Johann Hari on the Truth They Don’t Tell You about Ozempic EP 485
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Like a good neighbor, State Farm is there. Coming up next on Passion Struck. Between the year I was born and the year I turned 21, obesity doubled in the United States. And then in the next 20 years, severe obesity doubled again, right? Staggering. Has never happened in the history of the human species. What's going on there? I wanted to understand how did this happen?

And I also wanted to understand how these drugs work. Obesity rises everywhere in the world where one change happens. It's not where people develop weak willpower. It's not where people are just greedy pigs and all the other mean, cruel, stigmatizing things. It's where one change happens. Wherever people move from mostly eating fresh whole foods that they prepared that day

to mostly eating processed or ultra-processed foods. Wherever that change happens, obesity skyrockets. One of the key reasons is this new kind of food, which has never existed before, profoundly undermines our ability to know when we're full and to stop. Welcome to Passion Struck. Hi, I'm your host, John R. Miles. And on the show, we decipher the secrets, tips, and guidance of the world's most inspiring people and turn their wisdom into practical advice for

for you and those around you. Our mission is to help you unlock the power of intentionality so that you can become the best version of yourself. If you're new to the show, I offer advice and answer listener questions on Fridays. We have long form interviews the rest of the week with guests ranging from astronauts to authors, CEOs, creators, innovators, scientists, military leaders, visionaries, and athletes. Now,

Let's go out there and become passion struck. Hello, everyone, and welcome back to episode 485 of Passion Struck, consistently ranked as one of the top alternative health podcasts in the world. A heartfelt thank you to each and every one of you who return to the show every week, eager to listen, learn, and discover new ways to live better, to be better, and to make a meaningful impact in the world. If you're new to the show, thank you so much for being here, or you want to introduce this to a friend or a family member, and we love it when you do that.

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on Amazon, or wherever you purchase books. In case you missed it, earlier this week, I interviewed Dr. Tessa West, professor of psychology at New York University and author of the groundbreaking new book, Job Therapy, Finding Work That Works For You. In our interview, we explore the secrets behind job satisfaction. We learn how to identify the hidden psychological reasons behind career frustration and find out how to navigate your way to a fulfilling career. It's an episode you don't want to miss. And if you liked that previous episode or today's, we would so appreciate...

You're giving it a five-star rating and review. These reviews go such a long way in strengthening our community where we can help more people to create intentional lives. And I know we and our guests love to hear your feedback. Today, I welcome Johan Hari with us. Johan is not just a renowned author,

of three New York Times bestsellers. He's a thinker who challenges societal norms and exposes hidden truths. His work spanning from addiction and depression to attention and focus has captivated millions, including luminaries like Oprah and Arnold Schwarzenegger, and has even been adapted into an Oscar-nominated film. In this episode, Johan delves into his latest exploration, Magic Pill, the extraordinary benefits and disturbing risks of the new weight loss drugs.

After personally experiencing significant weight loss with the drug Ozepic, Johan was propelled into a year-long deep investigative journey into these new pharmaceuticals that are revolutionizing our approach to obesity and weight management. Johan shares insights from his personal experiences and extensive research revealing not only the life-changing benefits of these drugs, but also their lesser-known potentially life-threatening risks, from the dramatic economic impacts to the performance of the drug.

profound psychological effects and the urgent cultural questions they raise, Johan uncovers the complex webs of consequences tied to these drugs. Prepare to be enlightened about the science behind how these drugs work, the real reasons our society struggles with food, and what the future holds for our physical and mental health

in a world where comfort eating is no longer a comfort. Whether you're touched by these issues personally or curious about the broader implications, this is an episode you cannot afford to miss. Thank you for choosing PassionStruck and choosing me to be your host and guide on your journey to creating an intentional life. Now, let that journey begin. At Amica Insurance, we know it's more than a life policy. It's about the promise and the responsibility that comes with being a new parent.

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Earning your degree online doesn't mean you have to go about it alone. At Capella University, we're here to support you when you're ready. From enrollment counselors who get to know you and your goals, to academic coaches who can help you form a plan to stay on track. We care about your success and are dedicated to helping you pursue your goals.

Going back to school is a big step, but having support at every step of your academic journey can make a big difference. Imagine your future differently at capella.edu. I am absolutely thrilled and honored to have Johan Hari on PassionStruck. Welcome, Johan. Hey, John. Great to be with you.

I wanted to start out today because we're talking about a pretty sensitive topic today for many people. In fact, when I was thinking about doing this interview and I was talking to your publicist at first, I was really timid to do it because I know there could be a lot of pushback on this episode because what we're going to be discussing is the new weight loss tools and drugs that are out there.

And I wanted you to come on because you are a person who actively is using it still. And today we're going to be exploring everything about these drugs, the good, the bad, what people might not know, how it's benefiting people, et cetera. But we're going to be talking about your brand new book, Magic Pill, which I put up right there.

And I wanted to start out by asking you, what led you to begin using Ozempic and what was your personal experience like with it? Yeah, I shared your trepidation about writing about this. This is a subject weight that is from the moment we're born is so fraught with shame and there's so much loaded onto this topic by our culture and our society. Certainly it was for me.

The reason I spent a year doing really deep research into these drugs all over the world and taking them is because I don't remember any subject before where I ever felt quite so conflicted. I needed to resolve this conflict within myself and find out what was really going on. I remember the exact moment I learned that these drugs existed. It was the winter of 2022. It was that moment when the world was opening up again after everything we've been through. And I got invited to a party and I remember thinking,

In the Uber on the way there, feeling a bit self-conscious, this party was thrown by an Oscar-winning actor. I'm not saying that just to name drop it is relevant. And I was feeling self-conscious because I was quite overweight at the start of the pandemic and I gained a lot of weight during the pandemic. And I thought I felt a bit schlubby. And then I thought, oh, most people I know gained weight during the pandemic. So actually this party is going to be really interesting. It's going to be fascinating to see a load of these Hollywood people with a bit of extra weight on them, right? What are they going to look like?

And I arrived and it was the strangest thing. I was walking around and it's not just that the people involved had not gained weight. They were gone. They were markedly thinner than before the pandemic. And it wasn't just the actors. It was their kids, their agents, everyone. People I'd known for years were just much thinner. And I bumped into a friend of mine on the dance floor and I must have said in a bit of a daze, huh, looks like everyone really did learn take up Pilates during lockdown.

