197 - The science of obesity & how to improve nutritional epidemiology | David Allison, Ph.D
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- เผยแพร่เมื่อ 7 มิ.ย. 2024
- View episode show notes here: bit.ly/3HgjLMf
David Allison is an award-winning scientific writer who has been at the forefront of obesity research for the last 20 years. Currently the Dean of the Indiana University School of Public Health, he has also authored many publications on statistical and research methodology and how to improve research rigor and integrity. David’s focus on evidence and data brings forth an interesting discussion of what we know (and don’t know) about the science of obesity. He provides an insightful and unemotional explanation of the potential impact of nutritional epidemiology in public health while also explaining its many pitfalls and limitations. He offers his take on the path forward in addressing the obesity epidemic, and he closes with a lucid explanation for the evident lack of credibility in science and the steps we can take to change that.
We discuss:
00:00:00 - Intro
00:00:10 - David’s background, interest in obesity, and focus on evidence
00:08:44 - The moment when the obesity crisis was recognized, and the sloppy science that ensued
00:17:11 - What twins studies tell us about the genetics of obesity
00:20:36 - How doctors and scientists have historically approached obesity treatment
00:28:45 - Do surgical procedures for obesity prolong life?
00:34:08 - The ‘Obesity Paradox’
00:41:48 - Interpreting BMI and mortality data and considering confounders
00:49:54 - How body composition and ethnicity factor into consideration of BMI data
00:57:12 - Superior tools for measuring obesity at the individual level
01:02:31 - Using BMI data for actionable steps to combat obesity
01:06:55 - Why maintaining weight loss is more challenging than losing weight
01:18:44 - Differing perspectives on the utility of nutritional epidemiology
01:25:08 - A mouse study illustrating the impossibility of fully controlling for confounds in observational studies
01:29:59 - Limitations of nutritional epidemiology and how it can improve
01:42:06 - Addressing the obesity epidemic-the path forward and obstacles to overcome
01:53:28 - What David believes to be the most promising interventions we could take to address obesity and improve public health
01:57:45 - Reproducibility in science, normative and non-normative errors explained
02:05:27 - Rebuilding trust in science and differentiating between science and advocacy
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About:
The Peter Attia Drive is a weekly, ultra-deep-dive podcast focusing on maximizing health, longevity, critical thinking…and a few other things. With over 40 million episodes downloaded, it features topics including fasting, ketosis, Alzheimer’s disease, cancer, mental health, and much more.
Peter is a physician focusing on the applied science of longevity. His practice deals extensively with nutritional interventions, exercise physiology, sleep physiology, emotional and mental health, and pharmacology to increase lifespan (delay the onset of chronic disease), while simultaneously improving healthspan (quality of life).
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The only podcast I listen to as soon as it comes out. Peter put me on the path to medicine. Thanks Dr. Attia!
I started listening/watching Dr. Attia when the podcast came out almost 4 years ago now I think... Back then I was "just another high school dropout" and today i am currently completing the first of the four years of my medical degree.
As a psychologist now interested in nutritional research, I absolutely loved this conversation!
Closing remarks about advocacy is really a good one. Thanks for producing such high quality podcasts !
Dr. Allison's rant about epistemological honesty is something the entire world needs to think through.
1:38:14 - "The data are the data whether you have an MD or you don't have an MD."
Spot on.
As someone who used to be an athlete for many years and struggles to lose weight , I have figured out it is not a matter of will power but how particular foods affect me. Figuring out these foods is the difficult part
Absolutely I just came here to say that. As I entered my 50s with some weight issues from health problems I was tired of getting the sideways eyeballs from the Physicians telling me I was borderline but offering me nothing else but judgment. I had lymphedema which they told me was "progressive and incurable" so I set out to follow some European information since AMA seems to ignore the lymphatic system until there's cancer, and it really works for me. Of course no doctor has ever documented my protocol even though I lost 50 lb in a year. I did it by gathering all the healthy low-calorie nutrient-dense foods that I loved and even some that were just a treat in my everyday normal life like steak which I had once a month. I made sure it wasn't a grind and it was actually a pleasure every bite of food I took losing a pound a week was delicious and it was the kind of food that I could actually eat as much as I wanted whenever but that also filled me up sooner than carbs. When I started out I could not walk very far so I took up walking in my house and turning on the radio and dancing until I felt strong enough to take the hills in my neighborhood and ended up walking 45 miles three hills most days rainershine for that year and by the end of the year I look better than I had looked in my life at 53 years old. Just got to get in the mindset that that's the number-one priority in your life, Y O U. Make it fun.
