0:00

Hi, I'm Wendy Zukerman and you're listening to

0:02

Science Versus. Today

0:05

on the show, we're looking into the

0:08

latest fears around drugs like ozmpic. Before

0:16

we jump in, in this episode,

0:18

we are talking a little bit about suicidal

0:20

thoughts. So please take care while you're listening

0:22

and we're going to put some mental health

0:24

resources in our show notes. Okay,

0:27

let's get started. Last

0:29

year, just as drugs like ozmpic were

0:31

gaining steam, we did our first episode

0:33

about them. But since then,

0:36

a lot has happened. Prince

0:39

Charles became King Charles. Twitter

0:41

rebranded to X. And

0:43

Taylor Swift joined the NFL. Yay! But

0:47

one thing that hasn't changed, these

0:49

weight loss drugs are still big

0:52

news. One hot topic everyone in

0:54

Hollywood still seems to be talking

0:56

about is ozmpic. And it's not

0:58

just ozmpic. There's a bunch of

1:00

similar drugs out there, like wagovi,

1:02

monjaro and zepbound. And

1:05

something we keep hearing about them is

1:08

that they're causing these weird and

1:10

very scary side effects. The

1:12

ozmpic hype is starting to wither,

1:15

replaced with the reality that it

1:17

and similar drugs are very risky,

1:19

even deadly. Last

1:23

year, there were all these stories of

1:25

people becoming suicidal soon after taking these

1:27

weight loss drugs. Regulators

1:29

are looking into reports of suicidal

1:31

thoughts. I remember thinking to myself,

1:33

my family would be so much

1:35

better off without me because I

1:37

was so, just so depressed. There

1:39

are now fears that these drugs

1:41

are sapping our bodies of muscle,

1:43

which we're told can be incredibly

1:45

dangerous. You're losing equal amounts

1:47

of muscle and fat. Now, does that

1:50

improve how you look in a bathing

1:52

suit? Sure. But does that improve how

1:54

long you're going to live? Uh-uh, not

1:56

a bit. have

2:00

paralysed their stomachs, leading to

2:02

awful side effects. Debilitating

2:05

gastric issues. Vomiting

2:07

daily. Hospitalised repeatedly.

2:14

A year ago, when we first looked at these

2:16

kinds of drugs, they looked pretty safe. But

2:19

did science miss something here? Or

2:22

millions and millions of people are being put

2:24

on these kinds of drugs? How

2:26

worried do we need to be? Today

2:29

on the show, we're looking at the cutting-edge research

2:31

on these new weight loss meds. To

2:33

find out, are they scarier than

2:35

we first thought? When

2:37

it comes to ozempic, there's a lot of...

2:39

The ozempic hype is starting to wither. But

2:42

then, there's science. It's

2:46

all coming up. After the bake. This

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4:00

weight loss drugs like Ozempic are

4:02

scarier than we once thought. Okay.

4:04

So last year when we talked about Ozempic,

4:07

we looked at how these kinds of drugs

4:09

work, which is to mimic this

4:11

hormone that makes you feel full. So it's

4:13

basically like an appetite suppressant. When

4:16

it comes to losing weight, these drugs really,

4:18

really do work. They help a lot of

4:20

people lose a lot of weight. But

4:23

the question we're asking today is, are they

4:25

safe? What do we know now? And

4:28

to tell us all about this, is

4:30

the producer at Size Versus Rose

4:33

Rivla. Hey Rose. Hi Wendy. So

4:35

Rose, as you've been seeing these

4:37

headlines of like muscle wastage, suicide

4:40

risk, stomach paralysis, like

4:42

what has been going through your head

4:44

every time these headlines pop up? I'm

4:48

a little, I'm very curious, but

4:50

I'm a little skeptical because I know people

4:53

just love to talk about these drugs. The

4:55

last time we covered this, they

4:58

actually seemed pretty safe. There

5:00

was some concerns about pancreatitis

5:03

and gallstones and

5:06

thyroid cancer, but there were a lot of

5:08

it was kind of theoretical, seen

5:10

in rats or very rare. So

5:13

it seemed pretty safe. Actually the biggest problem

5:15

was that a lot of people get GI

5:17

issues like stomach upset, nausea

5:19

on these drugs. And that's kind of where

5:21

we landed last time. And I hear

5:23

you, that you could definitely

5:26

feel in the air that people want

5:28

to talk about these drugs. It

5:30

doesn't feel like you can lose this much

5:32

weight and not have some consequence. But

5:34

at the same time, a lot more people are taking

5:36

these drugs. And

5:39

it does sort of feel like maybe

5:41

science missed something here in

5:43

the early clinical trials, which can happen. It

5:46

could totally happen. Right, so Rose, let's

5:48

start with this thing that we've

5:50

always been hearing a lot about, which is this idea

5:52

that Ozemphic can mess with your muscles.

