Magic Pill Quotes

“Roughly one in ten of the people who have bariatric surgery develop an addiction to alcohol, or gambling, or shopping, or drugs, in the aftermath. They are often referred to as “addiction transfers”—where somebody’s obsession with being comforted by food shifts to being comforted by another compulsive behavior.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The fourth way is that processed food lacks two things we really need—protein and fiber. The effect this is having has been investigated by David Raubenheimer, a professor of nutritional ecology at the University of Sydney. Protein is a complex molecule that we all need to build muscles and healthy bones, and David wondered if there was a deep underlying reason why eating low-protein, processed foods—as most of us do these days—could drive us to overeat. What if we have more than one kind of hunger? We all know we have a natural hunger for calories to give us energy, but the body also knows that for it to function properly it also needs protein. So he asked—what if your body makes you hungry not just for calories in general, but also for protein, and it leaves you feeling unsatisfied until you get enough of both? If this was true, it could cause a problem in an environment full of processed foods. Imagine a table where, to the left, you have the kind of high-protein meals my dad grew up eating, and to the right, you have the low-protein meals I grew up eating. To get you the same amount of protein into your system, the meal to the right would have to be much bigger. You would have to eat much more. To figure out if this was true, David designed a small but clever experiment. He split people into two groups—one one was given a high-protein diet, and the other was given a low-protein diet. Both were told they could eat as much as they wanted. They were then monitored, to see how much they consumed. It turned out that both groups ate the same amount of protein—but to get it, the people eating the processed food had to consume 35 percent more calories in total. This, he told me, was proof that when we consume processed foods, we eat more of them “to get our fill of protein.” At the same time, fiber is a type of carbohydrate that we can’t fully digest, so when you eat it, it takes longer for food to pass through your body, and your whole digestive process is slowed down. David explained to me that (like chewing) this acts as “a brake” on eating. When you don’t have much fiber in your diet, you’ll get hungry again more quickly, and eat more. Processed foods are generally low in fiber.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“But as I learned, we've had several moments in the past where the new diet drug was hailed as a "magic pill", and then had to be yanked from the shelves because it was more deadly than obesity itself.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“You become constipated because the surge of GLP-1 slows down your gut and its emptying. The food and waste sit inside you longer and find it harder to get out. Similarly, you burp because “the valve that sits at the bottom of the stomach doesn’t open as quickly. The air must go somewhere, so instead of it going down into the small intestine, people start burping.” You become nauseous because the drug creates a sensation of extreme satiety—that you are full and can’t eat any more. The human brain struggles to distinguish between extreme satiety and sickness: the two signals get easily mixed up, which is why, even for people who aren’t taking these drugs, after a really big meal you often feel a little nauseous.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Sometimes, he says, the annual health checks required by the law flag up that one of his employees’ weight is swelling. When that happens, the government pays to refer them to a specialist who will see them over six months, and they can provide them with coaching and support to turn their health around. In his company, 100 percent of the people referred to counseling complete the course and see positive outcomes. But if a company fails and has a fattening workforce, it can be fined. For example, NEC, Japan’s biggest manufacturer of electronics, estimated it could face $19 million in fines for the poor health of its workforce, and introduced extensive changes as a result.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Up until this point, Adam and I had been seeing aspects of Japan’s approach toward health that seemed to me to be totally admirable. But next, I looked at a crucial part of their model that left me with mixed feelings. In 2008, the Japanese government noticed that obesity was slightly rising (although it was still laughably low by our standards). Panicked, they introduced a piece of legislation that became known as the “Metabo Law,” because it was designed to reduce one of the nastiest effects of obesity—metabolic syndrome, a combination of obesity, diabetes, and high blood pressure that really trashes your health. The law contained a simple rule. Once a year, every workplace in Japan has to bring in a team of nurses and doctors to measure the weight and waistline of every employee aged between 40 and 75, and if they have gone up, the company and the employee need to draw up a health plan together to bring them back down.