That is really interesting - do you have some examples of how certain foods influence you?
Brilliant discussion! ❤I loved the part about education. That is what I did. I asked myself - what is the best nutrition for me? And then I dove deep down into physiology, biochemistry and nutritional science to find the right answers for myself 😊 ❤
I love, love, love that you are one of the only hosts that actually allow your guests to speak, not interrupt them and drown them out with your own thoughts and opinions. So many other people should learn from you!!
Regarding obesity and biology, I have always had a problem with my weight. As little as 2 years old.. I have the ability to put weight on very easily. I work really, really hard at keeping a low weight. The only way I can control a 1000ish calorie a day diet so I won’t binge or overeat is with the addition of 5-HTP. I take 50mg around 10am and 50mg around 4pm. I only learned about this a year ago. All those years of torture and bingeing and frustration with myself for always “failing”, It does not help me to lose weight but it helps me to maintain my weight and my sanity around wright control and eating,
Thank you for sharing this topic!!!
I totally relate to your story. I can, and have, maintained my over-weight body on 800 daily calories, for months at a time. Going low carb has help with satiation and keeping weight steady. But generally, if I am not dieting, deliberately and strictly, I am gaining. Fasting has helped, too. But I have used that tool for over 50 years, since my mid teens.
I must look I to this 5-HTP.
THX!
I can only maintain my desired weight by walking a mile every other day. Not difficult, just be religious about it. Painless, really. ❤
@@kirstinstrand6292 Walking is the best. I clock in about 3 miles per day. And then I stand at my desk job. And I run around after my two grandsons all weekend long. That’s great that so little activity is all you need.
@@jellybeanvinkler4878 I think it’s hard for people to understand this that don’t have to live it. Fortunately, I do gravitate to very light foods!!! 😁
Omg HOW are you able to do a 1000 kcal a day?! Just the BMR of average person is 2100 🤷♀️ I am just curious as I eat about 3500 kcal a day 🤦♀️
Thanks for interviewing Dr. Allison. I'm a fan of him. He is a careful scientist and a kind caring person.
THANK YOU for freely sharing your knowledge
This dude David can think. Just good judgement and no gobbledygook. Thanks!
What did he really say that she’d light on the problem?
“Elevating our level of dialogue.” Bravo!
Wow, this is an excellent talk - I took notes.
I skipped through part of this .... so maybe it is there but I missed it. But I did not hear any talk of nutritional food versus empty calories. If I am fat it could be due to eating a lot of low nutrient carbs, or it could be due to overeating very nutritional food. I would think my life expectancy would be vastly different depending on which caused me to be overweight.
I have to agree with you that the discussion was around the science of surgical intervention and a pill. Granted, the current generation is so far gone and probably needs this support. However, what of the future? No mention of education on nutrition, the microbiome and time restricted eating. Also, from what I understand, the U.S government subsidises their food industry, in particular, questionable fructose and corn syrup in processed foods.
@@annetcell-ly4571 Yes, I know too many non-success stories with surgery, including two people who lost weight and regained more within a year or two post surgery, who then went on to lose and maintain that weight loss with low-carb/ keto - why not try low carb and keto or time-restricted eating first?
The body will make you eat until it gets its dose of aminoacids and essential fatty acids. So if you eat just carbs with very little protein, you will naturally overeat, because your body just really wants those nutrients...
I don't want a 3D photograph of me taken analyzed and put in my medical record. Goes along with to have access and use for their own purposes
No sh*t. That's ridiculous. Old school medicine. Scary.
What about Waist to Height Ratio as a better metric than BMI for both individual and population level evaluation?
This was so interesting to listen to. I see a lot working in a GI clinic and certainly saw a lot working in Primary Care. The frustration for me is that we know surgery works for the reduction of obesity related chronic disease, however, the people I see in clinic that have substantial weight regain and complications due to noncompliance is pretty common place.
I don't know how you work within that to prevent it; but living in a rural area makes it a lot harder with a lack of resources and mental health professionals and good RDs is just not there.
My observation as well. 2 friends had the surgery and have regained a significant amount of weight
By surgery they mean liposuction?
@@trismegistus3461 gastric bypass...
@@trismegistus3461I think they mean bariatric surgery.
