An Uncomfortable Conversation About Obesity | Dr. Mike Israetel

If I was still working at the university, I would never give this interview. Because saying that poor people on average have lower conscientiousness, I'm still worried about this going out. Holy (censored) that's insulting. If you're nuanced, then you're smart. You can understand how it's both real and not insulting. But if you're anything else and if you're very politically motivated, it's gonna be a nuclear bomb. You're blaming people for their problems.

Please welcome return guest, Dr. Mike Israetel PhD to "The Checkup" podcast. We had a very scientific, even philosophical discussion about the nature versus nurture debate surrounding obesity. We get into that and so much more, muscle, its implication on your health, what's hype, what's not. You're gonna enjoy this conversation. I know I did. Let's get started with "The Checkup Podcast with Doctor Mike."

Squared? I remember last time we talked about this, I don't think you read comments and feedback and stuff.

I do sometimes.

Oh, like I was looking at feedback at our conversation and a lot of people were saying that they don't believe AI is exponential, as you say it is.

Yeah, they're just categorically wrong. This is not really like a debatable topic for people who are deeply entrenched in the field. I can approach this from a variety of angles to illustrate this point. But it used to be that the number of people that were saying that artificial general intelligence, roughly human capability intelligence, back in the late nineties, the vast majority of AI researchers thought it was some combination of impossible. It would arrive later than 2100. Every single five years that they do investigations into what the consensus of the AI profession is, that number falls lower and lower and lower up until and originally Ray Kurzweil was kind of the real kind of, not the father, but one of the main progenitors of this idea that AGI is coming much sooner than people think. His original prognostication date was 2030. He later revised it to 2029, which is oddly specific. There are conversations now in among the CEOs of Anthropic, OpenAI, various people at Google. These are the people making these things. And the conversation is now is like, are we gonna hit AGI in like, 2027, or is it really gonna be 2029 or somewhere between? And so the entire profession has been coalescing into more and more aggressive prediction timelines. And so the idea that like I'm overly pessimistic or sorry, overly optimistic about it is I've just read enough about it to understand like this is the space that we live in and the pessimism. There's also another thing some, a well-documented human intellectual fallacy called the pessimistic fallacy. And most humans on average are more pessimistic than they should be. But it's also understandable because humans evolved in an environment. Most of our brain and the way we think was designed in periods of evolution where hunter gatherer survival was how we made things happen. Hell is a pretty good way to describe what that was like. You know, elements of paradise and lots of elements of hell and things also just did not get better over time in any measurable way. And you could absolutely depend on things getting real bad real soon for most people, like, the average age of survival was like, 30, so on and so forth. So that's where our brains kind of have a baseline feel of what's happening. And over the last five to 10,000 years, there's been an exponential growth in culture and society and industry that means that we're really out of touch with the rate of progress. We're not usually exponential thinkers. We're linear thinkers. Almost nobody predicted the internet. And I believe 1997 or 1988, Paul Krugman, Nobel Prize winning economist, had a comment that I'm sure he regrets making, which is, you know, "The internet's probably not gonna go anywhere "because most people just don't "have much to say to each other." I mean, like we're laughing at it now. He also recently, I believe, please don't take my word for this, you should verify this, but I think he also a few months back said something negative about AI as well. He'll be tripping twice in his life, unfortunately. But the internet was this thing that is just straight up pure magic. Like think about Amazon. You use Amazon?

Mm-hmm.

Like you think of something and you actually don't even have to type anything anymore. You go, "Hey Alexa, can you order me XYZ?"

I don't use that.

Me neither. My parents do. She's great. She's not even an LLM yet, believe it or not.

[Mike] She's not a?

Not a large language model, like.

Oh okay, got it.

You have to upgrade her to that. But you go on your phone and you go like, protein bars and it finds the one you like and you go, okay, click go hit. And then it could arrive is between 5:00 and 7:00 PM that same day. I'm like, how? How? That's insane. We live in an insane time already. Imagine telling someone in the nineties like, "Dude, you can just like, you'll have a cellphone." And they're like, "Okay, like one of those big ones?" You're like, "It's much smaller but way more power." Like a hundred times more powerful than your best desktop today. Like okay, it's gonna be in your pocket all the time. They're like, "Okay, so the rich have it?" Like, everyone in the world has one. Okay, you just click on something and then it just arrives later. Like, where's it arriving from? Like, I actually have no idea, but I don't care 'cause it arrives on time. You can think of about a hundred thousand different ways in which we take totally for granted the fact that we live in an era of insane abundance and prosperity and predictable improvement. And so combining all of that together and saying, well, Mike's like a bit too optimistic about AI. I would say I'm probably on the aggregate when I hopefully am alive in 20 years and look back, I was probably like more optimistic than most people, but still more pessimistic than the reality that occurred.

I think about rate limiting steps in the exponential growth 'cause I absolutely can see the amount of growth that we've had in scientific understanding achievement.

[Mike] Sure.

In fact, there's a great book called "The Half-Life of Facts" that initially was doing research to prove why we have so much scientific breakthroughs. And a big part of it is a pretty cool statistic where 80% of scientists that have ever lived are alive today.

Oh yeah.

Because this is the time when they started becoming scientists.

Sure, it used to be very rare to be a scientist.

And through that collaboration there's been an exponential growth. But then there's gonna be a rate limiting step because there's not that many people to keep growing the field of science.

AGI will solve that problem.

So that's the next factor that comes into it. Amazon, and the reason why its ability to be at the level where it is, is because of incentives and incentives aligning creates a really clear road for something like Amazon to occur.

[Mike] Yeah.

So you have incentivization from capitalism, people that want those products.

Yes.

The products being able to be made at a reasonable way, area for storage. All these things aligning together because we all uniformly agree that's what we want. And I think it's very easy for incentives to shift because humans are not always rational. And there's a lot of emotional components, wars, political divisiveness, disease, that can interrupt the algorithmic growth that we've seen in the past.

It has never interrupted it up until, never. So if you look at all of the important events in geological history, biological history, cultural anthropological history and the history of development technology and civilization, you can plot them all on the same log scale. And they basically don't move up and down accounting for wars, holocausts, massive natural disasters. And there's a reason for that. At least a candidate hypothesis. It's a very mysterious thing to see in the data. The data's crystal clear about it. Like how the hell did World War II not slow down progress? Because there are two things that allow progress to happen. One is abundance. Like you know, you have time to work on cool shit, you have money to work on cool shit. You develop cool shit. The other is incentive, the impetus to make something happen because of difficulty. And these work kind of as top and bottom end buffers to the rate of progress. When you have good times, you have a huge abundance but not a lot of incentive to make shit happen that's cool because it doesn't matter. Everything's kind of nice. So who cares? Like really, is it really more important to make the next amazing iPhone? Like the iPhone's pretty goddamn good, like who cares? However, when you get into wars, natural disasters, that's when the incentive to make radical innovations really pops up and seems to cover that difference. So what we see is a very homogenous rate overall. Now there are absolutely declivities and proclivities throughout, but in the grand historical sense, they seem to so far be very minor. Like the Cambrian explosion of life on Earth seems to be a big deal when you look at it. But when you spread out the timeline, you're like, oh, that's actually quite predictable if that would've happened, I guess it's all on the same curve, so.

Yeah, I think about it like I think of when investors pitch you their deck and they say, what's that line? Past results don't necessarily reflect future outcomes. (laughs)

Sure, sure. And that's absolutely it.

So I say all of that with that in mind.

Yeah.

Of how the future plays out. And it's been interesting how the natural human buffer that you discuss exists and has guided us here. And then there's also the regulation of it all and the wars and the economic progress of it all. Like there was talk about social media just continuing to grow in a way that was becoming unreasonable. And then you see young people say, "Well, I'm kind of getting bored of doing the same thing, "of posting perfect images on Instagram." Now you know what? The less tailored, less structured.

Streaming.

Yeah, exactly, streaming.

Live.

Yeah, live. So like it's not always been clear to me how the future will adapt to current technologies. And I'm always aware of that when trying to make predictions and that's why even though I probably would've agreed with someone who is very pooh-poohing AI 10 years ago, but not because I too pooh-pooh AI. I just pooh-pooh their ability to make a good prediction.

Sure. Most predictions that are very specific end up getting a lot wrong.

Yeah.

A hundred percent. But we can just go based on generalities. The amount of total intelligence in our society has been increasing exponentially for all of measured time. And it looks like it's gonna continue to do that. They've done lots of work on theoretical limits of intelligence based on like, physics and information theory. And the limits of intelligence are preposterous, like, way out of reach of anything you could surmise. Like, you could hypothetically turn like eh, a decent fraction of the earth's mass into a computer. And the amount of intelligence it has is like, humans are like a fungal growth on the earth's crust level of like occupying the solar system. People are like, what about physical limits? Like, you know, we could just mine Jupiter for matter and like I can't like, there's like a storm on Jupiter, the eye or whatever that's like, three times bigger than the Earth. Like it's a lot of hydrogen, you know? So you think about physical limits, you don't really get a big limit on that one. And then you think about trajectories, trajectories have been good so far and you think, okay, so if intelligence increases a little bit more and a little bit more and a little bit more, you can start to see certain problems kind of melting away. Because a lot of the problems that are are extant right now are because of a lack of intelligence. Here's something fun and wildly politically incorrect. Ta-da. So as you measure people's political opinions and you scale them against proxies or direct measurements of their intelligence, there is a massive degree of consensus on political opinions as intelligence scales on either way. People who are less intelligent on average, measured however you like, tend to be more authoritarian in both regard of social and economic freedom. So people that are less intelligent tend to not be for social liberties. They're not super big fans of gay rights, trans rights, women's rights, the whole thing. And they're not big fans of economic freedom in general. They seem to think that more government regulation is the way to do things. Like anytime they see something wrong, they go, "There should be a law that against that." People on average, as they become more intelligent, seem to become more libertine in their attitudes. They favor a freer economy, substantially less, more intelligent regulation and they favor more libertine approach to social things like live and let live kind of attitude. And so if you manage to increase the amount of intelligence in the system, it's going to cause a predictably better place for all of us to live. Because when you have peoples that tend to be lower intelligence on average running an institution or country wherever, they generally run it really poorly. And you have all of the social maladies that you can see in a variety of areas. Whereas as people become more intelligent or as the aggregate of people plus machine intelligence becomes better, things get better overall. And so if you scale that out at some point you're like, man, if our collective IQ us plus machines goes up another 10 points, a lot of places are gonna be free or more prosperous and cleaner and more stable and have less war. Because if you think about it for like a little bit, you know, basic economics, very basic economics, war almost never makes logical sense, almost ever. Like, should we attack the Netherlands? Why? To get their resources. Like, we can just buy the resources. We can get 'em for free. Like no, you still need to buy them 'cause then some of us live there and they sell us that stuff. Like the whole war for oil nonsense is just almost certainly just pure nonsense. There's all the war for oil in the modern time has just not occurred.

Well, that's that emotional reasoning that we're talking about in humans.

100%, yeah. And so like as you scale up your intelligence, your emotional reasoning tends to capture less and less of your cognitive bandwidth.

I don't know if I agree with that.

It's just demonstrably true empirically.

Well, I think-

On average. Now there are absolutely exceptions of smart people. You're really having a lot of feelings.

No, no, I'm not talking about the extremes. I just see that like as IQs and Nobel laureates have attested that they oftentimes are able to convince themselves of widely inaccurate theories and the belief that whatever they're saying is true when it's absolutely not true. That's also been shown. And then also there's a chicken or the egg effect here where it's when you are poorer and have less education, you need to have a little bit more of an authoritative mindset to succeed in order to be practically successful. And when you're wealthy and you have less to worry about, you think about being more free and you think about other things where as when you're poorer you have to survive so that you, it frees you up to think more liberally and peacefully. Which is why there's always so much disagreement of people who live on the coasts that have money versus people who are struggling to be rising in society and they want their children to focus and live the most strict lifestyle because they think that's the only way to achieve it. And they could be right, given their circumstances. Do you think that could be a reasonable thought?

Maybe. So to the first point of Nobel laureates questioning their ability or illustrating their ability to sort of justify anything they'd like, the fact that they're introspective enough to know that that's happening is already alienating them in their own little group.

Well, I don't think they're aware of it. I think we studying them are aware of that.

Oh, I see. I think some of 'em have talked about it openly.

[Mike] Maybe.

And we being less intelligent than global Nobel laureates are probably less self-aware than they are. And if we are self-aware of it, you have to ask what about people of substantially lower intelligence? They're substantially less aware in general. And so they're apt to make mostly emotionally biased choices. As a matter of fact, many people when you ask 'em what they think about politics are answering a completely different question. They're answering, actually I'm wearing my Thomas Sowell shirt to illustrate that exact thing.

Yep.

It's a former position of his, current position of his. Most people feel a certain way about politics. They don't think a certain way about politics, which is the wrong thing altogether because politics is asking the question of how do you run a society for the maximum benefit? However you define that, it's a technical question, it's a machine question. It's not a question of how you feel about things. Most people feel rather than think about these kinds of topics, people who are more intelligent tend to think on the margins more than not. And people who are less intelligent tend to feel more than not. And so on average, if you think Nobel laureates are biased, you should talk to someone of profoundly lower intelligence and you will see probably exclusively bias and almost nothing else.

Hmm, I wonder what the research of that actually entails.

And a whole-hearted confidence in those opinions.

[Mike] From an anthropology standpoint.

Give it a look. It's not a problem.

Yeah, because no, no, no. Like even from a practical standpoint of what I've experienced in my life of I treat two very distinct populations of where I practice medicine, where I have people who live in the wealthy community where my hospital exists. And then I have people who are coming in for the community health aspect of it, charity care aspect, perhaps that are employed by the people who are very wealthy. And I see the problems that they experience their logic by how they approach the world and the strategies that they each use to survive. And they're radically different in terms of looking at them on paper. But they're radically appropriate given their situation. I think if you are-

I think you're being very charitable.

I think if you're a single mother who's working two jobs, have two children, one of which that's struggling academically, you don't have the capacity or time to think about what a better world looks like for certain subsets of individuals. You're trying to be as practical and create the guardrails for the success of your immediate family. I think looking down upon that as dumb or wrong I think misses the point of how that person got there and therefore we're judging a whole group of people for making a decision that had we been in that situation, we would've made the same exact decision.

I don't agree.

You don't agree?

No.

Why is that?

Boy, so couple caveats. We're speaking in statistical generalities, so we're not trying to paint an entire group of people any way. The group of people we're painting is also a statistical abstraction. It's not an actual group of people you can point to. One example of this is people talk about the poor but something like a third of the poor or just like people who just graduated high school, most of them will end up quite wealthy. They're just at the wrong time of life. So you can't group them in with various other demographic groups that are poor consistently throughout their lives.

And when you talk about the rich, it's about how much money they have?

[Mike] Rich when, right.

Or how much they earn earn this year.

How much they're making, right.

Because as Thomas Sowell says.

[Mike] Right, that's not always the same.

That changes every year.

Oh yeah. All the time, yeah.

Because the people that are extremely wealthy may not have earned a lot this year.

Sure, sure. And they're also within any kind of category, let's just say poor people, there are vastly different kinds of people in that with vastly different kinds of behavioral patterns. But the behavioral patterns seem to be the number one correlate of what continues to keep you poorer than average or continues to push you on the trajectory of wealthier than average eventually. So when we say on average poor people do XYZ, you can give me millions of counter examples of poor people being very diligent, very organized, very conscientious, very thoughtful, and very coordinated in their action. And those people are much less likely to remain poor than the fraction of poor people that have the opposite of those characteristics. So when you look at wealthier people and poor people on average, you tend to find that wealthier people on average are more conscientious, more goal-driven, more organized, clear thinkers about things. They have lots of feelings just like everyone else, but they don't let the feelings take over as much as people who on average who are poor. But the averages kind of belie the fact that it really goes individual by individual. And whether or not you're rich or poor, you have no doubt, well, maybe no doubt, some people are not capable of having as many social interactions. But you've met at least four kinds of people, likely. Poor person who is like just a really conscientious, really organized, really thoughtful, calm person, who is very intelligent, very motivated to improve their circumstance even if they've been dealt a nasty hand like they had married someone who was really good to them, that person died an automobile accident, left them with three children and now they work two jobs and they're doing their goddamn best. That person and their children through the genetic relatedness of having those features inherited from them and the very nice father that unfortunately was taken too early, their children and them will probably be over time on average expectedly rising through the income strata because they're just good at stuff. That's just who they are. They don't spend excessively, they don't make impulsive decisions as often, so on and so forth. So that's subtype number one. Subtype number two of a poor person is when you hang around them for long enough, you don't say this to them personally. You could be like, "Motherfucker, "I'll tell you why you're poor, goddamn it." You spend all of your money, you're addicted to like 10 different things. You have an I don't give a fuck attitude about basically everything. You've never invested a dime in improving yourself in any way whatsoever. You're rude to everyone around you. How are you possibly gonna make money and hold onto it? An almost impossibility. So there's two subtypes of poor people.

