The Vergecast - Ben McKenzie vs. crypto

Episode Date: April 14, 2026

During the height of the cryptocurrency craze a few years ago, the actor Ben McKenzie found himself wondering why no one else was seeing what he was seeing. He joins the show to explain his yearslong ...attempt to understand Bitcoin and the crypto world, all of which is in his new documentary Everyone Is Lying to You For Money. (You can probably guess how he feels.) After that, The Verge's Victoria Song tells us about her testing of continuous glucose monitors, which have gone from medical device to influencer trend in some worrying ways. Finally, we answer a question from the Vergecast Hotline (call 866-VERGE11 or email vergecast@theverge.com!) about why all our gadgets seem the same these days. Vote for The Vergecast in the Webby Awards! A vote for The Vergecast is a vote that Brendan Carr is a dummy, that buttons are good, and that party speakers rule the world. Voting is open until April 16.  https://vote.webbyawards.com/PublicVoting#/2026/podcasts/shows/technology Further reading: Everyone is Lying to You for Money Low interest rates and loneliness: the origins of the pandemic crypto boom Continuous glucose monitoring made me continuously crazy Subscribe to The Verge for unlimited access to theverge.com, subscriber-exclusive newsletters, and our ad-free podcast feed.We love hearing from you! Email your questions and thoughts to vergecast@theverge.com or call us at 866-VERGE11. (Timestamps are approximate.) 00:00:00 Sprinkler Duty Intro 00:03:00 Ben McKenzie Crypto Journey 00:04:00 Is Crypto Really Money 00:09:00 El Salvador Reality Check 00:11:00 Could Crypto Ever Work 00:14:00 Crypto Culture 00:19:00 Casino Capitalism And Crime 00:23:00 Why Bitcoin Keeps Rising 00:30:00 CGMs Explained 00:32:00 FDA OTC And Wellness Boom 00:33:00 Government Push For Wearables 00:39:00 Longevity Wearables Boom 00:41:00 Why Try CGMs 00:44:00 Scary Readings Doctor Visit 00:47:00 Living in the Data 00:48:00 Apps Scores Calibration 00:51:00 Disordered Eating Spiral 00:54:00 No Consensus for Non Diabetics 00:57:00 Medication Tradeoffs 01:00:00 Wellness vs Medical Regulation 01:04:00 Using CGMs Thoughtfully 01:10:00 Vergecast hotline 01:11:00 Why Gadgets Got Bland 01:22:00 Final Thoughts Learn more about your ad choices. Visit podcastchoices.com/adchoices

Transcript
Discussion (0)
Starting point is 00:00:02 Welcome to the Vergecast, the flagship podcast of Number Go Up and also Down. I'm your friend David Pierce, and I am sitting in my backyard on sprinkler duty. So a thing you've probably already guessed about me, given my entire deal, is that I'm not good at keeping plants alive. I can't remember how tall the grass is supposed to be when you mow it. I don't exactly know which of my plants is which and how often I'm supposed to water any of them. But we had some work done on the backyard this weekend. They put down some sod.
Starting point is 00:00:31 They made the backyard bigger. It all looks great. I'm very excited about it. And the guy gave me a speech where he was like, David, you have to water this thing like you would not believe for the next 10 days.
Starting point is 00:00:41 So for the next 10 days, I live out here in the backyard just moving sprinklers around. This is apparently what I do now. Anyway, we have a really fun show coming up. First, we're going to talk to Ben McKenzie, who is an actor and author, and you might know him as Ryan Atwood from the OC.
Starting point is 00:00:55 He just made a documentary called Everyone is Lying to You for Money about kind of his descent into the crypto world and sort of his own descent into madness as a result. It's a really fun documentary with a lot of really interesting reporting and lessons about crypto. So he came on the show to talk about how he feels about crypto now. Then the Virges V song is going to come on and talk about her, I think, 18-month journey testing continuous glucose monitors and actually kind of her own descent into madness. We're doing descents into madness here on the Vergecast today while I sit
Starting point is 00:01:25 and descend into madness moving sprinklers around. We also have a really fun hotline, really fun show today. All of that is coming up in just a second, but first, I'm dead serious. My phone reminder just went off, and I have to go move to Sprinkler. This is the Vergecast. We'll be right back. What's up, y'all. I'm Skylar Diggins, seven-time WMBA All-Star, Olympic gold medalist, and mom. And I'm Cassidy Hubbard, host and reporter for nearly 20 years, covering the biggest names and stories in sports and mom. And this is Am Mom, a community for athletes, game changers, and moms of all kinds. Dropping May 14th. been with us. Do you ever wonder what's in your lotion? If you look at the back of the bottle,
Starting point is 00:02:06 it could contain more than a dozen ingredients. And they may not all be regulated. The threshold is so high that only 11 cosmetic ingredients have been restricted by the FDA since 1938. This week on Explain It to Me, the chemicals lurking in your cosmetics. New episodes, Sundays, wherever you get your podcasts. This week on Unexplainable. The Black Plague didn't happen exactly how you'd think. Like, among other things, it wasn't just about rats. We can look at other kinds of mammals. Camels, it turns out, are pretty good plague transmitters.
Starting point is 00:02:47 Camels! Sheep, potentially, as well. Follow unexplainable wherever you get your podcasts. All right, we're back. So a few years ago, Ben McKenzie, who you might know as an actor, he was Ryan in the O.C., he was in Southland. He's been in a Batman show. He's been in movies. He's been in lots of stuff.
Starting point is 00:03:10 I'm sure you've seen him before. he became sort of an unlikely voice against crypto. In the pandemic heat of the crypto craze, Ben was one of those people who would tell anyone who was listening, including television commentators and Congress, why crypto was a scam. I will just lay my own cards on the table. I largely think he's correct about that.
Starting point is 00:03:31 I think there is a lot of interesting stuff about crypto that became largely irrelevant because of the way that crypto turned into a bunch of ways for people to make a lot of money. So I wanted to have been on the show to talk about basically his whole experience with crypto and this documentary he made called Everyone is Lying to You for Money. It's out this week. If you can go find a theater that's playing it, it's playing in a bunch of big cities.
Starting point is 00:03:53 I think it'll probably get released more widely soon. If you can see it, go see it. But even if you don't, I think you'll enjoy this conversation. I wanted to have him on to talk about what it's been like to be down this rabbit hole for so long and what he's learned about what crypto is and how it got to be like that. I really enjoyed it. I think you will too. Let's get into it.
Starting point is 00:04:13 Ben McKenzie, welcome to the Vergecast. Thank you. Thank you for being here. We're going to talk about crypto and our feelings, which is, I would say fundamentally what your documentary is about. But I had this thought at the very beginning of the documentary, which I think is where I want to start, where you sort of as a joke,
Starting point is 00:04:29 start all the way back with the origin of money. And the very first thought I had like 10 seconds into the documentary is like, are we sure the story of crypto is actually a story about money? And so this is my first question to you. Is the story of crypto actually a story about money? That is a great question. I'm afraid the answer is both yes and no in the sense that all money is made up, right? It's just a social construct like government or religion.
Starting point is 00:04:58 And we've used, there's a very brief graphic sequence after the initial sort of playful misdirection where we briefly showed you many, many images of different monies that have existed in the past. like feathers or, you know, whales teeth or whatever. And so all money's made up, right? But what is money? It's trust. It's a way of running an economy so that, for example, if I give you a dollar bill, you take it from me, not because you trust me, but because you trust that you can use it, because it works.
Starting point is 00:05:31 And that's, I think, where crypto falls apart. Crypto says we don't need human trust. we can replace that with computer code. You know, we can create this trustless system and avoid all that pesky, you know, human interaction and human relationships. But that's, of course, nonsense, right? Because if money is trust and you're saying it's a trustless currency, then you're saying it's like a governmentless government or religionless religion. the words you're searching for are anarchy and cult. It just fundamentally doesn't make sense.
Starting point is 00:06:12 The other answer in terms of like, could it be money is also effectively no. But it's because the technology sucks. Bitcoin can only do five to seven transactions a second. These can do 24,000. So even Sam Bank, McFreed, when I interviewed him, said, yes, it doesn't work. But don't worry. It will in the future. It will in the future.
Starting point is 00:06:33 So Bitcoin can't do that. cryptocurrencies are, the blockchains are faster, but also, you know, are, suffer from, from hacks and from, you know, fundamental sort of technological issues because technology behind crypto sucks and is old. But even more fundamentally, the, if crypto, if money doesn't come from the government, it has to come from somewhere else. And so where does it come from with crypto? They don't like to talk about this, but the answer is corporations. It's where liberty financial in the case of Trump coin. It's even Bitcoin. The majority of the Bitcoin that are mined today are mined by multi-billion dollar corporations, many of which are publicly traded.
