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00:00MUSIC
00:04There's a global weight loss revolution happening right now.
00:07It's all over social media, with wall-to-wall before and afters.
00:11The most triggering piece of equipment in the world,
00:14there it is on the floor.
00:15I hate it.
00:16This is LA. Yeah.
00:17The doctor's like, yeah, you're fat as fuck.
00:19Hollywood is shrinking before our eyes.
00:22While the rest of the world is getting bigger,
00:24celebrities are quietly jabbing themselves thinner.
00:27Everyone who's anyone is on it.
00:2970. Two pounds.
00:32Three pounds!
00:33So is this little injection pen the Holy Grail?
00:36A way to lose weight and keep it off?
00:39There will always be people who eat less, move more,
00:42lose weight and keep it off.
00:44But it is the vast minority of people.
00:48Brands like Ozempic, Moonjaro and Weigovi
00:51are becoming household names.
00:53Originally created as a drug for type 2 diabetes,
00:56GLP-1 medication works on the stomach and the brain,
00:59mimicking a naturally occurring hormone
01:01which tells us we're full and slows down digestion.
01:05109 pounds.
01:07I feel fabulous.
01:08Very tired, explosive diarrhoea.
01:12I was peeking blood.
01:13In this documentary series, I want to find out
01:16what are the implications of this weight loss revolution
01:18for society at home and abroad.
01:21It should be an alarm bell going off
01:24that we have to now inject ourselves
01:26because the food environment is so toxic.
01:30There was always a Happy Meal commercial,
01:31there was always a Pizza Hut commercial
01:33and you're inundated with it because you would get toys.
01:36These drugs are rocket fuel for eating disorders.
01:39With 24% of Irish people in the obese range,
01:43are we really going to medicate a quarter of our population?
01:47Even if you're not clinically diagnosed as diabetic,
01:50should we have to wait until we are
01:52before we do something that can be helpful?
01:56I've always been an advocate of healthy eating and exercise,
01:59not just to try and maintain a healthy weight,
02:01but to live a long, healthy life.
02:04But does the arrival of these new weight loss medications
02:07mean it was all for nothing?
02:09Have I been wrong about everything I believe in?
02:12What about you can never be too rich or too thin?
02:15And tan.
02:17Tan, thin, rich.
02:23Happy face.
02:25Happy face.
02:27The subject of weight is so personal and complicated
02:30and can really be divisive.
02:32But whatever shape we are,
02:34most of us have our own stories of feeling the wrong size.
02:38When I was a kid, I was quite overweight.
02:40I would have felt the stigma of weight,
02:42I would have been called names.
02:45There is one school memory that I have
02:49that I will never forget.
02:51He was pointing out different children.
02:53Who was the smallest girl in the class?
02:56Who was the tallest boy in the class?
02:57Who was the fastest girl?
03:00Who was the cleverest?
03:02And then the finger pointed at me.
03:03And in Irish, everybody say it three times.
03:07Tá Catharine an CáilÃn is ráire sa seomra.
03:11Everybody, Tá Catharine an CáilÃn is ráire sa seomra.
03:14Catharine is the fattest girl in the class.
03:18I knew it was coming.
03:20I was waiting my turn to be singled out
03:22and absolutely humiliated.
03:27And I will never forget it.
03:33I can think of so many moments
03:36where I'm brought back to that stigma and shame.
03:41I suppose like a lot of kids, I grew up,
03:43I lost the weight because I found a love of sport.
03:46And with that, I found confidence and strength
03:49and an interest in overall health, to be honest.
03:51And my fear is that if we are just jabbing ourselves
03:55with this medication just to lose weight,
03:58like what does that mean for the enormous benefits
04:01that come with good food and physical exercise?
04:09When I set off to learn more about these drugs
04:12and their impact,
04:13there was one person I knew I wanted to talk to.
04:17I've come to London to meet an author called Johann Harry
04:20and he writes about big societal change.
04:23He's written a book called Magic Pill,
04:25which is all about weight loss medications.
04:27He's taken the meds himself.
04:28He's travelled all over the world talking to people about it.
04:31His good friend, Oprah, is a big fan of his work.
04:34So I'm just curious to know,
04:35does he really think after all of his research
04:38that this is a magic pill?
04:42When I learned that we now have a new kind of weight loss drug
04:45that really does produce enormous amounts of weight loss,
04:50the first thing I thought was, well, this could save my life.
04:54Because I was very conscious, I was about to turn 44,
04:57which is the age my grandfather was
04:58when he died of a heart attack.
05:00So loads of the men in my family get fat and die young, right?
05:0444 is young! 44, yeah.
05:06One of the real low points of my life,
05:07just before Christmas 2009, I went into my local KFC
05:12and the guy behind the counter said,
05:13oh, Johann, I'm really glad you're here.
05:16I was like, all right. He said, wait a minute.
05:18And he went off behind where they throw the chicken and everything.
05:21And he came back with a massive Christmas card
05:23and everyone who was working that day,
05:24in which they'd written, to our best customer,
05:27and everyone had signed it.
05:28And one of the reasons my heart sank is I thought,
05:32but this isn't even the fried chicken shop I come to the most.
05:35How can this be happening to me, right?
05:38So, yeah, I think basically from being weaned
05:41to, like, the age of 44,
05:44I ate almost nothing but junk food and fast food.
05:47So, in saying that, then, you are a big believer in these drugs,
05:51you are a big supporter of these drugs.
05:53These drugs have been amazing for you and your health.
05:56When I started taking Ozempic,
05:59for a long time, I had this sense that I was doing something wrong.
06:04I was doing something immoral.
06:06I was kind of puzzled by it.
06:08I was like, you know, one of my best friends
06:09was taking statins for his cholesterol, right?
06:12I've never once looked at him and gone,
06:14you cheat, trying to get ahead of me on cholesterol, right?
06:17It's never crossed my mind that he was doing something wrong.
06:19I thought, well, why do I feel there's something wrong here?
06:20It's very deep in our culture,
06:22the idea that obesity is a sin that deserves to be punished, right?