So for that second subtype, is that caused by society? A societal situation or is that a genetic situation?

It's a combination of the two. But the genetic explains much more of the variance as far as the literature I've consumed because both poor people are, both subtypes of poor people are exposed to roughly the same social influences and it does not affect everyone the same way. There are some cultural elements there that have to be thrown in 'cause there's kind of like society at large, there's genetics, but there's also an intermediary variable, culture. How do you process society and express your genetics? There's probably something to say for culture though, based on the more recent behavioral genetic data that I've seen, people in some sense secrete their culture based on their genetics, at least to some great degree. Like if you're the kind of person that's born into even a family of very highly unconscientious people, but you have a lot of trait conscientiousness, and they introduce you to a very low conscientious culture, like, "Just fuck it, do whatever. YOLO." You probably as you mature into teenagehood will be like, "This sucks. "I need to get the fuck outta here." You know, like the small town, get me outta here.

Sure, that exists.

I'm not made for this kind of thing.

We have two of those people so far. Two archetypes, very rough. Right?

And there's also, just to finish that point.

[Mike] Yeah, yeah.

I think there's a protective factor if you're in the correct social group. So how many kids that may, let's say genetically have an issue with addiction, with lack of delayed gratification ability, all those factors that we label as potentially successful, like they have low levels of that, but if they're in the right social class, they're born wealthy into a wealthy family in the United States, will they make mistakes and suffer consequences? Absolutely. But it's protective in the way that they're not gonna become drastically poor.

You just made category three of the four. So category three is people who come from wealth but exhibit very low conscientiousness and they tend to have that protective buffer. But you can work your way through any protective buffer and through multiple generations of low conscientious individuals you can lose absolutely everything and just become absolutely destitute, no problem. Say gambling addiction can cancel out every

Single bit of generational wealth in a matter of minutes, if you think about it. Definitely hours and days, for sure years. Profound drug addiction.

I would like to believe in a world in which people who have a huge proneness to drug addiction, you simply give them the right access to care and they’re better. Mike, you’ve seen the data on drug recovery rates. It’s not pretty. A lot of wealthy people who have all the resources who are prone to drug addiction just continue. I’m not gonna name any celebrities.

-[Mike] Oh yeah.

-Continue to struggle with it their entire lives. And so yes, the buffer is real, but we can’t paint the buffer too strongly as like, you’re never gonna be poor. Oh, you can recess down no problem.

-Yeah, what the data-

-[Mike] Much easier to lose than to gain.

-Yeah, what the data shows about specifically, let’s say substance abuse is quite interesting in that if you look at people who are struggling with substance abuse in decade three of their life, checking in back in with them at decade five, the odds that they still have a substance abuse issue is not as high as you think it would be. So really a lot of times it’s about buying time to get passed this issue by a means of risk reduction. And that could be taking a pharmaceutical medication to get you off of that medicine even though it has side effects. It could mean trading one unhealthy habit like substance abuse for a healthier one. How many people cope-

-Fitness?

-Yeah. With issues in their lives through abusing themselves in fitness or maybe overusing testosterone because before they were addicted to heroin and they’ve gotten off heroin but they still miss that rush or whatever it is.

-Sure, sure.

-And they’re getting it elsewhere in a slightly less negative way.

-[Mike] Yeah.

-So it’s pretty interesting to see how if you look at humans in one point in their life, that doesn’t always equate, like we say people who have substance abuse, the same way that it’s unfair to say people who are rich.

-Yeah.

-This year or earn the most this year, the top 1% this year. It’s not gonna be next year.

-Yeah.

-The same holds true for people with substance abuse.

-Yeah, and every other factor as well.

-Yeah, exactly.

-That’s an excellent point. But the other last category is people who are relatively wealthy already and also have high trait conscientiousness, and those individuals tend to have extreme amounts of continual success and aggregate high amounts of intergenerational wealth. I’ve met a few folks who are from old money, old money, and one of the things that stood out to me about them was how many of them were just mega degenerate losers. Just totally just riding it out. What also stuck out is how many of them were just unbelievably awesome, kind, conscientious people that you’re like, I can tell you why your parents were successful ‘cause you’re related to them and you got the same thing. Like, I know at least one person who came from money, money, and he’s on like his third $100 million business creation all by himself. No help from mom and dad in any capacity, just like same idea.

-Well, I can’t believe no help from mom and dad. If you have a protective buffer behind you, the amount of risk you’re willing to take on is gonna be greatly different-

-I have an exact counterpoint to that as an intellectual exercise.

-Tell me.

-If you have no impetus to succeed, because it doesn’t matter ‘cause you’re already rich, you have arguably much less drive to make it. People who came from very little always recount the fact that it’s because they came from very little that lift them up and made them drive. Whereas we are all familiar with the trope of the wealthy person that goes to Dartmouth, but they take whatever classes they feel like taking ‘cause who gives a shit? Dad did hedge funds and I don’t have to do anything. So how do you traverse that?

-The way that I think about it is they wanna do better than whatever goalpost was set for them. You know, we’re speaking of tropes. Daddy didn’t love me because he thought he was more successful than me, so I’m gonna outdo him. Or my dad started a billion dollar company, I wanna make a $10 billion company.

-Sure.

-[Mike] I think that motivation still exists for that industry.

-Definitely, but it also I think works the other way where people who have seen close to the bottom really don’t like to be close to the bottom and they’re maybe less likely to be lazy about things and just let it ride.

-Sure, but how much do connections matter, like coming to America for us?

-Almost not at all.

-Come on. That’s complete nonsense.

-Almost not at all.

-Come on. That’s complete nonsense. I’ll even give you a practical simple takeaway from it.

-[Mike] Sure.

-Moving to America, not having a connection for a plumber, a car repair person, a dentist versus someone who has all that and then that frees them up to have the time to work more, to achieve more, to have the buddy buddy relationship of a grant going their way is an inherent advantage.

-Yeah.

-So how can we say that it’s not?

-Yeah, yeah. It’s short-term advantage. It definitely makes things easier in the short term for you, but usually that stuff doesn’t last. So if you have somebody who’s been connected into business, like dad was in the industry, said, “Hey, hire my son.” You know, that sort of thing.

-Sure. Nepotism.

-Business is ruthless. I don’t give a fuck who you’re related to. If you’re related to dad and he said hire you, I’ll hire you. You don’t perform and your stock trading isn’t up to standard, I’m gonna hire some dude from China that’s a fucking merc. And he doesn’t give a fuck and I don’t know him.

-You would think so.

-I don’t know his parents.

-There’s so much nepotism. There’s so many people who are terrible at their jobs at the highest levels.

-Yeah, many. But it’s much rarer than you may think. And there are also so many people at the highest levels that are just good and over time, especially the free market. Now government’s slightly different, but the free market, private institutions, private companies, grotesquely over reward capability versus anything else. You ever been inside Google? And no offense to anyone, all jokes, all love and respect. Google, all the companies associated with the tech sphere, bro, it’s like one half of the nation of India. Is there some kind of thing where people just love Indians at tech companies? No, they’re fucking mercs, dude. They’re fucking good. They’re just good. And like, I’m gonna hire people that are good and it’s also, we like to hold two thoughts in our heads at the same time about, you know, the myth of the, maybe not myth, the exaggerated form of the greedy capitalist. It’s both a nepotistic asshole and a greedy asshole. Nepotism and greed don’t work very well together because if I’m greedy enough, I don’t need you, my son, working for my company because you’re flubbing. I need your Giriraj Patel working for my company ‘cause he fucking comes in at 6:00 in the morning. I don’t think he ever leaves. His portfolio looks like someone make-believed it into existence. I wanna get this guy. Who is the current, was it CEO of Microsoft? Or Microsoft or is it Google? One of the guys is like an Indian dude, right?

-Yeah, I think.

-Where’d he come from? Where was his advantage?

-What I’ve seen anecdotally speaking, the practical version of what you’re saying is you’re the greedy asshole that hires his son who’s inept and benefits from the hard labor of the Indian dude without paying them fairly. I think that’s the more reality of what a greedy person is.

-And then the Indian dude is smarter than all of you. And the Indian dude gets a startup going and he crushes you and buys out your company.

-How often do we see that happening?

-All the time.

-I feel like the big companies that have been in power are still in power. The blue chip companies.

-Google was founded by a Russian immigrant in the nineties.

-Yeah, this is during a period of transition of new technology, of a new industry being formed as opposed to an old industry being taken over.

-So which industries are the ones that are like the old boys still?

-Disney.

-Disney’s not an industry. Disney’s one company.

-Well, Disney’s industry is media. It’s amusement parks, it’s entertainment.

-Sure.

-Sports. You don’t see brilliant engineers taking over sports teams.

-I think the profit margin on sports teams is-

-Huge.

-Is it? Is the margin huge or is it the revenue of it?

-The valuation is huge of change.

-Sure.

-That’s the real value.

-Sure.

-And nowadays you can’t buy a sports team. It is now firms that are run by the same 10 people that are buying sports teams.

-10 people is not, so I’d say 10 people are probably ruthlessly competitive against each other.

-[Mike] Sure.

-It’s a very competitive landscape. Another thing is to the point of behavioral genetics, one of the reasons that nepotism actually still can be tracked statistically is because nepotism on average works. Because if you’re a real smart dad and you had a great company, yeah, your son might suck relative to everyone else at the company ‘cause they’re all studs. Compared to the average person, your son’s a killer. And so over time I think you see this effect that can be labeled as purely nepotistic, but in reality we’re just tracing the effects of behavioral genetics. Like people related to really smart, really capable people are on average smarter and more capable than everybody else. And so a huge degree of nepotism can be accounted just sheerly based on that and over long historical trends, nepotism has a way of not working out so well because private enterprise does not care about nepotism. So like the Paul brothers, I don’t know which one of ‘em made the Prime drink. You know the Prime drink?

-Logan.

-Sugar water. Logan Paul.

-Technically not sugar water, actually. It’s artificial sugar water. (laughs)

-Sweet tasting water with electrolytes and stuff.

-Right.

-So.

-Whose brother just attacked me two days ago, actually.

-Attacked physically?

-Social media.

-Oh my god. Even worse.

-[Mike] Yeah.

-Well good, you had it coming. And what was the attack about? Now I’m curious.

-He called me, “A book thumping sheep doctor.”

-[Mike] What does mean sheep doctor? Oh, like sheep like baa?

-He judged me for reading books, I guess.

-Oh, I gotcha. Yeah, not big on the thinking that man. Very well.

-Yeah.

-Wow. I didn’t think we would have like, middle school level bullying in adulthood, but here we are.

-I found it interesting, like if you were-

-What did you say that made him upset? I’m sure he didn’t reach out for no reason.

-Politico posted that President Trump wrote that he wants to hire RFK for HHS and he confirmed it and I wrote, “It’s a sad day for us in healthcare.”

-I see.

-And he took offense to that.

-Yeah, politics makes the mind go a little crazy at times. Yeah, book reading is good. Makes you smarter, so on and so forth.

-(laughs) Well, apparently not. Apparently it makes you a sheep doctor.

-[Mike] Sure.

-And he said I was indoctrinated.

-Yeah.

-But the doc was in quotes.

-Lots of indoctrination going around, may I assume he probably mislabeled you, but lots of indoctrination. So you gotta take the good with the bad, but I digress.

-[Mike] Yeah, yeah. So you’re saying the Paul brothers.

-Prime, the Prime drink. It just tastes really good, man.

-You like it?

-I don’t particularly like it. I think it’s fine.

-Oh.

-It’s not my favorite.

-[Mike] So how are you saying it tastes good?

-Everyone I’ve ever talked to around me says it’s amazing.

-Really? Interesting, okay.

-Like absolutely.

-Yeah, yeah, yeah. Sure. It’s like so it tastes good enough for lots of people to buy it.

-Right.

-And there are no Pepsi Cola hard liners left to defend Pepsi’s enterprise. If something’s better, people just buy it. Tesla with Elon Musk.

-What do you mean? RFK just tweeted that he’s gonna remove high fructose corn syrup in Coca-Cola and put cane sugar in it. That’s gonna fix our problem.

-Thank God. Finally, someone looking out for the people.

-(laughs) I mean like, come on. Like, if we’re talking about science.

-Yeah, yeah, so-

-And hold on. The whole RFK situation, isn’t that the prime example of terrible nepotism in success?

-I don’t think RFK is a nepotistic thing. I think RFK just really like, connects with people in a really simple and plain way.

-Mike, come on.

-I’m dead serious.

-Yeah, but how did he-

-People seem to like. There’s lots of other Kennedys which are really annoying and people hate.

-There’s a lot of RFKs walking around right now that are not in the level of where he is simply because of his family.

-What do you think his family did for him to help him out specifically?

-Money.

-Look, what did he use the money for? How did he use the money to become famous?

-How did he run his presidential campaign? How did he get media? How did he hire people?

-You think he used private Kennedy money for that?

-Of course.

-[Mike] I thought it was fundraising.

-Or he lived, well yeah. How do you get fundraisers? How do you get attention? How do you create people to wanna pay attention to you?

-Sure. Born famous. I guess just because you’re a Kennedy, it’s real tough to get a lot of things going behind you. I think he has some special qualities. I think he comes off as incredibly genuine when he’s conversing, which is super important. He doesn’t have that Hillary Clinton, you know, that Illuminati stare where you’re like, there’s no one in there, is there?

-Yeah, I don’t know if that’s a good thing that you’re explaining.

-Well, people seem to like it. And so I think that’s probably mostly why. Now obviously the Kennedy name doesn’t hurt and nepotism in politics is a much bigger deal than in economics.

-Well, wait, go back to the Paul brothers of it all.

-[Mike] Paul brothers.

-I wanna see where you’re going with that.

-Prime, the Prime drink is good ‘cause it’s good and people don’t care. They don’t care who made it. They’re not trying to honor anyone’s memory, the four-

-You don’t? You don’t think they’re buying it ‘cause they wanna support Logan or they love Logan or they think he’s cool?

-No, there’s not enough people that like him to make that economics work for like regular stores and stuff. Hell no. Most of the people that Prime-

-You think random people that are going in to buy Prime.

-Oh yeah.

-That made it what it is, don’t know who Logan Paul is?

-Oh my God. Tons, yeah.

-Really?

-I barely know who Logan Paul is. I think him, what does he have a brother named Jake or something like that?

-Yeah.

-I couldn’t pick ‘em. I couldn’t tell ‘em apart.

-I mean like almost 100 million people watched Jake fight Mike Tyson, fight Mike Tyson.

-Yeah, I mean I watch a lot of shows with lots of famous people. I don’t go running to buy their drink all the damn time.

-Right, because social media creates a parasocial relationship which is much stronger.