Starting point is 00:07:13 So if corporate money seems like a good idea to you, then you should go for crypto. Right. So, but this idea of like it might work, but it doesn't yet, it is sort of a running theme of crypto throughout the whole story. And is, I think part of the reason I like the doc is because I spent a lot of my time covering crypto wrestling with the same thing that I think you're wrestling with, which is that there is something at the beginning of the pitch for crypto that is really compelling. That is like, we can agree on a bunch of things, right, that our current financial system sucks and doesn't benefit everybody equally, that there are sending money across borders, which is one of the things you hear about in crypto all the time. Everybody will always tell you
Starting point is 00:07:53 that, oh, it's really expensive to send stuff through Western Union. Wouldn't it be great if you could just do it with crypto for free. Like, theoretically, yes. Do you have a sort of moment where that tipped for you to being like, okay, I've heard your pitch, it doesn't hold with the thing that you're building on the other side of it? I mean, it's hard to single out one single moment. It was like a series of revelations to me because I approached it with good faith in the sense of like, look, online in the midst of the pandemic when I fell down this rabbit hole,
Starting point is 00:08:24 I just ended up on the other side as opposed to the people that have, like bought Bitcoin like my buddy Dave and tries to like convince me to buy it early on. So I'm just on the other side. So I could be wrong. They could be wrong. I could be wrong. Let's find out. I go out into the real world and immediately I'm meeting guys like Alex Mischensky who was running this company called Celsius that sure seemed like a fraud. And sure enough was and he was arrested and ended up in jail now. And so there were obviously a lot of sketchy players, but that doesn't mean that the fundamental thing couldn't work. Right. There's sketchy players and all sorts of stuff.
Starting point is 00:08:56 I would say one real pivotal moment was when I went to El Salvador. It's the only country in the world that was trying to use Bitcoin as real money. And to your point about sending money overseas and the validity of that argument, El Salvador's economy is, the foundation of it is remittances.
Starting point is 00:09:13 Millions of Salvadorans who live in this country, who send money home, and it's 25% of the economy. It's really the foundation of the economy. And so they built this Bitcoin system and it was like, maybe you could just use crypto to send money home and avoid the fees.
Starting point is 00:09:28 So if crypto was going to work as money anywhere in the world, it should work in El Salvador. Right. Like I walk through a market. I try to pay, you know, it's a dollarized economy. Everything's in cash. These people have like $400. They make an average about $400 a month in El Salvador. It's an extremely, you know, poor economy, relatively speaking.
Starting point is 00:09:50 And I'm asking these merchants, like, can I buy? you know, the taco or whatever, the Pabusa in Bitcoin. And they look at me like the stupid fucking Gringo that I am and appear to be. And it just happens over and over again. So it was not used as
Starting point is 00:10:07 money. It never worked as money. Even the remittance thing didn't work at all. It was 2% of remittances when we started recording. It's even less now. It's less than 1%. And the reason is because the system does work very well. It's the same thing that plagues crypto more broadly. The system doesn't work very well. you know, the value of a crypto can suddenly collapse, you can have trouble getting out of the system.
Starting point is 00:10:27 And so people would rather spend, these people do not have money to gamble with. So that was a real revelation to me where it's like, because it just so clearly was a narrative that it had been constructed for Westerners. It had been constructed to convince crypto holders and potential crypto holders that, no, there was a future and it was happening in El Salvador. They were going to build this beautiful Bitcoin city in eastern El Salvador. I go there. It's not happening. It was never going to happen. It's a total grift.
Starting point is 00:10:56 So I'd say with that, that was the moment. Yeah. Yeah, the story works because it's super simple. Our system sucks. Like, everyone raises their hand. And then they say, uh, Bitcoin fixes this. Um, it's just the second part. That's the bullshit part.
Starting point is 00:11:09 The first part is if crypto serves any functions to, to highlight the myriad fails of a regulated system. And, and hopefully should, should encourage us to fix that system. Yeah. I mean, the blockchain fixes this is still a meme in tech circles. Like everywhere, oh yeah. What is a joke now? Oh, it's a joke.
Starting point is 00:11:26 Everybody thinks it's a joke. Almost everybody thinks it's a joke. But the idea of any problem you can think of the blockchain fix is this like, for two full years, people would just earnestly tell you that. Anything that was wrong with anything, we could just fix with the blockchain. And one of the things I've been trying to figure out about crypto forever is that if you could pull it apart, if it might have gone differently, right? If you could take out the fact that I think from pretty early on, it was overrun by
Starting point is 00:11:54 people speculating to try and make money, essentially running grifts, real and unintentional, right? Like, there were people doing the scams to make money and telling you that they weren't. If you could just take all of those people out of it and try to run this process as like an earnest technological advancement, could it have worked? And I think I also still land on no for some of the reasons that you're describing that, like, there is something at the base level of this technology that makes it not suited to the thing that everybody is saying that it's suited for. But I wonder how you feel about that.
Starting point is 00:12:25 So much of, I think, your focus has been on, like, I mean, the title of the doc is everybody's lying to you for money, right? What if they weren't? Like, if everyone had been trying their best, could this have gone differently? Or is there something about this thing that we pointed all this energy at that was just never the right thing for it? I would say no, and for a couple of reasons. The first is when they say they can create a trustless money, when they say they can create a money, and they say they can create a money that doesn't need human trust but only relies on computer code. That itself is a lie because computer code doesn't fall from the sky.
Starting point is 00:13:01 People write computer code. That's how it works. I mean, I guess with AI you could intro a prompt and then the AI writes it, but at least for now. It's a different set of problems and trust issues. Yeah. where it's a it's a it's a it's a it's a it's a it's a fallacy to say that you could just create replace people with code is ftx and sam bank freed because the way sam ran his con we later learned was he instructed one of his lieutenants to change the code the source code inside
Starting point is 00:13:34 of ftX so that his other company alameda could quote unquote borrow against his customers assets steal their money uh so it's very simple it was one line one line of code and he stole all the money so um it's just wrong it's just incorrect i i on the human level i i i i'm I think this is the problem with private money. You know, money has to be a public good. That's the only way you can scale the trust. All of the problems with our financial system, I think, start with our democratic system, the failures of our democratic system. That's just my own personal point of view, is that the reason we have such a fucked up financial system is that our democracy is really failing us here.
Starting point is 00:14:10 Our elected representatives due to, quite frankly, unfettered capitalism and citizens of united and all this stuff are really beholden to the tech oligarchs and the corporate interests and the past. hacks more than they are the people. And if we could change that, then we could get back the control and the system would never work perfectly. No human systems ever do, but it could work much better. But until we address that issue, you know, we're left floundering around in the dark. And because it's so bad, it gives certain credence to Bitcoin, right, or to crypto, because it's like, well, the system does suck. So might as well try this other thing, even though it might, in fact, is worse. The other thing I want to talk about is the sort of culture of crypto. and like crypto people that you found.
Starting point is 00:14:53 Because I think like the, what's in it for all the people who made all of the money is I actually think relatively straightforward. And you can feel however you want about all of those people. But you ran into a lot of people who didn't make a lot of money. And in many cases lost a lot of money and went through a lot of real hardship because of crypto, but still believed in it. And you went to Bitcoin Miami, which is now like famously just one of the weirdest places. on Earth was Bitcoin Miami. And it is this very specific group of people in a way that, like,
Starting point is 00:15:27 I've spent a lot of time in my life around finance people and I've spent a lot of time in my life around tech people. And if you smush those things together, you don't get anything like the crypto community. So like, what do you make of this group of people? What was it about crypto that turned into this sort of bizarre, culty atmosphere? Yeah. I mean, look, again, many different ways to answer the question. But one of the things that I found to be true is that crypto is just a get-rich quick scheme. So it's as old as time and they've changed the the terms and they've created all these terms that sort of in real life are the opposite of what they say they are, right? Currencies that aren't currencies, stable coins that
Starting point is 00:16:07 aren't stable, decentralized systems that are actually highly centralized. And there's about five or six percent of the population that's really into this stuff. If you look at the polling. And then there's about 80% of the population has never ever bought crypto and most of those people are very skeptical of it. In terms of who the people are, I mean, it's dudes. Like, it's really, really dude-having. It's a lot of dudes.
