Just As Well, The Women's Health Podcast - Dr Giles Yeo: Obesity, Food Noise and the Truth About GLP-1s

Episode Date: May 5, 2026

In this episode of Just As Well, Claire Sanderson and Gemma Atkinson are joined by Dr Giles Yeo — obesity expert, geneticist and bestselling author — for a powerful conversation on the science of ...weight. Together, they explore why obesity is a chronic disease rather than a simple lifestyle choice, and how our brains, genetics and environment shape the way we eat. Dr Yeo explains the concept of “food noise”, why some people feel hungrier than others, and why losing weight can feel like your body is working against you. They also take a deep dive into GLP-1 drugs, including how they work, who they’re designed for, and why they shouldn’t be treated as cosmetic quick fixes. From the risks of misuse to the potential future of these medications, this episode offers a clear, evidence-based perspective on one of the most talked-about topics in health today. A thoughtful and compassionate look at obesity, weight stigma and what it really takes to improve our health. Learn more about your ad choices. Visit megaphone.fm/adchoices

Transcript
Discussion (0)
Starting point is 00:00:00 Hello, I'm Gemma Atkinson. And I'm Claire Sanderson. We've just finished a lovely chat for another recording of our podcast just as well. We did. So our guest today was Dr. Giles Yo. He is an obesity expert from the University of Cambridge, a best-selling author. And someone, I'm sure, you'll recognise. He has a show on Radio 4 all about obesity.
Starting point is 00:00:20 He's a very well-known media commentator and so knowledgeable on the subject. It's very funny as well. Yeah, he was very funny. We spoke about some of the A listers on the red carpet and he went, that's not yoga, honey. It was brilliant. He dimes into obesity in that he states why it's a chronic disease and illness, not just a lifestyle choice, how it's a chemical,
Starting point is 00:00:46 it's something in your brain which programs you to think, feel and react differently to food than other people. He spoke about the population, the amount of millions of people relying on GLP-1s. He spoke about all the good things about them as well as all the bad things about them. Yes, he urged caution before taking them. He clearly thinks they're being taken too widely and the benefits don't outweigh the potential risks
Starting point is 00:01:16 for a lot of people who are taking them purely for aesthetic reasons. He actually said it is not lipstick. And by that he meant, it is not something you're doing just to improve your, appearance in a superficial way. There are endless health benefits to them, but they really should be used sensibly and only for people who really need them.
Starting point is 00:01:40 Yeah, and he shared his views and where he feels they will be in 10 years and it was quite scary, quite, quite scary actually, where the GLP one is going to go in 10 years. So, yeah, he was a fantastic, fantastic chat, great guy, enjoyed this. week's episode. And if you are liking the pod, please subscribe, leave us a comment, leave us reviews and let us know who you'd like to chat to next. Enjoy.
Starting point is 00:02:12 Dr. Giles, yo, welcome to Just as well. Thank you for having me. So Giles, I see you everywhere talking about obesity. You are one of the most eminent voices on the subject in the UK. I remember reading your book years ago. shortly after we first met actually about eight years ago a woman's health life and it's that long ago? It was that long ago.
Starting point is 00:02:39 It was, it feels like yesterday well not yesterday but it feels like six months ago no it was eight years ago and we were talking about obesity then way before GLP1s came into the conversation it's a subject that keeps on giving because it affects so many people and the conversation is evolving
Starting point is 00:02:59 and GLP1s are of very much part in our vernacular now. But let's just talk about what obesity is. And tell me, from your point of view, as the expert that you are, what is the chronic condition that is obesity? I think the biggest mistake that people make is that people think that obesity is just a number and a scale. And I don't think it is. So it's not your weight, because obviously you can be, have different amounts of muscle. I don't think it's your BMI. I think that obesity, the field is beginning to realize it is carrying too much fat that it begins to influence your health. Now, so by definition, obesity is a disease because it's influencing your health.
Starting point is 00:03:43 The nuance, the complexity underlying that, is different people carry too much fat safely or unsafely. So in other words, we all have a different amount of fat we can actually carry in us. Some can carry more. Some can, some can't carry any fat at all in skinny and suddenly have, have disease. So I think that's what obesity is. Obesity is you have surpassed your safe fat-carrying capacity, so it's begun to make you feel ill.
Starting point is 00:04:08 I'm glad as well you mentioned then when you touched on weight because a lot of people fixate on the scale as opposed to like you say, your muscle mass and your body fat. I'm 5'9 or around 72 kilograms. I do a lot of strength training. And when I go on the scales at the doctors or have my BMI, whatever it is they do, I'm told it's high. but when you do my body fat to muscle mass ratio, it's not at all.
Starting point is 00:04:36 But a lot of people, the era I grew up in, we were told if you're obese, you're fat, you're lazy, you eat too much and you don't move enough. That was literally, that was thrust down us. To the point where, you know, friends of mine who were overweight was so like, just depressed because that's what they were told. Fat, lazy, eat too much, don't move enough. What's those myths around it? What is that? So I think an issue with obesity is two things. It's a very public thing.
Starting point is 00:05:07 You can have a lot of other conditions, for example, a heart condition, arthritis, whatever. And it's invisible. So I can look at you, you can be suffering from whatever, and I can't actually tell. The thing about obesity is obviously is very, it's public, it's very visible and everyone can see it. So that's the first problem. The second problem is because it's obviously so related to what you eat, right? eating is also a very public thing, except for when you're eating, obviously, at home,
Starting point is 00:05:35 but when you go to the supermarket, the shop, when you go to a restaurant, everybody, first of all, can see your body size, whatever size you are, everyone can see what's in your shopping trolley, how much food have you ordered, and have you bought, and because we can only,
Starting point is 00:05:52 we're primitive mammals, we can only model the world around us and feel what we feel. I would say, well, hang on a second, I only needed one slice of pizza, and I'm full. Why do you need three slices of pizza? Because I'm trying to judge the way you eat, I say I'm pointing at you, but the judge that someone eats based on me. And that's the problem. So people go around the world and there's going to be some people who feel more or less hungry
Starting point is 00:06:16 or whatever. And so therefore are judging other people based on their feelings. That is why we have, that is why we have this problem with obesity. They do not understand how someone with obesity feels. And I think that is probably the key problem that we have. It's a public disease. Why do some people become obese, whereas others seem to manage their weight more effectively? So, look, I study the genetics of body weight, and we now know, we, the whole field, rather than me personally, that the genetics of body weight is the genetics of how our brain influences our feeding behavior. So what do I mean by feeding behavior? You know, how come some people eat when they're stressed
Starting point is 00:07:03 and other people stop eating when they're stressed? Why do people appear more hungry than others? How come some people need more food to get filled up? And these are not imagined behaviors. They're just the way we are around food. And we know of over a thousand genes now that actually function within our brain that influence our feeding behavior.
Starting point is 00:07:22 So ultimately, what happens is some people, for a myriad of different reasons, find it more difficult to say no to food than others, right? And so hence they just are more driven, more drawn towards food. They eat more, they gain weight, and obviously some people end up with obesity. And so that's it. So I'm not, whenever I talk about genetics or body weight, people think I'm anti-physics. I'm not anti-physics.
