Piers Morgan Uncensored - Ozempic: Magic Pill or Devil’s Bargain?

Episode Date: May 29, 2024

Ozempic has fast become the buzzword for dramatic weight loss, and considering the results users have been reporting, it’s easy to see why. To discuss the supposed miracle drug, Piers Morgan has assembled an all-star panel of doctors and patients, including; Journalist and author Johann Hari, 'The Fasting Doctor' Dr Jason Fung, Professor of Medicine Dr Marc Siegel, 'Real Housewives of New Jersey' star and author Jackie Goldschneider and 'Shahs of Sunset' star Golnesa Gharachedaghi. Johann explains to Piers that Ozempic has been an excellent weight loss solution for him, while Jason and Marc explain that while the drug works, it’s not right for everyone. Jackie expresses her fear for those with eating disorders and Golnesa gives a counterpoint, explaining that semaglutide helped her deal with weight gain from steroid treatment. Hosted on Acast. See acast.com/privacy for more information. Learn more about your ad choices. Visit megaphone.fm/adchoices

In the worst case scenario, this could lead to an opioid-like death toll of young girls. So the problem is not the drug, right? That's just a tool. It's how you're using it. I will be honest with you. It was very difficult coming off of it. But I'm fine. I think semi-glutide is amazing.

It's about to come out in a pill one way or the other. A year from now, you can get it as a pill on the street. It's made them look drastically different. But, I mean, it's all around me. You know, I worry a lot about them. message that it's sending to our daughters. And how am I supposed to be okay with gaining weight when everyone around me is shrinking? Well, the global market for weight loss drugs is projected to be worth $100 billion within the next decade. Cable television is saturated with ads

for products like a Zempic. The celebrity press is saturated with pictures of the shrinking stars who've used it, whether they admit to it or not. I'm looking at you, Oprah. But is it safe? What are the long-term effects? Is it sustainable for tens of millions of people to take a that zaps their appetites, but stops working almost as soon as they stop taking it. Well, depending on who you ask, it's either a miracle cure for an obesity pandemic now wrecking Western health, or a dystopian symbol for a pampered, overfed society that's lost all capacity for self-control. It's also confusing, after a decade of being lectured that big is beautiful.

So to set the record straight, I've assembled an all-star panel. joined by Johan Hari, the journalist and author of Magic Pill, the extraordinary benefits and disturbing risks of the new weight loss drugs, physician Dr Jason Fung, also known as the fasting doctor, Los Angeles, Golnessa Garra Cheidaji, who's the star of Shars of Sunset, and Jackie Goldshider, the Real Housewives of New Jersey star, and author of The Weight of Beautiful. Plus, Dr Mark Siegel, the clinical professor and Fox News contributor.

So it couldn't get a more stellar panel together to talk about all this. Johan, I want to start with you, because you've got this book out, which is a fantastically interesting read about what is a fantastically interesting social phenomenon. Because just about everyone I know is on this thing. Men, women, they're all at it. Some are admitting it. Some aren't admitting it.

But we're seeing a shrinking world right before our eyes. Is it, as you ask, the magic pill? Well, we're at this mind-blowing moment. The average person who takes these drugs loses 15% of their body weight within a year. That's what happened to me when I took the drug to research it. And, you know, Barclay's Bank commissioned an analyst to figure out

what is this going to mean for the global economy? She said, if you want a comparison, you've got to look at the invention of the smartphone, how explosive it's going to be. And for me, I remember when I started researching this, feeling so conflicted, because I'm older now than my grandfather ever got to be. He died when he was 44 of immersive heart attack. I've been obese most of my adult life.

I thought, well, you know, if there's something that can really reduce or reverse obesity that have huge health benefits. But I also thought, come on now, I've seen this story before, right? Every 20 years or so, a new miracle diet drug is announced. Loads of a stampede to take it. It's always discovered to have some horrendous effect. So I spent a year really deeply researching this, interviewing the leading experts.

It's interesting. The book is called Magic Pill because there's three ways these drugs could be magic, right? The first is the most obvious. They could just solve the problem. And there are days for me when it feels like that. My whole life... Are you still on it at the moment? I'm still on it.

I can tell you why. But for me, my whole life, I was addicted to junk. food, you know, I was massively overate, I was overweight. Now I inject myself once a week in the leg. I don't eat anything like as much. You are the rapidly shrinking, Johann, hurry. We've got before and after picture on a show people. I'm deliberately going to look away from that. Well, it's just your face, but you can see immediately there that you are a much more sveled version of the time of the Johanna last saw. And that's the, that's the most obvious way it could be magic, right? The second way it could be magic is much more disturbing. It could be that it gives you all these

benefits, but it also screws you over. Right. It could be like a magic, a magician who shows you a card trick while secretly picking a pocket. I go through 12 big risks associated with these drugs in the book that everyone needs to be aware of. We need to weigh those 12 big risks against the risks of being obese. But the third way it could be magic is actually, I think the most likely, if you think about the stories of magic that we all grow up with, think about like Aladdin, you find the lamp,

you rub it, your wish comes true, but never quite in the way you expected. This is unleashing all sorts of incredible effects. Some of them are really positive. 20% reduction in heart disease risk if you take these drugs. Some of them are catastrophic. I'm really worried about people with eating disorders. Some of them are just weird, right? They're huge rush on dealers having to refit people's wedding rings

because their fingers are shrinking so much, right? There's all sorts of unpredictable effects. What I hope my book does is a guide where people can stop for a moment at the brink of this incredible transformation that's coming for all of us because soon it'll be affordable to everyone. And weigh up all the odds.