Starting point is 00:16:30 Yeah, yeah. I mean, I just can't express how much of a schlong fest it is. Like, it is like, we posted on Reddit, on Celsius Reddit board to try to talk to functions of a Celsius scam and all dudes responded. Like, we didn't have to self,
Starting point is 00:16:46 it wasn't editing. It was just all guys. And I think that's interesting. You know, I think that's really interesting. Guys are more likely to be gamblers. We have a higher risk tolerance, as I say. And crypto is really popular, was really popular amongst young guys. 42% of guys 18 to 29 have bought used trade in cryptocurrency.
Starting point is 00:17:05 So almost half. Yeah, at least that was as of a couple years ago. I don't know what it is now. But it's a lot. And that makes sense to me. I mean, I'm a guy. I used to be a young guy, many, many years ago. And I used to like gambling.
Starting point is 00:17:17 And I'm not saying people shouldn't be able to gamble on stuff like crypto. You know, I don't think you can outlaw. It's not going to work. So I just want investors to be protected. I just want the bad guys not to be making so much money. And if people want to gamble with their money and there's reasonable, like, legislation around it and reasonable constraints, then, you know, go for it. But other than that, I'm really hesitant to stereotype folks even anymore because the truth of the matter is that crypto, because it's just a story, it's just a
Starting point is 00:17:47 projection of the hopes and dreams of the 40 million Americans who have purchased cryptocurrency. So it's as unique as those people are. They have their own reasons for doing it. But it's usually they want to make a little more money. And that's not, yeah, that's greed on some level. But it's also failures of our system to provide them with a better way of making money rather than just gambling on this weird stuff. Right. And that's a pretty abject failure on our parts. Yeah. I mean, it is very funny. Like one of the things I wrote down writing his documentary is, are we sure we're not just all mad at capitalism and the American dream? And I think to some extent the answer is yes, right? And I think we've spent a lot of time recently on this show and
Starting point is 00:18:26 we're talking about prediction markets and the rise of sports betting and this idea of just everything is gambling now. And I think that's all right next to the kind of stuff that you're talking about. And I do wonder, I don't know how much time you've spent, you know, on Kalshian Polymarket and all of this stuff or looking at the rise of Draft Kings. But is all of that connected to you, this idea that Like, what if everything was gambling and none of it was real and just sort of like full yolo nihilism about money in the world? Is all of that sort of together for you? Or do you think there's something different about what crypto is and was? I think there's a lot of overlap. You know, the subtitle of the book that I wrote with Jacob Silverman is cryptocurrency,
Starting point is 00:19:05 casino capitalism and the golden age of fraud. And casino capitalism is this really interesting term that you could sort of go back to like John Maynard Keynes if you want. to, but it's a notion of like, just because you have money doesn't mean you use money in a way that's either smart for you or productive for society. And gambling is fundamentally a zero-sum enterprise. We sit down at a table in Vegas and I might win a hand, you might win a hand, but at the end of the day, my wins are coming out of your pocket and vice versa. And while we play the game, the casino takes the rake. They take us a small piece of money to, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's, that's in Vegas, of course.
Starting point is 00:19:51 But if you play long enough, on average, you're losing. Right. Because again, how do they keep the lights on in the casino. And I think there is something, I think this is a broader theme in tech right now, but it is, I think, most obvious it has ever been in crypto where there are a bunch of people who tell you a tech story while they are just taking money out on the other side. And I get the sense that that same disconnect drove you crazy, the deeper you went down. Everybody's like, let me tell you this story while I am just pulling money out of your pocket. 100%. They're lying to you for money. They are lying to you for money. And what's different about Wall Street, I mean, look, I'm going to defend all of Wall Street or all of the financial. because obviously a ton of grifters there too. But crypto really is fundamentally and gambling. It's fundamentally different from the stock market because the stock market is a positive sum game. The money that investors invest by pay for stocks goes to the companies, at least some of it, the stock that's issued by the companies, they take that money and they can invest in their companies. They can make more stuff, provide more goods and services, which theoretically benefits
Starting point is 00:20:55 it's all, right? Rising a stock price, more stuff to buy, you know, all, everybody wins. Investors win, company wins, society wins. I'm not saying it's perfect. Obviously, there's lots of caveats to that, but like that is how it's supposed to work. That is how it has historically worked overall, right? Crypto can't do any of that because it's not a positive sum game. It's a zero sum at best game, really negative sum game. By the way, the thing that I should mention is like, it's not just the gambling. It's also the crime. There's an enormous amount of crime that's facilitated by cryptocurrency. It's gambling and crime.
Starting point is 00:21:32 Those are the only two use cases. So last year, a company issued a report, a crypto company, estimating that I think it was $150 billion of illegal activity was facilitated via cryptocurrency last year in 2025. $150 billion. That's a lot of effing crime. And that's a crypto company that's making that estimate. So I'm going to say that's possibly on the low end of the estimation, right?
Starting point is 00:21:59 It's a lot of crime. It's everything from, I mean, to give you just one example, it's Russian oligarchs selling sanctioned oil to the Chinese via crypto in exchange for drones that they can send to Ukraine. It's North Korean hackers who steal crypto and have funded half of the North Korean nuclear weapons program. It is an astounding level of crime. And the worst people in the world have benefited from this, including Jeffrey Epstein, who it was revealed in some of the recent files, was a secret funder of Bitcoin development via the MIT Media Lab 2015.
Starting point is 00:22:41 So there's only two things that you're interested in crypto. You're either trying to get rich because you're gambling and whatever. We can argue over that, how much you should be allowed to do that or what the rule should be or whatever. And then there's your criminal. I think it would be a really interesting conversation to have about crypto if some of the good stuff had come true. Yes. If what we had done is enable a really interesting cross-border global payments network, then it's like, okay, well, put that next to some of the bad uses of it. And let's have a conversation about whether this is a net good or not.
Starting point is 00:23:12 I wish that is where it had landed. It would have been a much more, like, robust and interesting conversation about crypto. But ultimately, I do think it landed where you are. It's either a way to gamble your way to make more money. which again, sure, feel however you want about that, or it is nefarious. And it really, those are the mass dominant use cases. And yet, Ben, and yet the number keeps going up.
Starting point is 00:23:37 And this is the thing. Kind of, but like, you know, in the doc, one of the numbers you say is 40K. And it's higher than that now. It has been much higher than that. Why do you think this thing keeps holding on? Is it just too big to fail? now, there's too much money in it and too many people too invested to let the thing fall apart.
Starting point is 00:23:58 Like, if it is all of the things that you say and we've had this series of scandals, why does the number by and large keep going up? Well, look at the history, right? Crypto was kind of floundering after all these guys were arrested, after all these trials, all these lawsuits got filed. And then in the spring summer of 2024, Donald J. Trump, who had as recently as 2021, described Bitcoin as a scam, decided he loved Bitcoin and cryptocurrency. Yeah.
Starting point is 00:24:29 We end the movie on a clip of him talking about this. He says, you know, have fun with your Bitcoin and your crypto and everything else you're playing with. That's a terrible Trump oppression. But like, as he embraced it, people said, hey, if he wins the presidency, he can do a lot to boost crypto. And so they started betting on it. The price went back up.
Starting point is 00:24:48 Sure enough, he won. And the price went way up to $120,000 for Bitcoin. Now it's in the 60s, right? So it's actually basically back to where it was the last high. It's almost exactly at the time, which is fascinating. Because if you allowed it to drop a little further, psychologically, there might be a real hell to pay, right? If it went into 50, people might really pay it. But somehow it's just managed to stay in the 60s range for quite a while, which is really interesting,
Starting point is 00:25:15 especially in a highly illiquid market controlled by a very small number of whales that hold a vast majority of Bitcoin. But anyway, the reason. that this things can last forever is obviously as I point out the manipulation of which is come on man the deepest of all ironies the supposedly decentralized thing that's fighting back against the government now needs to kiss the ass of the corrupt president of the United States who's the most powerful man in the world in order to basically carve out their own rules and not have to follow the rules so that they can keep the Ponzi scheme going and the vast percentage of the people that invest in those things like Trump coin or Melania coin or or Com Rocket one of my favorites um there
Starting point is 00:25:54 They're going to lose, right? They're going to lose. It's just how the thing works. So that's the answer. The manias can last a really long time. I mean, Robert Schiller was really influential to me, Nobel Prize winning economist, behavioral economist talks about how these manias can last a very, very long time. And sure enough, they have. I mean, Bernie Madoff ran upon his game for decades. So it's just we're weird people. What's the term the market can stay irrational longer than you can stay liquid? I think there's a lot of that in crypto right now. Yeah. And the market can stay irrational longer than you can remain solid. Solve it.
Starting point is 00:26:26 That's, yeah. John Maynard Keynes. Yeah. He's a great example, too, because, you know, brilliant economist, was so ahead of his time in terms of understanding the capabilities of economics beyond the sort of artificial constraints that have been imposed by sort of gold bugs and people that wanted to stick to the gold standard, things like that. But at the same time was trading, right? Was it actively investing and lost.
