The Journal. - Trillion Dollar Shot, Episode 3: Brad

Episode Date: June 2, 2024

Bradley Olson has tried a lot of different diets over his 20-year weight-loss journey, including popular programs like WeightWatchers. But nothing was as successful for him as Mounjaro, one in a new class of drugs that people are taking for weight loss.  In this episode, Brad talks about his experience on the medicine and grapples with everything the drug couldn’t fix, from his self image to our food system. He confronts the ghosts of diets past and wades into the larger cultural conversation around weight loss. Guests include: Gary Foster from WeightWatchers; Virgie Tovar, a body positivity advocate; Dr. Robert Lustig, an endocrinologist.  Listen to Episodes 1 and 2 of “Trillion Dollar Shot” now.  Learn more about your ad choices. Visit megaphone.fm/adchoices

Hey, it's Ryan. This is Trillion Dollar Shot, a special series about a new class of drugs like Ozempic, which are helping people to lose weight. The first two episodes are already in your feed, and you can find a link to them in the show notes. Hello again, Brad. Hello. Here we are. It's a big day. It is a big day, as I understand, at least. Yeah. We're going to be talking about your story in this episode.

Yes. And I think, I hope, it's a relatable story. I mean, I think so. You know, so many people in this country have been wanting to lose weight or have tried to lose weight. And, you know, you've said before that you've been on this weight loss journey for about 20 years. Can we go back to the start? Where did it all begin for you? It kind of starts with the weight gain, really. You know, I got married and I think just kind of wasn't well.

I don't know how else to say it. And ate my feelings, as it were, for quite a while. Had kids right away as soon as I got married. And so I was just in my 20s. And I think with the stress and everything, one kind of easy thing to do was to, you know, enjoy food. And so how would you describe your attempts to try to lose that weight? You know, it's a lot of defeat. You get kind of temporary victories. And all of the diets really almost feel like ways of like kind of tricking your brain into going along with something for a while. But then you just have this kind of this creep where basically I got it off and then it's like, can it hold? That sounds exhausting.

Did you feel that? It's hard because, you know, you go to the doctor and they'll tell you, you need to lose weight. You need to be healthier. And you're like, I want that. Of course I want that. And I know that then people would say, okay, but you don't want it enough because you still ate that donut, you know? Or like Arnold Schwarzenegger in your head from that movie Jingle All the Way, Arnold Schwarzenegger in your head from that movie Jingle All the Way where you hear him say, put that cookie down!

Put that cookie down! Now! I try to play that in my head. If I would grab a dessert, I would pretend that Arnold was in my ear being like, put that cookie down. You know, you try lots of things. Pretty intense voice in your head.

Yes, Arnold in your head is intense, you know, but it's good. It's just, like I said, it's like tricks, ways to trick your mind. But the defeat was basically that in the end it would add up to not really coming out ahead. Why wasn't Arnold enough? I think because the food noise was stronger. To the best that you can, can you explain

food noise to me? It's easy to describe it as like a voice in your head. Pizza, spaghetti, hurry, chips and ketchup, sauce, chips and guacamole. Where you're like, what are you going to eat? You know, what's going to be next? What's coming up?

And you'd kind of be like, F you, man. You know, leave me alone. But my guy was like, he just wouldn't go away. Like, he just wouldn't go away. Donuts. Strawberries. Diapers. Sugar. Seeds.

Candy. Cranberry crackers. But then the food noise was gone. Just zapped. The guy was dead. What killed the guy? The medicine. Manjaro.

It's the diabetes drug that I took off label. I lost 40 pounds over five months, and I just felt in control of my weight. My cravings totally went away, especially for sugar. You know that bowl of M&Ms at your friend's house or at your work? Yeah. Like I was always going to grab some of those M&Ms. Like even when I was dieting hardcore, I was going to get some of those M&Ms.

And once I was on the medicine, it was like, no thanks. Don't want those M&Ms. And I just was like, how did that happen? Yeah. How did that? I didn't miss the M&Ms either. That was the other thing is that I didn't even have a sense of loss. Wow.

It was just gone. And it was shocking. I mean, it sounds like it was a good thing. Yes. But it was also confusing. Confusing how? You're like, wait a minute. Confusing how?

You're like, wait a minute. If there's a drug, then like, what if I was just actually doing something impossible the whole time and then hating myself because I couldn't do an impossible thing? And then you don't feel so great. Then you feel kind of mad. Mad at who or what? I got mad at the time I wasted trying to lose weight and then feeling bad for not keeping the weight off.

