Dr. Mark Hyman (1:51)

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Dr. Mark Hyman (3:00)

David, welcome to the Dr. Hyman Show. It's so good to have you here in person. We did a show before which everybody should listen to about one of your previous books, but we're going to talk about diet drugs and dopamine, the new science of achieving a healthy weight. But it's really way more we're going to talk about, which is why we're in a metabolic crisis in America, why our food system is so messed up and what we can do about it, both from the personal and the policy perspective. Because you, for those of you who don't know, you have a very storied career. You were the FDA commissioner, a Democrat and a Republican, President Clinton and Bush. And you have also got a law degree from the University of Chicago. So you've got this really interesting kind of juxtaposition of medicine and law. It's allowed you to take on some really big issues. And you were the commissioner of the FDA that really took on tobacco, thankfully have saved untold lives because of that work. It taught you a lot about the science of addiction. It taught you a lot about the nefarious ways in which the tobacco industry was behaving, what they knew and when they knew it and what they did to lie about it and cover it up. That led to millions of deaths. And you took them to task and that's a big deal because tobacco is a big industry. And you've refocused your targets on the other addiction in America, which is food addiction and particularly sugar and starch, which are the things that are driving so much of Our metabolic crisis, our chronic disease epidemic, diabetes, obesity. Everybody who listens to this podcast knows. Knows this back and forth because I talk about it all the time. But we. We are in this interesting moment where I think we've reached a crisis that we can't ignore. And whether it's good or bad or whether people like it or not, whether like Bobby Kennedy or not, the idea that America has woken up to the idea that we have a chronic disease crisis is a good thing. Now, what we do about it and how the policies roll out, that's another question that we're going to talk about. But I think there's this really incredible moment we're in, and I want to have you start by. By sharing your own personal story with your own struggles with weight. Again, you've written an untold number of books on this issue, and still it was hard for you to. To. To navigate your own weight struggles. And I wrote a book in 2005 where I basically said, it's not your fault you're fat, because the food industry wants to blame you. Eat calories in, calories out. All calories are equal. It's all about moderation. Eat less, exercise more. Essentially, the subliminal message in there, it's your fault, is you don't have willpower. You're lazy. Get your act together. And that is as far from the biological truth as you could possibly get. You've unpacked all this in many books, including this current book, including Fast Carbs, Slow Carbs, including your book, Capture Unraveling the Mystery of Mental Suffering, which has to do with mood stuff, but also related to issues of addiction. Hijacked. How your brain is fooled by food.

Podcast Sponsor/Advertiser (5:43)

Your food is fooling you.

Dr. Mark Hyman (5:44)

How your brain is hijacked by salt, sugar, and fat. The End of Overeating, which I loved and was one of my favorite books, Taking Control of the Insatiable North American Appetite. Also your book about your struggle with the tobacco industry and your battle that you won. You come at this with a lot of knowledge, a lot of experience, both on the medical front as a doctor, on the legal front, as a lawyer, and as a leader in public policy in America. So take us through your own journey. What's sort of got you focused on this idea that was so antithetical to the medical establishment's paradigm, which is it's.

Podcast Sponsor/Advertiser (6:18)

Kind of your fault.

Dr. Mark Hyman (6:19)

Just eat less and exercise more. Eat a healthy diet, get more exercise, and you lose weight. And if it's not the case, then it's you. So how did you break that. And how did you come to what you understand now? Through your own story.

David Kessler (6:31)

So, you know, the most recent iteration was, you know, I had the opportunity to co lead operation.

Unidentified Guest or Contributor (6:41)

Warp speed.

Dr. Mark Hyman (6:42)

Yeah.

Unidentified Guest or Contributor (6:42)

Right.

David Kessler (6:43)

So a very intense period of time, Covid, for all of us. I was working 18 hour days, didn't leave, you know, my desk literally seven days a week, you know, 676 million vaccines free.

Unidentified Guest or Contributor (7:00)

Right.

David Kessler (7:00)

We got to the other side and I found myself some 40 pounds heavier at the end of it.

Dr. Mark Hyman (7:07)

And you were, you were working in a government building in Washington?

David Kessler (7:10)

No, I was, I was working remotely. I mean, I mean, I would go in when I, you know, needed to for a secure facility for certain meetings. But, you know, I was able to work remotely.

Dr. Mark Hyman (7:24)

The reason I ask is because the food is so crappy in the Senate and the Congress and all the agencies.

David Kessler (7:30)

It was also crappy. You know, just at home. At home. You know, my sense is if just I watched myself eat, right. And how I used food, you know, throughout the day, you know, I mean, for all of us, I think that these momentary, just these little ups and downs and I would use food, you know, to regulate how I felt. So 10 o' clock at night, you know, if I have three, four more hours of work, you know, and I'm tired and I'm fatigued and all of a sudden that, that, those thoughts, you know, well, do I go down to the refrigerator? Do I get something to eat? No, it's not good for me. Yeah. But I got to get through the next 2, 3.

Dr. Mark Hyman (8:17)

Saving the country from COVID Yeah, Just.

David Kessler (8:19)

Trying to get through the, through the day, right. These momentary, these blips. I mean, I was using food to, you know, regulate how I felt, energy, mood. I mean, I mean, exactly. I mean, you know, my guess is if I were born to, you know, two decades earlier, my, my parents or grandparents generation, I would have probably been a smoker, right. I mean, so I grazed, right.

Dr. Mark Hyman (8:44)

But.

David Kessler (8:44)

But I clearly I wasn't eating for, for fuel, right. I mean, and I had been here before, right. I would, you know, whether it was med school, you know, made exams papers, you know, young faculty member on the ER shift. I mean, I have to get through the next couple hours. I mean, how, you know, how am I going to power myself through that?

Dr. Mark Hyman (9:07)

Caffeine and sugar.

David Kessler (9:08)

I mean, and I was just, I mean, I used, I used food to do that. I would always be able to lose the weight, right. I mean, I dropped the weight, right. I thought I was done. You know, I went on with my Life. And I was. Gained it back now. So I was dean of two med schools. I ran the fda, right. I did warp speed. And here I can't control my weight. So I ended up, you know, after Covid, some 40 pounds heavier, and I didn't like myself. I mean, I just, you know, I just. I wasn't. I wasn't healthy. I mean, it was. It's not about that weight. It's about that toxic fat.

Unidentified Guest or Contributor (9:46)

Right? Right.

Dr. Mark Hyman (9:46)

I mean, that's what, belly fat, the visceral fat.

David Kessler (9:49)

It's that fat that gets into our liver, that gets into our pancreas, that gets into our heart.

Unidentified Guest or Contributor (9:56)

Right?

David Kessler (9:56)

It's that ectopic fat that's not, you know, it's not where fat is supposed to be. It's metabolically active.

Unidentified Guest or Contributor (10:04)

Right?

David Kessler (10:05)

I mean, and it. I think there is a convergence. I mean, I. I am sensing this, you know, I mean, if just, you know, attended the European, you know, heart meetings. I mean, if you talk to cardiologists or diabetologists and nephrologists, I think there is a convergence that this toxic fat, this metabolically active, you know, this. This sick fat is at the root of much of cardiac, renal and metabolic disease. And I think. I think medicine, including cancer, including 13 months of cancer, I mean.

Dr. Mark Hyman (10:44)

I mean, dementia, all of it.

David Kessler (10:46)

I think medicine is just waking up to that.

Unidentified Guest or Contributor (10:48)

Right?

Dr. Mark Hyman (10:49)

I'm laughing because I wrote books about this 20 years ago.

David Kessler (10:52)

No, I mean.

Dr. Mark Hyman (10:53)

Oh, everybody.

David Kessler (10:55)

I mean, take a bath, right?

Dr. Mark Hyman (10:57)

I don't care about that.

David Kessler (10:58)

I'd be like, you know, I mean, but seriously, you know, I am. I am because. But. But we all knew weight wasn't good for us, but we didn't understand it was causal.

