Episode 231: This week's guest on the podcast is Louise Adams. We talk about how dieting doesn't work, the problems with weight loss surgery, the horrendous fast track trial in Australia and the Obesitive Collective and its connection to Novo Nordisk.
Louise Adams is a clinical psychologist who works in private practice from her home in Sydney, Australia and has been practising in this field for more than 20 years. She has written two books, Mindful Moments and The Non-Diet Approach Handbook for Psychologist and Counsellors (with Fiona Willer, APD). She is also the founder of UNTRAPPED, a masterclass for those who desire freedom from diet prison.
Louise is Vice President of Health At Every Size Australia, and is also a Member of the Australian Psychological Society (APS), and a member of the Clinical College of the APS.
She has a special interest in problematic eating, body image, and weight struggles. Louise fights to educate people about the cruel trap of dieting, which only sets us up to fail. She uses an evidence-based anti-dieting approach to empower people to achieve permanent lifestyle change.
Louise is wholly committed to the Health At Every Size (HAES) movement, and to spreading the word about shifting our attitudes about weight and health. Louise is determined to make a difference in changing society’s perceptions about health, diets, weight loss, and bodies. Louise believes that people can approach health and happiness without attaching them to weight changes. She is for body diversity and against fat prejudice.
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Chris Sandel: Welcome to Episode 231 of Real Health Radio. You can find the show notes and the links talked about as part of this episode at seven-health.com/231.
Just a note before we get started. I’m currently taking on new clients. At the time of recording this, I have just a couple of spots left, so this will be the last time I mention this on the podcast for a while.
I specialise in helping clients overcome eating disorders, disordered eating, chronic dieting, body dissatisfaction and negative body image, overexercise or exercise compulsion, and dealing with irregular cycles or cycles that have ceased altogether.
If these are areas that you struggle with and you’d like help making them a thing of the past, then please get in contact. You can head over to seven-health.com/help, and there you can read about how I work with clients and apply for a free initial chat. The address, again, is seven-health.com/help, and I’ll also include that link in the show notes.
Hey, everyone. Welcome back to another episode of Real Health Radio. I’m your host, Chris Sandel. I’m a nutritionist that specialises in recovery from disordered eating and eating disorders and really helping anyone who has a messy relationship with food and body and exercise.
This week on the show, it is a guest episode. My guest today is Louise Adams. Louise is a clinical psychologist who works in private practice from her home in Sydney, Australia and has been practising in the field for more than 20 years. She has written two books, Mindful Moments and The Non-Diet Approach Handbook for Psychologists and Counsellors, which she wrote with Fiona Willer.
She’s also the founder of UNTRAPPED, which is a Masterclass for those who desire freedom from diet prison. Louise is the Vice President of Health at Every Size Australia and is also a member of the Australian Psychological Association and a member of the Clinical College of the APS. She has a special interest in problematic eating, body image, and weight struggles. Louise fights to educate people about the cruel trap of dieting, which only sets us up to fail. She uses an evidence-based, anti-dieting approach to empower people to achieve permanent lifestyle changes.
Louise is wholly committed to Health at Every Size movement and spreading the word about shifting our attitudes about weight and health. Louise is determined to make a difference in changing society’s perceptions about health, diets, weight loss, and bodies, and she believes that people can approach health and happiness without attaching it to weight loss. She is for body diversity and against fat prejudice.
I became aware of Louise in the last year. It was actually while doing some research with the podcast with Fiona Willer. Fiona Willer was obviously a past guest, and as I mentioned in the bio, she’s written a book with Fiona Willer. Louise has a podcast called All Fired Up, and I started listening to it and loved what she was doing. I actually talk about this with her in the intro as well as going on to what we’re going to cover as part of the episode, so I won’t repeat myself here.
Louise is a fantastic guest, and I think you’re going to really enjoy this episode. So here is my conversation with Louise Adams.
Hey, Louise. Welcome to Real Health Radio. I’m pleased to be chatting with you today – or tonight, in your case.
Louise Adams: Thank you so much for having me. It is tonight. It’s Friday night, and I’m in the mood for a good chat.