-If their drink sucked and maybe it’s not that great and maybe time will tell, no one gives a shit. No one’s buying your drink ‘cause it sucks. You can say you like a bunch of stuff, you’re not going out if you were to drink a shitty drink, you might do it once or twice. Like, “Oh, I really wanted to like Jake Paul’s drink,” didn’t work out. If it’s good, it’s good. And over the long term, people who are able to innovate and create great things rise to the top of the ability to have great wealth and influence. And it doesn’t happen quickly in all places, but a relatively more free economy like that of the United States, it happens at a substantial rate. So while nepotism is still a thing, over the long term, nepotism is really difficult to hold onto unless there’s an aggregate effect of nepotism actually making better products and services for people. Which is why when you run a Fortune 500 company and your ass is on the line for how the stock does, nepotism becomes a really faint whisper. If someone’s like Google had a bad year and someone, and Google’s like, “Hey, you need to hire my son.” The board is gonna be like, “Are you outta your fucking mind? Like, we need killers. We need people to turn this thing around.” When everyone’s ass is on the line, nepotism becomes a cruel joke. And what people really want is raw, ruthless, greedy, capitalism. People that can make stuff happen. And over the long term that means that most of the people that can make stuff happen end up being a real smorgasbord of individuals, most of whom don’t have nepotism. You look at all the best people in the industry around New York, San Francisco, LA, bro, it’s a goddamn rainbow out here. Like, I straight up have a policy of hiring as many Nigerians as possible as I’ve yet to meet a Nigerian that’s not amazing at everything. I don’t give, I don’t know, they’re very distantly genetically related to me. I don’t care. They’re just awesome and so-

-What do you take? What do you take away from the fact that most family businesses fail after two or three generations? I forgot what the exact statistic is.

-Nepotism’s not that great then, huh?

-Well, the question-

-I think most businesses in general fail within several years. So I’m not sure how to put that statistic in line with the family statistic.

-Hmm, because-

-You know what I mean?

-I think about nepotism and how it demotivates. But those people still have generational wealth that continues to earn them money, so I don’t know. But let’s move on off to nepotism topic ‘cause I do wanna discuss about the topic that you brought up, obesity.

-Yes.

-And how it’s impacted by perhaps genetics, social standing. And I’ve had tons of conversations about this with food industry experts, food political people. Just last week, it’s not public yet, but we had an interview with a bariatric surgeon who’s a director of the NYU bariatric program here, endocrinologists to talk about GLP-1 medications. And they all kind of have a slightly different take on all of it. So I’m curious what your take is.

-Well, they’re all wrong. I’m just the smartest.

-Obviously, you’re Dr. Mike.

-And the most handsome.

-There’s no Dr. Mike that’s wrong.

-When you arrive at the Dr. Mike status, you’re just, that’s nepotism.

-Yeah. That’s done.

-Like, get on in here. Enjoy the wealth. (Mike laughs) So this has been a passion of mine for a long time because I’m an astute dilettante, delusional recreational student of economics.

-There’s a lot of verbiage I failed SAT, I can’t.

-Excellent. Excellent.

-Keep up with that.

-Same, so I just made up a few words and I have been poorer than almost every American because I am from the Soviet Union. It’s a level of poverty that is difficult to comprehend. I was high on edible marijuana one day and I had this revelation that back when I was younger and still to this day, I have like an odd nostalgia for the fifties in the United States. “Nah, see,” you know, like the good old days.

-Mad Men.

-That kind of shit. And I was like, you know, I think I figured out maybe why. It’s because in the 1980s in the Soviet Union we were kind of at economically a similar level as the 1950s in the United States.

-Maybe not even so.

-Bro, exactly. I asked ChatGPT and it’s like, it’s usually really polite and it was slightly less polite and more like, “God no, the Soviet Union in the 1980s was like America in the 1910s,” or something.

-Yeah, that’s what I was gonna say.

-I was like, “Oh my God.” So that was thrown out entirely. (Mike laughs) So, you know, levels of poverty to where like people say like, there’s people say like, “I’m struggling to eat.” And you look at them and they have a BMI of 35 and you’re like, that can’t possibly be true in a way that you’re describing it that’s linear. But back in the Soviet Union, like yes. Like getting food was by no means clear a thing that you were able to do every day. So then, you know, I had all these experiences growing up and then I was taught later in various school programs that poverty was a cause of obesity. And I found that to be baffling. And I’ve been trying to digest it ever since.

-[Mike] Okay.

-And I have been perusing various fields of literature to try to align my ideas on the subject. And I’ve come away with some, maybe take-home-

-You mean to prove yourself right.

-And to prove my, not just to prove myself right, but to give me that feeling inside that I just got it all figured out. You know? Me, me, me.

-A little cognitive reassurance.

-Generally I just stare at a picture of myself and that’s good enough, but sometimes ideas get in there. So I didn’t like everything I found out. So the following is heavily caveated to say, I mean it all in the best possible way. Don’t kill the messenger sort of situation.

-We’re gonna kill you. Don’t worry.

-Oh, oh God. (Mike laughs) There’s a few people in the studio. Which one is it coming from? So as long as I’m sacrificed for big pharma, all as well.

-[Mike] Yeah.

-And here’s kind of how it looks to me. The typical argument or arguments for poverty causing obesity, if you ask a next level of questions about them, things start to fall apart. Level one of questions is like, how do people with more resources with which to buy food end up buying less food?

-Can I play devil’s advocate on all those questions?

-Absolutely, every single one, because I have many retorts to every single advocacy point-

-Perfect.

-You’re gonna bring up. In all likelihood.

-Okay. So say the first question. How do people with more resources, sorry?

-How do people who are wealthier seem to be consuming less of a thing that costs money than more? It at least requires a more complicated logic and as you know with Occam’s razor, the more complex your logic becomes just on very carte blanche levels of thinking, it becomes less likely to be true. So if someone says, okay, you take someone from the 1600s and you go, when people get richer, they get fatter. They’re like facts. And like, just kidding. It’s actually the reverse. They’re gonna be like, what?

-Mm-hmm.

-At face value seems to be very confusing.

-Sure.

-And so you have to at least-

-There’s a lot of that in science though.

-Sure, of course. Of course. And then you have to start walking down of like, well, what are the intricacies here? And we can address all the intricacies in turn and they start to paint a little bit of a different picture. A picture that is not super politically correct, but also can be I think, more closely aligned with reality. Because one of the big stumbling blocks in reasoning that people have on this subject is you don’t want to be the person that is derisive to the poor as a social class. It’s real fun to make fun of rich people. It’s actively funny. It’s within the Overton window.

-It’s safe.

-It’s safe.

-Okay.

-Not so with poor people. It’s considered unbecoming. In the same way, if you say, well rich people exhibit X, Y, Z qualities ‘cause it’s their fault, people are like, “That’s right. Fuck ‘em.” You say that about poor people, a lot of people don’t like that because it gives them very sad feelings inside. We should not be bound by how we feel about things to be able to elucidate what is actually going on so that in that third order we can help everyone, including poor people, navigate difficulties better.

-[Mike] Sure.

-So the idea that we’re gonna pretend that poor people are sort of like protected against any kind of moral reasoning on our behalf, I think just needs to be discarded right up front.

-Well, let’s get more specific with it than talking about abstract. Like, let’s say the notion of access of healthy food and the preponderance of processed food in someone’s cabinet that is poor.

-Sure.

-Much higher likelihood to have cheaper food that is likely

To be ultra-processed. That is likely to create a habit of overconsumption, less satiating food, and as a result, potentially lead to their obesity. True or false? - True. - So then what's the retort for it?

Highly processed, convenient food is by no means the cheapest kind of food there is, not by a long shot. The cheapest kind of food there is, by a long shot, is largely unprocessed basic food like bulk-bought rice, not even bulk bought. Any kind of white rice, canned vegetables, reduced-price high-fat meats, and other such products. Canned beans are almost free. Calorie per calorie and nutritional content, for nutritional content, they're undefeated. There is a diet. - How do you know that? - Through looking into it substantially. - What are those people not doing? - Which people? - [Mike] The poorer people. - Oh boy. So that's its own thing. But just to finish the thought really quick, the real cheapest way to get the best nutritional food is to buy those kinds of essential basics and not convenient snack foods.

