OZEMPIC EXPERT WARNING: 12 Risks You Need To Know | Johann Hari x Rich Roll

the second day I was taking oen piic I had woken up and I wasn't hungry easy weight loss maybe diet truck Miracle we last drug this is OIC OIC OIC could be a game changer this is a scientific breakthrough people are actually getting healthier if you want a comparison for what these drugs are going to do you got to compare it to the invention of the smartphone this will change the world for better and For Worse back for his third appearance on the podast is Johan Harry I decided to continue taking it and the reason

I did was pretty simple there are extraordinary benefits we live in an environment where it is very easy to be overweight or obese and very hard to be a healthy weight where your headed is very triggering to me you're actually not addressing your habits around food we know that obesity causes over 200 known diseases and complications all the things we fear are made much more likely by obes I think you've really got weigh two sets of risks you got weigh the risks of these drugs and you got weigh that against the risks of continuing to

be [Music] obese today's episode is brought to you by the awesome organizations that make this show possible it's lovely to see you again it's been a couple years uh and and as much as I would like this podcast conversation to stand apart from the other media appearances that you've been doing around this new book uh I can't escape the elephant in the room like we have to address it up front like your appearance is so dramatically different you look fantastic clearly you lost a ton of weight you've written this book you tell the story and

uh you look quite handsome my friend oh W yeah thanks the actually your appearance has also profoundly changed I feel like I'm being interviewed by gandal you got skinnier and I got gray and old basically this is not this is there yeah there's something inherently unfair about this no I don't think so um it's funny isn't it even now you sort of slightly hesitate to talk about this but yeah so I'm taking a zenic right I started taking it for the book that I've written because as soon as I heard about these new weight loss

drugs I felt a massive mixture of emotions first thing I thought was well I'm older now than my grandfather ever got to be he died when he was 44 of a massive heart attack loads of the men in my family get heart disease my dad had terrible heart problems my uncle died of a heart problem um if there really is a drug that can reverse obesity or hugely reduce it and we know the average person who takes asmic or wovi loses 15% of your body weight I thought wow that could mean a lot to me

right we know that obesity causes over 200 known diseases and complications you know a drug that can move you away from that that could be a big deal but I also immediately thought wait a minute I've seen this story before pretty much every 20 years going back to the first world war a new miracle diet drug it's the oldest it's the oldest story it dates back to the you know beginning of humanity you know what's the latest snake oil weight loss cure um we've seen it time and time again uh there's no biological free pass

uh there's no way that this could be you know you know on its face as as effic ious as one might be led to believe um but I think and we're going to talk about it the more you dive into this subject matter the more complicated and nuanced it becomes and there are many positives there's also many negatives and where you come out in the end I think is very case dependent on who you are and um and your relationship to you know wait right I think that's exactly right to try to get to the

bottom of this to resolve these contradictions to figure out you know can it be as good as it seems can you really have a you know a free lunch I guess with those zic it would be a smaller free lunch I went on this big Journey all over the world from Iceland to Minneapolis to Japan to interview the leading experts on this the biggest critics of the drugs the biggest Defenders and I think you're exactly right I think people should be very wary of anyone who's saying about these drugs either just uncomplicatedly yay everyone should

be on them or boo nobody should be on them I think is missing the much more important nuance and complex point which is you know the subtitle of my but magic pill is the extraordinary benefits and disturbing risks of the new weight loss drugs because the truth is both halves of that are true there are extraordinary benefits and there are 12 disturbing risks and there's no one size fits all for that and there's a lot we don't know but there's a lot we do know and I think what people really need to do is go

down the list of the benefits and risks see which ones apply to them which ones don't and also just be prepared for some of the psychological changes that happen when you take the drugs some of the big cultural changes that are going to happen now you 47% of Americans want to take these drugs this is blowing up all around us um everyone who takes these drugs becomes a kind of walking advertisement for the drugs this is huge this is going to change so much you know Barkley's Bank commissioned a very sober-minded financial analyst called Emily

field to go away research these drugs to guide their future investment decisions and she came back and said if you want a comparison for what these drugs are to do you got to compare it to the invention of the smartphone I think she's right there does seem to be something qualitatively different about OIC and these glp1 uh agonists uh that distinguishes them from past versions of what we might think of as a magic pill like there really is something unique and different here um but let's let's like walk through it like tell the story of

of how you came to decide that you you were going to give this a try yeah I think you know I remember the exact moment I learned about it it was um it was the winter 2022 was invited to a party it was that moment when the world got reopened right I hadn't been to a party like everyone else in the world hadn't been to a party and 18 months however long it had been and I was in an Uber on my way to the party and um it this was this was a party thrown

by an Oscar winning actor I'm not saying that just a name drop it's relevant to what happened next and I was saying there call me to say hey Rich you want to come along to this party you definitely be my date to the next one and uh on the way there I was feeling a little bit kind of self-conscious cuz you know I've been quite fat at the start of the pandemic and I gained quite a lot of weight during the pandemic and I was feeling a bit kind of schlubby and embarrassed and then I

suddenly remembered oh actually almost everyone I knew gained some weight during lockdown I suddenly thought oh this part is going to be fascinating I'm going to see some of these Hollywood stars with a bit of flab on them right and I arrived and it was the weirdest thing it's not just that they hadn't gained weight everyone was like gone everyone looked like their own Snapchat filter right they were like clearer and cleaner and sharper and not just the actors but like the agents everyone was like marketly thinner and I was wondering around and I bumped

into a friend of mine on the dance floor and I said oh you know looks like everyone really did take up Pilates during lockdown and and she just laughed at me and I didn't know why she was laughing and that was when it was explained to me and you're abely right that there's a qualitative difference obviously then began to research these drugs so these are new drugs that work in a completely new way on a totally new set of mechanisms which really do guarantee very high amounts of weight loss in fact the next in these

classes of drugs guarantee more mojarro the average person who uses it loses 21% of their body weight after for Triple G which is the next which will probably be available next year the average person loses 24% of their body weight which is only slightly below bariatric surgery and we know some things about how these drugs work so if you ate something nail Rich doesn't matter what it is after a little while your pancreas would produce a hormone called glp1 a gp1 is just part of your body's natural signals going hey Rich you've had enough stop

eating right but natural gp1 only stays around in your system for a couple of minutes and then it's washed away what these drugs do is they inject you with an artificial copy of glp1 that instead of sticking around for a couple of minutes sticks around for a whole week which has this bizarre effect I will never forget the second day I was taking oen piic I woke up and I was lying in bed and I thought huh I feel something really strange what is it and I couldn't locate in my body what it was that

I was feeling so strange about and then I realized I had woken up and I wasn't hungry that had never happened to me before right it's been my whole life eating processed food Ultra processed food I used to wake up with this kind of raging hunger and really on autopilot that day I went to this Diner just up the street from where I live and I ordered what I used to order every day for breakfast which I'm embarrassed to say to someone as healthy as you it was a a huge chicken sandwich with loads of

chicken and mayo in it and I would eat that normally and I would still like want to have a bag of potato chips or something and I ate it and I had like three or four mouthfuls and I just was full I didn't want anymore so what these drugs do is they boost your glp1 levels and some other gut hormones for the other drugs and they which makes you feel very full very fast now initially it was thought that was an effect primarily in your gut we now know actually gp1 goes to your brain we

have gp1 receptors in your brain so and it changes your brain in complicated ways but that's so this is a completely new kind of drug and the findings on weight loss are very robust right most people lose significant amounts of weight when they take these drugs but when they go off them it's something like a 70% reversal right they gain the weight back of time that's exactly right so there's a big debate about there seems to be anecdotally a minority of people who use these drugs to interrupt their habits build new habits then come off

them and keep the weight off but we don't have any studies of that yet we know that most people who sto taking them just regain the weight quite quickly now we want to take that with a little bit of a pinch of salt because those studies were funded by the drug companies who obviously have a vested interest in wanting you to take it forever but it does seem to be the case that these drugs are more like statins or blood pressure medication they work for as long as you take them and then when you stop

taking them the effect goes away it's not a a cure it's a chronic it's a treatment for an ongoing situation um which which makes it a much bigger deal to take them right it's not a holiday romance it's getting married and it's getting married if you're a Mormon right it's going to last your whole life if you want it to work initially when I started hearing about OIC and OIC face and you see these pictures of these people who are looking gaunt with their eyes kind of sunken in their head I thought like this there's

just no way that this can be good like I was just absolutely against the idea of this having any kind of long-term real meaningful benefit um but when you reflect upon the Obesity epidemic and what's driving it which is our unhealthy food ecosystem which you WR about and we're going to talk a little bit more about we're looking at incredible increases in the percentage of obese people in the western developed world I think it's something like 27.8% of the British population is obese much higher in the US something like it 42 42.5 or something like

that and then you consider that um obesity sits at the foundation of all these lifestyle illnesses that are debilitating and unnecessarily killing millions of people if there's a way to get people less obese if we can get get people to lose weight they can sidestep some of those illnesses um and this seems to be a very effective way to do that if you are a chronically obese person who's tried everything and been on every diet and has never been able to make it stick uh there seems to be you know a bit of opportunity here

right and so I think it would be helpful and informative for you to share your own history with food I mean you tell these stories about you know the chicken shops and the KFC and and your you know your friend who passed away and um this is this is something you've kind of contended with your entire adult life your relationship with food yeah uh I had many low points in my relationship with the junk food but uh perhaps the worst I can tell you exactly when it happened it was Christmas Eve 2009 at 100 p.m.

I went to my local branch of KFC where I lived at the time in East London and the guy behind the counter said oh yoan I'm really glad you're here and I was like oh okay and he went he said wait a minute and he went off behind me they friy the chicken and everything and he came back with every member of Staff who was working that day and a massive Christmas card in which they'd written to our best customer and everyone had written like little personal messages and one of the reasons my heart sank

is I thought this isn't even the Fried Chicken shop I come to the most this is not a good sign right so I spent you know my diet was predominantly [ __ ] basically most of my life um you know you I grew up in a working-class family um we we ate what I mean we're a little bit ahead of the curve we ate a little bit worse than British people did at the time but now people in Britain have basically caught up with where we were uh my diet was mostly processed and Ultra processed

foods and so I wasn't actually a fat kid but I became kind of um well I became obese when I was in my uh sort early 20s you know had periods where I would lose weight but I would always kind of go back and um you've you've gone to exactly the in your question you've gone to the heart of this dilemma right if you can lose weight through diet and exercise and a significant number of people can it seems to be 10 to 15% of people can do it that way and keep it off in

the long term in this environment everyone should try that first there's very few risks to that there's much less risks than there are for these drugs if that didn't work for you as it didn't work for me and we can explore why and there's some scientific evidence about why it doesn't work for a lot of people I think You've Really Got Away two sets of risks you got away the risks of these drugs 12 big risks some of them are really worrying and you got to weigh that against the risk of continuing to be obese

and this will sound weird and i' I think it'll it'll sound dumb to you because you know so much more about health than I do the thing that most shocked me in the research from my book is actually the thing I thought I'd known since I was a little boy it's just how bad for your health obesity is right um and this is a very painful thing to think about and I understand why a lot of people um want to avert their guge from it but even let's think about one of the most simple things