06:27And one of the ways you know we still follow that pattern of sin
06:29is what are the forms of weight loss we admire?
06:32The only form of weight loss we admire
06:34are ones that involve deep suffering.
06:36But with this, I realised part of the problem
06:39is it's so easy.
06:40I pick up this little pen, you know, once a week,
06:43I do a tiny little jab in my leg, I barely feel it.
06:46I'm not fat anymore.
06:47I'm not hungry anymore.
06:48Like, it's a wild thing.
06:50This is not a fad.
06:51This is not a craze.
06:52This is a staggering medical breakthrough.
06:55But you're having just a couple of bites of food.
06:58And what I don't understand is how are you getting enough nutrients?
07:02How are people getting enough nutrients into the body?
07:05Might be four or five o'clock in the evening,
07:06they've had nothing to eat, nothing.
07:08They're sitting across, they have a coffee, that's it.
07:10Malnutrition is a very real risk.
07:12And malnutrition is catastrophic for your health, right?
07:15I'm worried that there could be an opioid-like death toll
07:20of young girls, and it is overwhelming,
07:22young girls who get eating disorders,
07:24who starve themselves to death,
07:25who would not have been able to without these drugs.
07:28Dr Kimberley Dennis,
07:30who's one of the leading eating disorders experts
07:32in the United States said to me,
07:33these drugs are rocket fuel for eating disorders.
07:38Johan's perspective is really quite scary.
07:41It sounds like these drugs act like a straitjacket on your appetite.
07:45They're supposed to be taken for life.
07:48Evidence shows that when most people stop taking them,
07:50the weight goes straight back on.
07:54Ashley lost a staggering eight stone on GLP-1 medication.
07:58But at 150 euro a month as a single mom,
08:01she couldn't afford it anymore.
08:02And so she's doing everything she can without the drugs
08:05to maintain her weight loss.
08:08Oh, Jesus.
08:09It all kind of started when I was...
08:11I had my daughter when I was 22 and the weight just piled on.
08:14And what weight were you at that point?
08:1522.2 stone.
08:17OK. Or 134kg.
08:19OK. And a BMI of 42.
08:21And I just said, I can't continue like this.
08:23My heart rate is high. My blood pressure is high.
08:25I can't walk up one flight of stairs.
08:27My knees are hurting me. My hips are hurting me.
08:29I'm a young woman. I'm in my 30s. I need to do something.
08:32So I went to my GP on the 27th of June.
08:34I actually had said to him,
08:36can we please try Ozempic before weight loss surgery?
08:40And he agreed.
08:41As soon as I took that first injection,
08:43I changed my mindset around food very, very quickly
08:45because the night-time cravings were gone.
08:46So the food noise is gone.
08:49I knew I had to put in work with taking the Ozempic.
08:52I knew it wasn't just going to be a case of take it
08:54and watch the results roll in.
08:55But I knew I had to get weight off first
08:56before I could put in the work.
08:58Without data, I understand that it is a big commitment
09:01to your health to take Ozempic.
09:03It's a big decision to take Ozempic.
09:05It's also a big financial commitment.
09:06Yeah, it's horrible.
09:09It's not cheap.
09:10It's 150 euro, well, in some places,
09:13a month for one pen, one milligram pen.
09:16Since losing my job, I can't afford it.
09:19So how long are you off now?
09:21Since November of last year, so about 10 months.
09:23Okay, and you look mighty.
09:27Oh my God.
09:28I'm always afraid these days to tell people
09:29that they look great, or you know.
09:30No, you can tell me. It's okay.
09:31Tell me all you want, it's okay.
09:33Since losing weight, Ashley's health has improved
09:36and she's gone from weighing herself daily
09:37to just once a month.
09:39Look at your lovely clean bathroom.
09:41So the most triggering piece of equipment in the world.
09:45Are you actually shaking?
09:46Yeah, I'm starting to a little bit.
09:47You're shaking.
09:49Oh my God.
09:50It's just, oh, it's so hard to explain how this feels
09:53as someone that's lost all their weight.
09:56But what about the argument that forget about the scales
09:59and it's about how you feel and it's about...
10:03How you feel in your clothes and how you feel in your head.
10:05Like why do the numbers matter?
10:09It's a really good question.
10:10I never really thought about it like that.
10:12I suppose the numbers matter to me
10:13because the numbers were so big for so long
10:17and I need to make sure that I'm staying happy,
10:18I'm staying healthy and a healthy weight and a healthy BMI.
10:21And I can't let all my hard work for the last two years
10:24been for nothing if I'm gonna start gaining.
10:27Oh no.
10:28Okay.
10:29Do you know what number you want to see?
10:3173, because that's what I want.
10:3373, okay.
10:34Yeah.
10:39Oh, no way.
10:42What are you at?
10:4378.2.
10:48That's 5.2 kilos in a month.
10:51That's crazy.
10:55Oh my God.
10:57That's bad.
11:01No.
11:03Why is that bad?
11:05That's 5.2 kilos in a four week month.
11:09Four?
11:10Yeah, four weeks.
11:11But to me, that is danger.
11:13That is just red flag danger territory
11:15because that's how it starts for me.
11:18This 78 kilos, what about the next month it could be 88?
11:21And then before I know it, I'm back up for square one.
11:23This is all about me maintaining my healthy weight
11:26and not letting obesity come back into my life.
11:29And by the looks of that scale, that's a possibility now.
11:33I need to be on this long-term.
11:35It's not a short-term fix
11:37where you take it for two years,
11:38lose all the weight and then you stop.
11:41That was so hard to watch.
11:44I mean, the girl is living in constant fear
11:47and she's at war with her own body.
11:49Like that is no way to live.
11:52So maybe the right thing for her
11:54is to get back on the medication.
11:56Saksenda is prescribed for the treatment of obesity
11:59and more recently, Mungero has been licensed
12:01to treat type 2 diabetes and obesity.