Personal story time. Not that this matters, just personal stories are mostly just like, oh, I'm an NF1. Just for the people that'll be like, "This guy's rich, whatever." My parents were highly conscientious when we came to the United States, and the first time we had McDonald's was like, two years into being here, and it was considered an unbelievable treat. - Yeah, same here. - Same, right? - Yeah. - That is like- - I remember being with my dad and my friend, and I wanted a burger really badly, but I knew my dad would have to pay for a burger for my friend. And I was like, I'm not gonna ask for it because I'm embarrassed. I don't want him to pay for it. - A hundred percent. - Yeah. - Yeah, so like that clashes substantially with the conventional narrative of well, burgers are cheap. Like, compared to what? My parents and your parents were buying basics type of food, I suspect, mine were for sure. I can't speak for you, but it seems like they were. - Yeah. - And so that already puts a little bit of a situation because people like to envision that poor people are all relatively homogenous. That's absolutely not true. We can at least bifurcate them into two categories that we did earlier. Poor people of higher conscientiousness, poor people have lower conscientiousness. If you say they're on the same- - But that's not the only factor. It's hard to say though that's the one dividing factor. - It is probably by far the biggest dividing factor into how life outcomes occur for almost everyone, short of intelligence. - So social experiments like the marshmallow experiment, the delayed gratification of it all. Do you believe that that is a signal of conscientiousness? Jesus Christ. - (laughs) That took a little while. - [Mike] Yeah. - Yeah. - Why has the replication of it been a disaster? - Well, that's the one that's done on like four-year-olds and shit, right? - Yeah, they had the kids come in and they tracked them for their lives to say like, those who exhibited delayed gratification were able to have higher SAT scores, decreased crime rates. Like basically what you're saying, that they were able to exhibit this one factor at this age and that on the whole projected a greater success in their life, what we deem success. And then when we try to replicate that, we A, don't see that same pattern occur. And B, when we re-look at the past data, we see that the poorer kids who didn't have marshmallows just grabbed at the first marshmallow and then had lives that were in a position where they had less access to education, to proper discipline, to those things that perhaps poor kids don't have access to, then have worse outcomes. So it was like, are we really looking at the delayed gratification or are we looking at a more systemic issue here? And that's an interesting point. - Mm-hmm. The amount of evidence for trait conscientiousness impacting human lives throughout the lifespan is like a million times stronger than the marshmallow experiment, of which I'm not familiar with any serious behavioral geneticists that cites research to that effect for how important conscientiousness is. Psychometricians, behavioral geneticists, if you look up trait conscientiousness, how to express itself in life, the evidence for its enormous power in guiding people through their lives is overwhelming. - When do you measure it? - Say that again. - [Mike] When do you measure it and how do you measure it? - You can measure it at any point in a person's lifespan. The problem with measuring young children is that the correlation of whatever traits you have when you're very young to when you're old is actually quite low. And so like you know when people have like a 4-year-old that's like, "He's a genius for his age," like a lot of times that just ends up being quite regular later. He just got there earlier. But you can measure conscientiousness through a variety of behaviors in an ethnographic context. You just watch people do what they do and take very diligent notes. You can do it in an anthropological context, you can do it in a cultural context, studying different cultures. You can do it with a variety of validated tests like the big five personality, the OCEAN scale. The OCEAN scale's probably the most common one. And you can administer various tests of that nature to people of very many age ranges and situations. And they all give you a hint as to what's going on. But on aggregate, they paint a very, very similar picture overall. - So it's not the fact that there's a correlation between that trait and something else societally in their lives that's going well? - It's both. But there's a causal effect as well because conscientious people over time make different choices. Highly conscientious people make different choices of lower conscientious people. We also know that conscientiousness is profoundly genetic. Maybe 50% of conscientious behavior is accounted for entirely by the genes. The rest of it is a little bit mysterious as to how it aggregates. We're not entirely sure how that happens. There seems to be no very dependable way to massively improve conscientiousness with any kind of top-down intervention that we have done before. Having peaceful communities that give you a decent degree of education probably has some effect on that, but seemingly not as big of an effect on how we want. We also know that what your common home environment was like, how you were raised by your parents. It's almost no effect on your conscientiousness as an adult, if any effect whatsoever. It's actually a little controversial to say almost no effect- - Well, what about the effect of emotional regulation? If you have higher levels of what we call adverse childhood experiences, your emotional regulation is lower than that of someone who has less adverse childhood. - Are those studies controlling for genetics? Because almost none of the studies- - How do you control for genetics? - Twin and adoption studies. - I don't know- - Because when you look at the twin and adoption literature, a lot of that stuff completely disappears. - Yeah, I haven't looked at it specifically within the twin world, but knowing that you just said it's 50% genetic and 50% something else that we don't know. - [Mike] Roughly, sure. - What does that mean for the fact that those who are poor are more likely to be obese? - Yeah, so I can split it as I can simplify the matter. Two kind of different kinds of poor people. One kind of poor person has all of this kind of social burden foisted upon them, and they're doing their goddamn best. They're scrimping and saving, they're thinking long term. They're concerned about their health. They're concerned about their body weight. They're concerned about the choices of what kind of foods they're putting in their bodies, how it affects other things. They're trying to raise their children in a very diligent way. They don't spend excessively and so on and so forth. Like I said earlier, those people don't tend to stay poor over the long term. Sometimes through a variety of unfortunate circumstances, they stay poor. Like someone who's incredibly conscientious but has an incredibly financially burdensome medical condition will continues to stay poor and conscientious, which is a tragedy obviously. But there is another kind of poor person who is also poor, but exhibit very low trait conscientiousness, which means they just have a one-day, one-minute at a time what I feel like doing massive bias in their thinking and then the choice structure. - The emotional regulation of it. - Sure. The emotional regulation presupposes there is a desire to regulate emotion. There two ways emotional dysregulation could present itself. One. - Yeah, I mean the ability, whether or not they want to is a different thing. - Sure, but conscientiousness speaks to wants. People who are conscientious but have, let's say profound attention deficit disorder, know they need to be making better choices, desperately pray to God they can make better choices, but just keep getting off track because they can't maintain their attention and have a high degree of impulsivity. People of low trait conscientiousness don't care about making good choices nearly as much as they care about what's gonna be fun and pleasurable for me to do now. And it's not even a value judgment. Fuck it. YOLO is a way of life, bro. And it's fucking, a decent way of life, but it's going to lead to different outcomes. So if I am a poor person in the United States of a high degree of trait conscientiousness, I can easily make a variety of choices that will entirely prevent me from becoming obese in many circumstances. There's another component to this, which I'm excising for now, about food drive, which is also mostly genetic, which is critical to this discussion. I'll leave that for just a little later. If you are poor and someone tells you, well, I don't expect you to be fit because it's impossible for you and you have high trait conscientiousness and you've thought this through it for like 15 minutes, you're gonna be like, Planet Fitness costs $10 a month. It's also irrelevant to go to a gym 'cause you could do body weight exercises and have a high degree of physical activity for free anywhere. Any food you eat, you could just eat less of and become however much body weight you want. And if you're struggling with hunger, you can buy less palatable, actually more expensive foods and buy basic beans and rice like abuela raised you to eat. And all of a sudden like you just don't overeat that 'cause it's just not that good. We've seen that one of the sole explanatory factors for the rise in obesity is the ubiquity of high-palatability foods everywhere super cheap. If you don't access those, it saves you money and you become more fit. So the actual impediments to achieving fitness and health to poor people essentially almost don't exist, if you have trait conscientiousness very highly. If you have low trait conscientiousness, it doesn't matter if you're rich or poor because you're just gonna YOLO the shit. You, whatever you feel like eating, that's what goes in. And McDonald's just tastes better. No, you're not getting spaghetti, steak, and shrimp 'cause you're not a rich motherfucker, but you can afford very high-palatability foods, you know, chips and soda and ice cream. That's all very affordable to you, and that's what you want. And if people say like, what about your fitness and health? Generally your opinion is like, eh. And that's a totally fine opinion, but it's going to lead to some kind of outcomes. If you're ultra-wealthy and low conscientiousness, there's a high probability you're gonna end up exactly as fat as someone who is poor and low conscientious. There was a study that came out about 10 years ago, studied food deserts, I don't like that term. Highly insults people who have actually dealt with real food insecurity. You go to the Soviet Union in 1988, that's a fucking food desert, right? And they took a look at the data and they said that people who had vehicles, access to vehicles to leave the food desert to go to mega-conglomerate grocery stores became and were fatter than the people that didn't because they had the same low conscientiousness and not a distinct desire to be fit and healthy and lean. So when they went to the bigger mega grocery stores, they just got even better versions of the same fun snacks that they had slightly less access to inside the food deserts. So a person's individual proclivity of how they want to eat and what they wanna put in their bodies, whether or not what degree they care about it is something that's not discussed much in the medical community. Because again, like first of all, what are you gonna do about it? Telling low-conscientiousness people, they have to care about their body weight and their health and think forward. It's usually very ineffective. It's insanely pedantic and paternalistic. And doctors usually have a very realistic approach. I'm gonna try to help you in the way that I can, and if I tell you to eat healthy and you don't listen to me, we're going on medications, is just the only thing I can do. So when you take a look at the two sort of very artificial groupings of poor people, if you have high conscientiousness and you're poor, all of the systemic factors keeping you obese seem to disappear almost entirely. And if you are of low conscientiousness, whether you're rich or poor, and you have a high food drive, you're gonna be obese 99 times out of 100. - Eliminating highs and lows, 50th percentile people. They're the ones we're talking about when we're talking about generalizations. So why are we talking about high conscientiousness versus low? - Yeah, because- - Let's talk about middle. - [Mike] Sure. - Where the majority of people live. - Yeah, yeah, because poverty- - [Mike] Within one standard deviation. - Totally. That's a great question. On average, on average, poor people tend to exhibit lower trait conscientiousness than richer people, than wealthy people. - Which could be due to social factors. - Maybe. - As you said. - Maybe. The social factors are definitely a component of that. But we know that genetic factors are a massive component of that as well. And whether or not they're social or genetic, the conscientiousness is such a huge effector variable for everything else that that's kind of where the rubber meets the road. - So are you saying we need to target the conscientiousness of people in order to actually make change? Not actually the food deserts, not what they're eating. The trait is what we need to figure out ways to impact. Is that the takeaway of it? - No, I think that's a fine idea. My contention is that if we target food deserts, if we target big evil food companies, we are not targeting the core onus of why obesity is higher in poor people. And the reason it's higher in poor people is a two-factor situation. This is really explains, I think probably 80 plus percent of the variant- - This is your theory. - Hypothesis. Yeah, theory is a gravitation evolution, et cetera. Much lower than theory. (laughs) - Right. I say theory in the non-scientific way. - Yes. Stop doing that. - Yes. - (laughs) So, the biggest determinants of your body weight and proclivity to obesity in the modern world is gonna be a a two-factor system. Your trait conscientiousness degree of that and your degree of food drive. How much do you like food? How much do you like to eat? How big of a deal is tasty food to you? You no doubt have some friends that like, they'll eat like three and a half chips and they're like, "Nah, that's pretty good." They just sit there, you're like, "The fuck?" I get into some chips, I eat the whole bag. Food is amazing. Not everyone is like that. Right? - [Mike] Sure. - So if you have someone who's of relatively low trait conscientiousness and they have a high degree of food drive, even if they're poor, they can still afford to be grotesquely obese. No problem. In the modern context, back in the day, that was not the case. - Of course, yeah. - If you have someone who's wealthy and has any given food drive, they definitely have more of an arsenal to shoot. They can buy foods that are more filling but are still tasty. Like very Trader Joe's, Whole Foods type of shit. - [Mike] Yeah, yeah. - That definitely has an effect. But they have to have some impetus to go buy those foods. - Also pharmaceuticals. - Uh, yeah. - 'Cause access of pharmaceuticals especially these days is a big difference. - Just recently for sure. Just recently. 'Cause like just, two years ago we just, no one knew about Ozempic and no one even used it. - Well, bariatric surgery existed. - Totally, yeah. You know, very extreme situations. Again, most people, people of low conscientiousness usually are not interested in bariatric surgery because they're like, "Why the hell would I go do that?" It doesn't make sense to them why you would do that 'cause they don't seem to have- - Again, we're talking about low conscientious versus the average. - Correct. So again, on average you have many more, a larger fraction of low conscientious of people that are poor than are rich. - But the reason for why they're there, we don't yet know. - We know some of it, but we don't even need to postulate that because we have this thing of poverty causes obesity. That's the notion. Actually a combination of high food drive and low conscientiousness cause obesity. - Food drive. - And it just so happens that people who are less wealthy on average also have lower trait conscientiousness. - It's like the situation with vitamin D, that those who have lower vitamin D levels have higher rates of certain illnesses, but then supplementing the vitamin D past the norm doesn't actually reduce the outcomes of those diseases. - Sure. - So, much in the same way when we talk about food drive and you're talking about someone as that being one of the two variables- - Major variables. - That decide whether or not someone is obese, food drive is so impacted by social situations. One, if you're depressed, which if you're poor there's a chance that you're not getting help for your mental health situations 'cause we don't have great access to that in America. If you're poor, you have worse likelihood of developing adverse childhood events that lead to mental health conditions. You are likely to have been targeted by big food companies in their advertising, which has been proven through research for addictive products like ultra-processed foods, cigarette companies will specifically target their advertisements based on zip code, based on poor- - Yeah, that's curious. I have a reason for why. Those people like those things better. - Right. - They buy them more. - Correct. And that could be an education component, that could be a genetic component. It's probably a multifactorial component. - [Mike] Yes. - But why I find that interesting is because once those people are hooked on the product in a way where not that that food is addictive, and yes it's true, it is addictive, and once you consume ultra-processed foods, you're constantly hungry, not satiated, you're craving all that stuff. But also once you become obese, your epigenetics change of the fat cells. There was actually a recent study that came out. Eric Topol shared it on Twitter where, again in mice, so I have to give that prerequisite. - 92% genetic similarity to human study. You can extrapolate. - But still I generally don't like jumping from mice to humans. But it is not illogical to see how the creation of fat cells for storage then can impact your behavior as years go on. And the difficulty of escaping from those circumstances. So if your child that is born in an area that's poor, these are the things that are likely to happen and they're not gonna happen in every circumstance. Worse education, more targeting by big food companies, worse social situation from a mental health component, high likelihood of being fed ultra-processed foods by parents, which then raise your risk of being obese then sets you up as an adult to regain that weight even if you try and lose it in a much easier way than someone who never had that issue that grew up wealthy. And then you're saying here that the only reason is because of the trait conscientiousness? - Definitely not, I was explicit that it was not the only reason. - But those two. The food drive and the trait. - They probably account for I think, something like 80% of the variance, yeah. - Over what we just said? - Yeah. So all the other stuff you mentioned is insanely influenced by trait conscientious is the baseline variable. The reason that people have, let's say a more crime-ridden environment is because more people around are low conscientiousness. The tie between conscientiousness and criminality is insanely high correlation. So some of those same people are more likely to be criminally prone. They're less likely to take care of their communities leaving trash everywhere. They're more likely to make rapid choices based on desire and thus make you next to them, the proxy target of big food advertisement. Big food didn't try to target poor people just because. You'd much rather target rich people with every product you sell because they have more money to spend. Curious why they would target the poor. Because there are some large fraction of them that are low conscientiousness to begin with that want these sorts of things. They are attractors for them and they are the progenitors of many of these bad circumstance. Trauma doesn't come from the ether. Trauma comes from people being nasty around you. Most nastiness in humans is because people have a high degree of impulsivity and just kind of do what they want. That is the same variable of low conscientiousness, basically in some large component, not totally, describing why things are the way they are with very poor communities, let's say in the United States. - I think the difference in our hypothesis is that I see how you've gotten to see such a strong correlation between low conscientiousness and outcomes in obesity. - Causation. - That's what I was gonna get to. I see the very strong correlation that exists there, but at the same time I see the very strong correlation as well as poor education, difficult circumstances, all those variables that are also very strongly correlated. And I wanna know how you jump to the causation without having a trial that impacts the trait and then seeing a better outcome, when you said that that trait can't really be changed. - Yeah. Behavioral genetics, twin and adoption studies, genealogy heritability studies that show that your genetics is profoundly important as to how your life lays out in front of you. Everything else becomes usually secondary unless it is extremely, extremely different from the norm, which definitely explains some of the variation with really nasty growing up circumstances, but not as much as many people would think. So if you ever dip into the behavioral genetics literature, and I encourage everyone listening to give it a shout, don't expect to be very cheery at the end of that dive. It's a real thing, man. It's a real thing. - I certainly believe it to be a real thing at the extremes, at the highs and lows. But I think when you look at 75% of the population, I can't imagine it being a causative factor to the degree that another random variable is. - I gotcha. So I'll cite a couple of offhand random studies. - [Mike] Yeah. - Just for illustrative purposes. There's at least one study that showed that past the age of about 12 or 13, your common home environment where you grew up has almost no effect on your eating habits because they did it with twin and adoption research and they found out that if you came from a genetic stock of people that were prone to obesity or prone to making food choices that were more snacky, junky kinds of foods, if you were adopted into a home that gave you healthy foods as a child, child, up until teenage years, you ate what mom and dad made you, healthy food, the whole thing. Then as soon as teenage years hit, you were able to make your own food choices. You veer so far into the average predictive of what your parents used to like that the degree of influence of your parents, adoptive parents' healthy eating instructions are almost undetectable, insanely rigorous research keeps coming up over and over again. Any parents who have had children listening to the show, if you've had one child, you can attest to the fact of how great of a parent you were and how your effects made them who they were. As soon as you have child number two, you realize, holy shit, we're shooting in the dark. Kids kind of become sort of whatever the hell they were supposed to become and we have barely any effect. And anyone who thinks they have a large degree of effect on a teenagers, I dunno, insert joke here is large degree of delusion. The conventional wisdom on how education works and how upbringing works cannot possibly survive the rigorous data that shows that, for example, as I stated just now, food choice proclivity has almost nothing to do with a common home environment. - After age 12. - Correct, people- - And what about before? - Before it, it has a ton to do because you don't make the choices that you have. Like, they put stuff on

Your plate and you eat it. And don't you believe that if you're set up before the age of 12 with bad habits that potentially create a childhood obesity, that you're gonna have worse outcomes as you get older?

Yeah, for sure.

So then how are you saying that those social impacts are not equally as causative as the trait?

Because when you look at the behavioral genetic data, the social outcomes at the extremes can absolutely have an effect. But most of what you think are the social outcomes is literally just the expression of people's genetic proclivities over and over. Mom and dad have the same ones. You have the same ones. And if you try to get kids to eat hyper-palatable food all the time when they're younger, it definitely affects them when they're older on the margins 100%. But it doesn't affect their proclivity to make the same choices when they grow up. They're gonna start eating healthy and thinking of the future as soon as they become teenagers just like their actual mom and dad did. And then they're going to have extra adiposity and struggle with it. However, unless you become profoundly obese as a child, childhood overweightness generally resolves itself as teens mature unto adults. Because unless you continue on the path of egregious overeating, more or less, you can grow out of considerable chubbiness as you get older.

I would like to see the data on that.

Yeah, sure, sure.

How many kids that are obese and what their rates into adulthood are?

Sure.

I don't know what they are.

Sure, sure.

Do you know what they are?

Not offhand.

Oh.

No, but it's things that happen in your childhood can affect you long term but don't seem to affect you long term, nearly as much as people would think because your genetics become more and more an effector variable that's better and better detected as you get older.

In deciding causation, right? We think about changing a variable, randomizing it and seeing what happens. If I could wave a magic wand right now and stop food companies from advertising to children hyper-processed foods, especially in poorer areas, if I create access in food deserts, I know you don't like the term, but in areas where there's less fruits, vegetables for sale and I sell more of those foods, less of the ultra-processed foods, even through an authoritative method, if I greatly improve mental health support, maybe even medication in poorer areas.

What's the mental health thing have to do with it?

The mental health thing is that some people overeat as a way of coping through difficult moments.

It's because they have high food drive and that's a very happy thing for them to do. That's profoundly genetic. Many people in their most stressful time cannot eat.

Sure, but it still doesn't change the fact.

Sure.

That when they're sad they eat.

Sure.

And if they're more likely to be sad in an area where they can get help for mental health issues.

I think these people also eat when they're happy. Celebratory eating is a cultural universal.

It is. But I'm talking about the poorer outcomes where there's worse social outcomes.

Yeah.

And there's worse mental health support.

Yeah, what I'm saying is people with a high food drive don't need any stress to eat more. They don't need any less stress to eat less.

Yeah, I don't like doing the highers or lows because that's not representative of the average.

We're not talking about the average. We're talking distinctly about highs and lows because we're talking about poverty versus wealth and its effects on obesity is a conversation exclusively of highs and lows. Because in the average, actually you can't disaggregate anything and who knows what's going on.

Yeah, I'm saying in the average human, not, let's say you don't know and you're blinded to what people's poverty level is, you have to create a graph of what the average is.

Sure. So you're saying a lower degree of mental health on average causes people to become more obese?

Yeah, I think it's a factor.

Is that substantial-

I think it's a correlative factor.

Okay, is there a thing where like-

Well ACEs, that's like the emotional regulation of it all correlates very strongly with people who have issues of crime, issues of overeating, higher rates of blood pressure elevations. So those variables are there. I don't know about the twin studies 'cause I've never looked at those. But my point was that if you wave a magic wand and you fix all those issues that I discussed, you don't think there will be a significant improvement in obesity in poorer areas?

I think the improvement in nearly all factors would be very impressive and hugely helpful locally, not systemically, because you have all sorts of really nasty side effects like drug dealers who deal in food and not actual drugs because now tasty food is illegal and-

Well, I didn't say make it illegal. I said reduce and improve education.

How do you reduce it if you don't make it illegal?

You limit targeted marketing.

Okay.

Because that's so influential and that's outside of our control. There's ways that food companies change what we eat without ever us even realizing that they're doing it. It's the invisible hand.

Yeah, so I guess that's-

Changing government policy.

Sure, food companies wouldn't be, people wouldn't know as much about tasty junk food 'cause food companies don't advertise them. So you only have people who take advantage of that and let's say in the ghetto and bring to young children for sale healthy treats, unhealthy treats they've never seen. And those kids are like, "Well, what is that?" Like Cheez-Its. You ever had Cheez-Its?

Yeah, I'm sure that'll happen.

It'll happen because people want the food.

But the question is what will happen to the number?

Yeah, I think it'll go down. I think these, if they magic wand it, it'll be helpful for sure. Here's my contention. There are a huge fraction of people usually on the political left, who are just moderate reasonable people who have been educated in the United States or the Western world who believe that these variables of social effect food companies, et cetera, are, if not only, the only variables that very close to the only and the predominant variables. They expect the magic wand of external social factors to be waved and fix almost the whole problem if not the whole problem entirely. What you're going to get is almost an inversion of that reality where you'll get like a very serious improvement, 5, 10, 15, 20% of improvement in the problem. And you'll have like 80% of the problems still left over and be wondering why, since we have these amazing educational programs, these amazing programs of reducing food advertising, health, mental health enhancement, so on and so forth, that some people are still demographically much more likely to be obese than others. It is because we ignore the two most primary causative variables, which is conscientiousness and food drive. If you have really quick, if you have low food drive, it doesn't matter how conscientious you are or not, you're probably not gonna be overweight because like food's just not as big of a deal. If you have a very high food drive and you're very wealthy, you can deploy quite a bit of technologies and personal chefs and all that stuff. You'll almost certainly be significantly more overweight than otherwise. But maybe less so. If you have very high food drive and you have a low degree of conscientiousness, you are going to be very, very, very overweight. And all of the sociological variables in the world cannot help you to a huge extent. They can help you to a moderate extent. We're gonna have so much left on the table, they're gonna be wondering why. So what I'm proposing, and this is why I'm so-

Yeah, you're curious.