Starting point is 00:07:45 I realize you have to eat more than you need to gain weight, and therefore the reverse is also true. You need to eat less in order to lose weight. But if you have a higher drive, if you have a higher thermostat, in your hunger compared to someone else, that is what we're talking about. So for some people who are lean, naturally lean, without having to put too much effort in, some people might think they have more willpower or they may be more morally, you know, whatever. No, it's just a thermostat. So some people are set lower, to be comfortable or lower body weight, other people are just a higher thermostat. They're set higher. So with the brain playing a massive role when it comes to controlling hunger
Starting point is 00:08:26 and just being full, is that why now obesity is described more as a chronic health condition as opposed to a lifestyle choice? Because again, a lot of people say, well, it's their fault. They're the ones, they've chose to eat that full pizza. They didn't have the control. But if it's their brain, that's controlling that. It's surely not their choice if it's being overpowered by the brain. Exactly.
Starting point is 00:08:50 So, first of all, I really do not like the word lifestyle, because people have been calling obesity and type 2 diabetes, a lifestyle disease forever. I think they're behavioral diseases. Undoubtedly, they're behavioral diseases. So why am I playing with language? Because lifestyle implies choice. Whereas you do need to change your behavior in order to lose weight. Of course you do, right?
Starting point is 00:09:12 Whereas behavior just means that, well, some people's behaviors are different for different reasons. Anyway, so I do think it's a behavioral disease, undoubtedly. But because it's so driven by the brain and we don't actually know how, another person's brain is driving them to eat. So for some people, it is always going to be more difficult than others. People are fighting their biology.
Starting point is 00:09:33 I think many people are fighting their biology when it comes to food. You've mentioned the brain, but can some people eat more and not gain weight? So can there be two people who eat the same, but it will cause someone to put on to gain weight, but someone doesn't seem to gain weight, eating the same amount or is the thermostat of calories just very basic, you have a set point. If you're more than that, you're going to gain weight.
Starting point is 00:10:03 So, once again, there's a nuance there. Yes, two people can eat exactly the same amount of food and gain differing amounts of weight or not gain weight at all. The effect is not as high as some people would like to think it is, shall we say, but there undoubtedly going to be differences between how much you guys can eat and I can eat and what our body weight will do. The food intake is always going to be a far bigger effect.
Starting point is 00:10:28 So we're designed to eat food a lot quicker than we can burn it. So like a chocolate bar is what, 200 calories or something, right? And I could finish one in 30 seconds. But it doesn't matter how fast or slow I finish the chocolate bar. I will always need to walk but 20 minutes on a treadmill in order to burn it off. So we're designed to eat food far more quickly and efficiently than we are burning. But people do burn fuel at different rates. And when you said it's more behavior.
Starting point is 00:10:56 Yeah. Because you hear, I've read a lot of times it's genetics. My mum and dad were obese. I'm obese. Is it a genetic thing or is it just no, your mom and dad bought that type of food? So that's what you grew up on versus, you know, my mom and dad went to the gym every day. So I did that. Or is it the genetic component, which you're likely to gain weight quicker because of your parents.
Starting point is 00:11:19 So the word you use is component and that is going to be right. So it's not 100% genetics. I think when people misunderstand, I think, what geneticists do or what genetics can tell you, and people think that genetics sort of determines who you are in a fatalistic kind of way, then that's not true. Your genes will bracket a set of possibilities, okay, because they're your genes. But within that set of possibilities, you can move up and down. Okay, so, you know, you can ask different questions.
Starting point is 00:11:46 You can say, well, am I married, do I commute to work? Am I vegetarian? Are you rich or poor? even with exactly the same identical genetic drive, you can still be more or less, higher or lower body weight. I guess the other analogy I would use is this. Like, I will never ever be able to run as fast as Usain Bolt, okay?
Starting point is 00:12:08 And it's because of my genes. I'm sticking to that. But it doesn't mean that if I train, I won't be able to run faster than I do now. So that's probably the analogy. Yeah. Where you have a, I'm never going to be an Olympic athlete in terms of sprinting.
Starting point is 00:12:22 but if I train, I will run faster than I do know. Yeah, so that's probably the same thing, right? Where there are going to be some people who are set who are never going to be thick and sex, okay, who are never going to be skinny. But that doesn't mean you can't do something about it. It's just more difficult for some people than others. Because it's like people's, a lot of the time,
Starting point is 00:12:41 you are a product of your environment. There was a study. I can't even remember where it was from. It was two twins, identical twins, and both from a larger family, So as in the mum and dad were overweight. And they got separated. One stayed with the parents who were overweight.
Starting point is 00:12:59 One went to a family who had no illnesses overweight in the family, whichever. And they kind of brought them back together later on. And the one who grew up with the overweight parents was overweight. The one who didn't wasn't. Now they had the same, identical twins. So they were saying, again, a lot of it comes down to you mentioned whether you're rich or poor. One family didn't have access to the local gym to hold. foods to, you know, time off work to go on hikes and swimming and stuff, the other family did.
Starting point is 00:13:29 Is that a big factor as well in terms of the people you're seeing who are overweight? Is there a circumstance financially? It's a huge factor because if you take a look at, if you look at the prevalence of obesity in this country, 10-year-olds, so leaving primary school, if you go to the top, probably everybody listening to this podcast, okay, so the top 20% socioeconomically, then prevalence of childhood obesity is around the. 13 to 14%. Too high. But 13 to 14.
Starting point is 00:13:55 It is. But if you go to the bottom 20% socioeconomically, okay, and in this country, prevalence of obesity at 10 year old, 10 year olds leaving primary school, 31.5%, nearly 32%. That is far more than double. And there's no genetic difference
Starting point is 00:14:11 between rich or poor. It's an accident of birth. So your privilege and your poverty really do make a difference. The way that I conceptualize this, is this. So imagine have I have a twin with exactly the same
Starting point is 00:14:26 genetic drive to eat, whatever that drive is. Now, at the moment, I live in some leafy village outside Cambridge, right? I live so far away from anything,
Starting point is 00:14:33 deliver who doesn't deliver. So if I'm hungry on a Sunday night for something, and I have no takeaway place near me, I'd have to hop in a car or do something. I'd have to leap over a hurdle
Starting point is 00:14:46 to get some food. If, however, I lived above a chicken shop and clapham or something, okay, I could respond to that drive to eat far easier. So the exact same genetic drive. So your genes tell one part of the story, undoubtedly, and that's what I study, right?
Starting point is 00:15:03 And undoubtedly there will be drives and we try and understand the mechanisms. But your environment around you really, really, really matters as well. I think it's roughly 50-50. So 50% will be genetic drive. And there's some people who just use food as fuel and really would not think about food at all. So it doesn't really matter if they're rich or poor. Whereas there are going to be people, like myself, I love food. I really love food.
Starting point is 00:15:26 If I lived close to restaurants, I'd be fat and poor. It'd be terrible. It'd be terrible, yeah. Because Dr. Zoe Williams, whom we had on this podcast, spoke about just that, didn't she? She said her practice is in a very deprived area of London, Tower Hamlet. And she described it as a food desert in that if she needs to pop out and buy something healthy for lunch,
Starting point is 00:15:49 it is impossible unless she goes to the chicken shop and she has to really go out of her way to find somewhere far from where her clinic is if she wanted to find anything remotely fresh that's not processed and not deep fried and full of MSC etc and that is the reality of a lot of people from lower socioeconomic areas
Starting point is 00:16:11 who are on these high streets where almost exclusively takeaways. I look at where I'm from in South Wales which is a very deprived area, the South Wales valleys. And our high street, when I was growing up in a village, to call it as a high street, is sort of a mislabel, really. It's a, you know, we're old with a few shops. But there was a butchers, there was a pantry, you know, there was fresh food.
