Life Uncut - Is Ozempic The Magic Pill? Weighing Up Society’s Dysfunctional Obsession with Weight, Food and Our Bodies - Uncut with Johann Hari

Episode Date: April 30, 2024

In 2022, coming out of lockdown, Johann went to a party with Hollywood celebrities. He noticed that unlike him and his friends who had all gained weight in lockdown, these people had all somehow lost a lot weight. It wasn't because they had taken up pilates. It was because of a new generation of injectable drugs, designed for diabetics, except that no one was speaking about it. Immediately he felt conflicted about these drugs. On one hand, it seemed as though they may have the ability to significantly improve the health risks associated with obesity; but there was also a dark side that he felt the need to investigate.  Johann decided he would interview over 100 of the world's leading experts in science, medicine and the body positivity space to create his latest book "Magic Pill. The extraordinary benefits and disturbing risks of new weight loss drugs.” In this episode, we speak about: When Johann first became aware of drugs like Ozempic Fatphobia, stigma and shame that we have been conditioned to experience in our culture What these drugs could mean for people who already experience disordered eating How these drugs work and Johann's personal experiences on them The potential health benefits that they may have The risks and unknown outcomes of this class of drugs How weight is a 'status' symbol in our society Whether these drugs should solely be available for diabetics The potential future outcomes of weight loss drugs & what they could mean for our economy You can find all of Johann's books including Magic Pill here You can listen to our previous episode with Johann about Stolen Focus & Why We Can't Pay Attention   You can watch us on Youtube If you have an question please send it on it to life uncut podcast on Instagram Join us on tiktok Or join the Facebook Discussion Group Tell your mum, tell your dad, tell your dog, tell your friend and share the love because WE LOVE LOVE! xx  See omnystudio.com/listener for privacy information.

Life Uncut acknowledges the traditional custodians of country whose lands were never ceded. We pay our respects to their elders past and present. Always was, always will be Aboriginal land. This episode was recorded on Gadigal land. Hi guys and welcome back to another episode of Life Uncut. I'm Laura. And I'm Keisha, and we were so lucky to record this episode while Britt was away in the jungle. It is with one of my favorite guests who has joined us on the podcast before, and quite weirdly, it was actually you and I, Laura, back in 2022, who interviewed Johan Hari. That was about his work on Stolen Focus and why we can't pay attention.

But today we are having a conversation that you and I have wanted to have for a really long time, and I know that you've had a number of reasons as to why you wanted to be so particular about who we had this conversation with? Well, we have spoken about doing an ep on Ozempic specifically. I mean, it's been in the news. People have spoken about it for a very long time. This A-list celebrity drug that is either being used by people in secrecy or it's been almost like the magic fix around obesity and around weight loss. But we've also done so much work on this podcast talking about body inclusivity. So it felt like it was a jarring thing to then go, okay, well, let's unpack this idea of Ozempic. And so we wanted to be very

careful about how we approached this conversation, because on one hand, it's something that you cannot ignore exists. And on the other hand, we don't know whether it is contributing positively or negatively. And at the moment, a lot of the conversation that's being had is how negative it is, whether that is because it is taking medication away from people who have diabetes. That's been one of the big debates, or whether it's been a very negative step back for this whole idea, as I said, about body inclusivity. But Johan Hari, now he has just written a book and it's called Magic Pill, The Extraordinary Benefits and Disturbing Risks of New Weight Loss Drugs. The reason why Johan is the perfect person to talk about this is because he has been all ends

of the spectrum in terms of his weight. And he approached this conversation very much as though it was a research project. So he traveled the world. He spoke to the people who created the drugs, the people who have passed the testing for the drugs. He did the research on himself, the benefits, the risks that he's had on him. And he also talks around the very real dangers of what these drugs could have for people who already have disordered eating. I think something that I found very interesting about this whole conversation with Johan, and I really seesawed reading his book on whether I was pro or against these drugs and not for myself for society. There were so many factors that I thought, wow, these have the ability to

really improve people's quality of life and reduce certain health risks that are associated with obesity. Now, the other hand, there are unknown side effects of what these drugs could potentially do. And also we just have no idea and no way to measure how much this could really fuck with our psyche. And all of, like you said, the work that we have done in the body inclusivity space and really pushing that needle back to a place where people are feeling less stigma about their body. It is less kind of consuming in all of your thoughts. Like, are we just going to send us right back to where we started? And I really found myself flip-flopping of like, I don't know whether I'm for or against these drugs. And that's really what I enjoyed about this conversation is

that it's not in promotion of, but it's also not to take away from the benefits that they could provide society. It's just to give you more information so that you can make up your own mind about how you feel about them because like you said laura it's happening yeah and i didn't even see this conversation as like a question mark as to whether someone might want to try it like in no and i think it's very important to reiterate in no way is this a promotion of a zen pic but it's an understanding of something that exists and something that there is so much conversation around at the moment but it is so shrouded in secrecy because the people who are doing it are not talking about it and it's really interesting johan was like oh i thought when i

wrote this book i would be in so much competition because it's such a hot topic at the moment but nobody else has written a book on the Xempic because no one else wants to admit to the fact that they're taking it. And I think one of the things that he spoke about, which I think was so interesting, it was around the types of weight loss that we're okay with, how we expect people who are overweight to suffer for their weight loss, to almost like redeem themselves, to like torture themselves through working out and through fitness in order to get to a place where they've like earned the fact that they've lost weight and how that just once again reiterates the negative culture around weight and around fat phobia. He has such an interesting insight into it. And

at the moment, Johan is still on Ozempic. He's still taking Ozempic, but talks about how whether you approve of it or don't approve of it, how this, the drug is going to revolutionize society in so many different ways. And maybe some of those ways will be good, but there will also be a dark side of this that we need to be talking about. Johan, welcome back to the podcast. Woo! Woo! I'm so happy to be with you. Hooray!

Woo! I'm gutted we're not doing this in your house like we did last time. I know. Well, I mean, even so, it's so good to have you back. Last time you were on here, you shared us an Accidentally Unfiltered story about the Dalai Lama calling you fat. Not anymore, that's for sure. Going to send him an ozempic pin.

Where are you now, your holiness? Just send him your book. But I'd love to know if you have another Accidentally Unfiltered to share with us. Yeah, there's one that's been really haunting me, actually. I remember the exact moment it happened. It was Christmas Eve, 2009 at 1pm. And I went to my local branch of KFC, I used to live in East London. And I went in, and I said my standard order at the time, which is so disgusting, I won't repeat it. And the guy behind the counter said to me, Oh, Johan, I'm really glad you're here. And he went off behind where they fry the chicken and everything. and he came back with every member of staff who was working that day and a fucking massive Christmas card in which they'd written to our best customer and everyone who worked there had written like little personal messages for me and one of the reasons my heart sank is I thought

this isn't the fried chicken shop I come to the most like how can this be happening to me and I didn't go back there for about three months because I was so freaked out and then I bumped to that guy in the street and he said oh you didn't come back we assumed you must have had a heart attack oh no why is this a character assassination okay you're just coming here to get a chicken exactly it was brutal it was brutal what i want to know though is what did you get from the chicken shop that you frequented the most often what they do for you so i could i could literally write a whole book about the fried chicken shops of east london there's chicken chicken chicken halal fried chicken kfc tennessee fried chicken which i always thought was the