So today, I'm going to talk about that, about what my life was like before the drugs and how the medicine made me question not just the time, but all the money and effort I spent dieting. And we'll also look at your time on the drugs, Brad. Yes, and all the new questions that popped up when I was on them, because even as the drugs worked, I also saw their limitations. From the journal, this is Trillion Dollar Shot, how a new class of drugs is transforming bodies, fortunes, and industries. I'm Bradley Olson.

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August 2nd. So Brad, how many diets do you think you've been on in your whole life? Oh, like different diets, probably like four. But times on those same diets, I don't know, 20 or more probably. Yeah. This would be like Weight Watchers, Keto, Mediterranean, Atkins back in the day, and then things like Whole30, I think was maybe the most recent one I tried a while ago. It's a lot.

Yeah. I don't think I know anyone who hasn't been on some kind of diet. A lot of the ones that you've named too. And that includes me. I'm a smaller bodied person, but I've still felt that pressure to lose weight. And the people we spoke to for the series, they've tried just about everything out there. We would do like the military diets, the grapefruit diet, the liquid diet. Joining the gym, doing Zumba. Going swimming, lifting weights, aerobics class. I'm going to the gym two times a day. I'm eating meal prep delivery service.

Eat less, move more. Eat less, move more. Maybe you just need to work out more. Maybe you need to eat less. What was the first diet you remember being on? It was definitely Weight Watchers. You know, and I actually have some notes back at the time. So it's like a rare one that I have my memories, which obviously you can't always trust. But then I also have some

notes because I was trying to write about it even then, you know. Yeah, I was going to say, how very journalistic of you. Yes, yes. To be keeping notes. I've got the facts. I've got the facts in the notebook. Why did you choose Weight Watchers at that time? Basically, I've been honest or I've tried to be honest with myself that a lot of my weight loss does have to do with appearance. But I should also say that there's a history in my family of Alzheimer's, diabetes, dementia, high blood pressure, and some obesity. And so my aunt my aunt you know she just sat down and she was like brad you have a problem you know she had noticed my weight gain and so you know i listened to her and i said okay maybe i'll try weight watchers how would you describe weight watchers brad pretty much everyone's heard of weight Watchers, right? It's arguably the program that has exemplified mainstream weight loss for decades.

The idea behind it is to treat dieting as a game. So foods get assigned points based on nutritional value and calories. Like a banana is a fairly low point food. Pizza is a high point one. And then there are meetings where members talk about their progress and hopefully build healthy habits together. So basically, the Weight Watchers philosophy had a big focus on willpower, right? You shift your behavior to lose weight, no medicines involved. Exactly. And so when I tried it, I lost about 13 pounds. But then a few months in, I hit a wall. So what you find in weight loss is that you lose and you lose

and then you kind of plateau. It happens quite often. Right. Or really in the end, my willpower would fade. That's the best way to say it. It's not like I was perfectly complete with my caloric intake and everything and I followed everything to the letter and it still didn't work. That's really not what I'm saying.

I'm saying in the end, my ability to not eat bad food sort of failed. My willpower faded, you know. Yeah, that's so hard. I mean, it makes you think kind of like, why can't I stick with this? Yeah, because you're like, I should be able to do this, you know? It's like the choice you make when you go to work and you say, I have a really important story I want to do, and it's going to be so hard to do, you know, and I would just say, I'm going to do it.

And then the story would come out, I would do it. And so it's like, I can set my mind on a thing and do it. And that was true in almost every sphere of my life except this one. So you didn't stay on Weight Watchers very long. No, but those ideas stuck with me. You kind of learn something that you're able to use later on. I continued on other diets, some of the ones I named already, keto, Mediterranean, but they're kind of variations on the same theme. Lifestyle change, calories in, calories out. You can lose the weight if you just try. And all these diets in the end

boil down to a question of willpower. Can you stay on these diets? Can you stick with it? Can you be consistent? And for me, the answer was always no, at least not long-term. the answer was always no, at least not long-term. And so Weight Watchers felt like the standard bearer of that philosophy of weight loss. But then, Brad, last spring, their philosophy changed. Yes, it did. The company did something it had never done before, which was include weight loss medicine as part of their program.