Starting point is 00:16:35 Now there's two chip shops, three Chinese, an Indian, a Thai, two pizzas, and literally, I'm not joking here. And this is a village in the South Wales valleys and a spa. So you can go to your spa and get your milk. But apart from that, it's all takeaways. And then you wonder why obesity is endemic in these areas when that is what is available to them. But this requires legislation, right?
Starting point is 00:17:03 Because so this is a situation where personal choice, there's always some level of personal choice. I just want to be clear. It's your health. It's your kids' health. You need to sort of take some responsibility. Yeah, of course. But if this is the situation in an environment,
Starting point is 00:17:18 we're talking about, and you have a drive to eat genetically, then what are you going to do? So if you then, you're absolutely right about a takeaway. So people have done studies, colleagues of mine in Cambridge have done studies in which they sort of map the concentration of takeaways based on postal code. So entirely based on how rich or poor, that's postal code is. And they're not going to be a lot of takeaways in Chelsea and Westminster, whereas there's going to be tons and somewhere else. And it's, you're widening the health divide.
Starting point is 00:17:48 Why are there in terms of town planners, in terms of legislation, why are so many of these shops allowed to open? I'm not anti-takeaway, but I think concentration is an issue. And I do think we need to sort of have a real good look of understanding health inequalities or next to a primary school or whatever, right? I mean, we just got to have some basic rules about the number of types of shops in specific areas. otherwise we're never going to close the health inequality gap. And it's kind of like the modern food environment now. It's completely the opposite of how our bodies were evolved to eat and what we were involved to eat.
Starting point is 00:18:31 And you say about having rules and it being your responsibility, I totally agree with that. When we were growing up every Friday in our house without fail, it was a chippy tea. We were from a northern working class family. So every Friday, chippy tea in front of the teller. You didn't have to sit at the table. We'll eat it out the bag.
Starting point is 00:18:48 We used to look forward to it. But on a Sunday, Sunday dinner, my Nana or my mum, you know, proper potatoes and goose fat, you know. But in the week, whether I liked it or not, I had to sit at the table and eat my veg with my evening meal. And it was things like fish fingers with, you don't just peas and carrots. And I'd be like, oh, Mom, I don't want.
Starting point is 00:19:09 And she said, if you want your chippy tea on a Friday, you eat your veg now. And that was kind of like the trade-off for us. Had my mum, you know, and I'm sure at times she felt like it with two daughters, thought, oh, sod this, just go and have your chips. I probably would have got accustomed to that more and more. And then now I've got two kids, I'm very similar with mine. Weekend, if you want to have your pancakes for breakfast, you pick and mix, whatever.
Starting point is 00:19:34 But during the week, when you've got to be focused and at school, you need to eat proper. But I'm in the situation, like you say, I'm in an area where I can do that. I'm privileged to do that. I'm sure not every, well, I know not every family. has the access and like you say now, chippy is a lot cheaper. Going buying a fish and chips to share is a lot cheaper than doing a shop with all your veg. And it's so accessible for people. Like you say, they should be, they're outside primary schools.
Starting point is 00:20:00 How many like takeaways in shops do they put right across the road from high schools or primary school? Because they know, as soon as that bell rings, they're straight in. And then they're going home, loaded on sweets, loaded on whatever. And then sitting down, not wanting a good tea. They just want snacky snacks. calories have, I don't think I've ever been easier or to get in terms of the calories, just pure calories for the amount of money. I think people have sort of, you talk about chips, right? I think people have done the maths and they're thinking that you can get nearly a thousand calories for less than a pound or 90 people.
Starting point is 00:20:33 But what kind of calories, right? Are you getting in from fruit, from veg? Is it entirely 100% chips, right? And I think that is the problem where calories are easy to get and cheap, but not. But that's calorie density. Nutrient-dense foods, they are at the moment not cheap, right? So the healthiest foods, unfortunately, are not the cheapest foods at the moment, at the moment again. And people always say, well, wait on my hang on a second.
Starting point is 00:21:01 Whenever I say this, people go, yeah, but lentils are cheap. True. Okay, the dried lentil is definitely dirt cheap. The problem is you've got to look at the whole food cycle. Now you're looking at Mrs. Smith, two minimum wage jobs coming home at night, okay? and she's got to kind of feed her kids. And if you're saying, here's a bag of lentil. So a couple of things here.
Starting point is 00:21:18 First of all, do you know how to make a lentil taste nice culturally? Okay? This is going to be a different conversation in India, for example. But in this country, can you make a lentil taste nice? Second, you still need, what, half an hour, 40 minutes on a stovetop to turn on the heat and boil the lentil. Do you have money to pay for that heat? Or is it easier just to stick it into a microwave two minutes? Yeah.
Starting point is 00:21:41 Because it's the same amount of energy per minute. But now I'm saying, well, I'm only paying for two minutes worth of energy. And so when people, mostly middle class people, tell me that lentils are cheap, they do not understand the issues. The process. Exactly, the process, the whole food cycle. And so we need to improve the entire food cycle and environment so that someone, like a Mrs. Smith with two minimum wage jobs, who I can tell you for free, she's not looking at the back of the pack, she's not counting fiber. She's worried, I've got a tenor, I got to feed my kids. what am I going to get my kids so that everyone is not hungry?
Starting point is 00:22:16 And until you get into that frame and understand that situation and the decision she has to make, based on the resources she have, we will not be able to solve this problem. So let's talk about weight loss. That woman's health, we absolutely don't advocate waste loss for the sake of it, but if it's for health reasons, and we are in a culture of endemic obesity, weight loss for some people would make their life healthier. But why is it that people yo-yo?
Starting point is 00:22:44 So you can really try hard to lose weight, but then your body seems to be fighting to get you back to the weight that you were. Your body doesn't seem to be fighting. Your body is fighting. So the main issue is your brain hates it when you lose weight. So what happens is when your brain senses you've lost whatever weight you were before.
Starting point is 00:23:03 And it doesn't really matter how much weight you've lost. You can lose five pounds. You can lose 55 pounds. your brain senses it and then it begins to say remember we evolved through a time where we never had enough food right so your brain is always on our lookout for food and when there's food available you eat it this is just the drive we have so when you lose any weight at all a big red button
Starting point is 00:23:26 saying that this is reducing your chances of survival and so two things happen when you lose weight okay as anyone who's dieted will know you, the first five pounds is super easy and then the moment you've done a week on it, suddenly you get hungry. Okay, that's because your brain is making things hungry. First thing.
Starting point is 00:23:46 The second thing is it begins to lower your metabolism. So your metabolism is a shifty thing. And the moment you begin to lose weight and your brain thinks, uh-oh, and this is not any executive decision, your brain then says, okay, I'm going to slow down your metabolism every so slightly to try and drag you back up,
Starting point is 00:24:03 kicking and screaming. So if you diet in the traditional way or if you do something extreme, then what happens is you do lose the weight because you're saying, okay, I'm just going to, I'm just going to grit my teeth and I'm going to do it and in the next month, yay. But then the moment you then hit some new, I'm happy weight, then your brain will start dragging you back up. Sorry, I don't mean to be depressing.