freaky is because tennessee fried chicken its logo is a chicken beaming and eating a chicken drumstick and i was thought i'm not sure cannibalism is really the like brand you want for this right it's quite disturbing it's like basically the hannibal lecter of the chicken world will lure you in it was really chickens will eat this chicken that's how good it is exactly that's the message exactly oh well i mean gone are the days of you indulging in fried chicken as a part of your most recent work which is such a phenomenal read one thing i really wanted to start the conversation with was this discussion and kind of this deliberation that you had over using the words obese and overweight in your book can you kind of elaborate on that for us yeah i'm really

passionately opposed to stigma i spent a lot of time in the book talking about the scientific evidence that stigmatizing overweight and obese people something that obviously happened to me i was obese a lot my adult life is really really well firstly it's just a form of bullying and cruelty and we should oppose it just for that reason alone but also it is completely counterproductive in fact overweight and obese people are more likely to gain more weight if you stigmatize them and there's a whole range of reasons I go through five of them in the book one of them is just simple it makes you feel like shit and you want to comfort eat more actually there's a really deep reason why I think stigma is so counterproductive and it was actually articulated really well by

lindy west a really thoughtful body positivity advocate she said you don't take good care of the thing you hate and stigma makes people hate their bodies right it makes them think their bodies are bad they're broken they're disgusting and the more you make people hate their bodies they don't want to take better care of them they just want to kind of not be present with the pain and shame that you're made to feel so i thought a lot about do i use these words overweight and obese. And there's a person who really helped me to think this through, an amazing woman called Shelley Bovey. So when I was a kid, it was just taken for granted on TV that fat people were like the butt of the joke, particularly fat women. You think about the carry on films, for example,

like Matron, you know, this is always much worse for women. I know you know that much better than I do. So particularly fat women were just presented as ridiculous, the joke, people said the most hateful things about them. And the first person I ever heard challenge this was an amazing woman named Shelley Bovey. So Shelley grew up in a Welsh town called Port Talbot. And she was, she puts it, the only fat girl in her school at the time in the 60s. And one day when she was 11 after class, her teacher said, you are much too fat. It's disgusting how you look. You're a greedy pig and just berates her and says, stop eating so much. And of course she leaves in this kind of shamed state. And Shelley really spent her whole life, her first 30, 40 years of it, just

soaking up this abuse. She was constantly being told by the other girls in the school, you're so disgusting. When she got pregnant, the first thing the doctor said to her was, well, you shouldn't be pregnant when you're as fat as you are. When she gave birth, she had a very difficult birth for various reasons. And she was lying there just covered in blood. And the midwife said to her, you know, you really need to lose some weight. When her baby couldn't feed properly, he wasn't attaching. She took him to the doctor. And the first thing the doctor said was, well, what are you trying to do? Make the baby as fat as you are. So this is really horrifyingly common, right? 42% of women who have a BMI higher than 35 get insulted every single day. And so

Shelley's soaking this up and soaking this up. And like a lot of people like me at one point in my life, she just thinks, well, I just deserve this, right? I am greedy. I'm a pig. And one day she learned that there was this movement in the United States at the time it called itself the fat pride movement. We would probably talk more about body positivity now. And Shelley kind of began to think about this horrendous prejudice that had been directed at her. It was really just a form of of hateful bigotry like sexism or racism so she wrote this brilliant book called the forbidden body it came out in 1989 that was the first book ever in britain to kind of challenge this prejudice that's when i saw her on the tv and of course she was treated like a mad woman like a

joke you know but it actually played a really important role in giving birth to the body positivity movement and i went to meet shelly when i was researching my book but something happened after she wrote that book shelly was at the time 19 and a half stone i can never do the conversion to kilos you barbaric colonials whatever it is and she was losing her ability to walk she was only 50 but she was actually pushed in a wheelchair a lot her doctor told her he was really worried about her heart she was having problems with her heart and Shelly wanted to write about this dilemma at the time there was a kind of newsletter for the body positivity movement called fat news and they said oh no we don't want you to write about that we're

here to write about the positive things about this and she's like right but a lot of people who have the kind of way i have do face health problems that is just a fact right we have to live in reality we should be able to talk about both and she's kind of kind of shut down a bit but she really began to kind of try to pick through this and kind of go the way she explained it to me when when we met up is you know it's not either or it's not either you're against stigma or you're in favor of telling the truth about the physical harms caused by obesity obesity makes over 200 known diseases and complications more likely many of them hugely more likely it's not either or if you love yourself or if you love someone who's obese you want to protect them from two things

if you possibly can you want to protect them from stigma and bullying and if possible you want to protect them from you know the harms caused to their body and Shelley looked at the scientific evidence around this and just saw that it is just really overwhelming as the World Health organization says you know they define obesity as carrying excess weight that can harm your health you know i'm very open to criticizing medical consensuses i've done it in the past but i looked at the evidence for this and the evidence i'm afraid and i desperately wish this wasn't the case is absolutely overwhelming it's one of the most proven things in the whole of science that obesity on average of course there are exceptions but on average obesity makes you

much more likely to develop all sorts of serious health problems as Shelley saw so it really helped me the way Shelley talked about it that is a real phenomenon right we don't remove stigma by not talking about the truth we we challenge the disgusting bits the cruel bits the bits that are not true that it's a moral failing that it's your fault that there's something you know wrong with you as a person we challenge them but we also have to hold on to reality and to the truth about the biology. So that's why I think we have to find our way through this with all of the stuff in relation to these drugs and the obesity debate. We should always proceed with love and compassion and we always need to be truthful to the complexity. And I think that's where the

complexity lies there. Johanna, it's so interesting that you speak about this. And I'm so grateful for you to kind of preface this conversation with that as well, because we did an interview only last year all around fat phobia. And my biggest question was, is can these two things exist at the same time? Can we have the body positivity space and also have room to talk about things like a quote unquote magic pill like Ozempic? Can those two things coexist at the same time? And I appreciate the way in which you describe how they almost have to exist at the same time. Can you talk us through a little bit around what it was that led you to want to do this yourself? Where were you at in your, not just your weight loss, but in your mindset around your weight?

and what was it that made you go okay well ozempic's the thing that i'm going to try i'll never forget the moment i learned about the existence of ozempic it was the winter of 2022 and it was that moment when the world was opening up again after you know we'd all been locked away for so long and i got invited to a party that was thrown by an oscar-winning actor i'm not saying that just to name drop i'm slightly saying it's named drop but i'm also think it's relevant to the story and i remember i was in the uber on the way there and i suddenly felt like really self-conscious because i was quite fat at the start of the lockdown and i gained quite a lot of weight during lockdown and so I felt a little bit schlubby you know and then I suddenly thought

oh but everyone I know gained weight during lockdown so this party is going to be really interesting it's going to be fascinating to see all these Hollywood stars with a bit of light podge on them right and I arrived at the party and I went in and it was really weird it's not just that they hadn't gained weight everyone was markedly thinner they were gaunt and it wasn't just the actors it was their kids the agents the writers everyone that i'd known before covid was just much thinner i remember walking around the party and i bumped into a friend of mine on the dance floor at the edge of it and i said to her wow it looks like everyone really did take up pilates during lockdown and she and she laughed at me just like you guys did right

i must have done a kind of puzzle facial expression and she said right well you know it's not pilates right and I had no idea what she was talking about and she pulled up on her phone an image of an ozempic pen she actually wasn't on it and that's when I learned I guess I must have learned a little bit that night but I learned over the next few days that then is a new form a new kind of weight loss drug that works in a completely new way that really does deliver radical weight loss the average person who takes ozempic loses 15 percent of their body weight in a year for moonjaro which is the next in this class of drugs it's 21 percent of their body weight in a year after the next the next kind which is called triple g which will come on on