And she laughed and I must have looked puzzled. I didn't know why she was laughing. And she pulled up an Ozempic pen on her phone. And I learned that there's this new class of weight loss drugs which work in a completely new way, which cause the average person to lose 15% of their body weight. The next drugs in this class, Moonjaro makes you lose 21% of your body weight on average. Triple G, which will be available probably next year, makes people lose 24% of their body weight on average. And as soon as I learned this,

I felt profoundly conflicted. I could immediately see the benefits. I'm older now than my grandfather ever got to be because he died of a heart attack when he was 44. Loads of the men in my family get heart problems. My granddad, like I say, but also my dad had terrible heart problems. My uncle died of heart attack. One of my other uncles had terrible heart problems.

And I knew then that sadly, the science is very clear that obesity makes it significantly more likely you'll have heart problems and actually a huge array of other illnesses. So I knew if there's a drug that can reduce or even reverse obesity, that will have really positive health impacts. I also thought, wait a minute, I've seen this before, right? You've seen this whole story play out before. About every 20 years or so, a new miracle diet drug is announced. People stampede to take it.

It becomes hugely popular. They always discover whatever the benefits, it causes some horrendous side effect and it has to be yanked from the market, leaving a huge array of damaged people in its wake.

I thought, can you really, when it comes to something as complex as the human body, have a free lunch? I guess with those NPIC, it would be a smaller free lunch. And I also thought, what would this do for people with eating disorders? Will this reverse the progress we've made on body positivity? Just a whole array of concerns. So to get to the bottom of this, and like I say, in addition to taking the drug, I went on this big journey all over the world. I went from Iceland to Minneapolis to Okinawa in the south of Japan.

to meet the biggest critics of the drugs, the biggest defenders of the drugs, to really deeply understand what's going on here. And the truth is quite complex. I learned that there are extraordinary, as the subtitle of the book says, there are extraordinary benefits to these drugs and there are significant risks, 12 quite big risks. And it's a strange thing. I've learned a huge amount. I've learned a huge amount about what this is going to mean for our culture and our economy, what it's going to mean for our bodies, for better and for worse. But

Weirdly, this hasn't happened to me with my previous books. I'm still quite conflicted after everything I've learned. I think it's still quite finely balanced. And I think I know some people are reading my book and thinking, wow, this has persuaded me to take these drugs. And some people are reading the book and saying, this has really persuaded me to not take these drugs, which I think is probably a sign that I've done my job properly.

It is so amazing for me to see some of the people who I know who have taken these drugs and just the profound impact it makes in such a short period of time. I remember seeing this woman who had a baby and she had put historically had been thin, but she had put on all this weight. I knew she was unhappy.

with her weight situation. And I saw her about two months later, and she looked smaller than she had ever had in her entire life. And similar to you, I was sitting there going, what in the heck happened to her? And that's when her husband told me that she had taken these drugs and how quickly it had erased this weight. However, I have a friend who played

on a Notre Dame football team where he was a lineman. A lot of his teammates are linemen coming from that profession. A lot of them carried excess body weight and about three quarters of them went on these drugs. And what he also told me was coming off the drugs, all of them gained back a large component of their weight that they had lost.

so i want to explore all these different things today just so we can put everything on the table so listeners are very well educated on all aspects of this and i thought maybe we could start with how these weight loss drugs were discovered and what they specifically do within the body yeah so i interviewed the man who made the initial breakthrough he discovered a hormone called glp-1 his name is daniel drucker discovered in 1984. so basically

The first thing to say about your question, how do they work, is there's a disconcerting amount we don't know about how they work. But here's one thing we know for sure. If you ate something now, John, your pancreas would create a hormone called GLP-1, this thing that Dan was the first person to discover, Dr. Drucker was the first person to discover. And that hormone just naturally occurs when you eat, and it's part of your body's natural breaks. It's basically part of the system that says, hey, John, you've had enough now, stop eating.

And this natural GLP-1 stays in your system for a couple of minutes and then it goes away. So it doesn't last very long, but usually enough that people will stop eating. What these drugs do is they inject into you an artificial copy of GLP-1 that instead of lasting for a couple of minutes, lasts for a whole week. And it has this really strange effect. I'll never forget the second morning that I was taking it. I woke up, I was lying in bed and I woke up.

and had this strange feeling and I couldn't locate in my body what it was that I was feeling. I was thinking, oh, this is weird. What do I feel? It took me quite a long time to realize I had woken up and I wasn't hungry. And I thought, huh. And I don't remember any day in my life before that, that I'd woken up and not been hungry. On autopilot, I went to this diner near where I live that I used to go to every morning. And I went in and I ordered what I would have ordered every day, which was a big brown roll, bread roll,

with loads of chicken and loads of mayo in it. And I had like three or four mouthfuls and I just wasn't hungry. I felt full. And I remember the lovely Brazilian woman who runs it, Tatiana, runs the cafe running after me saying, hey, are you okay? When I left, because she'd never seen me leave my food before, right? And that afternoon when I went for lunch, there's a Turkish restaurant next to my office. I went, I ordered the same thing I always ordered, a Mediterranean lamb. Again, the same thing happened.

few mouthfuls and I just wasn't hungry. And it really, what it feels like is like a kind of shudders come down on most of your appetite. I was 80% less hungry than I had been before. This is why I had, like most people who take the drugs, had such dramatic weight loss. I lost 42 pounds in a year. So initially it was thought, because this is a hormone that's created in your gut,

that it works primarily on your gut. Actually, what we now know, and I know from interviewing the leading neuroscientists in the world and really doing a deep dive into their research, actually, it's increasingly clear these drugs don't work primarily on your gut. They work primarily on your brain. We don't know how.

But they are clearly changing something profoundly in your brain. There's a big debate about what they're doing to your brain. And I go through the debate and there's various different theories, all of which bring with them different benefits and risks, including a very broad range of things like addiction, depression. It was fascinating to feel how it worked in my own body, but also then to realize there's so much we don't know. This really is. It's like a trial, an experiment on millions of people where I'm one of the guinea pigs. It was disconcerting.