Starting point is 00:24:25 But this is how your brain functions. It's true. And that's why I think, now, GLP-1s now are so appealing for people who were in a desperate situation of they've yo-yo dieted for years and years. They've tried everything under the sun. It's just not working. And then someone says, here's a GLP. Have this every day. You'll not be hungry and you'll lose weight.
Starting point is 00:24:47 For those listening who don't know what a GLP is, can you explain to us exactly what they are? Okay. So GLP ones and GIP, which is the other gut hormone, are modified versions of native hormones within our body. native gut hormones. So what happens is, this is physiology, right? So every time you eat and it goes down your throat and out the other side, a whole repertoire of homodes are produced. And these hormones do a number of different things, but largely they're there to tell your brain what you've eaten and how much you've eaten, how much protein, carbs, fat, and things like that. They also do other
Starting point is 00:25:24 things like regulate the flow of food through your gut. So JIP and JLP 1 are two of these hormones. Okay, they do two things. They get released. They signal to the pancreas. to enhance insulin secretion for every gram of sugar you eat. That's why they were originally designed as diabetes drugs. But they also signal to the brain to make you feel full. The magic power of these drugs is that they keep them in the blood for longer. The problem is native gLP1 and jip only stick around the blood for two minutes. And then they're chopped up.
Starting point is 00:25:56 They're designed to do this. They're designed to be very volatile. Yeah. And so using the native hormone, if you infuse yourself with native hormone, your body would just chop it up. It doesn't work. So the drugs, then they have some molecular decorations on them and keep them around the blood.
Starting point is 00:26:11 So now, instead of lasting only two minutes, they last 10 days, which is why you can use them as a one's weekly injection, these GLP ones. And so hence, you inject them. For people with type 2 diabetes, you have more insulin being secreted when you eat, controlling your blood sugar.
Starting point is 00:26:28 For people who have obesity, they stick around the blood for longer days. They signal to the part of the brain, hind brain, and they make you feel fuller. You feel fuller, you eat less, you eat less, you lose weight. So, broadly speaking, that's what these GLP1 drugs are. And they switch off the food noise, I've heard it described as. So someone whom I would describe myself to someone who is tormented by food noise.
Starting point is 00:26:50 Food can literally talk to me if there is chocolate in the cupboard at home. Until it's eaten, this noise will not go off in my head. But GLP ones are good at quiet in that food. noise, you become less fixated on food. So food noise is an interesting term. I have never heard of the term food noise till this GLP1 has came up. And I think the reason is because people, as more and more people take these drugs, suddenly they realize I can stop thinking about food.
Starting point is 00:27:19 But I think food noise differs. So I have food noise too. But my food noise is when I'm eating breakfast, for example, I'm already thinking about what I might be having for lunch, dinner or dinner the next day. It doesn't mean that I will eat more breakfast. It just means I'm already planning the next meal. So that's my food noise. Whereas other people's food noise is the chocolate food noise where you know it's in the house.
Starting point is 00:27:43 Or actually, there are other people who just, I need a bigger portion because I'm feeling more hungry. I do think that, and these are different behaviors, the feeding behaviors we're talking about. And I do think that GLP ones tune down this noise. It sort of is so maybe I don't take GLP ones. But I imagined if I did, maybe I wouldn't be thinking about what I'm going to have for lunch tomorrow while having breakfast today. So yes, but I do think it's important that we begin to understand what this food noise is because it's going to differ from person to person. And understanding more about it and more than what the GLP ones do to it, I think will be helpful. So they're not suitable for everyone, GLP ones, or they're not advised for everyone.
Starting point is 00:28:26 There's certain ones that are only licensed for people with diabetes. Is that a Zempic, if I'm not mistaken? Is Zempic the one that's only licensed for people with diabetes, or is it the other? So the branding of it, the branding of it is complex. Okay. So the famous ones are Ozempic and Wigovi. Yeah.
Starting point is 00:28:46 Right. Wigovie is the obesity version. Ozempic is the diabetes version. Yes. But they're exactly the same rug. Right. I mean, like chemically exactly the same rug. Slightly different dosing schedule, but they have the same effect. But OZempic is designed for diabetes.
Starting point is 00:28:59 we go via is designed for obesity Munjarro, which is the one of that's designed for diabetes Yeah Zep Abound which we can't see in this country I told is designed for obesity So the problem is the complexity of the names But people will prescribe one or the other
Starting point is 00:29:17 Depending on what you are Depending on what is available I think the most important thing To first of all when we think about these drugs Is that they're drugs Yeah Like with a capital D So they're used to try and solve a disease, a condition.
Starting point is 00:29:34 They're not lipstick. They're not designed to be a cosmetic drug. So the moment you begin to think about it as a drug, as opposed to a cosmetic tool, then you begin to, I think, talk about these appropriately. Like, look, all drugs will have side effects, like paracetamol. I mean, look, we feed paracetamol to our kids for pizza, right? But if I decided today, then I'm going to have a, don't do this,
Starting point is 00:30:00 if I'm going to have a whole tub of paracetamol, I will still need to go get my stomach pumped, right? Because it was still, so here, we have a drug that we feel safe enough to actually give to our kids, okay, but has side effects. Because we understand them as drugs, they're not sweets. So if we now think about these GLP ones as drugs, what that means is that, okay, I have obesity, I have diabetes, what are the pros and cons of taking it vis-a-vis being having diabetes or obesity?
Starting point is 00:30:30 Then you think, well, this is going to benefit me more than harm me. I'm going to take it and watch out for the side effects. If it's purely cosmetic, the algorithm changes. You shouldn't be at risk of death for putting on lipstick. You shouldn't, right? So I think the moment we consider these drugs, not cosmetic tools, I think we'll have a better discussion about these drugs. Yeah, I think, as well, the problem around them.
Starting point is 00:30:53 is if they're taking just people, because people are getting them without a prescription from wherever. And like you said at the start, you can be classed as a certain health bracket determine on your weight, as opposed to your muscle mass and your fat loss. With the GLP ones is a weight loss, if only done with the injection.
Starting point is 00:31:16 If you're strength training, if you're eating a lot, enough protein and you're managing to maintain some kind of muscle mass, and bone density, then it's more fat loss. But because so many people are just taking them out of desperation, it's a whole weight loss, so then it's nutrients lost, it's minerals lost, it's hair lost, because your body then is not getting enough nutrients and vitamins.
Starting point is 00:31:42 So is there a cause for there is an absolute place for them, but only if done with the advice of someone medical and professional, not just I've seen it on the internet. I'm going to buy it and see what happens. I don't know if you know how many people take it in this country. So the numbers are really scary. So one in eight Americans, not one in eight Americans with obesity. One in eight Americans, adults,
Starting point is 00:32:06 but one in eight Americans are on the JLP ones. Wow. That's a lot of people. Then you think, wow, but America has a different kind of healthcare system. Last month, okay, in this country, in the UK, anywhere between 1.5 and 2.5 million people have been taking these drugs. And we have an NHS. In the last month.