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“So I was surprised to learn that actually most of Japan’s current food culture was invented very recently—in living memory, in fact. Barak Kushner, who is professor of East Asian History at Cambridge, has explained that, until the 1920s, Japanese cooking was just “not very good”—fresh fish was eaten only once a week, the diet was dangerously low in protein, and even the techniques of stewing or stir-frying weren’t used. Life expectancy was forty-seven. He told the food writer Bee Wilson: “Japanese culture is neither timeless nor unchanging.” It was only when Japan’s imperialist government was creating an army to attack other parts of Asia that they were disturbed that the population ate so badly and was so weak, and a new food culture began to be invented, quite consciously, to produce healthier soldiers. After the defeat of Japan in the Second World War, when the country was in ruins, the new democratic government realized that if they didn’t have a healthy population, they would have nothing, and they stepped up this transformation. “The Japanese only really started eating what we think of as Japanese food in the years after the Second World War,” Bee says. “Instead of being dispirited by the way the Japanese eat, we should be encouraged by it. Japan shows the extent to which food habits evolve.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The first thing we had to learn was “triangle eating.” In the West, he said, if you are given a meal with five different components, you eat them sequentially, one after another—you start the soup, you finish the soup; then you start the salad, and you finish the salad; then you start the pasta, and you finish the pasta. “In Japan, this is regarded as really weird,” he said. “It’s a rude way of eating.” A meal like this should be eaten in a triangle shape. “First, drink the soup a little bit, then go to the side dish—one bite. Then try the rice, for one bite. Then the mackerel—again, a single mouthful. Then go back and have another taste of the soup…This is also the key to keep you healthy…Keeping the balance, so you don’t eat too much.” The second thing we had to learn is that, in Japan, you are meant to combine the different foods in your mouth. Take a bite of the mackerel, chew it a little, and then, before you swallow, add in some of the pickle, or some of the rice, or one of the edible flowers, and chew that too. “The chef cooks the dishes, but in the end, it is you who does the final cooking in your mouth.” One of his chefs said: “In that way, Japanese food is something you can enjoy, because you can try out different things and make different flavors.” The third thing we had to learn is when to stop. In Japan, you are taught from a very early age to only eat until you feel you are 80 percent full. Eating until you are totally full is regarded as bad for you. It takes time for your body to sense you’ve had enough, and if you hit a sense of fullness when you are still eating, then you’ve definitely had too much.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“He explained that we were going to make a typical Japanese meal, the kind people were eating all over the country that lunchtime. We would grill a mackerel, boil some rice, make some miso soup, and prepare some pickles. You’ll notice, he said, that in our meals, we have very small portions, but more of them—five in a typical meal. This means that every Japanese meal contains a much broader range of ingredients. Usually, there are sixty to sixty-five ingredients used, while in a comparable meal cooked in the classic French style, there would be around twenty ingredients. (As he said this, I thought of what Tim Spector had discovered in London—that the more diverse your diet, the healthier your gut, and the more your overall health improves.)”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“It turns out that after a hundred or so years, Japanese-Hawaiians are now almost as fat as the people they live among. Some 17 percent of them are obese, compared to 25 percent of Hawaiians of other ethnic groups. Japanese-Hawaiians are more than four times more likely to be obese than people back in Japan. The fact that their obesity level is slightly lower than other Hawaiian groups suggests Japanese people’s genes may make them a bit less likely to gain weight—but only a bit.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Japan is the only country in the world that got rich without getting fat. It’s strange that sumo wrestlers are one of the most recognizable symbols of the country, because expecting other Japanese people to look like them is like expecting Americans to look like a bald eagle.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“So how well does stigma work in reducing obesity? One study of ninety-three women split them into two groups—women who believed they were overweight, and women who didn’t. They were all then shown a newspaper article about stigma in the job market toward overweight people. Afterward, they were all monitored, to see if it had any effect on their eating. It turned out that hearing these claims had no effect on the normal-weight women, but made the women who believed they were overweight eat significantly more. In a different study, overweight people who were shown a harsh and judgmental video ate three times more calories than overweight people who watched a non-judgmental one. There is now a broad range of evidence showing that stigmatizing overweight people is in fact counterproductive—on average, it makes them gain weight.