Passionate about the subject, is I like to take holistic approaches. I like to understand the landscape of the entire issue we're dealing with before going and rendering very, very confident conclusions. For example, if you look at the British public schooling system, there's some public schools that are not so great, I guess, and some public schools that are just unbelievable. And the recent, this is quoting Robert Plomin's work, behavioral geneticist. Behavioral genetic analysis of childhood success in school and after, especially after school, there's the quality of schooling, quote unquote, by ranked school systems in the United Kingdom that you received has almost no predictive effect on how successful you become. And when you see that, and this is insanely rigorous data, what do you have to shake off the page to make sense of that? Because when I read that for the first time, I was like, I almost stopped the car. It was an audio book. And I was like, "The fuck? How?" Like it was supposed to be a thing that you inject education into people and they just get better. And all of a sudden when gradations of public schools explain almost no variance for outcomes after, and there's programs where they rotated kids to different schools, all lots of variation. It has almost no effect. If you knew behavioral genetics in its aggregate before that you could have been like, "I could have told you that." And then you would've been like, okay, we should have predicted this wasn't gonna be a big deal. How do we really address these issues and understand what is the realism with which we can approach the situation? If you didn't know about behavioral genetics, you would've been like, "Dude, we need tons "of funding for all of these programs." And maybe that's a good thing. But then you would've expected it to work. And when it worked on the margins, but not in its entirety, you would've had to contend with the fact that we got, I think we've severely misunderstood the problem. A quick analogy just for folks who are listening, if you are under the guise, under the myth that genetics are not the biggest factor in athletic performance, you can take a scrawny little Jewish kid and try to get 'em into every single soccer camp in the world. I'm a billionaire. My kid's going to learn soccer from like, the Brazilian national team themselves. Day one, you poured millions of dollars into your kid and he's like 16 years old. He's the worst person on his non-select soccer team. And he's like, "I wanna play the violin." And you're like, "The fuck? "I thought I could pour athletic talent into you." And any sports scientist to quote paraphrase Jordan Peterson, "Worth their salt." And it's like hilariously Canadian expression would say like, "That's is not how that works." Sports science is about identifying talent and then improving it on the margins, sort of cultivating it that if you don't have the talent, you ain't doing a whole lot. Now you can get better. But it's a similar thing to the poverty, obesity thing. If we addressed all of the sort of endemic issues that you were talking about, the systemic ones, external social, cultural ones, we would get some decent traction. Yeah, you coach a kid in soccer with the Brazilian national team his whole life, he's gonna be pretty goddamn good at soccer, but he ain't going to the Olympics, no way unless he has mega, mega talent. The same is true about poverty and obesity and those relationships where if we don't address the food noise, which luckily, pharmaceutical companies are addressing now with Ozempic, which I think one of the best things we can do is make anorectic drugs like Ozempic and tirzepatide, et cetera, ubiquitously cheap and available to everyone that needs them. That's gonna make a big hit. Why? Because it addresses directly the variable of food drive. Trait conscientiousness remains. There is no drug you can take that improves it, unfortunately. And it's going to remain this kind of sand grain inside that makes the pearl. It's a constant nuisance that we'll constantly be there and we can have a lot of sociological, oh, we're just not doing enough. You know, education didn't work that well. We need more education. To your point earlier, like vitamin D, once you get enough of it 10 times the dose is technically toxic over the long term. Sure as shit doesn't help. So we have to understand the entire topography, the landscape of what we're dealing with and have to accept straight up that many of the core, most explanatory reasons for why poverty and obesity correlate with each other are outside of our ability to have traction on them in the modern timeline. And going from there, we should make all of the changes that you recommend, which I'm absolutely a hundred percent on board, you know, depending on how they're executed, of course.

Of course, yeah.

That all stuff matters, but it's going to matter a lot less than many people think. I can't speak for you and tell you how much you think it's gonna matter, but because of what we know about behavioral genetics and how causality works in this case, it's gonna matter substantially less than you think. And if anything else, it's disheartening. You did all this stuff and then what happened? Almost nothing.

I think that's the only point we disagree on. I think the trait matter of it all, the food drive of it all. You created this 80/20 guesstimation formula. I can't even argue against it 'cause I don't have the evidence to argue against it.

Sure.

And I don't think that you would even fight if someone said it's 70/30.

No, sure. No problem.

Right? Because it's an almost an arbitrary number 'cause we don't have it

Yeah, it could be 30/70.

Exactly, yeah. But I do believe that these traits matter. The way that I think about it as a practical clinician because I'm not a researcher, is you hear that we can change the 20% with that magic wand that I was talking about. And you say that's not the 80% that is really the issue. And I view it as 20% decrease in obesity rates gets us under the average person in America being obese. That's a monster win for me 'cause if we're, let's say, at 60% obesity in the United States, if we get 20% drop off, we're 40, we're less than the majority.

Yeah, the way I'm contextualizing it, it's gonna be 20% of 60. So it's gonna be whatever fraction that ends up being.

I don't know what the exact number is.

Yeah, yeah, yeah.

Sam, can you actually look up what percent of the United States is obese right now?

No, no, no. That's not my contention. I'm saying that if obesity is a problem and you solve 20% of it, you don't get an absolute 20% reduction.

Right. Yeah, of course, yeah.

You get a relative 20% reduction.

Right.

But so in any case, like Mike, I really, I love that point. I think I'm looking at it from a little bit of a Sowellian pessimistic take of, well, geez, like we're not even addressing the two biggest factors in the room. And it's totally fine to address all these other factors.

Well, we are now.

Well, sorry. Yeah, as a society or whatever. Policy.

And also, just to put in perspective from the bariatric surgery side of things, which has been ongoing for 30 years plus more than the GLP-1s. The reason bariatric surgery works is partially because how it impacts your food drive.

Oh yes. Almost entirely why it works that way, yeah.

So this is not new, medicine trying to impact food drive.

Sure.

This has been going on since before I started practicing medicine.

Yeah.

And that's number one. Number two, medicine usually practices on the fringes.

Yeah.

Like when we talk about vaccinating kids and we talk about saving hundreds of lives, someone might look at that and say, "I don't find it worthwhile to vaccinate kids "to save hundreds of lives."

Sure.

But we do, and science does. So yes, there's very little control that we have of ultimate human outcomes because controlling one, two, three, four variables in the grand scheme of life is usually ridiculous in thinking you control the ultimate outcome.

Yeah.

Which is why I don't like protocols that say like, oh, if you ice bath, you can create X, Y, and Z. I'm like, come on, man. One variable, especially such a small variable, is not gonna have some meaningful substantial change that we should give it this much air.

Sure.

But those issues to me that if we can change those issues, A, we get some benefit, even if it's not the majority of the benefit. B, the obesity change isn't the only benefit that we get when we change those things. If we change education, if we change their ability to-

What do you mean by education? I'm curious. That one I have a lot of ideas on.

Okay, when someone walks in to one of my man on the street interviews and I ask them a question of like, "What nutrient is most prevalent in your banana?" And they say protein, the odds are that they are from a worse education background from a health literacy standpoint is higher. Fair to say?

Mm-hmm.

That happens very often in lower economic schools, education systems, because there's not as much motivation to learn about those things. So the sales of a 64 ounce Slurpee is much higher in that area than it is in Greenwich, Connecticut. Some really wealthy area. Why? Partially because of education.

Nutritional education is a perfect example of a variable that is talked about as a preeminent variable. Here's one of my beefs with this. Coming up through the educational system in all of these fields, you're not really taught that. We were never taught that food drive was a thing that was largely genetically correlated. This is never talked about, we were never taught about conscientiousness. We were taught about things like nutritional education, empowerment to make better nutritional choices, monetary limits, advertising-

I think we weren't taught about those things because we didn't know how to impact them.

When I learned about these things, they were taught as a theoretical basis for why things happen. Whether or not you can impact something is very different than theoretically does it caused by something else? And so I think the reason that they theoretically were not taught is because most people in the end of the field didn't ask the question. Because most people in those fields are intellectually biased to the political left to begin with and do not to like to look to genetics and deep social forces outside of our control.

Why?

Why do you think they do that?

Because it makes them very sad about the state of affairs and it disempowers them. They believe in human malleability. They believe that no one can be blamed for anything. That it's social forces externally, all the way up and down and those are if not the only, the by far predominant reasons why people end up different is because of social forces. That is like-

But don't you think they always, like barring the extremes. Most people will say that it's a mix of nature and nurture.

I'm not talking about most people, I'm talking about the educational establishment.

In the educational establishment. You don't think they would say that it's a mix?

No. No. It's, you can lose your job for saying it's a mix. If I was still working at the university, I would never give this interview because saying that poor people on average have lower conscientiousness. I'm still worried about this going out. Holy fuck, that's insulting. If you're nuanced, then you're smart. You can understand how it's both real and not insulting. But if you're anything else, and if you're very politically motivated, it's gonna be a nuclear bomb. You're blaming people for their problems, even though in their private life everyone knows people are largely to blame.

I don't know. I don't if you're blaming. I think you're trying to establish a cause for why something has developed. I don't think you're necessarily putting blame on an individual.

I totally agree. (laughs)

Whether that person is conscientious, especially as you put it genetically, you're almost not blaming them. You're almost dissolving of the blame.

That's a very interesting way to look at it.

But aren't you?

Most-

Is that fair? Because you're saying genetically you have this predisposition to this trait, therefore it's not up to you. Determinism.

I think the concept of blame is one that the longer you look at it, the more it falls apart anyway. I don't like to deal in blame. I don't even know what that means. I like to deal in causality instead of blame. Blame is like an emotion you have inside from ancestral times when the police and court system were not there to enforce things. And by blaming someone, you could paint them in a negative light and interact with them less.

I think we're gonna get into this no matter what. Do you believe in free will?

No.

Oh, cool.

And I think that, (Mike laughs) yeah, sure. But I think the concept of free will is preposterous on its face. Because people will say, well, what about quantum mechanics and randomness? Because that's random will, it's still not free will. So I don't think there is a space for free will as most people understand it in a modern intellectual landscape. But at the same time, in your brain, you have a machine that decides what you're gonna think, which is out of your control entirely. And you have a part of that machine which reviews all the contents of your mind and decides on aggregate, am I gonna make this decision that I just thought of or not? And so the combination of having self-awareness and an ability to take all the information you know and aggregate it to not just my recent proclivity, but also everything else I know certainly makes a system that acts as if it has free will. But you really let lens down into it, it's not free at all. It's entirely mechanistic.

So what would you say people watching this that you're afraid of, that they'll say about you?

I don't give a fuck. That's why I'm here.

Well, no, but you're saying that you're worried about it going out. What are you worried about? Or why would you get fired?

Yeah, Mike's-

If you were so worried?

Mike's a Nazi.

Come on. For real.

No, I'm serious. Check your comments. Check 'em now.

(laughs) But in reality, you think they would call you a Nazi?

Yes.

And why would they call you a Nazi?

Because the Nazis took the idea that people had genetic differences that impacted their behavior and decided the end run best way to deal with that was to kill millions. I think there's a really big problem with the killing millions part.

And are you that?

(laughs) Do I have to answer directly?

Yes.

Yes? Israetel, that'd be a fun Nazi name. I am a politically very closely aligned with libertarians. I'm a secular humanist. And so I think anytime a complex human being dies, it is an unmitigated tragedy. I think that killing people and putting them into camps is abysmal. But you can reason yourself through sociological effects only and do the same thing. Evidence, Joseph Stalin and Mao Zedong. They didn't believe genetics had any effect on anything. They believed it was all sociological. What did they do? Put people into camps, toast 'em by the tens of millions.

You can weaponize any philosophy.

Oh yeah, sure.

To any extreme.

But if you're on one extreme or the other, you tend to weaponize the opposite.

The opposite, yeah. But you're still extreme 'cause it's still weaponizing.

For sure, it just so happens that most of the community, the intellectual community in the United States, the collegiate intellectual community is wildly left-wing biased for a generation and for three generations now. The problem is getting, let's see if it's a problem it's getting worse. It's becoming more and more of a thing that the campuses are attracting more and more left-leaning people. And so when we're talking about looking at this from a grander landscape of what really is the cause and effect situation for why poor people tend to be obese more on average? You're getting a very, very biased view from most of the academic establishment. They neither teach the basic theoretics of it. If you bring it up in class, you're lambasted as like having borderline Nazi thoughts and the whole thing.

But like, if you bring up food drive, people will call you a Nazi? I don't understand how that happens.

If you say food drive is mostly genetic, the right-wingers will say you're excusing people's willpower thing.

Okay.

And the left-wingers will in some situations be like, see? But then when you tie genetics to other factors, let's say racial factors, they're like, holy shit. Hitler reborn.

Hmm.

There are lots of people. The world has many beautiful things about it, it has many ugly things about it. And when you go, "Hey, this ugly stuff we should be looking at," there are lots of people that go, "Yeah." And there are lots of people that go, "You son of a bitch, how dare you?" And as intellectual, you know, every college

Campus says they're for intellectual curiosity and freedom of speech and freedom of thought. And in the United States, almost none is or isn't. You and I could sit here and really get, make fools of ourselves and get canceled by going, "What was Hitler right about?" You know, he was right about a lot of shit, right? He was a fucking murderous animal who was wrong about the core tenets of his philosophy, but he had a little stuff that was correct. Order, social responsibility, personal responsibility, pride in the greatness of your nation. That's fucking awesome stuff. We don't need to jettison that.

But people tend to feel so much more than they think in many regards that like, soon as you bring up, "Oh, I'm doing free thought, I'm doing cost-benefit analysis. Let's look at Churchill, Hitler, and Stalin and see how their philosophies differ." You know, cost-benefit, pluses and minuses. That intellectual exercise is damn near forbidden on college campuses today. So the idea that we have free thought has largely been jettisoned. Like I went to the University of Michigan as an undergrad, a phenomenal institution, but damn near a propaganda machine when I went there. They were like trying to get you to believe a certain version of the world that felt really nice for people on the political left to believe. And so they jettisoned entirely entire classes of introspection and trying to figure out what's going on, such as behavioral genetics, such as true cultural differences and where they stem from. They had an idea that you could re-architect external society to make any change that you wanted. That idea is wrong. It's always been wrong, but it's not completely wrong. It's partially correct. There's like, to your point earlier, it has some traction. You can change society and make people's lives better, even if they're the same people. But what you should expect out of that is a much more mixed picture. There's a lot of situations where you think the core variable of social, you pour tons of social resources into it, it changes up to a point, then it doesn't change anymore. And your answer is like, "We just need more social stuff." And that is the wrong answer. But if you're not willing to admit that this other thing even exists, what the hell do you do afterwards? That's a real curious situation.

"Yeah, I guess the real research that I would like to see is what can we do to impact this trait?"

"Like food drive and conscientiousness, respectively?"

"Yeah, well, food drive, we kind of have some at least beginnings of evidence for."

"[Mike] Correct, yeah."

"But for conscientiousness, as an example."

"And you can ask the same thing about intelligence, probably the single most beneficial thing you can have. I always go back and forth in my head as to which one is more effectual, conscientiousness or intelligence. But together they are the single biggest effector variables for everything else that happens in your life. If you are intelligent and conscientious above average, you're gonna be doing some really interesting shit. If you are significantly below average in conscientiousness and intelligence, there's a high probability you're gonna be in jail or highly unaccomplished and poor and making terrible decisions all the time. If you ask the question of how do we increase people's conscientiousness and increase their intelligence? Some of the answers are very straightforward. A cultural reinforcement of high conscientiousness like, 'Hey, save your money.' You know, it's better to think of the future, things like that. But now the political left in some extremes is so insane that even trying to say that to people is considered paternalistic and entirely outside."

"Yeah, but there's the exact opposite happening on the right-wing side where it's weaponized in the other direction."

"Totally. Equally as unhelpful."

"What I probably should have asked very early on in this conversation that I didn't, is when you say that there is a genetic tie to the trait of conscientiousness, what is that gene that you're looking at that you're describing? Because to me, when we look at a trait that is something that we've sort of elucidated on tests, but what actual gene are you looking at?"

"So it's almost certainly polygenic, which means hundreds if not thousands or more genes are responsible. This is true for intelligence. There's no intelligence gene, but there are lots of genes that have small fractional, mini percentages effect on intelligence. And in the aggregate, they make you much smarter or much less intelligent; conscientiousness is the same. You can track a lot of what conscientiousness is and how it acts by analogizing to child development. Every single 2-year-old is the least conscientious thing you'll ever meet in your life. They don't have the neural architecture to think of the future, mostly because they don't have a well-developed prefrontal cortex."

"[Mike] Sure."

"So prefrontal cortical development is probably really, really tied causally to conscientiousness. So if you had some wacky idea to genetically engineer people and you found a way through 150 genes to push the prefrontal cortex into more aggressive development, accounting for skull size, et cetera, then that would probably be something that would be a fruitful, you know, like if someone's profoundly athletic and has an amazing sense of balance, they probably have a larger, more well-integrated cerebellum because that is the seat for that kind of action. So these are all just like the brain is a computer, these are all computer properties of the brain."

