Transcription
I ran the FDA, and here I can't control my weight. So I ended up after COVID 40 lbs heavier, and I didn't like myself. I said, "Look, I've got to understand why do I keep on gaining this fat, and what is at the root of this problem?"
25% of us are going to develop heart failure. Half of us are pre-diabetic. 25% of us are going to have a stroke. We're going to talk about 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.
David Kesler is a physician, an author, a public health leader who has served as chief science officer of the White House COVID-19 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, 'cause the food industry wants to blame you." And that is as far from the biological truth as you could possibly get. I think it's important to change our paradigm of how we think about addiction. I filed this petition with HHS. I think the FDA has no choice. It's going to have to get its act together and say, "How do we change this food environment?" They're going to throw hundreds of millions of dollars of legal arguments against this. So, how strong do you think this would hold up in court?
Hey, it's Dr. Heyman. I'm so excited to share this episode with you today. But before we dive in, I want to get your help. Please take a minute to hit that subscribe button. Whether you're watching here on YouTube or listening on your favorite podcast platform, it truly means the world to me and it helps my team and I bring you this podcast every single week. Plus, I don't want you to miss a thing. So, thanks so much for being part of this community, and I'm glad you're here.
David, welcome to the Dr. Heyman show. It's so good to have you here in person. We did a show before, which everybody should listen to, about one of your previous books, but we're going to talk about Diet, Drugs, and Dopamine: The New Science of Achieving a Healthy Weight. But it's really way more we're going to talk about, which is why we're in a metabolic crisis in America, why our food system is so messed up, and what we can do about it, both from the personal and the policy perspective. Because you, for those of you who don't know, you have a very storied career. You were the FDA commissioner under 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 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. Uh, everybody who listens to this podcast 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 throw out, that's another question we're going to talk about. But I think there's this really incredible moment we're in. And I kind of want to have you start 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 navigate your own weight struggles.
And I wrote a book in 2005 where I basically said, "It's not your fault you're fat." 'Cause 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 Carb, Slow Carbs, including your book, *Capture: Unraveling the Mystery of Mental Suffering*, which has to do with mood stuff, but also related to issues of addiction, *Hijacked: How Your Brain is Fooled by Food*, *Your Food is Fooling You: How Your Brain is Hijacked by Salt, Sugar, and Fat*, *The End of Overeating*, which I loved and was one of my favorite books, *Taking Control of the Insatiable North American Appetite*, also your book about your struggle with the tobacco industry and your battle that you won. You've 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's sort of got you focused on this idea that was so antithetical to the medical establishment's paradigm, which is it's kind of your fault. Just eat less and exercise more, eat a healthy diet, get more exercise, and you lose weight. And if it's not the case, then it's you. So, how did you break that? And how did you come to what you understand now through your own story?
So, you know, the most recent iteration was, you know, I had the opportunity to co-lead uh Operation Warp Speed. Yeah. Right. So, a very intense period of time for all of us. I was working 18-hour days. Yeah. Didn't leave, you know, my desk, uh, literally seven days, uh, a week. You know, 676 million vaccines free, right? We got to the other side, and I found myself some 40 lbs heavier, uh, at the end of it.
And you were you were working in a government building in Washington? No, I was I was working remotely. I mean, I mean, I would go in, um, when I, you know, needed to for a secure facility, uh, for certain meetings. Um, but, you know, I was able to work remotely.
The reason I ask is because the food is so crappy in the Senate and the Congress and all the agency. No, but, but, but, you know, it was also crappy, you know, just at home. You know, my sense is if, just I watched myself eat, right, and how I used food, you know, I mean, throughout the, the day, you know, I mean, for all of us, I think that there these momentary, you know, 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, uh, and I'm tired and I'm fatigued, and, you know, 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 got to get through the next two, three. Saving the country from COVID. Yeah. Right. 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, energy, mood. I mean, I mean, exactly. I mean, you know, my guess is if I were born, you know, two decades earlier, my, my parents' or grandparents' generation, I would have probably been a smoker, right? I mean, so I grazed, right? But, but I clearly I wasn't eating, uh, for fuel, right? I mean, and I had been here before, right? I would, um, you know, whether it was med school, you know, mid-exams, papers, you know, young faculty member on the ER shift. I mean, I have to get through the next couple hours. I mean, how, you know, how am I going to power myself through that? Caffeine and sugar. I mean, and I was just, I mean, I used, I used food, uh, 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 always gained 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, so I'm 40 lbs heavier, and and I didn't like myself. I mean, I just, you know, I just, I wasn't, I wasn't healthy. I mean, it's not about that weight. It's about that toxic fat. Right. Right. I mean, that's what belly fat, or visceral fat. It is that fat that gets into our liver, that gets into our pancreas, that gets into our heart, right? That'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 am sensing this, you know, I mean, if just, you know, attended the European, you know, heart meetings. I mean, if you talk to cardiologists or diabetologists and nephrologists, I think there is a convergence that this toxic fat, this metabolically active, you know, this sick fat, um, is at the root, um, of much of cardiac, renal, uh, and metabolic disease. And I think, I think medicine, including cancer, including 13 of cancer, I mean, I mean, dementia, all of it. I think medicine is just waking up to that.