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The new weight-loss drugs are vastly more effective than anything that Jessica or Noelle could get their hands on. So what will happen when people with eating disorders get hold of them? One of the people who has been most vocal in warning about this is Kimberly Dennis. She is a psychiatrist and the chief medical officer of SunCloud Health, a group that runs eating disorders clinics in Chicago. She believes these new weight-loss drugs are like “rocket fuel” for people with restrictive eating disorders. Every day in her clinic, she sees people who are trying to starve themselves—and now these new drugs give them the most effective tool for self-starvation that has ever been discovered. Ozempic arrived at a time when there was already a rising eating disorders crisis. “During the pandemic,” Kimberly said, “rates of adolescents admitting to ERs and inpatient units for eating disorder treatment tripled. Skyrocketed.” Now, she thinks, it is going to soar further. This is not, of course, the intention of the companies manufacturing these drugs, who instruct doctors not to give them to people with a BMI below 27. But the sieve through which these drugs are being prescribed is very leaky. To get them, you can see a doctor online, and many of those medics are not checking your BMI effectively via Zoom.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“There is strong evidence that if you change the kind of women who are represented as beautiful, you change how girls in particular feel about their bodies. For example, in 1966, a survey of high school girls found that 50 percent of them believed they were too fat. Three years later, in 1969, 80 percent thought they were too fat. (In reality, only 15 percent of them were even slightly overweight in medical terms.) What changed? In 1966, a seventeen-year-old model named Lesley Hornby was suddenly and sensationally declared to be the new paragon of female beauty. She was announced as “the face of 1966” by the fashion press, and became better known as Twiggy. She weighed 91 pounds. After her rise to fame, fashion models shrank—and women’s hatred of their own bodies increased.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“After years of this exposure and reinforcement, we have been left with profoundly distorted abilities to even see our own bodies. One group of scientists gathered one hundred people at St. George’s Hospital Medical School in London, showed them a box-file, and asked them to estimate its width. They all got it right. Then they asked them to estimate the widths of their own bodies. They were way off, overstating the size of their waists by 25 percent and their hips by 16 percent.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Research in the 1950s found that very few people were unhappy with their bodies. But now “in the UK, in the US, upward of 90 percent of women feel some aspect of negative body image. About 70 percent of men experience some form of negative body image.” En masse, most of us began to feel our bodies were not good enough. Today, “the majority of people are discontent with themselves. There is no other field of psychology where we accept that as the norm. If you said 90 percent of people were depressed, we would have strategies in place to work out why and how we fix that. With body image, we’ve got to a place I think where we have just accepted this as normal.” We need, he believes, to see this as a crisis, and try to put it right.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The truth is that seven months into taking Ozempic, I was banking the benefits of the weight loss, but making almost no other changes in my life. I was eating much less, but I was, frankly, eating smaller portions of the same old shit. Instead of having a whole chicken roll coated in mayo for breakfast, I had a third of one. Instead of having a Big Mac, fries, and nuggets, I just had fries. My diet still consisted overwhelmingly of processed and junk food, just less of it. It was progress—but of a limited kind. Robert Kushner told me that many of his patients were in the same position. “Some people come in thinking the medication is working and they don’t go any further than that. So I force them to reflect. What are you doing with these new sensations? Are you choosing and consuming less ultra-processed foods? Are you having more fruits and vegetables? What is your pattern of eating? Are you having a more plant-based diet? Equally, are you more physically active? Are you doing resistance training? Are you going for hikes? Are you walking your dog?” When I told him I was still eating badly, he smiled sympathetically, and said: “We know diet quality impacts health. Forget about the drug. We know there’s mounds of data that shows that a nutritionally balanced diet, high in fruits and vegetables and reduced in