Science Vs - Weight Loss Meds: Is Ozempic a Miracle Drug?

Episode Date: March 23, 2023

People say drugs like Ozempic are helping them lose tons of weight. But are these drugs really all they’re cracked up to be? Or could this be yet another dangerous weight loss fad? We talk to endocrinologists Prof. Tricia Tan and Dr. Daniela Hurtado. Note: In this episode we discuss weight and weight loss. Please take care when listening, and here are some resources: U.S. helpline for the National Eating Disorders Association: 800-931-2237 SAMHSA's National Helpline US: 800-662-HELP (4357) National Suicide Prevention Lifeline: 800-273-TALK (8255), or text the Crisis Text Line (text HELLO to 741741).  Find other resources at: https://spotify.com/resources Find our transcript here: https://bit.ly/3FIPHv8 Find Science Vs Weight: Is Fat Unhealthy? Here: https://open.spotify.com/episode/771Gz9oycoeqSYtOVopRqp In this episode, we cover: (00:00) What’s going on with Ozempic?? (03:07) Do diets work? (09:00) How do drugs like Ozempic work? (21:13) Are drugs like Ozempic safe? (29:32) What’s our take on these weight loss drugs? This episode was produced by Rose Rimler, Wendy Zukerman, R.E. Natowicz, Meryl Horn, Joel Werner, and Michelle Dang. We’re edited by Blythe Terrell. Gimlet’s managing director is Nicole Beemsterboer. Fact checking by Carmen Drahl. Mix and sound design by Bobby Lord. Music written by Bobby Lord, Emma Munger, So Wiley, Peter Leonard, and Bumi Hidaka. Thanks to all the researchers we spoke to including Dr. Akshay Jain, Prof. Daniel Drucker, Dr. Eva Pila, Prof. Jeffrey Friedman, Prof. John Blundell, Prof. Peter Butler, and Ted Kyle. Special thanks to Brendan Klinkenberg, the Zukerman Family and Joseph Lavelle Wilson. And a big thanks to everyone who wrote or called in about their experiences on these medications.  Learn more about your ad choices. Visit podcastchoices.com/adchoices

Hi, I'm Wendy Zuckerman, and you're listening to Science Versus from Gimlet. And we are back for a brand new season. That's the crowd cheering, yay, you're back. But it's just me, alone. A quick note before we start this episode, we're going to be talking about weight and weight loss. So if this is a sensitive topic for you, please take care while you're listening. Today, we are kicking off this season by diving into one of the biggest news stories of the year. Meet the drug that tons of people are using to lose weight. It's called Ozempic.

It's the controversial diet drug that swept from TikTok to Tinseltown. Google searches for Ozempic have been skyrocketing. The topic Ozempic has over 300 million views. Ozempic is having a huge moment right now. Jimmy Kimmel even made it a punchline at the Oscars. When I look around this room, I can't help but wonder, is Ozempic right for me?

But Ozempic wasn't designed to make your Hollywood hunks look a little more chiseled. It's supposed to be a diabetes drug. And some people are worried that this new weight loss craze has gotten so out of control that now people who really need these meds can't get them. Some pharmacies are apparently in short supply of Ozempic because of perfectly healthy people who want to lose a little weight. But behind the headlines, we at Science Versus are hearing a different story. It's of people

who have been struggling to lose weight for years and have been desperate for something like this. I don't do it to be a size 2. I do it to maybe be a size 18.

It's been life-changing in ways that I never really thought it would be. This is the most incredible thing I have ever found. The most incredible thing I have ever found. The most incredible thing. Really?

Because we know that science has been looking for a magic pill or potion for weight loss for decades. And this actually has a really scary history. Some diet pills have even killed people. So today on the show, we're asking, what are drugs like Ozempic actually doing to our bodies to help us lose weight? Are they safe? And bottom line, if you're thinking of trying it,

should you? When it comes to new diet drugs, there's a lot of... Is Ozempic right for me? But then there's science. Science versus weight loss drugs is coming up just after the break. What does the AI revolution mean for jobs, for getting things done? Who are the people creating this technology and what do they think? I'm Rana El-Khelyoubi, an AI scientist, entrepreneur, investor, and now host of the new podcast, Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. Think of it as your guide for all things AI, with the most human issues at the center. Join me every Wednesday for Pioneers of AI. And don't forget to subscribe wherever you tune in.