Starting point is 00:26:52 many times. And ultimately, I think, was successful, but really sort of the most brilliant guy in the world, that quote comes from experience, right? He knows, you know, even he is able to lose. So that's just the truth of human nature and of economics, which is thought of as this dry mathematical profession study, but it really isn't, in my opinion, it's, or it can be, but it's really about human behavior. And humans are not rational. We do stupid shit all the time. Anyway. All right. Ben McKenzie, congrats on the doc. Thank you so much for being here. This is really fun.
Starting point is 00:27:29 Thanks, David. I really enjoyed it. All right, we got to take a break. And then V-Song is going to come on, and we're going to talk about the truly wild experience she's had with continuous glucose monitors. We'll be right back. Hey, I'm Matt Bouchel, comedian, writer, and floating head you may or may not have seen on your 4U page. And I'm starting a brand new podcast.
Starting point is 00:27:49 Wait, wait, don't swipe away. It's called, That Sounds Like a Lot, as in that feeling when you check your phone in the morning, you read three headlines and you immediately think, oh, that sounds like a lot. I can't deal with all this. But guess what? I can deal with it. And I'm going to get into it every Friday.
Starting point is 00:28:01 I'll break down whatever chaos is happening in the world. Then I'll sit down with a comedian. You can be progressive and not be like fucking annoying. Maybe an actor. They go, feminism has gone too far. You go, why? Because the Sadie Hawkins dance happened? Maybe a filmmaker.
Starting point is 00:28:15 Since leaving that show, I'm challenged sparing. I just got to hang out and try to do stuff. You're the one with a charmed life. Could be a politician. Basically, anyone who responds. to my cold DMs. We're recording the whole thing in a beautiful studio,
Starting point is 00:28:27 so yes, you can watch it on YouTube or you can listen wherever you get your podcast. This is not the place to get the news, but it is the place to feel a little better about it. That sounds like a lot,
Starting point is 00:28:36 part of the Vox Media Podcast Network. Buzzwords like progressive and affordability are thrown around all the time in politics. But what do they actually mean? For me, being a progressive means at least two things. One, being willing to unite
Starting point is 00:28:57 lots and lots of people all of the folks that are getting screwed over against the powers that be that are making your life worse. And then second, being progressive is essentially a hopeful enterprise that you think, I think, that the world can be much better, that we don't have to settle for crumbs or settle for the status quo. And is there a difference between what it means to the elected officials and what it means to the people? So money is essentially the root of everything. I don't care if you're gay. I don't care if you have all that.
Starting point is 00:29:28 That's like secondary, third. Like, that doesn't, that's not a priority. That's this week on America, actually. Let's begin. Complex and unprecedented, the Spanish authorities are calling it. Before the disembark, asymptomatikas. Passengers who'd been stuck aboard the Hanta or maybe Hanta virus-stricken Dutch cruise ship disembarked in the Canary Islands this weekend,
Starting point is 00:29:54 prompting the highest stakes game of where are they now since maybe COVID. Some of the evacuees, American and French, have since tested positive for the virus. and yet public health officials seem remarkably calm. We do have one individual who was taken to the biocontainment unit early, early this morning, and we assessed that individual. They are doing well. Possibly because this is not the one to freak out over. Today, Explain drops every weekday afternoon.
Starting point is 00:30:41 All right, we're back. The Verges senior reviewer of V Song is here. Hi, V. Hi. We have some science to do today. So much science. Some gadgets and some feelings as we are wanted to do here on the Burkcast. But let's start from the very beginning here.
Starting point is 00:30:55 What is a CGM? So CGM is something called a continuous glucose monitor. It is a small device with a incy, bency little needle sticking out of it that you inject into a part of your body. And it reads your glucose levels. And it's, like, important to note that it's not your blood glucose levels. It is your interstitial glucose levels. Interstitial fluid is like this fluid that sits between. your cells and you can kind of re-glucose levels from that.
Starting point is 00:31:28 Okay. And my sense is, until very recently, the answer to the question, what is the CGM, was something you either knew for medical reasons or had no idea about and had never thought about it and was not relevant to your life at all. And it seems like this product, this category has taken on a much broader relevance. Like really, really recently. What is happening here? Why have CGM suddenly sort of mainstream? streamed in a new way. Yeah. So previously, if you knew what a CGM was, you likely were a type 1 diabetic or a person who had a type 1 diabetic in your family. It is diabetes tech, so to speak, because you generally wouldn't have a reason to monitor your glucose levels in real time, which is
Starting point is 00:32:13 what this technology does, unless you needed to monitor your insulin levels. Right now, it's kind of hitting the mainstream much more broadly because in 2024, the FDA cleared them for over-the-counter use. They have to be different from the CGMs that diabetics use because, you know, type 1 diabetes, they can't produce insulin or they produce such little levels of insulin as to be not relevant. And so they need that to help much. monitor their insulin levels. Whereas the ones for non-diabetics, for people who have free diabetes, who have people who have type 2 diabetes who are not reliant on insulin, these CGMs function a bit differently. So yeah. And, you know, once you open it to the wider public, you get people
Starting point is 00:33:13 who are hopping onto this trend of metabolism optimizing. And that has taken the health world, the wellness world and the health tech world by storm over the last couple of years. And I've kind of been saying it because I've seen it creeping up. But it is like the number one frontier, I think, for wearable technology. So it seems to me that there are sort of two twin things happening here, right? And if I'm doing the timeline correctly, we have 2024, the Biden administration. The FDA clears the thing, like you said, for over-the-counter use. my assumption is not assuming this would become a wellness influencer phenomenon, but here we are.
Starting point is 00:33:55 And then on the flip side, you have the Trump administration, which appears to have embraced these things and sort of tried to even further extend the things that they can be for. What is the government doing here? Okay. So about sometime in the summer, I think June 2025, RFK Jr. basically made this huge statement about. how wearable technology is going to be a fundamental pillar of the Maha movement. And I remember this. It was about taking control of their health. And in particular, within the space of wearable technology, he pointed out CGMs as something that could help reverse diabetes.
Starting point is 00:34:38 And, you know, in the diabetic community, the concept of reversing diabetes is a hotly debated one. there's a reason why they say that. But, you know, we have a clip and I think we should hear it because I did see people complaining that, you know, why are we bringing the government into this? And there's a reason. There's a reason why we're referencing that. Yeah, all right. Let's hear this clip. We're about to launch one of the biggest advertising campaigns in HHS history to encourage Americans to use wearables.
Starting point is 00:35:12 It's a way of people can take control over their own health. They can take responsibility. They can see, as you know, what food is doing to their glucose levels, their heart rates and a number of other metrics as they eat it. And they can begin to make good judgments about their diet, about their physical activity, about the way that they live their lives. We think that wearables are a key to the Maha agenda of making America healthy again. And we are going to, my vision is that every American is wearing a wearable within four years.
Starting point is 00:35:49 In that particular clip we played, he did say you can take responsibility and see what food is doing to their glucose levels. In order to, glucose is not something that right now we can measure non-invasively. So, you know, when he says glucose levels, that is specifically mentioning CGMs. And he called it out in other statements, basically, about how I have friends who were CGMs, and they reversed their diabetes with that. And then if you look at his Surgeon General nominee pick, Casey Means, she is a co-founder of Levels, which is a CGM startup. And if you've read her book, which I did for research, both for this story and for an optimizer that I wrote recently, she heavily. promotes CGM use. She says in her book explicitly, you can use a CGM to discover whether your metabolism is functioning.
Starting point is 00:36:50 Her whole book and her whole premise is that if you can optimize your metabolism, which she describes as having good energy, you can prevent and, you know, basically you can prevent cancer. You can prevent any type of disease ranging from acne to. depression. So, you know, that's her claim. And, you know, whether or not she becomes the search in general is up for debate at the moment. But I think it's very significant that she could be the surgeon general and she has these relationships with CGM's, these thoughts on metabolism optimization. So, like, it was a very clear focus because the idea here, they're not saying it explicitly, but the idea here is that every American wears a wearable.
Starting point is 00:37:42 Every American optimizes their metabolism. So that means non-diabetics in this cohort. So, yeah. Okay, but just to translate all of that to actual humans and to get into your story a little bit here, I think the useful thing to do here is sort of bifurcate people who medically need this, right? Like you said, this is diabetes tech. and I think the question of how are those people interacting with it and for whom is it useful is fairly clear in that sense. On the other side, if you're not diabetic, not worried about becoming diabetic, this is still being pitched to you.
