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--:-- Noel King: Welcome to Today Explained. I'm Noel King.
--:-- Noel King: During the 2024 Olympics, a player on the U.S. women's rugby team, Alona Marr, got a ton of attention for talking about her body mass index. I do have a BMI of 30. Well, 29.3 to be more exact. I've been considered overweight my whole life.
--:-- Noel King: I remember vividly one time in high school I did turn in the physical to the office and right at the bottom of the page it said overweight.
--:-- Noel King: Ms. Mamm went on to win a bronze medal and also to illustrate the absurdity of BMI. But doctors and insurance companies still use this number to make judgments about your health.
--:-- Noel King: And then just yesterday, a global panel of experts advised that we measure obesity differently.
--:-- Noel King: The relationship between diet and weight and health seems like it should be clear and knowable by this point. But it's really not.
--:-- Noel King: Coming up on Today Explained, why the gospel on weight loss is always being rewritten, and how medications have added a brand new chapter.
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--:-- Noel King: Adio says it also allows you to create those email sequences, those real-time reports, those powerful automations, which they claim can help you build what matters most, your company.
--:-- Noel King: You can go to adio.com slash todayexplained to get 15% off your first year.
--:-- Noel King: That's A-T-T-I-O dot com slash todayexplained.
--:-- Noel King: You're listening to Today Explained.
--:-- Noel King: Sumita Mukhopadai is a writer and editor who was very anxious when she was hired as the executive editor of Teen Vogue back in 2018.
--:-- Sumita Mukhopadai: Like everyone else, I had seen The Devil Wears Prada, and I knew that the fashion industry was unforgiving.
--:-- Sumita Mukhopadai: But not long after I started there, I realized that things were changing.
--:-- Sumita Mukhopadai: You know, I entered the fashion industry at a really unique moment where there was an increased interest in plus fashion.
--:-- Sumita Mukhopadai: And so when I got the job at Teen Vogue, I started having all these fashion brands reaching out to me to be like, wow, we're so excited.
--:-- Sumita Mukhopadai: We're launching a plus collection. We'd love to talk to you about it. We'd love to send it to you.
--:-- Sumita Mukhopadai: How does it feel to be a fat fashion editor?
--:-- Sumita Mukhopadai: And at the time, I had kind of newly gained the weight.
--:-- Sumita Mukhopadai: And so I wasn't totally embracing it.
--:-- Sumita Mukhopadai: I wasn't, I didn't, it didn't feel empowering.
--:-- Sumita Mukhopadai: It was almost felt like something that was happening to me where I was like, oh, wait, I'm fat.
--:-- Sumita Mukhopadai: Like, you know, I had to kind of get over that first step before being like, I'm fabulous.
--:-- Sumita Mukhopadai: I love being fat.
--:-- Noel King: Okay, so you're in a period where Teen Vogue has become more accepting.
--:-- Noel King: It is okay to be a person in a larger body.
--:-- Noel King: And in fact, there's even some sort of advocacy or activism around the fact that there is more than one body type.
--:-- Noel King: And then you get some news that, again, changes how you see and experience all of this.
--:-- Sumita Mukhopadai: What happened?
--:-- Sumita Mukhopadai: While I was at Teen Vogue and kind of as I was leaving Teen Vogue, I had had a series of stressful family related things happen.
--:-- Sumita Mukhopadai: My father passed away of diabetes related complications.
--:-- Sumita Mukhopadai: My mother was diagnosed with breast cancer.
--:-- Sumita Mukhopadai: I had this really hectic job and I was managing all of it.
--:-- Sumita Mukhopadai: And my stress response was eating.
--:-- Sumita Mukhopadai: And it was not just eating.
--:-- Sumita Mukhopadai: It was like really not taking care of myself ultimately, right?
--:-- Sumita Mukhopadai: It was taking Ubers.
--:-- Sumita Mukhopadai: It was getting takeout.
--:-- Sumita Mukhopadai: It was kind of not really having a lot of time for myself.
--:-- Sumita Mukhopadai: And that did lead to some unwanted weight gain on my part.
--:-- Sumita Mukhopadai: And I was having some mobility issues.
--:-- Sumita Mukhopadai: I was having trouble kind of, I just thought it was because I was exhausted because I had never had these experiences, but I was having trouble getting up and down the stairs on the subway.
--:-- Sumita Mukhopadai: And I would just chalk it up to like, oh, I'm just so busy.
--:-- Sumita Mukhopadai: You know, like I have to take Ubers because I'm like busy and I'm exhausted.