"Thinking about traits like this historically has been problematic. You mentioned the Nazis."

"Yeah."

"How they weaponized it."

"It's not what they did that was a problematic thing. What they did was just killed millions of people."

"Right. Based off of that logic."

"[Mike] Sure."

"Again, their action is the issue."

"Yes."

"Self-esteem era of the 1990s elucidated that having high self-esteem was a big contributing trait that led to success from childhood. So we instituted participation trophies, praising children even when they're failing, creating a higher level of narcissism that perhaps didn't exist before. And largely we've seen it as a failure of modern psychology, of trying to institute false self-esteem."

"It's very well-intentioned and very from the political left."

"Very well-intentioned. And frankly, I don't care which side it comes from."

"Just to keep in mind the idea that this is not the first political left thing to come up to the surface to where there's an orthodoxy that you're supposed to accept and it is just wrong."

"Yeah, but there's a right-wing version of that in the past that has happened."

"The right-wing people do not run the universities. There are two types of people."

"Okay, they run the government now."

"Do they? Well they-"

"Literally, every part of the government. Supreme Court, Congress, Senate, legislature, right?"

"We won't get into. Something like 90% of actual government workers not accounting for police and military, politically on the left, just to keep that in the discussion. So the deep state on the extreme is an insane right-wing conspiracy, but in a more reasonable take. Like, yes, most people who actually work in government of all levels are Democrats. And so when Republicans are in charge, they're dealing with a largely antagonistic workforce."

"Which is great 'cause checks and balances are awesome."

"When Democrats are in charge, then it's bad, right? The corollary has to hold true."

"Well, I don't think that's necessarily true, because I feel like the pendulum swings in both directions."

"But it doesn't in the actual running of the day-to-day government."

"Yeah, I don't know what is the actual predominance of government workers."

"Yeah, it's 90%."

"I'm curious."

"Yeah, but just to say like-"

"Yeah. Well we did the well-intentioned self-esteem thing, right?"

"[Mike] Yes."

"I read a book by Roy Baumeister about the power of willpower. Have you looked at that? Any of his work? So there was a thought that it's not self-esteem, it's willpower. That's the thing, that if you have good willpower, you actually get better outcomes. And that's the one factor, we need to focus on boosting willpower. And there's little things that we can do to impact our willpower throughout the day, throughout our lives, et cetera, et cetera. And that's also fallen out of favor because we've seen that artificially trying to change this trait doesn't really help."

"No. Okay. So does it not help or does it not work? Like is willpower enhancement actually not something we can gain traction on? Or is it the fact that the people have substantially improved their willpower in a robust way that lasts and that doesn't still improve their lives?"

"That I don't, I think that-"

"It's probably the former."

"We don't know which of the two it is. We just know on a clinical practical sense, it doesn't."

"Yeah, so that comports back to the whole behavioral genetics thing. There's only so much you can change for a person's expressive psychology with external factors, even from childhood, definitely in adulthood. So the idea that you can change someone's general ability to yield willpower, which we express as discipline is curious. And the behavioral genetics literature would be like, you probably can't make much of a difference. That's the thing is both intelligence and conscientiousness seem to be deeply genetic. And if we have a robust plan to genetically engineer anyone who wants it, now we got a real solution going. Short of that, we should do our very best in every regard that you expressed on providing social services, so on and so forth. We cannot expect miracle resolutions to many of these societal issues because, and I'll say it very plainly, it's dope to talk about nutritional education and it helps many people on the margins. But when you try to educate someone who doesn't give a shit about what goes into their bodies, who cares? It doesn't matter. And the reality is that many people like to engender ideas of who they're helping, having met very few or none of the people who they're actually trying to help. If you talk to a lot of people who are very substantially overweight, a humongous fraction of them, sometimes in words, depending on the context, almost always in action, don't really approximately give a fuck to do anything about it. Many of them do. And those are the people who you're gonna be able to help a lot, but a lot of them don't. And the thing that, that revelation that you get from behavioral genetics and sort of multifactorial analysis that reveals like some people just kind of wanna do this stuff and they like eating junk and they're not gonna be bothered by it because there are hundreds of millions of them that exist in the world and tens of millions in the United States at the extremes, even, the optimism you have to have for your ability to change the situation has to be brought down to reality. And your bandwidth for how to think about addressing the problem has to expand to think, okay, we got people nutritionally much more educated. It helped a few percentage points. We thought nutritional education as we were taught in school, was it maybe a third of the issue, but it had a 6% reductive effect. And we're at the saturation point for nutritional education where people can tell you, and here's been my experience, almost everyone who walks through the door at McDonald's and out comes with a shake and burger. Do you think that's healthy? Almost everyone will go, 'No, hell no. What?' You give people a bag of chips or a green apple, which one's healthy? 90 some percent of every American is gonna be like, this as I said on the podcast. 'This is a trick question, right?' Like, 'No, no, no.' Legitimate question. They're like, 'You're fucking with me.' It's the apple, duh. Every, all of them-"

"Well, if you asked that to Dr. Gundry, he would disagree with you. He says grapes are basically the same thing as Hershey's."

"So you know how like once you, it's like the monk on top of the mountain, the simpleton and the monk agree."

"[Mike] Yeah."

"Gundry's that smart that he's come back around."

"Wow. Okay. You're giving him a lot of credit."

"Dr. Gundry, by the way. I'm so sorry I said Gundry, how insulting."

"(Mike chuckles) Do you wanna do a cigarette break really quick?"

"No, no, no."

"To enhance our health?"

"No, I wanna live a shorter life, so I'm gonna not."

"I almost broke my phone in half when I watched the cigarette clip by the way. But I decided to smoke a cigarette instead because I care about my longevity and something nicotinamide something or other. The British health study, you know the rest."

"Oh man, that was painful. If we control food drive, does conscientiousness not matter for obesity?"

"Oh man, I would like to agree with that. It won't matter nearly as much as it does now. So if you control completely food drive. It's like conscientiousness expresses itself in fun ways. You give people ubiquitous access to anorectic medications, let's say seventh gen in 2032. They're just ultra."

"The better version of Ozempic for those listening."

"The 10x better version. You still gotta take the pill. And there are people who, even if it's a one time genetic enhancer shot, you get the shot, your genes change. You're just gonna be skinny with your genes. Some people aren't gonna take the shot. Some of those people are just like, 'Hey, did you get to the treatment center to get your shot?' They're like, 'Nah.' How many people, what is the correlation between conscientiousness and doctor's visits? Mike, it's real high. Some people just don't give a shit. You ever deal with people in a hospital setting who like haven't been to the doctor in living memory?"

"Sure, of course."

"Yeah. So when your conscientiousness is low, short of us violating your civil liberties."

"Yeah, look, I have patients that are nihilistic that end up in my office for a variety of reasons."

"[Mike] A hundred percent."

"And I can't really help them."

"Right, right, right."

"(laughs) So."

"So, but the food drive thing is for all the folks with low conscientiousness that take the food drive medication and or get the shot or whatever, they're going to see enormous changes. However, even if you have relatively low food drive, junk food is still fun to eat and your ability to think of, is this good for me or bad for me? If we get you back down to like normal food drive, you can still be substantially overweight though not obese because you just really like to snack and someone's like, 'Are you hungry?' And you're like, 'Not really. I'm just eating.'"

"Well, like bodily autonomy is-"

"A huge deal."

"Everyone's right. So like I box and that's terrible for me and I know it is and yet I do it."

"Yes, yes exactly. I have taken grotesque amounts of anabolic steroids and all the bad things I talked about in the last time I was on the show. So it will have a huge effect. It won't have a complete-"

"A hundred percent."

"It won't have a hundred percent effect."

"But who's looking for a hundred percent?"

"I am."

"I feel like with one variable controlled, you're not gonna get a hundred percent."

"No, for sure. But you're gonna get a lot because food drive is absolutely the quintessential variable because if you-"

"So if you're gonna get a lot, why even talk about conscientiousness? It's not, you can't really change it as you said."

"Yet."

"Yet. If you control for the other variable that you talk about within the poor communities about food drive, it pretty much gets you almost all the way there."

"Yeah, a lot."

"Not all the way. A lot of the way there."

"For sure."

"A significant majority. Why talk about it?"

"Yeah, easy. So you're gonna have a situation in our magical mystery pretend world here where the difference in obesity rates between poor people and richer people used to be, let's say 10 imaginary units of obesity. And now there are two imaginary units of obesity, right? We made an 80% reduction in the difference between wealthier and poor people. We have addressed everything you suggested and everything I suggested, short of conscientiousness. Food drive, medication, access to everything. Everyone's no longer experiencing stress and trauma, relatively same rates, so on and so forth. Like look at Japan for example. It's actually just not true to say that poor people in Japan experience more crime, stress and trauma than richer people 'cause there's just no statistical differentiation hardly between them. Like there's just not really any crime and stress and drama anywhere in Japan relative to us, right?"

"I have no idea."

"So yeah, well, listen. You could look at the statistical data but if you go to Japan all of a sudden it seems like okay, where are all the violent people? I'm going to Japan in a little bit so I'm trying to bring violence to them. I'm kidding Japanese people, please. All jokes. So if you look at that situation in the future that we could have where we've reduced the problem an unbelievable amount, but differences still exist, you're going to have the temptation, especially with the ideological bias of most of these institutions that we have that actually make these changes. Like institute the regulations for food advertising, so on and so forth. The people behind them and the people politically who voted in those people, very well-meaning Americans who want the problem to be resolved because anything that's a difference between wealthier and poor people, including money itself is kind of fucking gross, right? Like what the fuck? Like just 'cause you have less money, you should have like shittier health? That's fucked up. Like we all want the difference to be zero. When the difference used to be 10 units and now it's two, holy shit. To your point, like that's it. Problem more or less solved, right?"

"Well it's not problem solved."

"No, no, but like we did it. Why do I still give a shit about conscientiousness? Here's why. Because when you have that smaller difference, people are gonna be like, alright, we're not doing enough on the regulation side, we're not doing enough education."

"Do you think they'll go too far? That's your concern."

"Well, they have in almost every other regard. That's just what they do. And you know, as soon as like, you know, the oppression Olympics situation that has happened recently in politics, as soon as you could no longer statistically detect different levels of oppression among different genders and races in the United States, which probably was most of the case about in the the 1980s, depending on what literature you look, some really in the 1970s, definitely 1990s. The nineties, you think like, dude, like overtly, insanely like racist, homophobic, like in the old Alabama way people, it just like the teeny, teeny tiny fraction and they can't possibly explain all these systemic differences and stuff. People went way overboard for 30 years trying to address these issues. Not coming back to being like, okay, what's the base reality here? So for the conscientiousness situation, if we kiboshed every other variable, but we still have this 20% which absolutely is much lower, but relative to someone who comes of age during that time and sees like big differences, you know what I mean? Like imagine someone from the year 1600 coming to America and you just give him a tour of New York City and they're like, 'What's that person like?' It's a poor person. Like he's overweight and he has a cell phone in his hand like, right. That's what poor people are like, but it's real bad. They're like, 'He has no place to sleep?' Like he has a place to sleep, it's warm, he has a gigantic color television, he has access to the internet. He gets essentially like functionally through the city. Really, really good healthcare. Like what's that mean? Like, nobody really dies of infections anymore unless they're like really untreated. All the diseases you know about don't exist anymore. And they're like, 'I don't understand why we even care about rich and poor, everyone's rich.' But to us growing up today, even small differences can seem quite stark. And so what we'll do in the future then if we don't account for conscientiousness being a relatively large variable, then we're gonna have this thing where we gotta do all this other stuff. And the reality is none of that other stuff is gonna work because it's completely saturated. We're going to be attacking a problem from completely the wrong angle because we've never admit, we've never sort of taken to task the real crutch, kind of the crux of the issue. A quick offhand example, if you've had some relatives who you deal with who you've had not so great relations with, you think it's the way I'm speaking to them, it's the way they understand me. We have to have a come to Jesus talk. We have to really do, we have to do therapy. And it turns out years later, like they have a psychological condition that's endemic and they have to be on drugs and therapy for it. But you never address that 'cause you didn't wanna be like, 'Hey Uncle Bill, I think you're fucking crazy, like crazy crazy. I think you need pills.' 'Cause you were like, 'Oh, that's not cool. I'm not telling him that.' You would've been like, you know what? I'm just not kind enough to Bill. Next time I'm bringing an even bigger Christmas or Hanukkah present or whatever the fuck. And every year you bring a bigger present, he's just the same kind of dick. Now it was better than when you didn't give him presents at all. But it hit a baseline and you're like, what am I doing wrong? And the answer is nothing. That's just who Bill is. People with very low conscientiousness can only be helped to a certain point. They just make different choices. It's like trying to expect your toddler to be formal with greetings and go to school on time by himself. You're like, that's a kid. You can't expect him to do that. People with low trait conscientiousness are going to live their lives in different ways and face a cacophony of problems that don't occur to people of high conscientiousness, problems that even exist for an adult. And if we don't have an understanding that that's a real thing that we should expect, we are going to spend a lot of time and resources that could have alternatively better spent in 50 other different ways on that problem. And they're gonna have no effect for generations. We've already done this with education in the United States. We've already done it with a ton of different factors. What I'm saying is let's get a full understanding compassionately of the problem at hand. Try to understand what fraction of what is accounted for by which variables, definitely address the variables we can. But then when people say like, how come there's still room left over? I would like future universities to say, look, you can help people a lot externally, but a lot of it depends on the person themself. And we haven't found a way to change that yet. And if you bright students of today have any great ideas about how to enhance trait conscientiousness in people, we need you to think that through. But so far we've kept away from it, but we know it's a factor. Versus saying, 'Why would you even care about that? You fucking Nazi.' And then all of a sudden we're back to square one where we're like, we've deployed all these strategies, we need more strategies. Imagine we are to a point where trait conscientiousness isn't accounting for all the obesity differences. And you're like, we need more anorectic intervention through drugs. Well, you're gonna drive people so high on the anorectic scale, regular people who don't have low conscientiousness and who could just say, you know, 'Fuck snacks. I don't need any snacks.' They're gonna be like, the government's gonna be like, 'Here's the average dose of future Ozempic we need you to take.' They're gonna be getting very low in body weight, they're gonna be getting osteopenic and you're gonna say like, 'Well more, they need more.' And they're like, 'No, no, no, no, no.' We're actually having real nasty side effects from this now. The thing you're trying to change is a thing that can't be changed because you're not even looking at the right variable. It's like, how much more basketball training do I need to give you for you to be able to dunk? You're like, 'Dude, I'm five three. There is no amount of training that's getting me to dunk.' You're like, 'No, no, no. It's gotta be something with the calf tendons. You need to go to Bulgarian basketball camp 24/7.' You've just pissed away a child's life changing an unachievable goal."

"You are worried about the future trying to create perfect scenarios that perhaps don't exist."

"Hmm."

"Because of some inevitably-"

"I would say that's the least charitable way to say that, yes."

"Unchangeable. No, no, no, because in the future that's the concern. It's not an issue. Now you're saying like right now think about the social things, but like once you get the benefit of that, then don't think that you need to do more."

"I don't know any people that I've ever talked to who are genuinely concerned to try to make social changes that think they're working on a 10 to 20% factor. Almost all of 'em think they're working on an 80% factor and they're not. So I think today is-"

Does that matter? Again, in the present.

Yeah. Oh yeah.

In the present.

Yeah. Oh yeah.

Why?

Because how the government has finite resources, and if you think you have a huge degree of traction on a really big problem, then you're gonna pour a lot of resources in that problem, and it's gonna take resources away from other problems. Whereas if you realize like, okay, we can pour some resources into this, and to be honest, we're doing pretty much as much as we can now, and the rest is kind of not up to us. Then you go, okay, we're doing decent here, let's switch to an alternate way of affecting other variables. We don't have free money coming outta the ground. If we start getting free money coming outta the ground, fuck it. Spend money on everything. We just have people eat money at that point.

Interesting.

You know what I mean?

