993: Johann Hari | The Skinny on “Magic Pill” Weight-Loss Drugs

993: Johann Hari | The Skinny on 'Magic Pill' Weight-Loss Drugs

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[00:00:00] Johann Hari: Coming up next on the Jordan Harbinger show, he took away the American diet and left it with nothing but the healthy food again, and he was pretty sure he knew what would happen. They would eat more of the healthy food than they had before, and this would prove that that kind of diet expands the number of calories you eat in a day.

What happened was much weirder, once they'd been exposed to the American diet, they refused to eat the healthy food at all. It was like they no longer recognized it as food. It was only when they were literally starving and wasting away that they finally reluctantly went back and ate it.

[00:00:33] Jordan Harbinger: Welcome to the show. I'm Jordan Harbinger. On the Jordan Harbinger Show. We decode the stories, secrets, and skills of the world's most fascinating people and turn their wisdom into practical advice that you can use to impact your own life and those around you. Our mission is to help you become a better informed, more critical thinker through long form conversations with a variety of amazing folks, from spies to CEOs, athletes, authors, thinkers, performers, even the occasional gold smuggler, economic hitman, former jihadi, Russian chest, grand Master of music mogul, or tech luminary.

And if you're new to the show or you wanna tell your friends about the show, I suggest our episode starter packs. These are collections of our favorite episodes on persuasion and negotiation, psychology, geopolitics, disinformation and cyber warfare, AI crime, and cults and more. That'll help new listeners get a taste of everything we do here on the show.

Just visit Jordan harbinger.com/start or search for us in your Spotify app to get started. By the way, Google podcasts is closing, so if you are a user of Google Podcasts. That is gone in the United States already. It's gonna be gone globally in June. You won't be able to get skeptical Sunday or feedback Friday on YouTube.

We do not film those. They do not go into YouTube music. They do not go into YouTube. So you need to get an app like Pocket Casts or castbox or Castro if you wanna continue to get the show. And you were a Google Podcast user, and if you're a Google Podcast user and you're wondering why you don't see Skeptical Sunday or feedback Friday, that's why now that Google's gone, they forward you to a YouTube feed, which only shows videos and audio from our videos.

Very weird. So go ahead and grab a different podcast app for Android or for Apple castbox podcasts, Castro, if you want to continue to get the whole show today. Johann Hari is back on the show. Y'all love his earlier episode on social media addiction, episode 7 0 7, by the way, today, talking about obesity and obesity, drugs, specifically ozempic and what it does to the brain and the body.

Like many of us, Johann ate tons of junk as a teen, even took antidepressants, fluctuated between. 30 and 40 inch waist, which I mean that's just absolutely hard to imagine. Actually later, he finds out about this secret weapon called ozempic. We're gonna tell that story here today. It's a so-called Safe anti-obesity drug.

It's compared to the smartphone in terms of changing things around food and weight. This is the holy grail in some ways, right? Especially for Fat America and the United Kingdom. There's a $200 billion market for this. The company is now the most valuable company in Europe, almost overnight. Today we dive into why Johann started with Ozempic after several wake up calls about his weight and health Vet did not wake him up.

We'll also explore how processed foods hijack our brains and cause us to overeat. We'll dig into the psychology of obesity and why it's not just about the calories and last, how we might be setting ourselves up for yet another health crisis. Who should and who should not be using Ozempic and a whole lot more.

So here we go with Johan Hari Bon Appetit.

I have to say, it's funny, I wasn't gonna start the interview off this way, but now I feel like it's just natural. You look good, man. I mean, you look like you lost a little bit of weight, which is very apropos what we're gonna talk about right now. It's

[00:03:42] Johann Hari: creepily apt, I think is the right phrase. Thanks. So

[00:03:45] Jordan Harbinger: it's been working for you.

We'll, I guess we'll get to that in a bit. I wanna back up though. I re I really related to your story at the beginning of the book, which is you go to a party, right? Post pandemic, and you're like, oh. I'm the fat guy at the party and I myself got quite fat. During the pandemic I had, you know, we had kids and I was just like ordering DoorDash every day, which, are you familiar with that?

I know you live in the uk. Of

[00:04:09] Johann Hari: course. My god. It's responsible for at least three of my chins. Yeah.

[00:04:12] Jordan Harbinger: Okay. Yeah, same here. So I got quite chubs. Your fried chicken story, you know, go into the fried chicken place and they send you like this nice note like, thanks to our best customer. And you're like, geez, this isn't even my top fried chicken place.

Like that sunk in for me. That hit for me. 'cause I got a message from DoorDash, it was like an email or something and it was like, since you signed up with Dash Pass, which is like their premium saver thing, you've saved $4,000. And I was like, not spend $4,000. Wow. Saved $4,000. Well done. Like you're a true American.

I mean that's, they should give you the presidential medal of freedom of, of something. 'cause I, I've never felt like such a, an idiot in my whole life. My wife and I were like, let's not do the math on what we had to spend to save $4,000 in DoorDash fees. And that was the impetus for me hiring a personal trainer.

And it's been three to five days a week since. But then of course exercise doesn't make you thin. And we can talk about that later too. But that, I just wanted to say that landed for me hard. 'cause I was like. I get being the guy at the party who's like, why is everyone skinny? I thought we all agreed to get fat during the pandemic.

What the hell?

[00:05:19] Johann Hari: It's so weird. This book has been a bit different to my other books for me, in that the minute I learned about the existence of these drugs, I felt really conflicted. And it comes from that moment at this party, right? So I remember it so vividly. It was the winter of 2022. It was the first party I'd been invited to and God knows how long.

'cause the world had not been having parties, right? And I was in an Uber on the way there and the party was being thrown by an Oscar winning actor. I'm not saying that just to name drop. It is very relevant to what happened next. No, it's nice. And I was thinking in the way there, just feeling really flubby like I'd been quite fat at the start of the pandemic, and then I'd gained loads of weight and I thought, Ugh.

You know, a Hollywood party being a bit fat, always a bit embarrassing. And then suddenly I thought, oh, but wait, everyone I know gained weight, right during the pandemic. This is gonna be fascinating to see these Hollywood stars with a bit of chub on them, right? And I arrived and I started walking around.

Literally everyone was gaunt. It wasn't that they hadn't gained weight, they'd all visibly lost weight. They looked like their own Snapchat filters, you know, like clearer and cleaner and sharper. I was quite in a bit of a daze and I bumped into a friend of mine on the dance floor and I said to her, huh, looks like everyone really did take up Pilates during lockdown.

Mm-hmm. And she laughed, right? And I had no idea what she was laughing. I must have done some weird face. And she said, well, you know, this isn't Pilates right? And I had no idea what she was talking about. And she pulled up on her phone, an ozempic pen, an image of an ozempic pen. And that was when I learned we now have a new kind of weight loss drug that works in a totally new way, where if you take it, the average person loses 15% of their body weight in a year.

Wow. For the next of this class of drugs, Manjaro, you lose on average 21% of your body weight. Wow. And for the next ones that will be available next year, triple G, you lose 24% of your body weight, which is only slightly below bariatric surgery. And the minute I learned this, I immediately thought, okay, I can see the benefits.

Mm-hmm. I'm older now than my grandfather ever got to be. He died of a heart attack at the age of 44. Wow. Loads of the men in my family get fucked up with heart disease. My dad had very bad heart problems. My uncle died of a heart attack. My other uncle had a heart attack. I knew that sadly these sciences very clear that obesity makes heart disease much more likely, along with an actually shocking array of other problems that makes over 200 known diseases and complications more lightly.

So I was aware that if you've got a drug that can reverse or hugely reduce obesity, that may well massively boost health.

[00:07:33] Jordan Harbinger: Yeah.

[00:07:34] Johann Hari: I also immediately thought, wait a minute. Wait a minute. What's the catch? I've seen this story before. Right? Every 20 years or so, a new diet drug is announced. We're told it's gonna save the world, it's gonna end obesity.

Mm-hmm. And loads of people stampede to take it. And then we always discover it has some catastrophic side effect that you know, means it has to be pulled from the market, leaving a trail of devastated people. It's wake. I also thought, what about people with eating disorders? What about. The progress we've made with body positivity actually immediately had all sorts of doubts.

So to get to the bottom of this, as you allude to, for a year, I took this drug and I went on this big journey all over the world from Iceland to Minneapolis. Mm-Hmm. To Okinawa in the south of Japan. Wow. To interview the leading experts in the world on this question, the biggest critics, the biggest defenders, the scientists who made the breakthroughs that led to these drugs.

The people who've been thinking about how is it gonna affect our culture and our economy? And it's kind of weird, Jordan. It's a bit different to the previous books we talked about. I learned a huge amount about the extraordinary benefits of these drugs, about the 12 disturbing risks of these drugs, about what they're gonna do to all of us in all sorts of complicated ways.

Mm-hmm. But at the end of this journey, although I know so much more, I'm still quite conflicted. Anyone whose reaction to these drugs is, yay. They're gonna uncomplicated save us all or boo, they're the devil, I think is missing the much more complicated and interesting picture in the middle. This is complicated.

We have to really think through. The detail of what it's doing to people and, and doing to the culture in a much more nuanced way than I, I think we instinctively do when we hear about these drugs, well,

[00:09:05] Jordan Harbinger: we want black and white thinking, right? I, I talk about this all the time, is we, we want certainty where we're like, oh, okay, I read Johann Hari's book, Ozempic Bad Next.

And it's like, oh, but bad if, maybe if you're like a fit person and you need to lose five pounds and you're just gonna take it because all your friends are, but like otherwise, what's worse? Dying of a heart attack when you're age 44 because you have serious problems. Or like, something might go wrong later if, but also maybe not, you know, you stay on it for anyway.

You mentioned earlier other health drugs in the past. Other health drugs include amphetamine. Right. Fen. Which I'm not sure if that's also amphetamine, but I remember the Fen thing from like, you ever see that movie Requiem For a Dream?

[00:09:47] Johann Hari: Yeah. Literally the most depressing film ever made. Yes. If I ever kill myself, I will watch that film first

[00:09:54] Jordan Harbinger: to get me into the moon.

The, exactly. And the old lady, she's strung out on like Dexatrim, they don't mention, they don't say the name, but it's like, and I remember Dexatrim ads from, you probably do too. You're 79, I'm 1980. I remember watching TV and it's like Dexatrim and there's a skinny lady being like, I lost it. It all with Dexatrim and then you look up.

I was like, whatever happened to that? And I look it up and it's like, oh, this is banned. Because it's literally just speed for housewives and it's like you can't take that, you will die.

[00:10:21] Johann Hari: It's fascinating. This looking at the history of diet drugs did not put me in a good frame of mind, particularly pic.

Although I did have some positive and negative effects on Ozempic. Um, I'm sure we're gonna get into details on that, but if you look at the history of diet drugs. It's pretty grim. So the modern history of diet drugs begins in the first World War. There was a factory in France where loads of soldiers were working with an explosive powder called drool, and someone noticed they lost a load away.

