Obesity Isn’t Your Fault: Biology, Addiction & Solutions with Dr. David Kessler

Mark Hyman, MD

Full Transcript

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Dr. David Kessler
I ran the FDA, and here I can't control my weight. So I ended up after COVID, 40 pounds heavier, and I didn't like myself. I said, look, I gotta understand. Why do I keep on gaining this back? And what is at the root of this problem?

Twenty five percent of us are gonna develop heart failure. Half of us are prediabetic. Twenty five percent of us are gonna have stroke. We're gonna talk about why we're in

Dr. Mark Hyman
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. David Kessler is a physician and author, a public health leader who has served as chief science officer of the White House COVID nineteen response team and previously as the commissioner of the FDA. He's a pediatrician by training. He also served as the dean of the medical schools at Yale and the University of California San Francisco. It's not your fault you're fat because the food industry wants to blame you and that is as far from the biological truth as you could possibly get.

Dr. David Kessler
Well, I think it's important to change our paradigm of how we think about addiction. I filed this petition with HHS. I think FDA has no choice. It's gonna have to get its act together and say, how do we change this food environment?

Dr. Mark Hyman
They're gonna throw hundreds of millions of dollars of legal arguments against this. So how strong do you think this would hold up in court? David, welcome to the Doctor. Heimer 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 gonna talk about diet, drugs, and dopamine, the new science of achieving a healthy weight. But it's really way more we're gonna 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 that's a 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're 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 we're gonna talk about. But I think there's this really incredible moment we're in, and I kinda want 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. 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, low carbs, including your book, Unraveling the Mystery of Mental Suffering, which has to do with mood stuff, but also related to to issues of addiction hijacked, how your brain is fooled by food, your food is fooling you, how your brain is hi 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 what what's sort of got you focused on this idea that was so antithetical to the medical establishment's paradigm, which is it's kinda your fault. Just eat less and exercise more, eat a healthy diet, get more exercise, and you lose weight. If it's not the case, then it's you. So how did you break that, And and how did you come to what you understand now through your own story?

Dr. David Kessler
So, you know, the the most recent iteration was, you know, I had the opportunity to co lead Operation Warp Speed. Yeah. Right? So a very intense period of time, COVID, for all of us. I was working eighteen hour days.

Yeah. Didn't leave, you know, my desk literally seven days a week. You know, 676,000,000 vaccines free. Right? We got to the other side, and I found myself some 40 pounds heavier at the end

Dr. Mark Hyman
of it. And you're you're working in a government building in Washington?

Dr. David Kessler
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
The reason I ask is because the food is so crappy in the senate and the congress and all the agency But but but the you know,

Dr. David Kessler
it was also crappy, you know, just

Dr. Mark Hyman
At home.

Dr. David Kessler
At home. You know, my sense is if just I watched myself eat, right, and how I used food, you know. Throughout the the day, you know, I mean, for all of us, think that there are these momentary just these little ups and downs. And I would use food, you know, to regulate how I felt. So 10:00 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 I gotta get through the next two, three

Dr. Mark Hyman
Saving the country from COVID.

Dr. David Kessler
Yeah. Just 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.

Dr. Mark Hyman
Energy, mood.

Dr. David Kessler
I mean, I mean, exactly. I mean, you know, my guess is if I were born two, you know, two decades earlier, my my parents or grandparents' generation, I would have probably been a smoker. Mhmm. Right? I mean, so I grazed.

Right? Yeah. 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, I 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 gonna power myself through that?

Dr. Mark Hyman
Caffeine and sugar

Dr. David Kessler
be I mean, and 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'm always getting it back. That was 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 and I didn't like myself.

I mean, I just, you know, I just I I wasn't I wasn't healthy. I mean, it was it's not about that weight. It's about that toxic fat.

Dr. Mark Hyman
Right. Right? I mean, that's what Belly fat. The visceral fat.

Dr. David Kessler
It it's that fat that gets into our liver, that gets into our pancreas, that gets into our heart. Right? It's that ectopic fat that's not, you know, it's not where fat is supposed to be. It's metabolically active. Right?

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, attending 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 forms of cancer. I mean Dementia. All of it. I think medicine is just waking up to that.

Dr. Mark Hyman
Right. I'm laughing because I wrote books about this twenty years ago.

Dr. David Kessler
It's I like mean, I

Dr. Mark Hyman
Hello, everybody.

Dr. David Kessler
I mean, take a bath. Right?

Dr. Mark Hyman
I don't care about that. I'd like You know what mean? I don't know. But seriously,

Dr. David Kessler
you know, I I am I 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
Well, we were doing DEXA scans in my work at Canyon 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 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.

Dr. David Kessler
So I finished, you know, 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 I set out to to write the the last book, the diet drugs and dopamine. Mhmm. And there is, you know, there is no doubt in my mind.

I mean, the the the diet is the the primary culprit. I mean, there there there is no there is no question about that. Now, you know, it's it's that diet in the food in our environment that interacts with our brains and the way our brains are are wired. You know, we tended to you know, we we talk about about addiction. We used to think addiction was for, you know, the the weak, the the downtrodden.

Yeah. I mean, it was about other other people. But

Dr. Mark Hyman
There's a lot of stigma about it.