stream probably next year the average person loses 24 of their body weight which is only a little bit below bariatric surgery and it was the weirdest thing i don't remember with any topic in my life i think where i've ever felt so divided so quickly so i immediately could see the benefits right i'm older now than my granddad ever got to be because he died when he was 44 of a heart attack i've always been worried that I was fat because obesity makes heart attacks much more likely along with lots of other problems so I could see wow if there's a drug that massively reduces or even reverses obesity that's going to have health benefits right but I also immediately thought wait a minute wait a minute I've heard this story before every 20 years go right back to the first

world war a new miracle diet drug is announced people stampede to take it loads of people take it and then we always discover it has some horrendous side effect gets yanked from the market and you know leaves a trail of broken people in its wake I also was really worried about body positivity what would it mean for the progress we've made there what would it mean for people with eating disorders just straight away I could think of so many issues and I and it was weird I I just thought well I need to understand this so I started to take it but mostly for the research but also it's an interesting question if I would have taken it had I not been writing the book I might have and I went on this big journey all over the world from you know Iceland to

Minneapolis to Tokyo to interview over 100 of the leading experts and people affected by this you know the biggest defenders of these drugs the people who created key parts of them their biggest critics and it's the weirdest thing I know so much more than I knew at the start about the benefits of these drugs about the 12 big risks associated with these drugs about what they're going to do to the culture how they're going to change women's lives in particular I think But weirdly, after all this journey, it's never happened to me with a book before, after all this journey and learning all this stuff, I'm still really conflicted about it, right? I don't have a kind of neat little, and now dear reader, here's the three things you

should do, right? It's weird. I feel better equipped to understand it, but I feel very conflicted. You touched on something and I think it's really important for us to not skim over it. And that is how this could affect people who have disordered eating. People who are already slim who are so deeply affected by the culture that we have to be the skinniest that you possibly can be because i think we can all understand the benefits for what this could do for someone who is at the health risk of being overweight but what about for those people who see this oh well maybe i could take it and it would be a wonder drug for me to get even skinnier i've got a lot of worries about these drugs but this is the biggest right the worst moment for me by far

in working on the book was to forget how long and it must have been four or five months to me taking the drug i was facetiming with my niece erin who's the she's the baby of my family she's the only girl in that my brother or sister had and in my head she's sort of fixed as a six year old she's actually 19 years old now but whenever you're whenever she gets a boyfriend i always want to go get away from her you pedophile uh but like oh no actually she's an adult woman right and her boyfriend's always very nice but one day we were facetimed so no one makes me more protective than erin right and one day we were facetiming she was in a pub in liverpool where she's a student she was like teasing me a little bit like oh I never knew you had a neck

before I never knew you had a jaw and saying oh you look good and I was sort of preening and then suddenly she looked down and she said will you buy me some ozempic and I laughed because I thought she was kidding she's a perfectly healthy weight and I suddenly realized it was actually a sincere question and I was like what the fuck am I doing all her life I've been trying to give her this message you know don't be judged by being skinny you know be yourself you know occupy space and and I thought what am I doing and I had to really think this through and think about well I think there's two very different categories here there's people who are overweight or obese who are taking these drugs to

get down to a healthy weight and then there are people who are already a healthy weight or skinny and by the way Erin didn't start taking it obviously but people already a healthy weight or actually skinny who are taking it to be super skinny and I don't judge any of those people that enormous pressures on women you know and i don't you don't need me to mansplain this to you but there's nothing women can do with their bodies that doesn't get them shit you know it's funny i said to a female friend of mine the other day i feel a bit funny going into interviews about this book because for the first time in my life i feel like people are going to sort of be scrutinizing my body and looking at me going oh wow he says you know there's benefits let's see him and she

said welcome to the life of all women all the time everywhere and i was like oh yeah you know like yeah it was one of those moments you kind of really become aware of your male privilege so there's a concern for people who are already thin I would urge them not to do it for several reasons one is about risking their own health so whenever you lose weight a lot of weight you lose muscle mass which is the total amount of soft tissue in your body it's really important for you to just like be able to climb the stairs or get out of a chair or move right and you naturally lose muscle mass from when you're 30 onwards you shed quite a lot every year so if you're going into the aging process with already a low level of muscle mass you'll probably be okay when you're in your

40s and 50s but you're really building up a time bomb for as you age so if you have low muscle mass when you're older you're much less likely to be able to just do anything to get out of a chair climb the stairs you're at great risk of a condition called sarcopenia which means poverty of the flesh you're much more at risk of falling over which is the single biggest accidental cause of death in older people you're just really building up a potential nightmare for yourself And we don't have to speculate about what happens when people with eating disorders get hold of diet drugs, because we've been here before. So in the early 1990s, there was a popular diet drug in the United States, an amphetamine-based diet drug, so it worked differently to these ones. But huge numbers of young women with eating disorders, it is overwhelmingly young women, not young men, were getting hold of these drugs and just starving themselves with them. there was a congressional, in the US, there was this really heart-rending congressional hearing that this young woman called Jessica McDonald testified. She wanted to be a ballet dancer,

and she described just taking so many of these amphetamines that she would just pass out from the hunger. But the most moving testimony for me was a man named Tony Smith who grew up, he was from State Center in Iowa. And his daughter, Noelle, from when she was a little girl, had been obsessed with the idea that she was fat. She was constantly saying, daddy am i fat am i fat why am i so fat when he would take her to the supermarket she would run to the fashion magazines and she would just say daddy why don't i look like these women what's wrong with me and she started taking these amphetamine based diet drugs and uh when she was 21 she died of a heart attack because she'd starved herself and he read out this poem she'd

written about how she would think about food and say i want to eat i want to eat but not yet not yet and i spoke to experts on eating disorders like dr kimberly dennis in in chicago who's one the leading experts in the united states on eating disorders who's already seeing patients coming to her with this so i'm really worried about this this is something where we can do a lot to prevent this harm and i really urge people because it hasn't arrived really in australia yet urge your senators on this there's a very simple thing you can do that could forestall quite a lot of this harm so in the us and britain you can get these drugs over zoom right your doctor is meant to check that you you're not already thin but it's pretty hard to do on zoom right how can they

measure you on zoom it's not easy so what dr dennis says i think she's absolutely right these drugs should only be prescribed in person by doctors who see you and doctors who are trained in spotting eating disorders and obviously if you're not overweight they absolutely shouldn't give the drug to you but also if they think you might you've got a history of eating disorders or you're at risk of eating disorders you should be given alternative forms of help not ones with these risks. Johan, I think it might be important for us at this point, because we've been talking about previous weight loss drugs, ones that were somewhat amphetamine based. There are a variety of these types of things. Can you explain for us how Ozempic actually works and why it's so

different to the ones that we've seen in the past? It's a totally new kind of mechanism. I interviewed the scientists who actually discovered this mechanism. It's really fascinating. So basically, if you ate something now, if you eat enough, your gut will produce a hormone called glp-1 really important hormone it's basically part of your body's natural system just saying okay you've had enough stop eating now right you're full but natural glp-1 only stays in your system in your gut for a couple of minutes and then it's washed away what these drugs do is they inject into you an artificial copy of glp-1 but instead of staying in your system for just a few minutes they stay in your system for a whole week which has this really weird effect i will never