saturated fat and trans fat and meat products, leads to a heck of a lot of [good] health outcomes…To improve your health, you have to go the extra mile. You have to now look at the quality of your diet and your physical activity.” Whenever I heard this advice, I both knew it to be true and felt totally at a loss about how to implement it. How would I even begin? I find this embarrassing to say, because I think of myself as a competent person—I can travel all over the world investigating complex concepts and making sense of them for large audiences—but when it comes to the basic skill of feeding my body, I had no clue what to do. I had never cooked anything that wasn’t made in a microwave. Literally never. Almost everything I ate, unless it was cooked by somebody else, was a takeaway or eaten in a restaurant.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Following bariatric surgery, a significant minority—17 percent—experience depression and anxiety so severe that they need inpatient psychiatric treatment. Carel Le Roux said: “After bariatric surgery, we [see an] increase [in] suicide fourfold.” The overall risk remains very low—but it goes up dramatically. It seems to happen for the same reasons that some people become addicted. Deprived of the underlying reasons why they eat, they find they cannot cope with life.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“In the 1970s, a scientist named Leann Birch at Penn State University was inspired by Hilde, and decided to use modern scientific methods to figure out if the psychoanalyst’s hunches had been right. She conducted over thirty studies through the years, aiming to discover whether, using Hilde’s core ideas, you could actually reduce childhood obesity. To give an example of one of her studies, her team at Penn State Children’s Hospital took a group of 279 first-time mothers, and split them into two groups. The first group was given intensive support in learning how to tell the difference between when their kids were crying because they were hungry, or overstimulated, or distressed, or tired. Ian Paul, a doctor who worked on the study, told me that the mothers and babies were taught that “food should be used for hunger,” not for solving these other problems. The mothers were gently guided to feed their kids when they were hungry, and to respond to the other situations not with food, but with different techniques. The second group was not given any of this training. Leann then followed these parents and babies over time, to see if there was any difference. The children of the mothers in the first group turned out to be half as likely to become overweight or obese. This and other studies conducted over the years suggest that Hilde was right: how our parents read our signals of hunger and respond to them shape us deeply, and can play a significant role in our later weights.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Nearly 31 percent of women and 19 percent of men say they respond to stress by eating in order to feel better. This coping mechanism has become very widespread. A team of scientists analyzed 475 games from the 2004–5 National Football League season. They discovered that if the home team lost, sales of common comfort foods like pizzas surged by 16 percent the next day. By contrast, if the home team won, consumption of these foods fell by 9 percent, and among highly committed fans, it fell by 16 percent. The bigger the pain, the more people hit the food. On the night Donald Trump was elected president in 2016, as the news of each state going into the red column came in, food orders on apps like Grubhub and Uber Eats in blue states massively surged, and people mostly ordered high-fat, high-carb junk. There was a 46 percent surge in people ordering pizza, a 79 percent surge in people ordering cupcakes, and a 115 percent increase in people ordering tacos. Over the next twenty-four hours, as the news sank in, Democrats comfort-ate even more. The day after the election, as the neuroscientist Rachel Herz has pointed out, sales of fried chicken were up 243 percent in Los Angeles, while sales of mac and cheese were up 302 percent in Chicago. This pattern follows after all shocking events. After 9/11, sales of unhealthy snack foods soared, too, as they did during the pandemic. It’s also true for personal disasters. For men, if you lose your job, your chances of adding 10 percent or more of your body weight shoot up.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“When Heath Schmidt heard about the results of the early experiments to inject GLP-1 agonists directly into rodents’ brains, his spider-sense began to tingle. He is the director of the Lab of Neuropsychopharmacology at the University of Pennsylvania and has been studying addiction his entire career. He told me he was particularly struck by one finding. If a GLP-1 agonist is jabbed into a rat’s brain, it will massively cut back on its consumption of junk food—but it will eat just as much of the normal, healthy rat chow. “So you can think of it as—we’re sitting here and we have a choice between a salad and a Happy Meal from McDonald’s.” Most of the time, we’re going for the Happy Meal. But if you squirt this drug into the [area of the brain known as the] VTA [which is also