Yeah, right. So after the war, some American scientists from Stanford went and studied this, and they realized they were absorbing it through their skin and swallowing it. It was an explosive powder. It made you lose loads of weight. So they turned it into a pill called reduce salt. When you consider how incredibly low obesity was at the time, it was incredibly popular.

Yeah. A hundred thousand people were using it. Then they discovered something unfortunate, which is that if you use it, you start to go blind.

[00:11:10] Jordan Harbinger: You start to go blind. Yeah.

[00:11:11] Johann Hari: And then you go into a horrific raging fever in which as one doctor put it, your body cooks itself. Mm-Hmm. I mean it works by speeding up your metabolism.

'cause it's literally cooking you from within. Yeah. So that got yanked from the market for obvious reasons.

[00:11:24] Jordan Harbinger: Bodybuilders still use it. They still use it. It's called DNP in the bodybuilding community. And yes, it makes you go blind. You can get like a 1 0 7 fever and have to take ice baths in order to not die.

It cooks your brown fat, which like this way too in the weeds, but you need to be brown fat. It's around your organs and stuff. And if you don't have it, I can't remember exactly what it does, but it's basically like you don't get to choose which fat it cooks off. It cooks off the stuff you need to survive, and also cooks off the stuff that, you know, makes your underwear stretch out.

And that's not good.

[00:11:55] Johann Hari: Yeah. It turns out that a great advertising slogan is not Take our drug, we'll cook you internally. Right. Not the best life slogan in the world. No. And that goes on pretty much every 20 years. We go through amphetamines, we go through jaw wiring, and particularly oof, savage and hideous practice.

People don't know. Literally, dentists would, yeah, take obese people and literally wire their jaw shut so they couldn't eat, and they could only get a straw for liquids. But it turns out well, A, that's just inherently barbaric and horrific. Right? But B, if you vomit while you've got jaw wiring, you choke to death.

Oh

[00:12:24] Jordan Harbinger: God, I didn't think about that.

[00:12:25] Johann Hari: And of course, was a complete failure. The minute you unwired the person's jaw, they went back to eating and they were in fact ate more. 'cause they were really traumatized by this unbelievably humiliating experience. Then you, you mentioned Fen. So Fen Fabu, don't remember this.

In the mid nineties, Fen was talked about in almost exactly the way that Ozempic is talked about. Now, the front page of Time Magazine was the new miracle weight loss drug. The way it worked, it was a combination of two drugs. It was a combination of at Appetite Suppressant called Flex Fluorine, which had been around for a while, but made you drowsy.

So it was never that popular. And an amphetamine called Phentermine, which counteracted the drowsiness and also I see, made you wired and made you burn more calories. And it was massively popular. In 1995 in the United States alone, there were 18 million Fenden prescriptions that were written, right? Wow.

And it worked incredibly well. And then some doctors in Fargo, North Dakota, noticed that some of their patients seemed to be having trouble breathing when they took this drug. There was then an investigation. It turned out that it gave you something called primary pulmonary hypertension. Which is when the blood vessels in your lungs contract, it's absolute agony.

Ugh. It's incurable. You have to be on oxygen for the rest of your life, or you die. Oh

[00:13:34] Jordan Harbinger: my

[00:13:35] Johann Hari: God. And lots of people died. It led to the biggest payout in the history of the pharmaceutical industry. $12 billion at biggest at the time. So obviously, looking at all this, I'm thinking, okay, is Ozempic gonna turn out to be like Fen?

Yeah. And I don't think it will, but there's many reasons to be worried. But you alluded to right at the start, I think before we talk about the risk, Jordan. I think it's really important because actually I'm not generally on a one hand, on the other hand kind of guys, you know? Yeah. But in this case, I think the truth is genuinely complicated.

And there are, I agree, are good arguments on both sides.

[00:14:06] Jordan Harbinger: I just, I wanted to highlight the idea that like, these drugs always end up terrible and I'm not a woowoo guy. I'm like a very sciencey guy, which is why I love your work, but I'm always like, okay, something's gotta give, you know, yin and yang or whatever way you wanna look at it.

There's no such thing as a free lunch. My dad likes to say, and he thinks that sounds deep, but like it's kind

[00:14:24] Johann Hari: of true. Well, you should bear in mind on Know Zen Pick. It would be a smaller free lunch. It would be

[00:14:27] Jordan Harbinger: a, A lunch you just stared at and didn't eat. Yeah,

[00:14:29] Johann Hari: exactly. It'd be a tiny free lunch composed mainly of dust.

So let's think about the benefits first, right? Because they're really important. Sure. If you wanna think about the benefits, one of the places I would start is actually by looking at a parallel area of science. So people have only been taking these drugs for obesity for a couple of years now. Yeah.

They've taking diabetes for much longer 18 years. So up to now it's been very hard, not impossible, but very hard to lose loads weight and keep it off over the long term. Yeah. Some people can do it just through calorie restriction. We all know people like that, but it's surprisingly rare. So the best comparison point for the effects of these drugs, I think is actually bariatric surgery.

Things like stomach stapling, gastric bands, that kind of thing. So if we look at that surgery, what do we know? A few important things. Firstly, it's a horrible operation. It's extremely grueling. One in a thousand people dies during the surgery. It's no joke. Oh, I didn't

[00:15:20] Jordan Harbinger: know that.

[00:15:21] Johann Hari: But people do it for a very good reason, which is that if you massively reverse your obesity or reduce it, or reverse it completely, the benefits for your health are staggering.

So if you have bariatric surgery in the seven years that follow, you are 56% less likely to die of a heart attack. You are 60% less likely to die of cancer. You are 92% less likely to die of diabetes related causes. In fact, it's so good for your health. Mm-Hmm? That you are 40% less likely to die at all of any cause, right?

In the seven years that follow. There's a lot we know about that and we can now see that these drugs are having a similar effect. So if you take Ozempic for example, for two years and you started with A BMI, higher than 27, your chances of having a heart attack or stroke go down by 20%. Wow. That's huge.

That's huge. That's huge. Huge reduction. And bear in mind, people with BMI 27 were only slightly overweight. Right? Right. It's not 30 and 35 and 40. Right. Exactly. And that was obviously a topic very close to my heart. Literally close to my heart. Yeah. 'cause of the heart disease in my family. Right. So the benefits are very clear.

And this will sound weird, but the thing I learned in all the research for the book and all the experts I interviewed and all the science I did a deep dive into will sound really weird. The thing that most surprised me is the thing I thought I'd known since I was a little boy, if you'd asked me when I was a kid, is obesity bad for your health?

Yohan? I would've said, well, yeah, right. I was amazed. By the scientific evidences about how bad for your health it is. Now that doesn't for a minute justify stigma and body shaming. Right. Which I hate and I'm strongly post, I'm sure we'll get to that. But we do have to tell the truth about the science and there's a very strong scientific consensus around this.

Think about something as simple as diabetes. Right. Okay. I've noticed I was a kid. If you are ob, more likely toge type two diabetes, but I think, I thought I did think until quite embarrassingly recently, okay, it's not good to be diabetic and if you are obese when you're 18, you have a 70% chance of becoming diabetic.

But provider, you've got health insurance and you get insulin. Mm-Hmm. You're fine. You're basically like everyone else. A diabetic plus insulin is basically me or you, I thought, right? Mm-Hmm. For interviewing doctors who treat diabetics, I mean, that is not the case at all. Really. Even when you get treatment, diabetes knocks 15 years off your life on it.

Oh, I didn't know that. It's the biggest cause of preventable blindness in the United States. Wow. More people in the US have to have a limb or extremity amputated. In the US 'cause they've got diabetes then because they got shot. And you will have noticed a lot of us get shot. Yeah,

[00:17:54] Jordan Harbinger: I was gonna say that's a lot of people.

[00:17:56] Johann Hari: It's That's a lot of people, right? Yeah. In fact, the effects of diabetes alone are so severe that one of the leading doctors in Britain, one of the best known doctors in Britain, Dr. Max Pemberton, who treats diabetics, said to me, if you gave me a choice between becoming HIV positive or becoming diabetic, I would choose to become HIV positive.

Really? Because if you're HIV positive and you get treatment, you live as long as everyone else. That is not true of diabetes, right? It radically shortens your life and it makes it much more likely, you'll have a horrific final few years, or you are blind or have dementia or lose whole parts of your body.

And that's just one of the causes of obesity. Nevermind cancer, dementia, heart disease, stroke, huh? So when we're thinking about the benefits and risks of these drugs, you have to think about it in this context. For me, I tried dieting many times. I'd lost weight, and I always regained more than I had at the start.

For me, the dilemma was. What are the risks of continuing to be obese versus what are the risks of these drugs right now? Different people come into the possibility of taking these drugs with different levels of risk. Right. You mentioned before, you know skinny people, right? People at that party that I went to, none of them were fat at the start, right?

They're not taking the drug to go down from obesity to a healthy weight. They're taking the drug to go down from actually being skinny already to being super skinny. Sharon Osborne has talked about this and I mean, look at her. She looks very unwell. I'm very concerned for her. So they're taking on all the risks for none of the health benefits.

Obviously, they believe they're aesthetic benefits that I'm particularly non-judgmental about the women in this situation. 'cause women are made to feel like shit about their bodies, whatever they do. Right,

[00:19:30] Jordan Harbinger: exactly.

[00:19:30] Johann Hari: Making that choice in an environment that they didn't choose, where there are intolerable pressures on them.

So I get that. I'm not being judgy or finger wagging towards them 'cause I think that would be foolish and cruel. But there's one set of risks around people who are skinny. Actually, they're endangering their own health because one of the 12 risks of these drugs is when you lose weight. Using any method, you usually lose muscle mass.

And muscle mass is the total amount of soft tissue in your body. Yeah. It's essential for like movement, you know, climbing the stairs, getting out of a chair or whatever. And as you age depressingly starting when you're 30 years old, oh man, you begin to lose muscle mass every year. You lose about 8% a year from the age of 30 where we're well on the downward curve.

Yeah, man. And

[00:20:10] Jordan Harbinger: not fun.

[00:20:11] Johann Hari: Not fun. If you're going into the aging process with already depleted muscle mass, you put yourself much more at risk of having dangerously low muscle mass as you age, which causes a condition called sarcopenia. It means poverty of the flesh in Greek, it's basically where you just don't have enough muscle mass.

You can't climb the stairs, you can't get out of a chair. You are much more limited in what you can do. So there's a risk that particularly the people who take it to be super skinny will get some aesthetic benefit now. We could be setting in train a time bomb of people 30, 40, 50 years from now, right? Who are gonna be much more frail and unwell as they age and much more likely to fall.

[00:20:48] Jordan Harbinger: They're gonna have that 90-year-old body at age 65 or something because they exactly cut their lean mass down. And it's very hard to build that. I mean, I know from working out with a train, it's very hard to build that back up. And it's literally not possible if you're not getting enough calories. Like my trainer's, like, you need to eat more.

You are not eating enough. And I'm like, well, but wait, I wanna lose. And he's like, you can either gain muscle or lose weight. You can't do really both things at the same time. That's why bodybuilders do bulking and cutting cycles. And it's a whole thing. And this isn't just for bodybuilders, this is like for people who want to be in decent shape.