forget a moment so two days after i first took ozempic i woke up and i was lying in bed and you know you're just coming around and i had this feeling and i thought i feel something really weird what do i feel and i couldn't figure out what it was i couldn't locate what the sensation was and i suddenly realized i'd woken up and i wasn't hungry every day before that i remember what often i'd be woken up by my stomach rumbling i'd be woken up by being hungry and i was like oh that's a bit weird and i went to there's a cafe up the road that i used to go to every morning i would get a huge brown roll with lots of chicken and lots of mayo in it and i ordered it from tatiana the lovely brazilian woman who runs the cafe and she brought it over and i had like three

or four mouthfuls and i was just full right i now know that's it was that effect right the drug basically makes you really close to full a lot of the time so you feel very full very quickly and i just didn't want to eat anymore when i left the cafe tatiana literally yelled after me are you okay right it's like why have you left the food and and for lunch that day i went to there was a Turkish restaurant next to my office that I used to go to and I ordered the same thing every day pretty much a Mediterranean lamb and again I had like a few mouthfuls and I just didn't want any more it was the weirdest feeling it was like kind of shutters had come down on my appetite it was a very strange sensation. Did it change the things that you wanted to eat as well like you say you

went and you were still ordering the same types of food but over time did it change not just your appetite but your food aversions I guess? So it's a really complicated question this and I think I was a bit unusual so I know I was unusual because I've spoken to lots of people so one of the most common things that people report as a drawback from these drugs is that it ruins their pleasure in food that they just don't get very much pleasure from food anymore so for example there's a brilliant food critic in Britain and he started taking a zen pic and he describes like he would go to the best Michelin-starred restaurants in Paris and it'd just do nothing for him which for him was like a nightmare right as you can imagine weirdly it had the opposite effect on me but I'm I'm sure

I'm unusual so I really began to realize this I went for dinner one night with a friend of mine a while into taking the drug and she said it's always been a bit weird eating with you she one of my oldest friends because you eat so much so quickly but you never seem to enjoy the food you don't taste it you don't savor it you just kind of cram it in and I think I grew up in a very crazy and violent family where there was a lot of addiction looking back I realize one of the ways I cope with that was by stuffing myself with food it was you know when you're a kid like that you don't have that much control but you can sort of cram food in and stuffing is a very particular kind of eating it's where you eat beyond the point of being full we all do it

sometimes like Christmas day or whatever where you feel a kind of pressure upwards on your esophagus and outwards on your on your stomach you can't eat like that when you're on a zempic you would just vomit you wouldn't be able to do it which had the effect had some bad effects on me losing that kind of soothing but one of the positive effects is I really had to slow down my eating so actually I started kind of tasting food a bit more and I don't want to overstate it I haven't become Jay Rayner I'm not like you know I'm never going to be a foodie that's not who I am but actually I've started to enjoy food more but for the first six months or so I was basically in smaller portions of the same old shit you know like I would go into McDonald's and instead of

getting a large big mac meal and six nuggets i would get like a hamburger but then after six months i did start to well i learned to cook i'm ashamed to say i was 44 years old i had no idea how to cook so i did start to learn stuff like that and it did really help me but it took a while for that adjustment to kick in and i still like today i've eaten basically smaller portions of the old shit i would have eaten i've not been very good today so you know i'm so interested by what you just said you said i've not been very good today and i think that that is so reflective of the way that we've been conditioned to think about food, weight, all of this stigma is so deeply ingrained in us. When I was reading your book, I actually had a moment where I put the

book down and I sat and I thought about the question that you asked. Is this what you said? Uncomfortably, I asked myself, do you have this psychological objection to these drugs? Because at some level you believe that obese people don't deserve to be healthy. Why is it that we think diet drugs like Ozempic are cheating? Why do we have such an aversion to people taking this quick route to weight loss? I think there's a lot of reasons. And I really struggled with this myself because I felt I was doing something wrong when I was taking these drugs. I don't mean I felt like I was taking risks with my health. I knew that, right? I knew there were risks associated with these drugs. And I'm sure we'll talk about them. I don't mean that. I mean, I felt like I

was doing something morally wrong. I kept thinking, this is really weird. Why do I think that? Like, I've got a friend, one of my best friends takes statins, right? For his cholesterol. and i never look at him and go are you fucker getting ahead of me on cholesterol with these drugs cheating it would never occur to me i would think someone was mad if they said that right and i was like well what's the difference and i think there's a few things going on here it's so interesting these drugs bring to the surface so many things that we push down that are sort of there in the culture but we don't really think about they're leeching them out they leech them out for you as an individual psychologically and in the culture there's two

very deep ways of thinking about overweight people in our culture so one is that they're sinners and i looked at the history of this go right back to the sixth century the pope pope gregory the first is the first person to lay out the seven deadly sins right and one of them is gluttony and it's always depicted as like some overweight person depicted to look grotesque kind of overeating think about the film seven right and that is so deep in our culture the idea that the overweight people are sinning and one of the ways you know that is there's only one kind of weight loss we admire and that's one that follows the pattern of how sinners get to be redeemed in like old christian theology right think about that disgusting american game show the biggest loser

so for people who haven't seen it it's where you get people who are very severely overweight and very unwell and they get them to compete to be the biggest loser by going through these horrific grueling exercise regimes and literally starving themselves we had nine seasons of it here in australia that was massive yeah another reason to be proud along with tony abbott you think about that game show what is that that's the classic pattern you're a sinner you've got to go to hell and then we'll let you come back and it's like oh now you've been punished we'll forgive you right so it's why we like to hear stories of suffering the more painful a diet is the more we admire it but with these drugs there's no suffering you go from being a sinner to what i

just it's you know i'm putting that in inverted commas obviously you just what you just inject yourself in the leg once a week and you get to be like everyone else it's like it's like you've offended against god against the natural order right but i also think there's another thing that's going on loads of people particularly women because of the horrendous pressures that are put on them that you can you know much better than me loads of women are making painful sacrifices every day to be thin we live in a culture that pushes us to be obese i can talk about why and it's really hard to keep weight off and so there a lot of women are experiencing pain every day to not be fat and so we picture ourselves as in a race right I'm in this race against you

I'm imposing suffering on myself you're imposing suffering on yourself and we compete to be thinner and in that contest that's why I'm not angry with my friend who takes statins right we're not in a race to have better cholesterol but we are in a race to be thin so in that situation i look like lance armstrong it's like you know how other cyclists must think about lance armstrong well i put in all this effort and you you fucker you just inject yourself once a week and you get all the benefits i get without any of the effort i can see why it brings out this anger but i think the way we need to reframe that is once you bring those ideas to the surface you can begin to say okay well is this how we want to think about obesity right i would hope we've moved on from

the ideas of a sixth century pope we're not sinners we don't think that way about being gay for example anymore right but also in a deeper way i think we are in a race we are in a contest but it's not you against me with each of us competing to suffer the race we're against is the forces in the society that are making us obese which are the processed food industry we are in a race to protect ourselves and our children against that and but when you reframe it is it's not us against each other, like rats in a sack tearing each other. And when you lose weight, I'll try to tear you down. And when I lose weight, you know, we'll try and tear each other down. It's more all of us together against these forces that are undermining our health.