I the guess I've known since I was a seven years old that if you obese you're much more likely to get diabetes right but I think I thought until I did the research for my book okay diabetes is not a good thing obviously I'm talking about type two diabetes diabetes is not a good thing but as long as you've got health insurance you know you get insulin you're basically like everyone else I thought a diabetic plus regular insulin is like you or me that's not true at all diabetes knocks 15 years off your life on

average you know and if you're obese when you're 18 you have a 70% chance of becoming diabetic in your life and diabetes causes horrendous problems it's one of the biggest preventable causes of blindness in the Western World more people here in the US have to have a limb or an extremity amputated because of diabetes than because they got shot and you will have noticed a lot of us get shot you know in fact the harms of diabetes are so severe uh a doctor I interviewed in Britain who treats diabetics Dr Max pton said something to

me that at first sounds very shocking but when you look at the evidence you can see why he says it he said if you gave me a choice between becoming diabetic and becoming HIV positive I would choose to become HIV positive because if you become HIV positive and you get treatment you live as long as everyone else that is not true of type 2 diabetes and that's just one of 200 diseases and complications that are made more likely all the things we fear are made much more likely by obesity dementia heart disease um stroke I

mean knee and hip problems because right that physical pain back pain just go right down the board I was taken aback by how bad that is so you've got to weigh the risk of incurring that realistically I would have I would have continued to be obese right I would have had periods where I wasn't periods where I died next size but realistically had been most of my adult life there's no reason to think that would have changed no matter how much I tried and I really did try several times we could talk about why it

didn't work for me but so youve got to weigh that against the risks of the drugs right and that is not a simple calculation there's a lot we don't know we a lot we know about obes some significant stuff we don't know about these drugs so I think you're totally right we got to we got to weigh those those different things it's hard to even use talk about this without using words like we right what uh what was your heaviest weight I'm bad at using the uh pound to stone stone to pound kind of you

barbaric Colonials don't pound Stone I think it's 14 but but double check this um so I think my fattest was I was like 15 and a half Stone let's figure out what that is if any you have a cal sorry um I can't believe you guys still use Stone it's like what what are we like in the Middle Ages exactly Stone we we us um but you lost like three stone right so what is that like2 4 yeah 4 onpic yeah in a year and are you still on OIC yes so I decided to continue

taking it um although I think there's lots of people who would look at the same evidence as me and come to the opposite conclusion and the reason I did was pretty simple people have only been taking these drugs for weight loss for a couple of years right mhm and I think if you want to understand the effects of these drugs I think it actually helps to look at another medical intervention that's been going on for much longer which is bariatric surgery right things like stomach stapling gastric sleeves and so on there's lots of different forms

of bariatric surgery so bariatric surgery what do we know about it it's rough one in a thousand people die in the operation it's Grim it's no joke but the reason people put themselves through that is because afterwards the benefits to their health from hugely reducing their obesity are staggering right if you have bariatric surgery in the seven years that follow you are 56% less likely to die of a heart attack you're 60% less likely to die of cancer you're 92% less likely to die of diabetes related causes in fact it's so good for your health

in those seven years you're 40% less likely to die at all right and we know now these drugs are moving us in a similar direction right it's why the first part of the subtitle is the extraordinary benefits of the new weight loss drugs so for example if you take these drugs uh and you have a BMI higher than 27 which I certainly did at the start your risk of a heart ATT tackle stroke goes down by 20% in the two years that follow that's that's extraordinary so for me given the heart disease risk in my

family that outweighed my very real concerns about some of the other stuff that's going on here but like I say a lot of people will not have that heart attack risk in their family and for them there'll be a different calculation so there all you've really I think got to I hope the book is a kind of guide to people could think in a much more personalized way about this what are the risks that might be playing out for me in both areas in the OB and in the in the um in the drugs I

have this incredible aversion to the idea that the solution to our poisonous food system that proliferates in ultra-processed foods that people become addicted to that's driving obesity that the solution to that poison is this other poison and it plays into the kind of vertical integration of big food and big Pharma and the control that these gigantic conglomerates have over the trajectory of our lives like I just hate that narrative so much and I'm so resistant to the idea that um that a drug could be a viable solution even in the short term to this problem

and that's you know informed also because of my own story and my own struggles with weight and this solution that I found and eating a whole food plant-based diet and restoring my health and this exploration you know into diet nutrition and Fitness that I that I've been on for many years but I also have to recognize exactly what you just said and I have a good friend who's a bariatric surgeon his name is G Davis uh he's in Houston he's been a guest on this podcast and he's a lifestyle medicine doctor who is on himself

a whole food plant-based diet and talks about it constantly and has been kind of uh you know proing this way of living not only for himself but with his patients but he he's you know through his own experience understands better than most how difficult it is to get people to change their lifestyle habits and he has said if there was a war between OIC and lifestyle medicine like OIC is going to win you know because people really struggle with changing their lifestyle habits and in his own practice his surgical schedule is not what it was

you know two years ago like because so many people are on these drugs and they're not undergoing surgery and I would agree that taking OIC from a risk analysis point of view is perhaps safer than undergoing the knife right a surgical procedure but to my mind and we're going to get into more pros and more Cons with more detail but in my mind it seems like the best case scenario is when you have a very obese person who has struggled for a very long time and has never been able to figure this out and is

on the precipice of all these you know down stream Health implications that you just kind of spoke to um having that person go on one of these glp1 drugs uh agonists as they're called um but pairing that with lifestyle medicine to use that period of time when their appetite is suppressed or they're feeling they're having that experience of feeling full so like you said you can't eat that much to teach them how to cook to teach them about nutrition to break those bad habits form new ones and do that repetitively enough like use this as

an educational period essentially um such that after however many days 90 days which I think is you know an adequate amount of time to break a habit and form a new one they can go off that drug and they have like those neural Pathways those grooves have been you know kind of created so that they can then begin to adopt these new lifestyle habits and make them kind of wrote in their life like they've cleared out their cup they've gotten rid of the [ __ ] food they have learned to cook they've you know have

all these skills and these tools that they didn't have before that would then set them on a trajectory uh a healthy trajectory and also kind of get out of of the risk of whatever these drugs are going to be doing to us long term that we still don't quite understand there so many things that you said there that are so important and that I so agree with can I just go back to the very first bit which is um um was one of my two or three biggest outs about the drug which was saying look

this is a problem that is caused by the environment treating it with a drug is not the answer right and I think this this was this the thing that almost made me stop taking the drug quite early on so for a long time I was researching why did obesity blow up right it's really important to understand cuz I think this has been kind of um forgotten obesity has exploded in our lifetimes you basically have I would just urge anyone to just pause this podcast for a second and just Google for a moment photographs of public

beaches in the United States in the 1970s so when you and me were born right just look at them for a minute to us they seem really weird CU almost everyone on those beaches looks to us what we would Now call skinny or jacked right and you look at it and you go well where was everyone else that day right was it like a skinny person convention at the beach and then you realize no that's what Americans look like when we were born right you basically have around 300,000 years where you have humans and obesity

is very rare it existed we know it's there in the historical record but it's always remarked upon because it's so unusual right and then essentially in our lifetimes this staggering explosion so between the year I was born 1979 and the year I turned 21 obesity doubled here in the United States and then in the next 20 years o severe obesity doubled again right and you look at that and think well what happened what's going on there cuz it goes to the heart of this point you were making where you're absolutely right we know why this

happened this change this explosion in obesity happens in every country that makes one change it's not where people suddenly have a collapsing willpower it's not where people suddenly become lazy it's where people move from Mostly eating a diet that consists of Whole Foods that they prepare on the day to eating a diet that mostly consists of processed and ultr processed foods which which are constructed out of chemicals in factories in a process that isn't even called cooking it's called manufacturing food and it turns out this new kind of food which never existed in the past

right which is totally new thing affects our bodies in a completely different way to the way the old Whole Foods used to affect us and there's loads of evidence for this I go through seven ways in in Magic pill that that these processed foods affect us so differently that lead us to gain weight but there's an experiment that to me just totally nailed it right um so there's a brilliant scientist called Professor Paul Kenny who I interviewed he's the head of neuroscience at Mount Si in New York and he grew up in Dublin in Ireland

and in the '90s he moved to San Diego I think to finish his PhD and he quickly realized at the time whoa Americans don't eat like Irish people did back then right it was much more processed and Ultra processed food sugary food salty food and like many a good immigrant he quickly assimilated within a year he gained like £30 and he was like who and he started to feel like this food he was eating wasn't just affecting his gut it was affecting his brain it was making him want things differently see designed an experiment to

test this which I have nicknamed cheesecake park right it's very simple experiment he got a lotad of rats and he raised them in a cage and all they had to eat was the kind of healthy food that rats ate over thousands of years what they evolved to have and it turned out when they only had that food the rats would eat when they were hungry and then they would just stop right they had some natur natural nutritional wisdom that said hey guys enough now right they never became overweight or obese then Professor Kenny introduced them

to the American diet right he fried up some bacon he bought a load of Snickers bars crucially he got loads of cheesecake and he put it in the cage alongside the healthy food and the Rats went ape [ __ ] for the American diet I don't if rats can go AP [ __ ] but you know what I mean they went wild for it they would dive into the cheesecake and literally eat their way out and just be slicked with cheesecake and they ate and ate and ate and ate the way Professor Kenny put it

to me is within a few days they were different animals right and they all became very overweight then Professor Kenny tweeted the experiment again in a way that to me as a former KFC addict feels a little bit cruel he took away all the American food and left them with the healthy food again and what he thought would happen he was pretty confident he knew what would happen that they would eat more of the healthy food than they had in the past and this would prove that junk food expans the number of calories you eat

in a day that is not what happened Rich what happened is much weirder once they'd had the American diet and it was taken away from them they refused to eat the healthy food at all it was like they no longer recognized it as food right it was only when they were starving that they went back to it now I would argue we all live in cheesecake park now right we live in an environment where is very easy to be overweight or obese 70% of Americans are overweight or obese it's the norm um and very hard

to be a healthy weight and that is because there's lots of things going on but the by far the biggest factor is processing ultr processed food 67% of the calories the average American child eats in a Day come from ultr processed foods right that's that's staggering so it's very clear to me looking at this research this is a crisis caused by the environment caused by the food industry has it happened in Japan there's almost no obesity in Japan I went to Japan to see why and it's because they did not allow that transition to happen

so it was very clear to me that's what created the kind of hole that these drugs fill right the food we eat profoundly undermines our satiety our ability to ever feel full to feel like we've had enough and what these drugs do is they give you back your sense of satiety I had never felt full until I took these drugs I don't think that's an exaggeration I'd felt stuffed but I'd never felt full um and when I learned all that you know a brilliant professor in Philly at drexo University Professor Michael low said to me

you got to understand understand these drugs are an artificial solution to an artificial problem and when I learned that I thought this is just [ __ ] hypocrisy for me to take these drugs I write all these books about how we shouldn't just deal with the symptoms of our problems we should deal with the underlying causes clearly the solution is to deal with the underlying problems with the food supply I got to stop taking these and I went one day to see one of my closest friends and I said that to her and this friend

is um 8 years ago she got very bad breast cancer and she nearly died and she's a single mother it was um horrific and I was there with her all through the double masectomy the hysterctomy the chemo and she said to me Yan when I got breast cancer you could very easily have said to me there's something in the environment that's causing breast cancer one in seven British women get breast cancer one in eight American women get breast cancer it's one in 38 in Japan right it's blown up and it wasn't like this in the

recent past something in the way we're living obesity is a big factor but there's other things going on and things that we don't know about I'm sure is driving up breast cancer she said to me you could have said well [ __ ] me the environment gave you breast cancer and now you're going to fill yourself with another poison that's crazy she said you did not say that to me you said we've got to deal with the environmental factors but first we need to make sure you live to fight another day right and she gave

me this analogy that really helped me she said if your house is on fire you can say it's a really good idea to change the building code so we build houses out of less flammable material good idea I'll support you but if your house is on fire that's no [ __ ] Ed to you you got to call the fire brigade and DOW the fire with water right and I sort of realized actually there's no contradiction between dealing with the environmental causes or I put it more subtly if we do this right that we could