Dr. David Kessler
I mean, absolutely. But but but the fact is

Dr. Mark Hyman
And there's a lot of stigma about obesity, which is unfortunate.

Dr. David Kessler
About both. 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 that energy dense food. That was responsible for survival. Right? Mean, in an environment to scarcity, right, we evolved. I mean, those those organisms survived if they could gain attention and focus energy dense food.

Dr. Mark Hyman
Yeah. I mean, bitter foods are sometimes harmful, but sometimes not. Sweet foods are universally You

Dr. David Kessler
circuits have at work here. Right? You have these reward addictive circuits in our brain. Dopamine. Right?

That chew 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, gone in and got something to eat, and, you know, my brain know, that that cue, right, triggers those thoughts of wanting, 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, I mean, actually consume, and then

Dr. Mark Hyman
Then it comes

Dr. David Kessler
it's gone. That then it's gone. But that that cue induced wanting, I mean, is part of 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 and I saw this, you know, with tobacco. The most powerful reinforces are the reinforces that can change how we feel.

Dr. Mark Hyman
Well, Brit, I want you to break it down a little bit because, you know, people say food addiction, and I talk about it. And it's it it it 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, fourteen percent of the global population, including fourteen percent of kids, are addicted to food by the Yale Food Addiction Scale. And and so what is this addiction?

Dr. David Kessler
But but but there's a spectrum.

Dr. Mark Hyman
Right? Right. It's not I'm sorry. The fourteen percent

Dr. David Kessler
is the worst. We call you right. But and and I think that that's the mistake here. I agree. It's it's not about fourteen percent.

It's about the sixty, seventy percent, eighty percent of us. I agree. I agree. For whom food is the the salient stimuli. That that that that fat, sugar, and salt, that that perfect trifecta of energy dense food that that that capture our our attention.

I mean, if anything, we were all I think we're majority of us are wired to focus, I mean, on on those cues. I mean and I mean, 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's I'm not surprised that sixty, seventy, 80 of us, you know, find food, you know, highly rewarding and and attract our attention and and have that call for it. It's it's the 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
Right? But it can be. Like 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 if I go on a rant of sugar, I'm just gonna want more of it.

Like, even if I don't have that predilection. And most of time, it doesn't bother me, but, like, occasionally, like, if I'm in a stressful situation or whatever, I'll go, oh god. I'm really,

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

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

Dr. David Kessler
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 an indifferent ballpark as far as the extent of that hit. Nicotine, on the other hand, is probably much closer to food.

Dr. Mark Hyman
And how hard is it to quit cigarettes?

Dr. David Kessler
And and again, it's this this gating of attention. Mhmm. Right? You you get I mean, next time you get hungry, just try to figure out what the cue is. 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 sense of wanting. Yeah. Right?

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

Right?

Dr. Mark Hyman
And and,

Dr. David Kessler
you know, we created this food circus. What did we expect to happen?

Dr. Mark Hyman
It's a it's a food carnival out there. It's yeah.

Dr. David Kessler
It's a toxic nutritional landscape that we're all exposed to. And 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 cardio renal metabolic disease? It starts early in life. I mean, we are seeing it in the liver of our kids.

Dr. Mark Hyman
Mhmm.

Dr. David Kessler
Right? I mean, and when it gets into the heart Yeah. Twenty five percent of us are gonna develop heart failure. Yeah. Right?

I mean, what? Thirty, forty percent, you know, diabetic. Half of us are pre diabetic. Twenty five percent of us are gonna have stroke. And at the cause of that, I mean, there there is this, I think finally, this convergence in medicine, I mean, and in public health.

We know what the we know what the problem is.

Dr. Mark Hyman
But you know, David, what's really striking to me is I I cofounded 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 one percent. Less than one percent. And insulin is the first thing to go awry when you actually have this visceral fat.

It it starts to go up, and nobody's checking it.

Dr. David Kessler
Well, not only that. Mean, if you if you look on a population basis, there has been a doubling in the last twenty years of insulin levels. Right? I mean, there is an epidemic of hyperinsulinemia.

Dr. Mark Hyman
And it's not being tested. It's crazy to me.

Dr. David Kessler
Now you can argue, you know, that assay is not the easiest necessarily. Right? It it it 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, get caught in this vicious cycle.

Dr. Mark Hyman
Although David literally talks about does overeating make you gain weight, or does it gaining weight make you overeat? And it's this paradox.

Dr. David Kessler
So so you you have these central you have these central circuits, right, that that focus our attention and our 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
You mean the microbiome?

Dr. David Kessler
No. I'm just talking about the hyperinsulinemia.

Dr. Mark Hyman
Oh, yeah.

Dr. David Kessler
Right? I mean, the the absorption of the belly fat, the the biochemistry, what what's going on in our our liver, and, I mean, the absorption of this rapidly absorbable glucose in a increasingly insulin resistant body. The American body is not not well. I mean, only twelve point two percent of us are metabolically healthy.

Dr. Mark Hyman
Well, actually, that was the last study. Then the new updated version, it's only six point eight percent from from Tufts, the same the same kind of data. It was like, that's frightening. I mean, that means they've been 93.2 of Americans have some degree of insulin resistance. They might not have prediabetes yet, but they're somewhere in that continuum.