And weigh up the risks, the benefits, and what it's going to mean for the culture, a culture. Okay, so what, how long have you been on it yourself? A year and four months now. And how much weight have you lost? So I lost three stone, which is 42 pounds. That's a lot. It's a huge amount of weight loss. I'll never forget, it was the weirdest thing. Second day I was on it. I woke up and I was lying in bed and I thought, oh, I feel something weird. What is it? I couldn't place what it was. And it took me out five minutes and I realized, oh, I've woken up and I'm not hungry. Right. Right. And I went to this cafe just at the road from where I live.

and I went in and I ordered what I used to order every morning for breakfast, which is a huge chicken roll with loads of mayo in it, and I would still be hungry after that. I had like three or four mouthfuls, and I just wasn't full. What these drugs do is they massively dial up your sense of satiety, your sense of fullness, your sense of having had enough and not wanting anymore, which is why it leads to such dramatic weight loss. Why have you stayed on it, and do you intend to always be on it?

I mean, this is the question of if you come off it, is it like, you know, the magic suddenly dies and you go back to how you were, Are you worried about that? Do you intend to stay on it for an extended period? I am worried about that. For me, the thing that swung it is that if you take these drugs and you started with a BMI higher than 27, your risk of a heart attack or stroke goes down by 20 percent. And there's so much of that in my family that for me, that outweighed the 12 big risks that

I write about a magic pill. But lots of other people will read those 12 big risks and go, whoa, it's not worth it for me, right? So I do think we have to, everyone has to think about this in a very personalized way. The risks of being obese, which I'm sad to say are really significant. over 200 known diseases and complications. You've got to weigh that against the significant risks of these drugs. Right. Okay, let's get it open to the panel, including Johan.

I want to bring in Dr. Mark Siegel, because Mark, you know, I talked to doctors about this, and really they say what Johan's just said. There are lots of benefits here, but there are also lots of potential pitfalls and downsides. What is your overview of these drugs like a Zen pic? Let's start with the fact here is that it's the first time we've done. had a tool that works, period. This actually causes weight loss. And as an internist, I'm very interested in that because of what was just said, which is I'm

worried about blood pressure, I'm worried about heart disease, I'm worried about diabetes. And I was originally approved for diabetes in 2017. And then they found it used for weight loss, and it worked well. But my problem is not that, because I definitely prescribed this for patients, and I do think it's a game changer, but my problem is on the flip side, which is, is this the cure for the Twinkie? I mean, we're at a time when, you know, 67% of our youth are eating fast food because it tastes so good. That epidemic is getting worse, and we're sedentary after the pandemic, and nobody's exercising. So can people do it naturally and do they then jump? So in other words,

do they jump to Wagovi or to Zebbound or to a Zemvik if they can get it? Because they bypass a step here, which is changing to a Mediterranean diet or increasing your exercise. Are they doing it because celebrities are doing it? Why are people doing it? And who's prescribing it? I want to be the rate limiting step for this. I don't want people getting it on the internet. I don't want a quick television giving this to you. I want to be able to assess people and decide whether they use it or need it or not. And yes, some people need it. And yes, it's an extremely valuable tool for me to have. But again, not everyone that comes to me for it really should be getting it right away. Need to go step by step with this.

There are also, I mean, I've just from personal anecdotal evidence, I've assembled from people I know who've been on it or doctors and so on. Two things struck me. One is that if you do this for a sustained period of time, you suffer significant muscle loss to the extent that a surgeon in Los Angeles said to me, this is becoming a real issue now with these drugs, because people who are on them for a year or more, they're losing a substantial part of them of their muscle. And that's a problem. And I saw Sharon Osborne as a good friend of mine.

She was on it, and bemoaning the fact she was finding it almost impossible to put weight back on after she stopped it. And a third person, I know, has been on it and got quite depressed, didn't want to go out. In the end of mind, not wanting to eat or drink, didn't actually want to socialize with people. All these are different kinds of issues with it.

But are you picking up the same thing, Dr. Mark, about this? Yes, that's exactly right. There's also ozambic face where you lose weight in your face too quickly. There's also the idea that some people suffer from gastrointestinal side effects, noise, you're vomiting. The delayed gastric emptying is a great thing, unless you have an underlying problem with that. People get migraines, headaches, dizziness.