get to a situation where there isn't a contradiction between fixing the environment and people taking these drugs to with the crisis we are currently in in the best case scenario I hope the drugs wake us up right to go how did we get to the point where 47% of us are willing to take a risky drug cu the alternative is an even more risky medical condition what the [ __ ] happened to us why did we let this be done to our kids why isn't it happening in Japan I hope it leads to an Awakening

now I bet there's a lot of you out there who've been pondering that new website you'd like to have but just haven't pulled the trigger well with Squarespace it's easy easy and affordable to build your own beautiful designer website so Squarespace has been a long time partner of the show and what I love about it is it just demystifies everything about what's required to make a website you don't need to be a designer you don't need to know how to code everything is right at your fingertips they make it super simple and they've got these

unbelievably beautiful templates to choose from that are oriented around whatever your needs may be whether you need a simple landing page or a full-on online shop snap crackle pop Squarespace has the tools you need to launch your business including e-commerce templates and inventory management so make that website you got it click the link in the description below for a free trial and when you're ready to launch use offer code Rich Roll to save 10% off your first purchase of a website or domain of course if the house is on fire you got to put the

fire out first but at some point personal responsibility has to enter the equation and the solution can't be to put a Band-Aid on a Band-Aid or to treat a poison with a poison yeah and I think and I believe that um there is a way forward with uh with an intelligent use of this drug in the short term for the people that need it most to put out that fire um but back to the to um the study the cheesecake Park rat study um I suspect that in that third phase where they reintroduced Whole Foods

and and the Rats resisted it if you allowed that phase of the study to persist for 90 days at some point they're going to return to a Baseline and they'll start eating that food again and that's because not only that's going to be driven not only by need because it's the only caloric Source uh available to them but also because there's changes in the microbiome and you know Cravings adjust over time you know this as somebody who's looked at addiction and the like you know when you take an interval of time a break in between

the thing that you crave you will slowly like the Cravings subside right and there will be physiological changes and you will reach some kind kind of uh you know equinity with the whole thing so to the lifestyle uh medicine piece using this period of time to you know get people trained up on healthy foods like there is something about eating the correct foods that will provide your body with the glp1 signaling that it needs like if you're eating tons of cruciferous vegetables and a high fiber diet you're going to feel full with less calories because

you're eating the foods that your body craves and when you're eating cheesecake you're eating tons of calories but you're not providing your body with any nutrients and there has to be something to the idea that you know your appetite is not sad because you're actually not nourishing yourself all you're doing is putting pounds on on the waistline along the way and so I think with respect to your journey uh I almost feel like the book is missing a final chapter which is what happens when you go off it and are you going to be able

to um be in a better place uh to master your cravings and your habits and adopt new ones healthier ones with staying power like that's the chapter that I want you to write next um and I know you're still on it but at some point my suggestion to you is to like as a journalist if for no other reason to like have that experience and share with that what happens that's so interesting because I'm inter think about the first bit what you said as well about responsibility cuz you're you're you're totally right um there are

people who deny that willpower is real or that personal responsibility plays a role here they're definitely wrong in my view everyone has experienced at some point in their life exercising willpower over something right and let me just interject one point Sorry Sorry to step on you but I do want to say that uh that when we talk about willpower and personal responsibility the caveat the important caveat I want to make is I don't know how intense your Cravings are like I I can't assume that whatever I went through in terms of my you know emotional

attachments and the Cravings that I experienced are on the same level as yours or anybody else's it's it's it's you know not out of the realm of possibility that whatever you experienced not too long ago was 10x what I experienced and I think we make an assumption that those experiences are Universal across the board and I'm certain they're not I think that's a really good point I think there's another sort of um additional insight about willpower that's so important for people to bear in mind so we live in an environment that is making it hard

to be a healthy weight and easy to be overweight or obese for all sorts of reasons we talked about and going to more we can go into more so the way I think about willpower in this environment is it's like an umbrella in a bad storm right for some people that umbrella is going to be enough to get them across the street and they'll stay dry but for most people the storm is so bad it's going to break the umbrella right um and that's why most diets fail right there's very strong evidence on this the

vast majority of people who go on a diet are not able to keep that weight off over time now some of that is willpower but a lot of that is psychological factors which undermine uh self-control which we can go into some of which really came up for me when I was taking these drugs but most I think it's environmental fact environmental socioeconomic there's a variety of factors of course huge and you know more three-year-old children in this country know what the McDonald's m means then know their own last name right from the moment we're born

you are inculcated with messages to eat [ __ ] all the time right try taking a kid for a walk around where we are right in LA and then not being bombarded all the time with messages for this stuff right that's that's what we live in and of course then there's the effect of the food itself on you and you're totally right when you were talking about nutrition if you think about even for example it's a really fascinating guy you should have him on called professor David ranheim in Sydney in Australia who's done this really

interesting research so he kind of hypothesized that in addition to having a general hunger for calories we also have obviously a physical need for protein so you have not just calory hunger but protein hunger right your body will make you seek out enough protein to be healthy but processed food ultr processed food has much less protein in it than healthy Whole Foods so to get the same amount of protein you have to eat a lot more processed food it's one of the things this underlying protein hunger in an environment field with process and Ultra processed

foods is likely leading us to overeat it's one of the seven factors that WR about magic pill in the processed food environment that are driving us to become obese and overweight I would I would suggest and this is just you know like Theory complete theory that it extends Beyond protein like if you're not if you're not eating any phytonutrients or micronutrients or uh you're not getting the adequate minerals and vitamins and what you're eating every day which is which is what's going to happen if you're just eating you know French fries and takeout uh that

your body on some level is going to be yearning you know and that's going to translate into some kind of signaling that's going to make you eat more I think that's absolutely true and I think one of the things that's happened in this environment is um as Professor Gerald Mand at Harvard who's the guy who designed the food label it's on all food so in this country said to me we've separated flavor from food right so if you think about all our instincts evolved let's say 3,000 years ago if a human being found something that

was sweet and soft that meant it was very likely fruit it was very good for you you should eat it right so those are our instincts um we evolve with really quite strong instincts around what's good for us what's bad for us what we should eat and what we shouldn't eat but now that system is like a GPS that used to tell you how to drive home safely but now tells you to drive off a cliff the instincts that used to make you cow fruit now make you cow Fruit Loops right now if you find

something that's soft and sweet it's as likely to be a milk banana milkshake as to be a banana right so our instincts are completely thrown off by this new food environment and actually um it's worse than being thrown off they lead us astray right so one of things we have to do is adapt the environment so it's more compatible with our instincts sure I mean it doesn't take a a rocket scientist to understand that you know everywhere you look it's fast food and this is our Great American export across the world no matter where you

go now I've been I've traveled through the Middle East and seen like you know strange American fast food chains in small corners of the world where you would never expect it to be like this is you know we're metastasizing this problem all across the world uh and if you go into any grocery store these massive grocery stores that we have in the United States uh only one aisle on the far end is fresh produce and everything in between those two kind of far end aisles is basically probably 90% processed foods so we're in a food

environment that is conducive to the unhealthy choice and short of a systemic change in which the Healthy Choice becomes the most convenient available and costeffective choice it's on the individual to take responsibility to seek out the healthier choices and find a way to make it work economically and that's overly burdensome for too many people so to kind of you know put a cap on the positive aspects of this before kind of digging deeper into the negatives um there's millions of chronically obese people who've tried everything and can't seem to figure out a way to sustain

any kind of weight loss obesity is driving so many of these devastating illnesses there's a billion uh people worldwide who who are obese obesity is the leading cause of death and not for nothing obesity is also driving insane costs in our health care System sure so to the extent that there is something that can um ameliorate this problem from an economic perspective even you know we're we're going to like save money and that's helpful for the economy um gu Davis my bariatric surgeon friend said something I never thought I would hear him say which is

it's easier for me to teach my patients healthy eating when they're not starving than it is when they're starving that's so interesting can I just pick on one thing you've said a few times where I just wanted to um possibly push back on it so um a few times you've framed it as the problem is chronically obese people and you're definitely right the problem is much worse for chronically obese people than for anyone else but one of so you like maybe these drugs are right for chronically abuse people one of the things that um really

surprised me is we picture health problems kicking in at very high levels of obesity actually the evidence suggests the health problems kick in just at being slightly overweight right actually you know if people are listening thinking well I'm not like you know 400 I don't need to worry about this I was kind of taken about by how how and I think the way the reason you're framing it that way and I think that your instinct is right which is well if you're closer to the borderline try the other stuff before the drugs because of the

RIS of the drugs correct me if I'm I'm wrong yeah I see where where you're headed is very triggering to me because it's because it's because it it gets into the personal responsibility piece like if you're somewhat overweight uh and not chronically obese you're not 300 pounds or what have you um to me like I can't help but think come on man like get it together that's so interesting cuz there's definitely a bit of me that think that and frankly I thought it about myself right so not in anyway critical of anyone who has that

voice cuz I directed that voice to myself I like come on you're not that fat why can't you just get it together right and I definitely think your instinct is right that people should definitely try the Alternatives first right but it was interesting to me as woman interesting that you frame it as the alternative when it should be like this is this is what we're meant to do this is not this shouldn't be considered an alternative that's such an interesting point you know this is like how we're wired to live right this should be the

the primary yeah that no that's a very wise point and I I you're right to to pick me up on that I think in terms of the that that feeling of um kind of come on man which we we all have I think um or almost all of us there was someone who really helped me to think about this a woman called Professor Tracy man brilliant professor at the University of um Minnesota in Minneapolis who I went to interview Jo was funny I went to interview she suggested we meet at a bakery called is bum

which is kind of institution in Minneapolis and I went in the guy behind the counter said have you been here before I said no he said oh we'll give you a free iced bun then and they give you this thing it must have been like 3,000 calories that just sat there and I thought wow this is the perfect thing to just sit on the table while we're discussing obesity right um but and I got get for nothing for free um and Professor man has done really fascinating work on this so she looked at so when

she began researching diet in the early 2000s actually the evidence was very clear on this diets work almost all the studies looked at people over three months and a few looked at six months and if you look at it was very clear if you stick at it you lose weight right but then she noticed the studies stop at 3 months or 6 months with the implication being and then you live happily ever after right she was like well it doesn't seem to be the case so she looked out all the studies there wasn't that much

research at the time but there I think 26 studies that had looked at diets over two years and over two years the outcome is very different now there are definitely people like you who succeed and and I have nothing but admiration for but the average weight loss over two years was2 pounds so it's pretty low right um not nothing it's not even outside statistical significance I think but it was low right surprisingly low from my point of view it would definitely been my experience with dieting and regaining weight and there's a big debate about this

um as question about why and there's an explanation that has persuaded a lot of scientists not all which I think is might help to help us to think about this also might help us to think about some of the effects these drugs are having on the brain although that's more controversial so if you go back to the 70s it was thought then that when you were born you're basically you're born with an innate what's called a biological set point that just fixes your body fat percentage roughly right so think about your temperature your body temperature

is fixed right by your brain um and if you go outside that range if you get too hot your body works really hard to make you sweat bring it back if you get too cold your body works really hard to you make you shiver bring it back up so we have a fixed temperature set point and your body works unbelievably hard to keep you at that temperature and if you get outside that your body you know really works hard it was thought of the time that basically you had something similar with weight so you could