You can't be a gaunt Kate Moss body type and then also hit the gym and build muscle. It just doesn't really work that way.

[00:21:27] Johann Hari: Yeah. You can't be Timothy with Shaima and Al sch number. Right, right, right. You gotta, you gotta choose. Yes. And, and you're right, what you're saying actually connects to another one of the 12 wrist related to these drugs, which is one of the more common ones.

Malnutrition. Mm-Hmm. And I really got a sense of how easy that is when I started taking them. I will never forget the second day that I was on Ozempic, I was lying in bed and I woke up. I thought, oh, I feel something really weird. What is it? And I couldn't locate in my body what it was that felt weird.

And it took me literally five minutes to realize I woke up and I'm not hungry.

[00:21:59] Jordan Harbinger: Right, right. Wow.

[00:22:00] Johann Hari: Every day of my life before that, I would wake up with like a raging hunger. Often what got me outta bed was being hungry and wanting food. And I thought, oh, this is weird. Up the road, there's a diner.

[00:22:09] Jordan Harbinger: Mm-Hmm.

[00:22:09] Johann Hari: That I used to go to every morning run by lovely Brazilian woman called Tatiana. And I, I went in and I ordered the thing I would order every morning, which was a huge brown bread roll with loads of chicken and lo of mayo. I'm not proud. And she brought it over and I had like less than a quarter of it, and I was full.

I thought, huh, this is weird. And I left. Actually, Tatiana called after me saying, are you okay when I left? Because we're like, what? Why did he left? He's never done this before.

[00:22:33] Jordan Harbinger: Normally this is gone before I check on you. But now you're leaving. Yeah,

[00:22:37] Johann Hari: exactly. It is like, and um, and then for lunch that day I went to, there's a Turkish restaurant near where I lived next to my office where I went in, I ordered the same lunch.

I always order, uh, Mediterranean lamb. It wasn't, oh yeah. Again, I had like two mouthfuls, three mouthfuls. I was full. This is really weird. So what these drugs do is they make you feel much fuller, much faster. Right. To an extraordinary degree. That's why I went from eating about 3,200 calories. So a typical day to about 1,800 is why I've lost 42 pounds.

Right. Wow. In a little bit more than a year. But there's a lot of good things about that, obviously. But one of the risks of that is malnutrition, particularly people taking high doses. For example, a close relative of mine is taking these drugs and literally was like wasting away, like her kid said to remind her.

Hey, you gotta eat.

[00:23:24] Jordan Harbinger: Oh man.

[00:23:25] Johann Hari: There's a risk of malnutrition from not eating enough. Right. And chronically undereating, there's very serious, I think with this, it's why actually some doctors are now prescribing alongside the drugs a diet plan. Not the entire typical diet plan to cut down, but a diet plan to make sure you eat enough, right?

[00:23:40] Jordan Harbinger: Yeah. So for someone like me who lost, I lost 40 pounds of fat, it took 10 months. Wow. I was weighing my food, but I was like getting one gram of protein per pound, a body weight ish for those 10 months. And it, it, it was not like injecting something. I mean, this is like protein shake in the morning, decent lunch, and then a packet of Turkey breast with some mustard for dinner every day, give or take for 10 months.

My wife was like, I can't believe you have the discipline to do that. And I was like, I can't believe I have the discipline to do that. But it's just one of those things I set my mind to. But 10 months of that is something that most people. Even when I look back now, I'm like, I don't think I could do that again.

That was kind of miserable and it took forever. The idea that there's a drug that can get you there faster, and I was not obese and I kinda wanna talk about what that means. 26% of the people in the UK are obese. 42% in the US are obese. What is the difference between overweight and obese? I, I know there's a difference, but I cannot remember for the life of me what it is.

[00:24:40] Johann Hari: Oh, it's very simple. BMI, which is dividing your height by your weight. Mm-Hmm. If your BMI is between 25 and 30, you are overweight. If your BMI is over 30, you're obese. Okay. It's a very simple measure, but I'm just thinking about what you're saying Jordan. It's so interesting, right. That difficulty you would have now to exercise that willpower.

Right. And it's fascinating. Willpower is a very real phenomenon. We've all exercised willpower at some point. Sure. Right. Over something. When people sort of deny it exists in relation to weight, I'm always like, no, you're being too simplistic. Equally, the people who think it's the only thing going on I think are being too simplistic.

Mm-Hmm. It's worth thinking about what is the factor that's undermining our willpower? 'cause it actually leads us for a long time I thought I was looking at two different questions. Why did people gain so much weight so quickly and how do these drugs work? Yeah. Actually, it turns out the answer lies in the same word.

That word is satiety, which is the feeling of having had enough and not wanting anymore. I'll come back to that word in a minute, but just start with the explosion in obesity in our lifetime. So I think we're, yeah, you are a year younger than me, right? Mm-Hmm.

[00:25:36] Jordan Harbinger: I'm probably younger than you by like you are 79.

I'm early eighties, so like we're probably within, right? We're year apart. Six to 10 months over a year. Yeah.

[00:25:42] Johann Hari: Yeah,

[00:25:43] Jordan Harbinger: yeah, yeah.

[00:25:43] Johann Hari: Between the year we were born and the year we turned 21, obesity doubled in the United States. Wow. And then in the next 20 years, severe obesity doubled again. If you wanna get a sense of this, everyone listening, just pause the podcast for a second and Google photographs of beaches in the United States in 1979 and just look at them.

Right? You look at them and it seems really weird to us. Everyone is what we would call Slim or Jack. Yeah. Everyone right? You like you look at it and go. This must have been like a skinny person convention that day. What's going on? And then you look at the population figures. That is what people look like in the United States in the year we were born, not a million years ago.

Not before the Civil War, right? Literally when we were born. So what happened? Right? What happened is the evidence is pretty clear about what happened. Obesity explodes everywhere. That makes one change. It's not where people lose willpower. It's not where people become greedy. It's where people move mostly from eating fresh whole foods that were prepared on the day to eating mostly processed or ultra processed foods that were built out of chemicals in factories.

In a process that actually isn't even called cooking, it's called manufacturing food. Oof. So we have 300,000 years where humans ate mostly whole foods and obesity was exceptionally rare. And then in our lifetimes, there's this dramatic swing to 78% of the calories the average American child consumes in a day and now processed or ultra process food.

That leads to this extraordinary explosion of obesity. And if you wanna understand why, it's kind of simple. I mean, there's many things going on, but the core of it, Mm-Hmm. Is that this new kind of food, which has never existed before, undermines our ability to ever feel full and know we've had enough. And there's loads of evidence for this I go through in the book, but there's an experiment that to me, really nails it.

Right? Oh yeah.

[00:27:27] Jordan Harbinger: Cheesecake Rats, baby. You tell me about Cheesecake Rats. You know, you want it. These, this is gross. Like legit made me kind of like have a bubbly stomach when I, when I read it.

[00:27:38] Johann Hari: Exactly. I'm gonna promote your weight loss by reminding you of this experiment every fucking day. So there's a scientist who's the head of neuroscience at Mount Sinai University called Professor Paul Kenny.

Brilliant guy. Yeah. He grew up in Dublin, in Ireland, and in the nineties he moved to San Diego, I think to do his PhD at Continuous Scientific Research. And he quickly realized, wow, Americans don't eat like Irish people did at the time. Right? There was a lot more processed food, a lot more sugary and fatty food.

Like many a good immigrant, he quickly assimilated and within a year he gained like 30 pounds. And he is like, why? What's going on here? And he started to feel like this food he was consuming wasn't just changing his gut, it was changing his brain. It was changing his whole relationship with food. So he designed an experiment to test this, which I have nicknamed Cheesecake Park.

It's very simple. He built a cage and he raised rats in it. And all they had to eat was the kind of natural, healthy food that rats had evolved to eat over thousands of years. And it turned out when they had that food, the rats would eat when they were hungry and stop when they were full. Okay? They never overate.

They never became overweight or obese given that food. They had a kind of natural nutritional wisdom that stopped them over eating. Okay. Then Professor Kenny introduced them to the American diet. He fried up some bacon, he bought some Snickers bars, and crucially, he bought some cheesecake. Yeah. And he put it in the cage alongside the option of the healthy food, and the rats went crazy.

For the American diet, they would literally hurl themselves into the cheesecake and eat their way out just completely slick with cheesecake. They ate and ate and ate and ate and that natural nutritional wisdom they'd had with the old kind of food. Yeah. Completely disappeared. As Professor Kenny put it to me, within a couple of days, they were different animals and very rapidly, they were all obese.

Then Professor Kenny tweaked the experiment in a way that, to me, as a former KFC addict seems a little bit cruel. Mm-Hmm. He took away the American diet Yeah. And left them with nothing but the healthy food again, and he was pretty sure he knew what would happen. They would eat more of the healthy food than they had before, and this would prove that that kind of diet expands the number of calories you eat in a day.

Okay. That is not what happened. What happened was much weirder, once they've been exposed to the American diet, they refuse to eat the healthy food at all. It was like they no longer recognized it as food. Hmm. It was only when they were literally starving and wasting away that they finally reluctantly went back and ate it.

Oh man. Now there's something very similar happening to all of us as Professor Gerald Mann at Harvard who designed the food label that's on all food that's sold in the US said to me, we know there's something about the food. We're eating this undermining our abilities. Feel full. So this word satiety, this food has robbed us of our satiety.

Mm-Hmm. Kept coming up. And then I kept hearing that word come up again when we talk about these drugs. Because what these drugs do is they give you back your sense of satiety. Dr. Daniel Drucker, who made the key breakthrough, one of the key breakthroughs in discovering GLP one, which at the heart of how Ozempic works Sure.

We talk about that, said to me, what they give you back is your satiety hormones. Mm-Hmm. They give you back that feeling of being thought. I realized. I don't think I'd ever felt full in my life. Oh God. Until I took Ozempic. Right? Yeah. Not really full. Not like I'd had times when I'd had too much and couldn't bear to read anymore 'cause I'd vomit.

But that's different to feeling sated, right? You get sated in other things in life. You get sated in, well, sex, for example. The times when you have sex and it's really good and then it's over in your life. Even if like the hottest person in the world came into the room, he would be like, I'm really sorry, I, I'm stated now, you know?

Yeah. What's

[00:31:06] Jordan Harbinger: on Netflix? Yeah, exactly.

[00:31:08] Johann Hari: He is like, sorry Keanu. Well actually to be funny just in case Keanu reach listens to your podcast. I wanna be clear. Keanu, I would find a way. Yeah. But um, but yeah, you know that Feelingly, right? Yeah. But the, so when I start to see it that way, there's a brilliant professor in Philly, um, professor Michael Lowe, who said to me, what you realize is these drugs are an artificial solution to an artificial problem.

[00:31:29] Jordan Harbinger: Yeah.

[00:31:30] Johann Hari: Processed food dug a whole insatiable hunger in all of us. And the drugs fill in the hole, but in their own risky, complicated way.

