The human brain evolved to deal with scarcity, not abundance.

You know, and for much of human history, there were no guarantees to when our next meal would arrive.

So our biological systems, our brains will seek out that sweetest, most energy dense food.

So we're wired to focus on the most salient stimuli in our environment.

It's not that our brains are not working well.

It's not that our brains are broken.

If anything, they're working too well.

Welcome to the Metabolic Mind Podcast.

I'm your host, Dr. Brett Scher.

Metabolic Mind is a nonprofit initiative of Bouzouki Group where we're providing information about the intersection of metabolic health and mental health and metabolic therapies, such as nutritional ketosis as therapies for mental illness.

Thank you for joining us.

Although our podcast is for informational purposes only and we aren't giving medical advice, we hope you will learn from our content and it will help facilitate discussions with your healthcare providers to see if you could benefit from exploring the connection between metabolic and mental health.

What's the biggest medical and public health failing of our lifetime?

Well, I'm joined by Dr. David Kessler, who's pretty clear that it is visceral fat, visceral adiposity, and the metabolic dysfunction and obesity that goes along with it and the just myriad of health complications related to it.

But what can we do about it and why are we here in the first place?

Well, Dr. Kessler has an extensive pedigree to help us answer this question.

He is a MD pediatrician, but also a lawyer.

He was the former commissioner of the Food and Drug Administration.

He's been the dean of two different medical schools and he's a well respected author.

The end of Overeating, Question of intent he helps, which was about the tobacco industry and he helped sort of take on the tobacco industry and now diet, drugs and dopamine where he explores this connection between diet, visceral adiposity, insulin resistance, GLP1s and the food that we're eating.

So there's a lot to unpack here, but I think it's going to help you better understand the predicament we're in and how to get out of it.

So enjoy this interview with Dr. David Kessler.

Many of the interventions we discuss can have potentially dangerous effects if done without proper supervision.

Consult your healthcare provider before changing your lifestyle or medications.

In addition, it's important to note that people may respond differently to ketosis and there isn't one recognized universal response.

Dr. David Kessler, thank you so much for joining me today at Metabolic mind.

My pleasure.

Well, as we've heard in the intro, you've got quite the pedigree with a lot in your background, in your history as a doctor, as a lawyer, as former head of the fda, and of course as an author.

Diet, Drugs and dopamine being your new book.

But what I found really interesting in your book is really started with a personal journey.

It started with your personal journey since you were a kid, of weight gain, weight loss.

So give us a little bit about that background, about your background.

What got you interested in this really this world of metabolic health and diet and how it all came to be for you.

The mystery of weight.

Right.

I've gained and lost my body weight repeatedly over my lifetime.

I have suits in every size.

You know, I had the privilege of co leading operation Warp Speed during COVID you know, an intense period of time for all of us.

You know, I found myself at the end of that, you know, 16, 18 hour days, you know, seven days a week, 676 million vaccines later, I found myself some 40 pounds heavier.

And I just really wanted to dig in to this mystery of weight.

Here I was, you know, I ran fda, took on tobacco, did Covid dean at two med schools.

I usually can get things done.

No one ever accused me of not having discipline or willpower, but I just couldn't understand what was going on with weight and wanted to tackle that.

And what makes your personal journey, I think so interesting is you talk about how during COVID you gained all this weight, but you weren't new to the concept of weight management.

I mean, you had already written the end of overeating years before that.

So you'd already researched it and looked into it and.

And yet it still kind of snuck up on you.

Did that, did that kind of surprise you?

Absolutely.

I was, you know, I did, you know, with a team, we did the food label back in the 1990s, you know, that nutrition facts panel on, you know, all packaged foods in the United States.

You know, I had written in this area, but I still had just, you know, very hard time controlling weight.

You know, I would always be able to lose it.

Right.

Get it off.

But then, you know, I would go on with life and I would gain it back.

And I really didn't understand why.

I didn't understand what was driving that.

Yeah.