part of the reward system], we’re going to reduce our desire to eat the Happy Meal, but leave our eating of the salad intact.” This is really unusual and significant, he said, for one key reason. In the past, scientists had tried designing drugs to reduce addictive behaviors, but they kept bumping into a problem. They could find drugs that dampened addiction, but the drugs also dampened “natural rewarding behaviors, like feeding and sex and social interactions.” They worked by dialing down your entire reward system, so if you took them, you lost your interest in cocaine, but you also lost your interest in life and all of its pleasures. That’s not much use. “The”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The tale of modern diet drugs began in a French factory at the height of World War I, when a weird accident took place. Men who were building munitions using an explosive yellow powder named dinitrophenol noticed that they had started to lose weight rapidly. It turned out they were absorbing the explosive both through their skin and by breathing it in, and this was causing them to lose their appetites. A group of American scientists at Stanford University heard about this and began to research the potential of the explosive as a weight-loss drug. They discovered that people who took it as a pill lost two pounds a week effortlessly, without feeling at all hungry. They then uncovered the mechanism that made it work: if you took it, your metabolism would speed up by between 30 and 50 percent. The drug companies of the day seized on this and started to market the chemical as Redusols, “a new and safe way to lose weight” and an “anti-obesity therapy.” It became wildly popular, especially when you bear in mind that obesity was so much lower than it is today. By 1934, 100,000 people were taking it. But then people started to notice the drug had other effects. If you took a low dose, you would often sweat profusely, or lose your sense of taste. If you took a medium dose, you often developed cataracts and went blind. The drug worked in part by raising your body temperature—it was, after all, an explosive—and doctors began to realize with horror that if you used it at a high dose, it could literally cook you from the inside. The historian Hillel Schwartz explains that for heavy users “there is a fatal hyperpyremia. That is, the body succumbs to an extraordinarily high fever. It burns itself up.” By 1938, Redusols was banned. It continued for years to be used as a powerful pesticide, because it is so good at killing anything that lives.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Max said the effects of diabetes are so severe, even when it is treated well, that he has personally reached the conclusion that if he had a choice, he would rather be diagnosed as HIV-positive than diabetic. He knows that sounds shocking, but urged me to look at the facts. “This is from a purely medical point of view. At the moment, people with HIV [who receive treatment] are living as long as somebody without. Someone with diabetes? You lose fifteen years of your life on average,” if you get it as a young adult. And it’s not just that you die much earlier. You are far more likely to live with terrible complications, often for years. “If you look at the last few years of your life with diabetes,” the odds are significantly increased that you “may be quite severely disabled. You might be blind. You might have renal failure. These are the complications of diabetes…You might have your leg amputated. You might have a stroke, so you’re paralyzed down one side. You might have vascular dementia. There are multiple things that could affect you if you have diabetes before it kills you.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The seven deadly sins were first spelled out by Pope Gregory I in the sixth century—and one of them was gluttony. He said overeating is a sin, and sin requires punishment before you can get to redemption. It is very deep in our culture to believe that obesity is a sign a person is greedy, so suffering is the just and necessary response. The only forms of weight loss we admire are ones that involve pain—extreme exercise programs, or extreme calorie restriction. If you go through that, we’ll just about forgive you. But if you’re suddenly thin at no cost in pain and sweat to you? We are outraged. I realized I had internalized this. I felt ashamed of being fat, and at some unconscious level, I believed I deserved to be punished for it—and taking Ozempic was skipping the punishment, a get-out-of-jail-free card. But when these ideas were brought to the forefront of my mind—once I had to say them out loud—I began to question them. I thought about this more deeply when I read an essay by the Irish journalist Terry Prone, who wrote about how a similar debate had played out two hundred years ago. When modern anesthetics were first introduced, many doctors resisted giving these painkilling options to women going through childbirth, believing that suffering was a crucial part of delivering a baby. Christ had suffered on the cross, and women should suffer when delivering a child. Suffering was ennobling. (I suspect there was also a strain of misogyny and Puritanism to it: a woman delivering a child has