Long before there was Ozempic, Michael Pollan wrote two books about the American diet and causes of obesity and illness, The Omnivore's Dilemma and In Defense of Food. I wonder what he makes of all this. Vicky Lansky wrote in the 1970s, in Feed Me I'm Yours, that we should eat food that remembers where it came from. That doesn't mean it's easy to resist what the food industry is doing to us, but the answer has been there for some time. I grew up with food as a reward in a family with weight issues. My kids are pretty well balanced and seem to have avoided that. Maybe these ideas helped. Still, for people who are very obese, at least the new drugs may offer a path out to start a healthier life, free of the stigma and prejudice they face.
I have been eating healthy, unprocessed foods for around 7 years. One really surprising "side effect" is that my pregnancy cravings are very different from what most women crave.
In my current pregnancy I've been craving kefir, unflavored yogurt, tomatoes, and red meat. Almost never processed food.
Once in a while I did feel like I wanted to have something like rice pudding or Doritos. And then I ate some, and the craving went away for good. I didn't eat bags and bags of Doritos, I ate a handful and then I was done with it for the rest of my pregnancy.
I also experienced very little nausea. Some in the beginning, but not much.
I also walk my dog for a couple hours every day. I've been doing this since I got my first dog as a teenager. And I could easily do it even at 9 months pregnant. 2 weeks after my first child was born I visited a friend. She freaked out when she realized that I walked all the way to her house (one hour).
Pregnancy is a natural state of a woman's body. It's not supposed to be a debilitating condition, but it so many women treat it like this.
I loved this interview, but I'm disappointed that Johann stayed on this drug instead doing a major of a lifestyle change after all the things he learned about obesity. Hopefully one day he will be ready to make real changes.
I found the podcast interesting, but noted that Ozempic and other semaglutide medications which were designed for the treatment of Type 2 Diabetes was not emphasized enough. Unfortunately, for those of us who are Type 2 diabetic, we are finding it more difficult to access this necessary drug. I have never been seriously overweight and exercise regularly, but pre-diabetes and Type 2 Diabetes runs in my family. I recently had to switch from Trulicity to Ozempic because Trulicity is on an extended back order. I am concerned that Ozempic may become unavailable. If I could remove the semaglutide medication from my prescription list, I would gladly do so. But to date it has been the best medication to keep my A1C in a positive place. I don't know what the long-term answer is, but competing for a medication that has become a world-wide phenomenon for weight loss, is difficult for Type 2 diabetics.
The cost of the drug was not addressed. I would like to get it but insurance won’t pay and it is nearly $1,000/month. Thus the reason why celebrities get it. I appreciated the reasonable way the author looked at the pros and cons.
I had to wait 50 minutes until I heard the word "exercise" and then it was just glossed over. I think a big part of why we are so obese is because we don't do manual labor like we used to (in the 60's and prior.) We are so sedentary. Exercise is probably the last thing Americans prioritize in their lives. Buzz, buzz, buzz, never enough time.
What the guest misses during his argument that he doesn’t treat people with medical conditions like high cholesterol as it being their fault is that it generally isn’t. Cancer usually isn’t people’s fault, which is why we feel bad for them. Except in the case of lung cancer because people are assumed to have brought that risk upon themselves if they are a smoker.
The difference between obesity and almost everything else is that obesity is generally within your control. Diet and exercise are the tried and true methods because they work, and failure to do them is most certainly a lack of willpower. I’m sorry to hurt people’s feelings, but if you have been overeating for decades I’m not going to treat you like shit but I’m also not going to pity you and pretend like you’re a victim.
Yes, the food supply can be shit sometimes, and food can be addictive, but that doesn’t let you off the hook for your choices. Even by the authors own admission, he still eats garbage and loses weight so you can’t exclusively blame it on the food supply. Its calories in versus calories out.
To the argument that calorie restriction is a “bad” method of losing weight, what exactly do you think Ozempic is doing for you? It’s not magic. It’s causing you to eat less. It’s making it easier for you to have a calorie restricted diet. It is a medically induced calorie restriction.
Do whatever you’d like people, but don’t come crying in 10 years when this destroys your body more than it was before and pretend like you’ve been duped. Anyone with a brain can see that radical medical interventions always come with side effects. If you choose to ignore them for your own vanity, do it at your own risk.