vary a bit just like you and me could go to the Sahara or we could go to the Arctic you can vary a bit but you couldn't it that much but then the Obesity crisis happened and blew up right and suddenly they thought well that can't be right you know how could that be if it's set fixed at Birth how could it explain this staggering rise but that's led to um and Prof people like Professor Michael L have written about this it's led to an adjustment in biological set point Theory which also been used by

some of people talking about these drugs so what they argue and there's some good evidence for this is that as you gain weight your brain fights to keep you at that higher weight so let's say you gained you know 100 pounds now like please don't it would be a tragedy to women and gays everywhere but if you did it would uh but you think about that weight gain as Dr Charles yo who's one of the leading obesity specialists at Cambridge University said your brain hates it when you lose weight it would fight to keep you

at that higher weight so when you tried to lose weight all sorts of changes would start to kick in that would make it harder not impossible but harder your metabolism would slow down we've got a lot of evidence for that so you would burn calories more slowly um you would crave more sugary and salty foods you would actually pay attention more to sugary and fatty foods um and I remember when I first at all these scientists were explaining it and reading it frankly I thought I do not believe this because why would Evolution endow us

with something that was so maladaptive if being obese is so bad for your health why would Evolution make us hold excess weight it made no sense to me but actually scientists explained it to me they said like Professor low you've got to picture the circumstances where human beings evolved in the circumstances where we evolve the situation we now live in where you're surrounded all the time by Massive excess calories that will last your whole life that never happened to human beings before us right it was impossible um you might have a short period where you

have lots of excess abundant calories but the risk that was really omnipresent for a lot of hum existence was completely the opposite risk it was famine right there was a risk that you were going to run out of food supply so in that situation when you have access to the calories you double down you get as much as you can and your body's going to do whatever it needs to do to hold on to that exactly because in a famine the fattest guy at the start is going to be the last man standing in you

know if there's a famine tomorrow Timothy shalomay will die in week one and me at my fattest will cry over his body and still be alive a month later right you can see I know I know no disrespect Timothy shal um um the um so you can see why our bodies are preparing us for a famine that will now never come right so if this is right it is contested there are other theories about what's going on there's a big debate about what's going on in your brain when you take these drugs right and the

the candid answer is we simply don't know we know it is massively changing your brain we know if you give the active component of these drugs some magati to rats and then you cut their brains open which obviously we can't do with humans the drug goes everywhere in their brain right it's affecting every part of the brain slightly alarming extremely alarming I remember saying to Dr clemon bluea a brilliant obesity researcher at Cambridge so which parts of the brain are affected by these drugs and she listed them and I said what else do these parts

of the brain do and I the exact ques in the book I might be misremembering it slightly but she said things like oh processing of memory control of your gut I was like oh okay just the trivial stuff then right so but one theory of what's happening in the brain is that it's effect and this is contested and highly speculative I want to stress that but one theory is that it's basically lowering that effect on your set point right it's lowering the increase in your set point that happened when you gain weight it's almost like

you know resetting your iPhone to the factory settings right when it comes to weight so that's one thing that that could be happening here again the long-term implications of that we don't know and the fact that you know it's lighting up the brain in all these ways uh and and how little we actually know about how the brain functions is is you know deeply concerning to me you're if you're totally right if I of the 12 big risks that I write about in Magic pill that relate to these drugs the one that most worries me

for myself there's some that worry me more for other people but the one that most worries for me for myself is exactly what you're alluding to there have you had have you experienced any changes in your cognition or memory or any other kind of brain related neurological kind of things as I mean it's been you've been taking this for two years right no no about a year and four months now but well again it comes back to that thing you got to weigh the Alternatives we know that obesity unfortunately has effects on cognition it's one

of the reasons why you're significantly more likely to get dementia um when you when you when you're obese unfortunately so you got to way the symptomology of that doesn't occur until much later even if it's underway you're right so if we think about the long-term risks right for me like I said the biggest thing that worries me is people have been taking these drugs for diabetes for 18 years so we have some long-term data but 18 years is not so long right so there's a comparison that was raised to me by Dr Greg Stanwood who's

a professor at Florida State University working on these drugs I want to stress he said this was speculative he broadly believes these drugs are safe but he raised a potential parallel that he thinks we should think about if you go back to the what was it the late 50s early 60s doctors start to give people antis psychotics cuz they judge that the benefits outweigh the risks and some people take those drugs for a very long period of time it was only 40 50 years down the line that they discovered if you take antis psychotics for

a long time you're much more likely to get dementia Alzheimer's in fact every form of dementia I think now he's not suggesting these drugs will give people dementia there's no reason to think that but he's just saying when something's long term we literally don't know right and this particularly worries me when it comes to children with OIC and this is for me the one that is the most charged and the most most difficult of the whole debate partly because it's so obviously an environmental problem with children um you're talking about children who are taking OIC

yeah so Novo Nordisk is currently running a trial on giving OIC to children as young as six years old there are loads of kids who have been given these drugs and I empathize with the parents in this there's a wonderful woman called Deborah Tyler who I interviewed she's a nurse in Connecticut a good person you would really like her and her daughter was very severely away she tried all sorts of solutions and she was told that her daughter was starting to have I forget if it was liver or kidney problems when she was like eight

or nine um exact details are in the book I don't want to get them wrong and Deborah was agonized she did not want to give her child these drugs but equally you know if you're as Dr jario put it to me you know if you're obese when you're young it is extremely hard to become un obese right um she started to give her daughter o zenic her daughter has got a lot her kidney or liver problems have gone away but she is really agonized about this partly because you think about those long-term risks right I

don't want to speak to Deborah now I'm speak about for myself but you think about those long-term risks because they only work as long as you take them her daughter presumably is going to be taking them for 80 years right and has begun taking them while the brain is very much in development exactly so all those worries I had for myself are much more acute the case when it comes to the dilemas faced by parents and the question about about children um but there's loads of I mean I experienced quite a few of the negative

effects myself well you talk about feeling nauseous the first time you you took it I mean what are some of the other experiences over the last year and four months yes so there's the kind of common side effect so almost everyone feels nauseous at first and for the vast majority of people it goes away for me it wasn't horrendous like if I had randomly felt nauseous like that one day you know two years ago I wouldn't have like not gone about my day and gone to bed I would have just felt a little bit nauseous

right it wasn't some people it's much worse you know I interviewed someone called Sunny Newton in Vermont who like was like horrifically nauseous for months on end she said it felt like an alien was inside her body right that's unusual but not unheard of um so there's lots of common side effects that I go through in the book actually weirdly for me the kind of minority but not uncommon side effect that was weirdest was it um for some people it increases the rate of your heartbeat not like massively but somewhat and for me it was

hard it's hard to have your heart racing and not interpret that as anxiety and just be like oh what's going on right so it took me a little bit of time to adjust to that but actually in terms of the 12 risks the one that most played out for me and I want to stress this is contentious and some scientists dispute that this is happening some scientists are concerned that it may be causing depression or even Suicidal Thoughts in a small minority of people using the drugs I want to stress most people who take the

drugs are happy they take them but there have been doctors who raised a safety signal on this both in Europe and the United States and I had this weird thing I had a real Epiphany about it so for the first six months I was taking the drugs my friend Danielle was pregnant and every time I bumped into her I was like it's like we're going in opposite directions right she was swelling and I was shrinking but I remember saying to her one day about 6 months in this is really weird right I'm getting what I

want I've lost a shitload of way but I didn't actually feel better I think I felt better in my body but actually in my mood I felt slightly muted I don't want to overstate it I wasn't depressed or anything certainly wasn't suicidal but I felt a little bit down and muted a little bit dulled and I said what's going on here and I had an epiphany about it not long afterwards I was in Vegas as you know I spent a lot of time in Vegas because I'm writing a book about a series of crimes that

have been happening there and I was researching the murder of someone that I knew and really loved and it was um very very hard and difficult thing to do and I felt like as you would expect someone to feel when they're doing that and I went to the KFC on West Sahara and I ordered what I would have ordered before I was on OIC right I ordered like a bucket fried chicken and I had a chicken drumstick and I realized I remember looking at the food thinking oh [ __ ] I can't eat this I

can't eat it right if onic if you tried to deliberately overeat you would I think throw up I I've never tested that but you it would be very hard it'd be like imagine you just had a whole Thanksgiving dinner and I showed up I mean I know if you this wouldn't apply because because you have plant-based diet but and I showed up and said hey Rich great news I've got you a KFC bucket right you'd just be like oh can't do it um and I remember looking at this chicken and thinking very consciously oh I'm

just going to have to feel bad right I realized in that moment and there's there's evidence for this I realized so what these drugs do this is something I really don't think people are being prepared for what these drugs do is they radically interrupt your eating patterns obviously and what that can do for some people is it can bring to the surface the Deep underlying drivers of your eating all along that were in your emotions I go through five reasons why we eat in in my book magic pill only one of them is like feeding

in your body right sustaining your body the rest are psychological they're factors and for me I realized you know you know I've talked about this before rich but you know I grew up in a family there was a lot of addiction a lot of craziness and I realized I think I I was sort of aware of this before but I didn't feel it as acutely until then how much I had learned when I was very young to manage my emotions by stuffing myself it's a very particular way of eating stuffing is where you eat deliberately

eat beyond the point of being full cuz you get a kind of yeah you're managing your emotional state through food you're muting those uncomfortable emotions through you know feeding yourself and all the blood goes to your stomach you feel differently it's not that different from taking a drug or gambling or any of these other kind of addiction Outlets but the thing that's interesting to me about the story you just told is that you're on OIC and then you still go to KFC whether you eat there are not like like you're on this drug you're losing

all this weight but you're actually not addressing your habits around food right you're still finding yourself at a fast food outlet and this goes to the Band-Aid on the Band-Aid thing like okay you've written extensively about addiction you have a lot of self-awareness around your behavioral patterns and who installed these buttons and how they get pushed and how you self-medicate and this is your opportunity while you have this reprieve from you know the appetite that's LED you astray for your entire adult life to basically you know like turn the iPhone off and reboot it like

install the new operating system and not go back to KFC but leverage this period of time to change those habits and and that's not only with respect to your food choices but also like these psychological drivers like can you be more curious about that what can you learn about yourself how can you untangle that knot so that you're not uh you know kind of um reactively uh turning to food to change your emotional state you're definitely right and I know you know this as well as I do it's one thing to know that intellectually and

another thing to do it right and I had this insight about it I realized I was interviewing a guy called Professor Robert Kushner who was involved in key parts of the resarch on these drugs brilliant scientist and I said to him so I've made a lot of progress but basically I'm eating smaller portions of the same odd [ __ ] right and that's better than eating huge portions of the same odd [ __ ] to be sure and he said yeah you got to understand even separate from the question of obesity you need nutrients right

I mean if you're not hungry at least when you're eating eat the healthy foods so I've made a progress on this I realized I'm very embarrassed to say say this I realized I was 44 at the time and I realized I didn't have the most Elementary skills right I didn't know how to cook I'd never cooked anything right um so I got my friend Rosie to teach me how to cook I I definitely going to Japan was a really transformative experience around their relationship with food and the way they eat food that is delicious but

makes you feel full so I I built a lot of Japanese food into my diet I'm a very privileged person that I can get to do that but it's been I've been surp surprised by how hard that's been like so there was one time when it was easy so after I finished the book I went to Jamaica for 3 months I went to an amazing fishing Village in St Elizabeth in Jamaica um partly to do some research and partly to kind of um decompress I said this before the podcast but you really know how to