Dr. Mark Hyman (11:09)

Well, we were doing DEXA scans, and when I worked at Kenya Ranch, and we were looking at visceral fat, and we were looking at insulin levels, and we're looking at particle size and lipids, and we're doing gluc glucose tolerance tests on everybody. And we were, like, just seeing this happening in real time, and it kept getting worse and worse and worse and worse.

David Kessler (11:23)

So I finished warp speed and I said, look, I gotta understand, why do I keep on gaining this back? I mean, and what is at the root of this problem? And that's why, you know, I set out to write the last book, the Diet Drugs and Dopamine. And there is, you know, there is no doubt in my mind. I mean, the diet is the primary culprit. There is no question about that now, you know, it's that diet in the Food in our environment that interacts with our brains and the way our brains are wired. We tended to, to, you know, we talk about addiction. We used to think addiction was for, you know, the weak, the downtrodden.

Dr. Mark Hyman (12:20)

Yeah.

David Kessler (12:20)

I mean, it was about other, other people.

Dr. Mark Hyman (12:23)

But it was a lot of stigma about it.

David Kessler (12:25)

I mean, absolutely. But, but, but the fact is.

Dr. Mark Hyman (12:28)

And there's a lot of stigma about obesity, which is unfortunate about both.

David Kessler (12:33)

Right, but, but if you just look at addiction, you know, addiction is not about, I mean, it's. Those circuits are in all of us. I mean, I am convinced. I mean, we were as a species, right? I mean, we evolved to be able to gate our attention, you know, I mean, on the, that energy dense food that was responsible for survival, right. I mean, in an environment of scarcity, right. We evolved. I mean, those, you know, organisms survived if they could gate attention and focus on energy dense food. Yeah.

Dr. Mark Hyman (13:13)

I mean, bitter foods are sometimes harmful, but sometimes not. Sweet foods are universal.

David Kessler (13:18)

But you have, you have two circuits at work here, right? You have these reward addictive circuits in our brain.

Dr. Mark Hyman (13:26)

Dopamine, right?

David Kessler (13:28)

That cue induced wanting, right? It could be the time of day, it could be a sight, it could be a smell. I, you know, I pass, you know, a location that I had been at, you know, I mean, and gone in and got something to eat. And you know, my brain, you know, that, that, that cue, right. Triggers those thoughts of wanting. That, that, that, that urge, right? I mean, it gates my attention. I mean, and you know, I don't, I, I can't get rid of that, that urge until, I mean, actually consume. And then it comes out, then it's gone. Then it's gone. But that Q induced wanting, I mean, is part of all of us. So I think it's important to change our paradigm of how we think about addiction. But certainly that energy dense food, I mean, in that environment, right? I mean, it is, you know, and I saw this, you know, with tobacco. The most powerful reinforcers are the reinforcers that can change how we feel.

Dr. Mark Hyman (14:30)

Well, I want you to break it down a little bit because, you know, people say food addiction and I talk about it, and I think most people think about it as a metaphor, you know, but it's not. It's actually a fact of biology. And according to a large population study, globally, 14% of the global population, including 14% of kids, are addicted to food by the Yale Food Addiction Scale. And so what is this addiction?

David Kessler (14:59)

But it's a spectrum, right?

Dr. Mark Hyman (15:00)

Right. I tell you, the 14% is the worst.

David Kessler (15:04)

And I think that that's the mistake here.

Dr. Mark Hyman (15:06)

I agree.

David Kessler (15:06)

It's not about 14%. It's about the 60, 70% of us for whom food is that salient stimuli, that fat, sugar and salt, that perfect trifecta of energy dense food that capture our attention. If anything, I think the majority of us are wired to focus on those cues. And it's that maybe 15% of the population for whom food, you know, is not a rewarding stimulus. Those are probably the most interesting people. I mean it's, it, it's, I'm not surprised that 60, 70, 80% of us, you know, find food, you know, highly rewarding and, and attract our attention and have that call for it. It's, it's. What I'm interested in is, is that part of the population for whom food is not the salient stimuli and what is it about them?

Dr. Mark Hyman (16:04)

But it can be like for example, I don't have, I don't think an addictive personality. I don't have the dopamine receptor genes that require me to get more dopamine stimulation to feel good. But if I go on a rant of sugar, I just gonna want more of it. Like even if I don't have that predilection and most time it doesn't bother me. But occasionally if I'm in a stressful situation or whatever, I'll go, oh God, I'm really.

David Kessler (16:29)

But that past learning, that past experience, that exposure, right. I mean, begets, you know, more of that. I mean it's all that cue induced wanting.

Dr. Mark Hyman (16:39)

So, so what is going on biologically? Like is it the same as heroin or cocaine or nicotine? Like what's actually happening?

David Kessler (16:46)

So we gotta be careful at. No doubt there are differences pharmacologically. So if you look at the dopamine hit, I mean heroin and amphetamine is clearly in a different ballpark as far as the extent of that hit. Nicotine on the other hand, is probably much closer to food.

Dr. Mark Hyman (17:04)

And how hard is it to quit cigarettes?

David Kessler (17:05)

And again, it's this, this gating of attention, right? You get, I mean next time you get hungry, just try to figure out what the cue was. There's always a cue. It could be the time of day, it could be a smell, something triggered that thought and that thought created this, you know, that, that, that, that sense of wanting.

Unidentified Guest or Contributor (17:25)

Yeah, right.

David Kessler (17:26)

I mean, and, and you know that that cue induced cue, wanting, right. I mean, is what really, I think it's part of all of us. And you know, and in the extreme form, I mean it's food addiction. And many people, you can just call it sort of disordered eating. But you know, you know, and at the heart of that, you know, we took fat, sugar and salt, put it on every corner, made it available 24, 7, made it socially acceptable to eat anytime cheap.

Unidentified Guest or Contributor (17:57)

Right.

David Kessler (17:57)

And she, and you know, we created this food circus. What did we expect to happen?

Dr. Mark Hyman (18:01)

It's a, it's a food carnival out there. It's. Yeah, it's a toxic nutritional landscape that.

David Kessler (18:07)

We'Re all exposed to and causing and causing this toxic fat. So that visceral adiposity, right, that you've been studying, right? I mean is it the heart of much cardiorenal metabolic disease? It starts early in life. I mean we are seeing it in the liver of our kids, right? I mean it gets into the heart. 25% of us are going to develop heart failure, right? I mean what? 30, 40%, you know, diabetic. Half of us are pre diabetic, 25% of us are going to have stroke. And at the cause of that, I mean there is this, I think finally this convergence in medicine. I mean and in public health, we know what the problem is.

Dr. Mark Hyman (18:54)

But you know David, what's really striking to me is I, I co founded a new company called Function Health that allows people access to their personal health data and lab testing. And I asked Quest Labs, who's our lab testing partner. I said how many labs that get submitted test for insulin? And they're like oh, less than 1%. Less than 1%. And insulin is the first thing to go awry. When you actually have this visceral fat, it starts to go up and nobody's checking it.

David Kessler (19:20)

Well, not only that, I mean if you look on a population basis, there has been a doubling in the last 20 years of insulin levels, right? I mean there is an epidemic of hyperinsulinemia and it's not being tested.

Dr. Mark Hyman (19:35)

It's crazy to me.

David Kessler (19:36)

Now you can argue, you know, that assay is not the easiest necessarily.

Unidentified Guest or Contributor (19:42)

Right.

David Kessler (19:44)

These things happen so fast, you know, I mean there's this cycle. I mean does the visceral adiposity, this toxic fat, does that cause the hyperinsulinemia or does the hyperinsulinemia cause the toxic fat? I mean you get caught in this vicious cycle.

Dr. Mark Hyman (20:03)

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Dr. Mark Hyman (22:07)

Well, David Ludwig talks about, does overeating make you gain weight or does it gaining weight make you overeat? And it's this paradox.