It's season three of The Joy of Why, and I still have a lot of questions. Like, what is this thing we call time? Why does altruism exist? And where is Jan Eleven? I'm here, astrophysicist and co-host, ready for anything. That's right, I'm bringing in the A-team. So brace yourselves. Get ready to learn. I'm Jan Eleven. I'm Steve Strogatz.

And this is... Quantum Magazine's podcast, The Joy of Why. New episodes drop every other Thursday, starting February 1st. Welcome back. Today on the show, science versus weight loss drugs, like Ozempic. What is going on here? Our senior producer, Rose Rimla, has been diving into this. Hey, Rose.

Hi, Wendy. So, Ozempic, when did this first cross your scientific desk? To be totally honest, if you want to know the real story, I first started seeing it in the gossip mags. Not that I would ever partake of such media, but there's a virus on my computer and on my phone. And this virus, the crazy thing it does is it just pulls up subreddits about celebrity gossip all day long. It's really weird. You should get that checked. Be on the watch for it.

Yeah, yeah, yeah. And I noticed that I kept seeing people talking about such and such celebrity is a lot skinnier than they used to be. People saying, oh, they must be on Ozempic. Ozempic? What is that? And when I read a little bit about it, I was like, oh, this is that weight loss drug that I had heard was coming because I talked to a scientist a couple years ago for a different episode, and he mentioned, oh, there's this weight loss drug coming out

that's going to change the game. So I was like, are we living through a scientific breakthrough right now? Why do we need these drugs? Because at least you hear that to lose weight, that is something we can do, right? Just by eating less. Yeah, I hear that all the time. And actually, when I was reading some of the magazine articles and stuff about Ozempic, I was also reading the comments section. And actually, when I was reading some of the magazine articles and stuff about Ozempic, I was also reading the comments section. And these were people talking about not just celebrities, but basically regular people who are overweight or obese according to their BMI, and they're using this stuff to lose weight.

And nine times out of 10, the first few comments were something along the lines of, people are so lazy. They're taking the easy way out. People just need to eat less. Like, why can't people just eat less? And that kind of boiled my blood because it's just so wrong. It's really wrong. I mean, the most polite thing I could say about it is that it's short-sighted. What's the least polite thing you could say about it? It's scientifically indefensible. Whoa!

Rose, it's all out! I think a lot of people have heard that maybe, and they've heard like diets don't work, and they don't believe it, right? So I'm going to tell you why. Cover your ears if children are listening. It's scientifically indefensible to tell someone that they're likely to lose a lot of weight just by dieting and exercising. Okay.

So we have study after study where people lose weight at first, but eventually the weight comes back. It creeps back up and up until they're often back where they started or even higher. So I'll give you an example. One study recruited people who were 30 to 70 pounds over what would be considered a normal weight. And the researchers put them on a diet for about a year and a half and then came back after another year to see how much weight they'd lost and kept off. So at the end of two and a half years,

the dieting group weighed 1.7 kilograms less. That's about four pounds less. That's it. That's it. That is so tight. You wouldn't even notice that. You wouldn't even notice that on yourself. No, your weight can fluctuate like that over the course of a month.

Like, just whatever. You could do a poo and it looks like you've lost one kilo on the scale. So you can lose a little bit of weight from dieting and then who knows if you can keep it off. That's pretty disappointing as a strategy. Yeah. And there's a bunch of studies that have found stuff like this. And so why is that? Why is dieting not working in the long run? I mean, if you actually eat less than you did before, you will probably lose weight. And it works because you're burning more calories than you're eating. The biggest issue here is not eating less. It's eating less forever. There are a lot of reasons why that's really hard to do. But one reason is that your body is actively working

against you doing this. So you lose weight. Your body is likely to respond to that by actually slowing down your metabolism to conserve energy, to make you burn less just by going about your normal business. We also know that people who start eating less, their bodies start pumping out more of a hunger hormone called ghrelin. You heard of ghrelin? Yeah, yeah. So like your metabolism slows,

and then you get more of this hormone that makes you hungry. So you get extra hungry while you're trying to eat less than you normally would. So these things together is kind of your body just like nudging you back up to regain the weight. So the point is that for people who want to lose a lot of weight and keep it off, it's really unlikely you can do this just by deciding to eat less. In fact, this is so rare that to lose a lot of weight and keep it off, it's so rare there's actually a national registry that follows people that can do this and studies them.