Dr. David Kessler
And in some people, they they hear that number and go, I mean, that kid just can't be right. Right? I mean, it's it's very interesting. They go I mean, twelve only twelve percent or nine percent or six percent of us are metabolically healthy. But the fact is, alright, that I mean, those are the the the numbers.

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

Dr. David Kessler
So so so here I am, forty pounds heavier. Yeah. Right? And the question is, what does it take to reclaim our health? I mean, and I think finally, finally Mhmm.

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 it's very complicated, but it's also very simple. I mean, you have one industry that makes billions of dollars, right, that 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 is.

Dr. Mark Hyman
It's actually trillions. Is is doing.

Dr. David Kessler
Right? The food is producing trillions. Yeah. The 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 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, 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. Mhmm.

Fix the root cause.

Dr. Mark Hyman
And and just to unpack what you're saying is is the change in the American food supply over the last fifty 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 it's 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.

Dr. David Kessler
Sure. If you go back, you know, and I and I went back in over the last, you know, few months, did the book, and then I filed this petition Yeah. With HHS. But, you know, went back and and looked at at the history. And the food industry back in the fifties and forties, fifties, sixties, learned how to take corn, learned 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. The the the the the they have names called maltodextrin or dextrose or aminoxylose or or or maltose Mhmm. Corn syrup, and and corn corn solids. I mean and that gave birth to an alternate universe.

I mean, you know, the it's really not not food.

Dr. Mark Hyman
It's not technically food. Actually, if you 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.

Dr. David Kessler
They they they took out the structure of food. Right? And they extracted these chemical components, and then they reassemble them in a way without the structure of that food, without the fiber. Right? Then all that slowed down eating.

Right? And and they took the I I look at this ultra processed foods, I say, there there are basically, there there are four components of this stuff. Right? Just when you look at how 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 the industry did from after it generated all these, you know, chemical ingredients, right, was to reassemble them. I mean, find some other chemicals that added to to mouthfeel or texture because it's and they were able to dial in, right, that palatability.

Dr. Mark Hyman
This wasn't an accident.

Dr. David Kessler
It certainly wasn't an accident.

Dr. Mark Hyman
Like, the tobacco companies are like, oops. We didn't know it was addictive, but baloney.

Dr. David Kessler
The the 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
Secretly hiding the data. Correct.

Dr. David Kessler
And and we went inside, you know, to do the really the the big investigation into the tobacco industry. And and when I did that, my friends at night had to teach me everything about addiction, and one of the the tests to on addiction was whether animals, laboratory animals, self administered nicotine. Correct. And they pressed the lever for for nicotine. But it was rewarding, whether it set off those reward circuits, right, I mean, of the brain.

And they always had a positive control there of sucrose. And I said, well, what about what about sucrose? Well, well, tell tell me about that. Why are you using that as a positive and they never paid attention to me. Yeah.

Right? And that that's what got me interested. What 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, right, again, not in the context of food or food structure, that food matrix Mhmm. Right, which is so key to that that absorption, and and and 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, in chemical ingredients. Did you see on the that that ingredient panel? You know, you look at it and you go, I don't know what half of those That's right. Mean.

Dr. Mark Hyman
Right.

Dr. David Kessler
Right? And and and to reassemble it, and no one asked what was the biological effect.

Dr. Mark Hyman
No.

Dr. David Kessler
So if you take starch, and you subject it to there's these, you know, numbered techn you know, processing techniques once called extrusion. I mean and I mean, it it basically molds that starch in that I mean, into any kind of form. It gives color. It 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 the sheer forces and these temperatures that change the molecular structure.

And no one asked. What happened

Dr. Mark Hyman
in the body?

Dr. David Kessler
No no no one asked what was gonna be the metabolic consequences of that.

Dr. Mark Hyman
Well, it they 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 they actually like, the tobacco companies designed these foods to be addictive.

Dr. David Kessler
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 wanna know. Yeah. Right? Right. That they went ahead and they created this alternate universe of, you know, this food system, this ultra processed food.

I mean, 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 the the salt. Right? And it all ended up being very rapidly absorbed, causing this hyperinsulinemia, causing this this 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 their 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 that's where the real you're adding that that that phi. Exactly. And that's where and that's what's going on. Yeah. And that's why and and again, it's not just staying it's not just the hyperinsulinemia.

It's not just the the the fat. I mean, it's it's that liver the liver consequences, the consequences in the pancreas, the consequences, that that ectopic fat in our heart. Yeah. I mean, that that's I mean, that's that's heart failure. I mean, that's that's causing some of this atrial fibrillation.

Dr. Mark Hyman
That's right.

Dr. David Kessler
Right? The fat's that's not where fat's supposed to be. No. And it's that fat is metabolically active.

Dr. Mark Hyman
And it's neurochemically active. And it's immunologically active. And it's hormonally active.

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

Dr. Mark Hyman
You know, what you're I just wanna 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. Correct. Broken them part chemically, altered their chemical structure and composition in ways that are completely new to nature. Correct.

They're Franken molecules. Correct. And then they reassemble them into things that look like food,

Dr. David Kessler
but actually aren't food. Bingo. And then they were cheap. Right? They and they dialed in palatability.