So depression, sometimes it lifts depression. But there are side effects here that I have to pay attention to on a one-on-one. one basis. Now, some of my patients will exercise more to overcome that body mass issue that you're talking about. But this is not a one-size-fits-all. This is a personalized decision with someone who knows what they're doing. Some of the people on your party are really experts in this and know what they're doing. So, yeah, side effects are an issue. One more point about side effects. We usually see them in the first few months. So that's another indication. If someone tolerates that they tolerate it.

Yeah, Han, I see you were nodding away at some of that. Have you had personal experience of what we're talking about you? Yeah, I had a real epiphany, actually, about the one that you talk about, that some people seem to be becoming depressed when they take these drugs.

It wasn't very severe for me. I had a real epiphany about this, because some people think that's because the drug affects your brain. We now know these drugs overwhelmingly affect your brain and not just your gut. But I actually think it's something much more basic. I had a real realization about this.

I went to branch of KFC. I'd had a rough day. It was maybe six months into taking the drug. And really on autopilot, I did what I would have done before I was taking a Zempec. I ordered a bucket of fried chicken to cheer myself up. And I ate one of the chicken drumsticks

and suddenly realized, oh, I can't eat this, right? So huge numbers of people use food to calm themselves down, to soothe themselves, to numb themselves. You can't do that when you take these drugs. What these drugs do is they interrupt your eating patterns, obviously in a way that's very good, but that can bring to the surface

some deep underlying emotional issues around food. That can be a good thing. There are obviously better ways to deal with not feeling good than Colonel Sanders, but that transition, can be pretty bumpy. It's one of the many psychological things that I want about in my book, magic pill that I think people really need to be prepared for when they're thinking of taking these drugs. All right. Dr. Jessifeng, the fasting doctor, what's your take on a Zembe? Does the positive

outweigh the negative for you? I think I agree with Mark. It's obviously a individual decision. I mean, if somebody is at very high risk, and I'm a kidney specialist, so I see people at very high risk, then yes, oftentimes the benefits do outweigh the risk. But the problem, of course, is exactly what we've been saying. If you don't fix the underlying problem, which is how to eat, how to exercise, how to change your lifestyle, then the minute you stop, all those benefits sort of go away. So I've been prescribing it fairly heavily for about five years now. and it's because the benefits were fairly obvious early on

that they were going to have these benefits for weight loss, which would translate into benefits for kidney disease, for heart disease as well. And the problem I see with hundreds and hundreds of patients is generally not that they're losing too much weight. It's that nobody wants to stay on it. And it's sort of easy to understand. If you're, you know, one of life's great pleasures is eating,

every culture has the same thing. You celebrate, you know, momentous events with a big feast. So it is one of life's great pleasures. And if you interrupt that, well, it can really be a problem. So it's great while you're losing weight. People are willing to put up with it for a year, two years. But, you know, after all the weight last has stopped, you've plateaued, well, you know, all of a sudden you just can't enjoy yourself anymore.

You can't enjoy food. You can't enjoy anything. So you see this, you know, in the suicide risk and the depression. And then you start to think to yourself, well, you know, what? I'm 40 years old. Am I never going to enjoy food for the rest of my life? Is it really worth it for me? So people don't stay on it.

I saw a New York Times article saying that at a year, only about 30% of people are on it. And the weight plateau is real. Like you lose that, you know, 20, 30 pounds, which is great. But if you're 300 pounds and you've lost 30, you're still significantly overweight. So, you know, on the one hand, it is a good drug. On the other hand, to call it a miracle, to me, is sort of out of line. I think, you know, obviously other countries have much lower levels of obesity. So I think it's a valuable tool.

I don't think that we should, like, ban it, but to jump to something and say, oh, let's do it. I mean, it's different for celebrities and people on TV where their livelihood is looking good, and they're always on TV and so on. But for somebody who's driving a truck or something like that, is it really worth never enjoying yourself? For most of them or it's no. I mean, I'm on TV and I find that the best way is to look at yourself on television. If you don't like what you're looking at,

get in the gym, work out more, drink less alcohol, and scoff less food. But both of the doctors have raised a really important point about the underlying factors here. And it's very important. I just urge everyone to stop for a second and Google photographs of beaches in Britain or the United States, in the year I was born, 1979,

they look really weird to us because everyone is what we think of as skinny, right? So what happened to us? Why has there been this extraordinary explosion of obesity in our lifetime? We know what causes it. That transformation happens everywhere that makes one change. It's where people move from mostly eating fresh whole foods they ate on the day to mostly eating process and ultra-processed foods, which are assembled in factories.

Once you've been screwed up by those ultra-processed foods, it's very hard to go back. Some people can do it. Everyone should try doing it the natural way. But actually, it changes your body in really profound ways. The way I began to think of it is processed food has put all of us or many of us into a trap. And these drugs are a trap door. They are a risky, rusty trap door.

