidal in less than 24 hours. Ketamine for some people can do the same thing. Psychedelics can do that thing. And obviously, the work that I've been doing is with the ketogenic diet therapy, ketogenic diets can take people who have severe crippling disorders that leave them chronically suicidal, and I can't even tell you how many patients I'm

aware of. People who are sharing their stories very publicly. I've shared some of them very openly all for free on the Brain Energy website and others. If you do follow me on Twitter or X. These people are out there. They're out there talking, sharing their stories. Just tweet me and I'll like summon them to share their stories with you. They are vocal and passionate because they know I was in that hell. I was trapped in that place. I was trapped in that desperate place. And I found my way out through ketogenic diet therapy. And I want to help others get out of that hellhole too. I want to help them get out. So when we as society instead say, yeah, you know, we've got limited resources. You're just a mentally ill person anyway. You haven't worked in years. You're on disability.

You're in and out of hospitals. You're kind of a burden to society. Oh, you want to die? Oh, we could sign you up for that. we'll make that easy. We'll make sure the job gets done. We don't want you to go wing it because you'll probably fail. Most people who attempt suicide don't actually succeed in committing suicide or completing suicide. So we'll go ahead and make sure it gets done right and make sure you're dead. You know, people with mental illness are some sometimes the most vulnerable citizens in society. They are beaten down.

The stigma against them is profound. They sometimes have no self-respect or a sense of self-worth. And again, some of this is their illness does that to them. Some of it is just a reality check. And then the way that people get to mental illness, Some of them have been abused and neglected and raped and drugged and everything else. So they already come to the table vulnerable and weak and we're just going to put them to death. And although it is primarily happening in the Netherlands, the UK is entertaining it.

The UK is using terms like terminal anorexia. the United Kingdom is telling some patients with anorexia nervosa, you've tried enough treatment. You haven't gotten better. I think we're done. You're going to die. And we will put you on hospice care or palliative care. But we're not going to really try that hard anymore to get you better because you

have what we are calling terminal anorexia. Canada has passed the law saying that they are going to start offering assisted dying to patients with mental illness. They have not yet implemented it. It was supposed to be implemented, I believe, in March of this year, and they delayed implementation because they are trying to round up enough psychiatrists who are going to sign on the dotted line for these people to die. But I guess once they get enough psychiatrists who are willing to do that, then they're going to

start offering assisted dying. And the concern is that the, I mean, I have a very, I have a very important. so many concerns, but to put them in a nutshell, the big concerns on my part. One, people with mental illness are discriminated against, they are vulnerable, they are often weak and disenfranchised. Two, they often don't have access to decent mental health care. It is not fair. We're not even trying. We're not even giving them a fair chance to get better because they're not even getting decent traditional mental health care. The next one, we've got a lot of emerging treatments.

And I obviously am a passionate believer in the brain energy theory and the metabolic theory of mental illness that comes with some common sense, very low cost, sometimes free interventions. We could be getting people with schizophrenia better with very low cost interventions like a ketodys. diet. That doesn't cost a lot of money. Antisicotics cost tens of thousands of dollars. This is relatively low cost. Now the saint procedure, the TMS, that's very expensive. But if it saves a life, I'm all for it. We spend that kind of money when people are having heart attacks and strokes. Why shouldn't we spend that money, that same amount of money to save someone's life who's got crippling depression with suicidality? Why shouldn't we?

Their life is just as valuable as another person's. And then finally, as I've said over and over, but I just want to, like, how do we tease apart the true rational decision to want to end one's life from a mental illness, from a symptom, an irrational, maybe even delusional thought that I want to be. be dead, how do we distinguish those two things in people who are mentally ill? It's not easy. And that means we're colluding with the illness. The illness is trying to take their life and we're going along with it.

Like, how unconscionable is that? Like, why would we do that? Why? Like, we should be fighting for these people. We should be saving them. It would be like saying like, oh, well, you know, somebody came in with cancer and their cancer's trying to kill them. So we're just going to help it along. The cancer is trying to kill them anyway.

You know, that's nature. That's natural. So the cancer is really trying to kill them. So, yeah, and they're getting kind of weak and beaten down and worn down. So we'll just go ahead and give them a lethal injection and call it a day. It feels similar to that, that when patients have severe suicidality, recurrent suicidality, a lot of times that's a symptom of their illness. And we should be fighting it just like we fight cancer.

We should be trying to save people's lives, not surrendering and helping it along. Well, Chris, I super appreciate you. commenting on that because as you've mentioned, I mentioned too, even though these numbers of these incidences and reports are quite low, they're very troubling because they're part of this greater trend towards an acceptance of the status quo. The status quo is that things are bad, they're going to continue to get worse, and for some people, they're never going to get better. And that, unfortunately, is the belief of a lot of people that are out there. And many, as you've addressed, unfortunately, that are part of the larger medical system.