David Kessler (22:14)

So you have these central circuits, right, that focus our attention and are wanting on this, you know, this energy dense, highly palatable, high glycemic index food. And then you have these peripheral, the peripheral biology, I mean, in our gut.

Dr. Mark Hyman (22:34)

You mean the microbiome.

David Kessler (22:35)

I'm just talking about the hyperinsulinemia.

Unidentified Guest or Contributor (22:37)

Yeah, right.

David Kessler (22:38)

I mean, the absorption of the belly fat, the biochemistry, what's going on in our liver, and I mean, the absorption of this rapidly absorbable glucose in a increasingly insulin resistant body, the American body is not. Well, I mean, only 12.2% of us are metabolically healthy.

Dr. Mark Hyman (23:01)

Well, actually that was the last study. Then the new updated version, it's only 6.8% from Tufts. The same kind of data. It was like, that's frightening. I mean, that means that 93.2% of Americans have some degree of insulin resistance. They might not have pre diabetes yet, but they're somewhere in that continuum.

David Kessler (23:17)

And in some people, they hear that number and go, that just can't be right.

Unidentified Guest or Contributor (23:22)

Right.

David Kessler (23:23)

I mean, it's very interesting. They go, I mean, only 12% or 9% or 6% of us are metabolically healthy. But the fact is, right, that, I mean, those are the numbers.

Dr. Mark Hyman (23:36)

It's true. I mean, we tested over 300,000 members in our company and it's shocking that the demographics of what the, like the population level data on insulin, on glucose, on the metabolic effects on cholesterol of this visceral fat are just.

David Kessler (23:55)

So here I am, 40 pounds heavier, right? And the question is, what does it take to reclaim our health? I mean, and I think finally, finally, right? I mean, I think we, we have the tools, right, to do this. I mean, look, I mean, you know, in the. It's pretty. In some ways, it's very complicated, but it's also very simple. I mean, you have one industry that makes billions of dollars, right, that's causing the problem. And then you have another industry now that, you know, is making equal profits to reverse what the former industry, it's actually trillions is doing, right? Yeah, the focus, the increasing focus on, you know, you would call it, you know, highly processed food or, you know, rapidly absorbable, you know, carbohydrates, ultra processed foods. I think the fact is that that food is engineered in such a way, right, that it goes down in a whoosh. It deprives us of satiety, right? It is rapidly absorbed. It's causing that metabolic chaos, right? And so you have this food on the one hand that's depriving us of this satiety, this ultra processed food. And now for a thousand dollars a month, you can go buy a drug to reverse what that food is causing, right? I mean, I mean, and it's just if you came from another planet and you saw what was going on, you'd say something's wrong. With that picture, fix the root cause.

Dr. Mark Hyman (25:37)

And just to unpack, what you're saying is the change in the American food supply over the last 50 years has increased the consumption dramatically of sugar and starch and refined carbohydrates in ways that have activated this ancient survival system, which is to store fat at all costs when we've come across something sweet because we don't know when we're gonna get our next meal. But now we're in a food carnival and it's everywhere. And it's hijacked our brains, it's hijacked our brain chemistry, our metabolism, our immune system, our microbiome, and it's created a cascade of effects that cause every almost single chronic disease of aging.

David Kessler (26:15)

So if you go back, you know, and I, and I went back in over the last, you know, a few months, did the book and then I filed this petition. Yeah, with hhs, but, you know, went back and looked at the history and the food industry back in the 50s and 40s, 50s, 60s, learned how to take corn, learn how to take starch, right? And was able, through chemical processing, chemical and physical processing to create, you know, a whole slew of other, what they called at the time nutritive sweeteners, right? These starch conversion products. They have names called maltodextrin or dextrose or amino a xylose or maltose, corn syrup and corn solids. I mean, and that gave birth to an alternate universe. I mean, you know, it's really not food.

Dr. Mark Hyman (27:22)

It's not technically food. Actually, if you look up the definition of food in the Webster's dictionary, it doesn't actually meet the definition of food, which is something roughly that promotes the growth and health of an organism.

David Kessler (27:33)

They took out the structure of food, right? They extracted these chemical components and then they reassembled them in a way without the structure of that food, without the fiber, right? All that slowed down eating, right? And they took the. I look at this ultra processed foods and I say there are basically, there are four components of this stuff, right? Just when you look at how it's made, there's these refined sweeteners, there are these refined starches made in flours, there's these added fats and oils, and there's salt, right? And what the industry did from after it generated all these chemical ingredients was to reassemble them, find some other chemicals that added to mouthfeed or texture, and they were able to dial in that palatability.

Dr. Mark Hyman (28:33)

This wasn't on accident.

David Kessler (28:34)

Certainly wasn't an accident like the tobacco.

Dr. Mark Hyman (28:37)

Companies Were like, oops, we didn't know it was addictive, but baloney.

David Kessler (28:42)

The tobacco industry did the science. They did exquisite pharmacology. They did all the EEG work, the imaging work. They knew everything about nicotine.

Dr. Mark Hyman (28:56)

Secretly hiding the data.

David Kessler (28:58)

Correct. And we went inside to do really the big investigation into the tobacco industry. And when I did that, my friends at NIDA had to teach me everything about addiction. And one of the tests on addiction was whether animals, laboratory animals, self administered nicotine.

Unidentified Guest or Contributor (29:20)

Correct.

David Kessler (29:21)

And they pressed the lever for nicotine, whether it was rewarding, whether it set off those reward circuits.

Unidentified Guest or Contributor (29:25)

Right.

David Kessler (29:25)

I mean, of the brain. And they always had a positive control there of sucrose. And I said, well, what about sucrose? Tell me about that. Why are you using that as a positive? And they never paid attention to me.

Unidentified Guest or Contributor (29:37)

Right.

David Kessler (29:37)

And that, that's what got me interesting. What the industry did was it generated this whole new generation of industrial sweeteners, these starch conversion products. And we're able to take those ingredients.

Unidentified Guest or Contributor (29:55)

Right.

David Kessler (29:56)

Again, not in the context of food or food structure that food matrix.

Unidentified Guest or Contributor (30:00)

Right.

David Kessler (30:01)

Which is so key to that, that absorption and reassemble that and make it highly palatable and energy dense and accessible. And it was cheap. No one went to study it. No one asked what was the effect of destroying that food matrix, leaving that aside, and just isolating these energy dense, I mean, chemical ingredients that you see on that ingredient panel, you look at and you go, I don't know what half of those mean.

Unidentified Guest or Contributor (30:34)

Right.

David Kessler (30:35)

And, and, and to reassemble it. And no one asked what was the biological effect. So if you take starch and you subject it to, there's these, you know, numbered, you know, processing techniques. One's called extrusion. I mean, and I mean, it basically molds that starch and that, I mean, into any kind of form, color. Well, it gives you that the thousands of products that are in the middle of that grocery. But to do that, you have to take that starch and exert these shear forces and these temperatures that change the molecular structure. And no one asked what happened in the body? No. No. No one asked what was going to be the metabolic consequences of that.

Dr. Mark Hyman (31:20)

Well, it's interesting, they may not have asked that, but they certainly knew the brain biology and they would do functional MRI imaging about what lights up what. And so they actually, like the tobacco companies, designed these foods to be addictive.

David Kessler (31:34)

Absolutely. And we will see. Okay, My guess is some in the food industry may have done that a bit, but my guess is they had their head in the sands deliberately. They didn't want to know.

Unidentified Guest or Contributor (31:48)

Right, right.

David Kessler (31:49)

They went ahead and they created this alternate universe of this food system, this ultra processed food of which these refined carbohydrates, these processed carbohydrates, these added sweeteners were a key component. Again. I mean, they had these, you know, added fats and oils too. They had this salt.

Unidentified Guest or Contributor (32:11)

Right.