Chris Sandel: Awesome. I’m a huge fan of your podcast, All Fired Up, and I highly recommend that my listeners check it out. What I like about the show is that you really take a detailed look at specific topics, and I can tell just how much time you put into them and the level of research that you do as part of them.
As part of today’s show, I want to focus on two of the topics that you covered on the show and see if we can go into them in some level of depth. One is the horrific Fast Track trial with intermittent fasting and teenagers, and then the other is the incredible work you’ve done investigating the Obesity Collective and Novo Nordisk. Both of these, for your podcast, were double episodes of the show, so we’re definitely not going to run out of things to say with these.
Louise Adams: I think you just mentioned the two big rabbit holes I’ve ever fallen down. [laughs]
Chris Sandel: But I’d also like to find out about you and your practice and your background and how you got into Health at Every Size and the non-diet movement.
00:04:43
To start with, do you want to give listeners a bit of background on yourself, who you are, what you do, what training you’ve done?
Louise Adams: Yeah, sure. Hi, everyone. I’m Louise Adams. I’m a clinical psychologist in Sydney, Australia, and coincidentally grew up quite near you, which is interesting.
Chris Sandel: We discovered before we hit record that we probably lived about 10-15 minutes away from one another for the first 20 years of our lives.
Louise Adams: It’s just such a small world. Oh my God. After I grew up and went to uni, I did psychology. I did my clinical master’s. I was in jail. I cut my baby teeth as a psychologist in jail, which was really interesting and formative for me. But it wasn’t a long-term thing, and I ended up in private practice.
When I set up the private practice, early 2000s, I wasn’t a specialist in this area. But everyone that I saw – literally everyone that I saw – had issues with their body or disordered eating or wanted to lose weight or had a full-blown eating disorder or a mixture of all of the above. I was like, oh my goodness. I didn’t expect this, but it was everywhere. As a clinical psychologist, I was trained in the treatment of eating disorders, but certainly no-one had talked about weight loss at university.
Being a good evidence-based scientist, I fell down my first rabbit hole of researching, if people want to lose weight, how can we do that safely and ethically? And also, if people have an eating disorder, what on earth do we do there? That was literally a huge rabbit hole of weight loss research in which I discovered that basically, diets don’t work. Weight loss attempts, if they’re ‘successful’, will only last a few months and then our bodies start fighting back, and that’s why we regain the weight.
I was blown away by this because for me, it was like discovering all of the science on climate change and then looking around and going, hang on, why are we still using fossil fuel? Why are we still offering and normalising this thing? I’d found out not only that they don’t work – and they don’t work not because of willpower or anything like that; they don’t work because our bodies are smarter than any diet. But also that dieting was the number one predictor of an eating disorder. There’s just no safe way to encourage people to pursue weight loss without massively increasing their risk of disordered eating, particularly if you do this at certain times in your life.
I was kind of left a bit bereft with this knowledge, and I felt so alone, like, what the hell do I do now? Then I found this awesome book called If Not Dieting, Then What? by Dr Rick Kausman, who’s an Aussie GP who is a real trailblazer here in Australia for the non-diet approach. I just loved the book. I remember flying down to Melbourne, doing his training, basically befriending him, and we ended up being really good friends.
Then I found out about Health at Every Size and then I found out about the work of Dr Lindo Bacon and the whole social justice movement that underpins Health at Every Size. I knew I’d hit on exactly what I’d been looking for. I’d been looking for an ethical way to help people who are struggling in this area. That was the beginning for me.
I’ve been doing this in private practice – ooh, a long time. [laughs] And oh gosh, since the pandemic, I’ve been online for a year, and I’m just starting to claw my way back out into the sunlight and I’m opening some new offices for in real life consults, which is exciting and a bit nerve-wracking, to come back into the real world.
I do a lot of online work. I have an online programme called UNTRAPPED, which helps people learn how to not diet and how to push back against diet culture online. Not everyone can afford to come and see a psychologist. Not everyone can travel to come and see a psychologist. I created UNTRAPPED as well because for me, this whole process of the non-diet, anti-diet stuff, HAES community, it’s been about community and connecting with other people who understand it because there’s such pressure from the climate change deniers in weight-centric thinking.