I think even this guy and many in this field don’t seem to recognize is the psychological side and the thinking -not intellectual- skills needed it takes to make a sustainable long term reduction in calories. Just telling people that they should follow a particular diet or that we know that the body may fight back against weight loss is not enough help. People need help negotiating so many different situations. I personally what has been the greatest influence besides my learning, how to deal with the thoughts that would convince me that it was OK to not stick to my food. Plan was also paying very close attention to satiety. I had already made some changes along those lines, but later, reading in the book the hungry brain about the supermarket diet that researchers figured out by using it with experimental animals that they could get them all to gain weight just by feeding them that and letting them eat to their fill. It doesn’t mean people can’t eat any of the ultra processed foods, but the likelihood that anybody is going to reduce their weight significantly and keep it off over a long period of time while trying to keep to the small amounts of those foods that it would take to do that is just nuts. And I was so miserable from compulsive overeating for decades that I just thought I have got to do what it takes to counteract that. I didn’t even set out to lose weight and I wasn’t sure I would, but I did eventually. But even, 12 years later, it still takes some vigilance.
question : is BMI linear ? I mean that since overweight is defined with values from 25 to 30, is it 27,5 half way or is a non linear function ?
The problem I have with fasting , is when it’s time to eat , I can’t control my jaws , they just take over, I know it sounds like I’m joking, but it’s true
Yeah, one day I realized that I needed to cook up smaller portions and that I needed to not bring home the foods I could not stop eating or drinking. LOL😮
👑👑👑As soon as I thought the Algorithm would not show me any more of the King of the Mr Humble Bragorama - It drags me back in & forces me to post another review❗❗❗
I think the guess got wrong the reference to the Selfish Gene. Please Peter invite Richard Dawkins to your podcast, he would probably accept. and Dr. Robert Lustig for a second time. I found weird that fructose wasn't named in a podcast on obesity.
Same here.
1:32:20 I think Confucius is older then “The Fathers of Epidemiology” 🙄 but fantastic pod, wonderful guest and so much info…thanks guys! ❤️💯👊🏻
Much better than the statin podcasts!!
02:18:00 German Health Minister Karl Lauterbach is both a public official required to promulgate policy positions, as well as a Harvard-trained epidemiologist. He explicitly changes hats when discussing policy or what he deems hygienic best practice. Three cheers for explicit hats 🤠
Perhaps the "Hispanic Paradox" is confounded that "Hispanic" as a demographic that adheres to a specific phenotype (or a limited set) is about as credible as someone from outside the US classifying "Americans" as a phenotype. This would be a nearly perfect demonstration of the failings of epidemiology for practical application
It's more the diet. Beans have been shown to be the key piece in the diet. When they disappear, so does the paradox.
@@toomanymarys7355 Really? Five of the six top consumers of beans per capita are in Africa. Or are Burandi, Rwanda, Tanzania, etc. now considered "Hispanic"? Brazilians - most certainly non-Hispanic, because you know, the country was not colonized by Spain, has higher bean consumption than Mexico. Oh drats, where does this end?
Problem is BMI does get used by insurance companies etc. to say you're overweight when you're lean and muscular.
On the evolutionary hypothesis for obesity, it seems far more likely that we weren’t always on the brink of starvation, but that we had these occurrences as evolutionary bottlenecks throughout the history of various populations at different time points. Recent history over several centuries with the isolated population in Iceland is a good case analysis since we know a lot about what foods were actually available, genetics of survivors and population expansion and contraction over several centuries.
Very wise man
Regarding the 1h10m mark, on how a selfish-gene would want to make copies of itself (asexual reproduction).. I recommend Rob Reid's recent interview with Kevin Wsvelt on the dangers of gene drive.. despite it's potential upside (eradicating malaria).
Link w/ diet, sleep, weight
1:46:00 "Assuming there is a diet that allows deprivation-free weight maintenance" -- I missed the declaration of one or more hidden variables.
I think the evidence against highly-processed food, in particular junk calories like HFCS, is reasonably indicative. But clearly something gigantic has changed, whether environmental endocrine disruptors or something else. A reasonable hypothesis is that there are diets more consonant with maintaining a healthy weight and general homeostasis, but we lack evidence that any such diet is necessary and certainly can't observe that it's sufficient to maintain weight and health.
Now that we know this guy has been at the forefront of obesity research for a long time, everything makes more sense!
I would love to see Allison and Ludwig on a discussion together.
When talking about nadir for BMI increasing with age I think it would be relevant to break down the body composition percentage of muscle tissue fat tissue white and brown fat tissue.