--:-- Sumita Mukhopadai: And I was having trouble keeping up on walks and I was having trouble sleeping.
--:-- Sumita Mukhopadai: I wasn't feeling well.
--:-- Sumita Mukhopadai: And, you know, on top of that, my clothes weren't fitting.
--:-- Sumita Mukhopadai: And so I went to the doctor and, you know, this is after I had left Teen Vogue and like kind of after the pandemic, I decided to start the process of, you know, figuring out if I was OK and also, you know, what I could do because I knew and I understood that diets don't work.
--:-- Sumita Mukhopadai: Right.
--:-- Sumita Mukhopadai: Like I knew I could restrict what I was eating, but eventually I'd gain the weight back and I really wanted something.
--:-- Sumita Mukhopadai: I really wanted a strategy that would be more effective.
--:-- Sumita Mukhopadai: And so I went in and got my blood work done and you know pretty much every indicator was elevated so I was had become pre-diabetic my cholesterol was elevated and so those scared me right like I had just lost my father to exactly the things that I'm now looking at in my blood report and so I was like you know I think it's finally time for me to really take this seriously and figure out, you know, a strategy to move forward.
--:-- Sumita Mukhopadai: And she suggested Manjaro.
--:-- Sumita Mukhopadai: It is a injectable that you take weekly.
--:-- Sumita Mukhopadai: That slows your digestion, basically, is how it works.
--:-- Sumita Mukhopadai: And in doing so, it reduces the rate at which you can eat and how hungry you get.
--:-- Sumita Mukhopadai: And so, you know, I decided to go on it.
--:-- Noel King: What did that mean for you? Like once you start taking it, what happens? Do you mean emotionally or physically? Both, both entirely.
--:-- Sumita Mukhopadai: I mean, both.
--:-- Sumita Mukhopadai: Thank you for asking.
--:-- Sumita Mukhopadai: Yeah, yeah, for sure.
--:-- Sumita Mukhopadai: I mean, emotionally, it was really hard to make the decision to go on it.
--:-- Sumita Mukhopadai: I saw it as two things.
--:-- Sumita Mukhopadai: I saw it as a betrayal to the kind of body positivity and feminism that I had ascribed to of loving yourself at any size and not trusting pharmaceutical interventions.
--:-- Sumita Mukhopadai: And also there was another voice inside me that was like, this is how bad it's gotten, girl.
--:-- Sumita Mukhopadai: Like you couldn't control this and now you have to take a drug.
--:-- Sumita Mukhopadai: That's how not well you are.
--:-- Sumita Mukhopadai: And so a lot of self-judgment, a lot of shame came out with the decision to go on the medication
--:-- Sumita Mukhopadai: Physically it is a bumpy road
--:-- Sumita Mukhopadai: It was for me
--:-- Sumita Mukhopadai: For me I struggled with very intense nausea
--:-- Sumita Mukhopadai: So one of the ways that it works is since it slows your digestion, if you overeat, you feel very sick.
--:-- Sumita Mukhopadai: And then a lot of digestive issues.
--:-- Sumita Mukhopadai: It is very hard to go to the bathroom when you're on it.
--:-- Sumita Mukhopadai: You have to take all kinds of laxatives.
--:-- Sumita Mukhopadai: They now have additional prescriptions.
--:-- Sumita Mukhopadai: They put people on that are taking it to help support with, you know, regular bowel movements.
--:-- Sumita Mukhopadai: And so it was not the best physical experience.
--:-- Sumita Mukhopadai: And then, you know, at a certain point, I got used to it.
--:-- Sumita Mukhopadai: But I think it was more that I just got used to managing the side effects.
--:-- Sumita Mukhopadai: They never really went away for me.
--:-- Noel King: You made being on Manjaro sound absolutely horrible.
--:-- Noel King: But I appreciate you being honest about the side effects because I don't hear talk about the side effects very often.
--:-- Sumita Mukhopadai: What was the good in this? What kept you on it?
--:-- Sumita Mukhopadai: It does something.
--:-- Sumita Mukhopadai: And I think it's physiological and a doctor can speak more eloquently to this, but it does trigger something in your brain, a hormone that suggests that you're satiated, right?
--:-- Sumita Mukhopadai: And so it started to help me feel satisfied with less.
--:-- Sumita Mukhopadai: One of my behaviors is I tend to compulsively eat in the evening, whether it's stress or just fun or boredom or binge watching TV, whatever it might be.