And here you are within the medical system, struggling with the things that so many Americans and worldwide are struggling with.

But yet you had the inside track.

So what do you think?

I mean, it's such a broad question, but what are we doing wrong?

Why aren't we succeeding as doctors, as a government, as you know, the fda, the dietary guidelines?

Why aren't we succeeding in helping people maintain a healthy weight and sort of by association, healthy metabolism, metabolic health?

I think the.

You tell me, but I think our colleagues, the medical profession has been relatively clueless on what is going on.

I think we've turned, we can turn around and see that the American body in general, overwhelmingly, I mean, is ill. Only 12.2% of us are metabolically healthy when it comes to basic parameters of blood pressure, blood glucose, lipids, waist circumference.

And I think we, more importantly, I think we are all waking up to the fact that the problem is not weight.

Okay?

I mean, it really isn't how big or how small you are, but it is this toxic fat, this visceral adiposity, the abdominal adiposity that is metabolically active.

You know, we always knew, I certainly knew that weight wasn't good for us.

We always knew it was a risk factor.

But what we didn't understand was that it was causative.

It was in the causal chain of many cardiac, renal, metabolic diseases, diabetes, certain forms of cancer, potentially dementia, that this visceral adiposity really was at the center of many of those diseases.

Why did we get here?

What happened?

I think that the way I look at it, these ultra formulated foods that consume much of our diet, these ultra formulated foods trigger the addictive circuits.

These new anti obesity drugs can help tame down that addiction.

But the ultimate solution is obviously to deal with these ultra formulated foods.

The problem is this visceral adiposity.

The only way you get into trouble is, you know, that accumulation of that visceral adiposity that is a result, I think, I mean, it's complex.

There's no doubt.

You have to be in an energy positive state to accumulate that visceral adiposity.

But the composition of food also adds fuel to the fire.

We're just waking up to this and I think, you know, medicine has really not distinguished itself, you know, greatly on this issue.

Yeah, it is interesting as we start to realize something, I don't know, being so obvious, we always ask the question, well, why didn't we know this earlier and it wasn't so obvious, this connection that you're drawing, you know, a decade ago, 20 years ago, maybe wasn't so obvious and really is taking sort of a new focus.

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Now, in your prior answer, though, you use the term addiction, which I think is really interesting because in your, in your prior books and your prior works, you didn't use the term addiction so much.

And I heard you recently on Food Junkies Podcast, which is sort of, you know, all about food addiction.

So I'm curious to learn a little bit more about your sort of evolution of coming to the word addiction.

Because it's a, you know, from a legal standpoint, from a regulatory standpoint, it's kind of a loaded word.

If we're just talking amongst ourselves, yeah, it makes sense to call it addiction.

But for you, someone you know from the FDA with a law background, for you to call it addiction, to me, sort of comes with a little higher bar.

So tell me about that.

So let's just see if we can agree that the effect of these foods are both on these reward or addiction circuits.

They also are on metabolic circuits.

Right.

So the reason for the complexity, in part because of the damage and because this is so hard, is because they're working on multiple biological systems.

No doubt in my mind though, they are working on these reward circuits.

And by they, you're specifically talking about ultra processed foods and the ultra formulated food.

Yeah, I mean, I, you know, I call them ultra formulated.

I call it the, you know, that perfect trifecta of fat, sugar and salt, fat and sugar, fat and salt, fat, sugar and salt.

I mean, there's no doubt that they trigger the reward circuits and those are the addictive circuits.

Look, I think the, the issue is that the word addiction is generally, you know, when we hear that, we think about the people who are weak, the downtrodden, right?

And the fact is that maybe we just have to, you know, just tweak that paradigm of addiction, Right?

Because it's not about the weak, it's not about the downtrodden, it's about those circuits.

In all of us, the human brain evolved, I mean, to deal with scarcity, not abundance.

You know, and from much of human history, there were no guarantees to when our next meal would arrive.

So our biological systems, our brains, you know, will seek out that sweetest, most energy dense food.