Starting point is 00:38:23 And I mean you broadly, but also you, V. Song, a person who has since spent a lot of time wearing one of these things, when you say optimizing your metabolism or why people should be tracking their glucose, what is the is the pitch here? Yeah. So again, I'm going to bring up Casey Means here. There is a lot of science and thought about how your metabolism contributes to chronic disease over a long period of time. It's a complicated field, and the pitch is actually somewhat shaky, but if you have good diet and if you have good exercise, we know that is extremely great for preventive health. So the idea is if you are optimizing your metabolism, if you're staying within a healthy range, you are limiting the amount of inflammation in your body. And again, I'm not a doctor. I am just consuming
Starting point is 00:39:16 the literature on this. I'm kind of observing how this is being described by various people in the wellness space and the health space. And so the idea is that you don't have these spikes and that these spikes are contributing to things like inflammation, things like your organs breaking down over time. And so if you control it, and if you have data that informs how these foods impact your body and your metabolism, then you can live a longer life. And these are exactly why you're seeing trends like age scores within wearables,
Starting point is 00:39:55 like whoop gives you a whoop age. I find the whoop age to be incredibly rude. I was going to ask you yours and now I'm not going to. It says I'm five years older than I am and I'm like, that sounds fake. Rude. You know, ORA has these metrics about your cardiovascular age and there is a hyper obsession and fixation right now within wearable tech about your longevity. Like ORA and WOOP both have partnerships with like Quest Diagnostics so that you can take
Starting point is 00:40:27 regular blood tests and feed it into their platform. So CGMs are directly tied to that. Abbott and Withings have a new partnership as of January Dexcom and ORA have an investment partnership with each other. So it's really coming for everyone. They are kind of positioning this as not just for diabetics. and, you know, it's, it's a lot. So there's a push to make this as mainstream as, I don't know, knowing your VO2 max or even like your heart rate or something. These things that I think are pretty normal sort of one tick above regular person biometrics. Like people want glucose monitoring to be as mainstream and as part of our lives as that kind of stuff, it seems like.
Starting point is 00:41:20 it is there's a definite push happening there so yeah i want to hear a bunch about your own journey but i also want to kind of go back to your motivations for this journey is this something that you're you're interested anyway like were you do you have experience with cgms is this a world you knew going in or did you sort of sense the mainstreaming of it and decide to try to figure it out for yourself a little bit of all of it just because um my first experience using cgms on myself was actually in 2020, I tested something called Nutrisense, which used one of the Abbott CGMs for diabetics, because in 2023, we did not have over-the-counter devices. I had a really terrible time training for a half marathon. I was following all the standards and, you know, me, I love to self-quantify, and I love to
Starting point is 00:42:15 see what I can improve. And I just did not understand why I whiffed it so hard at the New York City, a half marathon in 2023 when I was following really kind of science-based training regiments, experimentation with fueling. And at the same time, I was experiencing a flare-up in my PCOS, which is polycystic ovary syndrome. It is a hormonal slash metabolic condition where I do not burn calories efficiently. It affects my reproductive system. It basically means I have way too much testosterone naturally. And also it impacts my metabolism, making me more likely to be insulin resistant. I have a family history of diabetes. My dad had pretty severe type 2 diabetes. And it's just a lot of health things that I have been on a journey for a really long time to figure out.
Starting point is 00:43:14 So Nutrisense was like, hey, girl, we'll help you lose weight and optimize your athletic performance using a CGM. And I was like, okay, you know what? I'll give it a whirl. NutriSense has nutritionists evaluate your glucose data. And I was basically told, girl, you're doing everything right. Everything makes sense. You are super great. There's nothing to flag here. And I was like, this is amazing. I ate like crap during this entire, not like crap, but I wasn't. as locked in or dialed in during that testing period. And I'm perfect. Amazing.
Starting point is 00:43:49 So a year later, when the over-the-counter devices came out, I was like, okay, I know what to expect going in here. I'll test it for two weeks, see how this works and what the differences are between what I tested in 2023 and what I test it now in 2024. And, oh, no, it was different. It was not, it was not, I was even more dialed in at that point in 2024, too. because I was like, I have somehow gained 25 pounds doing nothing different, which is a hallmark of PCOS.
Starting point is 00:44:21 And what was happening was I would test the Dexcomstello and the Abbottlingo. And I would wake up with glucose levels at 110, 115 milligrams per deciliter. And what they say is you should be waking up under 100, like 99 and lower is what it's supposed to be. Because my dad had type 2 diabetes, I was aware of something called the Don phenomenon. which when you wake up, you tend to have an increase in glucose because it's your liver going, hey, girl, wake up, time to wake up, time to have energy for the day. So I was like, oh, my God.
Starting point is 00:44:55 And it wasn't a one-off. It was multiple of these CGMs over a period of several weeks. And I freaked out. I was like, oh, my genetics, I've been done in. I have pre-diabetes. I have to go to the doctor. So I went to a doctor. and all of my labs came back normal for blood glucose because I went and I said look at this data.
Starting point is 00:45:18 I'm concerned this is a big jump. And I'm like, girl, no, you are in like the most optimal zone. Like, chill out. Your liver enzymes are elevated. So. And you're like showing them the app on your phone being like, no. No, I actually, I had years of like. I'm sure.
Starting point is 00:45:35 I keep, I'm one of the most nerdy self-quantified people around. And so I had years worth of blood test data. I'm being like, no, no, no. As you can see this trend in my liver enzymes has always been there. I've been told in the past not to worry about it. It's likely because of other medications or just whatever. I'm the most annoying patient for doctors, by the way. Because I'm like, here's some evidence, madam or sir.
Starting point is 00:46:01 And, you know, they were just like, I can't believe they have non-diabics using this. I guess we can give you an ultrasound if you insist on it. And I'm like, verily, sir, I do insist. And so I get an ultrasound and they're like, yeah, you have a mild case of fatty liver disease, lose 10 to 15% of your body weight for a starter, and come back to us in a year. I was just like, all right, you know what? Fine. I have all these wearable devices. Let's try this.
Starting point is 00:46:30 And, you know, part of me was just like, I'm going to do everything right. And when the data proves that there's still something wrong with me, we'll have a discussion. Like, you know, I got a little crazed there because I felt so invalidated by that experience. Well, actually, on that point, help me understand sort of the day-to-day life of that. Because I think you and I have talked on the show before about how you feel about things like as simple as the streaks for closing your rings on the Apple Watch and the ways in which data collection turns sort of pernicious and addictive in a way that is really problematic. And it seems like from the bits I've heard of this through your reporting, which again is like 18 months long, that this became a particularly deep version of that rabbit hole for you. Like what was the sort of when you were like really in the deepest testing phases of this stuff, what was the sort of day-to-day experience of living with one of these monitors like? So it was a lot of time reviewing data, but it's like you wake up, you pull out the apps.
Starting point is 00:47:35 there were times where I would only test one CGM at a time and times where I would have two, one in each arm. And so when I had two, one in each arm, it's pulling out an app and then looking at two different apps and trying to understand why the numbers were different. And then also, you know, going, okay, I had to have a controlled experiment where I'm going to go on a run and see how that spikes it in one glucose monitor versus the other. So I'm pulling up three to four different apps looking at my heart rate data. looking at my blood glucose data. And then also, because nutrition is such a huge part of it, it involves creating a bunch of many experiments with what you're eating, what time of day you're eating.
Starting point is 00:48:18 So if I eat the same carb-heavy meal in the morning, in the middle of the day, and at night, how does that impact my glucose? If I cut off eating at a certain period of time, how does that impact my glucose? If I go for a walk after I eat a protein-heavy meal, versus a carb heavy meal. How does that impact the difference? Oh, you could drive yourself crazy doing this without even trying very hard.
Starting point is 00:48:41 Oh, without even trying hard at all. And then some of these apps themselves, like I will say that, you know, Dexcom, Stello and Abbott Lingo, I talked with all the teams behind these and, you know, wanted insight into how they developed certain features. Like the Stello will alert you to spikes, not in the moment after a certain period of as to not spike your anxiety too much, whereas the lingo will create a score. So if there is a spike that's activity related, you won't get a score. But if you spike it and it's food related, you're going to get a number of some sort. And so I'm waking up, and I'm seeing that overnight
Starting point is 00:49:23 on a night where I had not snacked, where I had not done anything that was bad, like eating ice cream in the middle of the night, done none of that. I was waking up with like lingo scores of 60 because I was spiking so hard in the middle of the night. And I was just like, what's happening the year? I don't know what this is because I had had a baseline of data from 2023 that showed no such behavior like that. And the way that I was responding to food compared to the year previous was not the same at all. So I actually have these screenshots of, how, you know, one year eating, taking a walk and then eating a meal, differed in terms of what my glucose response to it was.