Vacation like three months in Jamaica and then your other book you were how many how long were you out in Fire Island Province Town Province Town the only more deor gay place in the world than Fire Island and I was there for 3 months I I I believe in you know I'm un freakishly lucky that I get to do this but I'm um yeah I believe in that and especially Jamaica [ __ ] me what a great country Jamaica is I Jamaicans know how to live and I was in this fishing Village I barely left

it for three months um it blew my mind in lots of ways but in in this fishing Village basically you can't eat anything about healthy fresh food right there is nothing else right I mean Jamaicans have quite a limited diet but it's fresh healthy food um so like every day I was eating fish so I did have these three months and I would love to tell you a neat Redemptive Parable that I learned better habits and I came back but I've got to tell you this morning before I came here my breakfast was a pack

of Peanut M&M's right like come on I know it's I I want to love you learned nothing you write these obviously you write books where you know we write books to like it's because we need to learn something right yeah I deliberately don't write my books and I know you know this but I don't write it as dear reader I am the living example of all that is right I have done the right thing uh and now you must follow me on my great example because I'm a much more FL well I'm very wary of

anyone who says that in any context but I'm a much more flawed and and um uh broken person than that right so I think these psychological things run so deep the habits you learn when you're very young and they're not insurmountable you're absolutely right to push me on it I'm grateful to you for pushing me on it there's the psychological elements there's the environmental elements you know try staying in West Hollywood and you know having a healthy breakfast right it's not it ain't easy right well you got aana and Whole Foods it's true actually ww

is a lot easier than try Vegas right the uh not a place known for its uh great healthy healthy eating but the but of course you can eat healthily in those places and I'm uh I don't want to make excuses for myself in that you're you're right to push me on it um but I do want to be level with people about how resilient these patterns are and how it's not that easy not that easy to to to undo this although we should all be aspiring to maybe maybe maybe not easy but I would I

would suggest doable this is the challenge that I'm putting to you I am a total gear head and I've learned that people often Overlook apparel but what you wear isn't just clothes it is without a doubt technology that can make or break a performance and I can tell you that on is innovating in this space like no other with NextGen premium fabrics and just this heightened level of sophistication and intentionality previously unheard of that puts them just miles beyond the competition I've been rocking on high performance running apparel all super lightweight tailor fit built to

move and just gorgeous to get you out and get it done in Fleet foot Comfort no matter the weather I'm super proud to be a brand partner with this impressive team truly Swiss innovation at its finest to get you moving an is offering an exclusive 10% discount to redeem head over to on.com richr and use code Rich Roll 10 at [Music] checkout at some point you're going to have to go off this drug maybe I'm not not sure I will I genuinely don't know I think um I don't think if I was so for example

one of my best friends takes statins because he's got his um I think maybe a year older than me um I don't think you'd say to him you've got to come off statins at some point you would definitely say make all the lifestyle changes people like Dr Dean ornish who I've interviewed you know argue for to improve cardiovascular health maybe if you make BR dramatic lifestyle changes you can come off them but I don't think we would be uncomfortable with someone taking statins for the rest of their life right to reduce their cholesterol level some

scientists and I feel the doubt you feel but I just want to S also feel another side which is there are lots of scientists who are saying if the Obesity comes back if if that is the reality for most people we will have better studies on this soon if those studies find that you can use the drugs to radically change your habits stop taking them and continue without them and I very much hope that's the case and I your hunch is that's the case I I I feel a bit more agnostic I genuinely don't know

but I desperately hope that's true obviously the best case scenario is that's true in which case you and I agree happy days if that's not the case if those studies suggest that most people do regain the weight which I I suspect might be the case but who knows we'll know soon enough the early studies suggest that'll be the case we're in a harder set of decisions and I can imagine a scenario where in that if that is the case I would continue to take them for the rest of my life now that's I have this

unique vulnerability not unique but I have a um a vulnerability around heart disease in my family that a lot of people don't have obviously so that hugely skews the calculation for me in terms of weighing that against these big risks lots of which we haven't touched when I go through in the book but I'm not as confident as you are that I'll have to stop taking them now look there's a perfectly plausible scenario that this turns out to be like fenfen in the '90s people who don't remember um and for some people will remember it

in their nightmares so in the early 1990s a new weight loss drug was launched onto the market called fenfen it was a combination of two drugs uh Flex fomine which is an appetite suppressant that makes you very drowsy so was never very popular and they combined it with an amphetamin called fenamin which counteracted the drowsiness and also you know makes you more manic um as anyone who ever tried amphetamines knows uh also has a weight loss effect and it was talked about in exactly the way that asmic is talked about now in fact the front

page of Time Magazine was the new Miracle weight loss drug question mark and it was released huge numbers of people took it there were 18 million Fen prescriptions in this country in 1995 and then it was discovered it was in fact spotted just by a group of ordinary doctors in Fargo in North Dakota noticed huh a lot of our patients taking these drugs seem to be having trouble breathing so they raised a safety signal that was then investigated it was discovered this drug both caused heart defects and caused a horrific condition called primary pulmonary hypertension

where the blood vessels in your lungs radically contract and you can't breathe properly there's no cure for it if you get it you you're on oxygen the rest of your life it can kill you I I go through some really devastating stories in the book about that we also discovered the drug companies knew about this from the start there was it came out in the civil litigation I remember all this yeah I mean there's one uh I don't think it would have been an email then what it been an internal memo where they said one

of the people joked am I going to have to spend my retirement writing a bunch of checks to a bunch of stupid fat women who can't breathe hahahahaha I mean now I want to stress there's some reason to believe that fenfen is very different to these new weight loss drugs fenfen was launched based on one study by a company that were frankly shyers right um these drugs these new drugs have had a huge number of studies out on them they've been taken by di diabetics for 18 years it's not exactly the same to take it

for diabetes as to take it for obesity but you know that that does tell us something about the safety profile both good things and a few risks um I don't think it's likely this will be like Fen Fen but equally I don't think you can rule it out right so we may well I might be coming back on this show in five years time and I go [ __ ] I should have listened to you rich right I have had to stop taking it I do not rule that out we've got to be level with

people about the risks here well I thought it was interesting when you shared the the story of running into your your pregnant friend uh and you said that you actually didn't feel great like normally if somebody loses that amount of weight they have a boost in their vitality and their energy and uh they just have uh like an energized relationship with their body that often leads them into more physical fitness and and the like but for you to share kind of a different perspective which was not feeling really better and maybe even a little bit

worse than you did when you were very overweight I think is interesting I do feel that benefit now um I definitely do it took a while I think what I had I had to go through a quite bumpy process where I had to become more aware of the underlying emotional drivers of my eating and once they come to the surface of course there's a better solution to those problems than you know Colonel Sanders right obviously have you started exercising have you what is your relationship with Fitness yeah I mean I I walk for about 3

and a half hours a day that's the exercise I can tolerate I walk very fast because I can listen to audio books like some kind of David Sedaris exactly I love David Sedaris um I want to dig down we have we haven't even really kind of Taken inventory of of of all of the kind of negatives or potential negatives here um and there are plenty right we referenced a few but there's also a risk of bowel obstruction I think Mark Heyman said that there's there's like a 450% increase in risk of that uh pancreatitis risk

increase thyroid cancer risk increase um this idea that you know it it kind of violates this law of nature that is there's no biological free lunch for every benefit there's some kind of downside and we're not sure we truly appreciate or understand what that downside is and then also um and you talk about this in the book uh the shedding of lean muscle mass right like you're not just losing fat you're also uh in equal measure losing muscle mass and also perhaps bone density along the way right so when you're obese you got to put

the fire out right that's the most important thing but I think there's a lot of people who are mildly overweight or people who just want to get ready for the summer and lose that you know resistant 10 pound around the midsection and they don't give a [ __ ] about the long-term implications or the risks because vanity uh is such a powerful motivation it overrides our better judgment in many cases so even knowing the risks most people they want to look good when they look in the mirror they want to feel good about themselves and

they'll just say [ __ ] it I'm going to I'm going to go on this thing it's just the easiest fastest route to the body uh that I've always aspired to have and I actually don't really have to take responsibility or work for it or change my habits in any regard like this is going to do it for me I there's a few things in what you just said that are really important um vanity is definitely a factor in this it definitely was for me like one of my closest friends I remember challenging me on

this she was kind of you know as you know CU you know me Rich like I explore things through to discussing them with people right it's how my brain works I read a lot but I I have to process it through talking it out and the whole time we were talking the I know this must we must have had this argument about 8 months in she was the one of my friends who was kind of pissy whenever I would bring up this topic and it's kind of Weir because she's normally so interested in what I'm

working on she's not herself overweight so it wasn't like a personal sensitivity and one day we had dinner and I was talking about oh wearing the wrists and the benefits and she said I can't listen to this [ __ ] [ __ ] for a minute longer right you keep telling me you're wearing the wrists and benefits it's all about health [ __ ] be honest with yourself right yeah here we go you know a month into taking these drugs neighbor hit on you and that's why you're [ __ ] taking it right don't give

me this [ __ ] about health and she said you're taking all these risks cuz you know not because you want to avoid heart disease but because you want to have [ __ ] cheekbones right although sadly that's never happened uh Tina Fay once said um her cheekbones had to be uncovered by a team of gay excavators I think that's true of me as well but but and I she was going too far but there's a truth in what she was saying right no one can deny it a big motivation is to look back better

as it's defined by the culture right um and I think that can make us excuse your judgment you want to overplay the benefits and underplay the risks I think that was a factor for me I think I've got to be candid about that um and you think about some of the risks you were talking about this particularly plays out think about muscle mass right so I'm sure your listeners know but um muscle mass is the total amount of soft tissue in your body it's really important for like movement right um and naturally as you age

you shed muscle mass every day depressingly from the age of 30 which a statistic I don't like um so just whoever you are you're going to lose some muscle mass as you age the risk with these drugs is as with any other form of radical weight loss you don't just lose fat Mass you lose muscle mass so the danger is that you go into the aging process with a diminished amount of muscle mass now this is particularly true for a category of people we haven't talked about who I think are really important to think about

which is not people who are overweight or obese who are taking these drugs to get down to a healthy weight but people who are in fact skinny who are taking them to be super skinny think about that party I went to right right at the start of our conversation or or the joke at the Oscars like nobody who's getting on stage at the Oscars needed to go on OIC very very few exactly very I mean I can think of one or two but there a rarity right um so they in particular are potentially setting up

a big risk for themselves it won't show up now but if you're going into the aging process with very diminished muscle mass you're going to lose more and more and more you put yourself at the risk when you're older of a condition called sarcopenia horrible condition it means Poverty of the flesh it's basically where you just really struggle to do basic things like climb the stairs you know um get out of a chair you know so the danger is particular people who are skinny who are taking them to be super skinny we're setting in place

a kind of Time Bomb of much more frail older people further down the line it's why the firmest piece of advice I would give on this there's lots of things where I give advice with lots of caveats and UNC certainties but the one thing pretty much all the experts I spoke to agreed on is if you have a BMI lower than 27 don't take these drugs you're incurring all the risks for only aesthetic benefits right now don't diss those aesthetic benefits particularly for women women are made to feel [ __ ] about their bodies no

matter what they do in this culture there's a huge amount of pressure on them I'm not judging those people I understand where they're coming from I'm Not So Different to them right I'm not standing above them but I would say for yourself you are potentially setting in train a risk that you don't need to take I can imagine a lot of people hearing what you just said and just disregarding it especially if you're somebody who has a disordered relationship with eating or a full-blown eating disorder uh this just sounds like you know your greatest dream

come true so do we know or what what do we know and what do we not know with respect to how this is impacting people with eating disorders cuz I can just imagine somebody with an it's like I'm I'm going on this immediately until I just absolutely wither you know all the way down to the bone of all the things that I'm worried about this is by far the thing I'm most worried about and I don't think we need to speculate I think it's already begun so Dr Kimberly Dennis who's one of the leading Eating