12:04Ozempic is only licensed for people with type 2 diabetes,
12:07but like with lots of other medications,
12:10doctors are prescribing off-license.
12:13But then it's the pharmacists who are having to deal with that.
12:17It became a problem where, you know,
12:19a lot of celebrities started using it
12:21as they heard about the benefits for weight loss
12:24because it slows down the absorption of food from your stomach.
12:27It stops all that.
12:29They call it food sound and chatter.
12:31Community pharmacies received a letter
12:33jointly from the Medical Council,
12:35the Pharmaceutical Society, the HPRA, the HSE, the department.
12:38They all signed it saying,
12:40the licensed use of this medicine is diabetes
12:43and that is who you need to prioritise.
12:44This is about people who already feel stigmatised
12:49and these drugs now that everyone is taking,
12:52these drugs now that everybody is talking about online
12:55and their doctors are prescribing,
12:58and then sending people in to you
13:01who then are actually not in a position to hand out these drugs.
13:04The whole thing has, I suppose, created this element of division
13:08between patient groups and in reality,
13:12I don't think any of us were maybe prepared
13:15for the onslaught of queries that would bring
13:18and how to manage them.
13:20This scramble for medication in Ireland
13:22has led to a big increase in online platforms
13:25where registered Irish doctors are prescribing GLP-1 treatment.
13:29Apparently, all of the yummy mummies in Dublin 6
13:34are getting their weight loss meds here very easily.
13:38So, I said, I'd jump on and see how easy it was to get it myself.
13:44Do you have any of the following conditions concerning your thyroid?
13:47Cancer of the family? No, no, no, none of the above.
13:50Do you have diabetes? No.
13:52Have you ever been diagnosed with an eating disorder,
13:54for example, bulimia or anorexia? No.
13:56Please provide an accurate weight measurement.
13:59OK, well, my weight is in and around 65kg,
14:03so I'm just going to say I'm 106kg.
14:08And then what is your height in centimetres?
14:10So, I'm 5'7".
14:12And I'm going to put 160cm.
14:17I have responded honestly
14:19and provided complete and accurate information
14:21that reflects my up-to-date medical history.
14:24I accept.
14:26OK, here we go.
14:28So, sorry, it's not asking me for photo ID.
14:30It's not asking me for anything from my GP.
14:35It's literally just letting me check out.
14:39Is this right?
14:42Will I just pay the money?
14:44Let's get ordering.
14:47Is it as simple as that?
14:49Like, I could be a 15-year-old girl with an eating disorder
14:52and my mother's credit card getting these medications.
14:56That is bonkers.
14:59Your order has been placed.
15:05There are the things that you don't think about, you know?
15:06Professor Donal O'Shea, the HSE's clinical lead for obesity,
15:10runs Loughlinstown Hospital's Obesity Clinic.
15:13Over 25 years, he has seen seismic change
15:16in our understanding of the causes of weight gain.
15:20When I went to London in 1992 to do my research into obesity,
15:25I was told to read about three hormones.
15:27One of them was GLP-1.
15:29And I said I liked the other two
15:31and that I didn't think GLP-1 had any future.
15:34And my supervisor said,
15:38thanks for doing the reading, you will work on GLP-1.
15:42So I'm very pleased that he gave that advice.
15:45But it's a powerful stimulator of insulin release,
15:48a powerful suppressor of appetite.
15:52And we're also finding that it's overcoming
15:55the metabolic adaptation that happens when you lose weight.
15:59So explain then to me, what is metabolic adaptation?
16:03When the body loses a pound, it senses it
16:07and then tries to reduce its energy burn
16:12to get that weight back up to where it was.
16:15Then you introduce the food environment that we have now
16:19and the physical activity environment that we have now.
16:22And it's like petrol on a fire.
16:25So how do some people lose weight and keep it off?
16:28There will always be five to 10% of people
16:31who won't have that same metabolic adaptation.
16:35Will eat less, move more, lose weight and keep it off.
16:40There are some people who can do that,
16:42but it is the vast minority of people who can do that.
16:52And one of the big problems for our patients was the...
17:02This.
17:05Some of them have called this their Mount Everest.
17:08Do you know, they would look at that and say,
17:11I'm not going to be able to make it.
17:12Right.
17:14Wow.
17:15In the past, the treatment of obesity
17:17included wiring patients jaws shut
17:19to prevent them from eating.
17:21Nowadays, the combination of calorie restriction,
17:24bariatric surgery and GLP-1 medications
17:27are making a huge difference for patients like Gary.
17:31How are you keeping?
17:32I'm great, thank you.
17:33Good.
17:34Can I sit down?
17:34Yeah, yeah, yeah, go for it.
17:36I'll take a seat as well.
17:37Five years ago, he was 60 stone and rarely left his house.
17:41I had no future at one stage,
17:43catching, I was waiting to die.
17:46I was waiting to die and I used to have nightmares
17:48about my funeral and the embarrassment
17:52I would cause my family at the funeral.
17:54And the thoughts of maybe having to use a forklift
17:58or whatever.
18:00I am able to deal with situations a lot better.
18:03For example, I was in the marina market
18:05down in Cork before Christmas with my wife and son
18:08and a group of young men
18:10were using their phone to video me.
18:13And my wife got really, really angry about it.
18:16And I said, let them.
18:17I said, they don't know what I've been through
18:19the last few years.
18:20They don't know how much weight I've lost.
18:23You know, but then part of me later said,
18:24I should have just gone over and said,
18:26lads, you think I'm big now?
18:27I've lost 20-odd stone.
18:29You think I'm big now?
18:30Here's a picture, look at me.
18:32There was maybe five to six year period of my life
18:36where I'd never have gone to a shop, ever.
18:39So to be able to walk into the Lego store
18:41with my son and my wife and just have a look around.
18:44And it was literally a look around.
18:47It's the small things.
18:48Small victories are the big things.
18:50Chatting to you now, do you feel hopeful for the future?
18:53Oh yeah.
18:54Yeah?
18:55Yeah.
18:59And that's really important.
19:00And that's student medical dietician students are us.