Starting point is 00:50:12 And you could go insane over that. Like, why is this data behaving differently? And there's many reasons why. As I did research, I was finding out that, like, if you sleep on your side, that could impact these readings. Oh, wow. Because it compresses the interstitial fluid. And most of the time that leads to.
Starting point is 00:50:30 lower than real readings, sometimes it could be higher. So I was like, oh, is it the fact that I'm a side sleeper, is that impacting why there's a difference between these two devices? Let me test one in one arm and one and the other because I primarily sleep on one side. And then I realized throughout this experiment that I can't account for how I move during the night. I have cats. Is a cat sleeping on me going to affect it? There was no way to isolate and control for that, barring, booking myself in a hotel and putting a camera filming me at night. And then, you know, I contemplated doing these things. And I was like, that's actually insane, though. There's no, like, the normal person is not going to do that. And there's the only other way to do it. And this is what many diabetics do, would to be
Starting point is 00:51:17 by a finger prick test and calibrate the CGM that way. And as a non-diabetic, is that something I would know to do? And I was just like, I don't think the average non-diabetic would know that if they were to buy this device and try and test it organically based solely on the educational articles within the app. So like the TLDR is that I started going to social events and not eating anything because I was terrified if eating a slice of pizza was going to spike my glucose. I couldn't eat cake at friends' birthday parties because, oh my God, that's going to spike my glucose and it's going to make my metrics look wonky and then what do I do with that? I can't do, I can't eat carbs unless I'm measuring it. I bought a kitchen scale. I memorized the weight of my plates. I've learned how to scoop rice in such a way that I'm automatically getting a certain amount and I had studied what that amount of rice would do. And in some ways, it led to healthier things. Like I stopped eating pure white rice. I started mixing brown rice with quinoa. Like these are good things for you. These are things you should do or whatnot. So that was great. But those described.
Starting point is 00:52:28 Those behaviors I just described to you are like the early hallmarks of eating disorders and disordered eating, which are two different things. But, you know, my therapist noticed it. My friends noticed it. I had interventions held. And I was like, oh, I've become really obsessive in a way that is harming me and that I didn't even realize was harming me. Me is someone who is very aware of the ways that data fatigue can be pernicious.
Starting point is 00:52:57 I had slipped into, like, I don't know many athletes or women who have not had a period of disordered or disordered eating or eating disorders within their lives. It's very common. It's very pervasive. It's very supported by diet culture. I dealt with it as a teen and I worked really hard for decades to have a healthy relationship with food and exercise. And I found that I was just like, oh, I can just take a 40-minute walk after this meal. And then I'm a little. allowed to have a piece of cake. And that is not healthy thinking. That's not healthy thinking whatsoever. And if you don't like notice it, if you don't flag it, that can turn into something a lot more dangerous very quickly. And I legitimately had my therapist go like, hey, I've noticed
Starting point is 00:53:47 you've been talking about food in a way that you haven't in a really long time. And I just want to investigate why this is happening. And I explained this whole experiment. And she's like, I love your dedication to work, but can we consider that it's not out of the realm of possibility that you can enjoy a single slice of cake and see a spike? And that's okay. Right. And, you know, yeah. Well, it's the that's okay that I think is also interesting here because there is, I can just imagine the horrifying sort of causality between I eat this thing and I see the number go up. and I know that the number going up is bad.
Starting point is 00:54:28 And actually the answer is vastly more complicated than that. Talking to folks in this industry, is there any sense that we need a better way to represent this data that the things that we're giving to people who are supposed to review them with their doctor for medical reasons actually are nothing like the things we should be giving to people who are, quote unquote, optimizing their metabolism? This was the ultimate question I was trying to find out in the research.
Starting point is 00:54:52 And unfortunately, there is not a... good answer. So we have a lot of data about diabetics. We have no consensus among experts about the data from non-diabetics. So I actually interviewed Nicole Spartanow from, who had run this study where she took non-diabetic CGM data and gave it to 18 expert endocrinologists who extensively work with CGMs. I think a lot of health care providers don't have experience with these devices. And, you I can tell you, we just published a study surveying endocrinologists who have a ton of experience using this technology in people with diabetes. And we gave them 20 different glucose monitor reports. Sort of the visual is very similar to what you see on the app and ask them, okay, if someone came in with this report, would you,
Starting point is 00:55:55 suggest they have follow-up screening for this. And I think we had 18 different experts that we surveyed. And essentially, there was no consensus. In talking to these researchers, they were telling me it could take years, just like several years before we have enough data, enough peer-reviewed studies, enough consensus to have an actual actionable advice for people like me. And And I legitimately was losing sleep every night thinking that I had something wrong with me. And so I went to another doctor. I was showing her all my data. And eventually what happened was this doctor held my hand.
Starting point is 00:56:38 And she's like, I'm so proud of you. You clearly take a lot of interest in your health. And I'm here to tell you that your genetics are just crap. And you need medication because no amount of taking control of your life, as RFK is saying that Americans should do and making appropriate lifestyle changes, you've done it for over a decade, and it's not done anything. So I need you to hear me when I say, here are three medical prescriptions I'm going to write for you, have that. And throughout all of this, I was thinking about, like, what does it mean to actually be healthy? And it's kind of emotional for me, because when I started
Starting point is 00:57:15 this journey, I was in the best running fitness of my life, the best cardiovascular fitness of my life. these devices were telling me, you're seven years younger in your heart, you're, you're doing great, girl. I was, I had cut, at that point, I had cut 16 minutes off of my four mile time. I was lifting weights. I was gaining muscle. I was feeling great. I was eating healthy. And now that I'm on these medications, which for me have come with severe side effects, I have all these wearables telling me, hey girl, I want you to know that your cardio fitness is below average. I want you to know that, like, you're not doing so hot. But my blood, my biomarkers, for the first time in my, like, last 10 years, my cholesterol
Starting point is 00:57:58 is where it should be. I reduced my liver enzymes by 65%. I lost a lot of muscle mass. It's very conflictive for me because I almost wrecked my relationship with food. And in some ways, you could say this was a resounding success and that I've made a lot of progress with my metabolism. I've lost at this point maybe 26 pounds in a very, very short amount of time, I want to say. And like, I don't recommend that, actually. I've had so many side effects.
Starting point is 00:58:32 I can't run. Running is such a huge part of my life. And I have no energy to run at this point in time. I can't run more than a mile at a time. it's been a huge loss for me and my mental health as well. And so did I become healthier in this process? I think some people would say, yes, you are well on your way to optimizing your metabolism. And it made me think very deeply about the limitations of wearable tech just as influencers are like, optimize your life.
Starting point is 00:59:02 Well, is my life optimized? Is what I would posit to all of them? Is it optimized now? I don't know. I would argue not. Is it optimized for what? Right? Like I'm so struck as you're talking about this by you, I just have this visual of V perpetually wearing, you know, between six and 400 different devices that are measuring different things. And those are actually all measuring different things that are sometimes in opposition to one another that are going to yell at you to do the thing that they are incentivized to get you to do. Right. And I know you've been getting feedback from people in a lot of different situations. And I'm curious. I'm curious how you feel about the idea of CGMs in particular,
Starting point is 00:59:48 but also just this sort of medical grade data collection that we are increasingly giving ourselves, whether that's even a good idea right now. I have a lot of feelings about it. It actually keeps me awake at night. It really does keep me awake at night. Because, you know, and again, a lot of people were asking why we had to talk about the Maha framing at all with regard to CGMs and wearables at large. And I feel very passionately that we do have to talk about it because when you frame it in this way, that it's good for everyone,
Starting point is 01:00:25 I feel something that wearable health has not adequately answered at this point in time, is how do you distinguish between what is a wellness feature and what is a medical feature? And this is actually something that's being debated in Washington at this point in time. Politico has reported that a lot of Washington staffers are wearing whoops and aura rings. ORA is lobbying to have a different classification of device called a digital screener. And that's just relaxed FDA regulation so that they don't have to go through as rigorous a process as they have been. And there's reasons, there's valid legitimate reasons for doing that. Having to go through the FDA clearance process can cost millions of dollars.
Starting point is 01:01:15 Some of these features, these detection screening features, could save lives. I mean, we know that the Apple Watch has saved lives, for example, right? It is one of the reasons why the smartwatch didn't just die into oblivion. It's that we have atrial fibrillation. People viewed it as something that was integral to saving their lives. And we have real-life stories of that being the case. you could look at my case and say this was an unmitigated success because I did finally find an answer to something that had been plaguing me for 10 years. I think there's a strong argument to me made that what you actually got was a good doctor for the record.