I'm laughing because I wrote books about this 20 years ago. I mean, hello everybody. I mean, take a bath, right? Don't care about that. I'm like, you know, I mean, no, but seriously, you know, I, I am, I am. Because, but, but we all knew weight wasn't good for us, but we didn't understand it was causal. Well, we were doing DEXA scans, and when I worked at Canyon Ranch, 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.
I, so I finished, you know, uh, Warp Speed, and I said, "Look, I've got to understand why do I keep on gaining this back? I mean, and what is at the root, uh, of this problem?" And that's why, you know, I set out to write the last book, *Diet, Drugs, and Dopamine*. And there is, you know, there is no doubt, uh, in my mind. I mean, the, the, the diet is the, the primary culprit. I mean, there is no, there is no question, uh, about that. Now, you know, it's, it's that diet, uh, in the, the food in our environment, um, that interacts with our brains and the way our brains are wired. You know, we tended to, you know, we talk about addiction. We used to think addiction was for, you know, the weak, the downtrodden. I mean, it was about other, other people. Did a lot of stigma about it. I mean, absolutely. But, but, but the fact is, and there's a lot of stigma about obesity, which is unfortunate, 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, on the that energy-dense food that would, that was responsible for survival, right? I mean, in an environment of scarcity, right? We evolved. I mean, those who, those organisms survived if they could gain attention, uh, and focus on energy-dense food. Yeah. I mean, bitter foods are sometimes harmful, but sometimes not. Sweet foods are universal. But you have two circuits, you have two circuits at work here, right? You have these reward, addictive circuits in our brain. Dopamine, right? That cue-induced wanting, right? 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, you know, that, that cue right triggers those thoughts of wanting, that, that, that urge, right? I mean, it gates my attention. I mean, and, you know, I can't get rid of that, that urge until I, I mean, actually consume, and then then it's gone. Then it's gone. But that, that cue-induced wanting, I mean, is part, um, 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, um, I mean, it is, you know, and I saw this, you know, with tobacco. The most powerful reinforcers are the reinforcers that can change how we feel.
Well, 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, I think most people think about it as a metaphor. But it's not. It's actually a fact of biology. And according to a large population study globally, 14% of the global population, including 14% of kids, are addicted to food by the Yale Food Addiction Scale. And so what is this addiction? But there's a spectrum. Right. Right. Right. It's not the 14%. This is what we call, and I think that that's the mistake here. I agree. It's not about 14%. It's about the 60, 70, 80% of us, agree, right, for whom food is the that salient stimuli, that, that, that fat, sugar, and salt, that that perfect trifecta of energy-dense food that that capture our attentions. I mean, if anything, I mean, we're all, I think the 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 60, 70, 80% of us, you know, find food, you know, highly rewarding, and attract our attention and have that call for it. It is, it is what I'm interested in is that part of the population for whom food is not the salient stimuli, and what is it about them? 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 I go on a rant of sugar, I'm just going to want more of it. Like, even if I don't have that predilection, and most 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..." Like, 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.
So, so what is going on biologically? Like, is it the same as heroin or cocaine or nicotine? Like, what's actually happening?
So, so we've got to be careful. At no doubt there are differences pharmacologically. So if you look at the dopamine hit, I mean, heroin and amphetamine is clearly in a different ballpark as far as the extent of that hit. Nicotine, on the other hand, is probably much closer to food. And how hard is it to quit cigarettes? And again, it's this, this gating of attention, right? You, you get, I mean, next time you get hungry, just try to figure out what the cue was. There's always a cue. 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. I mean, and, and, you know, that, that cue-induced wanting, right? Um, I mean, is what really, I think, it's part of all of us. And, you know, and in the extreme form, I mean, it's food addiction. And many people, you can just call it sort of disordered eating. But, 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 24/7, made it socially acceptable to eat anytime, and cheap, right? And cheap. And, you know, we created this food circus. What did we expect to happen? It's a, it's a food carnival out there. It's, uh, yeah, it's a toxic nutritional landscape that we're all exposed to and causing and causing this toxic fat. So that visceral adiposity, right, that you've been studying, right? I mean, is at the heart of much cardio-renal, uh, metabolic, uh, disease. It starts early in life. I mean, we are seeing it in the liver of our kids, right? I mean, and it gets into the heart. 25% of us are going to develop heart failure. Yeah. Right. I mean, what, the 30, 40% you know, diabetic. Half of us are pre-diabetic. 25% of us are going to have stroke. And at the cause of that, I mean, there is this, I think finally, this convergence in medicine, I mean, and in public health. Um, we know what the, we know what the problem is.