5:55

And basically that you're not just losing fat, Which

5:58

is the goal for many people, The

6:00

also losing a ton of muscle

6:02

on these drugs. so here let

6:04

me do. Some. Headlines that I have read

6:06

recently. The race

6:08

is on to stop. Owes them

6:11

a muscle loss and other ones

6:13

are exempted know cause dangerous muscle

6:15

loss and.that is my favorite effect.

6:18

Last shot and city time bomb

6:20

is born or simply can go.

6:23

These are shrinking. Pay since

6:25

muscles. Yeah, I've

6:27

read assume and I've heard a lot

6:30

of people talk about it on

6:32

podcasts. you know does our past

6:34

sins of misinformation or whatever those success

6:36

And I specifically have heard this claim

6:38

that some muscle weighs says that happens

6:41

when people are on these medications

6:43

can also melt muscle off your face

6:45

and make you look like got and

6:47

weird and they call that owes them

6:50

pick face oh god it has its

6:52

are Dame now owes them big said

6:54

yes as and six days out

6:56

again. Sorry Mccaffrey doctor, we need

6:58

to be about this. Ah, If

7:01

it's true, that. Be. As impacts are

7:03

melts in your muscles a way. That.

7:06

Would be a big deal because. Your

7:08

muscles aren't just there to drink or

7:10

bones around which is kinda how I

7:12

think I have previously thought about it

7:14

that say it's actually a very important

7:17

organ and is very it's very active

7:19

organ. So what They

7:21

do as they pull sugar from

7:23

Adeline and then store. The

7:25

sugar, oh that's gold and.

7:28

In as nervous as did that and

7:30

that's about this with the passing on

7:32

to the doctor and scientists the Harvard

7:34

even when we're sitting. Muscle

7:36

is sort of sucking.

7:38

Up on the bloopers. Dislike: Almost like

7:40

be cynical of the vacuum. be seen

7:43

it consists suck away all the do

7:45

those So muscle is sort of a

7:47

storehouse Us Energy. And

7:50

to maintain. Healthy blood sugars.

7:52

Hell be metabolic steed. A

7:54

healthy muscle is very, very

7:56

important. I

8:00

don't know what you have the less efficient

8:02

this whole thing is. Moon. This.

8:05

Is all part of what's called

8:07

insulin sensitivity? and so just a

8:09

really land this point. One

8:12

said he took healthy people and had

8:14

them stay in bed for a week

8:16

and because they were inactive for a

8:18

week, they lost about three pounds of

8:21

muscle and their insulin sensitivity plummeted. It

8:23

went down by thirty percent. Oh wow

8:25

or and that's bad. like that can

8:27

lead to a whole bunch of problems.

8:30

Type two diabetes but also had that

8:32

pressure heart disease. City area. So.

8:36

You know this: You want to keep

8:38

your muscle right? Yes! Love, Love my

8:41

muscles So. Does his emphasis

8:43

meld them away? So straightaway You

8:45

need to know that every time

8:47

someone loses weight, They lose

8:49

muscle. And fat Studies that

8:52

have looked at weight loss generally

8:54

find that on average twenty to

8:56

fifty percent of the weight of

8:58

people lose comes from their lean

9:00

tissue, which is mostly muscle. So.

9:03

If somebody loses ten kilos,

9:05

two kilos of that could

9:07

be muscle to up to

9:09

five kilos which is a

9:11

lot is essential that is

9:13

substantial and one reason for

9:15

this is because when using

9:17

a. Because. You're taking you

9:19

must energy by eating less your body

9:22

is gonna look for energy in other

9:24

places as gonna try to get sicker.

9:27

And one place it in that that sucker. Some.

9:29

Your muscles. Okay so every

9:32

time we lose was some of that

9:34

way his muscles. Because. Your

9:36

body. Search of energy

9:38

eating away. At things including

9:40

your muscle and and on average.

9:43

About. Twenty percent to Fifty

9:45

percent of the weight that you

9:47

lose muscle The right. Yeah

9:49

to then the question because when

9:52

you're on. These meds are you

9:54

losing more muscles and you normally

9:56

would. Write that is the question.

9:59

So. To. Find that out! Researchers

10:02

have pulled people in said be scanners.

10:04

I can measure how much of your

10:06

body as fat, as much as bone,

10:08

how much as lean tissue muscle as

10:11

though they scampi blow before they start

10:13

these medications and then again after. They've

10:15

been on them for a while and

10:17

lost a bunch of weight. And here's

10:19

what they have found self and then

10:22

trial for treason time which is the

10:24

stuff in Missouri ends up and out

10:26

all the weight of people loss on

10:28

average about twenty five percent of that

10:30

was muscle. And then in

10:32

another child for the magnetized assassin

10:35

or something and will go the

10:37

almost forty percent as muscle out

10:39

almost forty percent and then twenty

10:41

five percent. Said.