Disorders specialist she runs suncloud Health in Chicago um she said that these drugs are rocket fuel for eating disorders right now this is me speaking now not her but I'm sure you've known people with eating disorders I'm sure everyone watch has you know that there's a conflict going on within them there the psychological part of them that wants to starve themselves for all sorts of complicated reasons and there's the biological part of them that wants to live and what these drugs do is they massively empower the psychological if you take a high dose they can

just amputate your appetite right um so my biggest fear about these drugs is in addition to all the benefits that we should we've rightly stressed in the worst case scenario we could have an opioidlike death toll of young girls and unfortunately Eating Disorders is mostly young girls there some boys but not many just a huge number of young girls who will be able to starve themselves to death using these drugs in a way they would not have been able to do had these drugs not been invented and we don't have to speculate about this think

back to the early 90s there was a actually much less powerful amphetamin based uh weight loss drug that loads of young women were using girls and young women um and there was a congressional hearing on it C called by the um I think it was the Ohio Congressman Rob weiden pretty chilling when you read it now you know there was a young ballet dancer called Jessica McDonald who testified who talked about how she would take these drugs until she passed out because she desperately wanted to be thin there was a really heartbreaking testimony for a

guy called Tony Smith who was from the state center in Iowa his daughter Noel from when she was a little girl had just been obsessed with the idea that she was too fat she would you know they go to the supermarket she would rush to the fashion magazine say daddy why don't I look like this why am I so fat and she started to take these amphetamin based weight loss drugs and um when she was 21 she died of a heart attack CU she was severely anorexic and he read out this heartbreaking poem that she'd

written saying she wanted to eat she wanted to eat but not yet not yet and there's a lot we can do right now to forall some of that happening so as Dr Dennis says at the moment right so think about you your entire crew everyone here you are not eligible for these drugs right none of your crew eligible for these drugs you all clearly have a BMI lower than 27 but I guarantee you every single one of you this afternoon could go on zoom and get it right from a legit doctor that easy to get

it what you do is just is I mean how you know how are these doctors prescribing it to people who are not suited they've been prescribed on Zoom um and the um the doctor is meant to check your BMI on Zoom but good luck with that also I mean frankly so I get it sometimes because I've divide my time between Britain and the US sometimes I get get these drugs in Britain and sometimes they get them in Vegas right so I initially got them in Britain and when I got them in Britain you know I

met the criteria right I was obese they test they tested me I went in they saw me by the time I came to Vegas I was actually below the BMI you should get it for because I'd lost so much weight now that's a legitimate use of it because I would take it to maintain that lower weight but they didn't check that I'd already been overweight I could have been anyone right I could have been someone with a healthy BMI was taking it to be much thinner right so what we need to do is really tighten

the regulations around this firstly no more zoom prescriptions right you should have to physically see a doctor who physically checks your BMI if you are lower than 27 they should deny it to you and that those doctors should be trained in detecting eaing disorders so that you can be diverted now that's not a perfect that's a leaky Civ right there's all sorts of issues with that but that will prevent some people who shouldn't be getting it getting it right we can't disinvent this any more than we can disinvent I don't know nuclear weapons or um

jello but we can do the best we can to reduce the harm around it and that is one of the things I don't know why I just compared it to nuclear weapons and Jello and what's happening in my head there it's a weird thought but you know what exactly but the reality I don't which has been worse for Humanity nuclear weapons or Jello definitely give me a lot more chins is jello Novo Nordisk yeah the manufacturer of OIC made $ 13.9 billion on this drug alone last year right um huge powerful company with a gigant

antic upside invested interest in making sure that this drug has staying power and getting as many people on board with it uh as possible and I suspect has a very powerful lobbying group in Washington uh that is going to fight tooth and nail against any kind of regulatory oversight that would impede the flow of this drug into as many hands as possible including Zoom prescriptions and the like so I'm not exactly sanguin about you know uh our our kind of uh regulatory bodies and and government entities being able to police this responsibly um and I'm

just imagining like you you mentioned this young girl who would look at the magazine and feel fat but now we're on steroids with that like every young person is scrolling on Instagram and Tik Tok and seeing idealized versions of of you know what they think uh you know their body should look like and it's feeling this you know massive mental health epidemic I just had Jonathan heighton here talking anxious generation and you know this is it's like epidemic stacked upon epidemic stacked upon epidemic the Obesity epidemic the mental health epidemic you know kind of taking

all of these things and pressing them together creates this toxic stew that's going to drive people to make irresponsible decisions around drugs like OIC and I think we're running a massive exper experiment without adequate data to know where this is going to lead and the idea that adolescence and young people um you know could get access to this drug because they want to be a little bit skinnier is only going to in turn fuel more disordered eating more anorexia uh more mental health issues um more dysfunction physically mentally emotionally spiritually like the whole thing is

kind of bankrupt honestly when I think about it uh and yet I have to reconcile that with the fact that we are in the midst of an obesity epidemic and there is a house on fire and there are people who can and are benefiting from this I think you put that so well and if I think about the dilemma I thought about two people as you were saying that so I interviewed a guy called Jeff Parker who's a retired lighting engineer in San Francisco he's 67 when I interviewed him he must be 68 now super

nice guy and he was severely overweight he was finding it painful to walk he had gout yeah was had I think liver and kidney problems he was taking fist fulls of pills every day and his friend Mel gave him munaro right because he tried all the apps he tried dieting all his life and he started taking mjara which is one of these new weight loss drugs and he lost a huge amount away he felt much better his doctor took him off most of his pills now he walks his dog over the the Golden Gate Bridge

every day he said to me I feel like now I'm going to finally enjoy my retirement and I said to Jeff but don't you think we should deal with the underlying environmental drivers of why you and me got into this state and he said I couldn't agree with you more sign me up for that fight but I got to tell you Johan by the time we win that I'll be dead and I want to live and I found that hard to so I think it's very hard to argue against people like Jeff there's much more

borderline cases where you and I might come down on different sides but I think it's very hard to say to Jeff given the risk he was in with the weight he was it would be better for you if no nois could never develop these drugs right so for all the concerns I have about Nova NIS and I do have concerns about their lobbying for exactly the reasons you said I want to also be fair to them and I'm very happy to criticize pharmaceutical companies I was very critical of them in in a whole different area

in my book about depression lost connections I want to be fair to Nova Nordisk these drugs wouldn't exist without without Nova Nordisk and Jeff Parker would have died much sooner right so I want to be fair to them in addition to criticizing them but the other person I thought of is a person related it's actually the worst moment I had in all the research for the book I've got a niece called Erin she's 19 now in my head so she's the only girl in my family and she's the baby of she's the youngest of my

nephews and mise so no one makes me more protective than her and like in my head she's fixed at six years old right whenever she has a boyfriend I always want to go get the [ __ ] away from her you pedophile right um and one day after I've been taking the drugs for a while we were FaceTiming she was in a pub and she was kind of complimenting me in her jokey way she was like hey I never knew you had a neck before I never knew you had a jaw and um and I

was kind of preining and she looked down and she said will you buy me some oen piic and she's a perfectly healthy weight and I thought she was kidding I laughed and then I realized she wasn't kidding and I thought [ __ ] mhm what am I doing here right yeah if you don't think that that isn't a conversation that's happening constantly with millions of young people right now you're duded you're right the way I think about this the book is called Magic pill because there's three ways these drugs could be magic the first way

is the most obvious right they could just solve the problem they could solve the problem of obesity there are days it feels like that rich right my whole life I've overeaten now I jab myself once a week in the leg I don't anymore yeah it's called Magic pill but it's act you have to inject yourself yeah they increasingly going to be p by the time the payback comes out it'll be pills but the the second way it could be magic is much more disturbing it could be like a magic trick it could be like the

condra who shows you a card trick while he picks your pocket it could be the 12 big risks that I go through in the book outweigh the benefits over time I do not rule that out that's a significant risk but I think the third way they could be magic is the one you're alluding to which to me is the most likely think about all the stories of magic that we grew up with when we're kids right think about U be a good example Aladdin you find the lamp you rub it the genie appears he grants

your wish and your wish comes true but never quite in the way you expected right so here I am I've rubbed my lamp and I get my wish I'm much thinner I'm it's I'm almost certainly getting the health benefits for my heart but here's my niece who's a perfectly healthy weight going [ __ ] I need this here's her seeing every woman in the public eye who was slightly larger has dramatically shrunk and says it's just cuz she's taken up Pilates and I don't criticize women in public I get [ __ ] so I understand

why they're doing that but unless there's been an outbreak of dentry in Malibu we know it's not you know we know what's going on there yeah there's loads of unpredictable effects this will change the world for better and For Worse the analogy that that Barley's Bank analyst came up with the smartphone is right if we were to wind back to whatever it was I think it was April 2007 when Steve Jobs unveiled the iPhone right we wouldn't have been able to game out Tik Tock and door Dash and a million things right that have made

our lives better made them worse how could how could being more connected turn out to be a bad thing it was it was unimaginable at the time I mean this is more ambiguous from the start I think you're right that we would have actually been more naively optimistic at the time of the invention of the iPhone um I think you're right that we're more alert to many of the potential risk now I don't think you could have forseen social media algorithms would promote political extremism that would undermine democracy all over the world right maybe we

would have been total Geniuses in 2007 but I doubt it right um so there will definitely be and even if you think about like small things that are playing out from these from these drugs Jeff Financial did a report for the US Airlines saying they're going to have to spend a lot less money on jet fuel pretty soon because it takes so much less jet fuel to fly a thinner population here in La there's been a big run on Jewelers cuz people's fingers are shrinking so much their ring yeah their wedding rings don't fit anymore

right so there's all sorts of like weird unpredictable effects and that's we're just at the beginning you know one of the scientists who worked on them I think it was Professor Carell Laro but it might have been someone else that quotes in the book said to me you know we've cracked the code of what regulates weight it's gut hormones there are more than 70 gut hormones that affect weight so AIC works on one glp1 or simulates one um munaro works on Two glp1 And GP um Triple G works on three but now there's 70 of

these damn things right there's going to be all sorts of combinations and increasingly it's going to be pills eight years we've got big issues around cost at the moment but eight years from now as then pick goes out a patent it doesn't cost much to make this as a pill 8 years from now unless we're in a fenfen situation which I don't rule out and if someone's watching this in the future on YouTube and go oh right okay um but 8 years from now it'll be a daily pill it'll cost a dollar a day barring

a catastrophe I would anticipate 47% of the population using it is a low estimate actually wow wouldn't you wow given that 70% are overweight or obese and a dollar a day ain't much right and and I would be worried about that and the biggest thing I hope is it wakes us up to go how like I said before how the [ __ ] did we get here and why are the Japanese not there right how come in Japan when I went to Japan it's the weirdest sensation to walk around a school of a thousand children

just a normal school and realize there were no overweight children in that school right because Japanese people protect their children from processed and ultr processed foods um and there's very few obese adults right 4% of Japanese people are obese compared to 42.5% here in the US I mean that's it's kind of weird that we our mental picture of Japanese people as a sumo wrestler it's a bit like expecting an American to look like a bald eagle right it's um but yeah so the hope is that it wakes us up now as I say that there's

a little bit of me that goes [ __ ] it'll send us to sleep if you've got a little technical fix why would you bother fixing the environmental problem it blinds you to getting at the root cause of what's driving the problem in the first place so it it it it moves us further away from the actual solution can I say the most this is not my settled opinion I don't think most of me thinks this but it's my most Bleak thought about what you just said so I would say to people I think I