The live to fight another day argument is concerning to me because that requires that people remember to fight after their immediate problem is solved-- that they don't fall into complacency and just continue to rely on this drug and just move on. At this point, having watched how our culture actually behaves most of the time, I really don't believe anyone is going to have the staying power to do anything about the problem, especially when we have an injection that removes the suffering essentially "for free". Also, he admits that he's continued to eat crappy food, just in smaller amounts, which is absolutely terrifying. I struggle with this too, I'm only about 25 LB overweight but I'm prediabetic and I have a real sweet tooth and a habit of cramming sugary foods down my gullet before bed. It seems crazy to me that the argument is that taking a drug with unknown long term side effects is better than dying from eating too much fried chicken when you can just maybe try to start eating some vegetables and lean protein and also try to do some exercise. I'm not a smart man, but isn't this some kind of logical fallacy, false dichotomy or something? Like you could just really try and care about yourself, put faith in a process that is known to work, do the hard work of restraining yourself and working out. It's very hard, I'm a recovering alcoholic and I stopped smoking, I get it. I'm struggling with bad food now, but the benefits are so worth it if you stay with it consistently. When I exercise for 10-20 minutes a day, my mood is better, my self-esteem is better, my joints don't hurt as much, my energy has increased. Take care of yourself -- it's not a puzzle, we know this is the answer. Find the ways that you're self destructive and get some help, come up with a plan to dismantle the bad habits that are killing you. I can see this drug being used to help people who are severely obese, to get them to a point that they can begin to form better habits, but it seems like it should only be used as a temporary part of a larger plan that allows a person can get down to a manageable weight that allows them to be active without hurting themselves.
I do have to acknowledge the fact that we are up against massive companies that are engineering food to be addictive, essentially hacking the human brain in the same general way that social media has. The average person 80 years ago, when obesity levels were sane, didn't have to deal with being constantly subjected to weaponized temptation the way we are today. How do we fix that? We're the sickest, fattest culture in all of history. We weren't like this several generations ago and we didn't need an ever increasing cavalcade of pills and injections back then to simply exist in a healthy state. Why not subsidize farmers who grow healthy food in healthy, traditional ways instead of subsidizing monocrops of corn and soy? Produce affordable food that is heathy.
We're going to have to learn to change our lifestyles to protect not only our bodies, but also our minds from the deluge of advertising, manipulation and programming that we are faced with constantly. So many things about our economy, culture, whatever have become parasitic. I don't really care about Capitalism, Communism or anything else so much as I care about whether or not what we're doing makes sense, is sane and makes us a better species on a long term scale. If what we're doing serves only to make money for a few people short term, it seems crazy. Ultimately, each one of us is responsible for our own survival, but throwing someone into a pit filled with snakes and then saying it's their fault for getting bitten seems kind of like a dick move. You have to fight if you want to save yourself, and it's very much worth doing, but c'mon, the deck is stacked against all of us here. I had a coworker who was a heroine addict and he told me one time he felt sorry for me as an alcoholic. He said that he had to actively seek his drug out but mine could be found nearly everywhere. The same principle applies here and I have the utmost compassion for anyone struggling with this, but don't just trade one substance for another. Keep waking up, forgiving yourself and then trying again as hard as you can muster. That's the only way.
As someone who was in the weight loss industry for 28 years, I have lots of thought about this, which I may post later. But one thing I will say is our society does not think health is important until your lose it, espcially women. Most of my client did not make time to eat meals or move. Companies think it is fine to eat at your desk. Taking time to workout is seen a vain and schools will give up gym before any other class. I love Bari, but you can see her business and her family all come before self care. And when you push yourself to the limit and have a stressful life, food is an easy, sociable comfort.
I have been overweight/obese most of my life. Most recently, I hit a BMI over 50 (and over 300 lbs) about almost two years ago. I was seeing my endocrinologist - who because of my continued gain, my expressed frustration with my inability to lose weight, and the fact that I was pre-diabetic, offered to write me a script for Ozempic. I said yes. After six months, i had lost about 10 lbs, and she upped my dose. By my next six month visit I realized two things - it wasn’t working for me and i absolutely needed to come off it. In that six month period I had gone through an entire family sized bottle of antacid, and lost only another 5 lbs). So we agreed to stop the med, let my system purge it, and readdress writing for a different one in six months time.