So the online programme helped me to create a place where people who were doing this in their own lives could connect with each other. It’s been a lovely online community that I’ve developed, and I’ve also got the private practice. So I’m quite busy.
Chris Sandel: Yeah. On that online side of things, from speaking to other practitioners in Australia, I know there is quite a good Health at Every Size movement in Australia, but depending on where you are, that might not be true for your local area. I work with clients all over the world, and there’s people I’m working with say in Germany that are like, ‘People have never even heard of any of this. This hasn’t even infiltrated into the country’.
So to have options where someone can be in a different location and then be able to work with you or get into your programme, I think that can be a godsend when there isn’t a local option for someone.
Louise Adams: That’s exactly why I did it. It can be so isolating if you’re the only one starting to wake up from all of this and everyone else is still drinking the Kool-Aid. And we’ve got members who are like the one person in their country who are like ‘I think this way, but I’ve got no-one to talk to’. [laughs]
It’s so powerful. I don’t think I could do half the stuff that I do if I didn’t have the support of the HAES community here in Australia. Because they’re not just my colleagues; they’re my friends.
Chris Sandel: Definitely. You need that support because in so many ways, you are going against the normal narrative. You are very much bucking the trend.
Louise Adams: I love bucking the trend. [laughs]
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Chris Sandel: It’s interesting; it feels like I started out in a similar way to you, where you set up a private practice and you in a sense didn’t necessarily know which way you were going to go, and then all of these people just showed up it was either about weight loss or dieting or disordered eating or eating disorders.
That was the same with me. I finished studying as a nutritionist and didn’t really know in what area I was going to go, and it was just that they were the people who started showing up more often than not, and that was the area that I discovered I really liked working in. Then it went from there because that’s the thing that I’m writing about in blog posts or starting to talk about as part of the podcast. But yeah, you just see how much of a need there is for this kind of work.
Louise Adams: There’s so much. For me, psychology often spends a lot of time looking for the ‘fault’ or ‘pathology’ in an individual. Harking all the way back to my days in jail, I knew that people belong in context. Forces that are bigger than us operate on us. That’s something that I think really resonated with Health at Every Size, because it’s a social justice movement. We can help individuals to maybe look at their relationship with food or movement, but without seeing it in the big context and the forces that play, and without fighting back against that, it’s really hard to help people heal in a culture that’s so toxic.
I have, I guess, taken it a little bit personally that I need to do advocacy. I need to do more than seeing people individually, trying to band-aid the wound that’s caused by all of this shit that’s going on in diet culture.
Chris Sandel: Yeah, and I also like the fact that you’re not trying to identify why a person is ‘broken’, but more like ‘let’s look at all the positive parts here or how you came to be in this situation, how the external influences are having an impact on this’. I’m a big fan of the whole positive psychology movement, and I think that’s coming from a really good place. I’m in agreement with that.
Louise Adams: I think I see it more from a trauma lens. You know that phrase that medicine might ask, ‘What’s wrong with you?’, but through a trauma lens we might ask, ‘What happened to you? What have you been through?’ and seeing the functionality in behaviours that people might at first think are wrong or pathological.
Binge eating is a good example. People might say, ‘I’m binge eating and it’s terrible and dreadful’, but may not be able to see or make sense of actually that binge eating behaviour is really functional. It’s doing something for you. Seeing the logic in it, seeing the function in it rather than just seeing it as some kind of pathology or disease.
Chris Sandel: Totally. I’m a big fan of Gabor Maté and a lot of his writing around addiction and the way he thinks about not why the addiction, but why the pain, and looking at it from that lens. Yes, you’re completely correct; whatever someone is doing, however much damage it is causing in all the areas of their life, there is (A) positive intent with it, and (B) they are getting something out of that. So let’s figure out what that is so that we can either (A) meet that same need in some other, more constructive way, or (B) what would have to change so that need is no longer so important? Really using what’s going on as a guide of like ‘There’s something here. Let’s understand this’ as opposed to just saying ‘Stop doing that. That’s a really stupid thing to do’.