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Click join now and use code Jordan to redeem a free week of coworking when you take a tour. If you're wondering how I managed to book all these authors, thinkers and creators every single week, actually, you're probably not wondering that. I'm just trying to awkwardly transition into pumping my free course, six Minute Networking.

It is free over@sixminutenetworking.com. I don't need your credit card information or any of that crap when you sign up. I'm basically just teaching you relationship building skills. And the course does that in a super easy, non cringey, very non schmoozy, down to earth way. So there's no awkward strategies, there's no cheesy tactics.

It's just practical exercises that'll make you a better connector, a better colleague, a better friend, and a better peer. And six minutes a day is all it takes. Really easy stuff. The course is very, very short and easy to apply, and many of the guests on the show subscribe and contribute to the course. So come on and join us.

You'll be in Smart Company Where you belong. The course is again free. There's no nonsense and I don't secretly trick you into anything weird. You can find it@sixminutenetworking.com. Alright, back to Johann Hari. So we don't get full from junk food. And I kind of looked up a little, a few of the reasons why.

First of all, the way they make it is horrifying. I'll talk about it in the show close, but we don't get full. There's junk food, almost has virtually no fiber. It's a really good blend of fat and protein. That's why when you eat one sort of like barbecue chip, you're like, I need a thousand more of these because it's just like a flavor profile.

I need a

[00:35:12] Johann Hari: thousand. Yeah. What kind of pussy are you? Jesus.

[00:35:14] Jordan Harbinger: Whatever's left in the bag is going down and you have to, I'm like, I'll go to my wife. I'm like, take these away from me. And she's like, good. And then she's eating 'em and I'm like, that wasn't the solution we were looking for. And also liquids. I was at the mall yesterday with my kids, taking 'em to some fun thing and I was thirsty.

So I went to the vending machine and they had Coke, mountain Dew, diet Coke. There was nothing like. There was nothing that wasn't just a soft drink in there that had a thousand calories in whatever, two liter bottle or, you know, 20 ounce bottle. I can't tell. And there's artificial sweeteners in some of 'em, and there's shaky science about whether that's bad for you.

I, I don't really wanna go down that thing, but basically the junk food hijacks, whatever navigation system our body has evolved around food. And I, I think you say it in the book pretty well, you say the same system that used to tell us to eat fruit now just tells us to eat fruit loops.

[00:36:02] Johann Hari: That's exactly right.

What you realize then it brings us right back to what you were saying about willpower. What the sign shows when it comes to the causes of obesity is there's three kinds of, cause there's biological causes, your genes can make you more sensitive to it as you become obese. Changes happen in your brain that make it harder to go back.

[00:36:20] Jordan Harbinger: Mm-Hmm.

[00:36:21] Johann Hari: There's psychological causes, things like comfort, eating, trauma, all sorts of things can make us comfort ourselves with eating. Then there's social causes, like the food supply system, right? So the fancy term for this is the bio-psychosocial model. Biological causes, psychological causes, social causes, and they're all real.

And when you think about it in that context, you begin to see where willpower comes in. Willpower is one little sliver of the psychological component to this, right? So it's real. And the way I started to think about willpower is it's like in this environment, willpower is like an umbrella in a bad storm.

Mm-hmm. Some people, you hand them the umbrella, they're gonna be able to get to the other side of the street and stay dry and all credit to them. Good luck. If you can do it with willpower, if you can do it with calorie restriction and exercise, do it that way because there's very low risks to that compared to the options we're talking about.

Yeah. But for most people in this environment, the storm is so bad that it's gonna break that umbrella. Right? So that to me is how we need to think about willpower.

[00:37:20] Jordan Harbinger: I agree. I I wanted to say this early in the show and just sort of, we got sidetracked. I wanna caveat this 'cause I've gotten in some trouble on this show for so-called fat shaming.

So I always wanna be careful in episodes where we talk about this kind of thing. I don't think I've ever actually done that, but pretty much anything you say about weight at all can trigger some people. And look, I'm less worried about the chronically offended as I am about the chronically overweight who've tried everything else.

For me, like I said earlier, losing weight was a matter of getting educated about nutrition, willpower, to stick to a healthy diet, which is not easy. And not everybody has the same. Problem because not everybody has the same genetics. Not everyone can afford to build a gym in their backyard during a pandemic.

And so it's a position of, of immense privilege. And I'm also privileged to speak to my audience about this, and I wanna make sure that we do that. And we are doing this, I think, in a way that is caring and understanding and results in people learning and feeling empowered by this and not feeling lectured by us coming away feeling ashamed or hopeless.

And I, I know you're on the same page, but I, I wanna plant that flag. Sure. 'cause you know, you hate to get a letter from somebody that's like, I feel like crap after listening to your episode about this. And you're just like, oh, could that have been avoided?

[00:38:28] Johann Hari: And this is something I've thought about really deeply from my book, Merick Pill, because, you know, the worst moment for me in the whole writing of the book was, it was a while into working on the book and obviously taking the drug.

I was FaceTiming with my niece Sarah. Mm-Hmm. She's actually 19 now, but in my head she's fixed as a 6-year-old. Right. She's the baby in my family. Yeah. She's the youngest. She's the only girl. So no one makes me more protective than her. Whatever. She has a boyfriend. I always wanna go get away from her.

You're pedophile. But then I realized she was like an adult woman now. Yeah. Um, although I refused to accept that. So we were FaceTiming and she was kind of, you know, teasing me. She goes, oh, you look great. I never knew you had a neck before. I never knew you had a jaw. Oh. And I was kind of laughing and preening.

And then she looked down and she said, will you buy me some ozempic? Oh no. And she's a totally healthy weight, and I thought she was kidding. I laughed and then suddenly I realized she meant it. And I was like,

[00:39:16] Jordan Harbinger: yeah,

[00:39:17] Johann Hari: have I undercut every message I've ever given her? I said I wanted to think a lot about stigma in the messages we send.

And one of the people who most helped me to think about this was an amazing woman called Shelly Bovie, who basically introduced body positivity to Britain, or as it would've been called then, fat pride. So when we were kids, right. Again, not a million years ago. Fat people only ever appeared on television as the butt of a joke.

Yes. Particularly fat women. But fat men too, right? You think about like John Candy, it was presented as inherently hilarious. That there were fat people in the world and they were bullied and treated appallingly in Yes. Every representation you saw of them, the first person I ever saw on television challenging that was Shelly.

So I just tell a bit about her story. I tracked her down to interview her about this 'cause she's such a wise person. A story when I was 10 years old on tv, unlike the equivalent to it's fact to say the equivalent to Oprah. But there is no equivalent to Oprah. But like, uh, I kind of, uh, trashier lower rent, uh, equivalent Oprah.

Much trashier. 'cause Oprah's not trashier or she's divine, but, so Shelly grew up in a working class town in Britain called Port Talbot. Like Scranton would probably be the American equivalent. Something like that. Okay. A tough working class town. Had the biggest steel works in Britain at the time. She describes herself, the only fat girl in the school.

And one day when she was 11, her teacher said to her, Bovie, stay behind after class. I wanna talk to you. So she's sitting there thinking, what have I done wrong? She waits. A teacher says to her, you are much too fat. It's disgusting. Go see the school nurse. She'll sort you out. So completely thrown. Shelly walks over to the school nurse, she said, the school nurse says, why are you here?

She says, the teacher says, I'm too fat. The nurse said, take off your clothes. I'll inspect you. And she starts pinching her and said, this is disgusting. Oh my God, you should be ashamed of yourself, and just berates her and tells her to stop being a pig as she put it. So Shelly leaves completely shaken and she basically spends her whole life soaking up, being treated like that, that the other girls are just constantly saying, thank God I'm not as fat as you.

And as she gets older, it's just everywhere. When she got pregnant, she went to the doctor. The first thing the doctor said was, well, you shouldn't be pregnant when you're as fat as you are. Oh, that's

[00:41:19] Jordan Harbinger: terrible.

[00:41:20] Johann Hari: She had a very difficult birth, and as she was lying there covered in blood, the midwife said to her, you know, you should really lose some weight when her baby wouldn't attach properly.

He wasn't feeding properly. She went to the doctor. To get some help. And the doctor said, well, what are you trying to do? Make the baby as fat as you are. This is insane. But this is constant. 42% of women with A BMI higher than 35 get insulted every single day. Right? Every day. So Shelly just completely internalized this.

At first she told me she'd never even looked at her own body in the shower naked 'cause she was so disgusted. She thought it was so wrong. And then one day she learned that in the United States there was this movement, which at the time called itself at pride and stood to some people still do that.

Basically said, this is just from bigotry. Yeah. This is just a form of cruelty. We don't have to take being treated like this and fought back. And so she introduced this to Britain. This is why when I was 10 years old, or I see her on this, uh, imitation of Oprah and she's treated like a mad woman in the audience.

Laugh at her. But nonetheless, her book was very successful. And a kind of modest body positivity movement is born in Britain. And Shelley, when I went to see her, she's 76 now, is incredibly proud of everything she did and stands by every word she said about stigma. But something else happened to Shelley next.

She was very severely overweight. She was. Not even 50. And she was losing the ability to walk 'cause of her weight.

[00:42:32] Jordan Harbinger: Oh my.

[00:42:33] Johann Hari: And she went to her doctor. She was in a wheelchair a lot of the time, and she went to a doctor and the doctor said that he was worried about her heart. And he said, look, I'm really sorry to tell you this, but this is all connected to your weight.

And Shelly felt this incredible dilemma because she absolutely believed every word she says about stigma. She's never doubted that that was true, nor should she. Mm-Hmm. But she could also see the scientific evidence was clear that carrying the level of excess weight she did in her body was physically harming her, and Indeed was gonna kill her, probably.

And she was really struggling to reconcile these things. At the time, there was a body positivity newsletter called Fat News in Britain, and she wanted to write for it about this dilemma. And they said, no, no, that's not what we want. We talk about the positive things about being fat. And she's like, I get that, but we are much more likely to develop these problems.

We do need to level about that. And they were kind, no, no, no. That's not what we want. Mm-Hmm. Now Shelly lost a huge amount of weight by calorie restriction. She went to a kind of equivalent to Weight Watchers. Now she's the first person to acknowledge that's extremely difficult. Only about 10% of people succeed at it.

But she said to me, I know that that weight loss saved my life. I wouldn't be alive at the age of 78 if that hadn't happened. My heart problems went away when I lost weight. Right? She said, we can't say we have a body positivity movement that isn't concerned at some level about keeping your body alive, right?

So she said, we keep presenting it as if it's either or. Either you're a poster stigma or you are in favor of, if possible, reducing obesity for people. She said, why is that the choice? Mm-Hmm. It can be both. And if you love someone who's obese, and I would guess every single person listening is either obese or loves someone who's obese.

What you want for them is to protect them from two things. You wanna protect them from bullying and cruelty, which is what stigma is. And you wanna protect them from the health harms of obesity, which are things like diabetes, cancer, heart disease, dementia, your knees and hips being destroyed, like just across the board.