They dialed in, you know, that that that that sugar, that fat, that that that sweetness, that trigger our reward circuits in many of us. Right? And and that cause that that metabolic harm because 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 it just gets so rapidly absorbed. It causes this hyperinsulinemia, and it and it it it's the the the reason why, you know, we're seeing the chronic disease that we're seeing in this country. I mean, I mean, we under now understand this is the primary cult.

Dr. Mark Hyman
A 100%. Amen. Hallelujah. I've been saying this for decades. Thank God you you and others are figuring this out.

I think what I wanna now do is is is kinda 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 twenty 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.

Started out of, you know

Dr. David Kessler
Not not a perfect definition.

Dr. Mark Hyman
No. I was say Right.

Dr. David Kessler
Mean, we gotta be careful. Right?

Dr. Mark Hyman
Mean, they they I'm gonna get to that. I'm gonna get to that. There was a Brazilian scientist who came up

Dr. David Kessler
Carlos Montero.

Dr. Mark Hyman
Montero who came up with the NOVA classification, which is an attempt to try to figure it out.

Dr. David Kessler
There are a number of other classifications. Right?

Dr. Mark Hyman
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? How do we

Dr. David Kessler
It's asking for the definition.

Dr. Mark Hyman
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 around it.

Dr. David Kessler
Yes and no. So certainly, if you wanna label something ultra processed food, you have to come up with a definition, but the the industry will challenge that that definition will always include certain things that you can argue, well, is this healthy and it's ultra processed? I mean, there's always gonna be those debates, mean, at the extreme. But but we certainly know what's in the components of this this food. It is refined sweeteners.

It's refined flours and starches. It's these added fats and oils. Right? I mean, it's it's salt. I mean, and it's these other chemicals that give it texture and mouth feel.

Right? And the this drives in the palatability. Yeah. So so so we we we really do know what the these foods are, and we know these foods don't exist in nature.

Dr. Mark Hyman
Yeah. And you just to be clear for everybody listening, you submitted a petition to the FDA that was based on their request for information for ultra proxies.

Dr. David Kessler
No. I mean, it actually wasn't for the request. It wasn't because of the request for information.

Dr. Mark Hyman
Oh, I thought it was.

Dr. David Kessler
No. The the petition went in separately. Right? I mean, it it it it it it certainly is consistent with that. Right?

And looks at this food system, looks at this this this system that got developed in the forties and fifties of you of developing these cheap ingredients out of food and reassembling them. Right? And creating this this food circus. It recognizes that. It recognizes ultra processed food.

Right? I mean, and highly processed food. I mean, can, you know, choose your how you wanna refer to this, but but it's certainly not food, I mean, as we know it. Mhmm. Right?

As as occurs in nature or stuff that we we make at home. The petition was very specific. Right? 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.

I mean, anything I mean, in fact, the nation's food laws are pretty comprehensive and strict if we were enforcing them. Yeah. Well. Right? So if you wanna 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 you balance risks and benefits. Yeah. 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. It was there was a definite there was a term called grass, generally recognized as safe. If you were generally recognized as safe, if you were GRAS, 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 GRAS.

So in and I went back, and I found this document, 1988, that it actually had its predecessor documents in the nineteen seventies. And it was a the grass evaluation for corn syrup, corn solids, dextrose, right, maltose, maltodextran, all those starch conversion products.

Dr. Mark Hyman
Most of those are derivatives of corn.

Dr. David Kessler
And gave rise to the the modern, highly processed food. I mean, you you you you mean, go look in the middle aisles. Right? Those corn syrups, corn solids, maltodextrans, right, were the 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 strips and corn solids, and maltodextrin, dextrose, etcetera, and said there's no link between those substances and obesity, no link with diabetes, no link with cardiovascular disease.

Wow. And therefore, that stuff is GRAS.

Dr. Mark Hyman
But they didn't they hadn't studied the link.

Dr. David Kessler
Let me just so understand GRAS. FDA right? FDA doesn't have to show that something is unsafe. Right? In order to be GRASS, there has to be a 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 and these substances were granted GRAS status. So if I ask you today, and I and I lump these these these ingredients into this term called processed refined carbohydrates. Yeah. Right?

You know it well. Yeah. You've written about it. Yeah. Right?

Before the term ultra processed foods, we understood processed refined carbohydrates. Processed refined carbohydrates are an essential part of ultra processed foods. Yeah. We can agree. You can't have these ultra processed foods without these processed refined carbohydrates.

The the the machinery, the the corn syrup, the corn solids, you you couldn't use in fact, sucrose would go gunk up the machines. You needed, you know, for that viscosity, for that lubricity, etcetera, for these machines to work to give rise to that moisture, you know, all this this processed food. You had all these starch conversion products that the industry learned to to use. So I ask you, is there general recognition of safety among experts that corn syrups, corn solids, maltodextrin are safe?

Dr. Mark Hyman
Today, the answer is no. Then, I think they didn't know.

Dr. David Kessler
The the thing about grass Although because something is grass let me give you two other pieces, and then we'll put it together. Just because something is grass back in the seventies 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
So why hasn't the FDA held them to account?

Dr. David Kessler
Bingo. So that's where the petition goes. So the petition basically looks at these corn syrups, corn solace, the the these refined what I call these refined processed carbohydrates. Now I don't deal. I exclude, you know, anything that's made at home, sugar, flour, starch.