Starting point is 00:32:28 95% of those, on average, 2 million people, are doing it privately. So why this big range? Because you think, well, hang on a second. Don't we know how many people get the drugs? We do when they take it off the NHS. Because the NHS will have records, everything is done. You know, everything is done. You do it privately.
Starting point is 00:32:46 Well, it depends where you get it from. You know, the more scrupulous pharmacists will report and say how many, but there's going to be some like drugs are us. I don't know if this drugs are us, but you know what I mean? Like less scrupulous. So here's the problem. The safest place to get these drugs are going to be within an NHS setting because then you'll have to go to the doctor.
Starting point is 00:33:04 They'll look at you that says, you don't need this drug or whatever. And they'll do your bloods and stuff. They'll do your bloods. Check what's going on internally. They'll say, please come back in two months. Yeah. We want to measure you. Whereas they're so easy to get.
Starting point is 00:33:16 And my, the biggest problem with this drug. So people ask, what's my fear about these drugs? And it's not the side effects. There are side effects, but the severe ones are very, very rare. That's not, it's not what concerns me. The main issue is these drugs do not have a weight limit to which they start working. So if you were 300 pounds and you need to lose 50, these drugs may very well be designed for you, okay, because that's what they're designed to do.
Starting point is 00:33:44 the problem is these drugs will also work if you are a 60-year-old girl who's 70 pounds. It doesn't decide that because you're skinny, I'm not going to work anymore. That's the danger of these drugs, which means that you really do have to make sure they end up in a right hands. Because otherwise, something really bad is going to happen. That's my biggest fear. And we need legislations and safety barriers in place to prevent the 16-year-old 70-pound girl getting these drugs. Because the problem we're facing societally now is you have certain
Starting point is 00:34:17 Hollywood actresses who are seemingly shrinking before our very eyes. Have you seen the Oscars red carpet light? That's not yoga. I'm sorry. It's not yoga. It's a worry. And when I think at my time at Woman's Health, which is a decade, and that look was coming to an end then.
Starting point is 00:34:35 I remember the heroine chic of the 90s in the early 90s, but it was coming to an end in the like 2017. And actually different body shapes were being celebrated. Stronger body shapes were being celebrated for women. Lifting weights was applauded. And, you know, that CrossFit physique was seen as attractive, not sort of fetishized. But are we going backwards?
Starting point is 00:34:59 Because the red carpets, which are very influential, because you see the images all over TikTok. And, you know, the platforms that these younger girls are very influenced by and they idolize these women. and skeletal is coming back. It seems in vogue again, which is a worry. It is a worry. No, no, like I said, this is the thing that worries me most about these drugs
Starting point is 00:35:22 because we're talking about them because too many people use them and discuss them as a cosmetic tool. And so we need to, I mean, I do something like this for the very purpose is so that we reach your audience that, look, these are drugs, which means they come with side effects, they come with the good, they come with the bad. but you accept that because if you're ill, you don't want to be ill anymore.
Starting point is 00:35:44 You cannot use these. They should not be used as a cosmetic drug because then the cost-benefit analysis shifts to being, I just want to fit into a dress or something, right, versus I'm trying to lose weight for my health. Do you have to be on them, say someone started them, do you have to be on them forever? Or is it a case of when you stop the weight? Because seemingly, if you have, if you're an obese person because you have that brain thing where you're more attracted to food
Starting point is 00:36:10 and you don't have to switch off. Surely once you turn the food noise back on, so to speak, by removing yourself from the jab, it's just going to come back on. And if you've not done any, you know, you've not looked into the reasons why you're overeating or, you know, you're not started the path to do some extra steps a day, whatever.
Starting point is 00:36:28 You can't be on it for life, surely. I think there's a few things. First of all, you are absolutely right. These are drugs. And they only work, unlike vaccines, which you use ones, and you can protect yourself. This is not what these,
Starting point is 00:36:40 drugs are. So they will work when you're on it. They'll turn off the food noise. When you're on them, the food noise will just come coming back on the moment you stop. Probably louder. Probably louder. The weight will come back on. Your brain will sense you've lost the weight. So the reality is this. I think a large number of people who are on these drugs for the right reasons are likely to be on some version of these drugs for a long time. Now, does that mean that you can't use your two years or one year or 18 months on these drugs to change your behavior? No, absolutely not. I think the best use of these drugs as a tool is when you're on the drug, and I think you should do this whether or not you're going to come off the drug,
Starting point is 00:37:22 is not to choose them in isolation. So you need to use them. And now that the food noise has disappeared, you can then say, okay, I'm going to think about how I'm going to cook this chicken and what portion of chicken do I need to cook? How much fiber do I put in? And because you're not hungry when you're doing it, it's like going to the supermarket, hungry, you can then actually put together something. And then you says, okay, I'm going to learn this new recipe. This is how much chicken I should cook or beef or whatever it is you're going to eat and learn. Or you're going to say, or and you can say, I'm now going to commute to work. Before when I cycle to work, when I got to work, I was ravenous.
Starting point is 00:37:56 Okay. Whereas now I have these drugs. I'm not. So if you now begin to say, well, I'm now going to cycle to work Monday, Wednesdays, Fridays, and on Tuesdays and Thursdays and I'm going to be vegetarian and I'm going to eat less chicken, whatever. And suddenly these are new habits. That's your fighting chance if you come off the drug that you've done improved your behaviour. But as I said, I think you should improve your behaviour anyway, even while on as drugs, to make sure you maintain muscle mass and you have a better relationship with food.
Starting point is 00:38:21 It's a tough one, isn't it? Because I'm trying to think, like, so I've got two children. And with my first, I put on four and a half stone with Mia. And she was four pound ten. So the rest, everyone said, is she a big baby? No, I just, I just binged. And it was 16 weeks before I did any type of training or anything afterwards. And I was eating, well, I was breastfeeding, so I was hungry.
Starting point is 00:38:44 But that first session back, I mean, I train a lot. But that first session back, it was so difficult. I couldn't do half of what I was used to doing. I was out of breath, even putting my shoes on, bending down with my shoes on. I still obviously had my belly for a good six months after. And I remember sitting there thinking, this is awful. I don't actually want to do this. And because I'd trained previously, I was like, no, it's got to be little steps.
Starting point is 00:39:13 You know you can do it. If I hadn't had that knowledge beforehand, feeling like that every single day would have been so... I felt humiliated in myself. I felt a little down and that was after having a baby. It wasn't like, you know, I'd just let myself go, so to speak. Well, I think of someone who feels like that every single day of their life just through food and, you know, they try it.
Starting point is 00:39:40 Like, I see a guy near me and he's overweight. He walks every day and he's getting smaller and smaller. But for the last year, I've seen him nearly every day walking with his headphones on. And I always think good for you because I know how hard you're finding that. What advice would you give to anyone who's just feeling like that every day?
Starting point is 00:39:58 Because for me, it was one day. And I went back in the house and cried. And I was like, I'm never, ever going to feel like I did. And to have that every time you step into a gym or every time you try and eat something nutritious, but then you end up having the cereal and pizza, then crying after it. What do they need to do?