The old guard of weight loss is getting on board with the latest weight loss sensation. Weight Watchers, which lost more than a million and a half members over the past two years, is now offering access to drugs like Wagovi. The company announced a partnership with a telehealth service to help people who want to lose weight get the drug faster. telehealth service to help people who want to lose weight get the drug faster. And since that announcement, the CEO of Weight Watchers has reflected on the way the company previously promoted dieting. Here she is in February. It's on us to recognize where we got it wrong and where we have been a part of the narrative that it is a matter of willpower. of the narrative that it is a matter of willpower. What did you think when you heard that Weight Watchers was going to offer these drugs as part of their program?

I was really interested in the decision they made because it kind of made me wonder if they are sort of acknowledging that they have a system that doesn't work as well. So I wanted to find a way to talk to Weight Watchers about this issue. And so I connected with Gary Foster. He's the company's chief scientific officer. The big question I wanted to ask him was,

was willpower alone the wrong answer for weight loss? And here's what he said. It's a false dichotomy to think, is it behavior or is it medication? It's both. It wasn't a situation where, you know, these medications were available and we're saying, no, we're a behavior change company. We don't do medications. You know, we spend a lot of time at our core program helping people navigate the environmental challenges, eating out at restaurants, dealing with cravings to eat more than you might have planned, folks on GLP-1 can get through those behavioral issues quite

swimmingly. So instead, the question became for us, is there a role for behavioral treatment in the context of these medications that are so powerful and produce whopping clinically significant weight losses. And Gary said, yes, Weight Watchers can be a community for GLP-1 users because it helps with nutrition and emotional support. And he said that a good diet and exercise are still really important on these drugs. So while the food noise is down, it's an opportunity to establish healthy habits. That it was easier than it had been. Instead of like pushing something uphill and encountering a lot of environmental friction,

now that biology was engaged and managed, that behavioral work became a lot easier. That's where we think we have a unique role as Weight Watchers to play. Sure. I think what you were saying is that the medicine requires behavior to work well. But what I've read from people who have taken the medicine, a lot of them have a sense of anger. I personally had a sense of anger about some of the failure that I experienced on many diets. And Weight Watchers was one of the places where I went.

What would you say to somebody that had a feeling of frustration or anger about their experience kind of trying and not really ever managing to reduce their weight, you know, using Weight Watchers? Was it a false promise? I think it's not a false promise. Was it a false promise? I think it's not a false promise. I am sure, actually, that we had never said this will be a cure-all. It will work for all the people all the time. What I would say to folks like you and many others who have had that experience is that we get it.

And it's much more a limit of the available treatments than any limitation of yours. And that it's not your fault that because biology gets in the way for some people, it's important to note that for many people, the behavioral methods work just fine. But for a fair chunk of people as well, they're not sufficient. So I hope people can take that anger or resentment or frustration or self-blame and look at it as, this is good news. There's new hope now. There's new hope now. That's interesting, especially when he says failing at a diet isn't anyone's fault. Brad, did you feel like that conversation addressed anger you feel about all the things that failed.

And so I kind of was glad that I got to put that question to him, you know, which was sort of like, you know, you took my money. But you knew that it like didn't work that well, you know. But you knew that it like didn't work that well, you know? And how do you respond when people bring that to you, bring those feelings to you in a way? And he kind of, I didn't mind his defense. In the end, his defense was sort of like, it was the best that we had. Would you say that talking to Gary Foster was kind of like confronting the ghosts of diets past? Oh, I love that. Oh, my gosh. Yes.

You're like stuck in this Dickensian tale of regret and wonder, you know, absolutely. Weight Watchers, everything. You know, I think it has all helped a little. It's not right to say it did nothing. But weight loss is an emotional thing. Dieting forced me to reckon with, I guess, my seeming lack of willpower. But the surprising thing, the thing I didn't expect was that the drugs gave me other things to reckon with, new things. Other things like what?

So as I was taking the medicine, when I was going through the weight loss, there were a lot of plateaus and it didn't seem to be working out that well. I came to have some misgivings basically. I didn't like the price. I didn't like this sort of life sentence of always needing the medicine. And I wanted more and more to learn to just love my body how I was made. Bottom line, you know, I just had a lot of misgivings. But then I looked at my closet and I saw this shirt my wife had gotten me probably eight years ago. It was plaid.