Dr. Mark Hyman
You wanna make cookies with flour?

Dr. David Kessler
I I I don't deal with that. But I what would you deal with see, the 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. Yeah.

Right? So you have to come with what's the ingredient. But the the law says, yeah, if you have an ingredient, right, you have to generally recognize safe under the under the conditions of use. So if you take that 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 you took the the 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 of refined processed carbohydrates in the petition. Right? That that also includes sucrose, refined flours, and starches.

When used with these humectants, dough conditioners, these stabilizers, I mean, these other chemicals

Dr. Mark Hyman
But they come along with the package.

Dr. David Kessler
It's that. When they these other processing aids, right, I say this, not a general not generally recognized the same. And it's a matter of science and law. These substances can't be grasped today.

Dr. Mark Hyman
You know I It just reminds me of when T. H. Huxley heard of the theory of evolution. He said, how stupid not to have thought of that.

Dr. David Kessler
Right. I mean, so I mean, so so in in order to put this together, I, 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, I mean, it couldn't be more simple.

Dr. Mark Hyman
Yeah.

Dr. David Kessler
Right? Yeah. 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 the this these rapidly absorbable carbohydrates. We the FDA said the the industry said it was safe, generally recognized as safe back in the seventies and eighties.

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 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 seventies, 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 re re require an interpretation of statute. It just requires enforcement of existing statute.

Dr. Mark Hyman
Yeah.

Dr. David Kessler
And the fact that there's one other thing. The industry

Dr. Mark Hyman
Very elegant. It's like it's like, wow. What a brilliant idea. Because you're putting the onus of proof back on the food industry.

Dr. David Kessler
Where it should belong. Yeah. Right? And now the the industry will come and say, well, what about one can of this or, you know, one teaspoon of that? That that is safe.

But there was there's something else about the 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, and the doses we're currently consuming them, they are not safe. Right? So so they got on this market, on the market because they were grass.

You can't be grass anymore. Right? 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

Dr. Mark Hyman
they are not hundreds of millions of dollars of legal arguments against this. So how how strong do you think this would hold up in court?

Dr. David Kessler
I think that it's easier than tobacco.

Dr. Mark Hyman
Easier than tobacco.

Dr. David Kessler
I think it's I think it's much tobacco, certainly, I I don't wanna get overly legal, you know, in a post Chevron world. I mean, for the lawyers, you know, or Citizenship. Interpreting the 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 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?

Dr. Mark Hyman
Of course.

Dr. David Kessler
Right? I mean, there there are all these, you know, I mean, very strong views, very I mean, in some ways, we eat our own. Yeah. 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. Right.

We could agree on that. Yeah. So so the the the 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 have gone after salt? Right? I mean, could I have done those are but but if you look at that, what's driving this metabolic harm, I think 90%, I mean, of the culprit has these processed refined carbohydrates. Maybe it doesn't deal with everything.

Dr. Mark Hyman
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 it it's not a big deal. But it's the cumulative dose and the pressure

Dr. David Kessler
The law requires you to evaluate the the the under the conditions of use as it as it's being used. You need look no long no more than just look around us.

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

Dr. David Kessler
But but 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 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 gonna have to come in, and it's gonna have to get get its act together and say, how do we change this food environment?

The ability to remake our food system.

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

Dr. David Kessler
All they have to say is is it's not not grass.

Dr. Mark Hyman
And then what happens?

Dr. David Kessler
The the the then you have to give the you probably give the industry a certain certain time Tuesday. And then they can come in, and they have to figure out how they're gonna remake and reformulate food, right, so that Americans can thrive.

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

Dr. David Kessler
I mean, I'm not even sure it's whether the government the the the government doing that would certainly be very important, but I actually think it's self executing. I think under the law, the food lawyers I've talked to, I mean, I I don't think you can credibly say it's generally recognized as safe. Certainly, the government does that force it. Right? Well, so so so that you're exactly right.

I mean and there the FDA did issue this document in '88 that said these things are grass. So I think FDA has to say that it is is not grass. People say it will take FDA a long time to study this and to figure out all the answers to these questions. They they it wrong. The burden is on the industry to show that it's safe.

Yeah. I mean, the the FDA simply says, hey. Just look at the dietary guidance advisory committee scientific reports. We've these refined processed carbohydrates, I mean, are there is a link with obesity, cardiovascular disease, and diabetes. Maybe we didn't see that link back four or five decades ago.

Maybe that was an area that we we didn't foresee.

Dr. Mark Hyman
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

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

Dr. Mark Hyman
Yeah. Much healthier.

Dr. David Kessler
And so the question is, we're gonna have to make remake our food environment. Mhmm. And and and remaking our food environment is gonna mean that, you know, the the the dose is gonna have to come very substantially down. Right? Because question, at current doses, at current consumption current cumulative consumption levels, right, we see the harm.

I mean, and the harm is demonstrable. Just look at the American body. We we we see that effect.

Dr. Mark Hyman
According to recent USDA data a few years ago, was like a 152 pounds of sugar and a 133 pounds of flour per person in America per year. That's almost three quarters of a pound a day. That's a pharmacologic dose.