Starting point is 00:40:16 I mean, the problem is I don't think they're easy answers, right? Because I think it depends on why you do it and why you're in that situation. Now, if you have a huge biological drive, then this is why something like the drugs are so helpful. because they sort of remove, they really give you the tools. You have to use it as a tool to try and change your behavior and do the things. But then you could obviously also be eating or not exercising for emotional reasons, for traumatic. Not everything has to be biological.
Starting point is 00:40:48 And so I think understanding why you're in that position, and once again, you've got to be privileged enough for someone to talk to you about it. But I do think that if you sit here and sort of try to be honest with yourself and say, okay, well, why do I, eat, why do we behave? And can you then tackle the root cause? Yeah. And then you have a, then you have a fighting chance. For some people, it is their biology. And maybe the drugs are going to be the answer.
Starting point is 00:41:11 For other people, maybe it has nothing or very little to do with biology at all, but some, something you haven't dealt with or some trauma. Then you've got to deal with that before then you actually come along and thinking about everything else. But there's no easy answer because it does depend on the individual and why they do what they do. Why do they behave the way they do? It's habits as well, isn't it? I remember at work when I used to film Holyox,
Starting point is 00:41:34 11 o'clock, we used to have a tea break. And 11 till 1120, it was a table full of tea coffees, but loads of biscuits as well. So it was just drilled into, oh, 11 o'clock. I'd look at, it'd be like 10 past 8 would be filming. And I'd think, oh, a few more hours and we'd get me tea break. And now it wouldn't dawn on me to have a Twix or a Kit Kat or whatever
Starting point is 00:41:53 with an 11 o'clock coffee. But for seven years, nearly every day, it was just part of work. a tea break. So I think it's a habit as well, like having a cup of tea with a biscuit. You don't need one. Habits do make a big difference.
Starting point is 00:42:08 You know, there are people who sit in front of the telly and automatically need to have whatever, popcorn or a snack. And the reality is you watch a movie and suddenly a whole bag of Doritos is this. And you're not actually hungry. It's just... Goes hand in hand with the movie.
Starting point is 00:42:22 Exactly. So that's a very different scenario to being drawn to the reels because you're hungry. And so I think you just need to... to sort of look at yourself if you're trying to be introspective and say, well, why do I eat? What am I doing? And I think you will get a different answer for how to solve the problem depending on your circumstance. Exactly. Exactly. You've mentioned there's a problem with childhood obesity. I look at my own two children. I have a 14 year old boy who is already
Starting point is 00:42:53 six foot and is actively trying to eat more because he plays rugby, etc. Then I have a daughter who's 10, who is the image of me in every way, but it's also like I was at that age, bigger than her friends, and I've always said that fat wants me, because I come from a long line of women. My grandmother was morbidly obese. My auntie was a large woman.
Starting point is 00:43:17 My mother wasn't, but I think she went the other way. I think she went an underwet because she didn't want to be like her relatives. And I can see it in my daughter now. Her drive to eat is insatiable. Like she will eat more than me. She will, after a meal, be asking for seconds when she's just eating a portion that is perfectly adequate.
Starting point is 00:43:38 And I can see the genetic drive to eating her, even albeit she grows up in a house where we have a home gym and I'm exercising all the time and, you know, I'm not obese or overweight, nor is my husband. Her drive to eat is very difficult to manage. And I do look at her and think, goodness, she is someone who is going to end up on GLP1s one day because she doesn't seem to be able to manage her appetite.
Starting point is 00:44:00 Are we anywhere near a time when children are going to be prescribed these drugs? So at the moment, GLP1s have been licensed down to 12-year-olds and above. Now, no, no, no, no, no. It's got to be pretty severe for a doctor to put someone who's 12, 15, and adolescents on these drugs. Especially if it's a female because of hormone, like periods and stuff
Starting point is 00:44:29 will be affected. Because these are hormones, they are hormonal drugs, right? That's what they're doing. So once again, cost-benefit analysis, the risk to the teenager has got to be pretty freaking high to start to alter any hormones. Because I think you've got to be in a situation
Starting point is 00:44:49 where you kind of get your hormones, get through puberty, get past 18, and everything is stable down, then you begin to alter things because of situations. So they are licensed down to 12, but it's got to be pretty, pretty severe for you to actually get them. What does the feature look like at this talk of tablets on the horizon?
Starting point is 00:45:12 There's also a lot of research about the wider benefits of these peptides, dementia, lower blood pressure, heart risk, etc. What does the feature look like for them? So it's a pendulum. you have a situation where this is the best thing since life spread and then this is the worst thing since whatever so it's swinging back and forth at the moment I think undoubtedly these drugs are going to have a really broad
Starting point is 00:45:35 effect societally and for people's health because the moment you change body weight when you're taking it correctly for a right reason you reduce your risk of so many diseases so many diseases there are weight independent effects as well which are very interesting so you talk about potentially we use some dementia.
Starting point is 00:45:56 I know, for example, people are using it for heart health and kidney health independent of weight loss. So those are going to be interesting in order to look at. Then there's some weird stuff. Okay, where it's still anecdotal, where my colleagues, so I'm not a clinician, but my colleagues who prescribe these drugs say that one and two people who they prescribe it to
Starting point is 00:46:15 suddenly give up smoking or vaping. They just don't feel, they're not trying, they don't feel that. need or they says, you know what, I'm not sure I want to drink alcohol anymore. So why is that? So we need to sort of have better studies, not everybody, but we need to have sort of better studies to understand these broader effects. Because side effects can be negative. Side effects can be positive. We just need to understand more about these, more about these drugs. The pills are coming. Well, they are here. Actually, one of them is a we govi pill. So in other words,
Starting point is 00:46:48 it's just these hormones packaged up. But I think the big game change is, will come when Eli Lilly's Ophalipfron, this is not going to be the name they sell under, is likely to be FDA approved by middle of this year and potentially then arrived here after. Now, the big difference, but this is one's daily pill, the big difference is this is a small molecule. So the Wagovi pill is simply the hormone package in a pill. So there's always going to be, and they're complex to make. So there's always going to be a flaw to how cheap they can get. A small molecule is a white powder.
Starting point is 00:47:20 So the moment that small molecule, and it's effective, goes off patent in 10 or 12 years from now. So in other words, the company is not making money from it anymore. You're going to end up with paracetamol. You're going to end up with a white powder. That is the time where we will get real penetrance of these drugs. So for better or for worse. Better because then equitable access to these drugs improves. Pills do not require a delivery device.
Starting point is 00:47:48 They do not require refrigeration. Okay, so it's easier to get it to them. Bad because it's easier to black market them. It's far easier to black market white powder than it is. What are we regulated? Exactly. So we have, I would say, we have about a decade, worldwide. We have about a decade to put together some safety barriers.
Starting point is 00:48:10 Because what are we going to do then? Because the pill will still work for 17 no-go who's 60 pounds. So what safety barriers are we going to put in place to make sure that only the right people The people who need the drug get the drug. And I'm serious about this. Because I think these are powerful tools. We've never had so many tools at our disposal to sort of treat people with obesity. Let's not screw this up, right?
Starting point is 00:48:33 Because if people begin to use them bully-nilly and then all kinds of bad crap happens, we need to keep our eye on the ball to make sure that these tools are used appropriately. Because like you say, if it's done properly, it could be the new era of obesity treatment if it's done correctly. Correct. If it's incorrect, I can see it now. Kids in school, peer pressured into buying them off someone in school because they're being picked on for being fat or overweight or not as quick as them in sport.