But, you know, David, what's really striking to me is I, I co-founded a new company called Function Health that allows people access to their personal health data and lab testing. And I asked Quest Labs, who's our lab testing partner, I said, "How many labs that get submitted test for insulin?" And they're like, "Oh, less than 1%." Less than 1%. And insulin is the first thing to go awry when you actually have this visceral fat. It starts to go up. And nobody's checking it.
Well, not only that. I mean, if you look on a population basis, there has been a doubling in the last 20 years of insulin levels, right? I mean, there is an epidemic of hyperinsulinemia, and it's not being tested. It's crazy to me. Now, you can argue, you know, that assay is not the easiest necessarily, right? 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, you get caught in this vicious cycle.
Well, David literally talks about, does overeating make you gain weight? Does it gain weight make you overeat? And it's this paradox. So, so 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, uh, index food. And then you have these peripheral, the peripheral biology, I mean, in our gut. You mean the microbiome? No, I'm just talking about the hyperinsulinemia, right? I mean, the absorption of the belly fat, the biochemistry, what's going on in our liver, um, and, I mean, the absorption, uh, of this rapidly absorbable, uh, glucose, um, in an increasingly insulin-resistant body. The American body is not, not well. I mean, only 12.2% of us are metabolically healthy. Well, actually, that was the last study. Then the new updated version, it's only 6.8% from from TUS. The same, the same kind of data. It was like, that's frightening. I mean, that means that 93.2% of Americans have some degree of insulin resistance. They might not have pre-diabetes yet, but they're somewhere in that continuum. And in some people, they hear that number and go, "That just can't be right." Right? I mean, it's very interesting. They go, I mean, 12, only 12% or 9% or 6% of us are metabolically healthy. But the fact is, right, um, that, I mean, those are, uh, the numbers. It's true. I mean, we've tested over 300,000 members in our company, and it's shocking that the demographics of what the, like the population level data on insulin, on glucose, on the metabolic effects on cholesterol of this visceral fat are just so, so, so.
Here I am, 40 lbs heavier. Yeah. Right. Uh, and the question is, what does it take to reclaim our health? I mean, and I think finally, finally, right? I mean, I think we have the tools, right? Uh, to do this. I mean, look, I mean, you know, in the, it's pretty, in some ways, it's very complicated, but it's also very simple. I mean, you have one industry that makes billions of dollars, right, that's causing the problem. And then you have another industry now that, um, you know, is making equal profits to reverse what the former industry, it's actually doing, right? Yeah. The focus, the increasing focus on, you know, we call it, you know, highly processed food, or, you know, rapidly absorbable, uh, you know, carbohydrates, ultra-processed foods. I think the fact is that that food is engineered in such a way, right, that it goes down in a whoosh. It deprives us of satiety, right? It is rapidly absorbed. It's causing that metabolic chaos, right? And so you have this food on the one hand that's depriving us of this satiety, this ultra-processed food. And now for $1,000 a month, you can go buy a drug to reverse what that food is causing, right? I mean, I mean, and it's just, if you came from another planet and you saw what was going on, you'd say, "Something's wrong with that picture." Fix the root cause.
And, and just to unpack what you're saying, is the change in the American food supply over the last 50 years has increased the consumption dramatically of sugar and starch and refined carbohydrates in ways that have activated this ancient survival system, which is to store fat at all costs when we come across something sweet because it's a, we don't know when we're going to 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 caused every almost single chronic disease of aging.
So, if you go back, um, you know, and I, I went back in over the last, you know, uh, few months, I did the book, and then I filed this petition. Yeah. With HHS. You know, went back and looked at the history. Um, and the food industry back in the '50s and '40s, '50s, uh, '60s 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, um, uh, what they called at the time, nutritive sweeteners, right? These starch conversion products, the, the, the names of called maltodextrin or dextrose or amino xylos or or maltose, corn syrup, and corn solids. I mean, and that gave birth to an alternate universe. I mean, you know, it's really not, not food. It's not technically food. Actually, if you look up the definition of food in the Webster's dictionary, it doesn't actually meet the definition of food, which is something roughly that promotes the growth and health of an organism. They they took out the structure of food, right? They extracted these chemical components and then they reassembled them in a way without the structure of that food, without the fiber, right? All that slowed down eating, right? And and they took the I look at this ultra-processed foods and I say there are basically there are four components of this stuff, right? Just when you look at how it's made. There's these refined sweeteners. There are these refined starches made in flours. There's these added fats and oils, and there's salt, right? And what the, 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 mouthfeel or texture, cuz and they were able to dial in, right, that palatability. This wasn't an accident. Certainly wasn't an accident. Like the tobacco companies were like, "Oops, we didn't know it was addictive." Well, bologna. The tobacco industry did the science. They did exquisite pharmacology. They did all the EEG work, the imaging work. They knew everything about nicotine, secretly hiding the data. Correct. And and we went inside, you know, to do the really the big investigation into the tobacco industry. And and you, when I did that, my friends at NIA had to teach me everything about addiction. And one of the tests for addiction was whether animals, laboratory animals, self-administered nicotine. Correct. And they pressed the lever for for nicotine, whether 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? Tell me about that. Why are you using that as a positive?" And they never paid attention to it. Yeah. Right. And that's what got me interested. 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, right, which is so key to that that absorption. Um, 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 that you see on the, that ingredient panel that you look at and you go, "I don't know what half of those mean." Right. Right. And and to reassemble it, and no one asked what was the biological effect. So if you take starch and you subject it to, there's these, you know, number of tech, you know, processing, uh, techniques. One's called extrusion. I mean, and I mean, it basically molds that starch and that, I mean, into any kind of form. Well, it gives you that the thousands of products that are in the middle of that grocery. But to do that, you have to take that starch and exert these sheer forces, ources, and these temperatures that change the molecular structure. And no one asked what happened in the body. No one asked what was going to be the metabolic consequence of that.