Dr. David Kessler
We are consuming, right, 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 the hepatic fat. But, certainly, those calories plus the refined processed carbohydrates are the toxic

Dr. Mark Hyman
Well, the calories are the usually, the refined carbohydrates. That's where they're coming. I mean, exactly. No. It's not like we're eating 500 calorie more of meat or chicken or fish.

Dr. David Kessler
So so if you look at what it is, it's about two, three hundred calories of these refined grains.

Dr. Mark Hyman
Mhmm.

Dr. David Kessler
Right? It's these starches and flours. Right? It's it's more sweeteners, although increasingly, the the the sweeteners, you know, are these artificial sweeteners. Right?

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

Look. Once you open the door what the petition does, I think, is

Dr. Mark Hyman
Ask the question.

Dr. David Kessler
It opens the door. Yeah. And once you open the door and say say, hey, it's no longer grass. There's no churning it back.

Dr. Mark Hyman
So so so 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 gonna tell them to take to actually make this a reality? Because it just seems to be like a loophole that you found that nobody's been thought about before that actually could solve the problem.

It it

Dr. David Kessler
it certainly gets the ball rolling and reframes the debate. It gives us the tool. So what did we do? Understand when when tobacco started actually, tobacco started with a citizen's petition. 1988.

Right? 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. Why low tar, low nicotine cigarettes as a drug?

Didn't didn't quite make sense, but it gave the regulatory hook. Right? It gave the authority, I mean, to ask those questions. And we reframed the question, not is low tar cigarette low nicotine no low nicotine cigarettes a drug. We reframed 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 those the CEOs testifying?

They believed in nicotine. Right? And then there was all this leg legislation. Took two, three decades. But once you what what the petition does by saying there's no longer grass, it it gives HHS, the regulatory and legal hook to be able to reframe the

Dr. Mark Hyman
food But it's gonna 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.

Dr. David Kessler
But that's the easy part. That just gets it started. Yeah. Then the question is, how are you gonna fix it? The the great public health success of our lifetime, tobacco.

Fair? Yeah. Right? Yeah. What in what in the end worked?

Dr. Mark Hyman
Litigation. Go ahead. Labeling? Labeling, avoiding advertising, taxation.

Dr. David Kessler
So focus on our kids, all all I mean, all that worked. But what really worked? What what did what did those things what those were all tools. Right? If you go back and you look at, certainly, in my parents' generation or my great great parent great my grandparents' generation, Right?

How'd they view tobacco? Right? Tobacco was sexy. It was adventuresome. Right?

It was positively valence. The industry in the early nineteen hundreds, they had that march down Fifth Avenue. It was associated with emancipation. It was they they hired the psychoanalyst, A. Abril, to come up with the phrase torches of liberty, symbols of freedom.

That was something you wanted. That's something you desired. Right? It it was cool. Right?

They made it cool.

Dr. Mark Hyman
They're drinking the slums. Right?

Dr. David Kessler
What did we do? What did we do? What did what did take us seventy five years?

Dr. Mark Hyman
Made it a pariah to be

Dr. David Kessler
a smoker. So what 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 it. Right? You need it. I mean, I can't live without it.

What did we do? We made it negatively. We had this critical perceptual shift as a society. I don't want that. Yeah.

So are we gonna have to label these suit? Are we gonna have to show people, right, that the these these chemically engineered the these foods, you know, that have these refined starches and grains, refined sweeteners, these added fats and all, these are not foods. Right? Sure. They make you know, in in the moment, may they get me past the next twenty minutes?

Right? May give me energy for two hours? But how is it gonna make me feel over the long term? Is it cheap? No question.

It's cheap.

Dr. Mark Hyman
For the short term,

Dr. David Kessler
not long term. But but for the long term, look look at the devastating cost. So we're gonna have to change we're gonna 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
So do you think it's like a public health education like we do with cigarettes? It's everything.

Dr. David Kessler
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 and explain that the stuff is no longer grass, and it's no longer a legal basis. Next panel is gonna be the next panel is gonna be the industry CEOs, and how are they gonna fix this? Right? And the question is, is the industry gonna 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
This is great. This is great. I love this idea. I'm actually good friends with the chair of the subcommittee on health in the Ways and Means Committee who wants to have hearings on these things. So so I think since Medicare is overseeing the health of America in many ways, it would be an interesting it would be an interesting place to have these hearings.

Dr. David Kessler
FDA has to do HHS has to do its part. We we have these hearings. The food industry has to solve come in with its solutions, and it's going to take is it just gonna be the revocation aggressor that's gonna solve this? No. But it's gonna have to put together that comprehensive package.

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

Dr. David Kessler
And 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
I mean, I read it, and my jaw was on the floor. And I we're gonna link to it in the show notes. 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 chat. She peed and asked you to summarize it to summarize it for you.

And if you

Dr. David Kessler
go back to the book, you you go back to the book, there's a chapter. Yeah. I think it's chapter 23. It said you could not have designed a better weapon to blow up the American body.

Dr. Mark Hyman
Meaning the petition, or you mean the the food? The food industry.

Dr. David Kessler
If if you look at what we did. Okay?

Dr. Mark Hyman
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.

Dr. David Kessler
Yeah. The the up until now, the industry has been able to, you know, do this with impunity. Put this out. Right? And say, it's not my food.