Starting point is 00:49:03 And it will be one kid, oh, have these, these will make you thin. And they'll go, all right. And that fills me with fear, having two kids myself. And they'll get a hand on whatever they're going to get their hand on. So you just need to, the barriers really need to be in place. That's my biggest fear. I want to discuss exercise and its impact on weight loss. Why is exercise, in your opinion, not the most effective way to go about weight loss?
Starting point is 00:49:30 It's a terrible way to go about weight loss for two reasons. I mean, look, once again, I'm not anti-physics, okay? It's just that mere mortals, non-elite athletes, do not exercise enough to keep weight down without changing your feeding behavior. So that's what I mean. Can't out-train a bad diet. Absolutely. Now, just to be crystal clear, nothing is better for you than exercise
Starting point is 00:49:55 for pretty much every aspect to your life. If you can put that in a pill, put it in a pill, right? For everything, your mental health, your physical health, everything about it. The only thing is not great for is weight loss unless you also fix your diet. Now, exercise is particularly effective at helping you maintain weight loss. So once you've shifted your diet or you're on a little,
Starting point is 00:50:18 JLP ones, whatever, however you've lost the weight, and you've reached some sort of level that you're kind of happy with. Happy is a strong word, but you've lost the weight. Then exercise plays a big role in actually helping you keep the weight off. Because as you lose weight, your metabolism drops, because your brain is trying to get you to gain weight again. Exercise will always temporarily, when you're exercising, increase your metabolism for obvious reasons. So exercising, and I don't mean necessarily going to the gym. I mean, walking around the garden, walking your dog, I mean, like moving, okay, will increase your metabolism slightly and help with maintenance of weight after weight loss. And muscle mass is so important as well, isn't it? The higher your muscle mass, the higher your basal
Starting point is 00:51:05 metabolic rate, and therefore the more calories you are burning just at rest. Correct. So because your muscle has more mitochondria, these are the things that burn energy compared to your fat, You can be a given weight, but your muscle to fat percentage is what really determines your basal metabolic rate. So yes, the more muscle you have, the higher your metabolic rate is going to be. And one of the worries about rapid weight loss on GLP1s is that people are losing more muscle mass than fat or as much muscle mass and fat. So they're not being left in a necessarily healthier state because they're depleted so much. And the bone density as well. The bones are, but you might know this.
Starting point is 00:51:48 I was reading recently again, they've not had to, legally up until now, put all of the negative side effects on the boxes. And apparently they're trying to get it approved whereby everything is still on there, the good in the side effects, but also now like the risk of osteoporosis later in life, muscle mass,
Starting point is 00:52:09 I think they now have to put it on all the boxes. Do you like they do with the cigarette box? They have that horrible image of the kid with the pipes. I don't know if that's true, but they were saying they're now moving forward going to give everyone the good and the bad information on them. So just to be clear, when you lose weight rapidly, you will lose on average, depending on who you are, 60% fat, 40% lean mass. If you lose weight rapidly, no matter how you do it, right, unless you mitigate against it. So there is no evidence that the muscle mass loss and the bone density, because you're lighter, your bones don't have to be as dense. is specific to the JLP ones.
Starting point is 00:52:49 However, that doesn't matter, right? Because they're going to be JLP1 specific side effects and weight loss specific side effects. And this is a weight loss specific side effect, but we still have to deal with it. Because we've not seen a weight loss tool that is as effective as the JLP ones, which means that there's going to be a lot of people
Starting point is 00:53:07 losing a lot of muscle mass. So it's not specific, but we have to deal with it because that's going to be a real danger. Do you think in the future, they'll have PTs specifically for GLP1 patients. They already are. Oh, are there? Really? PT, foods, diets, approaches. But only when done with the NHS.
Starting point is 00:53:28 Okay. I think when done with the NHS, but now you obviously have companies already sort of, because so many people are doing it privately, and some people are getting literally zero advice other than the injectable, I think they are already companies in which you can go pay for whoever, and they'll give you GLP1 specific PT and a dietary plan or some or supplementation or whatever.
Starting point is 00:53:52 See, that's good if it's done like that. It's good, but the problem at the moment is only people who can afford a physical trainer and a nutritionist. That's why the best place to get it is within the NHS setting because then you will get, okay, it's never going to be as good as hiring your own PT, but it's, that's why the best place to get these drugs is going to be within the NHS. So I'm hoping that the NHS.
Starting point is 00:54:15 will, I know why they're not doing it. One and four people in this country have obesity. That's nearly 18 million people, 18 million people, right, in this country have obesity. So at the current prices of these drugs, the NHS can't deal with this. They can't. But at some point, when the drugs come off patent and then NHS begins to be able to sort of handle this, more and more people will do it. And that, I think, is a situation where we then get better wraparound care,
Starting point is 00:54:41 dietary and physical activity advice. Because people are falling into the trap. and I heard you, Giles, talk about your son who took GLP ones to lose weight after he went to uni and Gade weight rapidly. And you and him went on a walk in Wales and you said to him, what have you eaten? And he said, oh no, I'm hungry, I've had a Snickers.
Starting point is 00:55:00 And you said, well, that is not food. But he was perfectly satisfied because he just wasn't hungry, so he had to Snickers. And people are falling into the trap of not making the healthiest choices. I'm also hearing that gym memberships are starting to decline
Starting point is 00:55:16 because people think, well, why do I need to be a member of a gym? Because I'm losing weight anyway. I don't need to. I've heard of these sort of fitness holidays, there's less uptake on them. Whereas because women are thinking, well, I don't need to pay four figures
Starting point is 00:55:28 to go away for a week and one of these like boot camp holidays because I can just lose weight on GLP1. So they're not necessarily making people make healthier choices for their altruistic. They're all around health. It won't, right? Because these, people have used a lot of hyperbole
Starting point is 00:55:45 around these drugs. Are there a panacea? Are there a silver bullet? Blah, blah, blah. They are a panacea for the 80% of people who respond to them appropriately by making you feel full. That's sooner. That's all they do, right, as a universal response. So you let you lose weight. It doesn't improve your diet. It doesn't increase your exercise. So for my son, which you're right, I had to sit them down. And so what I told them is, the problem is this. If you are not thinking about food, then maybe you haven't strategized, maybe you haven't gone to the supermarket to buy food. So what I told them to do is this is the way to mitigate against this. I say, buy yourself like a bag of frozen chicken breast or something, like keeping your freezer, some veg, I got them
Starting point is 00:56:25 an air fryer. And I said, look, so even if you get to the end of the day and you haven't thought about anything else and suddenly, oh, I'm hungry, because you still end up being hungry, then you can pop something in air fry, some veg, some spices, and bang, you have a, you have a , you have a relatively healthy dinner. Strategize, put together a strategy. That in terms of terms of physical activity, so my son has now started going to the gym, he has changed his behavior. I did an event, Elevate, the industry thing, so two years ago, I'm doing it again this year. And two years ago, I did an event call at Elevate, the main stage, called, gym or jab? Now, the answer is obviously Jim and Jab, right? But that's it. So the health and
Starting point is 00:57:03 the fitness industry were at the time getting a bit terrified. Will this destroy our industry? But I'm hoping through podcasts like this, me speaking to you guys and your audience, that we drive home the message, that we drive home the message that actually you need to improve your diet and you still need to exercise more. Yeah, yeah. Even when on these drugs. And would that be your starting point with anyone who came to you who was morbidly obese, you would advise that and send them off on that course first before just say,
Starting point is 00:57:34 no, I have a GLP one, if they hadn't tried to make changes? I think it is always the right advice to improve your diet and exercise more. You don't want to sort of lose the person in front of you. So I think it really depends on who the person in front of you is. If they're coachable, okay? So if there's someone who will listen, who will do it, I think that's the right advice. If it's someone who's clearly already spent a lot of time trying to lose their weight, will they be put off by this advice?