Well, it's interesting. They may not have asked that, but they certainly knew the brain biology. And they would do functional MRI imaging about what lights up what. And so they, they actually, like the tobacco companies, designed these foods to be addictive. 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 sand deliberately. They didn't want to 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 this salt, right? Um, and it all ended up being very rapidly absorbed, causing this hyperinsulinemia, causing this, this visceral fat. And certainly in anyone who is along that, that path, I mean, already, I mean, having, you know, challenges, you know, with with their weight, that, that insulin resistance. If you add, uh, 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 fire. Exactly. And that's where, and that's what's going on. And that's why, and again, it's not just the, it's not just the hyperinsulinemia. It's not just the, the fat. I mean, it's that liver, the liver consequences, the consequences in the pancreas, the consequences, I mean, that ectopic fat in our heart. Yeah. I mean, that, that's, I mean, that's heart failure. I mean, that's causing some of this atrial fibrillation. That's right. The fats, that's not where fat's supposed to be. And it's that fat is metabolically active, and it's neurochemically active, and it's immunologically active, and it's hormonally active. You know, go back. I mean, what's the, the cause of this? You know, what you're...
I just want to double-click on what you're saying because it was so important. The way in which food companies have taken commodity crops, soy, wheat, and corn primarily, and deconstructed them, correct? Broken them apart 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 but actually aren't food. Bingo. And they were cheap, right? They and they dialed in palatability. They dialed in, you know, that that that fat, that sugar, that fat, that that sweetness that trigger our reward circuits in many of us, right? And and that caused that metabolic harm because it, when you eat this, it goes down in a whoosh. It's rapidly absorbed. There's no satiety. There's no feelings of fullness. I mean, it gets just so rapidly absorbed, it causes this hyperinsulinemia. And it, and it's the reason why, uh, you know, we're seeing the chronic disease that we're seeing in this country. I mean, I mean, we understand this is the primary culprit. 100%. Amen. Hallelujah. I've been saying this for decades. Thank God you and others are figuring this out.
I think what I want to now do is kind of 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 part of a national conversation. And now it wasn't even a thing 20 years ago. It wasn't even defined. It was just junk food or processed food or fast food. Now we have a term for it. Started out of, you know, not not a perfect definition. No, right. I mean, be careful. I mean, I'm going to get to that. I'm going to get to that. There was a Brazilian scientist who came, Montano, who came up with the NOVA classification, which is an attempt to try to figure it out. There are a number of other classifications. Right. Right. But what's happening right now is that the FDA, where you're a commissioner, has requested, um, 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... It's asking for the definition. 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.
Yes and no. So certainly if you want to label something ultra-processed food, you have to come up with a definition. But the industry will challenge that. That definition will always include certain things that you can argue, well, is this healthy and is healthy processed? I mean, there's always going to be those debates. I 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 salt. I mean, and it's these other chemicals that give it texture and mouthfeel, right? Um, and this drives in the palatability. So, so, so we really do know what these foods are, and we know these foods don't exist in nature. 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... No, I mean, actually, it wasn't for the request. It wasn't because of the request for information. I thought it was... No, the petition went in separately, right? I mean, it certainly is consistent with that, right? And looks at this food system, looks at this this system that got, um, developed in the '40s and '50s of you of developing these cheap, uh, 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, we can, you know, choose your how you want to refer to this, but it's certainly not food, I mean, as we know it, right? As occurs in nature or stuff that we make at home.