In terms of what your friend said to you, the one who'd been a linebacker, I mean, he shouldn't be surprised by that because what he what he by his experience, because that's I mean, that's there in all the medical advice. These drugs work as long as you take them. And when you stop taking them, they stop working. They're like most drugs in that respect, actually. Blood pressure medication, statins, they don't cure the problem. They temporarily treat it. And of course, when you stop taking them, you regain most of the weight.

Which feels like a much more intimate engagement, right? It's not a holiday fling. It's like getting married, right? It's like getting married in the old days when it's hard to leave, right? Absolutely. You open up your book by talking about your diet over the years. And you share this story about going into this Kentucky Fried Chicken. And I think it's funny because we went boating with a friend of mine a couple weeks ago. And there is this fried chicken restaurant that everyone says is...

the best here in St. Petersburg. And my friend tried it a couple of days after that. And he's, oh my God, it is the best fried chicken I'd ever had. Then I talked to him about three hours later and he was still in a food coma. I've been there many times, I can assure you. Be warned that once you pick up a refreshingly cold drink from McDonald's

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Earning your degree online doesn't mean you have to go about it alone. At Capella University, we're here to support you when you're ready. From enrollment counselors who get to know you and your goals, to academic coaches who can help you form a plan to stay on track. We care about your success and are dedicated to helping you pursue your goals.

Going back to school is a big step, but having support at every step of your academic journey can make a big difference. Imagine your future differently at capella.edu. So many people would say from...

the perspective of weight gain, that it's our intentional choices. So I'm conflicted on this whole thing because I'm a person who has dealt with obesity my entire life and I'm like a roller coaster. I go up, I go down, I go up, I go down. And over the past seven to eight years,

I have probably had my most stable period in my life, but it's because I have adopted all these practices to make my lifestyle healthier. But similar to you, I was one of these people who used to eat fast food, used to eat lots of the food that you see in the middle of all our grocery stores that is processed.

But in your story, you go into this Kentucky Fried Chicken, they end up giving you a Christmas card. And I was hoping you could share more about the story and overall what your lifestyle was like at this point.

It was a low point in my life that day. It was Christmas Eve 2009. I was living in East London and I went to my local branch of KFC and I went in and I said my standard order, which is so disgusting. I won't repeat it on your show. And the guy behind the counter said, oh, Johan, I'm really glad you're here. And I was like, oh, okay.

And he went off behind where they fry the chicken and everything. And he came back with every member of staff and a massive Christmas card in which they had written to our best customer. And one of the reasons my heart sank, they'd all written these personal messages, is I thought, well, this isn't even the fried chicken shop I come to the most. How could this be happening to me? So, yeah.

I think you're absolutely right that we need to think about these drugs in the context of the food that we've been eating. And I say we because 78% of the calories that the average American child eats on a typical day is now coming from ultra-processed foods, right? That means foods that were built in factories out of chemicals and don't resemble anything like the food that our grandparents ate. And when I was initially, at the start of doing my work on my book Magic Pill, I was looking at kind of two areas that I initially thought of were quite different. I was looking at

Why did obesity explode in my lifetime? If you just everyone, I really recommend just pause this podcast for a moment and Google just put into Google images photographs of beaches in the 1970s in the United States and just look at them for a minute. They're really weird when we look at them now because everyone is what we would call skinny or jacked. Everyone. Right.

And you think, well, where was everyone else that day? And then you look at the figures for the population. That's what Americans look like in the mid 1970s, not a million years ago, just before I was born. Right. And you think, well, what happened? Obesity, you basically have 300,000 years where obesity exists, but it's exceptionally rare.

And then essentially in my lifetime, it explodes. Between the year I was born and the year I turned 21, obesity doubled in the United States. And then in the next 20 years, severe obesity doubled again. Right. Staggering has never happened in the history of the human species. What's going on there? I wanted to understand how did this happen? And I also wanted to understand how these drugs work.

And I thought there would be parallel stories that only join up at the end because, of course, the rise in obesity is what leads to the development of the drugs. But actually, the same word kept occurring in both topics again and again. And that word, it's not a word we use that often in English, but we understand it. It's the word satiety, the feeling of being sated, the feeling of just not having had enough and not wanting anymore. And it turns out

this food that we've transitioned to eating profoundly undermines our satiety so obesity rises everywhere in the world where one change happens it's not where people develop weak willpower it's not where people are just greedy pigs and all the other mean cruel stigmatizing things we say

it's for one reason it's where one change happens wherever people move from mostly eating fresh whole foods that they prepared that day to mostly eating processed or ultra processed foods which are like i say constructed out of chemicals in factories in a process that isn't even called cooking it's called manufacturing food right wherever that change happens obesity skyrockets and

And the reason is that one of the key reasons is that this food, this new kind of food, which has never existed before, profoundly undermines our ability to know when we're full and to stop. And I go through seven pieces of very broad scientific evidence that explain why it has that effect. But there's an experiment that for me just totally distilled it. There's a brilliant scientist called Professor Paul Kenny, who's the head of neuroscience at Mount Sinai in New York. And he grew up in Ireland, in Dublin.

And when he was in his 20s, in the mid 1990s, he moved to San Diego and quickly clocked, whoa, Americans don't eat like Irish people did at the time, right? Much more processed and ultra processed food. And like many a good immigrant, he assimilated, he gained 30 pounds in a year. And he started to feel like this new kind of food wasn't just changing his gut. It was changing his mind. It was changing his brain. It was changing what he wanted. So he designed an experiment to test this. It's very simple.

I've nicknamed it Cheesecake Park. It's not the official name. He got a load of rats and he raised them in a cage. And all they had to eat was the kind of natural whole foods that rats evolved to eat over thousands of years. And it turned out when they had that food and nothing else, they would eat when they were hungry and they would just stop when they weren't hungry anymore. They had some kind of natural nutritional wisdom that told them, OK, you've had enough now. And with that natural food, they never became fat, never became overweight or obese.