I mean, it's the it's the dietary patterns. Right? But it's these industrial foods that created the current dietary pattern. Mhmm. Right?

So there is there is and we need just to just complete full picture here. Right? So the question is, what do you do if you're the individual? Yeah. How do you protect yourself

Dr. Mark Hyman
Yeah.

Dr. David Kessler
From this environment?

Dr. Mark Hyman
Because clearly, we've been talking a lot about the public health interventions, which have to happen.

Dr. David Kessler
But it's absolutely true. Yeah. So, again, I left warp speed 40 pounds heavier. Right? And metabolically, my body

Dr. Mark Hyman
Busted.

Dr. David Kessler
Was was not good. I actually I started losing weight, you know, and I went on my typical, you know, low carb kind of diet. I lost a couple of pounds. Right? It wasn't going as quickly, I mean, as as as I wanted, I mean, interestingly.

And I threw a I had a kidney stone. You know, know, losing weight, I mean, you know, I I was at risk for kidney stones. I found myself in in e in the ER. Yeah. I was just, you know, dehydrated and, you know, had had the kidney stone.

I 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
And parathyroid hormone was It all

Dr. David Kessler
was a spurious result.

Dr. Mark Hyman
It was

Dr. David Kessler
a spurious result, but the endocrinologist happened to be doing some of the clinical trials on the GLP one drugs. Right? And I said I was losing weight. And he said, do you want to try to go on the GLP one drugs? You qualify.

My BMI was greater than twenty seven with a comorbidity. And I'm writing this book, and I said, hey. And I wanted to experience it. Right?

Dr. Mark Hyman
Diet, drugs, and dopamine. And dopamine.

Dr. David Kessler
Right? I mean, the dopamine I had, right, the the the those you know? And there there is when you look at the biology, and I think that this is key, I think, first of all, what 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 GLP ones for the vast majority of people. Ninety five percent of people lose weight.

They are not the the be all and end all. They're not the whole story. They are only one tool. They have real adverse events. Right?

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? Right. But what with the pharmaceutical how do these drugs really work?

Right? Why are they so effective? You know, we we talked about the sadonic, 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 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 emptying. Right? They slow down the the movement. Highly processed foods increase the speed of that food.

Dr. Mark Hyman
Your gut down

Dr. David Kessler
so And you're at and we've all experienced it. We've had the flu, our gut slows down. You and You're

Dr. Mark Hyman
not hungry.

Dr. David Kessler
You're not hungry. But how do you also fear? When you have the flu, and you don't wanna put anything else in your stomach.

Dr. Mark Hyman
Right? They're nauseous.

Dr. David Kessler
So what these drugs do is they delay gastric emptying, and they push you to that edge of nausea. Right? What's strong enough to overcome the addictive circuits? Wanting to puke. No.

So you you you you laugh. Now the great thing about these drugs is they titrate

Dr. Mark Hyman
I'm the kidding. I'm just

Dr. David Kessler
saying that.

Dr. Mark Hyman
No. No. But you're

Dr. David Kessler
but but that's exactly how this is work. So so so what happens the way these drugs work is they is they have this spectrum of you know, there's this spectrum of satiety. There is fullness. Right? There's you know, I 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 overt GI, you know, effects of that nausea. Right? I mean, the the the acute effects.

If I push you over the edge so what these drugs do is they stimulate that circuit. Right? This the gut and the brain, I mean, is working on the area per stream of the hind rate, and the gut you delay gastric emptying. You push people to that edge of nausea. Now we all everybody feels this differently.

And what do you do? What do if you know you're gonna put food in your stomach and it's gonna make you feel ill, what do you learn to do?

Dr. Mark Hyman
Not eat.

Dr. David Kessler
Or eat less.

Dr. Mark Hyman
Eat less.

Dr. David Kessler
So that's I mean, my guess is that's the primary thing.

Dr. Mark Hyman
Gastric bypass without the bypass.

Dr. David Kessler
Now how long are people on these drugs?

Dr. Mark Hyman
Well, often after a year, fifty percent stop because of the side Okay.

Dr. David Kessler
The vast majority are off these drugs eight, nine.

Dr. Mark Hyman
And then they gain back 65% of the weight or more.

Dr. David Kessler
So what's gonna happen? In three, four years, we're gonna go back and look, and the average person's on this drug 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. Right. But while they're on them, they delightly this gastric emptying. And you need this this seesaw. This is reward circuits that's gonna make me feel better, and this is gonna, you know, increase the tide and make me feel full.

I don't want this. Right? Just because I was born without the genes to have this satiety and I need this drug, there should be no shame associated with with using these drugs. Right? But we gotta figure out how to use these drugs wisely.

Right? They are an important tool, but they are not the only tool in the toolkit. Right? So can you use these drugs to to change, you know, your relationship with food, To condition yourself to eat less? Sure.

To give you this is high to take to to wanna eat real food, to eat eat not not eat I mean, people change. It's very interesting how these drugs change taste. They change what people wanna eat. For the first time, people say they wanna eat healthy. They get they don't want this, you know, highly high glycemic fat and sugar.

Because if what if that's just gonna sit there in their stomach, if how is it gonna make them feel?

Dr. Mark Hyman
Right.

Dr. David Kessler
Right? 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. Right?