Wow. And those are the stories, those rare people are the ones that we put up on posters to suggest that this is how it should be. But actually, these are like rare unicorns. Yes. Like you are like, you're one of the 10 California condors or whatever that like we've tagged and like we're watching to see like, are you going to make it?

It's just very rare to be able to do this. You are a rare bird. There is one thing that we've had for a while that does work. It's weight loss surgery. And that does work. People can lose weight and keep a lot of weight off. But you know, it's a major surgery. It's often irreversible. A lot of people don't want that, understandably, or they can't get it for whatever reason. So this is the world where these weight loss drugs are coming in, these Ozempics. It's an injection that you typically give to yourself once a week. Do they actually work?

Are they helping people lose weight? Well, why don't I let the people tell you, Wendy? So can I ask you how much weight you've lost? I lost like 10 pounds in the first month. I've lost 23 pounds. I've lost? I lost like 10 pounds in the first month. I've lost 23 pounds. I've lost about 35, 40 pounds. I've lost about 52 pounds in a year. My husband was like, you've lost the amount of a toddler. And I hadn't thought about that until now.

And I was like, you know, you're right. Those are all people who called into the show to tell us what it was like to take these drugs for weight loss. But, you know, those are just stories. I'm going to bust out the data. Yes, excellent. So we have data from a bunch of clinical trials, and I'll tell you one for example. This one had almost 2,000 people on semaglutide, which is the active ingredient in Ozempic.

And the researchers followed them for almost a year and a half. So on this stuff, smaglutide, people lost, on average, 15% of their body weight. So in this group of people, that was like 35 pounds. Mm-hmm. And then another clinical trial I want to tell you about is for a slightly different medication called Monjaro. A lot of people are using for weight loss. And on that trial, people lost, on the highest dose, people lost on average 21% of their body weight,

almost 50 pounds. 50 pounds, wait, so that's like 20, 22 kilos. That is serious. That is a very big toddler. That's a kid. Yeah, isn't that like a second grader? Wow, that's some serious weight that people are losing. And this isn't just about weight. There was a two-year trial where researchers followed people on this stuff and found that they had better blood pressure, blood sugar, better cholesterol. So there's a lot of health benefits. And then people I spoke to said that they were feeling better just day to day.

It really helped with stuff like knee pain. Okay, so how do they work? How are they doing this? Well, on these drugs, people eat less. It's basically classic calorie restriction. Wait, but didn't you say that most people can't just eat less, make this decision, I will eat less, and then lose weight? Yeah, well, here's the thing.

On this medication, there's no decision to eat less anymore. It's kind of like the drugs are making that decision for you. What do you mean? Well, the reason it's so hard to eat less is it's really hard not to eat when you're hungry. But what these drugs are doing is reducing people's level of hunger. So for example, we heard from this woman named Lacey. She's a pharmacist. She lives in Alabama. And she noticed this after the very first dose. I woke up the next day and I normally like I'm just starving. I'm ready to get something to eat. And there was just nothing. I made myself a protein shake and I was full after my shake.

And that has never happened to me before. And I honestly just wanted to cry because I was like, I can't believe something's working this well on the first day. And Lacey says this wasn't just about being really hungry at breakfast. It was about cravings that she was having all day long. And she calls this food noise. So with food noise, it's just that constant wanting to eat and like your body telling you that you're hungry, but you're really not.