Starting point is 01:01:53 That too. Or, you know, there's a strong argument that, you know, medication is important and can help when genetic deficiencies or genetic predispositions are not great for you. but you know what's happening in Washington with the discussion towards health tech and wearables it informs the the features that come out it informs why an AI nutrition chat bot in your Garmin app or your latter strength training app might tell you that you need to eat 135 grams of protein because RFK Jr. has said that there is a war on protein even though there is no scientific evidence proving that. Like, these things are so tightly married together that, you know, we can't talk about one without talking about the other. And, like, I don't think CGMs are bad.
Starting point is 01:02:46 I don't think non-diabetics necessarily using CGMs is inherently valueless. Like, people in my situation where you have a predisposition and something starts feeling not right with you, you want to learn early about what's happening. I don't think that's necessarily wrong. I just want us all to be hyper aware of what the cost is. I paid a pretty high cost throughout this experiment. I got to live and see firsthand how type 1 diabetics live, because this is life or death for them. It's not life or death for me, at least not in the short term. It is very much in the short term for them a life or death technology.
Starting point is 01:03:25 And I've gotten a lot of feedback from type 1 diabetics who are just like, I hate that they're, you know, marketing this widespread, just because in the same way that GLPs have been marketed widespread, it makes life harder for us. We have shortages now. And I think that's a valuable conversation to have, even as other people are saying, well, you know what, GLPs for addicts, for people who have PCOS like me, for people who have metabolic dysfunction like me, for people who have high cholesterol and all of these things, it also dramatically improves their lives. So there is so many conversations right now that are happening. And in my ideal world, I would say that there would be medical consensus, maybe people, if depending on the blood work that their doctor sees, says, hey, you know, we're up for your physical this year. I can get a really good sense about your A1C from this, but how about once a quarter we have you wear it for two weeks and just see where you're at with certain things if things are changing?
Starting point is 01:04:26 I don't think that there's inherently anything wrong with that. It's the idea of using this every day for everyone always reviewing the data that I find, like, maybe is a bit not the correct approach. I did a lot of research into seeing whether there is clinical evidence that wearables are linked to increased health anxiety and it's inconclusive. There have been a lot of studies done and they're like super great for some people. And, you know, the only concrete thing I could find in maybe like 10 to 12 studies that I reviewed was that it exacerbates symptoms. in people who already have eating disorders or disordered eating. And some people will be like, oh, that's been around forever. I encourage you to look into the science literature and see how many people have
Starting point is 01:05:11 disordered eating, particularly among populations who are attracted to this data like athletes, like female athletes. I want to point to Alyssa Liu, who just won the gold medal for figure skating. And how one of the things she said was her condition was, if I come back to this sport, no one is going to tell me what to eat and how much of it. So I, in writing this, really wanted to say, we need to have a much more thoughtful nuanced discussion about how to integrate these tools into our lives so that they remain tools. And we don't live our lives in service to a tool.
Starting point is 01:05:54 Like, we don't become the tools. We control the tools. Yeah, so it's, I feel very emotional about it because it's, it's, I think, not a clear-cut thing. Yeah, I agree. Well, I know it's been a journey, but thank you for being here and thank you for the story. I suspect it feels very good to finally have all this reporting out in the world. I cried. I cried because I was like, it's done.
Starting point is 01:06:24 It's out there. And, you know, I finally feel like my journey is not over because I really got to get these side effects like under control. But it feels like done enough. And I feel very strongly that if we can continue the conversation and have really smart conversations about it, that maybe we can push these companies to be a little more human and how they create these features. Because they do think about it. They really do do think about it. but the bottom line is profit.
Starting point is 01:06:56 So we have to think about that too. True that. All right, V, thank you for being here. Appreciate it. Yeah, thanks for having me. All right, we've got to take one more break, and then we're going to come back and do a question for the podcast hotline.
Starting point is 01:07:07 We'll be right back. This week on Net Worth and Chill, we're diving into another edition of Am I the Asshole, Finance Edition? And trust me, these money dilemmas will have you questioning everything. I'm breaking down real stories from real people who are navigating financial situations
Starting point is 01:07:23 that range from mildly awkward, to absolutely unhinged, and I'm giving you my unfiltered take on who's in the right and who needs a serious reality check. Because let's be real, when it comes to mixing relationships and finances, someone's always asking if they're the asshole. Learn how to set boundaries, protect your wealth, and avoid becoming the villain in your own financial story. Listen wherever you get your podcasts or watch on YouTube.com slash you are rich BFF. Does Chinese President Xi Jinping see Trump as a partner or an opportunity. So President Xi comes to this meeting with quite a lot of confidence. They recognize that President Trump is dangerous, potentially. He's unpredictable. But I think they
Starting point is 01:08:04 also believe that they can manipulate him. I'm John Feiner. And I'm Jake Sullivan. And we're the hosts of The Long Game, a weekly national security podcast. This week, former U.S. Deputy Secretary of State, Kurt Campbell, joins us to discuss the Trump Xi Summit in Beijing. The episode's Now. Search for and follow the long game wherever you get your podcasts. Hey, it's Francis Lamb, host of the Splendid Table podcast. Every week on our show, we celebrate the intersection of food and life. And this month, we're highlighting some of those iconic people in the food world. It's a new collection called Culinary Masters, and we revisit interviews with some of the people who have really changed how many of us cook and think about food.
Starting point is 01:08:46 People like Martin Yan. When I was so small in the first few years, I can only only work and help out to wash a vegetable to cut up something and help to bone the chicken. So that's why now I can bone a chicken in 18 seconds. Dr. Jessica B. Harris? Well, you know, I now know that it was neither the iron pots nor the wooden spoons, but there were multiple unspoken and as yet still unheralded and in many cases unknown gifts that Africa gave to the cooking of not only this hemisphere but the world. and Claudia Rodin, to name a few.
Starting point is 01:09:21 Why is this dish here? Who was here before? What kind of life did the peasants have? That's why this dish is the way it is. Search for the Splendid Table in your podcast app to listen to the series now. We're back. Let's do a question from the Vergecast hotline.
Starting point is 01:09:43 Reminder, by the way, we are doing that episode next week. Please call with all of your questions about the Verge, about the Vergecast, about podcast, about journalism, about Nilai's jackets, whatever you want. We want to hear all of it. The number, as always, is 866, Verge11. The email is Vergecast at theverge.com. I'm David Pierce.11 on Signal.
Starting point is 01:10:01 We're easy to find. Hit us up. For now, we have a question about, I don't know how to put this. Just gadgets. Gadgets in general. Let's hear it. That would be good for the show. How is it that we've gone from kind of the early Apple, like, clamshell,
Starting point is 01:10:22 mapbooks, which were beautiful and very colorful and very deep. detailed to kind of the situation where everything is quite planned, even some of them we're starting to lose the levels on some things, and we're having to skin stuff to be able to make it fun. Thanks. Bye. Okay. I've actually been asking various people a version of this question for a really long time because I became obsessed to this question of like, why aren't there more gadgets?
Starting point is 01:10:56 Right? Like you go back a long time ago and even Apple was a company that made a laptop that looked one way and a different laptop that looked completely different, right? Like a power book and an Ibook, utterly different ideas about what a laptop should be. And then all of a sudden everything converged and we have MacBooks, right? And MacBooks look slightly different, but they're all MacBooks. A MacBook is a MacBook is a MacBook. And everybody has a MacBook and there's a MacBook for everybody. You go back to like the early days of phones and there were lots of new ideas about phones.
Starting point is 01:11:26 and lots of different colors and lots of different styles and lots of different ways that screens would open and rotate. And then we all converged on this one idea. And you go back to like the early days of software and there were lots of ideas about how softwares look. And then there have been fewer and fewer and fewer over since. And I think in asking people about why this has happened, I've really come to two answers.
Starting point is 01:11:50 The first is just that as something gets sufficiently popular, it becomes very hard to change it at all, especially when something is popular and good and people like it. Like, look at the MacBook is maybe a perfect example of this, right? Apple basically found a design that looks good. It works well and it serves a lot of purposes. You can make it a little tiny bit thicker and you can put more battery into it. You can put a fan into it to cool it down when that was necessary and useful.