Dr. Mark Hyman
What's your sense of these drugs long term? Because, you know, we're talking about covering Medicare. I mean,

Dr. David Kessler
they they they they It's power. Should have mean, imagine struggling with your weight for your whole life. Yeah. Right? And you you have real that is real I mean, that

Dr. Mark Hyman
That's a real

Dr. David Kessler
your belly.

Dr. Mark Hyman
Right.

Dr. David Kessler
Right? I mean, let let let let's right. That'd be your belly. I mean, the the average male in this country who's fifty, sixty, seventy pounds overweight, and where is that fat?

Dr. Mark Hyman
Belly fat.

Dr. David Kessler
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. Right? But but in fact, what's going on with that that beer belly? I mean, we gotta help I mean, that that beer belly translates into heart failure, into a for

Dr. Mark Hyman
It's just a tool to get us there, but if people than 50% of people are

Dr. David Kessler
out give people care. You I mean, the You

Dr. Mark Hyman
gotta marry with nutrition and exercise and coaching and support.

Dr. David Kessler
And and you and and and it's not your fault.

Dr. Mark Hyman
Right.

Dr. David Kessler
Okay? 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
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.

Dr. David Kessler
And if we're just gonna put people back into an environment, right, with all this ultra processed foods, what's gonna happen when they're off the drugs? Yeah. So we gotta change the food environment, but we gotta give people the tools and give people the care. I mean, this is what you've always stood for. Fair?

Yeah. This is what you've cared about. Yeah. But you mean you mean people talk about longevity. What's longevity?

Let let let let's let's really talk. What's longevity? I mean, if I could prevent heart failure, if I can prevent atrial fibrillation, if we could prevent certain forms of these cancers, I mean, we are at the point Yeah. Right? If we can reduce this visceral adiposity, this toxic fat, Right?

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

Dr. Mark Hyman
this percent.

Dr. David Kessler
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 it's we have to change the environment. Right? We have these tools. We just now have to put it together.

Dr. Mark Hyman
This is this is incredible. I think between the in 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 choice is the healthy choice as opposed to the bad choice is gonna have it's gonna take a minute. I I don't know if it's

Dr. David Kessler
hopefully Tobacco? Yeah. How long did it take us?

Dr. Mark Hyman
Thirty years.

Dr. David Kessler
Alright. This is as big as tobacco.

Dr. Mark Hyman
I think it's bigger, but the question is everybody eats. No not everybody has to smoke.

Dr. David Kessler
But but you don't have

Dr. Mark Hyman
to eat Ultra processed food. You don't have

Dr. David Kessler
to eat in this alternate food universe.

Dr. Mark Hyman
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 it's, like, how we grow our food, and it it goes back to right

Dr. David Kessler
But it's how we're making this food.

Dr. Mark Hyman
Soil and how we're processing it.

Dr. David Kessler
But look at how the the this ultra processed food is coming together. It's not food. No. No. Right?

Mean, they they they 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
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 and and if it's something that detracts from your health, it shouldn't be covered by any government policy. Can make your own choice to drink soda, but we

Dr. David Kessler
we certainly shouldn't give it a a pass and say it's generally recognized.

Dr. Mark Hyman
No. It's it's sort of like it's sort of like imagine imagine with SNAP or the food stamp program. Imagine we were paying for a $125,000,000,000 of cigarettes for Americans. That's essentially what we're doing.

Dr. David Kessler
So so an incredible opportunity to get this done? There's an incredible opportunity. Yeah. Right? Yeah.

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

Dr. Mark Hyman
So what so what's gonna tip this point? Like, you you wrote this petition. It was brilliant. It was like 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 of others

Dr. David Kessler
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
I'm on it. Okay? I'm on it. Alright?

Dr. David Kessler
I mean, if you do that, right, then you open up the the you have the hearings.

Dr. Mark Hyman
Mhmm.

Dr. David Kessler
Right?

Dr. Mark Hyman
I'm on that too.

Dr. David Kessler
Okay. And you bring in the food industry. I can help that happen. And and they 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. Okay? 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
I love this. This is beautiful, and what a wonderful place to end. We can reclaim our health. And, you know, 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 in 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 gonna do whatever I can to help you because I I I have little levers I can pull. I know people. You know people.

We can we can we can pull this together. And I I have elevated this this petition to a bunch of people in the administration. I'm also, you know, wanting my community listeners to also talk about this to their congressmen, 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, this time has come, like let's go.

Dr. David Kessler
Thanks for having me.

Dr. Mark Hyman
Yeah. Thanks for being here, David.

Dr. Mark Hyman
If you love this podcast, please share it with someone else you think would also enjoy it. You can find me on all social media channels at Doctor Mark Hyman. Please reach out, I'd love to hear your comments and questions. Don't forget to rate, review, and subscribe to the doctor Hyman show wherever you get your podcasts. And don't forget to check out my YouTube channel at Doctor Mark Hyman for video versions of this podcast and more.

Thank you so much again for tuning in. We'll see you next time on the Doctor Hyman show. This podcast is separate from my clinical practice at the Ultra Wellness Center, my work at Cleveland Clinic, and Function Health where I am chief medical officer. This podcast represents my opinions and my guests' opinions. Neither myself nor the podcast endorses the views or statements of my guests.

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