When you speak about this idea that we're also in a fight against the fast food industries, and you say that, you know, everybody is working towards keeping weight off in a society that is fundamentally built to do the opposite. Can you talk us a little bit through why that's the case? So I found this really fascinating when I started investigating this because for a long time I thought I was looking at two different subjects. I wanted to understand why obesity massively exploded in my lifetime. So I was born in 1979. The year I was born, 6% of British people were obese. It's now 27%. Australia has had a comparable explosion. Has the benchmark for obesity changed at all? No, it's the same definition. Exactly. That's a very important

question so between the year i was born and the year i turned 21 obesity doubled in the u.s and in the next 20 years severe obesity doubled again right so this has never happened in the whole of human history it's a really interesting example in australian history actually just google you know when harold holt your prime minister drowned i think it was 1966 or 1967 just google so people random australians who were on the beach go and look for him that day right and you look at it the footage of them it looks really weird to us because everyone was skinny everyone on that beach was skinny right what we would call skinny and you look at it and you're like well where was everyone else on the beach that day was it like a skinny person convention and then you look at

the population figures for australia that is what australians look like in 1967 right there were almost no obese people in britain and australia in 1967 ask your parents when you when they were at school were there any obese children in their class there was usually one in a class of 30 and actually they even if you look at what the kids who were thought of as overweight then they would not be thought of as overweight now that's really weird right that's never happened in 300 000 years of humans existing and then in my lifetime it blows up why and i was also looking at obviously how these drugs work and for a while i thought oh they're separate stories but they'll join up at the end because the obesity means we want the drugs but actually the answer to these two mysteries

why we got obese and how these drugs work is densely interconnected and it comes down to a word we don't use that often in English it's satiety satiety is the feeling of having had enough and we all know the feeling of satiety I didn't actually know it from food until I took these drugs but I did know it you think about sex for example like after you've had really good sex and you're lying there even if Keanu Reeves walked into the room you'd be like sorry Keanu I'm sated right I mean to be fair just in case Keanu listens to your podcast I never will be that's not a good example but but you see the point I make right we've all had the feeling of being sated in some way in our lives right and what we know is obesity explodes everywhere

where one change happens it's not where people become weak-willed or they become greedy or all the other stigmatizing things we say it's where one change happens it's where people move from mostly eating fresh food whole foods that they prepare on the day to mostly eating processed and ultra processed foods which are constructed out of chemicals in factories in a process that isn't even called cooking it's called manufacturing food right wherever people make that change obesity blows up in the aftermath that's it it's by far the biggest factor and what we know is processed and ultra-processed food profoundly undermines your satiety, your feeling that you've had enough. And there's an experiment that really helped me to understand this. It's a very simple

experiment. There's a brilliant scientist called Paul Kenney. He's the head of neuroscience at Mount Sinai in New York. Great guy. And he grew up in Ireland, in Dublin. And when he was in his 20s, he moved to San Diego, I think to do his PhD. And he quickly clocked that Americans do not eat like Irish people did at the time, right? They eat much more processed food, much more sugary and salty food. And like a good immigrant, he assimilated. And within a year, he gained like 30 pounds. And he was like, ah, he started to feel like this different kind of food that he was eating wasn't just changing his body. It was changing his brain. It was changing what he wanted. So he designed an experiment to figure out what it does to us. It's a very simple

experiment. I've nicknamed it Cheesecake Park. That's not the official title. He got a load of rats and he raised them in a cage. And for ages, all they had to eat was the kind of healthy whole foods that rats evolved to eat over thousands of years and they had loads of that food but when that was all they had they would eat it when they were hungry and then they would stop right so when they had the kind of natural foods that they evolved to eat they had a kind of nutritional wisdom that meant they ate when they were hungry and just knew to stop at that point they never became overweight or obese then professor kenny introduced them to the american diet he fried up some bacon he bought some snickers bars and crucially he bought a shitload of cheesecake

and when he put it in the cage they still had the healthy food but the rats went crazy for the american diet they would hurl themselves into the cheesecake and eat their way out and emerge just totally slicked with cheesecake covered in it they would just eat and eat and eat that natural nutritional wisdom that they had when they had the kind of food they evolved to eat vanished as professor kenny put it to me within a few days they were different animals and within a very short period of time they were all actually quite seriously obese then professor kenny varied the experiment in a way that feels very cruel to me as a former junk food addict he took away all the american food and left them with nothing but the healthy food they had for the first part of their

lives and he was sure he knew what would happen they would eat more of the healthy food than they had before and this would prove that junk food expands the number of calories you eat in a day That is not what happened. What happened was much weirder. Once they'd had the American diet and all they had left was their healthy food, they refused to eat the healthy food. It was like they no longer recognized it as food at all. They shunned it. They only went back to eating it when they were literally starving, right? Now this fits with a much wider body of evidence with human beings. What we know is, and I go through seven reasons why I can explain them, but processed food and ultra processed food profoundly undermines your ability to get a signal that you are full that

you've had enough and what these drugs do is they give you back that feeling of satiety right the way one of the scientists who developed them described it to me is they give you satiety hormones but when you hear that what you realize is how weird a situation we're in one of the professors professor michael low put it to me these drugs are an artificial solution to an artificial problem, right? Processed and ultra-processed food undermine our satiety and these drugs give us back our satiety. But countries that never moved to processed food, like Japan, where I spent a load of time, they don't have any demand for these drugs because they didn't have any obesity because they didn't get screwed up in the first place, right? There's

almost no market for Ozempic in Japan. So you realize how weird this situation we're in really is. Yeah, and it makes me question something that I know is written about a lot in the media. and that is that once you start taking drugs like this you then have to be on them forever because of exactly what you're talking about this kind of satiation feeling is that the case from the researchers that you spoke to and has that been the case for you so what we know is that most people who stop taking the drugs regain the weight quite quickly we need more studies on this the only ones we have up to now funded by the drug companies who obviously have a vested interest in you taking it forever because then you have to keep buying it from them i do know some people

who took these drugs used it to interrupt their food patterns and eating patterns and have now stopped and are staying at a lower weight in the research we have at the moment they seem to be quite a small minority it's not nobody we'll know more in the coming years but for me i have not tried stopping them and it's it's for one key reason i know we're going to talk a lot about the risks and there's a lot of risks i'm really worried about i also want to talk about the benefits and the evidence about the benefits is really striking and actually i think one of the best ways to start to see it is to look at a different area of science so people have only been taking these drugs for obesity for a couple of years now diabetics have been taking them for

longer so actually i think the best evidence we have to look at something different so up to now it's been extremely hard to lose a lot of weight and keep it off and the best way of doing it best in inverted commas the the most reliable way of doing it has been bariatric surgery things like stomach stapling right now bariatric surgery is horrific it's really grueling form of surgery one in a thousand people die in the operation it's no joke right but what we know is and bear in mind obviously people who go through the operation are severely obese otherwise they wouldn't get it they wouldn't be allowed to do it but you've also got to get your weight down to a certain point in order to have it in the first place some people are not even suitable for it because they're too

overweight exactly so they've got to cut down you have to have been in a pretty bad state with obesity, you know, kind of unhealthy state with obesity to get it. So why do people take this extraordinary risk? It's because of what we know about what happens next. So if you have bariatric surgery, so you massively reduce your obesity, in the seven years that follow, you are 56% less likely to die of a heart attack. You're 60% less likely to die of cancer. You're 92% less likely to die of diabetes-related causes. In fact, it's so good for your health that you're 40% less likely to die of any cause at all and and what we know is with these drugs they move us in the same direction so we know from the best long-term studies so far that if you take these drugs and

you started with a BMI higher than 27 you are 20% less likely to have a heart attack or stroke and for me that was the thing that just decided it for me what we've got to do is carefully weigh the benefits against the risks because realistically for me I would have carried on being obese I had tried dieting many times it always failed in the long term so for me I had to weigh the risks of these drugs versus the risks of continuing to be obese and given my family's history my granddad as I said died of a heart attack when he was younger than I am now my dad had to have quadruple heart bypass surgery and he's that wasn't even his dad who was my granddad that was the other side of my family my uncle died of a heart attack my other uncle had to have a pacemaker

given all of that I thought for me and given that many of the risks that I'm really worried about don't apply to me I don't have a history of eating disorders I'm worried about the risk for pregnant women obviously I'm not risky getting pregnant the pleasure issue didn't come up for me there's a big issue around thyroid cancer I don't have thyroid cancer in my family so for me that calculation went that way but lots of very reasonable people reading about the risks that I write about a magic pill will look at it the other way and well the risks will apply differently to them so yeah that was why I've not taken a break from it because I just thought okay for me the heart issue is so significant that I'm going to stay on it for now.