Then Professor Kenny introduced them to the American diet, right? Get ready to salivate everyone. He fried up some bacon. He bought a load of Snickers bars and crucially, he bought them a load of cheesecake and he put it in the cage alongside 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 and emerge just completely. The whole body is just completely slicked with cheesecake and

they ate and ate and ate and all that nutritional wisdom they'd had when they had the kind of food they'd evolved with for thousands of years disappeared and they all became overweight or obese. The way Professor Kenny put it to me was within a couple of days they were different animals. Then Professor Kenny varied the experiment again. He, in a way that seems quite cruel to me as a former KFC addict, he took away all this food and

this American food and left them with nothing but the healthy food. 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 processed and ultra processed foods expand the number of calories you eat in a day. That's not what happened. Something much weirder happened. Once they'd been exposed to the American diet and it was taken away and all they had was healthy food, 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 that they finally went back and ate it. Now, something very similar is happening with human beings. I don't think you need me to spell it out too much, but I can if you want. But where this leads us to the drugs is what processed and ultra processed foods do is they profoundly undermine our satiety, our ability to know when to stop.

And what these drugs do is they give you back your satiety. In fact, Daniel Drucker, the guy I just mentioned, describes what they give you as satiety hormones, right? But of course, they're doing it in a highly artificial and potentially risky way. As Professor Michael Lowe put it to me, they're an artificial solution to an artificial problem. Processed and ultra-processed foods dug this hole

Now the drugs fill this hole, but in a risky way. Countries that never moved to processed and ultra-processed foods, like Japan, there's almost no obesity and there's almost no market for a Zempik, right? Yeah, I remember when I was in my early 20s, I was in the Navy at this time. I was stationed over in southern Spain. And what struck me as really odd when I was comparing Spain at that time to the United States is although they had supermarchés,

they were very limited in number. And what they did have was an abundance of local smaller supermarkets that had fresh food, fresh caught seafood, not as many meats as we have here in the States. And you would just go on that day to buy what you needed to eat and everything was fresh. Even the sauces you made were made with real vegetables, et cetera. And the population

of Southern Spain was very skinny, just like the Japanese. But I was recently doing this experiment where I have been trying to eliminate all vegetable oils. And it is amazing once you start going into the supermarket to try to find foods in the center of the supermarket that aren't made with these horrendous oils that we put in our bodies. I mean, I was going down the potato chip aisle

And I think out of all of the chips, I found one potato chip and one Mexican tortilla chip that were made with either olive oil or avocado oil. But it explains the issue that we're facing. And I just wanted to ask a philosophical question. So we've had this transformation of food supply into something that you call maximally addictive.

What ethical considerations do you think should govern the production of marketing of food? Because to me, I liken it almost a cigarette where when people started to understand the health ramifications about what they were smoking and how addictive it was, we started to do something about it. Do you think we're reaching a point where we almost have to do the same thing when it comes to our food supplies?

I don't think we've almost reached that point. This is the biggest killer of Americans. Professor Gerald Mand at Harvard, who designed the food label that's on all food sold in the United States, has calculated that obesity and food-caused illnesses kills 678,000 Americans every single year, right? Obesity causes over 200 known diseases and complications, from diabetes to heart disease to dementia to strokes.

to limb amputations, I mean right down the table. Now you might not think of my uncle Joe died of obesity, you'll think my uncle Joe died of a heart attack, but if the society was not so obese he would not have had that heart attack. So I would, the question is not almost, the question is absolutely, well it depends if we want people to live, have healthy long lives or not. If we do then of course, I don't, I wouldn't frame it in terms of it's an ethical obligation on the part of the manufacturer,

Food companies want to sell food, right? They'll sell the food that they can sell. It's not the job. It's the job of the society to regulate that food, right? It's the job of the law to regulate that. Of course, we can appeal to these companies to be more ethical. But I mean, good luck with that. How well did that work with

the lead industry or the cigarette industry or any industry in the history of capitalism, it's just not how it works. They will respond to regulation. And I've been to lots of places where they make changes and all sorts of things that we can do. And it's really important this because I'm sure we're going to get into the very difficult dilemma I believe people like me are facing now. You've got to weigh two things, the 12 risks of these drugs versus the risks of continuing to be obese.

And realistically for me, that was the choice, right? I have been obese most of my adult life. I've had periods where I dieted and lost weight and I always regained it. In fact, usually I regain more than I'd lost, right? So realistically for me, those were the two alternatives. That's not true for everyone. Some people, it sounds like you're one of them and it's really interesting to talk about how some people can lose weight just through calorie restriction and exercise and really keep it off. I have someone in my close family like that.

that. We all know someone like that. In fact, the evidence shows it's a very small proportion of people. And we actually know, I think, why it's so hard to do that. I can explain that as well. If that's, we're faced with that choice, right? Risks of the drugs versus risk of obesity. But it's absolutely crucial that people understand that does not have to be the choice for our children and grandchildren. I went to a country, Japan, where that isn't the choice because they designed their society differently and

that kids don't face a choice between obesity and these drugs because there is almost no childhood obesity in Japan. I've got to tell you, it's a really weird experience going to a Japanese school and walking around and there are no overweight children. I went to a school called Koenji School, normal lower middle class school in Tokyo, thousand kids. I said, where are your overweight children? To the school's nutritionist. We don't have any, she said. I could see they didn't have any, right?

If we make the right social changes, we will not put our kids and our grandchildren in this terrible choice between a risky medical condition and risky drugs. But we are where we are. We're in a trap. Let's discuss the nature of the trap door. But we should know that it doesn't have to be that way. And obviously I explain in the book that I went to lots of countries that have begun to make the changes or in some cases made them fully that could get us out of this trap and out of this choice. Johan, I think I want to now go into...

the two sides of this drug. So in the book, you talk about experts like Tim Spector and Clements Blowett, who have described the new weight loss drugs as the Holy Grail. From their perspective, what do they see as the top health benefits of these new weight loss drugs, especially for individuals with heart conditions or those at risk of stroke?

Well, both the individuals you mentioned have interesting and nuanced perspectives. But in general, the scientists have looked at this, most of them, but not all. And there's a very important kind of dissent from this. But the first part of the subtitle of my book, Magic Pill, is the extraordinary benefits. Right. And to understand the extraordinary benefits for a moment, I think it helps to look at a parallel area of science.

So up to now, like we just discussed, it's been quite hard, certainly not impossible, but quite hard to lose huge amounts of weight and really keep it off for a long period of time. Actually, the most reliable method for doing that has been bariatric surgery. So it's really interesting to things like stomach stapling, gastric sleeves, that kind of thing.