So I would just feel like I always need a snack or, you know, gosh, I'm so hungry. Like, oh, you need to go. You need to go into the pantry and get yourself like a snack. You need to go get some fruit snacks. You need to go. And it's not just like an apple. Like, I wish it was as simple as like, go get an apple or a banana. It's more like, no, you got to go get some candy right now. Go into the candy drawer and get, you know, six Starbursts, but that's going to turn into 10 starbursts. It's like these drugs turned the volume down on that food noise and took away these cravings. Actually, there was a study in rats where the researchers put them on this medicine and then offered them bars of chocolate. And the rats were like, just a small piece for me. I'd rather just

eat my rat chow. And rats love chocolate. This is something I have learned while making this show. Yeah. So this is a big deal for me. I'd rather just eat my rat chow. And rats love chocolate. This is something I have learned while making this show. Yeah. So this is a big deal for rats. They're junk foodaholics. So yeah, it's really interesting. And we know that in people, the net result is that people just in general eat less throughout the day. In lab studies, scientists have quantified this, people eat a quarter or a third less than they would normally eat when they're on these drugs. It's impressive. So how is this drug, I don't know, almost hijacking our brains to make us want to eat less? I asked an expert that. Her name is Tricia Tan. She's a professor at Imperial College London and an endocrinologist. I can talk all day about this. It's the, you know, how it acts on the receptors. We're still learning a lot on this. Okay. So

Tricia says, what you have to know is that there are hormones that are released from our intestines after we eat. So let's say that we've just sat down to a big delicious meal. And what's your favorite food? Gosh, I love food. Difficult to differ. There's too many choices. Maybe Japanese food. So let's say Trisha's eating sushi. So that food will hit her stomach and start to go through her digestive system.

Do you want me to soundscape this while you're explaining it? With your mouth trumping? Yeah. Please. Okay, all right. So go from the sushi hits the stomach.

Let's say Trisha eats some delicious sushi. That food will hit her stomach and start to go through her digestive system. And there are some cells along her intestine that can tell that there's food. And they send out these

hormones. And the hormones we're interested in go to a bunch of places in our body. We're going to focus on the brain and the gut. And one thing they do is they tell our body that we've just eaten and we've had enough to eat. And they do this by going to the stomach and they signal to the stomach to slow down, to keep the food in the gut, to be digested. The hormones also talk to the brain and they signal to the stomach to slow down, to keep the food in the gut, to be digested. The hormones also talk to the brain and they say, hey, you're full. So the more of these hormones that get released that you have in your body, the fuller you feel. So if you had lots and lots of food, okay, and you feel full and you know, if you suddenly stand up and you suddenly feel, oh my God, I'm so full, I feel sick. Well, if you measure your gut hormones at that stage, it's high. It's very high.

So that's a natural thing that our bodies do. And actually, remember when I said that weight loss surgery is a really effective way for people to lose weight and keep it off? Yes. Good. I'm glad you were paying attention. I was paying attention. Well, it turns out that one of the reasons for that is that people start making way more of these hormones after they get these surgeries. Scientists now think that that's why gastric bypass surgery works as well as it does. It's not just about making the stomach smaller. It's also because after the surgery, the gut starts releasing extra amounts of these hormones. So, turning back to Ozempic and their ilk, what they do is they mimic some of these satiating hormones.

I'm full, I'm full, I'm full. It's like we're bottling some of the effects of the surgery without anyone having to go under the knife. So, here's where we're at. These drugs really do work. Based on the studies, people are losing a lot of weight on them and they work by making people feel less hungry. How am I doing? You got it. Excellent. My next question is, where does diabetes fit into all this? Because all of this hoopla in the news is that Hollywood types and people wanting to lose a few pounds are stealing a drug from people who are diabetic and who really need it.

And that's now created a shortage. Well, Ozempic is approved as a diabetes drug. That's what it's for. And the reason it's good for diabetes is because these hormones will also talk to the pancreas and tell the pancreas to make more insulin after a meal. And that's, you know, really useful for someone with diabetes because it's going to help them just make more insulin and then control their blood sugar better. So Ozempic was approved by the FDA for treating diabetes in 2017. And people with diabetes were taking it and they did lose weight. So four years later, the FDA approved a version of the same drug that's in Ozempic under a different name.