said to Jeff Parker that guy was talking about in San Francisco or it might have been someone else but don't you think this will undermine the movement to deal with the causes and someone said to me what [ __ ] movement you can't imagine a more charismatic and persuasive person than Michelle Obama right a person more beloved by the American people even Michelle Obama couldn't get a movement going say people should physically move their bodies right so should we resist these drugs CU it might undermine a movement that didn't even exist in the first place

now I don't think that and the analogy I would use the reason okay I've just had a very dark thought I want to just liting it because I I actually do think this as soon as I say that another thought kicks in which is think about smoking right I think the thing that would most shock your kids if we could take them back in time like to say the world we grew up in is people smoked everywhere right people smoked on the subway on planes in restaurants I remember the doctor used to smoke while he

was examining you I think I might have said this to you on a previous occasion but there's a photo of me and my mother where she's breastfeeding me when I'm a baby smoking and resting the ashtray on my stomach and when I discovered this photo a few years ago I showed it to her I thought she'd feel guilty she said you were a [ __ ] difficult baby I needed I needed that cigarette right so that has been completely transformed right okay we've got issues with vaping I'm not dismissing that but we've gone from I

think the figures in 1987 was something like more more than half of Americans and British people have been smokers and now it's something like 12% Britain has actually just begun outling smoking for each basically no one born after the think 2006 will ever be legally allowed to buy cigarettes whatever you think of that we've had a massive transformation in smoking in a very short period of time I don't think we would have realistically thought that was possible in 2007 sure but if there was a drug that you could take that that uh curbed your your

craving to smoke just a little bit so only smoked one pack of cigarettes a day a day instead of two it's an interesting impacted you know this whole movement really interesting question that's a really interesting thing to think through and and you know when you laid out like the three uh most likely outcomes for this drug the third one being you know the the genie who grants you your wish uh but the wish doesn't pan out in the way you imagined the Genie's out of the bottle right so come what may then you know what's

the drug that we then have to take to treat the side effects of this you know there's no end woman becomes a fun house you know mirror situation all the way down the line and and and I think that is you know somewhat concerning and I would imagine you know you said we're just learning about you know we're we're learning every day more and more about the gut brain access and the incredible impact of our microbiome on all our metabolic and physi ological functionality and I feel like we're just at the starting line of beginning

to understand uh those complex systems and how you know the immune system and our hormonal system like every so much is regulated in our gut right and it's not AAP to imagine identifying an analog to this glp1 Agonist that would do for addiction what OIC is doing for obesity in other words is there some kind of hormonal system or particular hormone that if modulated could reduce the cravings for drugs and alcohol well there are lots of scientists who say we don't need to hypothesize that drug this is that drug now I want to say this

is highly contested of all the things I write about in the book this is the chapter where the scientists most disagree or where the picture is most still to come into view but there's a few things we know um we know that lots of people taking oen piic are anecdotally reporting that it seems to have reduced or eliminated their other addictions so for example I interviewed a mental health nurse in Canada called Tracy who she' had a bad breakup and she'd just become obsessed with online shopping in a really unhealthy way she was buying huge

amounts of clothes she'd never wear books she'd never read she started taking a zpic and that impulse went away lots of people are describing reductions in smoking um and actually drug addiction right so we know that anecdotally we know in animal studies there are staggering effects on this so for example I interviewed a woman called Professor Elizabeth yog who's at the University of gothenberg in Sweden so what they do what she did at her and her team they get rats and they get them to drink a lot of alcohol it say that rats really like

getting [ __ ] up on booze they wobble around in the cage you give it to them for week after week after week until it basically the rat cage starts to look like a dive bar in North Vegas and then you inject them with a gp1 Agonist stide and they drink much less and interestingly the heaviest drinkers are the ones who cut back the most but then they thought some scientists said well that could be that um alcohol has a caloric component so maybe it's just that they they want the calories less so other teams

have been researching who I also interviewed people like um Professor Patricia grigson at Penn State University she then experimented with giving getting rats to heavily use heroin and Fentanyl and again you give them a stide they have a really significant fall in their use of that um Professor Greg Stan who I mentioned before um did the same thing with giving mice cocaine I don't know why I find the idea of mice on coke really funny but I do uh but you get mice to use cocaine a lot give them stide big reduction in their use

50% reduction so the most casual cocaine use with exactly I always pitch like Al paccino in Scarface as a mouse but um but so what this the most optimistic scenario and I want to stress this is speculative is that actually this is not a drug that is about weight loss it's a drug that boosts self-regulation across the board that's the dream scenario right now what we know about the human trials on addiction are much smaller and they're a bit of a mixed bag we know they do reduce smoking but only if you combine them with

a uh nicotine patch we know they do reduce alcohol use but only if you had an alcohol problem there's a load of studies now going on we'll know much more in the next few years but um there are optimistic scenarios around these drugs that we should talk about cautiously but we should talk about which is that these drugs do significantly reduce addiction now again they're not dealing with the underlying drivers of addiction we've done a whole podcast on that you and me rich people can look at about my previous book Chasing the screen which was

all about addiction and the addiction in my family and addiction policies all over the world and you could say we don't need a drug for that we know what reduces addiction Portugal decriminalized all drugs and took all the money they used to spend on [ __ ] people up arresting them shaming them punishing them and spent it all on turning their lives around housing job creation therapy love and support lo and behold their addiction massively fell right so you could say we don't need a drug we've got a social solution we can deal with these

underlying factors it's maddening to me in my work in Vegas I'm seeing quite a lot of the time because the case I'm working on is I'm writing about relates partly to homelessness I'm seeing a lot of people who are dying who would live if they were in Portugal right so we don't need to wait for a miracle drug we got addiction policies that work we could choose them in this country if we wanted to um we could deal with the massive fental crisis that we're facing which is killing so many people who should get to

live um nonetheless that shouldn't preclude us being excited about this drug potentially although with a lot of caution so I got bit Ry there yeah I want to turn to a finer point of addiction um and you referenced you know you've you've written extensively on this we've talked about it in the past and you're no stranger to the idea that um the substance or the behavior really isn't the problem that's the solution to the problem the underlying driver of addiction the emotional disease left untreated will persist and find creative ways to express itself so I

want you to imagine a perfect world Johan in which OIC is completely safe you're able to regulate your food intake and all the heroin addicts in the world can take it and suddenly they have zero craving for drugs and alcohol it solves addiction it solves alcoholism everybody is able to suddenly and miraculously self-regulate without any downside right is this not just another way of putting blinders on that is a vehicle for continuing to separate ourselves from ourselves like I'm someone who subscribes to the idea that we're here to grow and we're here to evolve and

the obstacles that are thrown in our path are are meant to be faced with curiosity and um and as an opportunity to like learn something about yourself and evolve right so if you're dealing with food issues if you're dealing with substance issues or other behavioral issues or you have a childhood trauma like when you behave in a certain way that is not in your best interest that is your moment to kind of dive in and try to understand what's triggering that behavior and that is the opportunity to grow and evolve and if we just have

Pharma to throw up a shade to tell you everything's fine we never take advantage of that opportunity to look Inward and evolve and grow and we will live out the rest of our lives uh with these you know unresolved emotional dilemmas or triggers or Stories We Tell ourselves about who we are that are going to impulse our behavior and our decision- making and our thoughts and every interaction that we have and they will persist in being unaddressed because we've muted the most uh deleterious kind of indicia of those right they'll find other ways to manifest

I'm sure um but from a macro like 10,000 foot view like is this what Humanity actually needs or is it separating us from our inherent Divinity so I think there's a huge amount of wisdom in your question I want to just think through some of the things you said so with the caveat that I don't think that scenario will happen but just to understands me that it was as miraculous as you described but let's imagine for a thought experiment that it was right so the reason why I I I suspect you're right but I want

to just give a bit of friction so let's imagine the scenario for example that it just solved the problem of addiction right that you could give it to people who are taking heroin or fenil and they would never take heroin or fenil again there's a beat in your argument that I don't think would then happen so I do not think that if we could do that if we could just switch off the addictive behavior they would then experience emotional muting I think what would happen is the underlying problem that they were trying to deal with

through heroin and in escapable yeah would then come to the surface or it would or you would find another way to medicate yourself exactly so I don't think it would produce emotional muting I think it would produce in the best case scenario it would prod it would bring the emotions to the surface where they could be dealt with in the worst case scenario it would find other outlets so I don't think it produces I think there's a beat in there's a a beat in your argument that's totally right and there's a beat in your argument

which I don't I suspect and I'm spitballing here so I could be wrong is not quite right so the implication is that it's almost like the drug soma in Brave New World the Aldis Huxley novel from the 1920s which is basically it just sort of tranquilizes everyone I don't think taking away our dysfunctional behaviors tranquilizes us I think it it is the problem now that can be a disaster think about bariatric surgery we were talking about the benefits of bariatric surgery if you have bariatric surgery your suicide rate quadruples afterwards almost quadruples right seems really

weird why would that be it's still quite a low risk most people are glad they had it but I suspect what's happening is be in mind if you had Patric surgery you were severely obese you can't tranquilize yourself with food anymore probably um for some of them you've told yourself all your life if only I was thin my life would be great and then you're thinner and your husband's still an [ __ ] and you've still got a job you hate so all sorts of emotional things are surfaced there so I don't think it would

switch I think the underlying premise of what you're saying is one that actually is the and we've talked about this before and I know we agree on this is at the absolute core of my book lost connections which was about depression which is you need your pain you need your nausea right those are not malfunctions they are signals they are telling us something we we need to listen to and honor those signals because in fact it is through listening those signals to the signals that you understand yourself and grow and if we could somehow surgically

amputate them like with the drug soma that would leave you temporarily relieved But ultimately diminished right so perhaps you're suggesting that this might expedite that growth curve because you can no longer run and hide from those uncomfortable emotions through your favorite distraction right that they're going to percolate up and confront you um in a more acute way that is either going to break you or lead you on a path towards some version of wholeness but articulating my underlying premise you've made me doubt it you articulated it very well because I think that would happen with

some people right I think there would be some people look we know loads of people in recovery right there are some people who stop who grow in the most incredible ways I think about two of the people I most admire in the whole world who you should definitely have on your podcast um Rob banghart and Paul voto so Rob and Paul used to live in the tunnels underneath Las Vegas as people probably know there's many homeless people who live there um and Rob was known as hobo Santa he used to steal things and give them

out and he was a kind of low-level dealer for many years and um one day Rob was attacked by a rival group of drug dealers they thought he was sort of infringing on their their part of the tunnels they hit him in the head with an axe they broke his skull open they dragged him over to the train tracks and the uh train um was meant to run him over but fortunately someone saw him just before and he was rescued he spent nine months in hospital he never went back to his addiction he went into

recovery he now runs with Paul another incredible human being a charity called shine a light I really urge people to donate to them that every day they go back into the tunnels they help the people who live there they give them replies they help them get out one of the most moving and they're very close friends of mine and one of the most moving experiences in my whole life was um someone who used to live in Rob's tunnel with him a guy called picket died he ODed in the tunnel and me and Rob went there

all the picket stuff was still there and um Rob bumped into a woman he knew I'd never met her before and uh they she obviously love picket as well and they were talking about her and kind of commiserating and whenever Rob goes into the tunnels he they help people get out if they want to go to rehab but he also just brings supplies like tampons and you know water and flashlights and so on and he said to this woman oh who's in the tunnel over there I've got some supplies and she said oh you don't

want to go there and he said why and she named them and he said oh go okay and she said no don't don't and then he went and he came back and it was only a much later a few days later when I listened to the audio I said to Rob oh who why did she tell you not to go into that tunnel who was it and he said um oh those are the people who tried to kill me and I said but Rob why did you help them and he said um because they're human