10:43

Is. That. Is exactly what

10:45

you would expect so that. It's

10:48

exactly like his successor. It

10:50

was nothing special funding night

10:52

as far as we can

10:54

tell. Them. That

10:58

is so much vitriol around

11:00

Owes Emperor and the muscle

11:02

wasted problem. Like I haven't

11:04

read any headlines. That.

11:07

Were worried about muscle wastage when

11:09

people losing way through other means

11:11

like while this focus on the

11:14

suggs yes, we're a. Lot.

11:16

Of zipper things that business a

11:18

spotlight on these medications so any

11:20

little thing that they do is

11:23

gonna be breathlessly reported on. So.

11:25

This is our wind up with these

11:27

discussions about like quote unquote Olympic Face

11:29

when you lose a to lose weight

11:32

from everywhere including her face including your

11:34

freeze so I don't believe in of

11:36

them Pixies as though we'd lost. Said.

11:40

It as it is. and when it comes to muscle, Or

11:42

wasted. So what about like or is

11:45

anything to particularly worry about with a

11:47

census? As far as I

11:49

know I am. I haven't seen any evidence that

11:51

the way people's wait comes off. On.

11:53

These medications is different than. From.

11:56

Any other means of weight loss. That

11:58

being said, I mean, it isn't. point that people should

12:01

be aware of this whole muscle loss thing and when

12:03

people do lose weight on these

12:05

medications or otherwise, they should be

12:07

trying to preserve muscle, build muscle.

12:09

So, you know, that looks like

12:11

getting plenty of exercise and eating

12:13

enough protein. Right. Right.

12:15

Right. Right. So,

12:20

that's like lifting weights. But

12:22

the best is that any exercise that you

12:24

do consistently will help them. I

12:27

have one family that, you know, they like

12:29

to dance as a family for 30 minutes

12:32

every evening. Great. Whatever gets

12:34

you moving once. That's really sweet.

12:36

That's really sweet. I love that. All

12:38

right. So,

12:41

dance for 30 minutes if your honor is

12:43

epic. Love that. Oh, that's the takeaway. Yes.

12:46

So, Rose, what's next? So, the next thing

12:49

I'm going to dive into is pretty

12:52

scary sounding actually. So,

12:54

there have been hundreds of people who have

12:56

reported that after they started one

12:58

of these weight loss medications, they

13:01

got really depressed. And

13:03

some people have even reported feeling suicidal. That's

13:05

so scary. The idea of you take

13:07

a drug and then your

13:10

whole attitude and life switches

13:12

over because that's the claim, right?

13:14

Yeah. The claim is that

13:16

the medications were causing depression, causing suicidal

13:19

thoughts. And there were

13:21

enough reports of people saying this was happening to them

13:23

that the FDA decided to look into it. And

13:26

that made the news. Other countries decided to look into it

13:28

too. And so, all the media

13:30

around that, that's actually where our next guest first

13:32

heard about this. That's

13:34

really when it captured my attention.

13:37

This is Nora Volkov, and she's a neuroscientist

13:39

and director of the National Institute on

13:42

Drug Abuse. Why did it capture

13:44

your attention? Because so many people

13:46

are taking these medications. I mean, so many

13:48

people are being exposed to them. This could

13:50

be bad. Yeah, and it's not wild

13:52

to think that this could happen. Like

13:54

that a weight loss medication could cause

13:57

depression and suicidal thinking. In fact,

13:59

there is actually a war. on these drugs that

14:01

says people should watch out for

14:03

depression or suicidal thoughts. Are

14:06

you serious? Yeah, I mean, Legobi

14:08

and Zepbown both have this warning.

14:11

And I asked the FDA about that. They

14:13

told me the reason it's there is that

14:16

there have been weight loss drugs in the

14:18

past that have been linked to feeling suicidal.

14:21

In fact, there was one drug that was pulled off the market because

14:24

of this. Whoa. So

14:26

what do we know here? Do these new drugs

14:28

increase your risk of depression? Suicidal

14:30

thoughts? So, Nora and her team

14:32

decided to dig into that question. So

14:35

they pulled medical records from people from

14:37

across the United States, and

14:39

they combed through them to see who had

14:41

been prescribed some agritide. That is the Stemphin,

14:44

Ozempic, and Legobi. And they

14:46

were looking over a period of about a year

14:48

and a half. Okay. And they also pulled medical

14:50

records from people who had been prescribed a different

14:52

kind of weight loss medication over that same period.