Justifiable almost, you know, for you weighing up the pros and the cons. But I think something else that I learned about from your book was this increased risk of things like pancreatic cancer. And these are the things that we currently know about. Can you elaborate on what scientists are saying? And as you previously mentioned, it's a biased view because a lot of the scientists were involved in the development of these drugs. And so they're not going to come out and be like, oh, well, actually we've found something that's going to derail this trillion dollar thing that we've just created. But also they would have a pretty fair understanding of what risks are involved since people who are diabetic have been taking this drug for a very

long time. It's not that the drug itself is not new. It's just the application of it that's new. The amounts that people are taking have changed, but also there have been drugs on the market previously and we haven't known the effects of those things until 60 years later. What's coming out of the science at the moment. Yeah, I obviously dug very deeply into this. I was worried about it for myself and for the millions of people who are taking these drugs. So when you ask the experts about safety, you know, these are serious scientists who I don't think would cover up harm. I know they wouldn't. They're very serious doctors. When you talk to people about safety, a lot of them say a point that is true and should give people some sense of security,

which is like you say, people have actually been taking these drugs for quite a long time. So some people won't know, but in addition to having this effect on your appetite, these drugs also stimulate the creation of insulin, which is what diabetics are lacking. So diabetics have been taking them, including in Australia, for 18 years now. So what a lot of the scientists say, look, if there was some disastrous short or medium term effect beyond the well-known side effects like nausea, we would know by now. If it made you grow horns, the diabetics would have horns, right? But some other scientists said, okay, if that's our reason to feel secure about this, let's actually dig into the diabetes the evidence from the diabetics so for example there's a guy called

professor jean-luc failly who's the professor is a professor at the university hospital in montpellier so he was asked by the french medicines agency to investigate these drugs to see their safety for the french market and he looked at a lot of the him and his team looked at a lot of the clinical evidence and pre-clinical evidence which means animal studies and one thing really caught his eye if you give these drugs to rats they are much more likely to get thyroid cancer so what him and his colleagues did is they looked they have very good medical databases in France because you basically can't opt out of them it's extremely hard so what they did is they looked at a few thousand diabetics who'd taken these drugs between I think it was 2006 and 2012 and they compared them

to a very similar group of diabetics who had not been taking these drugs to see well were there different outcomes in thyroid cancer and what they calculated is quite startling so if he's right and other scientists dispute this these drugs increase your thyroid cancer risk by between 50 to 75 now at first you hear that you're like what the fuck but it's important to understand what that doesn't mean as he explained to me it doesn't mean if you take these drugs you have a 50 to 75 chance of getting thyroid cancer if that was the case we'd be burning them in bonfires all over the world what it means is whatever your thyroid cancer risk was at the start if he's right you are 50 to 75 percent more likely to get it now as he points out thyroid cancer is relatively rare

1.2 percent of people get it in their lives 84 percent of people who get it survive nonetheless it's a pretty big increase in a small risk now against that and this gives you a sense of the complexity and how you have to weigh this against that some scientists said to me well if he's right even if he's right you've got to weigh the risk that risk against the cancer risk that just comes from being obese which was one of the facts that most took me aback as cancer research uk the main british group explain if you carry excess weight in your body that fat isn't inert it doesn't just sit there doing nothing it sends signals through your body and one of the signals it sends is for your cells to divide more rapidly which can cause cancer it's why obesity is one of

the biggest causes of cancer in both britain and australia i'm really conscious i'm thinking about something you asked me before it's playing on my mind because we have this it's such one of the really difficult things in talking about this it's when I said I haven't been good today and you picked up on it quite rightly there's good in the sense of good for my health right and then there's good in the sense of morally good and you know like shaming myself and it's really hard to disentangle those two things when you've got all these millennia of fat shaming and one of the really terrible things about stigma there are so many bad things about it but one of them is it actually makes us harder to hear it makes it much harder for us to hear well-intentioned

medical advice right if you're constantly soaking up insults it makes it harder when you do actually need to hear a difficult truth like cancer increases the risk of obesity i also think it's because it's the first thing that trolls use as their kind of backing mechanism you know it's Like, well, being fat is bad for you and here's how it's bad for you. So it's intertwined. This medical advice that is given by non-medical professionals has been a weapon that people have used to be fat phobic for a really long time. So I can understand why there's such a complexity with receiving kind medical advice because

it's the same speech. It's just delivered with a different intention. That's such a good way of putting it. I wish I put it that way in the book. you put it better than I did but you're so right because it's that thing about you know they call it concern trolling oh babe I'm just worried about your health that's why I don't want you to be this jabber like pig and all the insulting well you know you you see how the that I think that's literally something it was lodged in my memory something someone said to me years ago literally

that phrase so yeah if you if you're soaking up concern trolling then even loving concern can sound like concern trolling right it's another reason why we need to oppose stigma because it really fucks us over on so many levels. The big debate at the moment, which I'm not sure if it's the same in the UK because Australia is a little bit behind in the way it's being prescribed, but a lot of the stigma and a lot of the debate against Ozempic has been how it's taking medication away from diabetics and how it's inconscionable that people who are obese

would be able to get something that is absolutely necessary to the health and wellbeing of diabetic people. do you think that there is a fair debate in this or do you think that that is just more fat phobia wrapped up in like the hysteria of it and people are able to then weaponize this as a way of being like well these people shouldn't be allowed to have the drug in the first place i think it's such an important question i think it's a bit like the concern trolling there's a legitimate concern here and a lot of people are using it to concern troll and you know kind of give their stigma a kind of fake moral exterior so i think to pull back

basically what's happened is every person who takes these drugs becomes a walking advertisement for these drugs everyone goes wow bob's lost a load of weight what do you mean bob's kidney problems have gone away wow what did you do bob oh i took ozempic so part of the issue is the drug companies are ramping up manufacturing of these drugs the whole time but they're they're rushing to meet a finish line that gets further and further away because everyone who uses it inspires other people to use it and inspire other people to use it i mean we're at the point where 47 percent of americans say they want to take these drugs right wow so in that rush what we should have done is we should have done what we did in australia and britain with the covid vaccine

we should have said okay this is a thing that's really important to lots of people's health we've got a limited supply we need to ration it based on medical need and if we had done that absolutely diabetics would have been at the front of the line right also pretty close to the front of the line would have been people like for example a guy called jeff parker who i interviewed he's a 66 year old retired lighting engineer in san francisco he was very severely overweight and he was it was very painful for him to walk his knees were getting really screwed up and he had kidney problems liver problems heart problems and he had gout and he was swallowing fistfuls of pills every day and his friend mel gave him some munjaro which is one of the these drugs