I like how Peter thinks it'll be good to discuss fighting over food, over food. But his guest is concerned about the threat of Peter taking his food
I am not an NBA center. I am a 54 year old male who has exercised on and off since my early teens. A good chunk of this time (during the periods where I was not exercising) I could be accurately classified as obese while a significant portion of this time I would be categorized as "overweight". Never been "normal" BMI in my life. My waist to height ratio is .47 (healthy) and my BMI is 27 (overweight).
No one in my family ancestry would be classified as "muscular", yet hear I am as a recreational athlete that has trained with resistance training VERY inconsistently over a 40 year period with a healthy classification in the metric that actually is meaningful for nearly 100% of the population. Yet Peter's guest is insistent on BMI as a valid and useful metric where there is a much better metric that could be used in its place.
The irony of the BMI standard is that one of the most useful tools (adding muscle mass) for maintaining a healthy weight is resistance training would manifest as a "negative" contributor in the BMI calculation.
BMI is a useful broad index of obesity (some people have high bone density - maybe your case). Consider using % body fat, a 20-25% would be a great goal for a 54 year old, 30% would acceptable. In my opinion, 40% or higher is high. Regards
@@perucho2194 really has very little to do with bone density. I have done resistance training along with other exercise on and off for 40 years. I can carry 35 pounds more than my brother can carry in spite of only a 3 inch height difference. I would not classify myself as anything approaching a competitive athlete even in my peak years. BMI is a completely useless for a significant portion of the population. Waist to height ratio is a nearly perfect metric for close to 100% of the population. It is very easy for anyone to do, yet we have medical “professionals” using a metric that is useful except for when it isn’t. L
@@dondajulah4168 Body fat % using BIA is cost effective, that should work well for you.
Resistance training increases bone density. I agree though BMI is frustrating measure, what you've described applies to me too.
Skeletal Muscle is the great equalizer. The more you have, the more non optimal lifestyle you can get away with.
Title of this video is misleading, as there was little to no discussion on how to improve nutritional epidemiology other than Dr. Allison saying study authors should be more honest.
I enjoyed your questioning the evolutionary “why” of each development but you may have missed the most obvious answer as to the ‘Why” of bisexual reproduction. Most vertebrates have longer gestation and infancy stages than simple bacteria for instance. Most asexual reproduction does not require two partners to bring a new-born to independent survival stage. It takes two parents to do that: one to procure food and one to guard the infants. The example of penguins springs to mind. Offspring of single penguin parents do not survive long enough to reproduce. Having a second parent with a genetic stake in survival of the young is an elegant evolutionary solution.
I think it is not that thinner people die earlier because they are thin. More likely you have normal weight, then you get sick and as a consequence you loose weight before you die 🤷♀️
Re: Allison's assertion that he doesn't think there is a diet that sustainably keeps the weight off. I've yet to see an obese person that eats Mediterranean-style balanced whole foods 3 times a day without overeating and maintains physical activity of some sort. I've seen many people who *claim* they do that, but then you ask them about details and it turns out that they are missing hidden sugar, eating processed grains (did you read the nutrition label on that "whole wheat" sugar-packed bread?), or think that a tub of ice cream or french fries are "whole foods." Now, I haven't seen that many people, and I may be mistaken here, but my experience tells me that people will engage in self-sabotage and self-deception just to get some piece of junk food into them. Especially since I was that type of person myself (and, no surprise here, was struggling with my weight.) But why? And for what? You want a burger - have a pasture raised patty on whole wheat bread with sugar-free ketchup. You want a desert - eat a bowl of berries with yoghurt or a banana with a spoon peanut butter. Amazing staples to be had if you don't want to cook too - e.g. chickpea block salad that takes a whole 1 minute to prepare. And then you are eating all this and asking yourself: Am I getting healthier or does this taste good? And the answer is "Yes."
Well I'm happy that you have gotten enlightened but being judgemental about those who have not gotten the memo is kind of mean there are a lot of people that do not get any nutrition education and some of them are doctors and therapists.
The misconception that fat is bad is why we are the worst healthcare in the world. 11/11. give up your paradigm it is the only hope we have. Cognitive dissonance over and aver again.
On a tangent, I can't think how you'd research it. People after reorganising the sense of themselves and others due to psychotherapy change physically, they walk differently do other things and such. Does it effect their relationship to food and health? Emotions and our view of ourselves and others is way under-researched for physical health.