14:54

Great. That was a control group. Loving

14:56

this study. This is exactly what we need. Thank you,

14:59

Nora. So in the end, they

15:01

had more than 100,000 people in this parenthesis.

15:05

And when they crunched the numbers to see were

15:07

people on some agritide more likely

15:09

to feel suicidal, they

15:12

found no. Mm-hmm. No. Okay.

15:16

In fact, Nora told me they

15:19

found something really unexpected, which

15:21

was that the people on some agritide

15:24

had lower rates of suicidal thoughts than

15:26

the other group. Oh. Actually,

15:29

we were very surprised because

15:31

we, based on what the accounts

15:33

were saying, we were expecting them

15:35

to be tired. But so

15:38

we were surprised when we saw that

15:40

they were significantly lower. Oh,

15:43

wow. And in

15:45

fact, scientists are digging into this

15:47

whole other question of whether it's possible that

15:49

this class of drugs can have

15:52

antidepressant effects. What? And that evidence

15:54

is very preliminary. It's mostly from

15:56

RAP studies, but there's some suggestion

15:58

that this could be done. happening.

16:00

So that's pretty interesting. Well this is,

16:02

well this is quite a switcheroo. It

16:06

is a switcheroo. Yeah

16:08

and no one's saying

16:10

that those reports of people feeling suicidal

16:12

aren't real. The ones

16:14

that triggered this whole thing. Yeah so

16:16

like what's going on there? It's possible

16:19

these were coincidences. It's also

16:21

possible it does happen as a result of these

16:23

meds but it's very very rare. But

16:27

overall in January the FDA said

16:29

they concluded that there's no clear

16:31

relationship between these medications and feeling

16:34

suicidal based on current evidence. And

16:36

here's how Nora put it. The evidence

16:38

right now does not support

16:40

that these medications will increase

16:43

by themselves the risk of

16:45

suicidal thinking or behaviors. Mm-hmm

16:48

okay. Well this is

16:50

great news for the many people on

16:52

these drugs. Yeah but the episode isn't

16:54

over yet. No.

16:57

So everything might not be quite this

16:59

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19:21

Today on the show we are

19:23

looking into fears around Ozempic. Rose,

19:26

this choo choo train

19:29

Ozempic train has

19:32

hit which station?

19:34

That's not even a pun.

19:36

It's not even a pun. It's not really anything.

19:38

We can

19:46

go a bit. We

19:49

go being where next. That's

19:52

good. Thanks. That's good.

19:54

Thank you. Where are

19:57

we going? Where are we going? next.

20:00

To the guts. Okay. Next

20:04

stop, the guts. Choo

20:07

choo. So

20:12

last time, we

20:14

heard that it was pretty common for people to

20:16

get stomach aches. Alright.

20:20

Choo choo. Last time. So

20:22

last time we heard it was pretty

20:24

common for people to get stomach issues

20:26

on these drugs. So like nausea,

20:29

especially when I first started taking them.

20:32

Yes. Yes. I remember that person

20:34

you interviewed who ate some fried chicken

20:37

and then vomited it all up. Yeah.

20:41

That kind of thing. Okay. Very common.

20:44

Right. But she got over it and it wasn't

20:46

too bad for her. So

20:48

now what's in the news is

20:50

people who are having something way more serious

20:52

happen to them. Okay. And

20:55

in fact, there are a bunch of lawsuits right now on

20:58

behalf of people who say that

21:00

these medications really messed up their

21:02

stomach, including claims from some people

21:04

saying that their stomachs were paralyzed

21:07

after taking these drugs. What does that mean

21:09

exactly? That they weren't moving. Your stomach has

21:11

to move to get food crunched

21:13

up and on like on its way out the door.

21:15

But what these claims

21:18

are is that the stomach has stopped

21:20

moving or is moving so slowly that

21:22

people have these like

21:25

terrible symptoms. One

21:27

woman says it was so bad it sent her to

21:29

the emergency room several times. She says

21:31

she vomited so much that she lost teeth.

21:34

Oh God. Oh God.

21:36

All right. That's the claim.

21:38

So let's dig into this. I called

21:40

up Michael Camilleri. He's a gastroenterologist and

21:42

a researcher at the Mayo Clinic. So

21:45

we actually have done some studies here

21:47

and with one of these weight loss

21:49

medications and we examined

21:51

the patient's stomach emptying at baseline

21:54

and after treatment. Michael is not

21:56

grossed out about this stuff but I

21:59

am. Life of me I

22:01

cannot figure out why I'm always. Sitting.