and he lost an enormous amount of weight his doctor cut back almost all his pills now he walks his dog over the golden gate bridge every day and he said to me I feel like I'm going to enjoy my retirement now so Jeff would have been pretty near the front I mean you would have had the diabetics at the absolute front but Jeff would have been near the front you would have had someone like me around the middle because of my family I wasn't hugely overweight I had a BMI of 30 so you know I would have been around the middle and you would have had you know I won't name the Hollywood stars we all know are taking these drugs but you know they would have been at the very end of the line right not all of them some of them were very overweight but you know the ones who

weren't the people at that party that I went to would have been at the back of the line right we didn't do that we have a you know capitalist free-for-all and in that capitalist free-for-all which we should not have done some people who had greater need are not getting it so interviewed a guy called Zami Jalil who's a musician here in Britain who's diabetic he couldn't get it and I was really ashamed when I interviewed him because I thought well I've got a load in my fridge right and his need was greater than mine and i didn't give it to him and i felt ashamed of that i really understand why zami is really pissed off with people like me i would be if i was him as well now i'd rather he was angry with the system but he can make the perfect reasonable point well

given that system isn't in place we didn't ration it if people like you hadn't done what you've done then i would still have my ozempic right and he's not wrong so i think there's a real i chose to prioritize my own health in this chaotic system but he's not wrong that his need is greater than mine he's definitely right about that so i think there's a complicated thing going on there again i always try to drive people more towards thinking well how do we solve this systemically rather than how do we just tear each other down and scream abuse at each other but i don't want to delegitimize the anger someone like sammy feels because it's he's right to feel angry i also do think it's important because this is the number one question i asked a friend of mine who's an endocrinologist

and I said are people taking these drugs away and for people listening I'm putting that in quotation marks from diabetic people you know are they taking away something that they need and she said it's complex there are other options for people with diabetes there are quite a lot of options and there have been for a long time whether they've developed a resistance or a sensitivity to a certain medication that's why they've needed to go on to this that could be the case. So I feel as though it's complex talking about this because I battle with the idea that there haven't been many options for people who were overweight to severely increase the enjoyment that they get out of life and the ability that they can have to experience pleasure by not having

these health complications. Because the options up until this point for people who, you know, need, again in quotation marks, to lose weight have been so limited. You know, I think that these things like you've said multiple times Johan they're so deeply complex and they're intertwined with stigma and they're intertwined with who needs this the most because what is a need but I I think it goes further than that because I mean on one hand like a diabetic does need medication to live to live and I don't think that we can we have we have spoken a lot about health on this episode and I think that that is by far for people who are chosen to take for obesity for being you know dramatically overweight that is such an important thing but

then when we talk about this line this order of priority we cannot not mention or not speak about the fact that people take it as well because there is an aesthetic to it weight loss does have a physical aesthetic that we praise within society and and i think it's this like crazed obsession that we have with weight loss, which then also we link to success in some ways. Do you for yourself think as much as so much of this was loaded in health, do you think there is a physical part of this? Do you think there is an aesthetic? Do you think there is a vanity part that you have received or that you feel people treat you differently now that you've lost a lot of weight? Yeah. One of the most difficult moments for me in working on the book

was a moment with a friend of mine who I call Lara in the book. That's not her real name. it's really strange so as you know from i was talking before and i'm sure you can tell i do a lot of research and one of the ways i process what i'm reading and the people i'm interviewing is i talk to my friends about it the whole time right and i'm very lucky that our friends are interested in the kind of things i'm interested in so i'm constantly you know all the way through working on a book i'm like why you won't believe what i learned today and most of my friends were really really interested in the stuff i was learning right for different reasons and lara is one of my oldest and closest friends and she was not interested in what i was learning she's not

overweight so it wasn't like a personal sensitivity and i could tell i was kind of pissing her off as we were talking that's a bit weird and she was in london she doesn't live in london and she was in london one day we went out for dinner and i was talking about it was actually just after what happened with my niece that moment my niece and i'm talking about how you know thinking about eating disorders and doing the research on that at the time and she's like i can't listen to this bullshit for another fucking moment and i was like what and she said you are not being honest with yourself I was really taken aback and I said what do you mean she said you're constantly talking to me about these the risk benefit analysis and all these things that's not why you're doing this

right you've got a level with yourself she said all the time I've known you you've and she's known me since I was 17 you've never been happy with how you looked I've always thought you look fine you've never been happy with how you looked this is not about health for you this is about vanity right and just admit that to yourself and I was kind of going and she was overstating it I knew she was I knew there was a real health concern for me but I was like thrown into this moment of doubt having to acknowledge there was also a lot of truth in what she was saying and I was kind of pushing back a bit she said be honest with me if this drug gave you all the health benefits that it currently gives you but it also gave you boils on your face would you take it and I had to be

honest the answer is no I wouldn't I definitely wouldn't right you should well doesn't that tell you something and it's complicated isn't it because part of what happened is I felt physically better I actually felt emotionally worse we can talk about that for the first six months that's a separate thing but I felt physically better and I was getting feedback right I mean literally like four months in my neighbor's hot gardener who I've been walking past for years hit on me and gave me his phone number right I was getting a lot more uh male attention I could feel I was higher status in this culture was that part of my motivation yes it absolutely was and i suppose it's funny when i said because i um how would i put it i feel embarrassed to say that because

it feels like oh if i talk to you about health it's a moral i could talk to you in these moral tones i'm this you know i'm a journalist talking about morality and it feels superficial yeah it feels superficial it feels vain that's not you know whatever uses that word as a compliment right oh i met a really i went on a great date with a guy who was really vain right no one's ever said that right it's not so yes that was part that was and is part of my motivation and i can't separate that from i mean i can sort of intellectually theoretically separate it from the other stuff, but I can't really separate it. I think it's also a really big contributing factor as to why people lie about taking it. So many people who are using Ozempic to assist in their

weight loss, lie about taking it. And you even mentioned in the first couple of pages of your book, you were like more women lie about it than men do. Men seem to be more okay with being open about the reasons and what they're taking. But we have a culture where the people who are taking it because it's shameful because there's so many opinions because it's this idea of cheating because there's vanity loaded into it there's it's so complex that it's easier to just say well i started eating healthy and walking more it was pilates in lockdown it's easy to say that unless there has literally been an outbreak of dysentery in malibu like a lot of those people are not so but i totally get it it relates to i wonder what you thought about this i was speaking

to one of my editors the other day and it's like we're positioned right is that because one of the biggest news stories in the world and my book is the first book about it and there are no rivals on the horizon we're both we're all finding it really weird like why are they where i thought there would be like five competitor books by this point and one of my editors said to me it's because no woman could a woman would be crucified if she wrote this book a woman would just be absolutely crucified and so that rules out like you know whatever is 60 of books are written by women right so you've automatically ruled out 60 of your competitors does that ring true to you yeah it does and i think it or it actually goes full circle back to what you spoke about a long

time ago and i even think that this could be what's going on in your own head we have been conditioned to think that the only way we value weight loss is through suffering yeah it delegitimizes it exactly it takes away the legitimacy of it and it takes away this idea of redemption back to a point that we deem you a higher status person, as you mentioned, Johan. The number one thing that I really sat and thought about throughout the entire time I was reading your book is that we could try to have a conversation about Ozempic from a health benefit or from a psychological point of view, but you can't without the other because we are so deeply intertwined with the way that we value weight, weight loss, and how we feel about our