Why do you think that when the self-esteem movement came about and people labeled that as the trait to focus on, no one called them Nazis?

Well, it's the opposite of a Nazi ideology. A lot of conservative thinkers called them socialists and communists.

When they said the self-esteem?

Oh, hell yeah, yeah, yeah. You're gonna make a bunch of entitled assholes and pussies, and you're gonna pussify a whole generation. There was all sorts of nasty things said about that. But fundamentally, when you say, look, who's against people having more self-esteem? Kind of nobody, you know? I mean, somehow if you could really improve people's self-esteem, people generally think that's a good thing. But if you say like, look, some people, the number one cause of the problems in their life is them and how they behave from a largely deeply cultural and genetic perspective. Like, there are entire subsets of American society with nothing racial, by the way. Every race has subsets of their culture that is like YOLO culture. Like, live for today, fuck everything else. Like, don't you think that matters? You're like, whoa, whoa, whoa. No, we're not gonna go judging people's cultures. It seems nasty to judge people's activities. It seems nasty to blame the victim, and that's why you don't get as much pushback about it. And that's why I'm here embarrassing myself to push back on it for reasons of, again, trade-offs of what issues you attack. Because if you think something's really tractable and you have the money to spend and it's worthwhile, fucking spend the money. If you think something's, ooh, not so tractable. We've already spent a lot of money. It does not seem to have marginal effects at this point. You gotta ask 'cause like from a grander perspective, the kind of issues that affect the rest of the world make us look like spoiled fucking children. There are parts of Asia and Africa that are destitute; they need our help. And being a humanist, I don't give a fuck about borders or nations or any of that shit. It has huge value in other regards. But we gotta help real people. And when you're spending hundreds of millions of dollars into nutritional education where you now know that the returns on investment are teeny tiny, and you could be sending hundreds of millions of dollars in development aid properly administered in Africa and and South Asia, oh my God. Like, you have a hundred to one lifesaving potential that you're looking like, eh.

You wouldn't do well in politics with that message, I'll tell you that.

Well, there's a reason I'm not in politics. (Mike laughs) You know?

You wanted to talk about muscle. Can I tell you my take on it, and then I want to hear yours?

Yes, I would love that.

Because I don't want your thing to influence what I'm gonna say.

[Mike] Oh, of course.

My thought about muscle is that right now muscle is talked about as a longevity organ because like, for example, someone will get an invite to a podcast and they'll say what's the most important organ? And they'll say your thighs. Because if you have good thigh muscle, you could stay independent, you can go see your friends, you can exercise, increase in muscle tissue, decreases rates of hip fractures and balance, and they'll point to all these things. And I think muscle is incredibly important, and there's even a protective factor in muscle from obesity and regaining weight after losing weight if you were once obese. But I think it's just another phase of excitement to talk about it obesity in a new way.

Mm-hmm.

That's my thought.

Yeah. Yeah, I probably agree.

Okay. (laughs)

You said it all. Alright, cool podcast. (both laughing) Wish all of 'em were this easy.

No, but what's your thought or how does it differ from mine?

So I think there are two components that in the real world are enormously, enormously effectual for health long-term, longevity, and a massive reduction in morbidity. Even more than an increase in longevity. And that is the balance of muscle and fat that you have. Fat's the more important one of them by a factor of like, eight, or some shit like that. But muscle is also important. And so at any given body weight, if you have more muscle and less fat, you are profoundly more healthy in every measurable way. And if your body weight is also relatively lower, you're also profoundly more healthy. So when we are seeing people who are, let's say in their fifties or something, their blood work's good. Health outcomes are good, no concern. A regular, and I don't wanna ascribe any opinions to people, so this is all fantasy land nonsense, which is really should be the title of the podcast. Mike's a delusional idiot, comma, and a Nazi in parentheses, Hitler himself reborn. So when people in a traditional medical establishment, which I don't ascribe you to be in.

I am.

Yeah, but you're one of these modern thinking doctors. You don't even smoke cigarettes when taking patients. What are you doing? (Mike laughs) You know, Dr. Gundry said. (laughs) (sighs) Now I'm becoming angry at various clips of Gundry in my head. So when people see 50, 55-year-olds in their office, regular health screening and all the blood work is good, they're like, "Sweet, have at it. "You're great. See you next time." If I'm a person who's got, you know, a little periscope to the office and I see them and I see that that person has a relatively low amount of skeletal muscle mass and a high degree of relative adiposity, relative body fat is higher. You know, people that are like normal weight but kind of made of mush, skinny fat or whatever.

Like me right now.

I've been looking at your body for quite some time. I haven't seen anything I've disliked yet, so.

(laughs) Well thank you.

No problem.

For your objective measure.

Okay, can we like stop the podcast and get a pop in?

Yes.

The cameras can stay on, by the way.

That's a different show, Mike.

Oh nice. I heard that's going well as well. Mine is also, mostly feet. I digress. When I see that person and if I'm that doctor and I'm not a medical doctor, but if I'm like a consultant to the medical doctor, like, "Hey sports scientist, what do you think?" I'll be like, we gotta try to talk to this person about resistance training, consistently, eating a diet of enough protein to make a difference and trying to get the balance of their fat and muscle through whatever ways, decrease in fat, increase in muscle. Usually it's much more decrease in fat 'cause muscle doesn't, muscle gain doesn't go as high as fat loss is capable of. I want to see them next time in the office looking, just thinking of older folks. You know, like a Willem Dafoe. Do you know who that is?

Of course.

It doesn't matter what age he is, he's fucking lean and he's kind of jacked, not jack jacked, but he's like, wiry. A person 55 years old of Willem Dafoe's body composition to me is a person who is outside of crazy whatever drug habit or whoever the hell knows for real people in the real world, at just the value of their body composition as a predictive variable for future morbidity and mortality. I would say look, if you're in really good health, but you have a high degree of adiposity, a low degree of muscle mass, even if you're of a healthy weight, you need to get to work on making your muscle mass higher and your fat mass lower because that is going to have a huge effect on how your health is later. And so if I'm a consultant to medical doctors, I don't rest until every patient I see over the long term eventually comes back to the office with visible muscularity and no grotesque aggregated adiposity, like massive spare tire, thighs, et cetera. Or if they flex their arm, there's some hard stuff in there versus just goop. Now none of this is a personal judgment whatsoever. I actually don't value people more or less based on how jacked or lean they are to any extent. I don't care at all. Most of the best people that I look up to in the world, I don't even know what their body comp is, they don't care. But as far as an individual perspective, the more muscular you can be and the leaner you can be, especially the latter, but definitely the former, the healthier you will be long-term. And the strength of these variables as effector variables is so massive that I don't want that doctor letting people out of his office with good blood work in their fifties who have very little muscle mass, but a lot of adiposity relatively and just be like, "You're good to go." I want that doctor if it's in the scope of practice and polite conversation to them to be like, "Hey, you're doing good. "Now your DEXA scan has you doing just fine. "The bones look strong, "but you'll benefit really, really greatly "if you do some resistance training. "Here are the resources for that. "Here are the resources for diet "to work with a registered dietician "to bring the body fat down and the muscularity up," and the person's gonna be like, "Why? My blood work's good." And you'll be like, "See, it's good now. "But the thing that makes it good is largely how much fat "and muscle you have over years and years and years." That's my big contention.

You're walking at this moment sitting oxymoron.

How dare you? I've never been accused of guys, what word does that? What did he say? I'm not a moron.

Do you know why I'm saying that?

OxiClean was a great product.

Do you know why I say that?

I have my suspicions.

We had this whole two-hour conversation, and the takeaway on your end it seemed was that the social issues require so much work but are not gonna give you the majority of the benefit. Does that sum it up somewhat fairly, from an obscure side?

Correct.

And then you want in the limited time we have in our offices to change human behavior by telling them, "Hey, lift more." And you think that's gonna lead to actual human behavior change? When we look at recommendations of diet and exercise for weight loss, 95, 98% failure over the long term.

Yeah, oh yeah.

Talk about getting little reward for the time spent.

Sure.

The thing you're talking about, which I agree with by the way.

Yeah, of course.

Is the thing that actually yields the worst results.

Yeah, I didn't claim it was gonna save humanity. (Mike laughs) The other thing is if you deal with highly conscientious people, it is possible to have an effect.

It sounds like you have a bias for conscientious people.

I do.

Okay. Well at least you said it.

Yeah.

Because you said you don't judge people based on their body mass, but you probably would bet judge them based on their conscientiousness.

We could have a long philosophical discussion on what judging people actually means. I appraise everyone I ever meet.

(laughs) Okay.

Like, you know? I've been on dates before when the girl's like, "Are you judging me?" I'm like, "Absolutely."

Are you the guy in the room that talks about what discrimination actually means?

Yeah. Hell yeah.

Can you tell the audience?

Oh, I'm not trying to cancel myself anytime soon. Discrimination is the ability to tell things apart. Yeah, Thomas Sowell on my t-shirt, man. I can't do that, I need to-

I read "Discrimination Disparities," and he did a great job talking about if you're discriminatory taste with wine.

Or with your sexual partners, yes.

You will be a fine describer of wines.

Yes, exactly. So basically first, yeah, if you tell people of low conscientiousness to like, hey, lift weights and eat better, reduce your body fat who fucking, who gives a shit? So people who are high conscientiousness, they'll have a better time of it and be able to do better. But this brings me to the next part of my talk where this kind of social effect is gonna hit some people. But it requires so much effort in our modern food environment to constrain your adiposity, to increase your muscularity. That a lot of people just don't find it as something that manages to squeeze in in their schedule. And I think that if you have a situation where you tell people, like really, doctors across America are really pushing resistance training, they're really pushing lowering adiposity, even relative adiposity if BMI is not too high, you're gonna have a substantial effect that's in that 10% of solving the problem. But that's like tens of millions of people whose lives have been extended, so it's wonderful. Exactly like I think that your sociological stuff is wonderful. (Mike laughs) That's great. Right?

But you don't like it.

Yeah, no I love it. I just think it's just not super powerful. So I agree with, I'm just total consistency.

Given that your career is about the non-super powerful thing.

Really my career is about like sports science. It's a hobby. I work in an the entertainment industry. Legitimately sports is just entertainment. So that being the case, I think the next step, and this was described well in a review article recently written, we need to really seriously consider the development of a non-androgenic anabolic drug. So we've now have the modern anorectic drugs, the GLPs, GIPs, glucagon agonists, that have allowed us to kick down to any body weight reasonably as we tolerate the drugs. Any body that you want, you just crank the dosage. Eventually you get to that body weight as long as you're just remotely interested in eating sort of the right things. That's just how it works.

Not necessarily the case.

I'll debate you all day about it.

It's not my take, again, the bariatric surgeon said that once you're in the BMIs of 50 and 60, the GLP-1s are not getting you where you need to be alone. And that's why multimodal therapy is now the forefront of the research where it's both.

Both what?

Bariatric surgery with the GLP-1 after.

Oh sure. Well yeah, then you have also like an insane number of fat cells at that point that are screaming really loud. And they just can't dial up the dose enough to.

No.

So that's why I mentioned side effects. If you could mute the side effects and dial up the dose, you could get people in the 500 or 600-pound range to weigh 100 pounds within a matter of years. But they're gonna look like skin bags or whatever. Which I will say of men, I have to say this as much as possible, the skin removal techniques as an industry, surgical and nonsurgical are the trillion dollar question for modern medicine in the late 2020s, early 2030s. So whoever the fuck is listening, hit me up. I'll invest in your company JK, please. Well I dunno, feel free to give me a shout out. I don't know if I'll see the email, but it's a big deal, right? Because Ozempic and all those drugs are helping so many people lose weight, and a lot of people think like, I'm gonna lose weight and I'm gonna look like whatever, like the celebrity I like, and they're like, "Oh shit, skin just doesn't go away." And so skin removal is a big, big deal in the future. But, so-

Maybe as bariatric surgery drops off because the latest study that came out showed a 130% rise in GLP-1 prescriptions. And a 30% drop off in bariatric surgeries.

[Mike] Makes sense.

So maybe as they have more time.

Skin removal.

Because when I asked the bariatric surgeon about that, she said that they have spent their time where they're performing less bariatric surgery, performing general surgery.

Interesting, also-

[Mike] Or maybe they could do skin removal.

For sure, and also, like it is a very different thing from developing medical techniques that are effective if you're in a very, very niche field of medicine, it's just not a huge environment with a lot of like total part of the economy going into it and total amount of thought going into how to resolve those problems. There's lots of people thinking about heart disease, very few people thinking about like, you know, austere monogenic conditions or like there's just those three guys in the world that study your condition. I'm really sorry. Hopefully we'll get more AI about it in the future. But I think it as literally tens of millions of people become candidates for skin removal surgery, that side of plastics is gonna be like exploding 'cause it's like, oh my god. Like anyone who figures out 10x cheaper and more effective, easily recoverable and aesthetically more pleasing skin removal technique, bro. Bro, the medical companies that do the tech and the doctors that do best surgery is huge. In any case, I digress.

Yeah, I was gonna say it's the exact opposite of what the future looks like for food companies.

Well boy, that's a whole other thing, we'll have to-

Oh I have a question 'cause I love your philosophic answers on these. Name one industry that benefits from societal significant weight loss.

That benefits from significant societal weight loss?

Like if we were to create like a better version Ozempic, Ozempic 10.0 that is better. No side effects, no issues, and we can get everyone into a healthy weight. What industry benefits from that?

The junk food industry.

Benefits?

Yeah, hugely.

How does it benefit?

Because now you can eat junk food and it doesn't fucking matter-

No, but you consume less junk food.

Yeah, less, but you're not gonna eat zero, and now you can eat tons of junk food, and as long as you get your protein and all the healthy foods in, you're not gonna be excessive on calories because you fill up so fast. So now junk food become, junk food companies want you to believe that junk food can be part of a healthy balanced diet. And they're completely correct for a small fraction of people that have very low food drive. In the future with modern anorectic drugs being ubiquitous, everyone's gonna have low food drive. And it's actually true to say like, dude, get a bag of Cheetos. And people are like, well, I don't know they're gonna lead to, no, they're not. Have a bag of Cheetos. You're fucking good. No one ever got fat from a bag of Cheetos. Now hundreds of thousands of bags of Cheetos over the lifetime, that's the thing. The junk food industry is going to adapt and make junk foods that are maybe some of the similar ones today. They also maybe make ones that are slightly healthier or higher in protein. So an industry that's gonna, I think absolutely blow up is the high protein healthy food, but fun snacking industry. You got a lot of people now, they're losing weight, they're empowered by these beautiful new drugs, but they're like, I still kind of wanna eat some fun foods but I know some of the shit's not good for me and these medicines have put me on the right path. Is there any way I can eat potato chips that aren't gonna fucking kill me? Healthy junk food is just glazed with glory and profit I think. But junk food in general, I don't think it's gonna-

You think more so than the current junk food that exists? Like there's higher profit margins in that than what is now?

In healthy junk food? Yeah, hell yeah. Because more people are gonna be, the medications are-

I just think right now the foods are so hyper palatable and so addictive that whatever healthy junk food you have, there's no way someone's gonna buy 10 bags of it.

Right, so I do have an interesting prediction. There is not a real war. Not a hot war. No shots exchanged. There is a war between hyper palatable foods and mono anorectic medications. The response for foods development now is gonna be like, okay, people are eating less with Ozempic. How do we make our food so fucking tasty even with Ozempic that they continue to eat them in large quantities? It's a cool thing. Eventually it's just gonna make a lot of food really, really amazing and really, really cheap. And a lot more people who want to be just as lean as they like eating those amazing cheap foods in moderation. But if in like 10 years you're not on mono anorectic drug and you're like the average food drive and you just eat sort of whatever shows up to your mouth, the probability that you're gonna be obese is insanely high. Same prediction it would've been in the 1950s. Like think about the fifties, right? Not a lot of hyper palatable foods going around. Just regular people with normal appetites that today are 300 pounds, were like 175 pounds back then. We'd be like, dude, in in the 2020s you're gonna be fat. Like bullshit, no way. Like food is gonna be so good and so cheap, you have no idea. Fast forward the 2020s, you're like, dude, you're right. I can't stop eating this shit. That trend is gonna continue. So the Ozempic stuff haven't ended, they're just another salvo in that fight of corporations bringing you pleasure. But ideally the best corporations bring you all the pleasure with none of the side effects. Which is why I think healthy foods that are super tasty but are good for you and fill you up. My God, imagine a bag of chips you could buy that was very nutritious, unbelievably delicious, and was super, super affordable. You would just eat that regularly. And because that company continues to sell you chips and has nothing to apologize for and can advertise like you can make this part of your diet.