Three months after that, I had gained the little weight I had lost back. Unhappy with that, I decided to go back to the one thing that ever had me losing weight. I downloaded an app, and started keeping track of what I ate (following macros). I told the app I wanted to lose 60 lbs. It gave me a target calorie count, and targets for protein, carbs, and fat. Since starting that, I am down nearly 40 lbs (my weight loss was slowed a little by foot surgery that has required me to be much more sedentary than usual). But I focused on what I was eating - and I realized I was eating tons of empty calories, not nearly enough protein and mindless snacking was killing me. Now, 7 months in, I’ve changed the foods I eat significantly, but in a way that I can still do things like enjoy a glass of wine, eat dessert, go to a restaurant, etc.
I’m an anesthesiologist by trade. Ozempic and the like have significantly changed the way I practice. My anesthesia groups are full of anecdotal stories of patients who had been NPO for 2+ days coming in for endoscopy with a stomach full of food. Now, we are asking patients to skip a dose prior to surgery (and we aren’t sure if that is helping) and even if they do, we still treat them differently than a standard patient because of their aspiration risk.
Given all that, I’m overall not a fan of the drug.
I like addressing the fast food/ manufactured food industry in the western world , it’s a huge problem, subsidized very much by agriculture oversupply of corn crops. We very much have an issue with gluttony and excess.
Just finished listening to this episode and immediately went to Audible to get the book! A complicated set of topics rolled up into this podcast with interesting, funny and important insights. Thanks for revisiting this topic with a curious and questioning mind. Really great listen!
"Fatty fatty 2 by 4, can't fit through the kitchen door"
-captain hero
...sorry, I have spent a lot of time on YouTube this week, the comment edicate is very different there.
I think it's obvious that addressing obesity with medicine should be a last resort, not a fashionable trend. Also, I would much rather date a heavy girl who is grappling with weight loss than one who drugs herself skinny.
Long before there was Ozempic, Michael Pollan wrote two books about the American diet and causes of obesity and illness, The Omnivore's Dilemma and In Defense of Food. I wonder what he makes of all this. Vicky Lansky wrote in the 1970s, in Feed Me I'm Yours, that we should eat food that remembers where it came from. That doesn't mean it's easy to resist what the food industry is doing to us, but the answer has been there for some time. I grew up with food as a reward in a family with weight issues. My kids are pretty well balanced and seem to have avoided that. Maybe these ideas helped. Still, for people who are very obese, at least the new drugs may offer a path out to start a healthier life, free of the stigma and prejudice they face.
I have been eating healthy, unprocessed foods for around 7 years. One really surprising "side effect" is that my pregnancy cravings are very different from what most women crave.
In my current pregnancy I've been craving kefir, unflavored yogurt, tomatoes, and red meat. Almost never processed food.
Once in a while I did feel like I wanted to have something like rice pudding or Doritos. And then I ate some, and the craving went away for good. I didn't eat bags and bags of Doritos, I ate a handful and then I was done with it for the rest of my pregnancy.
I also experienced very little nausea. Some in the beginning, but not much.
I also walk my dog for a couple hours every day. I've been doing this since I got my first dog as a teenager. And I could easily do it even at 9 months pregnant. 2 weeks after my first child was born I visited a friend. She freaked out when she realized that I walked all the way to her house (one hour).
Pregnancy is a natural state of a woman's body. It's not supposed to be a debilitating condition, but it so many women treat it like this.
I loved this interview, but I'm disappointed that Johann stayed on this drug instead doing a major of a lifestyle change after all the things he learned about obesity. Hopefully one day he will be ready to make real changes.
Great show. Makes me want to think and to learn more about the trade-offs discussed.
I found the podcast interesting, but noted that Ozempic and other semaglutide medications which were designed for the treatment of Type 2 Diabetes was not emphasized enough. Unfortunately, for those of us who are Type 2 diabetic, we are finding it more difficult to access this necessary drug. I have never been seriously overweight and exercise regularly, but pre-diabetes and Type 2 Diabetes runs in my family. I recently had to switch from Trulicity to Ozempic because Trulicity is on an extended back order. I am concerned that Ozempic may become unavailable. If I could remove the semaglutide medication from my prescription list, I would gladly do so. But to date it has been the best medication to keep my A1C in a positive place. I don't know what the long-term answer is, but competing for a medication that has become a world-wide phenomenon for weight loss, is difficult for Type 2 diabetics.