Starting point is 01:12:19 And you can make a big powerful laptop. Or you can shrink it very slightly, slim it down a little, bit and have a MacBook Air. You don't need a bunch of new ideas because you have one that kind of more or less works for everybody. This is the answer I find very frustrating, right? Because this is also the answer that leads to every other phone looks like the iPhone because once something becomes sort of the image in people's minds, anything you do that is different becomes a huge swing that you have to make people think differently about, right? Like, if I were to introduce the iBook now, it wouldn't work. Like, I'd really earnestly believe that. And so when you get
Starting point is 01:13:03 something like the MacBook Neo, what Apple does is take the rough outline of a MacBook, add some nice colors, change a couple of little things, right? Like, you tweak the trackpad to make it a little cheaper. But, like, that thing is still a MacBook. Nobody is going to look at that thing and think it's anything other than a MacBook. Whereas if you introduce the ibook, which is this big, round, plastic, sort of transparent thing with a handle, you'd get a lot of people who are like, what on earth is that? And even if it was objectively better, it would still be this huge uphill battle to convince people that it's better, because we have all this history with this sort of lowest common denominator device that people are more or less happy with.
Starting point is 01:13:44 It's the same with phones, right? I think this has been a really interesting challenge with foldable phones and going back to flip phones. We just converged on the, idea that a phone should look like this. And so every phone looks like this. It's a candy bar phone. You either have something that looks like an iPhone or something that is an iPhone. And those are essentially the two phone ideas in the world right now. That's not to say there aren't other better ideas. Like there are lots of people out there who long for the idea of a sidekick, which had that sort of flippy open screen. There are lots of people who miss their blackberries. There are lots of people who might actually be really well served by a phone like the LG wing, which had a screen that
Starting point is 01:14:20 flipped horizontally, which in a certain way actually makes quite a lot of sense. Like if you watch a lot of YouTube on your phone, maybe a screen that just flips horizontally, it would make a lot of sense. But again, it's just an uphill battle to convince people that they want that thing, to make software and accessories that support that thing, and to just push outside of the norm becomes harder and harder and harder. The other half of that is also that once people become accustomed to a certain kind of advice, they get really annoyed when you change it, right? Like, if your iPhone suddenly had a screen that flipped upwards, some people would think that's cool and some people would find it incredibly annoying. My favorite example of this always
Starting point is 01:15:00 is you look at an app like Microsoft Word. Microsoft Word is filled with buttons and ribbons and icons and stuff that like no one thinks this is good UI. No one, including at Microsoft, thinks this is like good, beautiful, modern software UI to have just a bunch of ribbons and 100,000 options in a menu. But the problem is there are millions of people who have used Microsoft Word essentially as it is professionally for decades. It is their livelihood to know where these things are in Microsoft Word. And so if you just move a little button, like somebody at Microsoft has said this to us
Starting point is 01:15:38 one time, and it's been stuck in my mind ever since that every teeny tiny feature that almost nobody uses inside of Microsoft Word is still used by millions of people. And so if you move that, even if you move it to a better, simpler, easier place, you have now created a bunch of new work for people to do. And most people don't want to do that work. And that's fine. Most people have better things to do than learn where buttons are, right? This is the sort of eternal struggle of any designer is you build something that people like and gravitate to and it becomes sufficiently popular, that it actually becomes almost impossible to change. And so you either have to do what like Google does, which is just endlessly try to.
Starting point is 01:16:16 to invent new things that mostly don't take off, or you just kind of let the thing slowly atrophy over time because you don't want to screw up people's workflows. The beauty of that is neither of those is the correct answer. And almost nobody is good at figuring out how to sort of slowly move people in the right direction without feeling like you're constantly making people learn new things. And I think this is true with all kinds of software. It's true with all kinds of gadgets. It's basically once we as a consumer society land on an idea that works, even if it's not the best idea, it's just something that works and we get comfortable with it.
Starting point is 01:16:53 Changing that thing becomes very, very hard. So that's all one thing. The other thing, and this is the thing people have told me many times, is it's much cheaper to make fewer things than it is to make more things. Right? So if you're Apple, again, just to keep picking on the MacBook, you can make. a bunch of different kinds of MacBook in roughly the same way with tiny little tweaks to your process and tooling pretty inexpensively, right? You have this incredible economy of scale that allows you to make tons and tons of these things. And if you want to make a Neo and all you're changing is like the color and a little bit of the size and a couple of parts,
Starting point is 01:17:31 you don't have to like spin up new factories and invent new tools and teach people how to do tons of new things. You just drop a couple of new changes to the process and you're off and running with a new thing. Whereas if you want to invent an entirely new gadget category or reinvent the way a laptop works entirely, that's going to be enormously expensive, like literally in dollars expensive, to change your whole manufacturing process. You have to change the packaging process. You have to change how things like move on trucks and how they fit into things. Like think about all the times Apple has redesigned the Mac Pro and the ways that that has been weird,
Starting point is 01:18:09 both to fit into people's workflows, and it has actually been hard for Apple to manufacture because going from, we have this rack-mounted large thing to we have a trash can, takes a lot of work and energy in how you make the thing, how you move it around the world, how you stock it in stores, how you sell it to people, how they install it.
Starting point is 01:18:26 Like, these changes are complicated and they're expensive. And so if you're Apple and you're like, well, okay, we can make either two completely different ideas about laptops that require two completely different processes from beginning to end. Or we can make essentially one laptop that gets slightly thicker and slightly thinner and maybe drop in a new part here and there. Obviously, at some level of scale, the only smart business decision is just to make the one thing. Especially, again, if you are not 100% confident that this other new thing is going to be such a gigantic success that it makes
Starting point is 01:19:01 all of it worth it. This is the challenge. And I think what you see is you see companies take much bigger swings with the first version of something than you do anytime after that. And that's partly for sort of consumer psychological reasons like we were just talking about, but it's also for reasons of like, well, we've built the damn factory. We know how to make this thing.
Starting point is 01:19:22 And it becomes much easier to go from making, you know, a hundred thousand of something to a hundred million of something because it becomes very successful than it was to figure out how to make that first hundred thousand of something. And so you build these systems, you build these tools, you build these supply chains, and then you don't want to blow it up over and over again
Starting point is 01:19:41 just in the name of having brand new ideas. Going all the way back, this is one thing I actually give Apple an enormous amount of credit for. We've talked about this a bunch on the show, but there was this run where Apple announced the IMAG3, the IMA G4, and the IMA G5, and there were three fundamentally different devices, different designs, different looks, different sort of vibes to them in really interesting ways. But even that was driven by this brand new technology that was flat screen monitors, right? So Apple is actually being forced to make these changes because there is a new technology that they want to
Starting point is 01:20:12 put in your products. So that becomes the forcing function for new devices. If you want some big new thing, you should root for some important new display technology or some wild new idea about how these things can work. That's what makes redesigns happen. And in most spaces, we haven't had that in mobile in a long time. Everything has been just getting sort of steadily better, but we haven't had like a sort of breakthrough new technology that has made its way into phones in a really long time. We haven't had it in laptops either. We've just been on this sort of steady march of progress for a long time. And so there's no forcing function for everybody to say, well, okay, we have to blow up the system anyway. Let's tear this whole thing down and start over. What you have is you could say we
Starting point is 01:20:59 want to spend an enormous amount of money to try and have a new idea about the iPhone, the most successful product ever, or you could just keep making better iPhones. And, like, is that the boring choice? Is it not the choice I wish they would make? Of course. But it is the obvious choice, and it is the choice almost everybody makes. So if you want more exciting gadgets, if you want more gadgets, root for new technology. Route for new displays, root for some breakthrough new, you know,
Starting point is 01:21:29 input device like Apple always talks about. What is the thing after the touchscreen? If we figure that out, I guarantee you we are set for a whole new kind of device category that will make all of this feel very fun again. Anyway, those are all my thoughts. That's what I've been talking about for a long time. I hope that helps. If you have any other ideas, if you have other things that I've missed, or if you think
Starting point is 01:21:48 there is a bunch of fascinating new idea, innovation happening in these spaces right now, tell me all about it. I want to hear about it. 866, Virgin1, Virgast of theVerge.com. For now, that's it for the show. Vote for us in the Webbyes. You have until Thursday to do that. I'm eternally grateful to all of you who have already voted for us.
Starting point is 01:22:05 Also, send us questions about the Verge and the Vergecast. 866, Verge11 is the hotline. Vergecast at theverge.com is the email. There's a lot going on right now. It's just, it all just keeps happening. You know what I mean? The Vergecast is a Verge production and part of the Vox Media Podcast Network. This show's produced by Eric Gomez, Brandon Kiefer, and Travis Larchuk.
Starting point is 01:22:22 I will be back with Neely on Friday to talk about presumably more of our weird DIY projects because I got a lot of feedback on my, dumb vibe coding stuff, and I have some catching up to do. We have more our news, more AI stuff, all kinds of good stuff. We'll see you then.

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