The petition was very specific, right? And let me just, let me back up for one second, give you a sense of the nation's food laws so you understand that. I mean, anything, I mean, in fact, the nation's food laws are pretty comprehensive and strict if we were enforcing them. Well, right. So, if you want to add something to food, it's a food additive, and you have to meet the definition of reasonable certainty of no harm. Reasonable certainty of no, you can't add anything to food that for which there's not reasonable certainty of no harm. Now, in a drug, you know, safety, no harm, you balance risks and benefits. Yeah. Not in food. The law requires you to, uh, be reasonable certainty of no harm. Right. But Congress enacted that in 1958. But there was this exception. It was, there was a definition. There was a term called GRAS, 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 could 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 1970s, and it was a, the GRAS evaluation for corn syrup, corn solids, dextrose, right? Maltose, maltodextrin, all those starch conversion products. Most of those are derivatives of corn and gave rise to the modern highly processed food. I mean, I mean, go look in the middle aisles, right? Those corn syrups, corn solids, maltodextrins, right? Were the, the essential items that gave rise to this industrial revolution of all this highly processed food. And back, there's an FDA document where the FDA says that it looked at corn syrups and corn solids and the, the maltodextrin, dextrose, etc., and said there is no link between those substances and obesity, no link with diabetes, no link with cardiovascular, and therefore that stuff is GRAS. But they didn't, they hadn't studied the link.
Let me just so understand GRAS, FDA. Right. FDA doesn't have to show that something is unsafe, right? In order to be GRAS, there has to be a consensus among experts trained in the field, right, 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 lump these these these ingredients into this term called processed refined carbohydrates, right? You know it well. You've written about it, right? Before the term ultra-processed foods, we understood processed refined carbohydrates. You, 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 machinery, the corn syrup, the corn solids, you couldn't use. In fact, sucrose would gum up the machines. You needed, you know, for that viscosity, for that lubricity, etc., for these machines to work to give rise to that moisture in all this processed food. You had all these starch conversion products that the industry learned to use. So I ask you, is there general recognition of safety among experts that corn syrups, corn solids, maltodextrin are safe? That today, the answer is no. Then I think they didn't know. The thing about GRAS, just because something is GRAS, let me give you two other pieces, and then we put it together. Just because something is GRAS back in the '70s doesn't get you home free forever. Just because you were GRAS back then, you have to continue to be GRAS. Right? And the burden is not on FDA. The burden is on industry.
So why isn't the FDA holding them to account? Bingo. So that's why the petition goes. So the petition basically looks at these corn syrups, corn solids, these, uh, refined, what I call these refined processed, uh, carbohydrates. Now, I don't deal, I exclude, you know, anything that's made at home. Sugar, flour, starch, you want to make cookies with. I don't deal with that. But what you deal with, see, the Food and Drug Act deals in ingredients. It doesn't deal in processing, except so you have to focus on what the ingredients are. So if you just say, "FDA, go deal with ultra-processing." Yeah. Right. So you have to come up with what's the ingredient. But 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, uh, 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 refined wheat and the refined starches and subjected it to extrusion technology, is there a general recognition of safety? No one studied that. Right? So I have these categories of of refined processed carbohydrates in the petition. Right? It also includes sucrose, refined flours and starches when used with these emulsants, dough conditioners, these stabilizers. I mean, these other chemicals. Don't they come along with the package? Is that when these other processing aids, right? I say there's not a general, not general recognition as a matter of science and law. Um, these substances can't be GRAS today.
You know, 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." Right? I mean, I mean, so, so 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. Yeah. Right. 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 these rapidly absorbable carbohydrates. We, the FDA said, the industry said it was safe, generally recognized as safe back in the '70s and '80s. If you look at the Dietary Guidance Advisory Committee in 2015 and 2020, you don't have to go look any further. They did the systematic reviews, and they have shown that these refined carbohydrates, I mean, they've shown all the adverse events associated with that, that they are linked with obesity, cardiovascular disease, and diabetes. So those statements back in the '70s, there was no link between these. Just go look at the dietary advisory, the scientific report, and the evidence is there. And and this does not require a new law. It doesn't require an interpretation of statute. It just requires enforcement of existing statute. Yeah. And the fact that there's one other thing, the industry 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 where it should belong. Yeah. Right? And now the industry will come and say, "Well, what about one can of this or, you know, one teaspoon of 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 see what the cumulative effect of processed refined carbohydrates at the doses we're currently consuming them. They are not safe, right? So, so they got on the market on the market because they were GRAS. You can't be GRAS 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 GRAS, and they are not. They're going to throw hundreds of millions of dollars of legal arguments against this.
So, how, how strong do you think this would hold up in court?