Be careful about going through them. But if you're in a trap, we've got to deal with the deeper factors so that our kids don't grow up in this trap. I went to Japan where they have almost no childhood obesity at all. In fact, almost no obesity at all. because they took big societal measures to do that. We should do that, but I can't do that on my own, right? We've got to do that together. When you're in the trap, you've got to think through the dilemmas.

Dr. Mark, let me bring you back in. I mean, look, here's my also my problem with people on exempting stuff. No disrespect to Johan, but a lot of them become crashing balls. They're no fun to be around. And when you are around them, all they want to talk about is a Zemphi, which is, you know, of limited appeal to people like me. But does it make you inherently just quite dull to be around the Zempe? Well, in a way, it does because there's one thing that the one in the panel has brought up here,

which is what this thing costs and that pharmacies, at least in the United States, are all out of it. So every Ozambic board is talking to me about, where am I going to get it? It's on back order there. I can't afford it. Can you get insurance to pay for it? So we're spending all day long trying to get it approved. And then, of course, they're out of it. you get millions of phone calls.

What do I do now? What do I do now? Because nobody wants that hiatus where they suddenly don't have it for four weeks. And I want to emphasize that other point. Again, the fast food, that's a really important point. Ultra-processed foods have nothing in them. They are empty calories. They don't have fiber.

They don't have vitamins. They don't have minerals. Someone asked me the other day, what can I do? I said, here's a place to start. Take margarine and butter out of your cooking and replace it with olive oil. incredible olive oil, mono-unsaturated fats, antioxidants, good for your brain, good for your heart. So I'm a big believer in substitutions in cooking. And again, with exercising peers, you said exercising.

I don't say three days a week. I say seven days a week because if people work out seven days and that's their goal, they end up doing five days. I also think just general mobility, actually, just moving around. I mean, if you go back previous generations and you go back and back and back, the amount of mobility has shrunk from generations to the next one, as life has got a little bit more sedentary and comfortable, and actually just moving around. And if you go back 500 years,

everyone got up in the morning and they kept moving all day. Now a lot of people don't move all day. And if you couple that with a poor diet, then you really are going to have a lot of problems. We've been joined by our ladies. Welcome to you both. Apologies for the tech issues we had. Jackie, you yourself, an interesting perspective,

because you've talked very openly about your battle with anorexia. And you're worried that these wonder drugs, as they're called, may actually precipitate a lot of other people having similar problems. And in fact, Johan did touch on that earlier and has covered that in his book. Tell me why you're concerned. Well, you know, I understand the value of these drugs for people who actually need them, people with obesity or binge eating disorder. But the vast majority of women that I know who are taking.

these drugs are taking them to go from a size six to a size two. And you're taking massive loads of women who have a healthy relationship with food and you're not only destroying that healthy relationship with food and setting them up for a life sentence on these diet drugs, but you're essentially giving them eating disorders. And I don't say that lightly, but when you think about what the benchmarks

of an eating disorder are, they are artificially cutting off your hunger cues, manipulating your body into believing that your body into believing that you're full when you are probably malnourished and potentially harming your organs and your body for the sake of being very thin. And I know the hell of living with an eating disorder. I know the hell of recovering from an eating disorder.

And we are setting up people who had a healthy relationship with food for a lifetime of eating issues. Jackie, this is so important that you're saying this, and you should be so proud of yourself for surviving and for talking the way you have. This is my biggest worry. I have all the 12 worries that I write about in my book

related to these drugs. This is my biggest worry. Dr. Kimberly Dennis, who's one of the leading eating disorder specialists in the US, said to me, these drugs are rocket fuel for people with eating disorders.

We know that people with eating disorders have got a battle within them, right? There's the part of them that wants to starve themselves and the part of them that wants to live. And these drugs empower the part of them wants to starve themselves. In the worst-case scenario,

this could lead to an opioid-like death toll of young girls who are able to kill themselves with these drugs who would not otherwise have been able to. And the solution to that, at least partial solution, is really important, and everyone watching should be fighting for this. We need to make sure that you only get these appointments

from in-person appointments with doctors like Dr. Mark and Dr. Fung who are trained in spotting eating disorders and do not give them to people who are not overweight or obese. We should be urgently fighting for that before this crisis blows up, as I fear it already is. Can we bring it? It's totally true because if you think about it, The risks and the benefits are different for so many people.

So if you're an 18-year-old girl, no, you should not be taking it. If you're a 60-year-old man with insulin and three different medications and a heart attack already, you probably might think about taking it, right? So the problem is not the drug, right? That's just a tool. It's how you're using it. And unfortunately, we've gotten to the point in the United States anyway, where you could go to – I mean, my friend told me they went to the medical spa and got it, right?

You have companies that basically, you know, go on the phone, as you've been saying, and will give you a prescription, like sight on the scene, right? So that's where the real risk is, right? Not that the drug is so bad. Let me bring in Godessa, been waiting patiently. You were the first celebrity to come forward publicly to admit to using a ZemPic. You even showed an injection example. So I think you're still on it, aren't you?