So we're wired to focus on the most salient stimuli in our Environment.

It's not that our brains are not working well.

It's not that our brains are broken.

If anything, they're working too well for the current environment.

I think there's no doubt that sweetness or these complex mixtures, I call it ultra formulated, not ultra process, just a nuance of addiction.

You know, those ultra formulated foods, you know, what we did was we, you know, we put them on every corner, we made them available 24 7, we made it socially acceptable to eat anytime.

You know, we're living in a food circus.

You know, what did we expect to happen?

But you know, the fact that they are reinforcing, and I think this is key, is that, what do we mean by that?

I mean they are, they are psychoactive, they can change how we feel.

I can certainly tell you how I use food.

You know, it's 10 o' clock at night, I'm tired, you know, I'm fatigued.

I need to, I need to, you know, focus for the next several hours to get work, you know, give me something to eat, you know, and it's not broccoli, I can tell you at 10:00 clock at night.

And I mean I would condition myself to use that food to change how I feel.

And I think that's, you know, just food is very powerful.

Yeah, yeah, well, and the food that we recommend as a country, as a government, as a, as a medical society is supposedly geared towards the healthy person.

Right.

Someone without metabolic dysfunction and presumably someone without a food addiction background.

But it's not really in practice that way, is it?

So you wrote a recent op ed for the Wall Street Journal talking about how you were recommending a separate recommendation for people with metabolic dysfunction, including a low carb diet.

So I'm curious if this concept of, you know, one healthy diet for everyone is just now outdated and completely unhelpful.

So what do you think there So.

A lot to unpack in what you just said.

What, you know, became apparent to me.

Right.

And I think increasingly when we, you know, our understanding of, of metabolism is this visceral adiposity is the culprit.

Right.

What do we mean by this visceral adiposity?

I mean, it's basically this fat accumulated in the liver, in the pancreas, I mean in the heart.

It's ectopic fat, it's pro inflammatory, it's releasing all these cytokines and chemokines that are causing organ dysfunction.

You know, interestingly, it's, it's, it, it's not all the fat.

Not that I'm giving, you know, subcutaneous fat a clean bill of health.

But there seems to be this sick fat that accumulates in the abdomen that is worse.

The thing that once you've are in, once that there's visceral adaptate, right.

The, the one thing that I am absolutely convinced the science shows is that if you are hyperinsulinemic, right.

If you're insulin resistant, right.

That is going to add fuel to the visceral adiposity and make it worse.

Now I think the sort of silent epidemic that's happened in the last 20 years, I mean there has been a doubling in insulin levels throughout, in the United States.

I mean just blood insulin levels.

And we know that if you are in a weight gaining state, in an energy positive state, if you have this visceral adiposity, that hyperinsulinemia is, I mean, is just doing you no good.

Bring down that hyperinsulinemia and we can see much of the metabolic disease disappear.

And I think one of the great debates is what's the effect of this ultra processed food on insulin levels?

Right?

And you know, I think that certainly when you see in an environment of excess calories, of energy dense foods, I mean this ultra processed, ultra formulated foods, not talking about the addictive circuits now, I'm talking about the metabolic circuits.

So I mean I take food, I remove anything that has any structure, I mean to the food.

So the food I mean is just, you know, fat, sugar and salt and the glucose and the fructose get so rapidly absorbed, right?

They flush through the stomach, they get absorbed rapidly into that, the, through the duodenum, through the early part of the small intestine and they give rise to these rapid glucose spikes.

And we've always been focused on glucose, but in some ways what we don't measure, I mean because it's complex, the assays aren't as reliable, is we don't measure insulin levels.

But when you look carefully, the reason why glucose isn't even more off the charts from this processed food is because that we're becoming hyperinsulinemic and that insulin is trying to bring down that glucose.

So imagine, right.

I mean, so by the time the glucose is elevated, the process has been going on for so long already, but we missed it because we didn't measure the insulin levels.

I mean, I think that that is fair.