So it's really helpful to look at the long-term outcomes from bariatric surgery. And they're quite striking. Bariatric surgery is a horrific operation. One in a thousand people die during the surgery. It's no joke. It's horrible. But the reason people put themselves through that, so many people, is because of what happens next. If you have bariatric surgery, in the seven years that follow, you are 56% less likely to die of a heart attack.

60% less likely to die of cancer, 92% less likely to die of diabetes related causes. And you are, in fact, it's so good for you. You're 40% less likely to die of any cause at all. Now this fits with a much wider body of evidence that I think we've actually underplayed. I was shocked by it. And I think we've underplayed it because we're trying to be sensitive and kind and

But I think we can communicate it in a way that is sensitive. And most importantly, we should always communicate the truth. And obesity is on average, I'm afraid, really bad for your health. Even think about something as basic as diabetes, right? I thought, I'm so embarrassed to say this,

I thought, okay, clearly diabetes is not good for you. I knew that if you're obese when you're 18, you have a 70% chance of getting diabetes in your lifetime. But I thought, it's not good for you. But as long as you've got decent healthcare, which I grant is a problem for lots of people in the United States, they don't. But provided you have decent healthcare and you get insulin, then you're basically like everyone else, right? If you're a diabetic who has a regular supply of insulin, I thought you're like me. That is absolutely not true. From interviewing leading diabetes specialists,

It's shocking. If you become diabetic, it knocks on average 15 years off your life. It is the biggest cause of preventable blindness in the United States. More people in the US have to have a limb or extremity amputated every year because of diabetes than because they got shot. And you will have noticed a lot of us get shot, right? This is devastating. In fact, one of the leading doctors in Britain, Dr. Max Pemberton, who treats diabetics, said, if you gave me a choice...

between becoming diabetic or becoming HIV positive, I would choose to become HIV positive.

Because if you're HIV positive and you get treatment, you live as long as everyone else. That's simply not true of diabetes. And that's just one of 200 problems that are made more likely when you become obese. Of course, there are exceptions. Of course, there are some obese people who don't get these problems, but they are exceptions. Just like my mother smokes 70 cigarettes a day and is alive and well at the age of 78. But she isn't, fortunately, in my case, a statistical outlier. So in terms of the benefits are very clear.

When you reduce or reverse obesity, you massively reduce the risk of all sorts of horrible medical conditions. And we now know this with these drugs. If you take these drugs and you started with a BMI higher than 27, you are 20% less likely in the years that follow to have a heart attack or stroke. That is a staggering reduction in the risk of a devastating condition.

And I just wanted to point out for the listeners, if you want to learn more about type two diabetes and how to reverse it, I've had a number of episodes on that. One was by Cyrus Kambada who wrote Mastering Diabetes. Another one was recently with Eric Edmeades where he wrote the book Post-Diabetic and then also Mark Hyman. But it's interesting that all of these people have found that with diet regulation, they're

Almost all cases of type 2 diabetes can be reversed and you can go back into a normal functioning state. But you bring up some important points about obesity and why these drugs are favorable in helping you to counter that and the positive outcomes from it.

Now I wanted to dive into what are some of the disturbing risks that come with this drug or this class of drugs? They range very widely and almost all of them, the evidence is contested. I think, of course, I wouldn't have included it if I didn't think it was plausible evidence that we should be at least concerned. Give an example of one. I'm sure we'll go through many. When you talk to experts about the safety of these drugs, this new class of weight loss drugs, often they make a good point. They say, actually, we know quite a lot about these drugs.

Because diabetics have been taking them now for 18 years. For people who don't know, in addition to having these positive effects on your appetite, they also stimulate the creation of insulin, which is what diabetics need. So many hundreds of thousands of people all over the world have been taking these drugs now for a long time, nearly 20 years. And I'm putting it more crudely than they do, but basically the experts say, look,

If these drugs gave you horns, the diabetics would have grown horns by now, right? If there was some disastrous short or medium term effect beyond the well-known side effects like nausea, we would know by now. And there's some truth in that. It's an important point and it should give people some peace of mind. But some other scientists, equally reputable, said, OK, if we're going to base a large part of our belief on the safety of these drugs on the diabetics, let's do some digging into the diabetics.

So I'll give you an example of a scientist I interviewed, a brilliant scientist called Professor Jean-Luc Fayet, who's at the University Hospital in Montpellier in France. And he was commissioned by the French Medicines Agency to look into the safety of these drugs for the French market. And they have unbelievably good medical databases in France. It's actually the best country in the world to do this research in because they basically don't have the equivalent of HIPAA. You can't really opt out.

And he looked at the evidence and he was immediately struck by one thing in what's called the preclinical evidence, which is the animal studies. When you give these drugs to rats, they're much more likely to get thyroid cancer.

And we know that you have GLP-1 receptors, not just in your gut and your brain, but in your thyroid. So it's sort of plausible. You can see, oh, if you're screwing with GLP-1, maybe it will have some effect on the thyroid. So what he did is he looked at a huge database of diabetics in France who'd been using these drugs between, I think it was 2006 and 2012. And then he compared them to a very large group of diabetics who'd not taken these drugs to see, well, what's the difference? And what he calculated is at first very disconcerting.

If he's right, and this is highly contested, these drugs increase your risk of thyroid cancer by between 50 to 75%. Now, it's important to understand what that doesn't mean.