This stood out to me as funny:
Dr. Allison calls out the diet studies relying on questionnaires
lather, rinse repeat. Several times.
Dr. Allison speaks approvingly of Gary Taubes.
FUNNY. The first time I really saw Taubes debunked was James
Krieger's takedown, which heavily relied on critiqueing Taubes'
heavy use of studies that relied on ... DRUM ROLL .... dietary self
reporting.
not eat lot of fiber is the key of obesity and disease .. cooking is key of human evolution .. cooking help human eat lot comples veg fiber . that fiber feed many type microbiome and they produce lot of nutrition..
The topic is science of obesity’s but the discussion is not what the topic indicate.Noticed many times this trend to hook people to listen .There is no science only housewives talk and chat.Thank you for your time .
It's clear there is no science of obesity now.
Oh my … I can’t believe what I am listening to now … increase your BMI in later life to increase longevity ? Is this contradictory to the current thinking ?
I believe that how a child is raised defiantly has a Hugh influence ,my reason is primarily held because food /diet choses and education level are a strong connection to obesity. Secondly genetic is NOT the main driver instead it is LACK OF FOOD REGULATION. Our culture and government have allowed genetically modified food along with processed food to dominate our diet. Any one who believes the human body is not insulted eating synthetic food, chemically treated sugars. Food that can stay on the shelf for years is NOT living , but dead containing no living enzymes and living nutrients , yet our body is living Also we can not ignore that to the degree that other countries pick up the US diet is to the same degree that that countries obesity climbs. Saying obesity is tied to genetics is smoke screen that will keep people from pressing those in power to put food regulation in place and STOP the synthetic food
00:57:12
Can these podcasts be shorter than 2 and a 1/2 hours that's a huge commitment of time
There is the pause button
So we shouldn't shame people unless they have a moral failing but gluttony is no longer a moral failing because...? Too many people are now gluttons?
Peter, I am a fan and listen to you regularly. But you totally disappointed me in this one by not pushing him back on his solutions. Bariatric surgery and medicines are the only plausible remedies for obesity. Seriously? Not a word on microbiome and its effects on obesity.
Agreed or addressing insulin resistance
Peter does not claim to be an authority on obesity; the other guy is!
That guy is an expert in obesity? Lord help us!!
50% of the population in the surgeon's table?! that's from a public health guy?
This is funny .I am the same way when I smoke .That’s why I keep it to a extreme minimum and when I’m alone .I feel your pain Bruh
Self-discipline is difficult to develop. Therefore, the easiest road to travel following obesity surgery will be regression.
It's not that complicated to find the correct answer! 😮
So...someone having an education is his answer to solving obesity??? Seriously????!!!!
So we’ve known for decades how to reduce obesity. That is to eat less. Not many people distinguish between losing fat and losing weight, once you understand this your goals change. In sustaining that fat loss, increasing muscle mass has proven to be an incredibly useful intervention to achieve this, now once again your goals have changed. By changing goals and reducing not entirely accurate information, your methodology makes acute changes. Then there’s the psychological aspect of understanding with nuance the consequences of obesity through a scientific perspective: we’ve all heard that being obese is bad for us, but how bad is it actually - how can I expect my lifestyle change as I age due to the choices I make in this moment. That sort of education is a more powerful and healthy motivatior for change: than I assume what most people feel: shame, self-loathing. Education also works to combat the problematic response to these negative psychological events. The science challenges both the ideas of “fat-acceptance” and “fat-phobia”, which are both emotional reactions to a medical condition.
Again we’ve already got the “solution” for obesity on the individual level. What we haven’t solved is compliance, misinformation about the process and how to accommodate for both these obstacles on a population level.
he must have seen every kind of strategy fail to fall back to such nonspecific approach
Yeah, what a horrible response. It's a politician's response. Maybe he'll run for office like Dr. Boz.
There is no "works" if it isn't long term. Fluctuation's bad, remember? So nothing actually works, according to the data.
Seems like a huge waste of money. It’s pretty simple eat real food and movement/exercise and get proper sleep 7+ hours. Everything else in moderation if you enjoy them.
Disappointing that surgery is his first option,foods are key but no money in that.🙁
Yup
Floyd Aldrich, He has bills to pay! He didn't become a doctor to be poor....if someone wants to be obese, well then we can always do gastric bypass 😂💯🙋🙏
@@floydald ✔️
I'm almost disappointed in Peter for having this guy on the podcast.