Starting point is 00:58:08 So I think for the kind of advice you would give, you just need to kind of judge the situation who the person in front of you is. And some people are going to be in a coachable stage. Other people might maybe need to go on the drugs first. So I don't think there's a universal answer. I'm hoping from this, people will take from what you've said,
Starting point is 00:58:27 more of a more sympathy with someone who's struggling with obesity. Because at the minute people look at someone who's obese. And I've seen it like, you know, I've seen it on airplay. when you're sat down and a few rows ahead, there's someone literally struggling to get in their seat. And people are like laughing and saying, as if I've had to pay for extra luggage and they can get on anyway.
Starting point is 00:58:50 And the, like, the negativity around it all, but the fact that you've highlighted, it's a brain response, it's a chemical response. They don't want to be like that. They've not thought, oh, do you know what, I really want to be struggling to go upstairs.
Starting point is 00:59:04 I want to be out of breath or have, you know, bad circulation. They've not... No one's making that choice, are they? No one's choosing to be like that. Everyone would always have, you know, a better life. No. You don't choose to be fat. It's a different way of looking at it, the way you've described it.
Starting point is 00:59:21 And I hope people listening, especially if they have kids. Because there's always an obese kid in school. There was in my school. It was. There's always the one who has to sit out of PE because they can't do it. And they're typically always the ones who grow up miserable, depressed and lonely because of how are the responding. to. So I'm hoping people will look at it differently after this chat that we've had with you.
Starting point is 00:59:42 I hope so. I hope so. I mean, I've been using the existence of these drugs almost as a tool because if we're able to change one or two hormone levels in your blood, then that's what we're doing with these drugs. And suddenly we completely change someone's feeding behavior, then how much choice was it to begin with? Right? Because then you might almost consider that some people or many people with obesity to have some kind of hormonal deficiency and all we're doing is fixing that. It's not a perfect analogy,
Starting point is 01:00:12 but I think that's what we're doing. We're sort of just adjusting the hormone levels and one or two hormones and suddenly you eat differently. How much choice was it before? And it's true with the hormones. I mean, when you're pregnant, I couldn't stop eating.
Starting point is 01:00:28 And it wasn't like, oh, I'm choosing to eat this because it's bad and it's just, my brain, my physiology was like, oh, and this, I'd be driving. from work thinking I need to get them crisp when I get home. As soon as the baby was out that feeling went. Exactly.
Starting point is 01:00:40 Literally like a light, so the feeling of it completely went. Me with lemon squash Yeah, you're on lemon squash. I used to get basmati rice. I used to microwave basmati rice, a full pack, put it in a bowl, green pesto and loads of cheddar cheese and just sit in front of the teller.
Starting point is 01:00:57 That sounds quite nice. That's not quite nice. I used to do that nearly every night when I was pregnant with me. But then a soon as she was out, I just didn't fancy it anymore. Because like you say, the hormones completely change. Correct. Yeah.
Starting point is 01:01:11 Well, Jaros, thank you so much for coming in to see her suggest as well today. Before we let you go, we have some quickfire questions. Oh, my God, okay. Yes. So, question number one, myself and Claire, we're clocking off early today. We're coming to your house for dinner. What are you going to make us? Do you know my favorite dish is Heinanese chicken rice.
Starting point is 01:01:29 So it's poached chicken. Right. And then you use the liquor. You make the rice. You make the sauce, you make a salad. So it's poached chicken over salad with rice cooked in the chicken stock. It's a peasant dish. It's a nice brothy thing.
Starting point is 01:01:42 Exactly. It's my favourite dish of all time. That's what I would feed you. It's very healthy with all the broth. All the goodness is in the broth. I wouldn't expect anything less coming to your house. You'll go into a desert island for a year and you can only take one thing. And you're on your own.
Starting point is 01:01:58 What would you take? Only one thing. Yeah. And it can't be a family or a loved one. That's cheating. I think the ability to play music, some ability to actually have music. I think that keeps me, that does keep me sane. So I think that's probably the one thing I would bring, because it was complete silence.
Starting point is 01:02:14 I'm not entirely sure what I would do. It's between that or a book, music. What should you go-to jam then? What sort of music is jazz playing on this island? Country and Western. Oh, I don't is my favorite music of all time, don't. I love that. I do.
Starting point is 01:02:31 I genuinely love. The old stuff, the new stuff, all of it. Love it. My father used to play growing up. And I listened to Radio 2. I'm of that age now. I listen to Radio 2. But they play a lot.
Starting point is 01:02:43 They do. Old Country on Radio 2. They do. So I'm with you on that one. I'll be on an island listening to Ake, break your heart. Yes, that's me. Question 3. You can only drink for the rest of your life, either coffee or wine.
Starting point is 01:02:58 Which one is it? Wine, red. Terrible. Don't. There's got more benefits. Yes, it does. It does. It does. No, it's not too bad. What's the last thing that made you belly laugh? The last thing they made me belly laugh? Yeah. That's a difficult question. I don't know the answer, don't it? Is it terrible? Any Netflix comedies that you're loving at the moment?
Starting point is 01:03:20 Now I've got to think about it. You've got me on a pressure now. What's the last thing that made me? Oh my God. Yes. Yes, yes, yes. The last program I watched, which was so funny and was so sad. Small prophets. was so funny and yet so sad. Belly laugh, there were some things that were belly laugh and then suddenly had tears. Really things, small profits. BBC, isn't it? I'm not seen it, but it's on my list. It is so bittersweet where you do have the belly laugh
Starting point is 01:03:45 and yet it's just so, the pathos behind it was not the answer you were expecting, but that was the last thing I saw on BBC. Okay, there's a recommendation. And that's my list. And the fifth and final question, what's one thing someone can do to make themselves feel? better now? If you want to just do it right this minute, what's one thing they can do? More variety in your life of everything. You know, change up how you exercise, change up what
Starting point is 01:04:11 you eat, change up what you wear, change up when you. And I think if people did variety on everything, then you wouldn't be so tied up with worrying about, did I exercise enough today? Am I eating this correctly? And so to my mind, if you try and do something different every day, I think that will immediately make you feel better. That's great advice. That is great advice. Yeah, I've never had that one before. So I'm going to do that today.
Starting point is 01:04:35 I'm going to do something completely new today. And it's not buy a different bar of chocolate on the way home. Exactly. Any anything? Oh, thank you so much. It's been lovely having you in. Thank you for joining us. Thank you for having me.
Starting point is 01:04:47 Thank you.

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