And not out of malfeasance, often, although some of that may exist, out of lack of awareness that there's a different way of treating and getting these patients help. And if we don't as a society, help spread the message of what's possible. And that by returning to many of the natural rhythms, dietary-wise, sleep-wise, community-wise, you know, support system, you know, church, whatever that might be for somebody that's out there, avoiding and minimizing substance abuse, many of the key basic principles that you talk about and go pretty deep into your book about, that simply by returning to these principles

that we could actually get people healthy, that we could get people feeling better, and you have many cases of those, and you've inspired a movement of many of those people sharing those cases online, that if we don't acknowledge that that's possible and that's happening, we are letting people believe that there is no hope.

And that's not a world that I want to live in. And I know that's not a world that you want to live in, where people don't feel like they have hope. And I know that's a world that our listeners today don't want to see unfold. So, Chris, I want to acknowledge you for all your work to help us avoid heading in that direction and to peel us back from a lot of the society that is unfortunate. unfortunately set up to maintain the status quo that people are unhealthy, that people have severe mental health disorders and there's nothing that you can do.

It truly is a fight and it's a noble fight and you're helping us lead it. And by you coming on the podcast today and diving deeper into many of these questions that our audience had from our first episode, you're empowering this army that's here to support you and many of the practitioners that are raising awareness. So I want to thank you and acknowledge you for coming back today and for putting in all the effort that you continue to put in on a regular basis. And I know you have a lot of support around you to showcase that there's a different way of going about things. Chris, thank you so much for being back on the podcast today. Brain Energy, the book is still out there.

It's been translated in many, many, many languages. I've lost count, actually, of the total. What's the count today of how many languages? They're not all released, but it's, I think we're up to 11 different languages that it will be translated into. So yeah. Oh, that's amazing. And if you are listening abroad, which we had many people listening before, we'll link to your website, the Dr. Chris Palmer website, where they can find those languages that the book may be in. Chris, anywhere else that you want to send our audience who's listening today? Yeah, if they, if people want to go to brainenergy.com, we've got a newsletter for free. We've got a lot of of information. There are articles there. And you can help us build a movement to improve mental

health care. We are really looking to gather people together who are passionate about doing something about this. It is a massive uphill battle. So please join us. If you're interested in this, if you or someone you know has a massive uphill battle. mental illness and they aren't necessarily getting better and you want better treatment for them, join us because we've got a lot of work to do and there's a lot at stake. And the only thing standing in the way, it's not knowledge anymore. We have treatments. We have knowledge.

The thing standing in the way are resources, political will. If we had more resources for treatment, for education, For research, we could advance this field so rapidly. And, you know, people got worked up about breast cancer, and they did something. They marched. They went to fundraisers, and they made progress. People got worked up about HIV-AIDS. They did something.

They marched. They started a movement, and they made tremendous progress. They took what was a life kind of ending illness, guaranteed death sentence essentially, to now a chronic illness that is treatable, that patients can take medications. We need a mental health movement. We need people marching in the streets, calling legislators, calling insurance companies, demanding action because the only thing standing in the way are people speaking out. And if more people speak out, we can get this done. So thank you, Drew, for having me on. Thank you for the opportunity to

share my passion. I get so worked up, I know. But I really do care about these people. And I am one of these people. And family members are these people. So I don't mean to say these people. I'm part of these people. But that's why I get so worked up too. I couldn't think of a better reason to get worked up. And I'm so thankful that you do get worked up and that you're willing to share your story and push forward this movement. Dr. Chris Palmer, thank you so much for coming back on the podcast. Thanks, Drew. Hi, everyone. Drew here. Two quick things. Number one, thank you so much for listening to this podcast. If you haven't already, subscribe, just hit the subscribe button on your favorite podcast app. And by the way, if you love this episode,

it would mean the world to me. And it's the number one thing that you can do to support this podcast is share it with a friend, share with a friend who would benefit from listening. Number two, before I go, I just had to tell you about something that I've been working on that I'm super excited about.

It's my weekly newsletter, and it's called Try This. Every Friday, yes, every Friday, 52 weeks a year, I send out an easy-to-digest protocol of simple steps that you or anyone you love can follow to optimize your own health. everything from nutrition to mindset to metabolic health, sleep, community, longevity, and so

much more. If you want to get on this email list, which is, by the way, free and get my weekly step-by-step protocols for whole-body health and optimization, click the link in the show notes that's called Try This or just go to Drew Perot.com. That's D-H-R-U-P-U-R-H-I-T-com and click on the tab that says, try this.