I think that it's easier than tobacco. Easier than tobacco. I think it's, I think it's much. Tobacco, certainly. I don't want to get overly legal. You know, in a post-Chevron world, I mean, for the lawyers, you know, citizens in interpreting the statute, this is the existing law, right? Requires that these substances be generally recognized as safe. There has to be an expert consensus, a consensus among experts. The FDA does not have the burden. The industry has the burden. All you have to do is show that there is not, there are these questions about the safety. Any doubt in your mind that processed refined carbohydrates, I mean, that there's questions about the safety? That's all FDA. That's all. I don't think anyone. I mean, what was striking about, so I submitted this petition, right? Fair to say that the nutrition community has divergent views within the nutrition community, right? I mean, there are all these, you know, very strong views, very, I mean, in some ways, we eat our own, I mean, in the nutrition community, right? I mean, you've lived it. You see the effect. The one thing that was striking is when everybody said, "I said processed refined carbohydrates are not GRAS." Everybody looked at that and go, "Oh, we could agree on that." Yeah. So, so 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? But, but if you look at that, what's driving this metabolic harm? I think 80, 90%, I mean, of the culprit has these processed refined carbohydrates. Maybe it doesn't deal with everything.
So, how do you thread the needle on the dose question? Because if you have like, you know, a cookie or two once in a while, it's not a big deal, but it's the cumulative dose. And the law requires you to evaluate the, the, under the conditions of use as it's being used. You need look no longer than just look around us. So would you say like, if it's more than five grams of sugar, refined carbohydrate, or how do, how do you do that on the? But, but that is going to be, look, I think the FDA has no choice. I mean, I think the Secretary and the FDA, you know, I mean, I don't think these things are GRAS. And once these are not GRAS, figuring that out on what can be safe shifts to the industry. And the industry is going to have to come in, and it's going to have to get, uh, get its act together and say, "How do we change this food environment?" The ability to remake our food system.
So, if the FDA enforces and says, "This is no longer GRAS. We, we, we missed the boat. We kind of had a blind spot here. Now, we get it." And as of tomorrow, all they have to say is it's not. And then what happens? Then you have to give the, you probably give the industry certain time, and then they can come in and they have to figure out how they're going to remake and reformulate food, right? So that Americans can thrive.
Basically, the minute the government says it's not GRAS, I'm not even sure it's whether the government, the government doing that would certainly be very important, but I actually think it's self-executing. I think under the law, the food lawyers I've talked to, I mean, I don't think you can credibly say it's generally recognized as safe. Certainly, if the government does that, it...
Well, so, so, so that you're exactly right. I mean, and there, FDA did issue this document in '88 that said these things are GRAS. So, I think FDA has to say that it is not. People say it will take FDA a long time to study this and to figure out all the answers to these questions. Now, they got it wrong. The burden is on the industry to show that it's safe. I mean, the FDA simply says, "Hey, just look..."
At the Dietary Guidance Advisory Committee scientific reports, we these refined processed carbohydrates. I mean, ours, there's 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 error that we we didn't foresee.
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, 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. Yeah. Much healthier. And so the question is, we're going to have to remake our food environment. Mhm. Um, and and and remaking our food environment is going to mean that, uh, you know, the the dose is going to have to come very substantially down, right? Because, no 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.
According to recent USDA data a few years ago, it was like 152 pounds of sugar and 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. We are consuming right about 500 calories a 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, uh, you know, glucose. I mean, that is contributing to the septic fat. But certainly those calories plus the refined processed carbohydrates are the toxic. Well, the calories are the usually the refined carbohydrates. That's where they're coming. I mean, exactly. But not, it's not like we're eating 500 calories more of meat or chicken or fish. So, so if you look at what it, it is, it's about 230 calories of these refined grains, right? It's these starches and flours, right? It's, it's more sweeteners, although increasingly, the the sweeteners, you know, are these artificial sweeteners, right? I mean, it's, it, it's not the the corn syrups. They've been replaced by these newer chemicals. I mean, the that sweeten foods. So, you have these added fats in oils. You have these refined, uh, starches, and you have these added sweeteners, and that's what makes up the additional 500 calories. And you were going to have to rethink the formulation, I mean, of these foods.
Look, once you open the door, what the petition does, I think, is ask the question. It opens the door. Yeah. And once you open the door and say, say, "Hey, it's no longer grass." There's no turning it back.
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So, so, so David, you're in a room with Secretary Kennedy, FDA Commissioner McCary, you, maybe a couple other scientists, maybe me, I don't know, and we're sitting there a month from now. What are the steps that you're going to tell them to take to actually make this a reality? Because this seems to be like a loophole that you found that nobody's thought about before that actually could solve the problem. It, it, it certainly gets the ball rolling. It reframes the debate. It gives us the tool. So what did we do? Understand when when tobacco started, actually, tobacco started with a citizens' petition in 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 that said FDA should regulate low-tar, low-nicotine cigarettes as a drug. Huh? Why low-tar, low-nicotine cigarettes as a drug? Didn't quite make sense. But it gave the regulatory hook, right? It gave the authority, I mean, to ask those questions. And we 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 believe. Right. And then there was all this legislation. Took two, three decades. But once you, what the petition does by saying there's no longer grass, it, it gives HHS the regulatory and legal hook to be able to, um, reframe, um, the food.