So tell me about your experience with a Zempick, first of all. Yes, I do think that, first of all, to Jackie, it's a very detailed process that I went through with my doctors in order to receive a prescription like this. So I do think that that consultation interview process between you and your doctors should be very intimate and seriously taken. Not everyone should be prescribed something, especially I think someone who does have any form of eating disorder. for me, I've always been very skinny my entire life. I have just naturally, this is my genetics, and unfortunately, I also have an autoimmune disease. I have rheumatoid arthritis in about 44 joints in my body. Anyone who knows much about autoimmune understands it's a lot of medications, a lot of steroids, a lot of just constant medicine that does cause you to gain weight,

and having an inflammatory disease itself adds. weight. After I had my son, my autoimmune went haywire, and I had to get a lot of steroids injected over a course of a year and a half, which got me to about 140 pounds. I will say this. I'm normally about 115 to 20 pounds, and I was 150 when I had my son. So 140 was a lot for my body. I was very large. I could not get the weight off because it was just steroids. sitting on top of steroids. I can't exercise because my joints are damaged. So I was scared.

I was very scared to go into the semi-glutide route. I thought this is only going to make me worse. I can't even risk it. But when I talked to my rheumatologist, my rheumatologist explained to me, this might even make your autoimmune better because it will fight off the inflammation and the sugars and whatnot that are causing issues.

So two months later. Yeah. How have you been doing it on it? I'm sorry. How have you been doing since you started taking it? It's good. I mean, I'm fine. I was on semi-glutide for four months, three and a half months total.

After two months, I lost almost all the weight. At three months, I lost 28 pounds. It was way too much for me. I wasn't happy with that much weight loss. I don't find extremely skinny to be attractive. So it wasn't what I was aiming for. I was aiming to just shed the excess bloating I came off.

I went into a maintenance program to kind of wean myself off of it. I will be honest with you. It was very difficult coming off of it, especially being able to reintroduce foods to my body that I hadn't been able to sort of eat. I was now hungry, but my body wasn't able to process or digest

or accept the foods that were coming in. So I did have extreme, almost like ulcer pain when I would eat anything. That lasted about a month. or two and it went away. But I'm fine. I think depending on the scenario, the right person, you're in your relationship

with your doctor, I think semi-glutide is amazing. I think it's going to be on every corner the way Botox is now. If you remember Botox used to be, everyone was against Botox, and now it's literally on every corner the way Starbucks is. So I see the same for semi-glutide.

Let me bring in, oh, hang on that. I mean, you've talked to a lot of people, obviously, for the purposes of your book. does that resonate with you that some people have a particular medical condition, for example, where it really works as a short-term fix for a particular issue. But I can also understand Jackie's concern that it could easily trip people into eating disorders, particularly if, for example, you're on it for, say, a year, you lose, I don't know, say, you lose 50 pounds, whatever it may, but a significant amount of weight.

And you love the way you looked at the end of that process, but you don't want to keep taking a drug. That desire to then try and keep that look could easily trip you into an eating disorder, didn't it? The worst moment for me in the writing of my book by far was it was maybe four or five months into taking the drugs. I was facetiming with my niece Erin, who's the baby of my family, she's 19, the only girl in her generation. No one makes me more protective.

And she was sort of started teasing me saying, oh, I never knew you had a neck before, Yoha. I never knew you had a jawline. And I was sort of preening. And then she looked down and she said, will you get me some ozenpick? And I thought she was kidding. She's a perfectly healthy weight.

And I suddenly realized she wasn't. So I have real worries about this. And I think we've got to always with this, I'm not generally on one hand or on the other hand kind of person, but we've really got away so many complex things in relation to these drugs. I think a lot about a guy called Jeff Parker, who I interviewed,

67-year-old retired lighting engineer in San Francisco, was very severely obese, was struggling to walk, was on fistfuls of pills a day, started to take these drugs, lost an enormous amount of weight, he's off his pills. now he walks his dog over the Golden Gate Bridge and said to me, I feel like I'm going to enjoy my retirement now. How do we weigh him against the risk to my niece?

It's very, very hard. The thing that most worries me for myself, so I'm going to carry on taking this because generally when you stop taking it, you regain the weight and the heart disease risk comes back. The thing that most worries me is we don't know the long-term risks at all, right? No one's been taking these drugs for more than, what, 18 years in the case of two diabetics and a couple of years with obese people.

But I really think a lot about saying that an obesity specialist called Dr. Shawna Levy said to me, she said, we don't know the long-term risks of these drugs, but we do know the long-term risks of obesity, and they are very severe. So if you're obese, I really think you do have to weigh these risks, which is quite separate to question of people who are not obese, who of course should not, or not obese or diabetic,

who of course should not be taking them. Okay, Jackie, you know a lot of people on a... Sorry, Mark, you want to come in? I want to just jump in. I agree with every word... that was just said, I want to actually focus in on the medical point. It's the gastric emptying that bothers me long term, where your stomach flowed down.