And then the question is, if you just have this wrap, if I'm just pouring in rapidly absorbable glucose and fructose, right.

What does that do to your insulin levels?

Yeah, I think there's no question that the ultra formulated foods are playing a central role in all this.

I guess one of the questions I have though is is it going to be enough to try to limit it?

And one, how do we limit it?

Right.

There are all these different, different permutations on that.

But the question of is it going to be enough?

And so that's what really, really got my attention with the Wall Street Journal editorial you wrote about dietary guidelines, including a low carb diet, and you've been in the fda, you know, the inner workings of government and health and how they interact.

And do you think there's any viable way to get a low carb diet in the dietary guidelines directed towards people who are metabolically unhealthy with visceral fat, with hyperinsulinemia?

You know, one, couple, couple of distinctions, couple of nuances, right?

You're using the word low carb.

Give me a little room here.

In the editorial, in the op ed piece, I use the word lower carb.

Lower carb.

Okay, lower carb.

I mean, I mean, the reason why, look, nutrition is probably the least studied field for the amount of, you know, effect on health that we could imagine.

So there's a lot we, we don't know about nutrition.

But I think it is, I mean, it's humbling that we all respond.

There's just such great variability.

I'm not sure low carb or ketogenic, you know, we can choose our terms is necessary for everybody.

I think there's great variability and I think we have to sort that out.

But if you're hyperinsulinemic, I mean, and you have visceral adiposity, I mean, then I'm with you.

I mean, then, then low carb, I mean, is, you know, I, you know, I, I think can be, have enormous health benefits.

Right.

Cutting, cutting that out for somebody who's not in that state.

Right.

I think that, you know, certain, I mean, you know, the same parameters don't apply someone who has a seizure disorder.

Right.

I mean, you know, I mean, if I want to achieve a ketogenic diet because I want to quiet down certain neural oscillations, right?

So I think, tell me what we need to treat and what we need to get.

Right.

But I think we're at a point where half the country is hyperinsulinemic.

And I think that we have to recognize that these ultra formulated, ultra processed, energy dense, highly rapidly absorbed, you know, high glycemic foods are just adding real toxicity, real poison to the system.

And we just got to Wake up to that.

Absolutely right.

And like you made reference to, if you're treating a seizure disorder, if you're trying to treat bipolar disorder, schizophrenia, you know, we're seeing the effects of a ketogenic diet, but that's very different than saying we have a countrywide, a global population crisis of metabolic health, and how do we best intervene to.

To reverse that?

And, you know, it seems like the medical answer is GOP1 medications, but from a dietary, lifestyle, nutrition perspective, I'd like to think we can still have significant impact and.

Sorry, go ahead.

Looks like.

Go ahead.

You want to say something?

No, no, I interrupted you.

I apologize.

I just bristled when you said GLP1s is the medical answer.

I mean, I think that the right medical answer.

Right.

Is to.

To bring to bear those tools that are effective, of which GLP1s can be one tool.

Right.

But I think the medical answer, I mean, has to include that full toolbox of, you know, nutrition therapy, physical activity, behavioral therapy, and pharmacology.

Right.

And like you said, you said, a medicine alone is not good medical care, and it's critical to also provide nutrition guidance.

But the question is absolutely, I mean.

Look, you know, we're in a, you know, what's the great public health success min of our lifetime?

I guess there could be a bunch, but are you talking about tobacco?

I mean, to back.

Right.

What's the great public health failure of our life?

Metabolic health and food.

I mean, and.

And obesity.

I mean, visceral adiposity.

Right.

I mean, I mean, I mean, all these diseases.

I mean that.

All these chronic diseases.

I mean, you know, no doubt if you were a, you know, if you came down from another planet and you see one industry making billions of dollars making us sick, and another industry making billions of dollars similar profits to reverse what the former industry does, you would say, you know, something's wrong with that picture.

Fix the underlying problem.

But, you know, I mean, this is at the core.

I mean, I think.

I mean, this is at the core of medicine.