But it's going to take decades. 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 substances are no longer grass." But, but that's the easy part. That just gets it started. Then the question is, how are you going to fix it? The great public health success of our lifetime, tobacco. Fair. Yeah. Right. What in, what in the end worked? Litigation. Go ahead. Labeling. Labeling. Avoiding advertising. Taxation. And focus on our kids. All, all, I mean, all that worked. But what really worked? What, what did those things? What those were all tools, right? If you go back and you look at, um, certainly in my parents' generation or my great-great, my grandparents' generation, right? How they viewed tobacco. Right. Tobacco was sexy. It was adventurous, right? It was positively valence. The industry in the early 1900s, they had that march down Fifth Avenue. It was associated with emancipation. It was, they, they hired the psychoanalyst, a Bril, 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. To what did we do? What did we do? What did, what did it take us 75 years? We made it a pariah. So, what we took something, an addictive substance, a reinforcing substance, power, 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 valence. We had this critical perceptual shift as a society. I don't want that. So, are we going to have to label these? Are we going to have show people, right, that the these these chemically engineered, the these foods you that have these refined starches and grains, refined sweeteners, these added fats, and all these are not foods, right? Sure, they may, you know, in in the moment, may it get me past the next 20 minutes, right? It may give me energy for two hours, but how is it going to make me feel over the long term? Is it cheap? No question. It's cheaper. Long term, but the long term, look at the devastating cost. So, we're going to have to change. We're going to have to have this critical perceptual shift. We understand what the problem is right now. There needs to be the coming together, and we just have to execute this.
So, do you think it's like a public health education, like we did with cigarettes? It's everything, right? It's everything you name. HHS has to act. Congress has to, I mean, hold that, I mean, hold that hearing, right? Who should be the first, you know, the first witness? Secretary has to go in, right, and and explain that the stuff is no longer grass and is no longer a legal basis. Next panel is going to be the next panel is going to be the industry CEOs, and how are they going to fix this, right? And the question is, is the industry going to just take the position, defend, defend, defend, or is the industry going to understand? I mean, when tobacco, you know, when we started, the industry was defend, defend, defend. This is great. This is great. I love this idea. I, I'm actually good friends with the the chair of the subcommittee on health in the Ways and Means Committee, who wants to have hearings on these things. So, I think since Medicare is overseeing the health, American, in many ways, it would be an interesting, it would be an interesting place to have these hearings. FDA has to do its part. 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 going to be the revocation of grass that's going to solve this? No. But it's going to have to put together that comprehensive package. 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 government actually testifying 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. I mean, I read it, my jaw was on the floor, and I, we're going to link to it in the show notes. So, if anybody wants to read it, I encourage you, or you can just read the New York Times about it article that you were featured in, which is also quite good, or or just throw it in chat and ask you to sum it to summarize them for you.
And and if you go back to the book, you go back to the book, there's a chapter. Yeah. I think it's chapter 23 that said you could not have designed a better weapon to blow up the American body. Meaning the petition, or you mean the the food, the food industry? If, if, if you look at what we did, okay, I think it's like lead in the pipes in Rome. It's like the end of the Roman Empire. You know, it's the end of the American Empire. And it's something we bring on ourselves by the permissive nature of how we allow food, the food industry to run roughshod over the 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. Now, 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, right? So, there is there is a, and we need just to, just to complete the full picture here, right? So, so the question is, what do you do if you're the individual? How do you protect yourself from this environment? Because clearly, we've been talking a lot about the public health interventions which have to happen, but also, but it's absolutely. Yeah. So, again, I left Whoop speed 40 lbs heavier, right? And metabolically, my body was, was not good. I actually, I started losing weight, you know, and I went on, you know, my typical, you know, low-carb kind of diet. I lost a couple of pounds, 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, you know, losing weight. I mean, you know, I was at risk for kidney stones. I found myself in an E, in the ER. Yeah. I was just, you know, dehydrated and, um, you know, had the kidney stone. They drew blood, and I had an, I had this elevated calcium level. Why did I have an elevated calcium level? It just didn't make sense. So, I went to an endocrinologist, right? Parathyroid hormone was, it was a spurious result. It was a spurious result. But the endocrinologist happened to be doing some of the clinical trials on the GLP-1 drugs, right? And I said I was losing weight, and he said, "Do you want to try to go on the GLP-1 drugs? You qualify. My BMI was greater than 27 with a comorbidity." And I'm writing this book, and I said, "Hey, and I wanted to experience it, right? Diet drugs and dopamine and dopamine, right? I mean, the dopamine I had, right? 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, they're highly effective. No question. You lose weight on the GLP-1s for the vast majority of people. 95% 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, uh, events, right? But the, 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, what the pharmaceutical, but how are these drugs really working? Right. Why are they so effective? You know, we, we talked about the, um, 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 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 the food, slows your gut down. So your, and we've all experienced it. We've had the flu. Our gut slows down, and you're not hungry. You're not. But how do you also fear when you have the flu and you don't want to put anything else in your stomach, right? They're nauseous. 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 laugh. Now, the great thing about these drugs is they titrate. I'm not kidding. I'm just. No. No. No. But you're. But that's exactly how this is working. So, so, so what happens, what the way these drugs work is they, is they have this spectrum of, you know, there's the 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, 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 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, it's working on the area stream of the hindgut 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 if you know you're going to put food in your stomach, and it's going to make you feel ill? What do you learn to do? Not eat, or or eat less? Eat less. So, that's, I mean, my guess is that's the primary. It's like a gastric bypass without the. Now, how long are people on these drugs? Well, often after a year, 50% stop because of the more. Okay. The vast majority are off these drugs, eight, and then they gain back 65% of the weight or more. So, what's going to happen in three, four years? We're going to go back and look, and the average person's on these drugs for eight to nine months. They gain back the weight. And what are we going to say? There's one big, big. These are highly effective drugs. Well, you're on them, but if you go off them, right? And if you go off them, you know, understandably, they don't work when you're off them. But while they're on them, they delightly this gastric emptying. And you need, there's this seesaw. There's these reward circuits that's going to make me feel better, and this is going to, you know, increase satiety 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 got to 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, this high, to to want to 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 want to eat. For the first time, people say they want to eat healthy. They, they don't want this, you know, highly, uh, high glycemic fat and sugar, because what if that's just going to sit there in their stomach? How is it going to make them feel, right? Right. But these, 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?