The cost of the drug was not addressed. I would like to get it but insurance won’t pay and it is nearly $1,000/month. Thus the reason why celebrities get it. I appreciated the reasonable way the author looked at the pros and cons.
Don't get it. You can just address the root cause for the fraction of the price and you don't have to use a drug that will slowly kill you.
https://articles.mercola.com/sites/articles/archive/2024/05/08/ozempic-weight-loss-injections-health-effects.aspx?ui=95f70efc3f0236a03d524f948ac0b5b27c302ad95a70226c1374f4f445d8c41f&sd=20231120&cid_source=dnl&cid_medium=email&cid_content=art2ReadMore&cid=20240508_HL2&foDate=true&mid=DM1569118&rid=16278054
here is some real actual information on the dangers of GLP-1 drugs. Do not use them is the real life answer.
I had to wait 50 minutes until I heard the word "exercise" and then it was just glossed over. I think a big part of why we are so obese is because we don't do manual labor like we used to (in the 60's and prior.) We are so sedentary. Exercise is probably the last thing Americans prioritize in their lives. Buzz, buzz, buzz, never enough time.
Because exercise is a lot less important than the inflammation in your body
What the guest misses during his argument that he doesn’t treat people with medical conditions like high cholesterol as it being their fault is that it generally isn’t. Cancer usually isn’t people’s fault, which is why we feel bad for them. Except in the case of lung cancer because people are assumed to have brought that risk upon themselves if they are a smoker.
The difference between obesity and almost everything else is that obesity is generally within your control. Diet and exercise are the tried and true methods because they work, and failure to do them is most certainly a lack of willpower. I’m sorry to hurt people’s feelings, but if you have been overeating for decades I’m not going to treat you like shit but I’m also not going to pity you and pretend like you’re a victim.
Yes, the food supply can be shit sometimes, and food can be addictive, but that doesn’t let you off the hook for your choices. Even by the authors own admission, he still eats garbage and loses weight so you can’t exclusively blame it on the food supply. Its calories in versus calories out.
To the argument that calorie restriction is a “bad” method of losing weight, what exactly do you think Ozempic is doing for you? It’s not magic. It’s causing you to eat less. It’s making it easier for you to have a calorie restricted diet. It is a medically induced calorie restriction.
Do whatever you’d like people, but don’t come crying in 10 years when this destroys your body more than it was before and pretend like you’ve been duped. Anyone with a brain can see that radical medical interventions always come with side effects. If you choose to ignore them for your own vanity, do it at your own risk.
The live to fight another day argument is concerning to me because that requires that people remember to fight after their immediate problem is solved-- that they don't fall into complacency and just continue to rely on this drug and just move on. At this point, having watched how our culture actually behaves most of the time, I really don't believe anyone is going to have the staying power to do anything about the problem, especially when we have an injection that removes the suffering essentially "for free". Also, he admits that he's continued to eat crappy food, just in smaller amounts, which is absolutely terrifying. I struggle with this too, I'm only about 25 LB overweight but I'm prediabetic and I have a real sweet tooth and a habit of cramming sugary foods down my gullet before bed. It seems crazy to me that the argument is that taking a drug with unknown long term side effects is better than dying from eating too much fried chicken when you can just maybe try to start eating some vegetables and lean protein and also try to do some exercise. I'm not a smart man, but isn't this some kind of logical fallacy, false dichotomy or something? Like you could just really try and care about yourself, put faith in a process that is known to work, do the hard work of restraining yourself and working out. It's very hard, I'm a recovering alcoholic and I stopped smoking, I get it. I'm struggling with bad food now, but the benefits are so worth it if you stay with it consistently. When I exercise for 10-20 minutes a day, my mood is better, my self-esteem is better, my joints don't hurt as much, my energy has increased. Take care of yourself -- it's not a puzzle, we know this is the answer. Find the ways that you're self destructive and get some help, come up with a plan to dismantle the bad habits that are killing you. I can see this drug being used to help people who are severely obese, to get them to a point that they can begin to form better habits, but it seems like it should only be used as a temporary part of a larger plan that allows a person can get down to a manageable weight that allows them to be active without hurting themselves.