That doesn't mean if you take these drugs, you have a 50 to 75% chance of getting thyroid cancer. If that was the case, we'd be having bonfires of Ozempic all over the world. What it means is whatever your thyroid cancer risk was at the start, if he's right, these drugs increase it by 50 to 75%. Now it's relatively low risk. 1.2% of people get thyroid cancer in their life. 84% of them survive, but it's a

Pretty big increase in that risk, right? It remains overall a low risk. Now, against that, and this is part of the kind of devilish complexity of how you have to think about these drugs. Against that, lots of other people said to me, even if that's right, you have to compare it to the cancer risk from being obese. And I was stunned by the figures on this. As Cancer Research UK, the biggest British cancer research group, explains that

If you carry excess weight, that weight doesn't just sit there. It's not inert. It's active. It sends signals through your body. And one of the signals it can send is for cells to divide more rapidly, which can, of course, cause cancer. It's why obesity is one of the biggest causes of cancer in the United States and Britain. So again, at every stage, you've got to be weighing these risks and trying to figure out, well, what is the greater risk? And there is no simple answer. There isn't a kind of

easy calculator we can pull out, especially with some of the risks where the evidence is highly contested. Another area I wanted to explore is what did your research show about pancreatitis and a link to potential pancreatic cancer? So there's no known list to risk to pancreatic cancer, but there is a risk of the university to pancreatitis. So for people who don't know what it is,

Pancreatitis is extremely rare, but it's an excruciatingly painful. It's basically a pancreas doesn't work properly. I interviewed a woman called Michelle Stasiak, who's in Myrtle Beach in Carolina. And she went to her doctor for Ozempic for weight loss. And the doctor said, oh, there's very rare side effects. One of those pancreatitis. Michelle said, no, my luck, I'll probably get it.

She started taking the drug. She lost loads of weight. She was very happy. And a while later, she went to visit her daughter in Pittsburgh and she woke up at three in the morning and just excruciating agony. She was vomiting. She was shitting herself. She was just in such pain. She couldn't speak.

she thought she was dying they took her to the hospital they gave her fentanyl for the pain and that's where they discovered that she had pancreatitis so pancreatitis if it's treated goes away but it's exceptionally painful doctors compare it to being stabbed with a knife and michelle said it was much more painful than any of her childbirths and the university of british columbia has scientists who've shown your risk of developing pancreatitis

increases by a factor of nine. So you're nine times more likely to get it when you take these drugs. Now it's still a vanishingly tiny risk. I mean, it's really, it's not like a thyroid cancer. It's exceptionally rare, but obviously nine times increase, even an exceptionally rare thing will mean a lot of people like Michelle who will be in terrible pain. And if you don't get healthcare, you die quite rapidly with pancreatitis. And then the last two I wanted to explore were kidney injury and gallbladder implications. Okay.

to my knowledge that there's no link to those but there's a link to lots of other problems i mean the one for me that i mean i did a lot of research i didn't come across those issues any credible scientists do claim that there were those issues but for me actually interestingly the negative effect that there's two that really worried me and one that played out i mean there's many that worried me but i mean for me personally worrying about my own health there were two i was particularly worried about one is the long-term effects remind me to come back to that but the first was actually

I had this funny experience. The first six months I was taking the drug, I was losing loads of weight. And my friend Danielle was pregnant at the time. And every time I bumped into her, it's like, oh, we're going on opposite trajectories, right? She was swelling. I was shrinking. But I remember saying to her one day, this is really weird. I'm getting what I want. I'm losing loads of weight, but I don't feel better. If anything, I feel quite muted. I didn't feel depressed or anything like that, but

It was weird. I couldn't quite figure it out. And there seems to be a subsection of people, although again, as with so many things with these drugs, this is disputed. But there are lots of doctors who believe there is a subsection of people taking these drugs who are becoming depressed or even developing suicidal ideations. That's strange. Why would that be? Now, it may be because like we talked about before,

These drugs primarily affect your brain. Perhaps it's having a negative effect on the brain. I can talk about some of the theories in relation to that. But I suspect for me it was something much more basic. And it became clear for me it was a moment when I had an epiphany, my second epiphany in KFC in this conversation. I was in Vegas. I'm writing a book about a series of crimes that have been happening in Las Vegas that I've been researching for many years now. And I was researching the murder of someone that I knew and loved. So it was a very, very painful thing to do.

I'm really on autopilot one day. I went to a branch of KFC that I've been to a thousand times over the years. It's the one on West Sahara. And I went in and I ordered what I would have ordered a year before, like a bucket of fried chicken. I felt awful. I sat there and I had a chicken drumstick and I looked at all this food and I thought, shit, I can't eat this. You just, you can't eat that much when you're on a Zen pic. If you tried to force yourself, you would vomit. And I suddenly thought,

oh, I'm just going to have to feel bad. And Colonel Sanders is on the wall, like he's in so many KFCs. And I thought it was like, oh, he's looking down at me going, hey, what happened to my best customer? And one of the things I think that people are not prepared for that I think is really important to understand in relation to these drugs is these drugs radically interrupt your eating patterns. And for a minority, but I think a really substantial minority, one of the things that can do is that can bring to the surface

some of the underlying emotional drivers of your eating all along right I realized how much I grew up in a family was a lot of addiction and craziness from when I was very young I realized now I would eat to soothe myself and numb myself and calm myself down and I couldn't do that and ultimately it was a good thing to bring that to the surface where I could become more aware of it I could talk it through I could think it through I could develop better strategies than

a KFC bucket, but it was a very painful transition. And interesting, we talked about some of the positive lessons from bariatric surgery for these drugs. It's worth thinking about some of the negative lessons. Your suicide risk quadruples after you have bariatric surgery. Now, I think some of that is that the surgery is really grueling and leaves you in pain. But I think a lot of it is exactly this, right? And I go through in the book, there's five drivers of why we eat. Four of them are psychological. Bringing those things to the surface can be very

disconcerting with this drug. To me, it's so fascinating. The book is called Magic Pill because there's three ways these drugs could be magic, right? The first is the most obvious. They could just solve the problem, right? And there are days when it feels like that, John. There are days in my whole life, basically my whole life, I've overeaten.

And now what? Once a week, I inject myself a tiny little injection in the leg and now I don't overeat. There are days it feels like a magical transformation. The second way it could be magic is much more disturbing. It could be like a magic trick, right? It could be like a conjurer who shows you a magic trick while secretly picking your pocket, right? It could give you benefits but harm you over much more than the benefits. I do not rule that out. That is a real risk. I'm especially worried about eating disorders. We can come back to that.

The third way it could be magical, I think is the most likely and the one that we're actually seeing. Think about all the classic stories about magic that we were told as kids. Think about Aladdin, right? How does the story go? You find the lamp, you rub it, the genie appears, you make your wish and your wish comes true. But it never quite comes true in the way that you expected it to, right? Think about Fantasia. You unleash the magic and it runs away from you in these chaotic and unpredictable ways.