19:03Can I just sit down for two seconds?
19:04Take a break.
19:05Sorry.
19:06He's quite a lovely guy.
19:07And it is undeniable how beneficial these medications are
19:11for people who are living with obesity.
19:13Like, they're life-changing for Gary and his family.
19:19But I suppose then the question is,
19:21how do we decide from a wider perspective
19:24who qualifies to take this medication?
19:28I don't qualify for this medication,
19:30but with a bit of fudging the figures
19:32and faking all my health stats,
19:34a package arrives to my house
19:35prescribed by an Irish doctor.
19:38So this was just delivered from a pharmacy in Ireland.
19:44Okay, so five pens.
19:46So within 48 hours, I have a medication
19:49delivered to my door
19:51that I don't meet the criteria for taking.
19:54You know, this is medication that needs to be
19:56taken under the guidance of your doctor.
19:58I put in all of the wrong information
20:00and was able to do this.
20:01And I suppose my worry is how this could snowball.
20:05If it's that easy, unless we put in the correct legislation
20:08around the meds, you know?
20:13People have different motivations for losing weight.
20:16And Alwyn, who I'm going to meet now,
20:18she's always wanted a family
20:19and her weight has been that barrier
20:23that stopped her achieving that dream.
20:25I always wanted to foster or adopt.
20:28And I remember BMI being one of the reasons
20:31that if your BMI was over 35,
20:34you could not foster or adopt.
20:37And I remember literally bawling my eyes out.
20:41I hung up, I bawled my eyes out,
20:44went straight onto Instagram and said it,
20:46and then started my IVF journey.
20:49You did four rounds of IVF in Greece.
20:51Yeah.
20:51Were any of those successful?
20:53The last one was successful
20:54and I got pregnant with a little boy,
20:56but then I lost him.
20:58Yeah, so.
21:00Like, I find it very hard to put a timeline
21:03on everything that happened
21:05because my weight's always been an issue.
21:07So it's like, it's very hard to put a timeframe on it.
21:11I think at my heaviest, though,
21:13I was like 24 and a half stone.
21:15OK.
21:16It's tough.
21:17Now, there, that's me, caught off guard.
21:21Mm-hmm.
21:23My weight started from my communion.
21:25The communion dress is handed down.
21:26When it got to me, it didn't fit.
21:29And that's when I kind of realised,
21:31oh, I'm putting on weight quite quick.
21:33But I think the biggest change would have came
21:35when I was going into secondary school.
21:38I was severely bullied,
21:40like really badly bullied for my weight.
21:42There was a girl in my class
21:44that I was really good friends with
21:45and it was her birthday party.
21:47And I remember them not seeing me there.
21:50And one of them saying,
21:52oh, her mum said,
21:53or her mum said she's not coming to her birthday party
21:56because she'd just eat everything
21:57and there'd be nothing left for anybody else.
21:59And it affected me really badly, like.
22:03And I actually hate talking about it
22:04because I'm in a good place
22:08and I just don't think the bullies should win.
22:12And I remember at my 21st,
22:13I invited them all to my 21st.
22:16And what happened that night?
22:17None of them came.
22:20Yeah.
22:21I became funnier, louder and fatter because of it.
22:26GLP-1 medications don't work for up to one third of people.
22:30The experts aren't sure yet exactly why.
22:33Alwyn didn't lose any weight on Ozempic.
22:37I asked my doctor.
22:38I've done my research
22:40and it does look like that people
22:41who are not successful on Ozempic
22:44have been successful on Mongero.
22:47Okay.
22:51That's a lot of work.
22:52Yeah, imagine if it doesn't work.
22:56Oh, sorry.
22:58But yeah, does anyone else feel absolutely shattered?
23:02Or is that not a side effect?
23:04I don't know.
23:04I'm losing my hair and my hair is thinning out so bad.
23:07You can see my scalp.
23:09I haven't been able to sleep for two days.
23:13I haven't been able to drink or eat.
23:15Taking these drugs as recommended,
23:17which is for life, is not a simple decision.
23:21Whether it's nausea, vomiting, constipation
23:24or more serious issues like pancreatitis or gallstones,
23:28these GLP-1 drugs do not come without their side effects.
23:31Suzanne Harrington's experience on the meds was short-lived.
23:35It was kind of vanity and curiosity
23:38and the desire to lose a stone
23:39without having to suffer for it,
23:42if I'm being completely honest.
23:46So tell me what happened when you took your first jab.
23:49I was having lunch with my son
23:51in our favourite Japanese place
23:53and I had had a little tiny bowl of miso soup
23:56and there was a plate with some steamed broccoli on it.
23:59And I was looking at this broccoli going,
24:01mmm, mmm.
24:03So I just said, and I didn't want to freak my son out.
24:06So I said, will you eat my broccoli?
24:08And he went, yeah, yeah.
24:09I got a bit anxious and I was thinking,
24:10is this worth feeling like, mmm, all the time?
24:14But I thought I'll persevere.
24:15But after three weeks or so,
24:18I realised that it was probably not feasible at that time.
24:23Now that I know that it's there and it exists,
24:25it's a very comforting feeling longer term,
24:29that, you know, if I were to gain weight again in the future
24:33and it's to the point where it was hurting my knees
24:35or my hips or whatever,
24:36I don't want to kind of go into old age
24:38and be stressing my joints.
24:41There is this kind of, it feels like a get out clause
24:43that never existed before.
24:46And that's a nice feeling.
24:49I can absolutely see the appeal of these medications
24:52if you're somebody who's been in a constant fight
24:54against your own body.
24:55And that's exactly what happened to Ashley.
24:57You know, she lost all the weight on the medication.
25:00She was offered for 10 months,
25:02doing loads of exercise, eating the right food,
25:04and the weight started to come back up again.
25:06So I'm going to see her in the gym now
25:08and I already know the decision that she's made.
25:12The big question, are you or are you not
25:15back on the ozempic?
25:16I'm back on the ozempic.
25:17You're back on it.
25:18I'm back on it.