It's a form of love to be against both. Now, of course, you could be in favor of weight loss in a cruel, concerned, trolling, vicious way, and we need to strongly oppose that. Or you can be in favor of weight loss where possible through love and compassion. Now, some people, and I stress it, is a minority within the body positivity movement, and I also wanna stress out, understand where they're coming from and have a lot of sympathy for them.

Mm-Hmm. But some people have, I would argue overcorrected, everything they say about stigma is right. But some of them also argue that pointing out the scientific evidence about the harms caused by obesity, of which there is no scientific debate, is one of the most proven facts in science. That pointing out those facts is itself a form of stigma, and that I'm afraid is not right.

[00:45:08] Jordan Harbinger: I agree. Something that hit for me when I was reading your book was the idea that if you've spent your whole life hearing abuse, being shamed, nearly everything coming in looks like abuse and shame. Even if it's a doctor telling you in a nice way. That you are going to suffer from these consequences.

This is very likely why I had some women in my inbox after a recent feedback Friday episode. Those are our advice segments. They came at us really hatefully and the advice we'd given, I went back and listened to it repeatedly. 'cause I was like, what did we do wrong? The advice we'd given was there was a person working in a doctor's office and her colleagues who were doctors were complaining about how they needed to lose weight because their blood work was bad and they didn't fit into their clothes and they felt like crap.

And this person was able to lose weight. And we gave her advice on gently approaching her colleagues and friends on who were complaining about this, on how to lose weight if they wanted, because she had done it successfully and get advice from her on how to do so. And my co-host and I, we were shocked at how people viewed this as fat shaming.

It was, it was almost delusional and we couldn't believe it when they told us what they were reacting to. And I found it really sad because these people, like, I couldn't get there mentally without crazy gymnastics. These people must view nearly every discussion around health or weight. Fat shaming, which has to be exhausting.

At first I was annoyed, but now I just feel bad because that is not going to help them lose weight and live longer.

[00:46:29] Johann Hari: I think we really need to understand where it comes from. Yes. There's an analogy that really helped me to think about this, right? As you know, obviously I'm gay. Maybe that's not obvious, or maybe I just sound British, but I mean, in fact, gay, I think

[00:46:37] Jordan Harbinger: the Keanu thing was our first hint.

[00:46:39] Johann Hari: Oh yeah. That gave in away, well, come on. You're telling me you turned down Keanu. Let's let, let's be real here. Uh, but you know, if you think about the AIDS crisis, right? Mm-Hmm. When the AIDS crisis started, doctors warn, look, it's a scientific fact that this is gonna affect gay men much more than other people because of the nature of anal sex.

Right? Interesting. And that's why there were moves in San Francisco to shut down the bath houses, to shut down points of transmission that were spreading the, the virus, right? And loads of gay men totally understandably said. Fuck you. My whole life I've been told there's something wrong with being gay.

Mm-Hmm. We're disordered. We're disgusting. And here you are. These other authority people telling us we're disgusting and we can't have sex. I've seen this story. You will carry on going to our saunas. Right. You're not gonna shut them down. Right. And I understand what was happening. They had been shamed and bullied all their lives and it meant they couldn't hear this well meant medical advice, actually.

Essential medical advice as anything other than more homophobia. And as a result, a lot of them died. Yeah. Now that's not their fault. Right. In their position. I might well have been the same. 'cause I see where it came from and I think it's something very similar happening with what you're describing.

And I think precisely because we want a body positivity movement to continue and survive. Even if we reverse the obesity crisis back to where it was when we were born, when it wasn't a crisis. If we go back to looking like those beaches in. 1979, there's still natural variety in body shapes and every, we want everyone to feel good in their body.

And so even if we solve this crisis, you'd still need a body positivity movement. But I think a lot about a guy I interviewed called Jeff Parker, super nice guy. He is a retired lighting technician in San Francisco. He's 60, 70, must be 68 now, and he was very severely obese and it was painful for him to walk anywhere.

Mm-Hmm. He had gout. He had liver and kidney problems and heart problems. Every morning he had to swallow fistfuls of pills. His doctor was very worried about him, and then his friend Mel, gave him some majaro, which is one of these drugs, and he lost an enormous amount of weight. He was taken off almost all his pills.

His gout went away. Now he walks his dog over the Golden Gate Bridge every day and said, I'm gonna enjoy my retirement now. Now, not everyone who takes a drug is gonna have the experience of Jeff and we'll, sure. We'll talk about some of the risks, but it's pretty soon every single person in the United States is gonna know someone like Jeff.

Right. If they don't already. Mm-Hmm. Someone whose health dramatically improved because they lost loads of weight because of these drugs. It was never scientifically plausible to claim that obesity doesn't harm health. Mm-Hmm. Pretty soon it's not gonna be emotionally plausible because everyone's gonna be like, Hey, what happened to Jeff?

What happened to Bob? Hey Susie, what do you mean you don't take these pills anymore and your heart problems gone away and your diabetes has been reversed? What do you mean? How did that happen? Right. Mm-Hmm. We absolutely desperately Indian movement against stigma. If that movement implies that the scientific evidence about the harms caused by obesity is itself performing stigma.

You know, as Shelly said to me, Shelly Bey, the woman I was talking about, said to me, we have to live in reality. It doesn't serve anyone to not live in reality.

[00:49:34] Clip: Yeah.

[00:49:34] Johann Hari: The only person who pays the price for that in the end is you. Right? We all know, we've all had moments in our lives where we wanna not hear bad news.

You don't open the bill, you can't pay, you don't answer the call from your doctor that you're afraid to hear, but we all know that in the end, if you don't listen to bad news and adjust for it. Who pays the price for that? But you,

[00:49:52] Jordan Harbinger: I couldn't agree more. It, this, in addition to the stigma, is one reason why I kind of waffle on using words like overweight or obese, right?

Because I know you've got an opinion on this, which I also share. You can use euphemisms, but like is that short-term relief at the expense of long-term honesty that could save someone's life?

[00:50:11] Johann Hari: Well, the truth is there's a physical reality, right? The World Health Organization, which is the biggest medical body in the world, defines overweight and obesity very simply as carrying excess weight that poses a threat to health.

Mm-Hmm. That's a real phenomenon.

[00:50:24] Jordan Harbinger: Yeah.

[00:50:25] Johann Hari: We may wanna change the words for it. I'm open-minded about that. But what we can't do is change the fact that there is an underlying physical reality there carrying excess weight, poses of harm to health. Now, not for everyone, not in every case. My mother smokes 70 cigarettes a day.

She's alive and well at the age of 78, but she's a statistical outlier, right? So some people come back and go, well, I'm, I weigh this and I'm alive and well. Unfortunately, again, the evidence is really clear on this. So for example, there was a big study here in London of government bureaucrats that track their health over many years.

[00:50:54] Jordan Harbinger: Mm-Hmm.

[00:50:55] Johann Hari: And what it found is at the start when they were young, the obese people and the other weight people had pretty similar health outcomes. By 20, 30 years on the obese, people were eight times more likely to become unwell than the people who were not obese. So there are ways of particularly talking about this prior to these weight loss drugs, a lot of people would kind of go, well, I can't change it anyway, so, right.

Why are you even telling me this? It's just upsetting me. Now we have this new tool. I mean, we did have tools before, but this is a much easier tool than the tools we had before. Although it does carry these 12 big risks, I think we need to have a loving and compassionate conversation. And when I think about the people I love who are obese, it's that I want to desperately wanna protect them both from bullying and from illness.

I. And I believe we can do both.

[00:51:39] Jordan Harbinger: I think you're right. I think in going back to what you'd said about our food system, yeah. I'm paraphrasing from your book. We built a food system that poisons us and then to keep us away from the consequences, we inject ourselves with a different drug that makes us not want to eat.

And I, I think the key question is, do we wanna live in a world where we don't solve the underlying problem, but we just drug ourselves to get rid of the symptoms? Now, on the other hand, for some folks, this is the best solution for the situation at hand, as you kind of talked about towards the top of the show.

And if somebody has cancer, we don't say, Hey, we need to get pollution outta the atmosphere. I'm so sorry. You got lung cancer. We pump them full of radiation and chemo to kill the cancer and keep them alive. So I'm not anti ozempic at all. I'm really not. It's just in part, I gotta admit, man, part of me is also biased and I'm trying to resist it.

Like there's a part of my brain that says, I worked out and I dieted to lose weight and drugs are cheating. And I know that that's bullshit and that's unfair, but it's somehow that's in the back of my head. I'm wondering what you think about that because surely I'm not the only person who has that bias.

[00:52:44] Johann Hari: I felt it about myself really for months and months when I was taking the drugs. I kept feeling like I was doing something really wrong. Mm-Hmm. I could think, why is that? Like one of my best friends takes statins first. Cholesterol. I've never once looked at him and gone, yeah. Fucker cheating to get better cholesterol than me never crossed my mind.

Of course, I would regard you as literally mad if you said that, right? Yeah. And yet these drugs bring out, remind me to come back to what you were saying before about dealing with the symptoms and what the causes, because that's a really important point as well. But in terms of cheating, I think one thing that's really interesting here is these drugs are bringing to the surface lots of deep underlying ideas that have been kind of semi-conscious for a lot of us.

Mm-Hmm. Some of those things are like actually the things that drive why we eat things like comfort eating, which was a very hard transition for me. But think about what you just said about cheating, right? And appreciate your, your honesty about it. And I felt it too. If you look at the history of ideas about obesity, if you go back to, for example, in the sixth century, the Pope, Pope Gregory, the first invented the seven Deadly Sins.

Right? People know this partly 'cause of the film Seven, though it turns out, uh, Kevin Spacey was a bigger risk than the, uh, seriality in that one. But the um, yeah. Puppy doesn't see me for that. The, you think about the seven deadly sins, one of them is gluttony, right? And it's always depicted with someone who's overweight eating in some grotesque way, right?

And if you think about how we think about weight loss, the only kind of weight loss we really like and admire is one that follows the old Catholic model of sin. You're a sinner. You have to go through hell. Mm-Hmm. And then we'll forgive you, right? Yeah.

[00:54:14] Jordan Harbinger: Yeah. So

[00:54:14] Johann Hari: think about that. Show The World's Biggest Loser, right?

A disgusting game show where they get very severely overweight people and make 'em actually do things that are very dangerous for their help. Sure. Like, you know, starve themselves and take part in very extreme forms of exercise to compete to be the biggest loser. Right? That's the classic model, right?

Yeah. We'll forgive you for being fat. If you've tortured yourself right. The more agonizing a diet is, the more extreme the exercise program, the more likely we are to go. Fair enough. Bob paid his price. Right. We don't quite articulate it that way. Or you think about another way, which is cheating. Lots of people in our culture, particularly women, because of the pressures they're put on them, are making massive sacrifices every day to be thin or thinner.

Right. They're denying themselves food. They're going hungry, they're uncomfortable, and I can well understand to them. I must look like Lance Armstrong looks to a cyclist. Sure. It's like what? I put in all this effort, I do all this work. I deprive myself and you, you fucker, you just inject yourself once a week in the leg and you get to look the same way I do.