You know, my.

My hat's off.

You know, there are a lot of people deserve a lot of credit.

They've been, you know, I mean, you know, on the periphery.

Right.

You know, steering back to the Dietary Guidelines, there was another part of the book that, that really stuck out to me where, where you said the dietary Guidelines sort of declare certain foods as healthy.

And it doesn't explicitly say it, but it provides sort of the aura of you can eat as much of these quote unquote, healthy foods as you want.

And since those by definition are high carb foods, the way the Dietary Guidelines is set up, it's provided an environment for us to eat lots of carbohydrates.

Do me a favor.

Define.

I mean, one of the problems is, you know, I mean, we can bring our friends, you know, and have this conversation.

What do we even mean by a car bottle?

Right, so, right.

So, so, so am I talking about a blueberry or am I talking about a blueberry muffin?

Well, it's not really defined so much, is it?

I mean, when you look at kids, schools, like when my kid goes to school, he's given a blueberry muffin as part of his healthy breakfast according to the, the Dietary Guidelines.

But I would argue anything but, right?

40 to 65% carbs.

I mean, I mean, there is a line in there.

Eat, you know, eat, you know, fewer, you know, refined carbs in there.

But, you know, there's, look, there's every bit of difference between that carbohydrate that has structure, that has food integrity, that has fiber, for which that glucose is not rapidly absorbed.

And I think that's the problem.

And there are other, quote, complex carbohydrates.

I mean, the, the, the, the starches, and I mean, that are every bit as damning as that sugar and, and, and fructose, it is as rapidly absorbed.

And look, we did, we did the food label back in the 1990s, right?

And you know, it was a big fight.

You know, we were very proud of it.

But we, but we didn't ask the question of what is the biology of those, you know, ingredients they were putting on that label.

It's fine if, you know, we can talk about, you know, what's the fat, what's the cholesterol, what's the protein, what's the carbohydrate, what's the added sugar in the food?

But no one asked what's the effect of taking all that structure out, processing that food, having those rapid risers and having that effect that hyperinsulinemia?

Well, and I think it's a, it's clear that we have to find a way to encourage people to eat less.

And just telling them to eat less doesn't work.

And that's why I was referring to sort of this halo of you can eat as much of these healthy foods as you want.

And again, that's where GLP1s can come in to help people eat less.

So I think we also have to steer the discussion of what type of dietary makeup helps people naturally eat less.

And I think forcing them to eat less is counterproductive.

And that's where, you know, low carb keto diets certainly can come in.

But not the only way to do it.

Look, I think you're absolutely right.

Gotta eat less, exercise more.

Right.

I mean, just, I mean, it was, we told people and no one could do it.

And why can't they do it?

They can't do it, you know, in part because of those addictive circuits.

Right.

And now you have, you know, these GLP1 drugs, right?

They give people a way to do it.

Now, I think we have to be clear that there's really no magic.

I mean, the pharmaceutical industry would like us to believe, you know, there's something magical about these drugs.

Right?

And when I tell my, talk to my colleagues and I say they are appetite suppressants, they bristle, Right.

Because they're more than appetite suppressants, they say.

But I mean, I think the reality is least in significant part, probably not in all, you know, you know, entirely.

I mean, I think we're coming to understand that they work by delayed gastric empty.

So food stays in your stomach longer.

And when food stays in your stomach longer, you know, we've all experienced that, whether it's we have the flu with this decreased, you know, our GI motility or we have food poisoning, food just builds up, I mean, in our stomach.

Last thing you want to do is put more food in your stomach.

The problem is, I don't know what you're seeing, you know, in your patients, but the average patient is what on these, you know, eight, nine months is the data that I'm seeing.

And the one thing we know, if you go off them, you know, that conditioning, that, that, that feeling, that visceral malaise that the late gastric emptying is going to go away over time, it's going to fade and then people are going to gain back the weight.

So three, four years, you know, we're going to look at this.