Yeah. But like kind of Western plaid. Okay. I'm from Texas and so I'm often looking for things that are like, remind me of Texas that I can wear but like not too gauche. And this was right on the border of that. In another universe, it could have had snaps. Like it was kind of like that. And, you know, and so my wife had gotten it from a nicer store

and it didn't fit. And then of course, a nice thing to do if somebody gets you a shirt that doesn't fit is to like, go get that shirt in the right size. But I never did. I just hung it up and looked at it to tell myself myself one day you're going to fit in that and then the years go by and it doesn't fit and it's just sort of this this thing that haunts you so anyway I thought well I'm thinner now even if I quit maybe I'll see if this fits you know and so I put it on and I was like, oh my gosh, it fits. There's no muffin top that's visible. And then I was like, oh my gosh, it's over.

All these things that I thought, I love my body, I accept who I am, all those things, I was like, gone. It's out. And now it's like, I like this image in the mirror so much. I guess I'm vain. I don't know, but it fit. And I was like, no, I'm taking it. I'm taking the next month for sure. It's wild how powerful that is, isn't it? Like when you look at yourself in the mirror and you just like feel good about what you see. Yes. I mean, it is wild. It's almost like there's some dopamine going on there or something. Yeah.

And that was a conflict for me. Even when I was amazed by the success of the drug, I still had questions. And as a journalist, I started to wonder, what concerns have come up about these drugs? What are critics saying? Right. And a lot of the folks we spoke to said these were miracle drugs, that these drugs did amazing things. But there are people who are skeptical.

People who question whether these medicines are addressing the right problems. And we spoke to two of them. That's after the break. Walk with us. Connect to the land that connects us all. Grow with us. Connect to the land that connects us all. Grow with us. Come together and make space for each other. Eat with us.

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It's an Uber account that allows your teen to request a ride under your supervision with live trip tracking and highly rated drivers. Add your teen to your Uber account today. So Jess, as I was grappling with these conflicting feelings around these drugs, I started to think about why I was trying to lose weight. I wanted to feel good about the way I looked and felt. Sure. But I also know that I've been told to dislike a bigger version of myself sort of culturally. I mean, I totally get that. It's really hard to disentangle all these things because the way we talk about weight and size, it's not just a medical

conversation. We've been presented with the message for decades that thin is best, thin is beautiful, thin is moral. Yes, I feel that so much. You know, when I think about body positivity advocates and all the work that they've done to try to help people love themselves as they are, I just felt so conflicted because I knew that what I was feeling was the opposite of that. I just felt so conflicted because I knew that what I was feeling was the opposite of that. And I kind of worried about what they might think of me, you know. Well, I did talk to an advocate who has a lot of thoughts about these drugs. Virgie Tovar is an author.

She's written books on fat acceptance. And she told me about her experience with weight discrimination. At around the age of five, I am taught that I am fat, that fat is terrible. It's the worst thing that anybody can ever be. And that I should try to stop being fat by basically eating as little as possible. So I really undertook that. And when you're a naturally larger person, what that journey often looks like, unfortunately, is that you end up with some version of disordered eating. I undertook starvation for the first time when I was like nine years old. Nine?

Yeah, really trying to get those results so that I could not be made fun of. I mean, it was horrible. Like every single day, people were like, you're horrible. You're ugly. We get to abuse you and you could make it stop just stop eating it's like why are you making us do this to you yes exactly and it was like my fault and it was my job to stop them from being cruel so by the time i'm in college i get to a point where i have lost my equal and this is from like not eating i've lost lost my equilibrium. And thankfully, I kind of, I end up in a relationship where I have a weight neutral partner who's really supportive of just me being in my body, me eating food that I like and not being terrified of food, which I was at the time. And then kind of going into graduate school, finding fat activism, very much by happenstance.

And it was so incredible. For the first time, I was introduced to the idea that, you know, that there are naturally larger people, that body diversity is real, that there aren't just thin people and diseased people. I mean, yeah, that is just such an important perspective. And for Virgie, it's like, sure, these drugs are effective in the sense that they help people lose weight. But to her, they're just the latest craze that's being sold by the weight loss industrial complex. And that's a philosophical issue for her. And now here we are, and people have started calling Ozempic and Wegovy and all of these drugs a miracle drug because of how they've experienced its effects for weight loss. How does that make you feel?