In terms of insulin, increasing insulin and improving overcoming inflammation and insulin resistance, which is another thing the drug do. I think that that's got to be really healthy. But I want to throw in one point that we haven't brought up yet. So in other words, part of the drug bothers me long term what it does to the GI track. Here's something we haven't talked about. It's about to come out in a pill. one way or the other over the next six months of the year,

there's a lot of companies competing on this. Can you imagine what that's going to do? If we have an explosion now, imagine a year from now, you can get it as a pill on the street. So the point that was just made that doctors need to be in the loop, experts who are used to this and know how to prescribe it, but it's getting completely out of control and it's going to get worse with the pills.

And there's the GI tract issue, which you've raised, is so important, but also interviewing the leading neuroscientists about this, we know these drugs primarily work by changing your brain. It's big debate about how. Chronically activating the brain over long periods of time, obviously does contain risks. They have to be weighed alongside. Also, I think what you're saying about pill

is so important, Dr. Mark, because if we look at the evidence around that, so 47% of Americans want to take these drugs at the moment. Eight years from now, a Zemik will be out of patent. It will be a daily pill. It will be a dollar a day. I would predict by then if these 12 risks don't massively blow up, which they might,

actually 47% is an under-restrict. We really need to. This revolution can be incredibly good for a lot of people and incredibly bad for others. We really need to slow down and think about it, and you could not be more right. Doctors need to be the gatekeeper. Anyone at the moment could go online and get it, right?

That is a disastrous situation that we need to rein in urgently so we don't have repeats of somewhat happen with the opioid crisis, for example. Jackie, you know lots of people who have been taking a ZenPake. What have you noticed about what it does to them in terms of their personalities,

never mind there anything else? Well, these used to be people. who I looked up to as people who really enjoyed eating, who didn't obsess about things, and now I go to dinner with them and they don't eat. So that social part of it is gone. I know that they are very conflicted about food. Sometimes they want to eat, they want to drink,

but it makes them sick afterwards. It's changed there. I mean, it's made them look drastically different, and they are complimented on their bodies immensely, which is very confusing for me. As somebody in recovery, in active recovery, I try to not internalize the message that the more weight you lose, the more compliments you're going to get.

But, I mean, it's all around me. Almost my entire cast is on one of these drugs. And, you know, I worry a lot about the message that it's sending to our daughters. And in general, that it's societally unacceptable to live in a bigger body. And how am I supposed to be okay with gaining weight when everyone around me is shrinking?

Yeah, I mean, Dr. Jason, the thing that I keep coming back to is does it really change your behavior? You know, it's a short-term fix or maybe a middle-term fix. It'll crash your weight if you're overweight. But is it really conditioning you longer-term in a way that, for example, having a lifestyle amendment where you just work out more, you eat more healthily, you do things in a much more logical, organized way

that we've always done to try and lose a bit of timber and get a bit fitter. Is that all going to get lost in the wash here where if you can literally go and get a pill that saves you having to get to the gym, I can see a massive problem down the line with people who aren't physically fit. They've just lost a lot of weight very quickly with a pill.

I completely agree, because the whole thing is that if you don't take that opportunity to learn healthy eating behaviors, then you're lost. You're taking it forever. Otherwise, that weight is going to come back. And as you say, maybe it's much better to talk about cutting ultra-processed foods, which is going to be sort of a societal effort, increasing the amount of activity. But then the other thing I always come back to is if we compare the 1970s, for example,

where I grew up to the 2020s, the big difference. is that people are just eating all the time, right? There's no sense that you, there's no part of the day that you shouldn't be eating, which is different from when I grew up, right? If you wanted an after-school snack, your mom would say, no, you're going to ruin your dinner. If you wanted a bedtime snack, your mom would say, no,

you should have ate more at dinner, right? Like, you only ate at certain times at a table. I personally think that there is a way to do both. I think there's a way to do both of these things. I think there's a way to be able to actively, want to lose weight and still want to indulge in your lifestyle and do things like that. I feel like, again, I'm going to bring up Botox because I remember very clearly the craze that was behind Botox when it first became very public and being used everywhere.

I remember everyone trying to shut it down. Everyone was talking about how it was ruining your face. It would collapse all your muscles, paralyzed you, deform you, all of these things. And then now we see how, you know, it's been revised. It's been done whatnot to compensate the mass production and the way it is being used now. Because Botox is no longer being used for what it was designed for. It's being used for beauty, right?