--:-- Sumita Mukhopadai: I will sit down with like an array of snacks and kind of eat mindlessly, not always keeping track of how much I'm eating, not necessarily food that had good nutritional value.
--:-- Sumita Mukhopadai: When I was on Manjaro, I would finish dinner and I pretty much would not physically be hungry in the evening and I just wouldn't have space to eat anything else.
--:-- Sumita Mukhopadai: And if I got the munchies, I started to reach for healthier snacks because I noticed that I digested them easier.
--:-- Sumita Mukhopadai: And so if I just like ate an apple or some grapes, you know, like I ate so many freaking grapes or, you know, a handful of carrots or whatever that might be.
--:-- Sumita Mukhopadai: And all the things we tell ourselves, we're like, this is the healthy choice.
--:-- Sumita Mukhopadai: Let's make the healthy choice.
--:-- Sumita Mukhopadai: The healthy choice all of a sudden became easier.
--:-- Sumita Mukhopadai: And so that was part of why I stayed on it, that it really gave me this release from this yearning that I always had where it wasn't a challenging decision.
--:-- Sumita Mukhopadai: I didn't feel a lot of strain around it.
--:-- Sumita Mukhopadai: Whereas historically, when I would beat myself up for eating at night, I never felt like I could stop.
--:-- Sumita Mukhopadai: And with the kind of pharmaceutical intervention, I was able to stop.
--:-- Noel King: OK, so there are pros. There are cons.
--:-- Noel King: Here we are early in 2025.
--:-- Sumita Mukhopadai: How is it going?
--:-- Sumita Mukhopadai: I guess when Manjaro hit the market, they had given a manufacturer's coupon to early people, to people that had first started taking the drug.
--:-- Sumita Mukhopadai: And, you know, I don't read the fine print.
--:-- Sumita Mukhopadai: No one does, girl.
--:-- Sumita Mukhopadai: I thought that was my insurance covering it.
--:-- Sumita Mukhopadai: Like, I didn't understand that, like, the reason it cost that much was a coupon and not my insurance.
--:-- Sumita Mukhopadai: And so the coupon is rescinded.
--:-- Sumita Mukhopadai: And overnight, the drug becomes $600 to $800 a month.
--:-- Sumita Mukhopadai: I think it was like, I think it was 800.
--:-- Sumita Mukhopadai: And they were like, we can do this other coupon that will get you to like 600.
--:-- Sumita Mukhopadai: Like I'm kind of like, these aren't the exact numbers, but all I'm saying is like, it was an insane amount of money that I was like, what?
--:-- Sumita Mukhopadai: Like I live in New York City.
--:-- Sumita Mukhopadai: You can't just take on another payment like that.
--:-- Sumita Mukhopadai: That's crazy.
--:-- Noel King: Yeah, exactly.
--:-- Noel King: I think the combination of the cost and the side effects, and I had lost a lot of weight.
--:-- Noel King: Like I think I lost 50 pounds about.
--:-- Sumita Mukhopadai: And I was feeling great.
--:-- Sumita Mukhopadai: And I was like, you know, let me just try without it.
--:-- Sumita Mukhopadai: Let me phase out of it.
--:-- Sumita Mukhopadai: And so I came off the drug at the end of 2023.
--:-- Sumita Mukhopadai: And, you know, I will say like maintained the loss for quite a bit of time.
--:-- Sumita Mukhopadai: I probably gained like 10 to 15 pounds within like two or three months.
--:-- Sumita Mukhopadai: And that was definitely not a great mental experience.
--:-- Sumita Mukhopadai: Like I definitely came back to that feeling of control of like, oh my God, I'm losing control.
--:-- Sumita Mukhopadai: I'm losing control.
--:-- Sumita Mukhopadai: And, you know, but I was excited because I had made some lifestyle changes that I was maintaining and that felt like a really positive intervention.
--:-- Noel King: Now, this is like the first interview I'm doing about this in like six months.
--:-- Noel King: And so I will say the last six months have been really stressful for me.
--:-- Noel King: I launched a book.
--:-- Noel King: I got married.
--:-- Noel King: Thank you.
--:-- Noel King: Nothing like gaining weight for your wedding.
--:-- Noel King: But I started, you know, some of the things that I had been committing to like cooking and getting enough, you know, my steps every day and all of that like fell to the wayside a little bit.
--:-- Noel King: And so the weight started to creep on and creep on and creep on.
--:-- Noel King: And now I've probably gained back like 60 or 70% of what I lost.
--:-- Noel King: Which has been really hard.