22:03

Here in this shared Hockey Neil

22:06

about disgusting semite. As I said

22:08

from south out of this keep

22:10

happening What? I did have some

22:13

myself. There is nothing disgusting about

22:15

a good. So what

22:17

is going on here? So. I'm

22:20

going to seem to disagree to

22:22

better understand. What? Happens in the

22:24

summer of people who are on these kinds of

22:26

medications. They

22:29

got one hundred and twenty four people in Finland.

22:31

About half of them were on a drug like

22:33

of them back actually with an earlier version but

22:35

it works in a summer. Well. For

22:38

everybody they took them up a very

22:40

nice breakfast. At me a we

22:42

use real scrambled eggs so he. Used

22:45

to eggs, a glass of skim

22:47

milk, a slice of brown bread,

22:49

but. Then cycle as a

22:51

special. Ingredient and then the small

22:54

amounts of isotope which is a

22:56

very small amount of radioactivity. Excellent

23:00

is he spikes their breakfast

23:03

with a small about of

23:05

isotope. Because adding an isotope.

23:07

Let's michael Follow the food as

23:09

it's moving to people digestive tract.

23:13

Because if you point a special

23:15

kind a camera called a nuclear Camera

23:17

people and take pictures of them you

23:19

can see the food glowing through that

23:22

oh so michael seem to pieces of

23:24

people with this glowing breakfast as it

23:26

moves along and then time how long

23:29

it took food to get squeezed out

23:31

of the next and I've seen

23:33

the pictures and it's funny because you

23:35

can't. See the person you can just see. The.

23:38

Chewed up food in their senate. Glowing.

23:40

Guy glowing and affixes it's white. it's a

23:42

black and white picture and you could just

23:45

going down down the got at one hour

23:47

at two hours. Three hours like less and

23:49

less as in the semi Get. It's like

23:51

moving into the small intestine A are like

23:53

I said is that process is like moving.

23:55

Food drew the gods

23:57

getting scrambles by the

23:59

thing. Well, Spence. Did

24:02

you get that pun, the Scramble? Yes.

24:05

Got it? Registered? Excellent. There's

24:08

no need to, like, laugh at all. It's like, it's just

24:10

a thing. I know we're beyond that. I know. Exactly.

24:14

We're much more sophisticated than laughing. 100% show

24:16

appreciation for a pun. So,

24:19

quiet appreciation. Kind of where I'm at these days.

24:24

It's beautiful. So,

24:26

when Michael carefully watched what

24:29

happened to that radioactive meal, when the people

24:31

on the medication were digesting it. Everything.

24:36

It was significantly slower. So, it was a

24:38

good, almost an hour longer to

24:41

get half the meal out of the stomach.

24:44

And what Michael thinks might be happening here

24:46

is that on the medication, the stomach isn't

24:48

contracting the way it typically does. So,

24:51

instead of contracting, let's say, two or three

24:53

times a minute after the meal, it might

24:55

only contract once a minute

24:57

or once every two minutes. So,

24:59

the whole stomach as a muscular

25:01

bag is not squeezing the way

25:04

it's supposed to. That's exactly

25:06

right. Oh,

25:08

interesting. And this happened to

25:10

around 30% of the people

25:12

in Michael's study who were on these drugs. Meaning

25:15

that their digestion slowed down and stayed

25:18

slowed down. And

25:21

for some people, not everyone, but for

25:23

some people, this can be

25:25

bad. It can lead to something called

25:27

gastroparesis, which is another way

25:29

of saying paralyzed stomach. So, your stomach

25:32

isn't moving properly. And

25:34

the symptoms for that are people

25:36

feel really bloated or they're unable

25:38

to eat or it might make

25:40

you vomit. Right. The

25:42

woman who vomited so much,

25:45

she lost taste. Oh, God. Yeah.

25:48

It's really terrible. Wendy,

25:50

we reached out to the drug companies to ask

25:52

about this gut stuff and the lawsuits that are

25:54

going on. So, we talked

25:56

to Eli Lilly. They make ZEPBOUND and

25:58

Novo Nordisk. and

26:01

they both say that they're always

26:03

monitoring, evaluating and reporting safety stuff.

26:06

And Eli Lilly also told us that yes, there

26:08

can be bad GI reactions to these meds,

26:11

but they said that healthcare providers know about

26:13

those risks. And both companies

26:15

told us that they're vigorously defending

26:17

against the claims and the lawsuits.

26:19

Okay. So then I guess

26:22

my next question is, how

26:24

common is it to get really,

26:26

really nasty GI symptoms

26:29

from these drugs? Like from Michael's study,

26:32

it looks like a lot of people

26:34

get the sort of slowing down of their

26:36

stomach, but what about the

26:38

stomach paralysis? Yeah, Michael

26:40

said we don't have a fantastic study

26:42

yet to ask that question, but

26:45

I looked around and I think we do have some clues.