David Kessler (32:13)

And it all ended up being very rapidly absorbed, causing this hyperinsulinemia, causing this visceral fat. And certainly in anyone who is along that, that, that path, I mean, already, I mean, having, you know, challenges, you know, you know, with, with that weight, that, that insulin resistance. If you add these energy dense, high glycemic foods, I mean, to somebody who's, you know, insulin resistant, I mean, it's adding. That's where you're at. That's where the real. You're adding that fuel, that fire. Exactly like. And that's where. And that's what's going on.

Unidentified Guest or Contributor (32:55)

Yeah.

David Kessler (32:56)

And that's why. And again, it's not just staying. It's not just a hyperinsulinemia. It's not just the fat. I mean, it's that the liver consequences, the consequences in the pancreas, the consequences that at topic fat in our heart.

Dr. Mark Hyman (33:10)

Yeah.

David Kessler (33:11)

I mean, that's heart failure. I mean, that's causing some of this atrial fibrillation.

Unidentified Guest or Contributor (33:16)

That's right.

David Kessler (33:17)

The fats. That's not where fat's supposed to be. And it's. That fat is metabolically active and it's.

Dr. Mark Hyman (33:23)

Neurochemically active and it's immunologically active and it's hormonally active.

David Kessler (33:27)

You know, go back. I mean, what's the cause of this?

Dr. Mark Hyman (33:30)

You know what you're. I just want to double click on what you're saying because it was so important the way in which food companies have taken commodity crops, soy, wheat and corn primarily, and deconstructed them.

David Kessler (33:41)

Correct.

Dr. Mark Hyman (33:42)

Broken them apart, chemically altered their chemical structure and composition.

David Kessler (33:46)

Correct.

Dr. Mark Hyman (33:46)

In ways that are completely new to nature.

David Kessler (33:49)

Correct.

Dr. Mark Hyman (33:49)

They're Franken molecules.

David Kessler (33:50)

Correct.

Dr. Mark Hyman (33:51)

And then they reassembled them into things that look like food but actually aren't food.

David Kessler (33:55)

Bingo. And they were cheap.

Unidentified Guest or Contributor (33:58)

Right.

David Kessler (33:58)

They, and they dialed in palatability. They dialed in, you know, that, that, the, that, that sugar, that fat, that, that, that sweetness that trigger our reward circuits in many of us.

Unidentified Guest or Contributor (34:11)

Right.

David Kessler (34:11)

And that caused that, that metabolic harm because it, when you eat this, it goes down in a wash. It's rapidly absorbed. There's no satiety, there's no feelings of Fullness, I mean, it gets, just gets so rapidly absorbed, it causes this hyperinsulinemia. And it's the reason why we're seeing the chronic disease that we're seeing in this country. We now understand this is the primary cold.

Dr. Mark Hyman (34:37)

100%. Amen. Hallelujah. I've been saying this for decades. Thank God you and others are figuring this out. I think what I want to now do is kind of just dive down a rabbit hole because in America in this moment, there seems to be a rare and unique opening to have a conversation about this, that ultra processed foods has been a part of a national conversation. Now, it wasn't even a thing 20 years ago. It wasn't even defined. It was just junk food or processed food or fast food. Now we have a term for it.

David Kessler (35:03)

Started out of, you know, not a perfect definition. No, I was just saying you have to be careful.

Unidentified Guest or Contributor (35:08)

Right.

Dr. Mark Hyman (35:09)

I mean, I'm going to get to that. I'm going to get to that. There was a Brazilian scientist who came.

David Kessler (35:13)

Up with Carlos Montero, who came up.

Dr. Mark Hyman (35:15)

With the NOVA classification, which was an attempt to try to figure it out.

David Kessler (35:18)

There are a number of other classifications. Right.

Dr. Mark Hyman (35:21)

But what's happening right now is that the fda, where you're a commissioner, has requested an RFI request for information from scientists and experts around the world. What is ultra processed food and what should we do about it? How do we think about it?

David Kessler (35:36)

How do we. It's asking for the definition.

Dr. Mark Hyman (35:38)

It's asking for the definition because before you, unless you, unless you know what the definition is, you can't actually start to regulate or legislate or around it.

David Kessler (35:44)

Yes and no. So certainly if you want to label something ultra processed food, you have to come up with a definition. But the industry will challenge that. That definition will always include certain things that you can argue, well, is this healthy? And it's healthy processed. I mean, there's always going to be those debates. I mean, at the extreme, but we certainly know what's in the components of this food. It is refined sweeteners, it's refined flours and starches. It's these added fats and oils.

Unidentified Guest or Contributor (36:12)

Right.

David Kessler (36:12)

I mean, it's salt. I mean, and it's these other chemicals that give it texture and mouth feel.

Unidentified Guest or Contributor (36:18)

Right.

David Kessler (36:19)

And this drives in the palatability. So we really do know what these foods are. And we know these foods don't exist in nature.

Dr. Mark Hyman (36:30)

Yeah. And just to be clear for everybody listening, you submitted a petition to the FDA that was based on their request for information for ultraproposis No, I mean.

David Kessler (36:39)

Actually it wasn't for the request. It wasn't because of the request for.

Podcast Sponsor/Advertiser (36:42)

Information thought it was.

David Kessler (36:44)

No, the petition went in separately.

Unidentified Guest or Contributor (36:46)

Right.

David Kessler (36:47)

I mean it certainly is consistent with that.

Unidentified Guest or Contributor (36:51)

Right.

David Kessler (36:52)

And looks at this food system, looks at this system that got developed in the 40s and 50s of developing these cheap ingredients out of food and reassembling them.

Unidentified Guest or Contributor (37:07)

Right.

David Kessler (37:07)

And creating this food circus. It recognizes that. It recognizes ultra processed food, right. I mean, and highly processed food. I mean we can, you know, choose your. How you want to refer to this. But, but it's certainly not food. I mean, as we know it, right. As. As occurs in nature or stuff that we, we make at home. The petition was very specific.

Unidentified Guest or Contributor (37:34)

Right.

David Kessler (37:34)

And let me just, let me back up for, for one second. Give you a sense of the nation's food law. So you understand that. I mean anything. I mean, in fact, the nation's food laws are pretty comprehensive and strict if we were enforcing them.

Unidentified Guest or Contributor (37:51)

Well, right.

David Kessler (37:52)

So if you want to add something to food, it's a food additive and you have to meet the definition of reasonable certainty of no harm. Reasonable certainty of no. You can't add anything to food for which there's not reasonable certainty of no harm. Now in a drug, you know, safety, no harm, you balance risks and benefits. Not in food. The law requires you to be reasonable certainty of no harm. Right, but Congress enacted that in 1958. But there was this exception. There was a term called grass, generally recognized as safe if you were generally recognized as safe. If you were grass, you didn't have to come in and prove that you were reasonable certainty of no harm. You can just go onto the market and the industry was able to self determine whether it was grass. So in, and I went back and I found this document, 1988, that it actually had its predecessor documents in the 1970s and it was a. The grass evaluation for corn syrup, corn solids, dextrose, right. Maltose, maltodextran, all those starch conversion products.

Dr. Mark Hyman (39:12)

Most of those are derivatives of corn.

David Kessler (39:14)

And gave rise to the modern highly processed food. I mean, go look in the middle aisles, right? Those corn syrups, corn solids, maltodextrants, right. Were the essential items that gave rise to this industrial revolution of all this highly processed food. And back there's an 88 document where the FDA says that it looked at corn syrups and corn solids and maltodextrin, dextrose, et cetera, and said there is no link between those and substances and obesity, no link with diabetes, no link with cardiovascular disease. And therefore that stuff is grass.

Dr. Mark Hyman (40:02)

But they didn't, they hadn't studied the link.