--:-- Noel King: You know, it's hard and it's also feels like it's forcing me to really face my relationship with my health and my own body.
--:-- Noel King: And to like, it's like I understand the options that are out there, but the options are limited.
--:-- Noel King: I wouldn't even say that I would necessarily go back on it because when I think about it, I just get sick to my stomach again.
--:-- Noel King: I'm just like, oh, I just don't know if I can go through that again.
--:-- Noel King: But you know it's been a roller coaster emotional roller coaster having the kind of high of like oh like the weight came off and then to like be feel like I'm back to square one even though I know in my mind and my heart and my spirit I am not
--:-- Noel King: Sumita Mukhopadai, writer and editor coming up is the age of diet and exercise over
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--:-- Noel King: You're listening to Today Explained
--:-- Noel King: I'm Dan Besserson
--:-- Dan Besserson: I'm an MD by trainee
--:-- Dan Besserson: I'm an endocrinologist
--:-- Dan Besserson: I'm here at the University of Colorado in Denver
--:-- Dan Besserson: and I do clinical work taking care of patients at our county hospital, Denver Health, and I do research here at the medical school
--:-- Dan Besserson: I'm also the director of this building called the Anschutz Health and Wellness Center
--:-- Noel King: Dan, you have 47 jobs, man
--:-- Dan Besserson: All right, let's talk about the beginnings of this sort of cultural and medical interest in obesity
--:-- Dan Besserson: When did doctors start thinking of obesity as something that needed to be fixed, something that needed medical attention?
--:-- Dan Besserson: I think there's always been people with really high weights that doctors thought, well, that's probably a health problem
--:-- Dan Besserson: But I don't think it entered the general public consciousness until sort of the late 80s to the mid 90s
--:-- Dan Besserson: The disease is obesity, but obesity is just a symptom of the real problem we as a nation face
--:-- Dan Besserson: Frances, you've been overweight since you can remember?
--:-- Frances: Since a child
--:-- Frances: About early teens
--:-- Dan Besserson: Americans overeat
--:-- Dan Besserson: We are obsessed with food, and it's an obsession that's killing us
--:-- Dan Besserson: And when Greta was one year old, she weighed 100 pounds
--:-- Dan Besserson: Almost 100, yeah
--:-- Dan Besserson: Almost 100
--:-- Dan Besserson: That's a lot
--:-- Dan Besserson: I think people looked around and thought, what's going on here?
--:-- Dan Besserson: There seems to be more and more people at higher weights
--:-- Dan Besserson: And NIH had an expert panel that defined obesity using BMI
--:-- Dan Besserson: BMI is sort of controversial, but that was the point at which we had this accepted standard
--:-- Dan Besserson: And shortly after that, the CDC looked at data they had and said, what's been happening with obesity?
--:-- Dan Besserson: And I think they were sort of shocked to find there was just a dramatic increase in the number of people with obesity
--:-- Dan Besserson: And so in 1999, they published these maps, these CDC obesity maps
--:-- Dan Besserson: Maybe some people have seen those
--:-- Dan Besserson: And they really brought a lot of attention to what really looked like an epidemic
--:-- Dan Besserson: If you had looked at those numbers and it was HIV or cancer, people would be quite worried
--:-- Dan Besserson: And people said, gosh, something is happening here
--:-- Dan Besserson: We should do something about this
--:-- Dan Besserson: And what was the something that doctors decided they should do?
--:-- Dan Besserson: Yeah, I think that the NIH panel had thought about levels of weight and that treatment or what intervention somebody did should be based on how serious the problem was
--:-- Dan Besserson: So people with a modest increase in their weight might change their diet and increase their physical activity
--:-- Dan Besserson: People with a more severe weight problem might take a medication
--:-- Dan Besserson: And those at the highest weight might benefit from surgery
--:-- Dan Besserson: For most Americans, lifestyle is what was suggested
--:-- Dan Besserson: And I think at that point, we were still early in understanding the biologic basis of weight regulation
--:-- Dan Besserson: And we all eat, we all move, and it seems like we choose those things
--:-- Dan Besserson: And so the obvious first step was to say, maybe people just don't know what to eat
--:-- Dan Besserson: And if they just thought about it some more and ate less and moved more, that this problem might go away
--:-- Dan Besserson: So that was the first thought
--:-- Dan Besserson: And the Surgeon General had a call to action
--:-- Dan Besserson: Obesity, a major problem that has increased dramatically since 1990
--:-- Dan Besserson: Based on these numbers rising of obesity saying, you know, people ought to move more and eat a healthier diet
--:-- Dan Besserson: When it comes to physical inactivity, obesity, diabetes, the fact of the matter is we're moving in the wrong direction in terms of these areas
--:-- Dan Besserson: The advice seems obvious
--:-- Dan Besserson: Change what you eat and move more
--:-- Dan Besserson: Do diet and exercise prove to work?