25:18Okay, and how's it going?
25:20I wanted to show people when you stop it,
25:22you can still maintain,
25:23you can still be the healthy weight.
25:25And I really wanted to be that person.
25:26And I worked so hard to be that person.
25:29I can't do that.
25:30And I wanted to.
25:31But what about the argument of metabolic adaptation?
25:34Yeah.
25:34That is what the experts are saying.
25:36And your body is always trying to get you back up
25:38to that higher weight.
25:39Yeah.
25:40So that's not you failing.
25:41There are some people out there
25:42that can lose weight conventionally
25:43by eating less and moving more.
25:45Then you have people like me, like you said,
25:47metabolic adaptation.
25:48I can't.
25:49And I need this medication to sustain my weight.
25:52You've achieved great success,
25:55but it has become a bit of an obsession.
25:57Would I be right in saying that?
25:58Like the weighing scales?
26:01If I'm being 100% honest, cards on the table, yeah.
26:04There's no sugarcoating it.
26:05It has.
26:06It's-
26:07How many times a day are you weighing yourself now?
26:12Four.
26:13So I weigh myself when I get up in the morning first thing.
26:15I weigh myself probably around lunchtime,
26:16probably four or five o'clock.
26:18And then again, before I go to bed.
26:19I really feel your fear when I'm with you
26:22and you're talking about it.
26:23I really do feel it.
26:25And it's genuine fear.
26:27Do you think you'll ever be free?
26:33I hope so.
26:35In 1997, the World Health Organization
26:38officially classified obesity as a disease.
26:41It's a decision that has polarized
26:43the medical world ever since.
26:46I have spoken to so many doctors for this documentary
26:49who do not think obesity is a disease,
26:51but they won't go on camera and say it.
26:53Here's a doctor here.
26:55Some people metabolize food at a different rate to others,
26:57meaning they are more likely to lay down fat stores
27:00than other people.
27:01But this is a reason to eat less
27:02when you see your weight start to creep up,
27:03not to become fat.
27:05Medicalizing obesity, trying to frame it as a disease
27:08rather than a consequence of behavior, helps no one.
27:12Professor Karel Leroux, who works as an advisor
27:15for two of the biggest pharmaceutical companies
27:17that make these drugs,
27:19has heard this dismissive attitude before.
27:22The same narratives we heard
27:24when it came to actually understanding
27:26that we can reduce cholesterol
27:28with a drug that changes the liver.
27:30People said, no, you can't medicalize cholesterol.
27:34People should just eat fewer eggs.
27:36But eating fewer eggs does not reduce heart attacks.
27:39Taking a statin reduces heart attacks by 25%.
27:43If we're saying that the environment doesn't matter
27:46and that food doesn't matter and exercise doesn't matter,
27:50if you have the disease of obesity,
27:51it's a biological thing
27:52that you have to treat with medication.
27:54It doesn't give much hope.
27:55Do you know what I mean?
27:56It's to medicalize something like this, as simply as that.
27:59There's no doubt that, you know,
28:01the environment has changed dramatically
28:03over the last 50 years.
28:05At the same time when the disease of obesity has changed.
28:08So yes, the environment has changed,
28:11but they have a biological disease
28:14that is now driving the problem.
28:16So in 10 years time,
28:18do you think we'll be injecting children with these drugs?
28:20Do I think we will be treating children
28:23that have the disease of obesity
28:26with effective treatments?
28:27Absolutely, yes.
28:29How long have you worked with Novo Nordisk?
28:31So I have worked with these companies
28:33for about 20 years now.
28:35What's your view on people that say,
28:37somebody in your position,
28:39that actually it can't but be a conflict of interest
28:42for you to be talking about how great Ozempic is.
28:45So I always, you know, would argue,
28:47I work with so many companies.
28:49I have so many conflicts of interest
28:50that I have no conflicts of interest.
28:53I am not on their marketing advisory board.
28:56I'm on their global scientific advisory board.
29:00So we are actually channeling, you know,
29:03where they actually are spending their money.
29:06Now, clearly I'm, you know, on the advisory board.
29:09They don't have to listen to me, you know,
29:11but, you know, we give our opinions
29:13because we actually want to make the world a better place
29:17in 10 years from now.
29:21These kids are the first generation of children
29:24who are gonna grow up in a world
29:26where this medication looks like
29:28it's gonna be readily available.
29:31And it's been called the game changer for health.
29:32It's the first of its kind.
29:33It's a revolution for weight loss
29:35and therefore a revolution for health.
29:37I mean, I don't know what that means.
29:38I don't know what that world looks like.
29:41You know, does that mean everything that we've learned
29:42about healthy eating and ensuring physical exercise
29:47is part of their lives?
29:48Does that just vanish?
29:50I don't know.
29:50Like, it's kind of scary.
29:54It's only a half-pistachio.
29:59Just collected my prescription.
30:01Ta-da!
30:03And she said, if I get my prescription from my doctor
30:07and it has like, say, three or four months on it
30:11and I don't want to get them all in one visit, I can.
30:15So that's good news.
30:18Ozempic didn't work for Alwyn.
30:20She's hoping the GLP-1 drug Moonjaro
30:23will help her lose weight
30:24so she can fulfil her dream of having a family.
30:27Being refused fostering and adoption
30:30because of my BMI affected me more
30:34than five rounds of failed IVF.
30:36I was like, why is it always me?
30:40Why have I done five rounds of IVF and it's not working?
30:43Why am I after trying to foster and adopt and I'm too fat?
30:47Why am I too fat for Ozempic?
30:49Why am I too...
30:50I always feel like that's my question.
30:52Why am I too fat for anything?
30:55We've got a problem already.
30:56What's that?
30:58There's no needles.
31:00Oh, you have to choose to get the needles.
31:02Yeah, which I wasn't told in the pharmacy.
31:05Everybody else has spare bin bags.
31:07You have spare needles.
31:08Yeah, but this is from Ozempic, okay?
31:11And how much was that?
31:12This was 143 pounds,
31:15which works out at just over 160 euro, I think.