I feel, I mean, there's a lot of things I feel. I feel, if I'm being completely honest, I think this is going to come off as patronizing. I feel a little scared for them. I feel like I understand them. I feel a lot of empathy. I understand the feeling of freedom. That's real and that matters. I understand the joy and the delight and the sense of being a miracle. I understand all that. The problem is what's going to happen when they have the conversation with their doctor that they're expected to pay for this out of pocket and they're

supposed to be on this for the rest of their life. What's going to happen when they hit the plateau stage, even if they're eating almost nothing? So I think they're not miracle drugs. It's fundamentally caloric restriction, which is just a diet. So Virgie was already skeptical of these drugs. And then she learned about

some promotional content from the pharmaceutical companies behind them. We must stop fat shaming. Health is not about what weight we lose. It's about all the things a body can gain. Carrying the weight of other people's opinions and living with their disapproving looks,

their judgment, and their name-calling. Yeah, so I've seen these ads. Both Novo Nordisk and Eli Lilly have come out with campaigns in the U.S. that seem to speak to body positivity communities. Novo has one called It's Bigger Than Me. And at Lilly, they have one that they call Get Better. Right.

And to be clear, these are not ads for the drugs. The website for Novo's campaign points to a, quote, movement. And it includes language like, let's ignite a chain reaction that ends shame and shatters the misconceptions. And that language was really alarming to Virgie. It's a problem that Novo and other pharmaceutical companies and promoters of these GLP-1 drugs are using language that has been used in the body positivity movement. Yeah. I mean, basically, the fat activism and body positivity movement created that language. And that that language has been co-opted wholesale as a way to sell a product is deplorable. And I think it really speaks to, I mean, it has to speak to the morality of like what's going on here to sort of like, oh my God, that you would steal the language of like the self-love revolution from our movement to sort of promote weight loss is like really troubling.

our movement to sort of promote weight loss is like really troubling. To Virgie, it's impossible to reconcile telling people to accept their bodies on the one hand and on the other, selling them a product that would change their bodies. And even if every single person with a larger body took these drugs and lost all the weight, Virgie says that still doesn't address the very ingrained cultural idea that fat is bad. We have not gotten rid of the software or the psychology that bigger bodies are worse and smaller bodies are better. So what's going to happen? Sociologically, I would argue, a new body standard will emerge. And then what? Novo Nordisk said they're not trying to denounce body positivity or to track from the strides made towards inclusivity.

And they said, quote, our mission is to educate about the science behind obesity, its complexity as a disease, and the societal stereotypes that prevent people from seeking help. And the CEO of Eli Lilly told me that they can find, quote, common cause and remove judgment and stigma. Brad, what did you think of what Virgie was saying? I mean, she's right. You know, at the end of the day, she's right. And I think her point is a moral point. And that's what makes this so hard and so complicated. You know, the way bigger bodies are looked at as bad, as unhealthy,

you know, people can be healthy and bigger. And that's something important to remember. That stigma isn't being addressed by these drugs. And I do worry that maybe these drugs could make that stigma even worse. Right. I mean, I could see that. And then, Jess, we even spoke to a therapist who is worried that people with eating disorders are at risk of abusing these drugs. Yeah, I mean, that's something I heard about too in conversations about these drugs just out in the wild. Yes, I mean, there's clearly just so much conflict when it comes to people's bodies and the role this medicine plays in how we view ourselves.

Okay, so that conflict is one issue you were grappling with after you started taking this medicine. But you also came across another criticism of these drugs, right? Yes, and that had to do with the food I was eating, or I guess the food that we're all eating. I started thinking about this when I heard a podcast with this guy, Dr. Rob Lustig. He's a retired endocrinologist who used to treat children with diabetes and obesity. And when it comes to this new class of drugs, Rob is a bit skeptical. So I invited him into the office to talk to him.

Dr. Lustig, do you want to go out first? Rob. Rob, okay. And I showed him to our kitchen, and we took some time and looked at the available snacks that our lovely employer provides. Yes, so we're in the Wall Street Journal's San Francisco Bureau kitchen, and I'm going to show off some of the things that used to be particular weaknesses for me.

But one of them here that I'm grabbing is the frosted flakes. But I know these aren't good, but you know very scientifically why they're not good. Well, they're not good because, number one, it's processed. Okay. And number two, sugar coating on it. So let's talk about sugar coating for a minute. Okay. Okay.

Let's switch out the Kellogg's Frosted Flakes for Kellogg's Raisin Bran. Okay, we have Raisin Bran. Here we go. We have Raisin Bran. Okay. Okay. Oh, there we go. What color are the raisins in the package? They're white. Oh, really? They're white. Okay, why? That's because all the raisins are soaked in a sucrose solution. Wow. So that white is sugar.