I can well understand it, but I think we need to unpick these ideas. Firstly, I think we can move beyond the idea of sin. We, we should be able to think a little bit better than a, a sixth century pope by now. Mm-Hmm. But when it comes to cheating, I actually think we are in a race. We are competing. But it's not me competing against my neighbor.

It's all of us competing against the forces that have made us obese, processed and ultra processed foods. And I went to countries where they dealt with that problem. Japan, for example, 42.5% of Americans are obese, 4% of Japanese people are obese. Right. Wow. And it's mind blowing when you go there and see how they did it.

I'm sure we'll come back to that. It's kind of weird that we expect Japanese people to look like sumo wrestlers. 'cause that's basically like expecting an American to look like a bald eagle. Yeah. But the like, it's very rare. So you're totally right. And, and this actually comes back to the other thing I wanted to pick up on, which is when you were saying as well about, this was one of my biggest concerns about taking these drugs.

I went to my closest friend, I think it was maybe three months into doing it. I was researching a lot of the stuff about y obesity had rhythm at first. And I said to her, I've gotta stop taking these drugs. I'm being a complete hypocrite here. I write all these books about how we need to deal with these deep, underlying social causes of problems and not deal with the symptoms.

And here I am with a problem that's got profound environmental causes. And here I am jabbing myself to deal with the symptoms and congratulating myself on how good I look. Right? Right. And so this is a friend of mine who eight years ago she got very bad breast cancer. She nearly died and she's a single mom.

So you can imagine how horrendous it was. And I was with her all through the chemo and the double mastectomy and the hysterectomy and and all those things. And she said to me, Johan, when I got breast cancer, we could have said something really fucked up is happening in our environment that's causing breast cancer.

One in seven British women get breast cancer, one in eight American women. Mm-Hmm. That didn't happen in the recent past in our parents' generation, not happening in Japan where one in 38 women get breast cancer. Something is going on that's causing breast cancer. Right. So you could have said to me, well

[00:57:06] Jordan Harbinger: yeah,

[00:57:07] Johann Hari: you've already got this problem caused by the environment.

Don't inject yourself with all these poisons, but no, you said, let's make sure you live to fight another day. Then we can think about the environmental cause. And she gave me this really great analogy. She said, imagine if your house is on fire. You could make a very good argument to say. We should change the building code so houses get built out of less flammable materials.

You could make a very strong argument to go apartment blocks, make sure they've got sprinklers. If your house is on fire, that's no fucking ty. Call the fire brigade and douse the house in water. Right? In the same way she's like, yes, this is an a hugely environmentally driven problem. We've gotta deal with that.

But how does it help for you to just sacrifice yourself on that? You know, I'm strongly in favor of gun control. Many reasonable people I love disagree with me, but I'm strongly in favor of gun control part. 'cause I've known so many people who were murdered with guns. Mm-Hmm. In the us. But if someone gets shot in front of me, I don't stand over them going, well, we must show close the gun show loophole and we must get background checks for everyone who goes in to buy a gun.

Mm-Hmm. I say, call a ambulance. Right. Right. There's no contradiction between dealing with the symptom and dealing with the deeper causes. Especially if failing to deal with the symptom for you will mean that you die and you can't deal with environmental causes if you die. So another guy really underscored that for me was Jeff Parker.

That guy I was talking about in San Francisco, who, when I said to him, but don't you think we should be dealing with the environmental causes? He said to me, a hundred percent, sign me up. I'll join that fight. But let's be honest, I'll be dead by the time we solve that problem. Yeah, I wanna live right. And I found that very hard to rebut.

There's many legitimate reasons to reject these drugs and be concerned about these drugs, but I don't think that's the right one.

[00:58:43] Jordan Harbinger: Don't need to starve yourself. In fact, take an extra helping of the fine products and services that support this show. We'll be right back. This episode is sponsored in part by StoryWorth Man.

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These solutions we have to come to terms with what eating does for us, right? The underlying issue needs addressing and it, it goes to your earlier point about the ozempic just addressing the symptoms of the eating. And I found it interesting you mentioned how often people substitute the eating for something else like booze or even exercise.

And we see this with bariatric surgery patients going and finding something that's not food like I don't know if they start smoking, but some of them start drinking. I'm sure some start smoking and some start going to the gym four times a day. And I know somebody who used to be overweight and eat a bunch and they lost a bunch of weight and now they go to the gym literally four ti, they work out, I should say four times per day.

That is not normal. And I asked him, do you think you just substituted one addiction for another? And he goes, oh yeah, a hundred percent. It's just that this one's less likely to kill me because I'm doing a lot of yoga and a lot of weightlifting. And I'm just like, gosh. But four times, I mean, if you do anything four times a day.

That takes an hour. That's a part-time job, man. I actually found it quite, here's a whole separate show I wanna do. You mentioned that sometimes being overweight is psychologically comforting and there's a connection between sexual abuse and weight gain. Can you speak to that a little bit? I, I literally wanna do like a whole episode on that because I just found that endlessly fascinating.

[01:02:48] Johann Hari: Yeah. I'm gonna tell you a little bit about my own experience in relation to this. Not the abuse component, but something else. And then talk about the abuse thing. The evidence about abuse. This was probably for me personally, other than that moment with my niece, the hardest element of taking the drugs and it really became clear to me.

I had an epiphany about it. I was in Vegas, as you know, I'm writing a book about a series of crimes that had been happening in Vegas, and I was researching the murder of someone I knew and loved. So obviously it's a very painful thing to do. Really on autopilot. I went to this KFC I've been to a thousand times.

It's on West Sahara for people in Vegas. It's the Iest KFC in Vegas. Mm-Hmm. Which is saying something. Yeah, it is. Um, and we're good at skeezy fast food places in Vegas and I went in and I ordered what I would've ordered a year before I ordered a bucket of fried chicken. And I sat down and I had a chicken drumstick.

And I remember very, almost hearing it as a voice in my head looking at this chicken and thinking, I can't eat this. Mm-Hmm. I'm just gonna have to feel bad.

[01:03:41] Jordan Harbinger: Yeah.

[01:03:42] Johann Hari: And one of the fascinating things about these drugs is because they so radically interrupt your eating patterns. For many people, not everyone, they bring to the surface the underlying drivers of your eating all along.

So I go through five drivers of eating in the book, but you've gone to one that I found really difficult. So I interviewed a man called Dr. Vincent Felli. He's a doctor. He was in San Diego in 1981, obviously long before I met him. And he was approached by Kaiser Permanente, one of the big, not-for-profit medical providers in California.

Mm-Hmm. And they said, look, we've got a problem. OB Sydney's blowing up. In fact, it was laughably low by our standards, but it was blowing up. And we give people diet advice and it doesn't work. And we even give people personal trainers, it doesn't work. What can we do? Can we give you a load of money to just do blue skies research and figure out what the hell's going on?

He said, sure.

[01:04:28] Jordan Harbinger: Yeah.

[01:04:28] Johann Hari: So he started working with 200 severely obese people, people who weighed more than 300 pounds, and he thought, well, what can I do with them? And he had an idea that sounds, and in fact it is quite dumb, he said, what would happen if really obese people literally stopped eating and we gave them like vitamin shots so they didn't get scurvy or whatever.

Would they burn through the fat supplies in their body and get down to a healthy weight? Mm-Hmm. So with an absolute ton of medical supervision, they did it. And incredibly, at first it worked. There's a woman who I'm gonna call Susan, not her real name, who went down from being more than 400 pounds to 132 pounds, like a staggering level of weight loss.

Wow. And Dr. Felli, you know, she's saying, Tim, you've saved my life. Family ring up and saying, you've saved her life, mind blowing. And one day something happened that no one expected. Susan Crack, she went to KFC, or actually I think that's me projecting, I don't think it was K Ffc, but somewhere it starts hugely overeating and quite quickly went back to a, you know, dangerous way.

Not where she'd been, but a dangerous way. And Dr. Felli said when he called her in Susan, what happened? And she looked down, she said, I don't know, I dunno. She was obviously really ashamed. He said, well, Susan, tell me about the day you cracked. Did anything in particular happen that day? It turned out something had happened that day that had never happened to Susan before she was in a bar and a man hit on her.

Not in a nasty way, in a nice way. Mm-hmm. And she got completely freaked out and went and started eating. This is when Dr. Felli asked her something he'd never thought to ask his patients before. He said, Susan, when did you start to gain your weight? In her case it was when she was 11. He said, well, did anything happen when you were 11?

That didn't happen when you were nine or 14. Anything in particular happen that year? And Susan looked down and she said, well, that's when my grandfather started raping me. Mm-Hmm. Dr. Felli interviewed everyone in the program and he discovered that 60% of the women. Had made their extreme weight gain in the aftermath of being sexually abused or assaulted.

And at first he was like, what? What is this about? Mm-Hmm. And Susan explained it to him really well. She said, overweight is overlooked and that's what I need to be gaining. Weight has a sexually protective function. Of course it can still happen, but you are significantly less likely to be raped if you are very overweight.

Roxanne Gay, a brilliant writer, has written about, she was getting raped when she was 11 by a group of boys and very consciously thought, that must never happen to me again. I'm gonna eat as much as I can to be as fat as I can to ward off male attention. When we think about obesity, one of the things we have to think about is the psychologically positive functions of obesity.

That's one of them. There are other ones. It can lower people's expectations of you 'cause of stigma, which can be something that a lot of people need, right? There's all sorts of things that can happen. And it can also mean that when people take the drugs. They suddenly feel incredibly frightened and vulnerable.

Mm-Hmm. And they dunno why. And of course, I mean, there's many reasons why, and it can be related to the other psychological factors as well, but that's one of them. It's why, um, a lot of people have heard this phrase by now, but Dr. Robert Ander, who worked on that research with Dr. Flii, it's, he said, when we see people who appear to be doing something dysfunctional, massively abre, injecting drug users, whatever it might be, we need to stop asking what's wrong with you and start asking what happened to you?

Mm-Hmm.

[01:07:37] Jordan Harbinger: I think that that is, well, one, like I said, endlessly fascinating. And two, this is the real part of the real epidemic. Right. It's 'cause look, that's 60% figure. Is enormous and what fills in the other 40% because there's probably other trauma that fills in at least some of that that is not sexually abusive in nature.

It could be bullying, it could be literally anything else, and fighting those underlying causes seems to be the key here. I do wanna, I know we're running outta time. I wanna talk a little bit about the potential, not just side effects of these drugs. I mean, there's ozempic face and ozempic, but where you sort of empty out of fat and then you need fillers to correct it, which is, you know, those are, I.

Cosmetic side effects, but what about things like cancers or, first of all, don't our bodies resist change as well? Aren't there, isn't there a hormonal component? I know you mentioned when you're dieting, and I had this as well, you just, you see food and you're like, I really want to eat that right now.

Like you're just focused on it because you're, you're hungry in some ways and metabolism changes. We evolved to hold onto fat, right? We evolved to thrive in lean times and we're not gonna change that there. There's no amount of therapy that can change that. This is our evolution. Correct.

[01:08:56] Johann Hari: I think there's some truth in what you are saying.