This one's called Wagovi. And they approved it specifically for weight loss. So inside the package, it's the same stuff. The semaglutide, you mentioned. Semaglutide, yeah. And that partly explains the shortage we've been hearing about, because the diabetes med can also be used as the weight loss med. And with more and more people wanting to use this stuff for weight loss, there's less and less of either drug to go around. Uh-huh. And do we know how much Hollywood and its ilk are to blame for this shortage? We don't know, as far as I can tell, because there's, you know, there's no surveys. Nobody

was taking a survey at the Oscars, right? Are you taking Ozempic or is that just a rumor Jimmy Kimmel is spreading? That'd be nice to have. But, you know, the company that makes this stuff, they did put out a statement saying that one reason for the shortage is, and this is a quote, an unexpected increase in consumer demand. Sounds like a fad, an unexpected increase. Yeah, so are some of these demanding consumers Hollywood types? Like, maybe, but I will tell you, Wendy, that a lot of people I spoke to who said this drug was really helping them with their health, they felt that all this attention on Hollywood and people on social media using it just to get a little skinnier,

they feel like this has created a stigma around these drugs. I just feel like there's so many media hit pieces out there that just frame us in this light of like, oh, look at these chunky Karens who are desperate to fit back into their high school jeans but are too lazy to put down the McDonald's and go to the gym. And so instead, they are, you know, stealing the drug out of the hands of the worthy type 2 diabetics at the Walgreens pharmacy counter and leaving them to die on the floor. Like, that's not what it is.

It's been life-changing in ways that I never really thought it would be. So, Rose, bottom line, it looks like there's a whole range of people that want to take this drug. If we did have an infinite supply of it, would that be okay? Like what are the downsides? Because so far it looks like if you want to lose weight, this is too good to be true. That's what I said. I said that to Lacey. Kind of sounds like too good to be true, doesn't it? I know.

It almost sounds like a fairy tale or something. Like, there's no way it could be that way. And I mean, we've had fairy tale weight loss drugs before that turned out to be less Cinderella and more Wicked Stepmother. So there's Fen-Phen, of course. Oh, yeah, that drug from the 90s? Yeah, it was a diet drug approved in the 90s that was effective, and people lost a lot of weight. But it got pulled after doctors realized that people were getting

serious heart damage from taking it. So could this be another Fen-Phen? We are going to talk about that after the break. Welcome back today on the show, Weight Loss Drugs. We've talked about how they do feel a little miracle-y. People are losing a lot of weight on them. But now, what's the catch? Rose Rimla. Okay. Yes. Hi, Wendy. Okay. Let's start with the short-term side effects. That's the stuff that happens to you right away. And a big one of these is nausea. The drugs can make you nauseous or nauseated,

as Blythe, our editor, would make me say. You can't be nauseous? Is that wrong? It's wrong, yes. You're supposed to say nauseated. And I think you have to say it in a British accent too. Nauseated? Wait, Blythe, pop in here.

Is that incorrect? Nauseous actually means you cause nausea in others. And so that would be like, the drug is nauseous because it causes nausea in you. But you can only be nauseated. But to be so specific about grammar can be nauseating.

Precisely. Now you've got it. Okay, so there was a clinical trial okay so at um people's nausea got worse and worse for some people until it reached a peak uh at about five months in about 25 percent of people on the med say they didn't feel so good oh there's a bunch of other GI stuff. So like GI stuff in general is a problem here. On Manjaro, on the highest dose, one in three people had nausea and some people had diarrhea or constipation. Lacey experienced this, our pharmacist from Alabama. Here's what happened to her. I live in Alabama. I had some fried food one day. That was like a day after my shot. I woke up at 3 a.m. to vomit a lot. Oh no. I learned from that. So I do have, it kind of

teaches you like, okay, if you don't eat well, there might be a few consequences because that was like fried chicken and french fries. And so now I know I'm like, I can't I can't eat that poorly. Does that mean you can never have fried chicken ever again? Not necessarily. Like sometimes I'll still eat it, but I ate way more than I probably should have. Like I pushed myself. Do we know why that is? One way it was explained to me by a couple of scientists is that you're basically

telling your body that you're as full as you are at like the end of Thanksgiving day, you've totally overdone it. So even though you haven't eaten that much food, and I think the richer the food is, the more it's going to push you towards that feeling of being so full that you are kind of sick. Oh, so on these drugs, just like a little bit of food, you'll get that, you are full, you are full. And then if you keep pushing yourself, it'll be like, you are so full, get this out of your system right now. Yes.