David Kessler (40:04)

Let me just, so understand grass. Fda, right? FDA doesn't have to show that something is unsafe, right? In order to be grass, there has to be a consensus among experts trained in the field right out there, that there's a general consensus that the substance is reasonable certainty of no harm, right? And these substances were granted grass status. So if I ask you today, and I lump these ingredients into this term called processed refined carbohydrates, right? You know it well, you've written about it, right? Before the term ultra processed foods, we understood process refined carbohydrates. Processed refined carbohydrates are an essential part of ultra processed foods. We can agree you can't have these ultra processed foods without these processed, refined carbohydrates. The machinery, the corn syrup, the corn solids, you couldn't use, in fact, sucrose would gunk up the machines you needed for that viscosity, for that lubricity, et cetera, for these machines to work to give rise to that moisture. In all this processed food, you had all these starch conversion products that the industry learn to use. So I ask you, is there general recognition of safety among experts that corn syrups, corn solids, maltodextrin, are safe today?

Dr. Mark Hyman (41:28)

The answer is no. Then I think they didn't know the thing about grass.

David Kessler (41:33)

Just because something is grass. Let me give you two other pieces, and then we put it together. Just because something is grass back in the 70s doesn't get you home free forever. Just because you were grass back then, you have to continue to be grass, right? And the burden is not on fda. The burden is on industry.

Dr. Mark Hyman (41:51)

So why hasn't the FDA held them to account?

David Kessler (41:54)

Bingo. So that's where the petition goes. So the petition basically looks at these corn syrups, corn solids, these refined, what I call these refined process carbohydrates. Now, I don't deal, I exclude, you know, anything that's made in home sugar.

Dr. Mark Hyman (42:13)

Flour, starch you want to make cookies with.

David Kessler (42:17)

I don't deal with that. But what you deal with, see, the Food and Drug act deals in ingredients. It doesn't deal in processing, except. So you have to focus on what the ingredients are. So if you just say fda, go ban, go deal with ultra processing, right? So you have to come with, what's the ingredient? But the law says if you have an ingredient, right, you have to generally recognize safe under the conditions of use. So if you take that carbohydrate or that rapidly Absorbable carbohydrate, and you subject it to extrusion or certain kind of processing, then you consider that processing. And so when you took the refined wheat and the refined starches and subjected it to extrusion, technology is a general recognition of safety. No one studied that. Right? So I have these categories of refined processed carbohydrates in the petition, right? That also includes sucrose, refined flours and starches. When used with these humectants, dough conditioners, these stabilizers. I mean, these other chemicals, they come.

Dr. Mark Hyman (43:22)

Along with the package.

Unidentified Guest or Contributor (43:23)

It's bad.

David Kessler (43:25)

These other processing aids, right? I say there's not a general. Not general recognized as a. And as a matter of science and law, these substances can't be grassed today.

Dr. Mark Hyman (43:39)

You know, it just reminds me of when TH Huxley heard of the theory of evolution. He said, how stupid not to have thought of that, right?

David Kessler (43:46)

I mean, so. So in order to put this together, you know, so I had to go to law school, I had to do tobacco, I had to be FDA commissioner, I had to write these books. And then all of a sudden, it couldn't be more simple.

Unidentified Guest or Contributor (43:57)

Yeah, right.

David Kessler (43:58)

I mean, we have this huge chronic disease problem. We know the culprit, right? We understand the metabolic harm. We understand the toxic fat. I mean, in our liver, our heart and pancreas. We know that our diet is the primary culprit. We know that it's this. These rapidly absorbable carbohydrates. The FDA said, the industry said it was safe, generally recognized as safe back in the 70s and 80s. If you look at the Dietary Guidance advisory committee in 2015 and 2020, you don't have to go look any further. They did the systematic reviews, and they have shown that these refined carbohydrates, I mean, they've shown all the adverse events associated with that, that they are linked with obesity, cardiovascular disease and diabetes. So those statements back in the 70s, there was no link between these. Just go look at the dietary advisory, the scientific report, and the evidence is there. And this does not require a new law. It doesn't require an interpretation of statute. It just requires enforcement of existing statute. And the fact that there's one other thing, very elegant.

Dr. Mark Hyman (45:07)

It's like, wow, what a brilliant idea, because you're putting the onus of proof.

David Kessler (45:12)

Back on the food industry where it should belong. And now the industry will come and say, well, what about one can of this or one teaspoon of that? That is safe. But there was something else about the law, law that is key. The law requires an Evaluation of safety based on the cumulative effect, the cumulative dose. So I mean, if you go look around, right, you, you, you see what the cumulative effect of processed refined carbohydrates at the doses were currently consuming them. They are not safe, right? So, so they got on this market, on the market. Cause they were grass. You can't be gr.

Unidentified Guest or Contributor (45:51)

Right.

David Kessler (45:51)

So in some ways it's self executing. The industry does not have a legal basis to be selling these processed refined carbohydrates if they are not grass, and they are not grass.

Dr. Mark Hyman (46:01)

They're going to throw hundreds of millions of dollars of legal arguments against this. So how, how strong do you think this would hold up in court?

David Kessler (46:08)

I think that it's easier than tobacco. Easier than tobacco, I think, I think it's much tobacco. Certainly. I don't want to get overly legal, you know, in a post Chevron world, I mean for the lawyers, you know, citizens general in interpreting the statute, this is the existing law, right. Requires that these substances be generally recognized as safe. There has to be an expert consensus, a consensus among experts. The FDA does not have the burden. The industry has the burden. All you have to do is show that there is not. There are these questions about the safety, right. Any doubt in your mind that processed refined carbohydrates. I mean there's questions about the safety. That's all fda, that's all. I don't think anyone, I mean, what was striking about. So I submitted this petition, right. Fair to say that the nutrition community is, has divergent views within the nutrition community.

Unidentified Guest or Contributor (47:07)

Right.

David Kessler (47:07)

I mean there are all these, you know, I mean, very strong views, very. I mean, in some ways we eat our own. I mean in the nutrition community, right. I mean, you've lived it. You see the effect. The one thing that was striking is when everybody said, I said processed refined carbohydrates are not grass. Everybody looked at that and go, oh, we could agree on that.

Unidentified Guest or Contributor (47:31)

Yeah.

David Kessler (47:32)

So again, does this deal with all processed foods? All ultra processed foods? No. I mean, could I have gone after added fats and oils? Could I gone after salt?

Dr. Mark Hyman (47:42)

Right.

David Kessler (47:42)

I mean, could I have done those? But if you look at that, what's driving this metabolic harm, I think 80, 90%, I mean, of the culprit has these processed refined carbohydrates. Maybe it doesn't deal with everything.

Dr. Mark Hyman (47:55)

So how do you thread the needle on the dose question? Because if you have like, you know, a cookie or two once in a while, it's not a big deal. But it's the cumulative dose and the.

David Kessler (48:08)

Law requires you to evaluate right under the conditions of use, as it, as it's being used, you need look no longer, no more than just look around us.

Dr. Mark Hyman (48:19)

So would you say, like if it's more than 5 grams of sugar, refined carbohydrate, or how do you do that on the.

David Kessler (48:25)

But that is going to be. Look, I think FDA has no choice. I mean, I think the secretary and the fda, you know, I mean, I don't think these things are grass, right? And once these are not grass, figuring that out on what can be safe shifts to the industry. And the industry is going to have to come in and it's going to have to get its act together and say, how do we change this food environment? The ability to remake our food system.

Dr. Mark Hyman (48:56)

So if the FDA enforces and says this is no longer grass, we missed the boat. We kind of had a blind spot here. Now we get it. And as of tomorrow, all they have.

David Kessler (49:07)

To say is grass.

Dr. Mark Hyman (49:10)

And then what happens?

David Kessler (49:12)

Then you have to give the, you probably give the industry certain time and then they can come in and they have to figure out how they're going to remake and reformulate food.

Unidentified Guest or Contributor (49:22)

Right.

David Kessler (49:23)

So that Americans can thrive.

Dr. Mark Hyman (49:25)

Basically, the minute the government says it's not grass, it gives them a deadline.