Louise Adams: Or ‘What you’re doing is dysfunctional’. Always, always a function. And curiosity. It’s looking at everything through the lens of curiosity rather than judgment. That’s another thing I’m sure you see as well. Everybody that comes in is full of judgment towards their body or judgment towards their behaviours with food or exercise. Judgment is so disinterested. Judgment just slams the door and says, ‘You’re doing it wrong. Come back when you’re fixed’. Curiosity is like swinging the door open and going, ‘This is really fascinating’. It’s trying to pretend that what you’re doing is interesting rather than wrong.
Chris Sandel: Curiosity is a word that I repeat again and again when working with clients. Let’s treat this as an experiment, or let’s see what you can notice. In a sense, there is no way of doing this wrong. Whatever happens, this is something you can learn from. I think if you’re always in this mode of ‘I’ve got to get this perfectly right’, 99 times out of 100 that’s not going to happen. Whereas if there’s that curiosity, it’s like, ‘You know what? Whatever happens, it’s fine. We can learn from this’. I think that shift in how someone thinks has the trickle-down effect that people start to do behaviours or act in a way that is more in alignment with their values or is more in alignment with recovery.
Louise Adams: There’s just the potential there when you start getting curious, which kind of gets smashed by judgment.
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Chris Sandel: You said that when you started in private practice and you started to investigate dieting and if there is a way of doing this in an ethical way, a way of doing this that is sustainable, it sounds as though that was your first entry into dieting. But in terms of your own personal experience, if we go back to you as a kid or as a teenager, did you have lived experience with dieting?
Louise Adams: Yes. I’m a human female. [laughs] Growing up in the ’80s and ’90s, yeah, God, so many diets. I was always a very small human, but still someone who felt the need to restrict food and felt guilty around food. I guess if I saw me, I would classify me as a disordered eater from way back.
Funny – not a funny story; this is a dreadful story. But opening my first private practice – when was it? Like 2006 or maybe 2005. For some reason, I was convinced that I needed to open the private practice and transition from working in jail, and along that path I needed to lose X amount of kilos. I literally don’t know where this came from, but I dutifully did it. I think it was Jenny Craig. I lost the X amount of kilos, opened the practice, immediately put it back on again, and that’s when I started the research.
So I was coming off my own experience of a really crystallised example of how it doesn’t work. But yeah, totally. I don’t know anyone who hasn’t dieted or restricted their food. One of my clients, the one who had the most, I think she counted 500 diets that she’d been on in her life.
Chris Sandel: Wow. That’s insane.
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Louise Adams: When you ask people, again, about their dieting experience, you will hear what the science says, which is you lose a bit and then it comes straight back on. Over time, it creeps up and up and up, and you’re feeling worse and worse about yourself. What we’re not being told is the truth about weight loss / dieting is that it’s an ineffective and harmful practice. I wish it was illegal. [laughs] But we’ve got a way to go now, haven’t we?
Chris Sandel: Yeah, we do. Or if it wasn’t illegal, have proper informed consent.
Louise Adams: Informed consent, exactly.
Chris Sandel: ‘These are the real statistics on it. This is what happens. This is what happens one year out, two years out, five years out’. And if you still want to pursue it, fine. The same way as there’s pretty blatant messages and pictures on a packet of cigarettes. There is no-one these days who starts smoking that is unaware of that, and if you’re still going into that situation and smoking, that’s fine. Dieting should be in the same realm of that, like if you still want to do this, that’s okay, but you need to know all of this up front.
Louise Adams: Yeah. And not just the impact on weight regain, but the biological impact on things like metabolism, on hormones, on growth if you’re in your childhood/teen years. There’s so much information we know that’s literally not being mentioned. You very rarely read something in the media, for example, that gives an honest overview of dieting. We only ever hear the diet honeymoon periods being presented as inspiration. We don’t hear what happens after the honeymoon.
Chris Sandel: Totally. I was speaking to a past client recently, and she is in her late fifties, early sixties, but she either dieted or had disordered eating for a really, really long time of her life. She’s now at a place where she’s like, ‘My bones are shot to bits. They are so brittle, and I’m in a really bad way because of this. I’m terrified of getting another DEXA scan because I don’t know what that’s going to show’.