On the whole, this doesn't seem to be that bad. And, you know, generally these side effects get better with time. I talked about this with Daniela Hurtado. She's a doctor with the Mayo Clinic who prescribes this stuff to her patients for weight loss. I want to say, yes, these side effects can be common, but I rarely have to stop these medications in my patients. Because it always comes to finding that sweet spot at which they are able to tolerate the side effects, knowing that they will get better, and we are seeing that the medication is working. And that's what we see when we look at clinical trials too. In one trial, only 7% of people

dropped out of the study because of the side effects, and that's compared to 3% in the placebo group. Interesting. So low. So that's what we know for short-term side effects. The thing is, people who take this stuff are probably going to have to take it kind of forever. Here's what Daniela tells her patients. If we stop the medications, you're going to regain the weight back. So we're talking about using these medications long-term. The moment you start feeling hungry again, you start eating more, and then you put on the weight. Yeah, because you're hungry. You're back to being hungry totally and in clinical trials where researchers

followed people after they stopped taking the medication they did see most of their weight come back so for people who are taking this for year after year after year, it just feels like something's going to go wrong. Not just because we have this history of diet drugs, you know, like fen-fen, where scary things have happened to people on diet drugs, but it just feels like you can't just hijack the body in this way, make people lose the weight of a small child and then not be some consequence at the end, right?

Yeah, I get that feeling. And I had that question too. And I looked closely at the clinical trials that have come out. And I also went back and looked at the body of research from this class of drugs generally because there are other drugs that are similar and have been around a long time, mostly for diabetes. But we can look at all that data and look to see were there any weird safety signals that popped up.

Yeah, yeah, yeah. What are we saying? Are people growing little tails or stuff? No reports of little tails. Second ears. Oh, we've already got two ears. Yeah. People seem to continue to be bilaterally symmetrical.

Sorry. Sorry. Wait, so what do you find here? What did all your research show you? The more serious thing that I did see pop up in the clinical trials was gallbladder stuff, like gallstones. You know, those can be painful. And people on these drugs seem to have more... Slightly more. Slightly more gallstones than those who weren't on the drug.

Yes. But painful, but painful. Okay, what else? In the research on these, like, broader research, not necessarily Ozempic, but similar drugs, scientists have been squabbling about whether or not they might cause pancreatitis. Pancreatitis is inflammation of the pancreas, also can be very painful.

But it's not a very clear connection. And even the FDA actually looked into this a few years ago and they said that they don't see a link here. So, you know, it's like something to keep an eye on. actually looked into this a few years ago and they said that they don't see a link here. So, you know, it's like something to keep an eye on. But it didn't leap out at me as like an obvious like red flag. And neither did the one that I hear reported about the most, which is the one about thyroid cancer

that is on the box. It's like, warning, you could get thyroid cancer. Even that one is like, it's like in rats. They saw it in rats. They haven't confirmed that there's an uptick in people on these kinds of meds getting thyroid cancer. So that one's also like, you know, be on the watch. And so how did your doctor, Daniela, what did she think about all this?

She said that if you're using these drugs for health reasons, then the benefits really clearly outweigh the risks at this point. These medications are pretty new, so you don't know what is going to happen in three, five, six, ten years down the road, right? We may find that

these medications could be associated with certain types of disease. But, you know, I don't think there are any long-term side effects that we need to really be concerned about. It's a different risk-benefit analysis for everybody. But, you know, if you don't have any weight-related health problems, you are taking a bigger risk taking know, if you don't have any weight-related health problems, you are taking a bigger risk taking this stuff because you don't have the same benefit on the other side of the equation. Of course. Of course. Okay. So then where does this leave us in the world of miracle weight loss drugs? Well, with the caveat that we cannot predict the future, for the moment, they seem pretty safe.