Not only his focus on surgery being the "best and most effective treatment for obesity", but his treatment of BMI. He states, "Obesity starts at about 30". Twenty years ago, it started at 26. They have moved the goalposts.
This guy has been drinking his own Kool-Aid. Not impressed.
Let’s say I agree with the docs premise at the beginning that there is a strong genetic factor in obesity. Then what has caused the acceleration in obesity in the last 30-40 years? Has it been via natural selection…that is…obese people have more kids, therefore there are more obese people? Are we saying that in the past these obese genes were never “turned on” and now they are? Are we saying there isn’t an acceleration in obesity and it’s just following the normal increase every year like it has since the 1700s? How have the genes changed in the last 30-40 years?
Quite curiously, McDonald's Supersized their meals in 1987!
I just Googled the year super-sized fast foods (and candy were triple sized in SUGAR content!)
Please do not side step reality by giving us some "socialogical bs model." What's the deal, can't call out the US FOOD INDUSTRY. Of course, no one wants to get their funding cut.
This guy being interviewed🙄 really says absolutely nothing new. A gazillion people before him have been saying all of this.
The highest survival rate by BMI to COVID-19 also is 25-30. Older people have increasing BMI because the ones below that BMI died already! Increased BMI is improved immunity. Researchers need to understand how the immune system works. nobody does that. It sepsis that kills you!
Obesity is already an Inflammatory condition.
Yup, cut them up. Pop a pill. Don't even think about changing diet to real food only, shame people for "gluttony" when our whole food paradigm is wrong. Jesus this interview was depressing.
Horrible!
I hear that if a person doesn't eat food, they can lose weight. Go figure!
yeah, cool. everybody knows that. you know what i heard? americans are still getting fatter every year. apparently just telling people “eat less, move more” doesn’t make them lose weight. this is a discussion about what can be done beyond being an asinine internet commenter
We have lost on the intellectual battle to right wing propaganda and big business/$$
Peter I am almost 80 few months to go. I lost about 5 years ago sustained so far now Carnivore lost on Keto. I do Fast two days eat five. I have always exercised 19.5 BMI cardio still run 3 mi week days now do resistance bc of you . Light weights and machines. I wish you get an exercise woman older preferably would be great to do a healthy longevity discussion. Maybe two one for elderly and one for younger bc you might lose views. I lost to 122 too skinny gain 4 but I think muscle bc I can see. Lost other things dizziness which is great.
Please employ grammar to make your comment logical.
@@KJB0001 I don’t see a wrench 🔧 by your name. I think Dr Attia is smart enough to decipher even though you may have a problem. It isn’t the grammar more my short handed expression. Still not your place uncalled for. See if you can get the job?
@@lynnwilliams5432 huh?
Have you thought about swimming. I think there’s a lower risk of injury than running, because as an older women the likelihood of recovering from an injury is lower than the population. I think after that you should focus on flexibility, again with the same goal of reducing injury, stretching to increasing mobility and keeping ourselves strong in a variety of postures will increase quality of life. For this I can recommend kit laughlins courses, he takes a very logical approach to this topic.
It’s really admirable to hear that you’re keeping fit at 80.
@Lynn Williams
Why fast so much if you are too skinny?!
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Real simple to debunk all these eggheads..... Post your blood test.
this guy is too set on energy intake.
Scary, elitist, guy. His recommendations for the public are bone-chilling. Was he asked about obesity bc he's a public health guy? He doesn't seem to know anything about it. Why does he talk about science & yet never mention rates of recidivism post bariatric surgery & pharmaceuticals or their toll on overall health? Doesn't the evidence show that eating disorders are most prevalent in the class that he states is thinnest--the one he suggests we should learn from? Well at least we can see that above all, he holds himself in the highest regard.
amazing lol
dudes in obesity research for 30+ years, accolades for days and peter gushing over him. meanwhile, the country is more obese and unhealthier than ever, and yet somehow this dude still gets a pat on the back.
its like the ultimate meteorology meme, this guy could get the weather wrong every single day and still come back with a job. unbelievable, really. maybe perform the equivalent of bariatric surgery on his brain to stop this nonsense from leaking out. worst episode ever?
And here we have someone who 1) Did not listen to the podcast 2) Is trolling or 3) Understood 10% of what was said.
@@guyincognito1985 oof, not surprising though
Horrible guest. Horrible plan of action. Notice who gets off the hook: "we may never know what causes obesity" (code for: 1 don't expect science to figure it out or 2. public health to help at all)