Can you name one food like that right now?

Oh, I have a really good example. Fairlife shakes.

The dairy based protein shakes?

Correct. They are unbelievably delicious and really, really nutritious as well.

All right. Are you sponsored by them?

No. God no. Fairlife, please sponsor us. (Mike laughs) I love them. I love you. I'll sing your praises, dude. Fairlife's amazing. Yeah. There's lots of like, cool chicken sausages they have now that you can get at the store and grill up that are incredible macro, super high protein, low fat, and they're ultra delicious and super healthy.

Heme iron.

Say that again.

Heme iron.

What's that?

Dangerous component of meat-based foods.

Oh yeah, sure. Yeah. Well let's make a sausage together that's like the Prime drink or what's that Lunchly of sausages?

Mm-hmm, Lunchly.

I'm kidding. It's terrible what you did on Twitter by the way.

What did I do on Twitter?

I'm kidding. You had that one post about Twitter misrepresenting all of your-

Oh, on YouTube.

Make belief tweets of yours, remember?

Yeah. Isn't that wild?

That's so fun. Yeah. All's fair in love and thumbnails and titles, so.

No, that's not right. I don't agree with that.

Well, that's my opinion. Not yours. What the hell were we talking about earlier when you took me off track on the philosophical bullshit? Oh yes, yes.

Probably more philosophical bullshit.

No, no, I got it. So it's all the same. So doctor's offices and telling people, hey, you should lift more weights and do this. Non-androgenic anabolics. We've already started to solve the problem of food drive and appetite with medication. But now we have an even bigger problem in the muscle mass side. Used to be muscle mass, low muscle mass was something that affected predominantly older individuals. Individuals of certain ethnic groups more than others. People from Southeast Asia struggle with low muscle mass, and you've seen a lot of the metadata on their health stuff. People in their late twenties who are type 2 diabetic and you're like, you're not even overweight. Like muscle to fat ratio is all wacky, right? And so what we can, we had, and this is gonna be worse and worse of a problem over time, is the only thing keeping many, many overweight Americans non-sarcopenic, which is to say enough muscle mass to not cause activities of daily living or metabolic dysregulation. The only thing keeping them having high enough muscle mass was their enormous food intake. Because if you eat more food, you gain muscle and fat. Now they're gonna be eating less food but they're not getting into fitness and activity, not all of them.

So you're gonna see these new modern anorectic medications driving a new wave of sarcopenia. Junk food and overeating has just been covering up that wave of sarcopenia because, like a lot of overweight older adults, they're not sarcopenic. Sedentary. But as soon as you get them down in body weight, oh my god, they're sarcopenic.

We desperately need the development of a non-androgenic anabolic, 'cause anabolic steroids, they build muscle real well. But they come with like 18 trillion different side effects; they're just a non-starter. If you have a non-androgenic anabolic potentially attacking the myostatin regulation system, which is ultra powerful—you ever see those like cows that have like two times the muscle of the regular cow, or the greyhound, or the mouse, or whatever? That is already a monogenic vector of attack. We could be developing and, who knows, you know, I'm not into pharmaceutical backend, but I guarantee you companies are working.

(Mike speaks faintly) Yeah. Oh yeah.

So these are all tractable problems, and as soon as we get a non-androgenic anabolic going, we can prescribe dual therapy. So instead of coming into the office and saying, "You should lift weights and eat better," and they're like, "Okay." You're like, "Alright, see you next Monday." You want it to be dual therapy; it would be a single pill. That would be dope. The thing with—okay, so I'm not pushing back, I'm just thinking out loud—two Jews get together and talk like, "Oh, you're wrong." A single injection would be dope. The thing is, people have different genetics for muscularity and food drive. And so a single injection would kind of do a real, a ton of good. But I think two pills can also make sense because like some people don't need much more muscle but they need much less food drive. The other way around is also the case.

Sure. But in any case, let's just go with one pill, right? To make it super simple. People come in today, we're like, "Hey, go resistance train and eat better." They're like, "Dope. See you never." And they fucking don't do it. Nowadays, now some of them do, and that's great. But now maybe in the future when we get a non-androgenic anabolic developed that's safe and effective and really very targeted, then we have the situation where people are taking a medication that not only lowers—let's say, goddamn it, back to two medications just to keep this very clear—they're taking a medication that lowers their overall body weight and adiposity; they're brought the fat down. Now they're taking a medication that does two things: one, it brings the muscularity up, and if they want to engage in resistance training for mobility, for health, for strength, for enjoyment, for connective tissue stuff, it makes that a much more fruitful enterprise.

I can't tell you how many people I've consulted and trained and seen over the years who people tell them, "Resistance train, it's great." And these are people with good genetics. They're often young. These are older people with not so great genetics for muscle. Bro, they're in the gym weeks and weeks and weeks. Something happens, but not much. If you look at the exercise science data directly, you'll notice there are a group of people, maybe like about one fifth of everyone who's in an exercise science study. They don't lift weights, and all of a sudden for 16 weeks they make 'em lift weights three times a week. Something like a fifth of those people gain undetectable amounts of muscle. Like, if in the first 16 weeks of a program you don't gain detectable muscle, people talk about noob gains, you know? Like you gain a wildly disproportionate totality of your muscle in the first few weeks. If that ain't happening for you, man. Can you imagine your doctor says, "Lift weights," you do, you come back a year later, you're like, "Three days a week I've been doing an RPI hypertrophy app, I did it all." And then you, they measure you, they do the DEXA, you're like, "You lost a pound of muscle," that legitimately happens.

So just to cut this off at the pass, I'm not saying we need to replace resistance training in gyms with modern non-androgenic anabolics. They're gonna be empowering for everyone. And look, if you never go to the gym, hey shit, they'll be empowering for you too. And then we can get to this world where people are in their fifties, sixties, seventies, and they are lean and they have lots of muscle mass. Not a ton, just like a decent amount. And it's going to impact disease across the board in an unbelievably profound way. Because when I look at folks that are in their fifties, sixties, et cetera, and they're soft, they're not large, they're soft. I'm thinking, "Man, five or 10 years you're gonna break something, or your type 2 diabetes is gonna go up, and what do I do about this one?" You know, "Eat better and try to make better choices." They already eat pretty well. They just don't have enough muscle to—there's no glucose sink. You solve that problem; it's enormous.

Now the first wave of AI-powered drug discovery is already cresting. They've been—most of the pharmaceutical companies are pretty open with what they're working on. It's not that—because they're working on, look, Alzheimer's, diabetes, crazy killer problems that millions have. This, I think, is hopefully gonna be next gen, and when it happens, it'll be a big deal.

I think that's your most reasonable prediction that you made thus far.

It's more of a hope than a prediction really, I've actually—

But I think it's the most reasonable, 'cause when you look at a lot of the medications that exist in dual therapy in that way, there are almost counteractive, so.

Yes.

For example, there's some medications that have an NSAID and then a sucralfate to coat a stomach to reduce the side effects.

Yes.

Or an opioid medication plus an anti-constipation medicine with it. So like they're always trying to pair two things that take one of the problems—

Yes.

And solve the backend side effects.

Yes, and I think this is just insanely obvious, and usually you're very good at pushback. I haven't heard much from you in this regard, 'cause it's like it's a real thing, right?

Yeah.

And I think so many people don't know that having higher muscularity within a given body is so health-promoting. And if you have a non-androgenic anabolic in the mix via nutrient partitioning, most of what you eat now goes to feed the muscle, 'cause it's so hungry all the time. And so it actually is a second-order effect is to keep you leaner. So for any amount of food you eat, if you're on a decent dose of non-androgenic anabolic, you're actually gonna be leaner because muscle simply occupies more of that space and takes more of your food. Like, you know when you're lifting a lot and you're jacked and lean and everything, you just eat tons of food, and people are like, "Don't you get fat?" You're like, "I don't know, man." I lift weights so much and I have so much muscle, it's just hungry and eats all the time, and my fat's like, "Damn it, feed me," and has nothing left. That is such a profound thing that I think I'm really excited about that future development. And I hope folks listening that maybe work at a pharmaceutical company can like, I don't know, talk to a CEO or something. Tell 'em, "Hey, there's money to be made here." Something like that.

I'm surprised you think that right now people don't think muscle's a big component of health.

I think they do, but I think they're like an order of magnitude away from how big of a component they—like how important it is. There's a thing about recognizing the importance of something nominally, and there's a thing about like, "Well, how important is it?" Like, "Pretty important." Like, "No, very important." I think people need to shift more towards, "This is really important."

Okay, muscle's very important. You're a Nazi. There's great takeaways from this podcast.

I had fun.

I had fun too. I actually wanted to talk about like 10 other subjects, and we got none of them. So that sounds like part three. Maybe we can do it on your show.

I'd love that.

Yeah, if you, you know, I'm still waiting for the invitation, so.

You're too important to invite. We've invited you 10 times, and your butlers keep saying that mail's going to some other part of the compound they call it.

Okay, let's make it—what do they call it?—a smart goal. So at least let's be specific. When I come on your show, what topics are we talking about?

Geez, you're making me brainstorm live.

Live. People are gonna see how that mind works.

Easy. Sure, no problem. Flex the Jew brain. Got it. (Mike laughs) I would love to talk to you about if I am a male in my thirties and forties and fifties, I lift regularly, I eat well, but I don't know anything about doctors and medicine and pills and what I could be missing and all this other stuff. Maybe I'm on TRT, maybe I'm not. When I go to talk to my doctor, what labs do I need to be curious about? What is A1C? What does that mean? How do I know that what I'm doing today is setting me up for health and longevity and muscularity later versus like, "Dude, you're on the real wrong path." I know you lift and eat well, but like you missed this whole thing that real doctors know about, 'cause I teach 'em about exercise stuff and general health stuff, but I know almost nothing about the medical side. I would love for you to fill in the blanks of like, how do you talk to your doctor about blood work? What other measures can you take? What really are the most profound things? Are there any medications that you need to be taking? Another one is this: what multivitamins and multiminerals should I be taking? Can I ask my doctor to test me for deficiencies? Because the big thing is, the great canon has been so far, if you're eating a well-balanced diet, you don't need a multivitamin. And that's true, but still millions of Americans have various vitamin and mineral deficiencies, low-grade ones. But if you fix them, you're gonna get some ROI. Is that a thing I talk to my doctor about? Because unfortunately there's—you can talk to doctors about it, or you can go—no offense—to the local health food store, and they're like, "Yeah."

Yeah, you can fix everything.

We got all kinds of stuff to sell.

Well, the whole premise of that—like, just to touch on it so briefly to end this podcast—is validation of when you change something, whether or not it creates a clinical impact and whether or not it's valuable to spend the time—as we said in, how important it is with limited time to make a change—is the same way that I think about protocols from Gary Brecka, from Huberman, from Peter Attia, and there's nothing, there's no—

You went down the scale of like, empirical believability.

Yes, but the problem is all three of them function in the same world where they create individual protocols that they set themselves as experts in their own right, and when I say experts like this, 'cause it's clearly a wide variability—

Yes.

One has a bachelor's degree, one is a PhD, one is an MD. So there's variability in expertise, and yet they have their own protocols expertly derived. And here's why I don't buy into that. When they disagree with an organization like the CDC, American Heart Association, AAFP, the American Academy of Family Physicians, because the recommendations that those groups give me as a clinician is validated. So what's the current world record for bench press?

Well, I broke it yesterday in my own home.

(laughs) So what is it?

I think it's just shy of—

What is the recorded?

I think it's just shy of 800 pounds, yeah.

Okay, if I was to tell you non-jokingly that I benched 950, what would you say to me?

Being that you are you and look like you are?

[Mike] Yeah, yeah, yeah.

I mean power lifters will find this funny. They'll be like, "Oh, what federation and with what triple ply shirt?" But that's an austere reference. So I would say, "Oh, that's cool." And then I would tell my friends, "You're insane."

Right. And why do you jump to the conclusion that I'm insane? Can you prove that I'm insane?

With the way I understand proofs to work in philosophy probabilistically through inference, yes.

Probabilistically.

Yeah. Oh yeah.

But not with a hundred percent certainty.

No. Well, you could just be a total freak.

Totally. So I can't disbelieve their protocols just like you can't a hundred percent disbelieve that I'm saying it, but there's enough reasonable certainty and probability that they don't have the validated bench press shirt, federation judge—

Whatever.

Watching you form.

Yes.

Whatever it is that minutia, that's incredibly important to judge whether or not that thing is true and validated that I can't buy into that and recommend it on a general scale because it might be true, but they need to go and validate it for me before I start telling it to people.

Totally.

And that's my issue with the protocols.

Totally, and what my audience would like to hear I think are not protocols. They get those plenty from those other folks. I think what they would like to hear is how to think about the situation of, "I'm an adult who's pretty healthy, who exercises and eats well, but what about on the medical and diagnostic side? Do I need to be aware of?"

Sure.

And to talk to my doctor about.

Yeah, I think a good thing for us to talk about would be how doctors are trained to go into a visit when they think about prevention, treatment—

Yes.

Catching things early. What we're trained to do versus what I'd like for some doctors to do more of.

[Mike] Yes.

And what to do if your doctor's not.

Huge.

[Mike] That's what I want to talk about.

That really is it because the subset—a lot of times doctors will do that thing I talked to you about earlier where like a 55-year-old who's made of mush, they're like, "Well, your blood work looks good. See you next time." For fitness people it's extra more of that conundrum because they're like, their blood work is great. I mean, it's just stellar for their age, but they want more. They want an extra insurance policy of health and fitness. And because the doctor deals only in generalities, 'cause that's how they were trained and that's most of the population, they never get the care and attention they need. And another thing I'd love to ask you about in the future is like, how do we go about selecting a doctor that works more with fitness people and knows, "Okay, you want extra A-plus attention, 'cause you're willing to do it, then what do you look for?" Because here's a big problem: most of the people that are looking for the A-plus in fitness go end up being like, "My doctor is a 70-year-old man who thinks that because I lift weights, I'm gonna hurt my back." And even though he's okay with my blood work and everything, he says, "You're fine, you're fine." You have lots of doctors be like, "You're fine, everything's fine. See you later." His 15 minutes are up. Who's left over to go to? If we can't find an evidence-based practitioner that can give them that extra boost, like, "Look, let's look at your vitamin D levels over every three-month time span," things that aren't worth it for most of the general population but are worth it to you. Let's do it in an evidence-based way that makes sense. But there are so few of those people around and so difficult to find. I'd love to ask you about how to find them. How to get to know. Because usually these people end up going to like, fucking quacks, and they're like, "Well, this guy's the only one talking about enhancement."

Correct.

You know? Like the human—whatever the fuck Gary Brecka says, "I'm a human biologist." Like, "Oh, I usually speak to primatologists about this, but…" (Mike laughs) I'm just being a dick.

Well, to talk about Dr. Gundry again, give him a nod. He kept telling me about how how great apes—

Our esteemed mentor.

Only eat fruit during parts of the year, therefore we should not—

What do they eat during the other?

I don't know. But that he kept telling me that, and I'm like, I don't really know what to make of that.

It sounds profound and intellectual.

Because he said we shouldn't be eating fruit all year round. And I'm like—

Well, of course. Well, everyone knows that.

I'm like, "Well, clearly humans that consume fruit are really the problem in our country."

That's the—who the least healthy people are is the linear correlation.

The people who eat fruits and vegetables, disgusting animals.

Yes, I actually can—I do know a little bit of something about this. The sort of like annual variations in food consumption. You see, Mike, when the sun hits the fruit… I got nothing.

That's honestly refreshing, 'cause saying "I don't know" is sometimes more powerful than creating a story about great apes.

It's the story of my life.

Thank you. Mike, I appreciate you.

I love it. Thank you so much.

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