They seem effective. I also think, and like, here's like, siren, purr, purr, purr. This is an opinion. This is my opinion. Okay, okay. This is just me. I'm not speaking for anyone else. Personally, I don't know if society is ready for this.

Because despite those pretty BMI charts at the doctor's office, science hasn't actually worked out exactly where the line is between healthy weight and too fat. We went into this in detail in an older episode we did a couple years ago. So I won't do it again here. But trust me, it's like we haven't worked it out and scientists have not worked it out and doctors have not worked it out. So I worry about people being pressured to take these and deal with these side effects and accept some level of risk that we don't maybe fully understand when they don't really need to.

Yeah. And then on the Hollywood front or just regular folk who are skinny and using this to get skinnier, I just wish we would have gotten to the point where we have better and healthier images of beauty before these drugs came out. But instead, we get them right at this point where skinny is still beautiful, despite it not necessarily being healthier. Yeah. How did the people you spoke to feel about that tension? You know, the person I talked to the most about that was this woman named Aaliyah.

So she lives in Washington, D.C., and she's been trying to lose weight basically her whole life. And being on Ozempic has finally moved the needle for her, and she's lost 50 pounds. She's really happy about that. But she's still grappling with just how to think about all of this stuff. I think that I tow a very narrow line between like self-confidence and loving the body I'm in and then being like, I want to lose weight. You know, like it's really hard to reconcile those two things in my head on like a daily basis. And to do it in a way that doesn't impact my relationship with food and my relationship with my body, my current body. But my goal isn't to be skinny. It's not to be real then. My frame would look very odd that way. Ultimately, taking off more weight is just healthy for me in terms of like being able to keep moving. While my blood work might be great, it's not great on my knees to carry so

much weight. And that's why I do it. I don't do it to be a size two. I do it to maybe be a size 18, which doesn't really change how the world sees me. I still will be a plus size woman in a country and in the world that that's not the ideal. But I just try to do the best I can with what I got. That's Science Versus. And for those who are new to the show, welcome. At the end of every episode, we have what we call the Citations Chat, which is where we tell you guys, our listeners,

about all the research that we did to make this episode. So Rose, how many citations are in this week's episode? 106. 106? Yep. And if people want to find these citations, where should they go? They should check out our show notes and they'll find a link to the transcript there. And if you click on that, that's where all the research is compiled. Excellent. And you mentioned that there's this episode that talked about

whether being heavier is unhealthy and at what point. Can you tell us more about that? Yeah, we go into a lot of stuff about the BMI and what it means and how well it does or doesn't measure body fatness. And like, is it actually unhealthy to be heavy and all that stuff. And if people want to hear that episode, it's called Science vs. Weight. Is fat unhealthy? And they can find that in Spotify. It's super interesting.

It's an episode hosted by Rose. Go check it out. This episode was produced by Rose Rimler, along with me, Wendy Zuckerman, Ari Natovich, Meryl Horne, Joel Werner, and Michelle Dang. We're edited by Blythe Terrell. Gimlet's managing director is Nicole Beams-DeBoer. Fact-checking by Carmen Draul. Mix and Sound Design by Bobby Lord. Mouth Trumpet by me. Music written by Bobby Lord, Emma Munger, So Wiley, Peter Leonard and Bumi Hidaka. Thanks to all the researchers that we got in touch with for this episode,

including Dr Akshay Jain, Professor Daniel Drucker, Dr Eva Pillar, Professor Geoffrey Friedman, Professor John Blundell, Professor Peter Butler, and Ted Kyle. Special thanks to Brendan Klinkenberg, the Zuckerman family, and Joseph Lavelle-Wilson, and a very, very big thanks to everyone who wrote to us or called in telling us about their experiences on these medications. Science Versus is a Spotify original podcast and a Gimlet production. Follow Science Versus is a Spotify original podcast and a Gimlet production. Follow Science Versus on Spotify. And if you want to receive notifications every time we have a new

episode, which you do because it makes it so easy to find us, then you've got to tap the bell. There's a little icon of a bell on Spotify. So you just tap it and you'll get notifications when there's a new Science Vestas episode. I'm Wendy Zuckerman. Back to you next time.