26:47

So for example, there's one paper that

26:50

looked at bad gut reactions and people

26:52

taking some agutide. And

26:54

the researchers of that study, they looked

26:56

specifically for reports of gastroparesis and they

26:58

looked at more than 600 people who

27:01

were taking some agutide. Okay. And

27:05

they found that only four

27:07

of them got gastroparesis. Okay,

27:10

so four out of 600-ish. All

27:12

right, so if you've got thousands of people on

27:15

this drug, you're gonna get some

27:17

with this thing. It's gonna pop up. It's

27:19

gonna pop up, interesting. But it's not all

27:21

that common as far as we can tell.

27:27

And actually what Michael and other experts think

27:30

is the more common problem from

27:32

this whole stomach slow down thing is actually

27:35

about what can happen if you have to have surgery. So

27:38

normally before you have surgery, you're asked

27:40

to fast. And the

27:42

reason is that they don't want you to throw

27:44

up when you're under anesthesia and choke. Well,

27:48

researchers are finding more and more often

27:50

that people on this class of

27:52

medication still have food in

27:54

their bellies, even after they fasted.

27:56

Right, right, right. They've actually poked

27:58

cameras down into people's... stomachs and

28:00

like seeing whoops there's food in there and sometimes

28:04

Wendy they even find this

28:06

thing called a bezewar.

28:10

What's a bezewar? Yeah

28:12

that's what I asked Michael. First

28:15

of all bezewar I mean

28:17

that sounds medieval that's a real thing. A

28:21

bezewar basically is a collection of

28:23

non-digestible food that remains

28:25

in the stomach. So Wendy do

28:28

you ever put veggies in a food processor

28:30

or a blender like if

28:33

you made like a kale smoothie and there's

28:35

like a chunk of the kale that just

28:37

like won't break up just like not getting

28:40

caught up in the blades? Obviously I have

28:42

never made a kale smoothie but

28:44

I do understand the concept yes yes yes

28:46

when there's still like a chunk of

28:49

stuff in the food processor that

28:51

is what a bezewar is. That's

28:53

a chunk of stuff. What

28:57

is a bezewar look like? Have you ever seen one? Yuck

28:59

yes. Did I

29:01

finally find something that grosses you out? Nothing

29:05

really grosses you about it for the gastroenterologist.

29:08

I want to say I want to say it.

29:10

Yes I have a picture for you and I'm

29:12

sending you the link now. Okay

29:15

I'm opening the link.

29:18

Oh

29:25

wow it's like a

29:28

marble small

29:32

brown piece of sh** is what it looks

29:34

like. Piece of crap. It's

29:38

like a black slimy

29:40

stone. Yeah. I can

29:42

imagine it in a tide pool. I don't really

29:45

want to imagine it in my stomach. Wow and

29:47

it's just stuck there? Yeah it has

29:50

to get broken up. And

29:53

does it get broken up? Well

29:56

there A doctor might have to do

29:58

it. You Might they might have to go in and like. I

30:00

took it up and the pull it out or

30:02

you know what monday and other way that they

30:04

feel better was. The

30:06

Coca Cola oh really they have like

30:09

that to they say put like a

30:11

tube of Coca cola and like sir

30:13

a that how his enemies of the

30:15

hospital and they run pokes through your.

30:19

Nasal passages like up and endure some big and

30:21

up in around and around and around and it

30:23

like breaks that I what because it's. So

30:25

parts is so acidic and

30:27

gripe is that a good

30:29

for a south of Bezel

30:31

office? Wow. Well. I know

30:33

how they figure this out. But

30:36

I know I know your next question. Yes,

30:39

Diet Coke works to access.

30:41

A. Lot

30:49

of still act like solas.

30:52

It's to the. Your. Dollars over

30:54

and over again. Legends, History. Haven't

30:58

you can't gauge and all I just

31:00

read get this is but since my

31:02

Say relays the Senate something yells at.

31:04

Their own as a matter of. Fact

31:07

and such. As

31:09

diverse. People. On or them

31:11

big and civil A drugs are probably

31:14

at a higher risk of getting Bezel

31:16

was that other people? yeah me either.

31:18

Buzzwords: For other reasons I love look

31:20

at them from eating Persimmons Am. Fun

31:23

facts but for be well you know

31:25

specifically getting them from being on these

31:27

medications. but I'll really know how common

31:29

it is. But there is a paper

31:32

where surgeon specifically looked in people's stomachs

31:34

before they had a surgery. for

31:37

better or worse and found that of twenty three

31:39

people who took this kind. Of. Medication for.

31:42

Had a bestseller. right? But.

31:45

And that's higher than you'd

31:47

expect from a general population.