David Kessler (49:30)

I'm not even sure it's whether the government, the government doing that would certainly be very important. But I actually think it's self executing. I think under the law and the food lawyers I've talked to, I mean, I don't think you can credibly say it's generally recognized as safe. Certainly if the government does that. Well, so you're exactly right. I mean, and the FDA did issue this document in 88 that said these things are graphs. So I think FDA has to, to say that it is not good. People say it will take FDA a long time to study this and to figure out all the answers to these questions. They got it wrong. The burden is on the industry to show that it's safe. I mean, the FDA simply says, hey, just look at the Dietary Guidance Advisory Committee scientific reports, these refined processed carbohydrates. There is a link with obesity, cardiovascular disease, in diabetes. Maybe we didn't see that link back, back four or five decades ago. Maybe that was an area that we didn't foresee.

Dr. Mark Hyman (50:27)

But what about the dose question? To be back to that? Because I think that's challenging because it's like the dose makes the poison according to Paracelsus and so.

David Kessler (50:34)

Exactly. But look at our food environment and then go to the European food environment, where there's much less ultra processed food.

Dr. Mark Hyman (50:41)

Yeah. Much healthier.

David Kessler (50:42)

And so the question is, we're going to have to remake our food environment. And remaking our food environment is gonna mean that the dose is gonna have to come very substantially down.

Unidentified Guest or Contributor (50:57)

Right.

David Kessler (50:57)

Because no question. At current doses, at current consumption level, current cumulative consumption levels, we see the harm. I mean, and the harm is demonstrable. Just look at the American body. We see that effect.

Dr. Mark Hyman (51:14)

According to recent USDA data, a few years ago, it was like 152 pounds of sugar and 133 pounds of flour per person in Americ. Year, that's almost three quarters of a pound a day. That's a pharmacologic dose.

David Kessler (51:26)

We are consuming.

Unidentified Guest or Contributor (51:27)

Right.

David Kessler (51:27)

About 500 calories a day more. Now, maybe calories aren't everything when it comes to toxic fat, but it's certainly part of that. It's the toxic fat plus the refined, rapidly absorbable, you know, glucose. I mean, it is contributing to the hepatic fat. But certainly those calories plus the refined processed carbohydrates are the toxic.

Dr. Mark Hyman (51:48)

Well, the calories are the. Usually the refined carbohydrates. That's where they're coming from.

David Kessler (51:52)

I mean, exactly.

Dr. Mark Hyman (51:53)

No, it's not like we're eating 500 calories more of meat or chicken or fish.

David Kessler (51:56)

So if you look at what it is, it's about 2, 300 calories of these refined grains.

Unidentified Guest or Contributor (52:04)

Right.

David Kessler (52:05)

It's these starches and flours.

Unidentified Guest or Contributor (52:07)

Right.

David Kessler (52:08)

It's more sweeteners. Although increasingly the sweeteners are these artificial sweeteners.

Unidentified Guest or Contributor (52:13)

Right.

David Kessler (52:14)

I mean, it's not the corn syrups. They've been replaced by these newer chemicals. I mean, that sweeten foods. So you have these added fats in oils, you have these refined starches, and you have these added sweetness, and that's what makes up the additional 500 calories. And you were gonna have to rethink the formulation, I mean, of these foods.

Unidentified Guest or Contributor (52:34)

Look.

David Kessler (52:37)

Once you open the door, what the petition does, I think, is ask the question, it opens the door.

Unidentified Guest or Contributor (52:42)

Yeah.

David Kessler (52:42)

And once you open the door and say, hey, it's no longer grass, there's no churning at bath.

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Dr. Mark Hyman (52:57)

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Dr. Mark Hyman (53:45)

So, David, you're in a room with Secretary Kennedy, FDA Commissioner McCary, you, maybe a couple other scientists, maybe me, I don't know, and we're sitting there a month from now. What are the steps that you're going to tell them to take to actually make this a reality? Because this seems to be like a loophole that you found that nobody's been thought about before that actually could solve the problem.

David Kessler (54:10)

It certainly gets the ball rolling and reframes the debate. It gives us the tool. So what did we do understand when tobacco started? Actually, tobacco started with a citizen's petition. 1988.

Unidentified Guest or Contributor (54:26)

Right.

David Kessler (54:27)

The American Lung Association, American Cancer Society, American Heart association submitted a petition to fda. It was sitting there when I got there. It said FDA should regulate low tar, low nicotine cigarettes as a drug.

Unidentified Guest or Contributor (54:43)

Huh.

David Kessler (54:43)

Why low tar, low nicotine cigarettes as a drug? Didn't quite make sense, but it gave the regulatory hook, right? It gave the authority, I mean, to ask those questions. And we reframe the question. Not is low tar cigarette low licine? No, low nicotine cigarettes a drug. We reframe the question is nicotine a drug? And once we asked that tobacco that question, we did the investigation into the industry. We found out what the industry knew, right? We got those hearings, remember the CEOs testifying they believed nicotine. Oh, God, yeah, right. And then there was all this legislation. Took two, three decades. But once you, what the petition does by saying there's no longer grass, it gives HHS the regulatory and legal hook to be able to reframe the food.

Dr. Mark Hyman (55:41)

But it's going to take decades. I mean, you're, you're sitting with, with the people who are making decisions in Washington and you say, okay, you guys have to go back to industry and say these subs are no longer grass.

David Kessler (55:52)

But that's the easy part. That just gets it started.

Dr. Mark Hyman (55:55)

Yeah.

David Kessler (55:55)

Then the question is, how are you going to fix it? The great public health success of our lifetime. Tobacco fair. What in the N word?

Dr. Mark Hyman (56:04)

Litigation.

Unidentified Guest or Contributor (56:06)

Go ahead.

David Kessler (56:07)

Labeling.

Dr. Mark Hyman (56:08)

Labeling, avoiding advertising, taxation, focus on our kids.

David Kessler (56:13)

All that work. But what really worked, what did those things, those were all tools. If you go back and you look at, at certainly in my parents generation or my grandparents generation, right, how they view tobacco, right? Tobacco was sexy, it was adventuresome, right? It was positively valence the industry. In the early 1900s, they had that march down Fifth Avenue. It was associated with emancipation. It was. They hired the psychoanalyst a. A Brill to come up with the phrase torches of liberty, symbols of freedom. That was something you want, wanted, that's something you desired, right? It was cool, right? They made it cool. What did we do? What did we do? What did it take us? 75 years.

Dr. Mark Hyman (57:05)

You made it in pariah.

David Kessler (57:07)

So we took something, an addictive substance, a reinforcing substance, a powerful substance, biologically active, that affected our brains, affected our metabolism, right. Affected our bodies. And we changed the valence. The industry made it positively valence. What do you do if something's positively valence? You want to it, right? You need it. I mean, I can't live without it. What did we do? We made it negatively based. We had this critical perceptual shift as a society. I don't want that. So are we going to have to label these, Are we going to have to show people, right, that these chemically engineered, these foods that have these refined starches and grains, refined sweeteners, these added fats and all these are not foods? Sure. They may, you know, in the moment, may they get me past the next 20 minutes, right? May give me energy for two hours, but how is it going to make me feel over the long term? Is it cheap? No question it's cheap short term, not long term, but over the long term, look at the devastating cost. So we're going to have to change. We're going to have to have this critical perceptual shift. We understand what the problem is right now. There needs to be the coming together and we just have to execute this.

Dr. Mark Hyman (58:18)

So do you think it's like a public health education like we did with cigarettes?

David Kessler (58:22)

It's everything, right? It's everything you name. HHS has to act, Congress has to, I mean, hold that. I mean, hold that hearing, right? Who should be the first, you know, the first witness secretary has to go in, right? And explain that this stuff is no longer grass and is no longer a legal basis. Next panel is going to be, the next panel is going to be the industry CEOs and how are they going to fix this?

Unidentified Guest or Contributor (58:49)

Right?

David Kessler (58:49)

And the question is, is the industry going to just take the position, defend, defend, defend, or is the industry going to understand? I mean, when tobacco, you know, when we started, the industry was defend, defend, defend.