--:-- Dan Besserson: I think there's a couple ways to look at that
--:-- Dan Besserson: One is around this same time, there was a study published, the Diabetes Prevention Program
--:-- Dan Besserson: And what they found was that a modest weight loss, a 5% weight loss, could reduce the risk of developing type 2 diabetes by half
--:-- Dan Besserson: It was a really dramatic study
--:-- Dan Besserson: And so it was really based on that that people said, gosh, this is achievable and it has clear health benefits of 5% weight loss
--:-- Dan Besserson: I'm just doing the math in my head
--:-- Dan Besserson: If you weigh 200 pounds, that's take 10 pounds off
--:-- Dan Besserson: Yeah
--:-- Dan Besserson: 300 pounds, take 15 pounds off
--:-- Dan Besserson: That feels like nothing
--:-- Dan Besserson: It seems like a small change in weight and yet it had dramatic benefits
--:-- Dan Besserson: I got to tell you, I mean, I see people in clinic and so I've spent whatever, 20 years trying to sell the benefits of a 5% weight loss
--:-- Dan Besserson: Most people don't buy it
--:-- Dan Besserson: Most people want more weight loss than that
--:-- Dan Besserson: It's not a weight loss that most people see in the mirror or that their friends are going to notice
--:-- Dan Besserson: But it has clear health benefits and has become a benchmark of what a clinically significant weight loss is
--:-- Dan Besserson: A little bit of weight loss helps
--:-- Dan Besserson: So what happened after the study was over with these folks who lost 5% of their weight and then saw their health improve?
--:-- Dan Besserson: Did they keep the weight off?
--:-- Dan Besserson: Most lifestyle studies show that most people regain much of the weight
--:-- Dan Besserson: It's not like everybody regains all of the weight, but much of the weight is regained
--:-- Dan Besserson: What has happened over the last 25 years is a real explosion in our understanding of the biology that underlies weight regulation
--:-- Dan Besserson: I think now we think of weight much like we think about blood pressure or glucose that there complex biology that the body got its own idea about what it wants to weigh
--:-- Dan Besserson: And what it seems like the body wants to do, it doesn't regulate around a set point
--:-- Dan Besserson: It regulates around a trajectory of gradual weight gain across the life
--:-- Dan Besserson: So the biology of weight really pushes back against efforts to change our diet
--:-- Dan Besserson: And so that's why people regain the weight is when they lose weight, the body goes, this is not good
--:-- Dan Besserson: And the people become more hungry
--:-- Dan Besserson: Their energy expenditure goes down
--:-- Dan Besserson: And these things tend to push the weight back up to where it was before
--:-- Dan Besserson: You mentioned two other ways that doctors saw of treating obesity, medications and surgeries
--:-- Dan Besserson: How common was it for a doctor to say, you, sir, or madam, you're going to need medication
--:-- Dan Besserson: You're going to need surgery
--:-- Dan Besserson: I don't remember so much of that like 20 years ago
--:-- Dan Besserson: Only maybe 1% or 2% of people ever had that conversation, ever got that medication
--:-- Dan Besserson: And there are a number of reasons for that
--:-- Dan Besserson: One is the older medicines had some side effects
--:-- Dan Besserson: There were some bad stories about health problems with fen-fen and other medicines
--:-- Dan Besserson: Oh, fen-fen
--:-- Dan Besserson: If you took the diet-drug combination known as fen-fen or the diet drugs pondamin or redux, you may have heart valve problems and not know it
--:-- Dan Besserson: Before Chicago area women are taking the makers of FinFen to court
--:-- Dan Besserson: It's been one week since the prescription diet drug was pulled off the market
--:-- Dan Besserson: And I think to doctors and patients, doctors especially have this idea that, well, Mrs. Jones, you ought to be able to handle this on your own
--:-- Dan Besserson: This idea that weight is regulated, it's taken a long time to get any traction there
--:-- Dan Besserson: Doctors would say things like, you know, if you show me you can stick to a diet, well, then I'll maybe talk to you about a medicine
--:-- Dan Besserson: We don't do that with diabetes or high blood pressure
--:-- Dan Besserson: We're very quick to go to a medication in those conditions
--:-- Dan Besserson: So I think there's a lot of maybe bias and stigma directed at people living with obesity that we tend to blame them for their health problem
--:-- Dan Besserson: So medicines that weren't super effective and an environment that really thought that people could do this on their own
--:-- Dan Besserson: How long have you been in this line of work, Dr. Dan?