31:20So I'm on one dose
31:22and then I take this off, this off.
31:25And you don't need to read anything now before we do this?
31:27No.
31:28Okay.
31:29And then I'll just go here and I'll hold it.
31:35And then you're slim.
31:35No, you're not.
31:44One month after all, when Boyle started Moonjaro,
31:47I'm back to see how she's doing.
31:49I've never had a day in my life since,
31:51probably since my communion.
31:54Weight's been part of all of my life.
31:56You hate weighing scales, do you?
31:58Yeah, because-
31:58I don't think I've met one woman
32:00who likes the weighing scales.
32:02No, it's just I obsess about it
32:03and I'd stand on it every day
32:05and if nothing happens, then I'm really upset.
32:08And then that in turn will make me go,
32:10oh, I forget about it
32:11and then I don't want to be eating to, you know,
32:13or go back down that road.
32:16But you know, like you're like,
32:17oh, I better go to the toilet first, quick.
32:19Anything, take your earrings off.
32:21Oh, maybe my bracelet's very heavy.
32:24Right.
32:26So I'm only down two kg.
32:30So are you disappointed?
32:32How are you feeling right now then?
32:34I'm a bit meh.
32:37Yeah, a bit meh.
32:40I don't think, I think now,
32:43yeah, I don't know.
32:44I don't know if I financially could afford
32:47to keep going down the road for that.
32:50You know, it's working out at 200 euros a month
32:56for four injections.
32:59We only got the good news this week
33:03that the BMI is now gone from Tuzla's regulations.
33:09So maybe that's a sign and maybe that'll helpful
33:14and maybe they can just do a health screening on me
33:17rather than put me down to a number.
33:21Just when it seemed that society was becoming accepting
33:23of bigger bodies, Ozempe came along.
33:26And women we looked up to for embracing their bigger size,
33:29Oprah Winfrey, Amy Schumer, Rebel Wilson,
33:32all began shrinking before our eyes.
33:35Podcaster, journalist and mom of two, Louise McSharry
33:38has always been an outspoken supporter
33:40of the fat acceptance movement.
33:42And I want to know what she thinks of it all.
33:44So when you heard about these new weight loss medications,
33:47what was your first reaction?
33:49I was skeptical at first.
33:51And then I was like really just disappointed to see
33:53that already thin women were using them
33:55to become even more thin.
33:57But then I suppose I would be lying
34:01if I'd said that I hadn't thought about it for myself.
34:03You know, I have spoken to my doctor about it.
34:05I don't know where I'm gonna land on it
34:08because I've always said and would never deny
34:11that yes, of course, if I could take a medication
34:13and wake up thin tomorrow, I would do it
34:15because my life would be easier in so many ways.
34:17Honestly, like I have been researching this
34:21and working on this for months.
34:22And some days I go, okay, I think this.
34:26And then other days I go, I think this.
34:27Like it's just so nuanced and it's so divisive.
34:32And I just, for whatever reason,
34:33I keep going back to my kids.
34:35You know, God, you want a world
34:39where they don't think about what they look like.
34:41You know what I mean?
34:42I do.
34:43And I want that for us.
34:45I want that for everyone.
34:47I have had very real connections
34:48with many people over the years.
34:50I was on holidays a couple of months ago
34:51and a woman came over to me very apologetically
34:53and said, I'm really sorry to bother you.
34:54I know you're with your holiday or with your family.
34:56But I just wanted to say,
34:58I'm basically wearing swimming tugs today
35:00with my daughter because of you,
35:01because of something you posted a few years ago
35:03about like, you know, get in the pool with your kids,
35:06put your swimming tugs on.
35:07Like it's, you know, it's more important
35:09than you feeling perfect bikini body and all the rest.
35:14And I would hate to disappoint those people.
35:17That would be a big factor in my decisions, you know?
35:19Obesity was classified as a disease
35:22by the World Health Organization
35:23and the European Commission.
35:24What's your thoughts on that?
35:25Because it has been so polarizing in the medical world
35:28and actually in general.
35:29It feels like my existence is a disease.
35:32And that is, doesn't sit well with me.
35:38That's hardcore.
35:39That's how it feels.
35:41That's how it feels.
35:42It feels like you are a disease.
35:49I'm going to visit friends of mine now
35:50and Nikki is a really good friend of mine
35:52and she has struggled with her weight all her life.
35:55And she honestly reckons these medications
35:57are the greatest things in sliced bread.
36:00A year ago, I was 50 pounds heavier, 50.
36:05Yeah, but for a third of people, it doesn't work.
36:08But when it does work, it works really well, you know?
36:11Do you not believe that people can do it with lifestyle alone?
36:14I think it's very difficult to sustain it long term.
36:19And...
36:19A bit like it's very difficult to sustain it on Ozempic alone
36:22because once you come off Ozempic...
36:24But I think the thing is,
36:25you can stay on Ozempic forever, really.
36:27Like, that's the other thing.
36:28But you can have a healthy lifestyle forever.
36:29Yeah.
36:32Thanking you, I'm going to pass it around this week.
36:35My friends, Shane and Liz,
36:37who's Nicky's sister,
36:38are big fans of the GLP-1 weight loss drugs.
36:42I'm the odd one out here, right?
36:44I'm the only one who's not taken Ozempic.
36:46When I first heard about Ozempic,
36:48the first person I said...
36:49Yeah, of course, me.
36:50You are going to...
36:51Yeah, straight on.
36:51So I was in the States,
36:52so I was straight to the doctor in the States.
36:54Did you?
36:55Yeah, so like, this is LA.
36:56The doctor's like,
36:57yeah, you're fat as fuck.
36:59So like, no problem.
37:01Like, he was just like...
37:02How much was it in LA, out of interest?
37:03It was actually 1,500 quid.
37:05Yeah.
37:05What?
37:07I took it for the one week
37:08and then I had to come home
37:08with the four injections in the bag,
37:10got home, and the four injections on the plane,
37:13I fat-weighted.