I think that's the most likely scenario here. This is having already so many unpredictable effects, positive and negative. Barclays Bank commissioned a very sober minded financial analyst called Emily Field to go away and look at the evidence around these drugs to guide their future investment decisions. And she came back and said, if you want a comparison for how big an effect these drugs are going to have, you've got to look at the invention of the smartphone. Right. And I think she's right about that.

This is going to 47% of Americans want to take these drugs, right? Eight years from now, when the patent passes on Ozempic, it'll be a daily pill and it'll be a dollar a day. And my prediction is 47% of Americans will take it, right? Barring the discovery of some horrific effect, which I don't rule out. That is going to have huge and transformative effects on the economy, the society, how we think about our bodies, how we think about ourselves, how we move the kind of diseases we get. I mean, this is,

a very significant change for better and for worse. Johan, one of the things that has really come about over the past decade is the whole philosophy of self-acceptance. How do you think these weight loss drugs affect the cultural movement towards self-acceptance and diversity in body types? Does their use imply, in your opinion, a societal step backwards in terms of body image?

The worst moment for me in working on the book was a moment with my niece. My niece is the baby in my family. She's called Erin. She's actually 19 now, but in my head, she's always fixed as a six-year-old. No one makes me more protective. She's the only girl in her generation in my family and the youngest. And one day I was FaceTiming with her and she was saying that it was a while into taking the drugs and she was saying, oh, you look really great. And then she was teasing me. She's saying, I didn't know you had a neck before, didn't know you had a jaw before. And I was preening. And then she looked down and she said, will you get me some Ozempic?

And I thought she was kidding. I laughed. And then I suddenly realized she meant it and she's perfectly healthy weight. And I was like, shit, have I undermined everything I was ever trying to teach her since she was a toddler. Right. And I wanted to think this through very carefully. One of the people who most helped me to do it was an amazing woman named Shelley Bovey. So when I was a kid, I know this would have been the case for you as well, John, the only overweight people you ever saw on television were the butt of the joke, right? Particularly overweight women.

They were there to be ridiculed. And the first woman I ever, first person I ever saw challenge this was this woman, Shelley Bovey, who basically introduced body positivity into Britain. And her story is amazing. So she grew up in a working class town in Wales. It's because the equivalent would be like Scranton or something in the US, right? It's a working class town with a big mine, coal mine, big steelworks. And she was, she puts it, the only fat girl in her school. This was the 60s.

And one day when she was 11, her teacher said to her, Bovie, stay behind after class. So she sat there thinking, oh, what have I done wrong? And the teacher said to her, you're much too fat. It's disgusting. Go to the school nurse. She'll sort you out. So completely thrown, Shelley walked over to the school nurse. The school nurse said, why are you here, Bovie? She said, oh, the teacher said I'm too fat. The nurse said, take your clothes off. I'll inspect you. So she had to take all her clothes off.

And the nurse said, you, it's absolutely right. You're too fat. It's disgusting. And the nurse just berated her and shamed her. And Shelley just left completely distraught. And she spent her whole life soaking up this kind of abuse. She was constantly being told by the teachers, but sorry, by the other kids. So I'll say it again. She was constantly being told by the other kids. Oh, you're so disgusting. Thank God. I don't look like you. And as she got older, she just got this

And again and again, when she got pregnant, she went to the doctor. And the first thing the doctor said was, well, you shouldn't be pregnant when you're as fat as you are. And when her baby was born, she had a very painful and difficult birth. And she was lying there covered in blood. And the midwife looked at her and said, you really need to lose some weight. And when her baby wasn't feeding, he wasn't attaching properly to her breast. She took him to the doctor and the doctor said, well, what are you trying to do? Make the baby as fat as you are.

It was just this constant drumbeat of abuse. 42% of women with a BMI higher than 35 get insulted every single day. And I've been fat, you've been fat, we know what it's like. It's much worse for women than for men. This drumbeat of abuse. And Shelley completely internalized this. She thought that there was something wrong with her. She hated her body. She told me she'd never even looked at her body naked, not even in the shower, because she was so sickened by her own flesh.

And Shelley learned in the late 1980s that there was a movement in the United States that at the time called itself Fat Pride, as some parts of it still do. And she began to think, well, what if this is just a form of bigotry and prejudice like racism? And she wrote a beautiful book that was the first book ever in Britain to make this case. It's called The Forbidden Body. And I saw her on TV when I was 10 years old and I never had anyone say this. And she was treated like a lunatic, but she

Her message got through and it really spawned a lot of the body positivity movement. I mean, it existed to some degree before, but it hugely grew as a result of her book in Britain. And I wanted to discuss these struggles with her, so I tracked Shelley down. She's 76 now. Shelley explained to me she's incredibly proud of the work she did opposing stigma and she stands by every word of it. But something happened to Shelley after she wrote the book. By that time, she was very severely overweight and she was not even 50 yet and she was losing the ability to walk. She had to go into a wheelchair.

And her doctor said that he was very worried about her heart. She was developing all sorts of health conditions related to obesity. And Shelley wanted to write about this in the body positivity movement. There was a newsletter called Fat News. And they said, oh, we don't want you to write about that. We're here to tell the good news about obesity. And she said, right, I believe that. But the scientific evidence is very clear that there are also these drawbacks. And she started thinking, how can I reason this through? And she then

started radically restricting her calories she lost a huge amount of weight and her health problems went away largely went away her heart problems went away she went from not barely being able to walk to being able to run now she's the first to admit it's extremely hard to lose weight just through calorie counting she's part of that lucky 10 percent sounds like you are too john and she started to think well how can we think this through and i spent a lot of time discussing this with her and obviously the new drugs and she said to me we're encouraged to think it's either or

either you're opposed to stigma, which is a form of hateful cruelty and bullying, or you want to reduce obesity where possible. But she said, why is that the choice? The choice shouldn't, it's not either or, it's both and. If you love someone who's obese or you are yourself obese and you love yourself, as I did, you want two things for yourself. You want to protect the person you love from cruelty and bullying and spite.