So I see semi-glutide working the same way. My doctor who prescribed it to me was working very tightly with a pharmaceutical company that was adding, I might be pronouncing it incorrectly, L. Karnatine? Is that the L. Karnatine? I think is the pronunciation. And that was alleviating the nausea, as well as increasing the weight loss to happen a little faster. And I have a lot of people that I know, at this point, like Jackie said, at this point, almost everyone, you know, in the TV industry or is on it, and you hear these different stories. And I hear people who have absolutely zero side effects from it,

zero side effects. I hear people who just say, oh, I did. one shot and I couldn't handle it. You know, it is what it is, but I do think that this is going to be our new normal, and I think that there's a way to adjust our lives around it and not ridicule it. It would be the same as me ridiculing anyone who dyes their hair a certain color, knowing that dyes go into your skin and can be cancerous, but you continue to bleach your dye your hair. So it's just about finding what the new normal is.

Yeah, I think it's so important. There's two things that are coming out that you like to address if it's okay. So we've mentioned quite a few times that some people lose their pleasure in food taking these drugs. Few of us have mentioned it. That's important and that is a very common experience. But actually, strangely, for me, I had the opposite experience. I used to eat to stuff myself. Now I have to eat more slowly.

I actually enjoy food much more than I did before. Now, I think there are more people like the people you're warning about who lose their pleasure. But it's worth just knowing that. Also, I think what you were just saying about zero side effects, I think is really important because it's important also people to be aware. So people who are already skinny, who are taking them to be super skinny, it's important for you to know you likely won't experience any horrible effect now. But what these drugs do, any form of weight loss does,

is it means you don't just lose fat mass, you lose muscle mass, right? As you age, you naturally lose muscle mass as well. If you're going into the aging process with very low levels of muscle mass, that's what you need to move, to climb the stairs, to get out of a chair. That won't show up now, but the risk is that 20, 30 years from now, you'll be much frailer, you'll be much more likely to get sang, called sarcopenia, where you'll really struggle to get out of a chair or climb. So the risk is that the people who are skinny who are doing it.

And I totally understand where they're doing it. Women get shit no matter what they do with their bodies. I'm not judging anyone who's doing it to do that. But I do, I would really urge those. Do you work out on it, Johan? Do you work out while you've been taking your Zem? I do. I have a very good personal trainer called Josh, but I had one before as well.

And have you noticed any difference between your ability to work out before and after Zemphic? A thousand times easier. If you're really, a lot of people, this is. was not the case with me, but a lot of people don't go to the gym when they're overweight because they feel embarrassed. They feel humiliated, right? It's partly that. And also just that try exercising with like three stone less on your body. It's much easier. So I think some people say, oh, this will stop people exercising and there is a risk of that. It's an important thing to raise your right to raise it, peers. But I also think there'll be lots of people who do actually

exercise much more now because of these drugs. Okay. Dr. Mark, I mean, you know, I've been baffled by some of the body positivity movement in recent years, not least. when there was a 300-pound five-foot-two-inch model appearing on the front cover of Cosmo in the UK, as if this was an example of body positivity, when in fact she was clearly very morbidly obese. And I thought that celebration of morbid obesity was very dangerous. It seems to me this is the reverse of this,

and that if it ends that celebration of real obesity, that is not necessarily a bad thing for society, as we've been getting fatter and fatter and fatter. That is a great point, and I agree with that. I don't think stigmatization ever makes sense, but I think championing obesity was very dangerous medically because I look at something boring and non-sexy, like a high blood pressure that comes from it

or a heart attack. You're totally right about that. But I also agree with the point that was just made. Let's not stigmatize OZembek itself. Let's think of it neutrally as a tool. But so in other words, we shouldn't switch back and go from bashing obesity. Now we're agreeing obesity is a bad thing.

So let's bash one of the tools. I don't think we should. But I want to get back to a point you made earlier, Pierce, which we need to emphasize. There's a cultural difference here. If you go to Europe, and you all know this, you go to Europe, everybody walks everywhere. I check my watch, and I'm walking 10 miles a day in Europe.

In the United States, nobody's walking anywhere. And that's a huge issue. It's not just working out in the gym. It's also walking. And then, again, the point about ultra-processed foods. Everyone thinks you can have pasta in Italy. You can't have it in the United States. What are they adding to it?

The food is different from one place to the next. And that's a huge part of the problem in the U.S. where obesity has gone way out of control. It's so important. There's a really fascinating experiment that really shows what you're saying, I think. It was done by this guy called Professor Paul Kenney, who's the head of neuroscience at Mount Sinai in New York. New York. It's a very simple experiment. It got a load of rats and he raised them in a cage.

And all they had to eat was the kind of natural, healthy foods that rats evolved to eat over thousands of years. And when that's all they had, they would eat when they were hungry and they would just stop, right? They never became overweight or obese. Then Professor Kenny introduced them to the American diet. He fried up some bacon. He got a lot of Snickers bars. He got a load of cheesecake. He put it in the cage. And the rats went crazy for the American diet. They would literally dive into the cheesecake and eat their way out. And they ate and ate and ate. And they eventually, quite rapidly, actually, all became severely obese.