37:14No!
37:15Oh my God.
37:16So expensive.
37:18I know you, like, my entire life,
37:21you've struggled with disordered eating.
37:23I know that you've struggled with disordered eating.
37:25Why were you taking Ozempic?
37:26I just took it because I was going on holidays
37:28and I wanted to lose half a stone.
37:29I was just like, sick of dieting.
37:31I'm sick of trying to lose those menopause five pounds,
37:34six pounds, seven pounds.
37:35And I was like, fuck it, I'm just gonna take it
37:36and see what happens.
37:37You know, and we walked into the pharmacy in Dubai
37:39and I was like, do you have Ozempic?
37:40What Ozempic would you like?
37:41We can give you X, Y, and Z.
37:43And what, it'll be 20 minutes
37:44or we can carry you to your hotel
37:45if that's too long to wait.
37:46It's about 300 euros.
37:47It was like having lobotomy.
37:49It was like, I injected myself
37:50and I took out all personality I had.
37:53So how much weight did you lose?
37:54Half a stone.
37:55Yeah, perfect.
37:56That's what I wanted.
37:58Like a lot of people I know,
37:59they just want that half a stone.
38:00This is medication.
38:01Like, this comes down to people's ill health.
38:04Do you know what I mean?
38:05This is a different conversation we're having.
38:06This is around aesthetics and it's around weight
38:08because when you get to a lower weight,
38:11you're gonna feel better about yourselves.
38:12If you suddenly put on three or four stone
38:15in the next few years, inexplicably, possibly menopause,
38:18for whatever reason, you just ballooned.
38:20Fast forward five years, would you do Ozempic
38:22if it was an option?
38:23What you're saying is if I've done everything,
38:24there's always a reason.
38:26There is always a reason, whether it's genetic,
38:29whether it's environment.
38:30But if it's genetic, you can't fight it.
38:32Yeah, and if it's menopause, it's bloody hard to fight.
38:34Yeah.
38:34Telling you.
38:40The United States of America,
38:41as the biggest per capita prescription drug spenders
38:44in the world, has fully embraced the GLP-1 revolution.
38:49But at 10 times the price for a monthly dose
38:52than you would pay in Ireland,
38:53not everybody can get their hands on it.
38:56And an inequality of access is emerging.
39:00I'm reading an article here in the New York Times,
39:01which really sort of points to the socioeconomic divide
39:04when it comes to these drugs.
39:05It says last year, about 2.3% of people living here
39:08in the Upper East Side
39:10were taking injectable weight loss medications.
39:13Now, this is the healthiest, wealthiest,
39:15whitest part of New York City.
39:17And that's double the amount of medications
39:20that are being prescribed in boroughs
39:22like the Bronx and Queens,
39:24where the need is obviously greater.
39:32So this is Manhattan.
39:34We have the West Side.
39:36Yeah.
39:37That's the Upper West Side.
39:38Central Park in the middle.
39:41I went to high school a few blocks from here
39:43and we'd come here to, you know, smoke a joint or make out.
39:47This was our parents' backyard.
39:50This is where we went.
39:52We weren't in, you know, we didn't have a basement.
39:55Advertising executive Jill Weingarten
39:57is an Upper East Side girl through and through.
40:00And like many of her friends and family,
40:02she's an enthusiastic user of Moon Jarrow.
40:05So Jill, would you say you live by
40:06nothing tastes as good as skinny feels?
40:08Yes, I guess so.
40:09I don't even think about it that much anymore
40:12because I'm not that interested in the taste of anything.
40:15And what about you can never be too rich or too thin?
40:18And tan.
40:21Tan, thin, rich.
40:23So when you saw me today,
40:24did you expect me to be skinnier than I am?
40:26Be honest.
40:27Yes.
40:28I wasn't really worried about what you weighed,
40:30but I was like, oh, she could lose a few pounds.
40:33Jill had been unhappy with her weight for years
40:36when she noticed her whole world
40:38was literally changing around her.
40:40I always thought I was skinny.
40:42A thin person, but I happen to be fat.
40:44And then I went to a family function in Los Angeles
40:49about two years ago and nobody was eating.
40:54Nobody was eating and there was a ton of food at this event
40:57and I'm the only one ordering bacon and my cousins,
41:01everyone's emaciated, no one's eating
41:03and everyone seems fine.
41:05And finally, they all told me they were on
41:08Manjaro or Ozempic or Wacovi.
41:12And I'm like, okay.
41:14And I took one shot.
41:15I just kept losing.
41:16I'm like, okay.
41:18I said, I thought it was big bone.
41:20I guess not.
41:21So I just, and then I stopped.
41:23All of a sudden I just got to this weight
41:25that I'm not losing anymore.
41:28I don't want to.
41:29And I've started doing shots every other week
41:31instead of every week.
41:33Is it about health or is it just about being skinny?
41:35Being skinny.
41:36Yeah.
41:40I mean, talk about living in a skinny world.
41:43I mean, she just personifies that upper east side.
41:47It's just about skinny.
41:48It's not about health.
41:51You know, she was very honest.
41:52She just reckons I need to lose a few pounds.
41:58I've booked an appointment at the very famous
42:01Schaefer Clinic on Park Avenue.
42:03One of the divisions that they have
42:05is a company called Advitam,
42:07which offer intravenous vitamin drips,
42:10but also they're offering GLP-1 treatment for weight loss.
42:14My understanding is that they can mix your vitamins.
42:17So whether it's B12 or vitamin D,
42:19whatever you might need,
42:20they can mix your vitamins and give it to you.
42:23And then you can take it to your doctor.
42:25So whether it's B12 or vitamin D,
42:27whatever you might need,
42:28with your GLP-1 medication.
42:30And they can also microdose.
42:33So microdosing is pretty big in the States.
42:35It's not big in Ireland yet.
42:38So they tailor make your treatment for you.
42:49Jamie?
42:50Yes, hi.
42:51Hey, how's it going?
42:51Lovely to meet you.
42:52How are you?
42:53Nice to meet you too, excellent.