had sex, and that, too, should be followed by the infliction of pain.) To have a child without pain was cheating the laws of nature. The beliefs around this only changed very slowly. A key moment came when Queen Victoria revealed she had used anesthetics during her childbirths. Today, few people would say that a woman was “cheating” if she dulled the agony of childbirth with meds, and you would regard me as crazy and misogynistic if I told you that a woman giving birth deserves to suffer. So I asked myself: Why should recovering from obesity involve pain? Do I really think Jeff deserves to suffer? Or my late friend Hannah? Or my grandmother, who was obese for most of her adult life, ruining her knees and likely contributing to her dementia? Do I think they are sinners who deserve punishment—or have I moved beyond the ideas of a sixth-century pope?”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The science is mixed and not always of the highest quality, but some rigorous studies seem to suggest that even these diet drinks can cause you to gain a significant amount of weight. For example, Susan Swithers, professor of psychological sciences at Purdue University in Indiana, has carried out experiments where she gives rats either sugar or artificial sweeteners—and the rats given artificial sweeteners gained more weight. She said the sweeteners seem to cause “metabolic derangement” in rats. When I first read this, I thought it couldn’t be true. How could a zero-calorie drink make you fatter than a sugary one that’s crammed with calories? Tim investigated this—and he started by experimenting on himself. He wired himself up with a glucose monitor, and drank a mixture of water and one of the most common artificial sweeteners. These chemicals are marketed as “inert”—that is, they don’t have any effect on your body and are just passing through, like good tourists who leaves the countryside in the same pristine condition as when they arrived. But as Tim watched his glucose levels, he was startled. They surged by more than 30 percent. He told me: “It’s obviously not inert. It’s doing something.” In a study published in 2022, a team of Israeli scientists split 120 people into groups. Twice a day for two weeks, they gave them either one of four artificial sweeteners or real sugar. The artificial sweeteners had a striking effect. Two of them raised blood sugar for everyone who drank them, and all four of them altered the bacteria in the people’s guts in the way that happens when you have high blood sugar. What causes this? It is in part, Tim suspects, because these chemicals have an effect on your brain. You drink something sweet, and it expects a surge of energy from sugar. Everything in our evolution primes you for it. When it doesn’t come—when your brain realizes it’s been tricked—it responds by making you more hungry, to give it that fresh surge of energy it was expecting, and so “you suddenly want cake.” Susan’s groundbreaking studies have led her to believe that the presence of artificial sweeteners in our diets might be one of the big drivers of the obesity crisis.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“The second way our satiety is being undermined is that these manufactured foods often contain that uniquely powerful combination of sugar, fat, and carbs—and this seems to activate something primal in us. We go crazy for it, in a way we don’t for other kinds of food. Dr. Giles Yeo, an obesity researcher who I interviewed in his lab at the University of Cambridge, told me his hunch about why that is. There is, so far as he is aware, likely only one foodstuff available in abundance in nature “where you have carbs and fat naturally mixed together as a unit”—and it’s breast milk. This is the first food almost all of us consume. It soothes us. As a species, humans didn’t access this seemingly unique sugar-fat combo after we’ve been weaned—until now. So we lap at it like an infant at the breast, and gorge.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“Then, once the rats were extremely fat and had got used to eating the processed food for a few months, Paul did something harsh. He took it all away. He abruptly cut off the supply of junk food, and the rats were left with just the nutritious, healthy rat chow they had been consuming all their lives until recently. Paul was fairly confident about what would happen next. They would eat larger portions of the standard rat chow than before, proving that the junk food had expanded their appetites and made them crave more. This would be a worrying effect, to be sure. But that’s not what happened. What actually took place was more extreme. In the absence of their beloved junk food, the rats refused to eat almost anything. To Paul, they seemed lost and angry. “They basically starved rather than eat this other food. They rejected it. They thought it was horrendous.” It was like they had forgotten what real food was, and no longer recognized it as food at all. “You begin to see this dramatic weight loss. The animals are really starving themselves,” he explained. It was only when they reached the point where if “they didn’t eat it, they’d starve to death, [and] they had no choice” that they returned reluctantly to the nutritious food, eating a little of the old rat chow. So before they were exposed to the new American diet, they had an ability to naturally limit how much they ate, and even though they had an abundance of food, they never became obese. But once they were exposed to it—high sugar and fat, all in a highly processed package—the rats became obsessed, ate far more than they had before, gained a huge amount of weight, and got sick. And after trying it, they had to be starving before they would go back to the way they used to eat.