No-one would’ve said throughout her life, ‘This needs to be changed’. Every step along the way, it was praised and ‘Gosh, I wish I could have your willpower, I wish I could have your body’ or that kind of stuff. And she’s now living with a situation where she’s past the point of menopause; there’s probably some bits and pieces she can do now to help, but in a lot of ways the damage has been done.
Louise Adams: That’s right. When you lose your bone density, you’re done. We can’t do anything to manage that. That’s actually a really good point. We never hear about the risk of osteoporosis from chronic dieting, but it’s really real.
Chris Sandel: It really is. The other one that should terrify people more than it really does is how it affects cognitive function and your likelihood of getting Alzheimer’s and dementia and those kind of diseases – which for me is potentially one of the scariest things, to lose your mind in that way. From a place of being realistic and sane about it, you’re losing your mind at an early age for what? To be thinner.
Louise Adams: It’s thin at all costs. We literally are seeing an explosion in gastric surgery, which is so invasive, completely irreversible, and has an enormous impact on people’s ability to absorb nutrients, which is a pretty fundamental need. It’s at all costs. That’s what breaks my heart, that we’re not being more critical. I mean, why is that preferable to learning to live in a world where we have body diversity? I don’t understand. [laughs]
Chris Sandel: The stats on that blow my mind as well. Maybe I’m getting these slightly wrong, so these aren’t the exact stats, but with bariatric surgery, it’s like 1 in 200 people will die in surgery or as part of that surgery, and that still goes ahead. But when Fen-Phen, the weight loss drug, was pulled from the market, it was something like 1 in 15,000 people would get issues with their heart. I can’t remember exactly what it was doing, but 1 in 15,000 was enough for them to say ‘Hey, we cannot sell this drug anymore. It needs to be pulled from the market’. And yet 1 in 200 people die from bariatric surgery and it’s like ‘Okay, that seems like a fair ratio’.
Louise Adams: That’s because we’ve devalued the existence of larger bodied people, to the point of insinuating that that’s a cost that is bearable. It’s terrible.
You’re talking about the death rate in surgery, but the death rate from suicide following surgery is actually terrifying. I’ve even written a blog about this. A research paper from WA found after weight loss surgery, people were two to three times more likely to be hospitalised for psychiatric illness. There was also increased risk of psychoactive substance abuse, more neurotic behaviour and schizophrenia-like symptoms, a fivefold increase in people presenting to hospital rooms for deliberate self-harm, and 10% of all post-op deaths were suicides.
You were talking about that comparison with Fen-Phen; we have black box warnings on antidepressants for the suicide risk, and there’s no black box warning on weight loss surgery. People literally don’t know about this, but it’s really quite well-established now.
Chris Sandel: Yeah, and it makes sense. When someone is deprived of energy, deprived of vitamins and minerals, calories, etc., there are things that happen across the board, and they’re well-studied.
You look at the Minnesota Starvation Experiment and all the symptoms that arose as part of that. You’re doing the exact same thing when someone’s having that surgery; you just don’t know it because you’re like, ‘Well, they’re in a larger body. They’ve got lots of stuff on their body that they can use as energy, so everything’s going to be fine’. The reality is that is just not true. So yeah, you increase psychosis, you increase all of these things that are hallmarks of malnutrition and starvation. But we’re like ‘No, this is a good thing to do’.
Louise Adams: This is the golden ticket, right? It’s increasing in funding. ‘Let’s give it to more people and younger people’. It’s truly upsetting that more of a fuss isn’t being made about this because I think it’s really abhorrent stuff.
00:28:25
Chris Sandel: I agree, which then segues nicely. Let’s talk about the Fast Track trial, then.
Louise Adams: Speaking of horrific stuff. [laughs]
Chris Sandel: Exactly. To start with, do you want to describe what the Fast Track trial is? Is it ‘is’ or ‘was’? I’m not sure where it’s up to.
Louise Adams: Sadly, it still is. A few years ago I was at an eating disorders conference, and one of the psychologists in our community was given an achievement award. This is a lovely woman who has done a lot of body image research in the area of eating disorders and disordered eating.