31:49

Wow. Many lives in a sammich says of a bunch

31:51

of people who were non these medications they did. None of

31:53

them have as worse. So

31:55

it seems like there could be a higher risk

31:58

here. So we. to

32:00

have like a bezewah epidemic. I

32:04

don't know we need to have I hate

32:07

to say this we need more studies of

32:09

course we do we really don't have more

32:11

information on the bezewah thing this this is

32:13

kind of a new concern but I thought

32:16

it was worth bringing up because we know

32:19

that bezewah can do things like they can obstruct

32:21

your stomach they can cause stomach bleeding and they

32:25

can need to be removed with coke

32:28

or surgery so you

32:30

know it could be a real issue that happens

32:32

to people. Okay all right so

32:34

jokes aside bezewah headlines

32:36

may await us. This

32:38

could be a serious this

32:40

could this what are we to make

32:42

of this? I don't know we'll see I'm gonna keep

32:44

looking I'm gonna keep following it yeah don't worry

32:47

everyone I'm on the case. Good

32:49

do you? Yeah I think the jury's

32:51

out on how serious this is but

32:53

one thing that has come up within the last

32:56

year is that experts are now a little bit

32:58

more aware of this stomach slowdown thing

33:00

and how it could be a problem

33:02

for surgery like I mentioned and so now

33:04

the official recommendation is that if you're on

33:06

one of these medications and you have to

33:08

have a surgery you skip a dose before

33:11

you go under the knife. That's one implication

33:13

here another one is that like if you

33:15

have a really bad gut reaction gastroparesis and

33:18

maybe you get a bezewah you

33:20

might have to go off these medications and so that means

33:22

that there's a chunk of people out there that the

33:25

supposed game-changing weight loss

33:27

drug is not going to work for them. Mm-hmm

33:31

interesting interesting okay

33:33

and now um I

33:35

guess we've spent a lot of the episode talking

33:37

about the fears and

33:39

side effects around ozemphic

33:42

and drugs like it um but

33:46

do we what about the good stuff

33:48

I mean obviously it is helping a

33:50

lot of people who want to

33:52

lose weight lose weight but are we

33:54

hearing about anything else? Yeah I mean

33:56

the big one was a clinical trial

33:59

of people who were on

34:01

somaglutide for weight loss who had

34:03

heart disease. And this paper

34:05

made a big splash. And the reason is because it

34:08

didn't just measure, like, how much weight did you

34:10

lose, or how much, how did your cholesterol change,

34:12

your blood pressure change? Does someone actually measured how

34:14

many heart attacks people had and how likely they

34:17

were to die? And

34:19

it found that people on these medications had

34:21

fewer heart attacks and were less

34:23

likely to die. So, I mean, death,

34:25

that's a pretty, lack of death is a

34:27

pretty spectacular outcome, right? Yeah,

34:31

yes, exactly. And so, like, over

34:33

social media, you just see a lot of

34:35

scare-mongering about these drugs. But, you know, then

34:37

there's studies like this. I mean, that's huge.

34:40

That's heart attacks. Yeah. The whole

34:42

thing is that it's all about the pluses and

34:44

the minuses, right? Like, all medications. And so, Pupa,

34:46

who's the doctor that we talked to earlier in

34:48

the episode about muscle loss, this is one thing

34:51

that she and I talked about. And

34:53

she said that at the end of the day, we

34:55

know that for a lot of people and a lot of

34:57

her patients specifically, the pluses here

34:59

outweigh the minuses. My

35:02

pet theory is that, like, the people are

35:04

overstating some of these downsides

35:07

because they're morally opposed to the medications because it

35:09

looks like it's an easy way out. What do

35:11

you think? Do you agree with that? I

35:14

agree. I agree, you know,

35:16

that there are definitely, even

35:19

in amongst my colleagues, you know,

35:22

physician colleagues who, it's

35:25

a new concept. These are

35:27

tools. They're no magic wand,

35:30

but they're a beautiful tool and should

35:32

be used appropriately. Yeah,

35:38

right. Because, like, just to

35:40

summarize what we've learned today, when

35:44

you look at muscle loss, yes,

35:46

it does happen on these drugs, but

35:48

it's nothing special. It's just part of

35:50

losing weight. The fears

35:53

around having suicidal thoughts doesn't

35:55

seem to be panning out. And

35:58

then the stomach is... I

36:00

mean, we're going to have to wait

36:02

and see what's going on with those bezoars. And

36:05

yes, some do seem to

36:07

be slowing, but like really, really

36:09

nasty symptoms, they

36:12

seem to be quite rare.