People are going to spend thousands of dollars, the average person's on this for eight, nine months and they're going to gain back, we're going to get back all that weight and want to say, this is one big national failure unless we figure out how to use these drugs.

And so I think, you know, my old agency needs to do a better job of getting, certainly requiring the manufacturers.

I mean, how are we going to use these drugs in the real world?

I mean, can I go back on, can I go off them?

I can go back on them.

Is that so once the FDA approves The drug.

I mean do they have any role in insane how they're used or they're just approved?

Now there's post marketing.

Well, I mean they certainly have requirements to get the data.

These drugs were proved under the, the premise, I mean the people will stay.

On them for life, which they're not doing.

Well, I mean maybe if some people will do that.

But I, but I, you know, and I'm not sure, you know, what percentage we'll see but that's not been the case.

And you know, I think we're all, you know, people are experimenting with microdosing and intermittent use and I mean that's the wild west.

That's no way to do pharmacology.

So fda, certainly you want to make billions of dollars selling this drug in the United States.

You can, FDA can require them to do studies, the post marketing studies of how this drug can be safely used.

It certainly has the authority to do that.

Well, and I like your analogy.

If someone came from outer space and saw one industry making billions of dollars sort of making us unhealthy and another spending billions of dollars trying to undo that, it seems like the logical place is not to focus on building up the, the after effect, but to try and cut off the pre effect to try and cut off the industry making us unhealthy.

But in the world of regulation, in the world of free markets and companies, is there any hope at all of that happening?

When you're taking care of one of your patients, you're going to tell them wait for the day where the environment and we fix the environment.

Or you're going to try to help them today to reclaim their head.

I mean, I think for the first time.

Tell me how you feel.

Right, But I think finally, finally we have the tools so people can reclaim their metabolic health.

Well, that's interesting.

I mean it depends on what the tools are.

So for me personally, you're absolutely right.

I'm not going to wait for that day.

And that's why I use low carb and ketogenic diets in a lot of those people because I've seen it reduces the cravings, it addresses the addiction, it takes away the potential for those ultra processed foods.

But that certainly hasn't reached mainstream in that form in, in medicine.

So what, what tools are you referring to when you say we have the tools?

No, well I'm, I'm talking the same tool you and I have.

We have, we have the same tools, right?

So we, we have nutrition therapy, of which there can be, you know, diet, you Know, we, you know, the ketogenic diets, lower, low carb diets, right?

So that can, that can take away food noise for some people.

Fair.

And we also have a, you know, some drugs, such as, not just the GLP1s, but the phentermine topiramate combinations.

How did those drugs work?

What circuits do they work on?

And then we have the GLP1 drugs.

Now the one thing that's always fascinated me and I can't quite understand is there's no doubt that, I mean, how do those ketogenic diets decrease that food noise?

What are they doing?

Right?

And, and you know, some of my colleagues, well, it's ketone bodies, you know, when I, I mean, I can simulate that decrease in that food noise by either these aversive circuits can counterbalance those addictive circuits, that GOP ones, or these drugs like, you know, topiramate can change, you know, the neural oscillations.

I wonder whether the ketogenic diet in these GLP1s, I mean, in these other drugs, and I mean, this decrease in this food noise, whether the, whether the kind of neural changes that are happening that mean to me that that decrease in food noise is just a reduction of that addiction, right?

It's a reduction of that cue induced wanting, right?

I mean, normally I'm highly responsive.

I go in front of the refrigerator, it calls out.

I go past, you know, my favorite place, you know, on the highway, and you know, all of a sudden I get cued, I get these thoughts of wanting and I can't get it out of my head.

How do I quiet that cue induced wanting, right?

So that is clearly, you know, neural.

And you know, my sense is, I mean, there are neural circuits, not just one neuro, you know, neuro chemical.

I mean, that is at play here.

And, but my guess is if we understood ketogenic diets, these drugs like topiramate and these GLP1 reward mechanisms, I think we would find that, hey, maybe there's a common, common link to that food satiety.