What's your sense of these drugs long term? Because, you know, we're talking about covering Medicare. I mean, they, they, people should have, I mean, imagine struggling with your weight for your whole life, and you, you have real, this real, I mean, that be your belly, right? Let's, let's, right? That be your belly. I mean, the average male in this country who's 50, 60, 70 pounds overweight, and where is that fat? Belly fat. And what did we, we used, we've 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 got to help. I mean, that that beer belly translates into heart failure, into atrial fibrillation. It's a tool to get us there. But if people, more than 50% of people are, we got to give people care. You, I mean, you got to marry it with nutrition and exercise and coaching and support and and and it's not your fault, right? 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. 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. And if we're just going to put people back into an environment, right, with all this ultra-processed foods, what's going to happen when they're off the drugs? Yeah. So, we got to change the food environment, but we got to give people the tools and give people the care. I mean, this is what you've always stood for. Fair. Yeah. This is what you've cared about. Yeah. I mean, I mean, people talk about longevity. What's longevity? 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 can 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 going to be taken up by disability because of this, because of this heart, this cardiac, I mean, maybe 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.
This is, this is incredible. I think between the the public health focus and the clinical focus and the structural changes that have to happen in our society to allow people to make better choices, where the default choices are the healthy choices, as opposed to the bad choices, it's going to have, it's going to take a minute. I, I don't know if it's, hopefully, tobacco. Yeah. How long did it take us? 30 years. All right. This is as big as tobacco. I think it's bigger. But the question is, everybody eats. No, not everybody has to smoke. But, but you don't have to eat ultra-processed food. You don't have to eat in this alternate food universe. Yeah, it's true. It just requires a whole restructuring of everything from field to fork. And that is really important because it's not just a policy issue. It's not just a personal choice issue. It's, it's like how we grow our food. And it, it goes back to, right? But it's how we're making this food, soil, and how we're processing it. But look at how the this ultra-processed food is coming together. It's not food. No. No. Right. I mean, they're taking, right, these supercharged ingredients and putting that together in some kind of mixture, and then they're adding back that palatability. That's not food. Yeah. I agree. I mean, I think 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 it, and if it's something that detracts from your health, it shouldn't be covered by any government policy. You can make your own choice to drink soda. But we certainly shouldn't give it a pass and say it's generally recognized. No, it's, it's sort of like, it's sort of like imagine, imagine with SNAP, with the food stamp program, imagine we were paying for $125 billion of cigarettes for Americans. That's essentially what we're doing.
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. So, what, so what's going to 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 didn't 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 others. There's not one finish line in tobacco. There wasn't just one finish line. It was a series of chapters. We got to get HHS to act on the petition and simply say, "There, this," get the ball rolling. I'm on it. Okay. I'm on it. All right. I mean, if you do that, right, then you open up the, the, you have the hearings, right? I'm on that, too. Okay. And you bring in the food industry. I can help that. And and they got to be able to part of the solution. We're going to 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. 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 and won, I think, you know, it would be a beautiful bookmark to your life to take on the ultra-processed food industry and create a win for America. And I'm going to do whatever I can to help you because I, 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 and their senators to start to socialize this idea because it is a powerful idea. There's sometimes these ideas that happen once in a while that catalyze some shift. And I think this is one of those ideas. It's simple, it's clear, it's irrefutable. It's time has come. Like, let's go. Thanks for having me. Yeah. Thanks for being here, David. If you loved that last video, you're going to love the next one. Check it out here.