36:15

And so like if we as

36:17

a society could separate out our

36:19

emotions about these drugs and the facts around

36:21

them, it'd probably be

36:23

a good thing. If we

36:26

as a society could separate out our emotions from what

36:28

facts are, then you would and I would be out

36:30

of a job, Wendy. That's

36:32

so. Wow,

36:35

lucky for us. Thank you, Rose.

36:41

Thanks, Wendy. Hey,

36:46

Rosie, we're going to try out a new

36:48

segment on this show called, How

36:51

Did You Find the Bezoar?

36:53

Ding. Wow. Is

36:55

that going to be a recurring segment? How

36:57

did you find the bezoar? Who knows who

37:00

can say at this point? In

37:02

every episode? I just have

37:04

to ask you, how did

37:06

you find the bezoar? I

37:08

saw the paper where four

37:10

out of 23 people, when they stuck

37:12

an endoscope down their throat, they

37:15

found bezoars. And

37:17

was that paper like the headline of

37:19

that paper? Like bezoars or was it

37:22

hidden? Oh, it

37:24

was in the headline. That was

37:26

an easy click for me. And

37:28

did you know what a bezoar was at that point? Okay,

37:31

well, that delighted me because there's like a scene

37:33

in Harry Potter where a bezoar is

37:36

used as an antidote to a potion.

37:38

And it's like something about like a

37:40

medieval remedy when there's a stone of

37:42

a goat stomach or something. So I

37:44

thought of it as like A, extremely

37:46

old-fashioned, B, kind of magical, and C,

37:48

something that happens to

37:50

goats. So I had

37:53

a lot to learn about bezoars.

37:56

And then that brought you to the Coca-Cola house.

38:00

paper I was reading about bezoars, every

38:03

paragraph is more absurd

38:05

than the preceding paragraph.

38:07

It was like bezoars,

38:09

goats, poison, surreal, they

38:11

can be cured with Coca-Cola. I was like, excuse

38:14

me? And then the next paper was like, other

38:17

researchers tried this with Diet Coke, and

38:19

I was like, Diet Coke? And it

38:21

was just too good to, it was

38:24

too good to leave behind. So

38:29

that caps off our inaugural segment

38:31

of, how did you

38:33

find a bezoar? Can't

38:37

wait to see what people talk about

38:39

on the second segment. I think

38:42

you've pretty much covered it.

38:44

Yeah. And Rose, while

38:46

you're here. Yeah. How many citations are in

38:48

this week's episode? 65. Yes.

38:51

And if people want to find them, where should they

38:54

go? They can check the link to the transcript, which

38:56

they'll find in our show notes. And

38:58

if people want to follow us

39:00

on social media, we are on all

39:02

the social medias. We're

39:05

really, we're really giving it a go.

39:07

Aren't we? We're at science underscore BS

39:09

on Instagram. I'm on TikTok at Wendy

39:11

Zuckerman. Come and say hello. We'd

39:14

love to hear from you. Love to hear what you

39:16

thought about this episode. And if you want to see

39:18

a photo of a bezoar, we will put one

39:20

or several on Instagram. And we've got some

39:22

other fun stuff for Instagram too. Yeah. All

39:25

right. We'll see you there. Thanks

39:27

Rose. Thanks Wendy. This

39:37

episode was produced by Rose Rindla with

39:39

help from me, Wendy Zuckerman, Merrell Horn,

39:41

Michelle Dang and Joel Werner. We're edited

39:43

by Blythe Terrell. Fact checking by Erica

39:46

Akiko Howard. Recording assistance from Selena C.

39:48

Reynolds. Mix and sound design by Bobby

39:50

Lorde and Peter Leonard. Music written by

39:52

Bumi Hidaka and Maimunga, Peter Leonard, So

39:54

Wylie and Bobby Lorde. Thanks to

39:56

all of the researchers that we spoke to for

39:58

this episode, including Dr. Dr. Kristin

40:00

Beavers, Dr. Ellen Fallows, Dr.

40:03

Joseph Henson, Dr. Demetrius Papamargaridis,

40:06

Professor Roger McIntyre, Professor Russ Weitman,

40:08

Dr. Saib Kolsor, Dr. Travis Masterson

40:10

and Dr. Etienne Wang. A special

40:12

thanks to all of the listeners

40:14

that we chatted to about how

40:16

they're going on these Weitluss meds.

40:18

We really appreciate all the time that you took.

40:21

And thanks to the Zuckerman family and

40:23

Joseph Lavelle Wilson. Science Versus is

40:25

a Spotify Studios original. Listen to

40:27

us for free on Spotify or

40:29

wherever you get your podcasts. Yes,

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Science Versus is everywhere. But if

40:34

you are listening on Spotify, then follow

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us and tap the bell icon and

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then you'll get notifications every time a

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new episode pops up. I'm

40:43

Wendy Zuckerman.