bodies. And it's not just external. It's not just from the food industry. It's so deep that it's internal as well. It's so deep that even children, like little children pick up on it. Like my little girl, she's four years old and we don't talk about weight. Weight's not something that we have to, and I don't say this to be like, we don't have to worry about it. Like we're a slim household. And so weight is not something that we ever really have to focus on in our house. but she was standing in the mirror the other day and she was like, I look fat in this. And she had a dress on that had a big frill. She's four, she's four years old. And I was like, when have you ever even heard people use the word fat? Like, why is that something that you know exists, but it's so

ingrained in so many parts of what we speak about that they pick it up at daycare or in their friends or, you know, around maybe an auntie or an uncle or someone else who's just said, I feel fat it starts as soon as they're born so more three-year-old children know what the McDonald's M means than know their own last name so they're simultaneously getting the signal it's bad to be fat it's bad to be fat and you don't feel good good news there's a happy meal waiting for you right so it's the worst possible combination they're living in what's called an obesogenic environment that's pushing them to be fat in fact the explosion in childhood obesity is absolutely, when you look at the graphs, it's breathtaking. And they're being told that it makes

them disgusting, you know, and then all these stigmatizing things, which actually make the problem worse and make them more likely to become obese and make them more likely to hate their own bodies. So it's this, it's a really bad combo. Johan, I will let you go eventually. One last question for you. When I initially heard about, you know, the shortages of this and how it was kind of wanting to be preferenced, but that's not possible because we live in a capitalist society where people can be greedy. The question I had was, why don't they just make more? Why don't they just make more of this? If there's more of a need, get in the lab, cook up a few more batches, dispense it. Why is that not possible to be done? And how does

copyright come into this? Yes, there's two bits of that. So there's Novo Nordisk and Eli Lilly, who are the companies that own the patents on these drugs, are scaling up as fast as they can because obviously, I mean, they have an inherent incentive to do that. I mean, Novo Nordisk is now the most profitable company in the whole of Europe. They're from Denmark. The entire Danish economy has had a massive boost just from Ozempic, like a staggering economic boost. And there's all these crazy, if you look at the figures on this, how much it's blowing up and how fascinating and unpredictable the effects are. I mean, Barclays Bank commissioned a very sober minded financial analyst called Emily Field to go away and look into the implications of these

drugs for their future financial investments and she came back and said if you want a comparison point for how much this is going to change things you've got to look at the invention of the smartphone right that's how big the effect will be and even just crazy things like this but just been a financial report showing that the american airlines are going to have to spend much less on jet fuel in the quite soon because it takes much less jet fuel to fly a much thinner population it's wild so why aren't they just scaling it up massively i mean they are scaling up as fast as they can but there are just logistical challenges you have to have physical factories you have to establish them and I have a lot of criticisms of these companies and concerns about them as well

as some praise for them but I think they are doing it as fast as they reasonably can without compromising safety but you asked about a second thing which is about patents which is really important so at the moment these drugs are unbelievably expensive when I buy them in Vegas it's a thousand two hundred dollars a month here in Britain because I spend a lot of time in Las face but here in britain when i get it here it's about 250 pounds a month so it's not actually that expensive inherently to make them it's about 40 a month just to make them it's the rest of that goes in profit to the drug company who argue look we developed this we develop lots of drugs that never come to anything this wouldn't have happened without us there's some truth in that i mean i

would say you don't have to make quite this much money right like that i mean you'd have to be the richest people in the world so what a lot of places are doing is making compounded versions of the drugs basically generics the equivalent of a knockoff louis vuitton bag there are dangers to that obviously process is not supervised you had some instances i think four corners just did a investigation in australia of people who were selling stuff they claimed was a zempic it wasn't a zempic at all in austria not that long ago there were a load of people who thought they bought a zempic and ended up going into comas because they've got a completely different drug so there's inherent risk with that the shortage is going to continue for the foreseeable future

because every time they meet the new benchmark more people want it more people want it more people want it i mean it's funny the book is called magic pill because there's three ways in which this could be magic right the first way is the most obvious it could just solve the problem right and there are days when it feels like that you know my whole life i've overeaten and now what i inject myself once a week in the leg and i eat drastically less and i've lost three stone there are days it just feels like magic the second way in which it could be magic is much more disturbing it could be a magic trick right could be like the you know the magician who shows you a card trick while he's picking your pocket it could be that the 12 big drawbacks to these drugs and risks that

i describe in the book are actually going to outweigh the benefit and screw us over that is a real possibility but the third scenario i think is one that's relevant to this question which is and actually i think the most likely scenario if you think about most of the stories of magic that we grew up with think about aladdin right you find the lamp rub it the genie grants your wish and your wish comes true but never quite in the way that you expected it's with some unpredictable element you think about fantasia you unleash the magic and then the magic runs away from you i think that's what we're seeing now right the magic is running away from us it's having unpredictable effects but what we know is by 2032 a zempic will be out of patent at which point

anyone can manufacture it for 40 a month by then it'll be pills the pills are already available at the point at which you've got a pill that's a little bit more than a US dollar a day that's giving you 20% body weight loss. I mean, most of the scientists I spoke to, their anticipation was that conservatively 30% of people will be taking it, assuming we don't discover some horrendous side effect between now and then. So you can see how explosive that will be and how important it is that we really pause and think about this now. If we had been talking on the day that Steve Jobs unveiled the iPhone in 2007, we would not have been able to game out, you know, TikTok and Uber Eats and Donald Trump and all these things that have transformed our

lives. This is going to transform our lives. It's coming for us. There are lots of people listening who are going to think, well, I never want to take these drugs. And a lot of them will be making absolutely the right decision for them. But even if you're not interested, it's going to transform the culture around you, particularly for women, particularly for girls, in some ways that are positive, in some ways that are really negative. I think we really need to take a beat and really think about it and what this is going to mean for all of us. Johan, thank you so much for coming and for being a part of the podcast. You're an absolute delight. We love having you on. And just for how even-handedly you speak about it, I think it's

so important because we would hate to have this conversation and for someone to walk away from it and think it's the magic fix or for it to be promoting something that is unsafe, but it's very real and I think there's so many people who are interested in finding out more but don't no one wants to talk about it that's the reality yeah it's funny I'm not normally a very even-handed person it's just I think actually the truth the truth with this is quite even-handed I think it is genuinely complicated one of my favorite writers Graham Greene said when we are unsure we are alive and when I was working on this book I really felt quite alive to the the gray in the middle and the you know I don't think it'd be much use to people to write a book going yay

hey, a Zen pick, woo, or boo, boo, no good, nothing good here. I do think the reality is in this much more interesting and complicated. We hope that you loved the episode with Johan Hari. And also, if you want to hear any more from him, we did do an episode back in 2022 all around Stolen Focus, as you mentioned, which if you're somebody who feels as though they're trapped to their phone or you feel like your relationships are affected by your inability to really clock in on the people that are important to you

because you're so distracted by all the things that we're subjected to. It is such a good conversation. And we will link all of that in the show notes as well. The other thing that I think was quite interesting that popped up in that conversation that we just had with Johan and also in the one back in 2022 was this conversation around processed food and how much that affects not only our satiety, like we just talked about, but also affects our attention. He's got his finger on the pulse of these things that are really affecting us right now and are going to be affecting us in the future so yeah go back and listen to that if you have the chance the links to johan's book and all of his social media that he doesn't really use will be in the show notes and

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