42:54Oh my God, look at this office.
42:55Look at this view.
42:56Yes.
42:58What is the basis of what you do here?
43:01We would call it longevity,
43:03metabolic and regenerative medicine.
43:06Where do the weight loss injections come into it then?
43:09Somebody comes in and maybe they're not full-blown diabetic,
43:14but I have baseline blood work from two, three years ago.
43:17And we see what's happening to their sugar levels.
43:21You can kind of step in there a little bit sooner
43:25and make them a little bit more efficient
43:27so they don't become insulin resistant or diabetic.
43:32So you potentially can use that from a preventative measure?
43:36You can.
43:37Okay.
43:38Things are changing.
43:39We are getting more aggressive at treating things
43:43or identifying problems
43:45before they become full-blown disease processes.
43:49Well, I didn't think this was part of the concept.
43:53Putting me on the weighing scales.
43:55That serves me right.
43:58Okay, Jamie, I'm good.
44:00You're ready?
44:01Ready to go.
44:02All right.
44:03What's this looking for in me actually?
44:05So this is a body composition analyzer.
44:08Starting your in-body test.
44:11Do not talk or move during the test.
44:14So it can measure the difference
44:16between an organ tissue, bone, fat, muscle.
44:22Not bad.
44:24I'll just be really interested to hear
44:26whether I qualify for GLP-1 treatment.
44:30You know?
44:32Let's see.
44:35It's like waiting for the report card, isn't it?
44:37It's like the leave and cert results.
44:39Oh, here he is.
44:39So I have your results.
44:42And so it's not to make you feel bad.
44:44We're just going to break it down a little bit.
44:46And so first it looks, it tells us your weight in pounds,
44:50151 and a half pounds.
44:53The SMM, that's skeletal muscle mass.
44:55This is pretty, this is excellent.
44:57So you have 58.9 pounds of muscle.
44:59So to me, if I were to guess,
45:02you definitely do resistance training.
45:04They're recommending that about 11.7 or 12 pounds of fat
45:08would be ideal if you lost that.
45:11Like, is the GLP-1 treatment something
45:13that you would prescribe for me?
45:16We could use a GLP-1 with you.
45:18I'm not in the obese category.
45:21Like I would say I'm a normal,
45:22I'm in the normal weight range.
45:24And is there enough evidence for people
45:26in the normal weight range who are not in the obese range
45:29to be using these medications?
45:31If you're looking at it black and white,
45:33because somebody told you it's only for this,
45:36that's because some people decided initially
45:39that this is what it's for.
45:41But it's like vitamins.
45:43It's like minerals.
45:45It's like food.
45:46It's very a natural substance for your body.
45:50Like my years of trying to eat well
45:53and exercise and weight training resistance,
45:56but now there's something that makes it easier.
46:00Right.
46:01It does make it easy.
46:01Like, I'm not saying it's the easy way out,
46:03but it is an easy option.
46:05Even if you're not clinically diagnosed
46:07as insulin resistant or diabetic or pre-diabetic,
46:11should we have to wait until we are
46:13before we do something that can be helpful?
46:17Have you taken GLP-1s before yourself?
46:19Not yet.
46:23Next, I went downstairs
46:24to meet world-renowned celebrity plastic surgeon,
46:26Dr. Schaefer, to get more of an insight
46:29into how Ozempic is literally shaping
46:31the rich and famous of New York social scene.
46:34How long would you recommend somebody be on GLP-1s?
46:38Because the pharmaceutical company is safe for life.
46:41I've been on it about a year and a half to two years
46:44and I've reached my steady state.
46:46So now I'm looking into maybe
46:47I should start doing micro doses.
46:49Do people find it easier to maintain the weight loss
46:51with a little bit of micro dosing?
46:53Like if I miss a dose, for instance, over the holidays,
46:56I do notice if I miss that dose,
46:58that hunger starts to come back,
47:00the carb cravings start to come back.
47:02And that's what makes me a little nervous
47:03about going off of it.
47:05There's more people on the GLP-1s already than on Botox.
47:09So with the GLP-1 treatments now,
47:11we're having this rapid weight loss, which is great.
47:13Your body's looking really good,
47:15but all of a sudden now you have Ozempic faces.
47:18What is Ozempic ass?
47:19Basically it's drooping of the butt.
47:21So the butt becomes deflated
47:23and now you have this loose, sagging butter,
47:26like a pancake butt.
47:27What I thought was interesting was just how
47:30the aesthetic industry and the GLP-1s,
47:34like they've kind of, they work very well together
47:36and it's just kind of part of treatment here.
47:39And so you must have seen a huge change
47:41over the last five years
47:42in terms of how that's all developed.
47:43I mean, it's really been amazing.
47:45And, you know, I developed the whole Schaeffer Clinic
47:47as a place like an all-in-one.
47:50So it's really been a boost to our business,
47:52both our surgical business and our non-surgical business,
47:55such as laser and other treatments.
47:57So it all comes together and really complements each other.
48:04You know what, it's funny.
48:05Here I am standing on the 34th floor,
48:07looking down over Fifth Avenue
48:09and the whole thing just feels so normal.
48:12Like the blend of GLP-1s and aesthetics
48:15and it just feels like normal life.
48:17And compare that to the conversations
48:19that I would have had at home in Ireland.
48:21It is a different world.
48:22There's one side of the story in New York and LA
48:24and places like that,
48:25but there is another side of this story in America.
48:29Next time I travel to West Virginia,
48:31the most obese state in the US,
48:33and get a very different insight into these drugs.
48:35Hey, how are you?
48:36You can't afford to go and buy fresh fruit
48:39and vegetables here.
48:41I meet more people whose lives have been transformed
48:44by the medications.
48:46And I travel to Japan to ask if the skinny jab
48:49is the only way out of this obesity crisis.
48:53How many people in this class like eating fish's heads?
48:59I just don't know if the fried fish
49:02with the head and the tail on
49:03would work for six and seven-year-olds in Ireland.
49:06Not sure.