One of the weird things about these drugs is we don't actually know how they work. We know a few things. It's very disconcerting to interview the leading scientists and realize this. So we know a few things for sure. If you ate something now, Jordan, no matter what it is, after a while, your pancreas would produce a hormone called GLP one, and that's part of your body's natural signals.

Just saying, Hey, Jordan, you've had enough. Stop eating. It's the breaks, basically. But that natural GLP one only stays in your system for a couple of minutes, then it's washed away. What these drugs do is they inject you with an artificial copy of GLP one that instead of sticking around for a few minutes, stays around for a whole week.

It's why when I went to the cafe up the road, a few mouthfuls, and I'm full, right? 'cause I'm so close to full already because of this GLP one already being in my system. Initially it was thought, well, okay, GLP one is a hormone that's made in the gut. The effects of this drug are mostly in the gut. It might be it's slowing down, gastric emptying, something like that.

There are definitely effects on the gut. Everyone agrees on that. But we also know that you don't just have GLP one receptors in your gut. You've got them in your brain, and it's increasingly clear that these drugs work primarily on your brain. It's very disconcerting. We don't know how.

[01:10:06] Jordan Harbinger: Yeah,

[01:10:07] Johann Hari: but we know that if you give these drugs to a rat, for example, and then you cut open its brain, which obviously we're not allowed to do with humans, you see that the drug goes everywhere in the brain, right?

And the kind of effects we're seeing are clearly brain effects. And you know, Dr. Clements Blue, a, who's a brilliant obesity specialist at Cambridge University, said to me, you know, the brain is the most complex object in the whole universe. We shouldn't be surprised. We don't understand everything about it.

But if you think about, there's several different theories about what's happening in the brain, and one of them relates to what you just asked. So talking about how we resist change, we try to hold higher levels of weight, right? So if you gained three stone, now I'm terrible at pounds, sorry, I'm barbaric.

Colonials. Don't use the measurements that we

[01:10:44] Jordan Harbinger: use. Yeah. Uh, stone. I like that though.

[01:10:45] Johann Hari: Uh, 41, if you gained 41 pounds now or whatever anyway, and then you tried to lose weight, you would find it hard to go back, right? Because your brain tries to hold onto the excess fat. It slows your metabolism down, it makes you crave more sugary and salty foods and sweet foods.

It makes you more lethargic. So it's harder to exercise. There's all sorts of changes that happen for which there's a lot of scientific evidence. Some scientists argue, and I stress this as a speculative theory. What this drug does is it undoes that effect. It undoes that resistance to change that in a way, and this is, I'm putting this more crudely than the scientists would, that it's a bit like resetting your iPhone to the factory settings, right?

Mm-Hmm. It just lowers that, that effect that you get after you gain weight that makes it so hard to come back. That's one potential way of thinking about it. There are other theories we don't really know, but it also makes me think about what you're saying. You know, my book is called Magic Pill. 'cause there's three ways these drugs could be magic, right?

The first way is the most obvious. They could just solve the problem, right? Mm-Hmm. And I've gotta tell you, Jordan, there are days when it feels like that. My whole life I have overeating food, and now once a week I inject myself in the leg, boom. I don't eat anything like as much of it. It feels like magic.

The second way is much more disturbing. It could be a magic trick. It could be like a conjure who shows you a card trick while picking your pocket, right? It could be that the 12 risks that I go through in the book are these drugs undo the good or outweigh the good. Mm-Hmm. Right. The third way in which it could be magic is actually the one I think is the most likely.

If you think about the classic stories of magic that we grew up with, think about like, uh, what be good example, Aladdin, right? You find the lamp, you rub it, you get the genie, you make the wish, and your wish comes true, but never quite in the way you expected,

[01:12:27] Jordan Harbinger: right? Right.

[01:12:28] Johann Hari: It starts to unfold in some complicated, weird way that you could never have foreseen at the start.

Well, think about Fantasia. You unleash the magic and it starts to run away from you. We're already at that point, 47% of Americans wanna take these drugs, 47%. Wow. It's transforming the economy in all sorts of crazy ways. Barclays Bank commissioned a very sober minded financial analyst to look into the, the science of these drugs, to do a report to guide their future investment decisions.

And she came back and said, if you want a comparison for how big these drugs are gonna be, you've gotta look at the invention of the smartphone.

[01:13:02] Clip: Wow.

[01:13:02] Johann Hari: Right. And I think she's right. My prediction, my best prediction would be. Eight years from now when Ozempic goes out, assuming we don't discover some horrific side effects and I do not rule that out.

[01:13:12] Jordan Harbinger: Mm-Hmm.

[01:13:13] Johann Hari: Assuming we're not in a fend scenario, I would anticipate, so Ozempic goes out patent in 2032, at which point you'll be able to manufacture them as pills for $40 a month. I would guess half the population of the United States will be taking them. Mm-Hmm. Roughly. I mean, that's gonna transform the economy.

Look already what's happening, Krispy Kreme stock are down head Nestle. He's publicly himself about the future of the ice cream market. That's

[01:13:36] Jordan Harbinger: crazy.

[01:13:37] Johann Hari: Jewelers in LA have a, have had a huge run on refi wedding rings because people's fingers have shrunk so much in LA that their wedding bands no longer fit them.

Right. Wow. There was just a big report for the American Airlines that said prepare to spend much less money on jet fuel. Pretty soon we're gonna have a much thinner population. Right. And it obviously costs more money to fly people who are larger. Wow.

[01:13:57] Jordan Harbinger: I'm sure they're gonna pass those savings down to us.

Right? That's how that works, I'm sure. Yeah.

[01:14:01] Johann Hari: Yeah. That's the nature of capitalism

[01:14:03] Jordan Harbinger: always, man, that's crazy. By the time you're manufacturing fewer knee and hip replacements and saving millions of dollars on airline fuel and Nestle's like, oh crap, how are we gonna sell all this stuff that makes people sick like you?

I mean, it's really, you kind of want to be team ozempic at that point, right? You're, you're like, oh, good. What? But again, we're not solving the underlying problem, which is always what freaks me out.

[01:14:25] Johann Hari: We're not so the underlying problem, and there are risks. Now, of course, we can do both. We can treat the problem in the same way that I call an ambulance for my friend who's been shot and I fight for gun control.

We can take the drugs and deal with the underlying factors that causing it. Indeed, one of the things I hope is that it wakes us up. We go, how the, did we get into the situation where we're forced to choose? Yeah. Particularly for our children between a risky medical condition and a risky drug. And it's worth just unpacking a little bit more, some of the risks.

I'll give you an example. When you talk about the safety of these drugs, what most of the experts say, and they're making a good and important point, is we actually know quite a lot about these drugs in the medium term because diabetics have been taking them for 18 years now, and I'm putting it more crudely than they would.

But basically if the drugs gave you horns, the diabetics would've grown horns by now. Mm-hmm. Right.

[01:15:11] Jordan Harbinger: Yeah.

[01:15:12] Johann Hari: And that's a good and important point, and it should give people some sense of security. But some equally reputable and brilliant scientists said, well, hang on a minute, if we're gonna base a key plank of our belief in the safety of these drugs on the diabetics, let's dig a little bit deeper into the diabetics.

So for example, there's a brilliant scientist called Professor Jean who's at the University Hospital in Montpelier, in in France. He was commissioned by the French Medicines Agency to look into the safety of these drugs for the French market. So he looked at what's called the preclinical evidence, the animal trials, and he was immediately struck by one thing.

If you give these drugs to rats, they're much more likely to get thyroid cancer. And we have GLP one receptors in our thyroid in addition to our brain and our gut. So it kind of makes sense that there's at least a plausible mechanism there. If you've screwing with GLP one, you might be screwing with the thyroid.

Sure. So he started to look at, could this be happening with humans? So he looked at, they have very good medical databases in France, 'cause they don't have HIPAA rules like we do. So you have to be on the database. And he looked at a really large group of diabetics. I think there were people who were taking the drug between 2006 and 2012, if I remember right.

And he compared them to a really big group of diabetics who were not taking these drugs who are in every other way similar. And what he found, if he's right and it's highly contested, is very sobering. He calculated that these drugs increase your thyroid cancer risk by between 50 to 75%. Wow. Now, when at first you read that, and he said this to me, I was like, what the fuck?

He said, no, no. You need to understand what that doesn't mean. It doesn't mean if you take the drug you chance of getting thyroid cancer. Yeah. If that were the case, we'd be having bon Pfizer pic everywhere in the world. Right. What it means is whatever your thyroid cancer risk was at the start, it will increase if he's right by 50 to 75%.

Now, thyroid cancer is relatively rare. 1.2% of people get it. 84% of people survive. Nonetheless, that's a flashing red light for me. Mm-Hmm. Particularly when we remember that with Fen, these things start small. Right? The things that unravels Fen, where a few doctors in Fargo, you know, saying, oh, it looks like our patients can't breathe very well when they take this drug.

Right? Although, I wanna be balanced about this because I think the truth is balanced against that. Some other scientists said to me, well, even if Professor Faye is right, and it does significantly increase the thyroid cancer risk, you've gotta compare that to the cancer risk just from being obese. Cancer Research uk, one of the biggest cancer groups in the whole of Britain, and in fact in the whole of Europe, has explained if you carry excess weight, it doesn't just sit there.

It's not inert in your body. It's active. It sends signals through your body. One of those signals is for cells to divide more rapidly, which can cause cancer. This is why actually, although we don't talk about it this way, obesity is one of the biggest causes of cancer in both Britain and the United States.

So again, at every stage when you think, oh, I've got a thing to hold onto here, you realize that in this very complex calculation, what I really recommend people do is they go down the list of the 12 risks that I wrote about in the book. They go down the risks of obesity. They try to weigh these for themselves.

It's so hard to talk about this without using words like weighing as well. Unfortunate,

[01:18:15] Jordan Harbinger: yeah.

[01:18:15] Johann Hari: I think anyone is just like there's a blanket answer for everyone. Mm-Hmm. Unless your BMI is lower than 27, in which case I think there is a blanket answer, don't take them. You don't have the risks of being overweight or obese, so you're taking on all the risks of the drug for none of the benefits, none of the physical benefits.

Unless you're in that category, I think it's a fiendishly complicated decision and you should inform yourself in great detail about those risks. Also, you should inform yourself about things like what it's gonna do to you when you take it. I hope the book helps prepare people to know that and we should all be thinking about what it does to the culture.

Because you may be sitting here thinking, oh, I'm not interested in taking these drugs. But you know, in 2007 when Steve Jobson builded the iPhone, you may well not be interested in buying an iPhone. Yeah. You might still not be interested in having a smartphone, but the smartphone changed the world around you for damn sure.

And these drugs are going to change the world around us for better and for worse, for better, for people with serious obesity or just obesity for worse, with people with eating disorders and in between for everyone else. Right. So I think this, we've gotta reckon with the complexity 'cause the stakes here are so high.

Professor Gerald Mander I mentioned before, has calculated that 678,000 Americans die every year as a result of obesity or what he calls food related illnesses caused by our diets. Right. That's more than all the soldiers, American soldiers who died in the entire 20th century combined. Wow. You know, that's 10 times more almost than the number of people who died by being shot.