And you want to protect yourself from diabetes, heart disease, stroke, cancer, all these things that the scientific evidence is overwhelming. It's one of the most well-proven facts in science that obesity does increase these risks. And I think she made a very powerful case. She made a very powerful case that we've got to do both, right? We've got to oppose stigma, which makes the problem worse and is just hateful, but

And we've got where we can to reduce obesity. And I'm really concerned about this because we need a body positivity movement. Even if we went back to the world we had before ultra processed food,

um like japan basically remained where they were there's still some overweight people and they should be protected from bullying and there's a broad range of body types so we're not all going to look like brad pitt or timothy chalamet if we're men and we're not all going to like angelina jolie if we're women and absolutely we need to celebrate a broad range of body types and we want everyone to feel good about their body um

Pretty soon, everyone in the United States is going to know someone like Jeff Parker, a man I interviewed. He's a retired lighting engineer, 67-year-old retired lighting engineer, super nice guy. And he was severely overweight. And Shelly, he was losing the ability to walk. And he had gout. And he was on all sorts of pills. And his doctor was really worried about his liver, his heart, his kidneys. And he started to take Mojaro, one of these new drugs. And he lost an enormous amount of weight.

All of his health problems have gone away pretty much. Now he walks his dog over the Golden Gate Bridge every day and he said to me, "I'm going to enjoy my retirement now." Now if the body positivity movement is built on saying to Jeff he shouldn't have made that change, that there's no difference between how he was before and how he is now, it's going to lose a lot of followers. It was never scientifically plausible to deny that obesity causes health problems on average and it won't be emotionally plausible.

If we build the body positivity movement on those claims that obesity doesn't harm health, well, as Shelley says, we have to live in reality and people can see reality all around them.

If it's built on a much deeper moral intuition that no one should be bullied, that we want everyone to feel good about their body, that we want to help them as much as we can. There'll be loads of people who don't want to take these drugs for very good reasons. And they may well be vindicated because the risks may outweigh the benefits. And there will always be a variety of human body types. If it's built on those moral insights, then I think it absolutely it will be as necessary after these drugs as it was before.

Thank you so much, Johan, for that explanation. And I guess from my personal experience, growing up during most of my childhood, I was overweight and I remember just how much bullying and teasing I would get as a result of it. And then throughout high school, I slimmed down, in the military, I slimmed down.

And then throughout periods of my professional career, when I put the weight back on, I just was so disappointed in myself because of what it precluded me from doing. Meaning you don't have as much energy to spend with your kids. You don't feel like you have the energy to go out and do the walk or perform in the way that you want to. Your sleep gets impacted. So many of your life aspects fall apart from work.

when you've experienced the other side of it. And that's what really pushed me to make the changes I have, but some people just aren't able to do that. So I think this discussion has brought a really good both sides to the whole argument here of why in some cases people may feel compelled to do this, but also it helps them understand some of the repercussions. There's a lot more if they read the book of taking the drugs and the long-term risks. Last question for you is what do you hope

readers will take away the most from your book? I think it relates to what you just said, that sense of shame and failure that you felt, that I felt, everyone feels when they gain weight pretty much in this culture. It's not your fault. You didn't design this food environment. You didn't invent this completely new way of eating that was invented just before we were born, right? You didn't invent the fact that

More three-year-old American children know what the McDonald's M means. They know their own last name. You didn't choose that world. We didn't build that world. That's not on us. Now, we can fix that, right? We can fix that wider societal issue. I've been to places that have done it. These drugs are a tool. For some people, they'll be helpful. For some people, they won't. Some people won't want to use them.

The thing I hope we most get out of is a structural understanding of how we got into this situation that it's not your fault, right? It's not on you. The difference between that beach in the 1970s and the beach today is not that we all became morally fallen, right? That's not what happened, right? And that mysteriously every country in the world becomes morally fallen the moment ultra processed food is introduced. That's not what's going on here. So I hope it gives people that level of insight and that a different way of thinking about themselves that has really helped me in that respect.

Well, Johan, thank you so much for bringing this book to the world. And thank you so much for joining me on Passion Struck today. Well, great questions. I really enjoyed it. Thanks so much, John. And I should just say my publishers taser me. Anyone who wants to know where to get the audio book, which I read myself, or the ebook or physical book can go to magicpillbook.com. I meant to say you can get it from all good bookstores, but the truth is you can even get it from shitty bookstores where you don't have a quality test. So brilliant. Thanks, John.

What an incredible honor that was to interview Johan Hari and I wanted to thank Penguin Random House and Johan for the honor and privilege of joining us on today's episode. Links to all things Johan will be in the show notes at passionstruck.com. Please use our website links if you purchase any of the books from the guests that we feature here on the show. All proceeds go to supporting the show and making it free for our listeners. Videos are on YouTube at both our main channel at John R. Miles and our clips channel at Passion Struck Clips. Please go check them out, subscribe and join the

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then take the PassionStruck quiz today. It consists of 20 questions, takes about 10 minutes to complete, and it will show you where you stand on the continuum of becoming PassionStruck. You can also find it at passionstruck.com. You're about to hear a preview of the PassionStruck podcast interview that I did with Dr. Chris Kenobi, a distinguished physician, ophthalmologist, and nutrition researcher. Could the diet...

of our ancestors prevent, treat, and reverse chronic diseases like being overweight, chronic heart disease, cancer, type 2 diabetes, Alzheimer's disease, and autoimmune disorders. Dr. Kenobi believes so, and his answer lies in eliminating vegetable oils from our diets. Join us as we welcome Dr. Kenobi's groundbreaking research that

compellingly shows how these oils that are high in omega-6 fats can cause numerous chronic diseases. Discover the profound impact of ancestral diet strategies and learn how to transform your health by making simple yet profound changes. Industrial seed oils are what I call chronic metabolic biological poisons. In short, they're poisons, plain and simple. And they behave in our bodies very much like arsenic would. And there's many parallels because

Anything that causes oxidation is like we're rusting inside, devastating to every cell and every organ that it comes in contact with when it's in significant amounts. And anything, any amount of vegetable oils is significant. We really shouldn't have any. These are not natural foods. These are the most processed foods that there is available, the most processed food component. And if you look at the quantity,

of processed food ingredients, vegetable oils are the leading caloric component of processed foods. The leading caloric component. Remember that we rise by lifting others. So share the show with those that you love and care about. And if you found this episode with Johan Hari useful, then definitely share it with those who could use his advice on the magic pills that we're seeing everywhere today. In the meantime, do your best to apply what you hear on the show so that you can live what you listen. Until next time, go out there and become passion-struck.

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