beings they [ __ ] up I [ __ ] up plenty of times everyone needs help and um I think about Rob and Paul he set such a high moral bar and that growth you're absolutely right that growth that they have experienced to make them literally the most admirable people I know came from this deep pain right and you know that line that roomy the great Persian poet said the wound is where the light enters you I'm sure that was somewhere in L Cohen's heart when he wrote you know there's a crack in everything it's

how the light gets in so we absolutely do not want to take away people's pain that would be taking away their growth but I don't I think weirdly to extend this analogy probably much further than it can go I suspect that if there was this drug that could just switch off the adictive behavior for Rob it would have been like being in hospital for nine months it would have surfaced all this stuff and give him an opportunity to grow rather than just been like oh I'll just carry on exactly as I was I don't see

that he would have done that I could be wrong and I'm I'm going quite far out on a limb in imagining you're hypothetical but I think it's a very fertile one to think about yeah I think it's interesting I mean it's I think everything you said is accurate uh you know but I layer on top of it this idea that anything of value has to be earned right and the idea that there's some kind of shortcut to whatever goal that you're trying to achieve um robs you of the value of experience and it is the

value of experience that you know basically girds your you know growth trajectory and so if you're if you're receiving things that are unearned then um you're not having the life experience that's required in order to kind of grow and evolve right so that man that you just shared about like his pain drove a certain growth um trajectory for him and he had to earn that for himself and so to the extent that there are things out there that are that are kind of moving people away from the experiences that are required to earn you know

a certain level of wisdom or life experience that you know can be shared for the benefit of others and for oneself like that I think you would agree would not be the best thing I do agree with that I'm just thinking about a few things as you say it this is not what you're saying but there are some people who I think hear that and they think there's this old argument like the worse things get the better they'll get right that in a way um I'll give you an example I believe in gun control partly

because I've had someone I loved who was murdered with a gun um reasonable people can disre me I have lots of friends don't agree with me on that but if someone was shot in front of me I wouldn't say well don't call an ambulance leave them to bleed because that will prove the case for gun control their death will will add I don't believe that if things get worse it necessarily makes things better further down the line sometimes things just get worse right so I think I don't think again I know this is not what

you're saying but I don't think say to say Jeff Parker that guy in San Francisco well you should just die of your obesity and not take this drug and will prove the terrible harms that obesity causes and processed food industry causes and and then we'll use that to fight for change right I don't think you can say to people I think the fact that suffering can lead to growth or you need to face your suffering and and exactly I don't think we can say that yeah of course I understand I think I think there's such

an important Insight in what you're saying and I've said it to other people I think it can be taken too far and I think we and I don't think the boundary for saying it is easy right I think it's a very hard um but I also think there's another thing that might be playing out in how you're thinking about this just cuz you live in this culture I think it plays out for almost everyone it's an implicit thing and I think it would be less in you CU you're a very loving and non-judgmental person than

is in a lot of people but I think it's worth thinking about so when I was taking the drug at first for quite a long time I felt like I was doing something immoral yeah this was this was exactly where my head was going our intuition is telling us like if this if this is all it's cracked up to be OIC then why should we be embarrassed or guilty or ashamed and and afraid to like tell our friends that this is what we're doing right yeah exactly like there's something about it and it's loaded culturally

obviously because we you know it is considered oh you're cheating you're not doing it the right way in the same way you know uh an athlete on performance-enhancing drugs you know would be considered exactly I really wanted to prank this understand this for my book magic pill because I could feel it about myself right I could feel me criticizing myself on these grounds I think that's kind of weird because so like I mentioned before one of my best friends takes statins I've never looked at him and thought you [ __ ] cheat getting ahead of

me on cholesterol it's never like that thought has never crossed my mind I think you'd think I was kind of crazy if I thought that and I think to understand these attitudes it really helps to think about I looked a lot at history of how we think about obesity right so if you look at in the 6th Century the pope Pope Gregory the first uh formulated for the first time or put in writing for the first time the seven deadly sins right and one of them is gluttony and it's always depicted as you know a

very fat person pigging out right um it's very deep in our culture the idea that obesity is a sin and one of the ways you can see that is what the only forms of weight loss we admire are ones that follow the classic pattern of you got to go to hell you got to earn your place back and then we forgive you think about that game show the world's biggest loser right this is a very cruel example of that but you know people who haven't seen it please don't watch it it's [ __ ] vile

but it's a game show where you get very severely obese people and get them to take part in actually what are very dangerous exercise regimes people of their weight uh very extreme exercise regimes really starve themselves um and then the Biggest Loser is the winner right M we admire them it's like you were a sinner we watched you go through hell we saw your suffering you cried well because gluttony is considered a moral failure or or a character defect and you can see why that evolved over a long period of time almost all humans before

us have lived in situations of food scarcity if you were a glutton you were [ __ ] over everyone else in the group right so it's not hard to see why there make perfect sense to have a taboo around gluttony I'm not saying by the way that obese people are Glutton but you you see the point I'm making um so I think we have these very deep ideas about but there's an even deeper one which is about cheating right why did I feel like I was cheating in this environment it's very hard to not be

overweight or obese be for all the reasons we've talked about so even the people who are not overweight or obese are often making quite big sacrifices to not be obese they're going hungry they're you know doing lots of honorous things and I can well understand that they look at me and think like they I must look to them like Lance Armstrong looks to a cyclist right well I put in all this effort to get this and you you [ __ ] you just inject yourself once a week and you get it so I can see

where it comes from but the way I began to think of it is firstly I don't think we're Sinners I think that's a outdated way of thinking although I understand where it comes from we should acknowledge exists in all of us pretty much but when it comes to cheating that comes from the belief that we're in a race and I actually think we are in a race but it's not me against you against your neighbor who's on mjar or whatever the race is between the forces that are making all of us almost all of us

heavier than we should be and us right now we can deal with those forces together right but if you reframe it that way look we can turn this you're not definitely not doing this and I really appreciate this whole conversation we can turn this into a toxic argument if we want to right every [ __ ] argument we have in this culture turns toxic pretty quickly partly because it's happening through social media which is you know driven by algorithm that reward people for being angry and hateful like we talked about for my previous book stolen

Focus well this can be another argument that's toxic if we want we can tear each other down but I think if we remain stuck in these old stories about Sin about cheating about anger it blocks us from the much more sensible conversation which is the one we've been having which is what are the benefits and risks here what does this mean for our society but we can't think clearly about any of those things if we're trapped in this uh um bitter rage filled conversation which not to say there aren't things to be angry about people

who can't afford it people are angry about some of the risk they're not wrong um I I agree with them on many of the things they're angry about but we've got to have a a better conversation than that and I actually think you've kind of been modeling that in yeah I mean it's not a it's not a binary thing obviously um and I have mixed feelings about the whole thing like yes we live in an environment where all the incentives and all of the you know all of the industrial structures are driving us towards these

unhealthy choices but I recoil from the idea that we have to be victims of that that we lack agency and to the extent that the discourse around a drug like this is that we are powerless like I I don't like that aspect of it um we do have a responsibility to ourselves to honor ourselves to make better choices if the house is on fire I can understand the appropriateness of this but then it becomes incumbent upon the individual to shoulder responsibility for their own choices going forward and that's my hope for you like I I

I don't want you go to KFC occasionally because you can get away with it I want you like I said at the outset to like really honor Yourself In This Moment moment to learn better habits for yourself and to begin to master those so you can be around for a long time you know and I think you are having this opportunity um and I would like to read the chapter where you go off it even if even if you end up going back on it to have that experience and to see what happens and to

see if you can adopt healthier habits and and and make them stick yeah I'm going to think about what you the thing it's funny as you said that the thought I had in my head was what's the quote from the American Revolution you know they'll have to take the fried chicken drumstick from my cold dead hands you're going to keep you know jabbing your leg so that you can go to KFC once in a while this is the like this is what I meant by like the Blinder you know that's preventing you from the growth

that is within your grasp I think that's I think you're definitely right and I think the we don't want to make the perfect the enemy of the good if the choice is eating a KFC bucket every day and go to KFC once a week take the on a weak option but you can do better yeah no you're right you're being a good friend and you're urging me to do the right thing you're you're definitely right and it has um and I and I did do better in Jamaica and you because you were in an environment

that was more conducive to healthy choices so how can you be a better curator of the environments that um you know that you find yourself in and that's West Hollywood right now there is there's an airwan right down the street you got cash in your pocket you don't have to go to KFC see you're right right I'm going to literally go to Air1 for lunch today you've inspired me um you have an incredible Knack uh for writing books that just are of the moment like super zeitgeisty and books take a long time right but you

have this neack this uncanny like Acumen to like deliver a book that speaks to you know something that we're all thinking about or is you know just very kind of current with something that's happening in the culture and you've done it again with this book I don't know how you figure that stuff out like years in advance um I know this you know book that you're writing this crime book in in Las Vegas is taking you a minute maybe that's a different kind of book defit but true crime is definitely a thing I don't have

to tell you that so um hopefully we can expect that book soon but congrats on the book I I think it's uh really I and I appreciate that you're not bringing a binary you know kind of perspective to this that it is nuanced and you know once again you've you've put yourself in the narrative as a protagonist but in this one more so than any other in and in a more vulnerable way and I think it's I think it's cool and I think this is a conversation that we need to be having um and we

need to continue to have as we learn more oh I really enjoyed this rich thank you so much thanks van so magic pill pick it up everywhere uh should we hold up the cover way publish is tasing if we don't hold it up come on you're shame You're such Shameless Shameless promoter are you well you work like a [ __ ] on a book you want people to read it I meant to say people can get the audio book The ebook physical book they was tell me to say you can get it from all good

bookstores but the truth is you can get it from shitty bookstores as well we have like a a quality test but the the website get it from your favorite shitty bookstore exactly got seek out the worst [ __ ] dive um one next to the KFC in Las Vegas yeah actually Vegas has one of the best bookstores in the entire United States um it just up the street from uh Fremont Street why am I blanking on its name it's um yeah it's called Riders block um a completely yeah one of the best bookstores in the

US actually lots of nice little ones as well so don't diss the Vegas bookstores all right there you go all right well come back and share more about Las Vegas then when you finish this stupid book no say when you finish this book and uh you have gone off OIC and just mastered your diet I like the strict rules you're laying down all right I like it cheers cheers Rich [Music] peace that's it for today thank you for listening I truly hope you enjoyed the conversation to learn more about today's guest including links and resources

related to everything discussed today visit the episode page at Rich roll.com where you can find the entire podcast archive my books Finding Ultra voicing change in the plant power way as well as the plant power meal planner at at meals. roll.com if you'd like to support the podcast the easiest and most impactful thing you can do is to subscribe to the show on Apple podcast on Spotify and on YouTube and leave a review and or comment this show just wouldn't be possible without the help of our amazing sponsors who keep this podcast running wild and

free to check out all their amazing offers head to Rich roll.com slss sponsors and sharing the show or your favorite episode with friends or on social media is of course awesome and very helpful and finally for podcast updates special offers on books the meal planner and other subjects please subscribe to our newsletter which you can find on the footer of any page at Rich roll.com Today's show was produced and engineered by Jason ciolo the video edition of the podcast was created by Blake Curtis with assistance by our creative director Dan Drake portraits by Davey Greenberg

graphic and social media assets courtesy of Daniel siss and thank you Georgia Wy for copywriting and website management and of course our theme music was created by Tyler P Trapper Patt and Harry matys appreciate the love love the support see you back here soon peace plance namaste [Music]