Dr. Mark Hyman (59:03)

This is great. This is great. I love this idea. I'm actually good friends with the chair of the subcommittee on Health and the Ways and Means Committee who wants to have hearings on these things. So I think since Medicare is overseeing the health of America in many ways, it would be an interesting place to have these hearings.

David Kessler (59:23)

FDA has to do, HHS has to do its part. We have these hearings. The food industry has to come in with its solutions and it's going to take. Is it just going to be the revocation of grass that's going to solve this? No, but it's going to have to put together that comprehensive package.

Dr. Mark Hyman (59:38)

But I love the idea of having like, you know, industry experts and CEOs held to account. I love the idea of scientists and people in the government actually testifying and.

David Kessler (59:48)

Government doing what it can do. And fda, FDA now has, in this petition, it has the regulatory hook. I mean, I have shown this to the best food lawyers, I mean, in the country. And this is straightforward.

Dr. Mark Hyman (60:01)

I mean, I read it, my jaw was on the floor and I. We're going to link to, to it in the show notes. So if anybody wants to read it, I encourage you, or you can just read the New York Times about it article that you were featured in, which is also quite good. Or just throw it in ChatGPT and ask you to summarize in front of you.

David Kessler (60:18)

And if you go back to the book, you go back to the book. There's a chapter, I think it's chapter 23 that said you could not have designed a better weapon to blow up the American bottom body.

Dr. Mark Hyman (60:31)

Meaning the petition or you mean the food, the food industry.

David Kessler (60:35)

If you look at what we did.

Dr. Mark Hyman (60:38)

Okay, I think it's like lead in the pipes in Rome. It's like the end of the Roman Empire. You know, it's the end of the American empire. And it's something we bring on ourselves by the permissive nature of how we allow food, the food industry to run roughshod over American people, how we don't properly regulate it, how we allow things like advertising of junk food to kids that are banned in most countries, how we don't have clear warning labels on food that's harmful for you.

David Kessler (61:04)

Up until now, the Industry has been able to do this with impunity, put this out and say, it's not my food. I mean, it's the dietary patterns, but it's these industrial foods that created the current dietary pattern.

Unidentified Guest or Contributor (61:26)

Right.

David Kessler (61:26)

So there is. And we need just complete full picture here.

Unidentified Guest or Contributor (61:33)

Right.

David Kessler (61:34)

So the question is, what do you do if you're the individual? How do you protect yourself from this environment?

Dr. Mark Hyman (61:41)

Because clearly we've been talking a lot about the public health intervention which have.

David Kessler (61:44)

To happen, but it's absolutely key. Again, I left warp speed, 40 pounds heavier, right. And metabolically, my body busted was not good. I actually, I started losing weight, you know, and I went on, you know, my typical, you know, low carb kind of diet. I lost a couple of pounds.

Unidentified Guest or Contributor (62:09)

Right.

David Kessler (62:09)

It wasn't going as quickly, I mean, as I wanted. I mean, interesting. And I threw a. I had a kidney stone, you know, losing weight. I mean, you know, I was at risk for kidney stones. I found myself in the er. Yeah, I was just, you know, dehydrated and, you know, had the kidney stone. They drew blood. And I had an. I had this elevated calcium level. Why did I have an elevated calcium level? And this didn't make sense. So I went to an endocrinologist, right.

Dr. Mark Hyman (62:39)

And parathyroid hormone was that.

David Kessler (62:41)

It was a spurious result. It was a spurious result. But the endocrinologist happened to be doing some of the clinical trials on the GLP1 drugs. And I said I was losing weight. And he said, do you want to try to go on the GLP1 drugs? You qualify. My BMI was greater than 27 with a comorbidity. And I'm writing this book and I said, hey, I wanted to experience it, right?

Dr. Mark Hyman (63:07)

Diet drugs and dopamine.

Unidentified Guest or Contributor (63:09)

Right.

David Kessler (63:09)

I mean, the dopamine I had. Right, those, you know, and there, there is. When you look at the biology, and I think this is key. I think, first of all, what are the. The one thing the drugs show, right, Is they're high, they are highly effective. No question you lose weight on the GLP1. So the vast majority of people, 95% of people, people lose weight. They are not the be all and end all. They're not the whole story. They're only one tool. They have real adverse events.

Unidentified Guest or Contributor (63:43)

Right?

David Kessler (63:44)

But if you look at those drugs, certainly those drugs work through biology. So it's proof that it's not willpower. We can agree on that, Right?

Unidentified Guest or Contributor (63:57)

Right.

David Kessler (63:57)

But with a pharmaceutical, how do these drugs really work?

Unidentified Guest or Contributor (64:01)

Working. Right.

David Kessler (64:03)

Why are they so effective? You know, we Talked about the sardonic, this reward, this addictive circuit in our brains, this dopamine circuits in our brain, the reward circuits, right? There's another set of circuits, right? In our biology. You mentioned it when you talked about bitter. There are these aversive circuits, right? And so what do these drugs do, right? I mean, these drugs delay gastric empty, right? They slow down the movement. Highly processed foods increase the speed of food. It slows your gut. And we've all experienced it. We've had the flu. Our gut slows down. You're not hungry, you're not hungry. But how do you also fear when you have the flu and you don't want to put anything else in your stomach?

Dr. Mark Hyman (64:50)

They're nauseous.

David Kessler (64:51)

So what these drugs do is they delay gastric empty and they push you to that edge of nausea, right? What's strong enough to overcome the addictive circuits?

Dr. Mark Hyman (65:01)

Wanting to puke?

David Kessler (65:03)

No. So you laugh. Now the great thing about these drugs is they titrate.

Dr. Mark Hyman (65:08)

I'm not kidding.

David Kessler (65:09)

I'm just saying. No, no, no. But that's exactly how this is work. So what happens, the way these drugs work is they have this spectrum of, you know, there's a spectrum of satiety. There is fullness, right? There's, you know, I'm satiated and then there's Thanksgiving eve fullness, right? I mean, right, where you push. And then there's the, you know, I push you over to the avert gi. You know, effects of that nausea, right? I mean, the acute effects if I push you over the edge. So what these drugs do is they stimulate that circuit, right? This is the gut and the brain, I mean, is working on the area per stream of the heim, right? And the gut, you delay gastric dentin, you push people to that edge of nausea. Now we all, everybody feels this differently. And what do you do? What do you. If you know you're going to put food in your stomach and it's going to make you feel ill, what do you learn to do?

Dr. Mark Hyman (66:03)

Not eat or eat less.

David Kessler (66:05)

So that's, I mean, my guess is that's the primary.

Dr. Mark Hyman (66:08)

It's like a gastric bypass without the bypass.

David Kessler (66:10)

Now how long are people on these drugs?

Dr. Mark Hyman (66:12)

Well, often after a year, 50% stop because it's even more.

Unidentified Guest or Contributor (66:15)

Okay?

David Kessler (66:15)

The vast majority are off these drugs.

Dr. Mark Hyman (66:18)

8, 9, and then they gain back 65% of the weight or more.

David Kessler (66:21)

So what's gonna happen in three, four years? We're gonna go back and look, and the average person's on this drugs for eight to nine months they gain back the weight. And what are we gonna say? There's one big. These are highly effective drugs while you're on them. But if you go off them, right? And if you go off them, you know, understandably they don't work when you're off them. But while they're on them they delightly this gastric empty and you need this seesaw. This is reward circuits that's going to make me feel better and this is going to increase the tide and make me feel full. I don't want this just because I was born without the genes to have this satiety and I need this drug. There should be no shame associated with using these drugs. But we got to figure out how to use these drugs wisely. They are an important tool, but they are not the only tool in the toolkit. So can you use these drugs to change, you know, your relationship with food to condition yourself to eat less? Sure. To give you. This is high to want to eat real foods to eat, not eat. I mean people change. It's very interesting how these drugs change taste, they change what people want to eat for the first time. People say they want to eat healthy. They don't want this, you know, highly high glycemic fat and sugar. Because if that's just going to sit there in their stomach, how is it going to make them feel?

Unidentified Guest or Contributor (67:46)

Right, right.