--:-- Dan Besserson: I'm an old person with kind of gray hair
--:-- Dan Besserson: I prescribe Fen-Phen
--:-- Dan Besserson: So I've been doing this for, gosh, whatever, almost 30 years
--:-- Dan Besserson: Sometime in the last 24 months, I became aware of Ozempic
--:-- Dan Besserson: A lot of people became aware of Ozempic
--:-- Dan Besserson: I'm just wondering what the conversation was like in the medical community among doctors who do your type of work about the fact that there are these GLP-1 drugs that seem to work magically, work for a lot of people, and are now widely available
--:-- Dan Besserson: Yeah, I would use the term game changer
--:-- Dan Besserson: There's never been anything like this
--:-- Dan Besserson: We've done studies with older medications, and, you know, the medications worked okay, but people weren't happy with them
--:-- Dan Besserson: These medicines just, not only the ones we have now, which are semaglutide and trisepid, but the ones that are coming after that, that are in clinical trials
--:-- Dan Besserson: We're in a time now that medications are likely to provide the kind of weight loss that we used to only see with bariatric surgery
--:-- Dan Besserson: I understand that there's more than 100 medications in this anti-obesity medication pipeline
--:-- Dan Besserson: We've been doing studies with some of the next generation, and they're even more effective than the semaglutide and trisepatide are
--:-- Dan Besserson: Oh, damn
--:-- Dan Besserson: Yeah
--:-- Dan Besserson: And, you know, when we have somebody go to bariatric surgery, we prepare them for that
--:-- Dan Besserson: They see a psychologist
--:-- Dan Besserson: They see a nutritionist
--:-- Dan Besserson: They talk to other people who've had surgery and say, how was that for you?
--:-- Dan Besserson: They think about it
--:-- Dan Besserson: And then it's kind of a go, no go
--:-- Dan Besserson: You know, either you have surgery or you don't, and you get what you get
--:-- Dan Besserson: Medications are going to give that kind of weight loss, but we're not preparing people for that
--:-- Dan Besserson: We're not, what does your life look like when you're not interested in food?
--:-- Dan Besserson: I had a woman tell me, you know, my husband took me out to this fancy restaurant here in Denver for my birthday
--:-- Dan Besserson: He was so excited
--:-- Dan Besserson: I looked at the food and I thought, gee, this is not going to work for me
--:-- Dan Besserson: So it makes changes in people's relationships with other folks
--:-- Dan Besserson: When people see someone losing weight, they wonder, what are you doing?
--:-- Dan Besserson: Do you have cancer?
--:-- Dan Besserson: Who do you tell that you're out of medicine?
--:-- Dan Besserson: What do you tell them about why and what your goals are?
--:-- Dan Besserson: What are your goals?
--:-- Dan Besserson: How much weight do you want to lose?
--:-- Dan Besserson: And how will you know when you're done?
--:-- Dan Besserson: These are questions that we've never had to ask before
--:-- Dan Besserson: And we don't have good data
--:-- Dan Besserson: And people are willing to pay
--:-- Dan Besserson: So there's all these market forces with people just want a medicine
--:-- Dan Besserson: They don't want a doctor
--:-- Dan Besserson: They don't want advice
--:-- Dan Besserson: They just want the medicine
--:-- Dan Besserson: But they don't really know what they're getting into
--:-- Dan Besserson: So it's a bit of a chaotic environment
--:-- Dan Besserson: I think the key message I'd ask people to understand is this idea that weight is biologically regulated and that it has some health problems for some people, maybe even many people
--:-- Dan Besserson: And that ideally they find somebody that they can talk to, a doctor or a health care provider, that they can get useful information from over time because it's a journey
--:-- Noel King: Dr. Dan Besserson, he's an endocrinologist
--:-- Noel King: Miles Bryan produced today's show
--:-- Noel King: Jolie Myers edited
--:-- Noel King: Laura Bullard fact-checked
--:-- Noel King: And Andrea Kristen's daughter and Patrick Boyd are our engineers
--:-- Noel King: I'm Noelle King
--:-- Noel King: It's Today Explained
--:-- Noel King: Thank you
--:-- [Theme music fades in]