Then Professor Kenny tweaked it again in a way that feels a little bit cruel to me as a former KFC addict. He took away the American food and left them with nothing but the healthy food. He thought he knew what would happen, that they would eat more of the healthy food than they had at the start. And that would prove this food makes you eat more calories. That is not what happened. Something much weirder happened. Once they'd had the American diet and it was taken, away. They refused to eat any healthy food. It was like they no longer recognized it as food

at all. They only went back to it when they were starving. But this shows, and I go through loads of evidence in my book, Magic Pill about this, the seven reasons why processed food undermines our satiety. I had never really felt full until I took these drugs because I ate that food pretty much all the time. What these drugs do is they give you back your satiety, your sense of being full, but at a cost, this is why Professor Michael Lowe said to me, they're an artificial solution to an artificial problem. The process. food digs this whole of hunger in all of us. The drugs fill it, but at a cost, clearly what we need to do is for our kids. It's probably too late for someone like me. But for our kids, we need to

absolutely stop this happening in the way they do in lots of other countries, like the Netherlands and Japan, and not allowed them to be screwed up by processed food in the first place. Okay, listen, it's been a fascinating debate. I just want to go by asking all of you, and I'll start with you, Dr. Jason. Asempe, we've had the debate. Is it going to be ultimately a force for good or not? I think that's going to depend on who's using it. Like with any drug, there's risks and there's benefits. So there are many, many people who it's net beneficial, clearly.

And there's going to be a lot of people, as everybody is afraid of, that it's a net negative, but they will take it anyway because they're going to be able to get it. And it's no different than any other drug. Like there's no reason to take steroids or whatever. But in certain situations, they are highly beneficial. So I think it's going to be both. I think it's going to be very beneficial in those people who, you know, are going to benefit, the people who are at risk of heart disease and organ damage, that kind of thing.

Those people at high risk of eating disorders and so on, that's going to be a net benefit. So it's going to be this sort of dual population. Dr. Mark, would you agree with that? Yeah, I agree with that completely. It's a mixed bag. Ultimately, it's a tool for good if doctors are controlling it, which I'm worried we aren't going to be. and it's definitely good for some people, but easily abused by others. I'm glad it's in the world, but we've got to watch out with a warning, too.

Jackie? Yeah, I think it's wonderful for people who need it, but for the 30 million Americans who have an eating disorder, it's very dangerous. And I'm afraid for, you know, it's in advanced pediatric trials right now for kids as young as six years old, and the fact that we might be putting first graders on these kinds of drugs is terrifying to me. Golnessa?

I am 100% behind Summit glute's high. I believe it's fantastic with doctors saying every day that too much insulin in our body is not a good thing with people who have high cholesterol don't need to have medications, they need less insulin in their bodies. And to know that we have GLP-1RA in our summit glutide and America is literally dying of cardiovascular issues and obesity, and you see that there is this magic medicine

that is helping a lot of that. I'm for it. So, I'm going to end with you. We began with you. I'm going to end with you. Is there a danger? And you spell out the argument so well on both sides here, but is there a danger that in 10 years time, the sequel to your book, Magic Pill, is actually called tragic pill. And this would have turned out to have been a terrible social experiment that backfired on the world. There's a significant risk of that. We're actually in a tragic social experiment where we eat foods that undermine our ability to feel full and make us catastrophically obese. This is an attempt to get out of it.

I think Dr. Mark nailed it when he said it's a tool. To me, it's a tool like fire is a tool. Fire is a great tool if you use it to warm your house. It's a catastrophic tool if I use it to burn down your house, right? It's a tool. It's out in the world. We can't put it back in the box, right? What we need to do is think about this

in a super personalized way. We've heard this on the panel really movingly. What is right for me and may well be saving my life because of the heart disease risk in my family would be absolutely disastrous for some of the people on the panel, right? We've heard that. I think that's absolutely true.

Anyone who's just saying, yay, this is going to save us all, or boo, this is the devil for everyone, I think it's missing the much more interesting and complex question, which is that we need to go through the benefits and risks in a really thoughtful way and we need to put in place guardrails now

really, really urgently before this starts causing really big problems. But you're totally right, Piz. Someone might find this on YouTube in 10 years and some of the really big risk. There are doctors who are worried it might be causing thyroid cancer. There are doctors who are worried that pregnant, will you give it to rats,

they're much more likely to have deformed fetuses. There are really significant concerns around this. Some of them, at the moment, they don't look like they're turning out to be big catastrophes, but there are doctors who are significantly worried, and someone can find this on YouTube in 10 years and say, wow, he should have listened to his doubts, but equally, the alternative for me was that I would have continued to be obese.

I had tried dieting so many times, and I always ended up fatter than I was at the start. So most people, 70% of Americans are overweight or obese. Most of us are facing the choice. Risk of the drugs versus risk of obesity. And that's what we need to think through. What a great discussion. Thank you to all my panel. I know a lot more about a Zempec than I ever thought I needed to,

but I appreciate it very much. I will be heading tonight to the gymnasium and doing it the old-fashioned way. but I think it's a really interesting topic. Thank you all very much indeed. Cheers, Pears. Thank you. Thank you.