David Kessler (67:47)

But these. But, but, but we have very powerful tools that can. That are highly effective. But they, but we don't know how to use them in the long term.

Unidentified Guest or Contributor (67:57)

Right.

Dr. Mark Hyman (67:57)

What's your sense of these drugs long term? Because you know we're talking about covering the Medicare.

David Kessler (68:01)

I mean people should have that. I mean imagine struggling with your weight for your whole life.

Unidentified Guest or Contributor (68:07)

Right?

David Kessler (68:08)

And you, you have real, this real. I mean that beer belly.

Unidentified Guest or Contributor (68:13)

Right.

David Kessler (68:15)

That beer belly. I mean the average male in this country who's 50, 60, 70 pounds overweight and where is that fat belly fat? And what did we. We used. We actually, you know, that dad bod or whatever people refer to it. I mean but, but we made it cool in this country.

Unidentified Guest or Contributor (68:32)

Right?

David Kessler (68:32)

But, but in fact what's going on with that. That'd be your belly. I mean we gotta help mean that that viability translates into heart failure into afib school.

Dr. Mark Hyman (68:42)

They get us there. But if people. More than 50% of people are.

David Kessler (68:44)

But we got to give people care. You, I mean you got to marry.

Dr. Mark Hyman (68:48)

With nutrition and exercise and coaching support.

David Kessler (68:51)

And, and you, and, and it's not your fault.

Unidentified Guest or Contributor (68:56)

Right. Okay.

David Kessler (68:56)

But the one thing you can Decide to do is to do something about it, but you have to be. But then we have to give people help.

Dr. Mark Hyman (69:04)

I mean, personally, I think it's malpractice to prescribe these drugs without a nutrition consultation, without higher protein intake, without exercise training and building muscle.

David Kessler (69:13)

And if we're just going to put people back into an environment.

Unidentified Guest or Contributor (69:16)

Right.

David Kessler (69:16)

With all this ultra processed foods, what's going to happen when they're off the drugs? So we got to change the food environment, but we got to give people the tools and give people the care. I mean, this is what you've always stood for.

Unidentified Guest or Contributor (69:30)

Fair. Yeah.

David Kessler (69:31)

This is what you've cared about.

Dr. Mark Hyman (69:32)

Yeah.

David Kessler (69:33)

I mean, I mean, people talk about longevity. What's longevity? Let's really talk. What's longevity? I mean, if I could prevent heart failure, if I can prevent atrial fibrillation, if you can prevent certain forms of these cancers. I mean, we are at the point.

Unidentified Guest or Contributor (69:50)

Yeah, right.

David Kessler (69:51)

If we can reduce this visceral adiposity, this toxic fat.

Unidentified Guest or Contributor (69:55)

Right.

David Kessler (69:56)

That's longevity. Fair. I mean, that's what's killing us. That's what's. In our senior years. How many years of chronic disease of that health span is gonna be taken up by disability because of this? 100% because of this heart, this cardiac. I mean, it may be cardiac disease, it may be renal disease, it may be metabolic disease, but it's going to manifest itself, that toxic fat. And we could do something about that. We know how to change the. We know we have to change the environment.

Unidentified Guest or Contributor (70:23)

Right.

David Kessler (70:23)

We have these tools. We just now have to put it together.

Dr. Mark Hyman (70:27)

This is incredible. I think between the public health focus and the clinical focus and the structural changes that have to happen in our society to allow people to make better choices where the default choices, the healthy choices and opposed to the bad choice. It's going to take a minute.

David Kessler (70:44)

I don't know if it's hopefully tobacco.

Dr. Mark Hyman (70:46)

Yeah.

David Kessler (70:47)

How long did it take us?

Dr. Mark Hyman (70:48)

30 years.

Unidentified Guest or Contributor (70:49)

All right.

David Kessler (70:49)

This is as big as tobacco.

Dr. Mark Hyman (70:50)

I think it's bigger. But the question is everybody eats. Not everybody has to smoke.

David Kessler (70:55)

But you don't have to eat ultra processed food. You don't have to eat in this alternate food universe.

Dr. Mark Hyman (71:02)

Yeah, it's true. It just requires a whole restructuring of everything from field to fork. And that is really important because it's not just a policy issue. It's not just a personal choice issue. It's like how we grow our food and it goes back to. Right.

David Kessler (71:18)

But it's how we're making this food.

Dr. Mark Hyman (71:20)

Soil and how we're Processing it.

David Kessler (71:21)

But look at how this ultra processed food is coming together. It's not food.

Unidentified Guest or Contributor (71:27)

No, no. Right.

David Kessler (71:28)

I mean, they're taking, right. These supercharged ingredients and putting that together in some kind of mixture, and then they're adding back that palatability. That's not food.

Dr. Mark Hyman (71:40)

Yeah, I agree. I mean, I think if there was one sweeping policy that the US Government could make that would change everything would be like, if you're eating something, does it promote or detract from your health? And if it's something that detracts from your health, it shouldn't be covered by any government policy. You can make your own choice to.

David Kessler (71:55)

Drink soda, but we certainly shouldn't give it a pass and say it's generally recognized.

Dr. Mark Hyman (72:00)

No, it's sort of like. It's sort of like imagine, imagine with snap, with the food stamp program. Imagine we were paying for $125 billion of cigarettes for Americans. That's essentially what we're doing.

David Kessler (72:09)

So an incredible opportunity to get this. There's an incredible opportunity, right?

Unidentified Guest or Contributor (72:13)

Yeah.

David Kessler (72:14)

We understand what we need to do medically, there's finally a convergence.

Dr. Mark Hyman (72:18)

So what's going to tip this point? You wrote this petition. It was brilliant. It was this insight that I was like, oh, my God, why did I think of that? It's so good and it makes sense and it seems straightforward. So how do we get this over the finish line? Because you and I and a few.

David Kessler (72:32)

Others, there's not one finish line in tobacco. There wasn't just one finish line. It was a series of chapters. We gotta get HHS to act on the petition and simply say, get the ball rolling.

Dr. Mark Hyman (72:44)

I'm on it.

David Kessler (72:45)

Okay, come on in.

Unidentified Guest or Contributor (72:46)

All right.

David Kessler (72:47)

I mean, if you do that, right, then you open up the. You have the hearings.

Unidentified Guest or Contributor (72:52)

Right.

Dr. Mark Hyman (72:53)

I'm on that, too.

Unidentified Guest or Contributor (72:53)

Okay.

David Kessler (72:54)

And you bring in the food industry.

Dr. Mark Hyman (72:56)

I can help that happen.

David Kessler (72:57)

And they gotta be able to. Part of the solution. We're gonna have to give people care. We can't just wait to change our food environment. People need care today, Right? These drugs are one. They're powerful. They're not the whole answer.

Unidentified Guest or Contributor (73:12)

Okay?

David Kessler (73:12)

But we have to give people access to real food. We have to give people access to care. I mean, and finally, finally, what you've always wanted to do. I think we can reclaim our health.

Dr. Mark Hyman (73:26)

I love this. This is beautiful. And what a wonderful place to end. We can reclaim our health. And you've been a pioneer in this space for a long time. I have huge respect for you. I followed your work from the days back when you were the FDA commissioner under Clinton and Bush and the fact that you took on tobacco and one, I think, you know, it would be a beautiful bookmark to your life to take on the ultra processed food industry and create a win for America. And I'm going to do whatever I can to help you because I have little levers I can pull. I know people, you know people. We can pull this together. And I have have elevated this petition to a bunch of people in the administration. I'm also wanting my community listeners to also talk about this to their congressmen and their senators, to start to socialize this idea because it is a powerful idea. There's sometimes these ideas that happen once in a while that catalyze some shift and I think this is one of those ideas. It's simple, it's clear, it's irrefutable. His time has come. Like, let's go.

David Kessler (74:31)

Thanks for having me.

Dr. Mark Hyman (74:32)

Yeah, thanks for being here, David.

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