So, you know, whether I can achieve that aversion through GLP1s or whether that aversion through ketogenic diets.

You know, I think that, I mean, my guess is, you know, we just don't understand ultimately what they're working.

Yeah, yeah, you know, it's a good point and it is fascinating.

I've had a couple of interviews recently with people who are working with ketogenic diet specifically on addiction, whether it's alcohol or drug addiction.

And certainly that also plays into food Addiction.

And I, like in your book, you actually quoted Dr. Tro.

Tro Kalasian, who's been a vocal supporter of using ketogenic diets for food addiction.

So I think there's definitely a crossover, and I don't want to keep bringing it up to say ketogenic diets are the one and only answer, but I think they need to be embraced as a potential answer, especially when we're Talking about the GLP1s not being as successful in the real world as.

As, you know, the FDA had hoped.

I think one of the reasons, one thing I do in the book is, you know, the reality that people are only going to be on these GLP1 drugs for eight, nine months.

I mean, whatever it is, some people will be on it for years, some will be on it for a lifetime, some will be on it for months.

But what do you, what do you do when you want to go off these?

How are you going to control appetite?

So I then go on a lower carb diet.

Yeah, yeah.

So how do we get to the point where we, as a medical society and nutrition society and a government can recommend multiple different ways of eating as long as it addresses someone's metabolic health, addresses someone's addictive tendencies, addresses someone overeating, rather than saying, here's the one way for people to eat?

Well, first we've got to, you know, as they say, you got to understand the problem.

You got to understand you got a problem, and we got a problem.

And the Dietary Guidelines have failed.

Right?

And they failed miserably.

I mean, again, this is the biggest public health failure, I mean, I mean, in our lifetime before.

So we got to understand there's a problem.

We got to understand what the cause of that problem is.

I think it the, you know, I mean, at the core of that is this accumulation of this, know, for lack of a better term, this toxic fat, this visceral adiposity, this, this chronic disease.

What is feeding that chronic.

That visceral adiposity?

I think it's hyperinsulinemia.

What is triggering that hyperinsulinemia for, you know, what's making that worse?

For many people, I think it's rapidly absorbable carbohydrates.

First we gotta understand, you know, we got a problem.

And once we understand, you know, the, the.

The.

The cause, right, we can, you know, either take societal action or we can take individual action, but at least we can be armed with an understanding in a way that, you know, the, the fact that, I mean, how many books, diet books have been written, I mean, Right.

I mean, so.

So the fact that, you know, I just wrote a book, you know, diet Drugs and Dopamine, on the mystery of weight after thousands of books have been written, you know, I mean.

I mean, something's wrong with that picture.

And I think there is a.

You know, as docs, I mean, there is, you know, much of this chronic disease, I mean.

I mean, goes back, you know, to this core adiposity that is being fed by what.

By what we eat.

All right, very good.

Well, I really want to thank you for taking the time to join me today to explore all these concepts and.

And if people want to, you know, find more about you, where.

Where can we direct them to go?

Oh, well, I mean, so the book took everything I could, you know, I mean, took everything out of me.

Right?

I mean, it was an intense period.

You didn't tell me.

What did I get wrong?

I mean, in the book, what did you get wrong?

Well, gosh, that's an impossible question to answer.

I mean, I'm not sure there is a right or wrong.

I mean, like you said, you're.

You're really trying to lay out the problem, and then the question.

I think the question is, what is the solution?

And.

And how do we go about doing that?

There are so many different layers to that solution.

And that's why I did the book that.

I mean, that's what I try to do in the book.

And it's not beyond our reach, right?

I mean, you can.

You can make.

I mean, if I come to you, right, I mean, you can.

You can help me become metabolically healthy.

Fair.

I mean, that's a profound thing, and that's gonna.

I mean, that has profound implications.

Very good.

I encourage everybody then to check out your book to learn all about you and your work and your prior books, too.

So we'll link to them in the description of this episode for sure.

So thank you again for joining me.

Thanks, Ramakhala.

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