Every year. Almost everyone listening will not have loved someone who died of obesity. Although we don't talk about that. Your uncle dies of a heart attack at 61. Your aunt got breast cancer at 50. We don't say they died of obesity, but obesity is such a driver of those factors that they, it may well have been.

Right. So the stakes here are really high. Whether we get this right or wrong is hugely consequential, and I'm not sure I've made the right decision even for myself. Nevermind advising anyone else? Yeah, so I would say don't trust anyone who's highly confident on this. Trust the people who are talking you through the detail.

[01:20:10] Jordan Harbinger: That's right. Yeah. So yeah, go through your doctor, read this book and do the math, and don't order that crap online. Thinking like, oh, I got this. I watched a couple of YouTube videos, including this one. For God's sake. Yeah,

[01:20:21] Johann Hari: exactly. Exactly.

[01:20:22] Jordan Harbinger: Thank you so much for your candor or your transparency. Not a lot of people are gonna put something like this in their body and then as an experiment, experiment and then spend the next few years writing about it and also hit a brother with an invite.

Next time you go to one of those Hollywood parties, I got poopy diapers all day over here. Could use a little glamor.

[01:20:37] Johann Hari: All right, I'll do it.

[01:20:40] Jordan Harbinger: Are you addicted to drama? Check out this preview of the Jordan Harbinger Show with psychologist Dr. Scott Lyons.

[01:20:47] Clip: Do you vent constantly? Do you find yourself changing the stories?

Do you find that wherever you go, there's always something that's wrong or happening? Do you find yourself believing the other shoe will always drop that no matter how good things are, something bad is gonna happen? Do you find yourself crisis hopping if you're in it? You will have no idea that that's what you're doing.

And it takes a lot of time for those addicted to drama to recognize, to even be aware of the pattern is happening. Our primal needs as a kid is to be seen and heard, to feel safe, and so you will go to whatever extremes, intensely shouting is needed to pierce through the chaos of a family household to be seen and heard.

Even if it's burning down the house, a wave of an emotion, it lasts 30 to 90 seconds. Anything after that is the story we're feeding to maintain it. We're trying to keep that emotion. Active. We're feeding off the emotion as opposed to processing or metabolizing it. We're not letting it go because there's some belief system.

If we let it go, we'll be victims. If we let it go, we won't be safe. Whatever it is, why we won't let go of the emotion. Even a small trauma can feel like death because we feel helpless, and if we don't have the resilience capacity to know that someone will help us. There are tools out there to help us if we don't inherently know that it feels like we're gonna drown in that moment, it feels like death.

[01:22:19] Jordan Harbinger: Learn to recognize and heal from drama addiction On episode 8 36 with Dr. Scott Lyons on the Jordan Harbinger show. Fascinating conversation. Johann's. So funny, man. That guy was just a trip to talk to. I really like him. It's crazy. His diet was so bad as a kid. His dad was a chef, so it must have been weird that he was immersed in food culture and he's just also inhaling processed junk food.

It must have, there must have been some tension in the house. With his dad being like, I, I know. In fact, his dad was like, why are you eating this? I, I'm a chef for God's sake. And it was just like a cultural thing that they couldn't beat. Johan got a Christmas card from a fried chicken place. This was one of his wake up calls that kind of didn't wake him up.

He didn't tell the story during the show, but this was a wake up call because when he got a Christmas card from a fried chicken place, his first thought wasn't, wow, I buy too much chicken from this place. His thought was, dang, this isn't even my favorite fried chicken place. It's not even my second favorite fried chicken place.

So imagine getting a Christmas card for being the best customer of your third most visited fried chicken place. That's kind of what he was dealing with when he decided to change his habits in his ways processed foods. By the way, we're gonna do a skeptical Sunday on this. I dare y'all to Google how these are created.

It is not pretty. The worst ones are loaded with modern chemicals. Everything's a chemical. I'm talking about modern chemicals. There's glue in there, there's bacteria, of course, in all this stuff, and they create something called pink slime, which is sort of like this meat. Product D offshoot kind of deal.

And then of course, if you were to just eat that, it looks gross. It tastes gross. So what do they do? They inject flavors, but then it smells gross. Well, they inject fragrance into it, and then it looks gross. Well, then they add color to it. So that's what we are dealing with, and that's what we are eating, and that's what a lot of this stuff, especially fast food, super ultra processed stuff, that's what that stuff is, and it is, it's vile.

Not to mention all these kinds of foods. This ultra process stuff is hijacking our gut and undermining satiety as discussed in the interview, which means that it makes it hard for you to get full. Our gut biome these days, on average has 40% less diversity in there than our ancestors. What that means is there's far fewer different kinds of bacteria in our gut than our ancestors have.

That doesn't make a hell of a lot of sense, right? Why should it have less bacteria, less diversity of bacteria than our ancestors? When you can eat. Any kind of food at any time. You can get fresh fish from Hokkaido and next you can be eating sea bass from Spain. Right? We should have more diversity in our bio.

Not less, but no, we're eating too much of the same crap and it's not supporting that same variety of bacteria eating these processed foods because we're hungry. It's like trying to quench your thirst by drinking sea water. We eat it and it just makes us more hungry. I know we had a note earlier in, uh, in the show, a little sidebar about fat shaming The cold Truth is that society just hates overweight people.

I learned this when I was chubby as a kid for a little while. Uh, I got out of that phase 'cause I just didn't want to hear it anymore. And not everybody has the luxury of being able to just turn things off like that. I wasn't addicted to food. I just had some bad habits. I cut 'em out and that was the end of it.

Nobody knows this. Better than overweight people. Of course, the fact that society hates overweight people. Nobody knows this better than overweight people. Of course, look, we shame them, right? We pretend we're doing it for their own good, but often it's to protect ourselves and to make ourselves feel better.

And even parents are doing this. It's really kind of sad. I even found in research that overweight people are more likely to be convicted of a crime in court during trial by jury. That is shocking. I'm not saying to be clear, I am not saying overweight people commit more crimes. I'm saying juries view overweight people as somehow morally defective in this results in a higher conviction rate.

That is absolutely bananas. It should be no surprise. I mean, UN until recently, fat shaming was more or less acceptable in society and in many places it still is. The major problem with this is often that, well, there's a million problems with it, but one of the major, major problems is that the constant abuse that people take, it causes them to tune out.

Even if they're getting good advice, let's say from a professional, a nutritionist, a doctor, they're used to just turning their ears and their brain off when they hear about this because it's been so hurtful and traumatizing throughout their whole life. So this is, it is really don't do it. People, I've become much more sensitive about this, and I don't mean talking about it whatsoever.

I'm gonna get hate for just for doing this show, and I get in trouble for quote unquote fat shaming all the time, even when I'm not doing it. I really think it's traumatizing and I, I feel for people who are that sensitive about it because there's obviously a reason, and the reason is because these people are treated so poorly.

So don't be part of the problem people. I'm trying to be part of the solution with an episode like this, I think y'all should do the same Anyway, so stepping down from my soapbox here, I. It's not just about blood pressure or whatever. Being obese causes inflammation. It causes other diseases like cancer, autoimmune stuff.

I know it contributes to dementia, which is terrifying. It also grinds cartilage down on your knees and hips. It's hard to sleep. If you're overweight. You suffer from sleep apnea and breathing issues. It's really just bad for your body and your brain. All around. Now, Ozempic was originally a diabetes drug.

I think we noted that in the show now it's so popular, a lot of diabetics are having trouble getting it. I took an Uber a few weeks ago and the driver was talking about it on the phone and I said, Hey, I, I hope you don't mind me eavesdropping while you're on this call, but are you taking Ozempic? You look good.

And he goes, no, no, it's for my wife. And I said, oh, is she, is she enjoying the results? And he goes, what are you talking about? She's diabetic. I don't think there's really any results you would enjoy. It's just a diabetes drug. He was having trouble getting the drug and the price is way, way up. He actually had no idea that it was being used for cosmetic purposes.

And he drives Uber specifically to pay for this drug for his wife. With diabetes, he's otherwise retired. That is so sad to me that this guy had to take another job doing that to pay for a drug for his diabetic wife, because otherwise they couldn't afford it. Absolutely nuts. He was, unfortunately, the scary part is he was looking at a Chinese knockoffs from compound pharmacies because it's so much cheaper and it's quote unquote the same thing.

And now I hope my conversation warned him away from that, but I basically took the wind out of his sails 'cause he thought he was gonna retire from Uber and that, that just, the whole thing just kind of makes me sad. I'm especially fascinated in the idea that if Ozempic interferes with satiety and cravings in the brain, that this could be used for addiction.

If it's killing cravings in the brain, maybe we can kill cravings for heroin, not just Cheetos and stuff like that. But if it decreases desire for addiction, could that not also decrease people's desire for other things that include rewards raising kids, having a fulfilling career learning skills.

Anhedonia is a real thing. The absence of pleasure in life. We do not want to increase that. A lot of people turn to drugs because they have that it can affect bonding with children, raising children. Now I'm speculating, but this is very much within the realm of possibility. In the end, the conclusion that Johann came to essentially was, we wanna starve ourselves, and now we've got a drug that just makes it a hundred times easier.

I just cannot see how this doesn't end up making many of us worse off in the long run. So if you are taking this drug, more power to you, but please, please keep up with your health. Make sure your doctors have a close eye on you. Make sure your nutrition is on point. I need you to stick around for a while.

I don't want you to grow another head or whatever, unless both heads are listening to this podcast, in which case my downloads will go up. But otherwise, I don't want you to go anywhere. I want you to be healthy and happy because you are loved. Even though I don't know you, statistically you're loved.

There's a few of you I could do without, but most of you. I really enjoy your company virtually or otherwise. All things Johann Hari will be in the show notes@jordanharbinger.com that includes transcripts, advertisers deals, discount codes, and ways to support the show. All at Jordan harbinger.com/deals.

Please consider supporting those who support the show. Also, our newsletter available@jordanharbinger.com slash news. A lot of really good feedback. Now Gabriel and I are writing this. It's practical. It's an under two minute read. That's the idea. Something that'll have an immediate impact on your decisions, your psychology, your relationships.

It's a very We newsletter over at Jordan harbinger.com/news. Six minute networking. Don't forget that. Six minute networking.com. I'm at Jordan Harbinger on both Twitter and Instagram. You can also connect with me on LinkedIn. I'm doing a lot of written content on LinkedIn now about podcasting and other things I've learned from guests, so find me there.

This show is created in association with Podcast one. My team is Jen Harbinger, Jace Sanderson, Robert Fogerty, and Gabriel Mizrahi. Remember, we rise by lifting others. The fee for this show, you share it with friends when you find something useful or interesting, and the greatest compliment you can give us is to share the show with those you care about.

If you know somebody who is taking ozempic, thinking about taking Ozempic, definitely share this episode with 'em, or if they're just interested in the science and nutrition in the brain. In the meantime, I hope you apply what you hear on this show so you can live what you'll learn, and we'll see you next time.

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