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“In the year 2000, a young scientist named Paul Kenny moved from Dublin to San Diego to continue his neuroscientific research. He noticed something pretty quickly. In the main, Americans don’t eat like Irish people. They eat more, and they consume more sugars and fats in particular. Paul was thrown at first, but he soon assimilated—and within two years, he had gained thirty pounds. “I was like—oh my Lord, what is going on?” he told me. He rose to become the chair of the Department of Neuroscience at the Icahn School of Medicine at Mount Sinai in New York, and on the way, he grew curious about something. Did this different American diet change your brain? Once you start to eat in this way—lots of processed, fatty, sugary foods—might it be harder to stop? With his colleagues, he designed an experiment to test this. They raised a group of lab rats, and fed them nothing but pre-prepared rat chow. “It’s healthy. It’s balanced,” Paul said—the lab rat equivalent of what my father grew up eating. When this was all they had, the rats would eat until they were full, and then their natural instincts would kick in, and they would stop. They never became obese. Then he introduced the rats to the hyper-American diet. He bought some cheesecake and Snickers bars, and fried up some bacon. He split the rats into two groups. The first group was given access to the junkiest American food for one hour a day. The second group was given access to it almost all day. Both groups also, at the same time, had access to as much of the healthy rat chow as they wanted. You might call these cages Cheesecake Park—a place where the rats got to eat just like us. Paul watched as the rats sniffed the cheesecake and the Snickers and the bacon, and they began to eat. And eat. And eat. The rats who only had an hour with the cheesecake would “dip their head into it” the moment it arrived “and munch all the way through” until it was totally gone, Paul said. “The head would be slick with cheesecake. They’d gorge themselves,” and emerge “smothered in cheesecake.” The rats who had access to it all the time would eat even more, and they consumed it differently. They would eat some, leave it for a little while, then come back and eat some more. They were frequently topping up with sugar and fat. For both groups, as soon as they had the American diet, they lost interest in the healthy old rat chow. They shunned it. It bored them. The rats who got cheesecake for an hour a day would get just a third of their calories from the rat chow. The rats who had cheesecake all the time got just 5 percent of their calories from ordinary rat chow. They lost their ability to control their eating. Their old instincts, which kept them healthy, stopped working. They simply gorged.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“As the drugs began to be used widely across the world, financial analysts started to figure out what this would mean for the global economy. Strategists at Barclays Bank urged investors to move away from the fast-food and snacks markets. There’s already been a decline in the value of the stocks of the doughnut company Krispy Kreme, which analysts directly attributed to the growing popularity of Ozempic. Similarly, Mark Schneider, the chief executive of Nestlé, said that “food and snacking-related categories are the most impacted. In our case that will be the frozen food side of things, confectionary, and to some extent, ice cream.” Morgan Stanley calculated that, because people drink less alcohol when they’re on these drugs, there will likely be $3.5 billion knocked out of the market for booze in the US over two years. The effects are rippling out into unexpected parts of the economy. Companies selling devices for hip and knee replacements have seen their values plunge, because obesity causes so much damage to those parts of the body. An analyst for Jefferies Financial said that airlines are poised to save millions of dollars a year because less jet fuel is burned when you are flying slimmer people. Even jewelers have seen a shift in their business, because people’s fingers are shrinking as they shed weight, so they need their wedding rings to be refitted.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs

“This means that for the medication to work, you have to take it forever. It’s not like taking a drug to treat malaria, where you take a course, and then it’s done and you’re cured. It’s like taking statins to lower your cholesterol levels, or blood pressure tablets—you have to keep using it, or lose the effect. This drug, in other words, isn’t a holiday fling. It’s a lifelong marriage.”
― Johann Hari, Magic Pill: The Extraordinary Benefits and Disturbing Risks of the New Weight-Loss Drugs