I know you look at something like that, I mean, seeing the white on the raisins, and it kind of makes you really feel like the game is pretty rigged. Because people get raisin bran and they think, oh, I made a healthy choice in my food. Exactly. Yeah. Jess, every snack that Rob showed me had surprising amounts of sugar in it. Oatmeal, peanut butter crackers, even ramen. We did reach out to Kellogg, and they said that cereal is the number one source of fiber and whole grains for kids.

And that cereal contributes less than 5% of the added sugar to U.S. diets. But Rob's argument is that this type of food, processed, high in sugar, is the main cause of obesity. He says it's unhealthy and addictive. And he says that because there's too much of it in our food system, it sets people up to fail in their diets. So Rob's point is, we need to address the root of the problem, which is the food we eat. to address the root of the problem, which is the food we eat. So, number one, yes, these medicines work. I don't say they don't. Semaglutide, 16% mean weight loss. Terzepatide mean 20% weight loss. That's not chicken feed. But the question is, is there anything we could do to the food that could get you to an equal amount of weight loss and not cost $1,300

a month? And the answer is you can cause weight loss by getting rid of added sugar. Now, will that work in every single person? No. Will it work in the overwhelming majority? Yes. Will it work in the overwhelming majority? Yes. I will say personally that I always wanted to beat sugar in my life and always couldn't. I understand. And then I took this drug, and like I'm telling you, I have not wanted a donut since August. And it's shocking.

How do you reckon with this sort of feeling that people have, which is like, I've tried so many things, I've failed for so many years, and finally something worked, and it felt kind of good for it to work, you know? I couldn't agree more. I'm for helping people. Having said that, it's not an actual fix. I believe that these medicines are a band-aid for the problem because they're not really addressing the actual problem of what's going on in obesity, which is the food. You know, people ask me all the time, are these good medicines? From a clinician's standpoint, we've never had a pharmacotherapy that was this successful and this potent. I think that this has a very specific place in the patient who nothing else has worked in and will suffer from the morbidity and mortality of their diseases. You know, people have said,

oh, you know, he doesn't believe in GLP-1s. I actually do, for the right patient. We asked Eli Lilly about Rob's argument. They emphasized how complex obesity is, calling it a chronic and progressive disease that involves far more than personal choices. Also important to note, Rob's opinion isn't universal. There are plenty of experts who say that these drugs do work on the root cause of obesity because they see that root cause in the brain, not in the food supply. But I was wondering, Brad, what you thought of his message. Did Rob say anything that surprised you?

I mean, I knew at least in theory how bad our food supply was, but to confront its pervasiveness, I've never really done that before, you know, and I wonder if it'll change how I approach eating. When you start to think about it, you know, and you start to look at labels regularly, to look at the added sugar amount where it kind of seems excessive or unnecessary. I just think, why do we let food companies put that much sugar into almost everything? And so obviously it's easy to take his point into account. But as far as his pushback on GLP-1s go, I think I have a little bit of pushback of my own. What kind of pushback?

Essentially what he's saying is there's a better solution out there. And it's a solution that would involve, you know, government or congressional or other effort, you know, to kind of make things better. And in the end, I don't know how much faith I have in political solutions. And so for me, I guess my only pushback is like, well, we have something that we know works. And then we have something that people have been saying for a long time and we haven't been able to convince anyone to change it or to make any headway on it. You know, Brad, you said in the last episode that you stopped taking the medicine after five months, mainly because of the price. But it also sounds like you went kind of back and forth on your feelings on these drugs. Like you had your misgivings and then things would come up that would make you feel really good about the drugs again. Whether it was how you looked after you lost weight in that shirt or how the medicine helped you stay off sugar.

How did you carry all that conflict into your decision to stop taking the drug? I'm just so glad that we were able to talk to people about these concerns. Of course, as it comes to my body, I've still got to wrestle with the question of loving yourself as you are. And so that body positivity message is so important. And even when people lose the weight, they still have to deal with that. And then you still have to wrestle with food. You still have to figure out what was problematic with what you ate before and how you're going to fix that. But in the end, just being aware of some of the issues around them that we still have to grapple with and figure out is helpful.

What were your emotions around stopping? Like as the date came up, how did you feel? I was nervous. You know, I've lost it and I've gained it again, you know, cycle after cycle. And so I tried to figure out a way where in my mind I believed that it was going to stay off. And so I make a plan. That's how I deal with my fear and anxiety. I make a big plan, you know.