I do have to acknowledge the fact that we are up against massive companies that are engineering food to be addictive, essentially hacking the human brain in the same general way that social media has. The average person 80 years ago, when obesity levels were sane, didn't have to deal with being constantly subjected to weaponized temptation the way we are today. How do we fix that? We're the sickest, fattest culture in all of history. We weren't like this several generations ago and we didn't need an ever increasing cavalcade of pills and injections back then to simply exist in a healthy state. Why not subsidize farmers who grow healthy food in healthy, traditional ways instead of subsidizing monocrops of corn and soy? Produce affordable food that is heathy.
We're going to have to learn to change our lifestyles to protect not only our bodies, but also our minds from the deluge of advertising, manipulation and programming that we are faced with constantly. So many things about our economy, culture, whatever have become parasitic. I don't really care about Capitalism, Communism or anything else so much as I care about whether or not what we're doing makes sense, is sane and makes us a better species on a long term scale. If what we're doing serves only to make money for a few people short term, it seems crazy. Ultimately, each one of us is responsible for our own survival, but throwing someone into a pit filled with snakes and then saying it's their fault for getting bitten seems kind of like a dick move. You have to fight if you want to save yourself, and it's very much worth doing, but c'mon, the deck is stacked against all of us here. I had a coworker who was a heroine addict and he told me one time he felt sorry for me as an alcoholic. He said that he had to actively seek his drug out but mine could be found nearly everywhere. The same principle applies here and I have the utmost compassion for anyone struggling with this, but don't just trade one substance for another. Keep waking up, forgiving yourself and then trying again as hard as you can muster. That's the only way.
As someone who was in the weight loss industry for 28 years, I have lots of thought about this, which I may post later. But one thing I will say is our society does not think health is important until your lose it, espcially women. Most of my client did not make time to eat meals or move. Companies think it is fine to eat at your desk. Taking time to workout is seen a vain and schools will give up gym before any other class. I love Bari, but you can see her business and her family all come before self care. And when you push yourself to the limit and have a stressful life, food is an easy, sociable comfort.
Will there be a written transcript of this episode?
If you have an iPhone, the podcast app will transcribe.
I have been overweight/obese most of my life. Most recently, I hit a BMI over 50 (and over 300 lbs) about almost two years ago. I was seeing my endocrinologist - who because of my continued gain, my expressed frustration with my inability to lose weight, and the fact that I was pre-diabetic, offered to write me a script for Ozempic. I said yes. After six months, i had lost about 10 lbs, and she upped my dose. By my next six month visit I realized two things - it wasn’t working for me and i absolutely needed to come off it. In that six month period I had gone through an entire family sized bottle of antacid, and lost only another 5 lbs). So we agreed to stop the med, let my system purge it, and readdress writing for a different one in six months time.
Three months after that, I had gained the little weight I had lost back. Unhappy with that, I decided to go back to the one thing that ever had me losing weight. I downloaded an app, and started keeping track of what I ate (following macros). I told the app I wanted to lose 60 lbs. It gave me a target calorie count, and targets for protein, carbs, and fat. Since starting that, I am down nearly 40 lbs (my weight loss was slowed a little by foot surgery that has required me to be much more sedentary than usual). But I focused on what I was eating - and I realized I was eating tons of empty calories, not nearly enough protein and mindless snacking was killing me. Now, 7 months in, I’ve changed the foods I eat significantly, but in a way that I can still do things like enjoy a glass of wine, eat dessert, go to a restaurant, etc.
I’m an anesthesiologist by trade. Ozempic and the like have significantly changed the way I practice. My anesthesia groups are full of anecdotal stories of patients who had been NPO for 2+ days coming in for endoscopy with a stomach full of food. Now, we are asking patients to skip a dose prior to surgery (and we aren’t sure if that is helping) and even if they do, we still treat them differently than a standard patient because of their aspiration risk.
Given all that, I’m overall not a fan of the drug.
I like addressing the fast food/ manufactured food industry in the western world , it’s a huge problem, subsidized very much by agriculture oversupply of corn crops. We very much have an issue with gluttony and excess.
Just finished listening to this episode and immediately went to Audible to get the book! A complicated set of topics rolled up into this podcast with interesting, funny and important insights. Thanks for revisiting this topic with a curious and questioning mind. Really great listen!
"Fatty fatty 2 by 4, can't fit through the kitchen door"
-captain hero
...sorry, I have spent a lot of time on YouTube this week, the comment edicate is very different there.
I think it's obvious that addressing obesity with medicine should be a last resort, not a fashionable trend. Also, I would much rather date a heavy girl who is grappling with weight loss than one who drugs herself skinny.