And then, okay, worst case scenario, I gain it back. And I try to give myself permission to gain it back. And so the permission to gain it back was like, I'm still a good person. I'm kind to people. You know, I love my family. Yeah. You know, and this is just a problem and a challenge that I have.

And it's not the worst thing in the world. I've dealt with it before. I can deal with it again. So when you did stop the drug, did the food noise come back? Yes. And it was just really sad. I'll just not going to sugarcoat it it was kind of a tidal wave washing over and feeling like i'm not sure i can swim through this it sort of instantly goes from being easy to being very very hard work so yeah that, that was, that was, it was just a huge bummer.

And you kept some voice journals, right, throughout your time on the drug and off it. What was it like hearing yourself talk about the experience? It was pretty revealing, you know, I felt like I had some days when I was in control and feeling good. It doesn't feel as hard as it used to, and I have habits that are propelling me, but everything's fine, my weight is still the same. You know, I had a pretty good workout, worked pretty hard, and had a good sweat,

and nope, didn't want to eat anything. Yeah, it was kind of up and down. And there were definitely harder days, too. My cravings are, like, all the way back. I wanted to eat a little bit more, even as much as I want to resist it. Absolutely famished. I just made, like, four eggs and, like, a bunch of chicken and avocado, you know, and cheese with it. So that was a lot.

And then I was like, nope, I'm still hungry. It just took a while to feel full. It's like, okay, well, I already messed up, so I'm going to reset tomorrow and I'll have ice cream and just kind of get this sort of desperate feeling of like, you must eat right now. Eat and eat and eat. I'm not sure I can beat those voices.

Man, every time I hear those moments, it just really hits, you know, I guess I have a veneer of positivity that I always try to have. I guess I have a veneer of positivity that I always try to have. And then when you hear that evidence of the challenge and the weight and the anxiousness, you know, it's hard to hear and maybe to be reminded of the reality, which maybe I wish was easier. was easier. Now that you've been off the drug for a while and you're in a lot of ways back to the old stuff, right? Like diet and exercise, some of those lessons that you mentioned you learned from programs like Weight Watchers. Do you think it'll be different this time? this time? I hope so. I know that, you know, when you look at the things that I'm doing, they're the same, right? You're kind of watching the food that comes in, you're watching the food that goes out, you're trying to put your best foot forward. And so all of that seems the same, and I know how that worked before. So it would seem to kind of be bleak, but at least in this moment,

I have seen success with enjoying nutritious food, which is absolutely a first. And I don't know if my experience is unique and that may not happen to everybody, but it's definitely happened to me. I can salivate over a pear or a salad or even a hard-boiled egg, which is like, what is happening?

That part feels pretty good, and so it helps me to feel a little more optimistic. Do you miss being on the drug? Do you miss being on the drug? I miss it being easy to kind of, yeah, it's like having the genie, you know? I mean, if you had a genie, would you miss the genie when you didn't have it? Like, yeah. Yeah. But do you also recognize that, like, at some point you have to go find your way without it?

That's how it was for me. I'm not sure that I ever thought of it as something that I would have forever, you know. Brad, thank you so much for sharing your story. You're welcome. You know, I love how we were able to look so intimately at your experiences and your doubts and misgivings on these drugs. But for our next episode, we're going to zoom out. These drugs are having a huge economic impact on companies beyond pharma and on conditions beyond diabetes and obesity. I don't really have the desire to go and have drinks after work, you know, on Friday. You know, food companies are going to take notice.

A number of executives acknowledge that this is potentially a pretty seismic shift. There's a good probability that terzapatide could be a super important medicine that could be used globally. That's next time

on the final episode of Trillion Dollar Shot. Thank you. Produced by Jeevika Verma with help from Matt Kwong. The series is edited by Catherine Brewer. Fact-checking by Sophie Hurwitz. Series art by Pete Ryan. Sound design, mixing, and music in this episode by Peter Leonard. Our theme music is by So Wiley. Remixed for the series by Peter Leonard.

Special thanks to Maria Byrne, Stephanie Ilgenfritz, Kate Leinbaugh, Peter Loftus, Sarah Platt, Jonathan Rockoff, Jonathan Sanders, and Lei Ying Tang. Thanks for listening. Our next and final episode of Trillion Dollar Shot will be out in a week.