Then one of the participants in the audience noticed that this same researcher was involved in something called the Fast Track trial, which was the first I’d heard of it. When I did hear the details, I was kind of horrified. It’s essentially an extreme weight loss experiment with Australian teenagers, kids aged 13 to 17. They’re looking to recruit somewhere close to 200 teens to do what they’re calling an intermittent fasting (hence the ‘fast’) track.
It’s about putting kids on very restrictive diets for a month for the first month, all of the kids have basically a liquid diet up to fast, and then for a year – for an entire year – these kids are going to be put in two groups. One’s the intermittent fasting group where a few times a week, they’ll be starved down to – I’m not going to mention the calorie level because it’s too triggering, but it’s essentially below what a toddler needs – and then the rest of the time, encouraged to ‘eat healthily’. The control is still calorie restricted but not intermittently.
Chris Sandel: But still pretty calorie restricted. It’s still low calories. Either group does not sound fun.
Louise Adams: These are teenagers. I have one, and they’re supposed to grow. To inflict – it is a starvation diet. It’s the definition of someone being put into a starvation state, not just for like six weeks – I’m not saying six weeks would even be good – but for an entire year of their lives. This is what the kids were being asked to do.
So, horrified was the eating disorder community’s reaction to this. It was 2018 back then, but we knew. It’s like, ‘Let’s try the Minnesota Starvation Experiment on kids and see what happens’.
I had a chat to the psychologist who was involved, and she said, ‘But intermittent fasting is showing some great results out of the States’. It was just a really surreal moment of denial of the reality, really, that dieting is the number one predictor of developing an eating disorder for kids. And here we are not just doing a little diet; we’re doing an extreme, long-lasting diet.
Chris Sandel: The Minnesota Starvation Experiment was 26 weeks as opposed to a whole year, and at least going into that, the point of it was to understand what happens when people are starved, to see how they could best support the rest of the world if everyone was going into famine after the World War. It was understanding what happens when someone is in a famine state.
The idea of this is like, ‘Can we do this thing and then get everyone doing it because we think it’s good for health?’ That’s a completely different scenario.
Louise Adams: Yeah. The justification was that it was based on adult research showing long-term efficacy. That was the first point that I tackled in my complaint to the ethics committee that approved it: it’s by no means proven in adults to be effective in the long term, as no diet has been. But that is what they were saying to justify using fasting.
It’s just so terrible on so many levels. You’re right, there was at least a noble cause underlying the Minnesota, and we didn’t know. But we know. It’s 70 years of research. We know. If we put kids on a really restrictive diet for an entire year, we are going to screw up their metabolisms. We’re going to interrupt their growth cycles. We’re going to mess them up psychologically, and we’re putting them at enormous risk of developing an eating disorder.
What the hell are we thinking? This is where weight-centric thinking has got us. We are so bought into the hysteria of the dreaded obesity epidemic that we will risk the psychological and metabolic health of kids on a whim. And they got a million dollars of NHMRC research money to do this experiment. I was horrified.
00:34:18
I wrote a complaint to the ethics committee that approved it, saying ‘What the hell?’, listing all of the data on eating disorder risk associated with diet, listing all of the non-results that are being found from intermittent fasting in other populations, and pleading to not do this. I got a huge amount of support. I had 30 other health and eating disorder professionals who co-signed the complaint.
And essentially, we were rejected. They came back saying, ‘Look, we’ll make some tweaks. We’ll still do it, but we’ll make some tweaks. We’ll increase the amount of assessments we’re doing to pick up eating disorders’. Essentially saying ‘We hear what you’re saying, but these kids might lose weight’.
Chris Sandel: Yeah. Or more like ‘Okay, we’ll add that in as a tick box exercise because you’ve raised it, but we don’t really consider it an issue’.
Louise Adams: Yeah, it felt like that. ‘We don’t really agree with the entire eating disorders community because we are an obesity research centre’. There’s a longstanding history here of tension between, clearly, eating disorder community and the obesity research community. It really was a dismissal.
So I complained again to the head of the Westmead Hospital and got knocked back again, so I complained again to the Australian Research Integrity Council, who said, ‘We can’t do anything’. So that’s when I decided to start a petition, because I thought the only thing we can do is to raise public awareness of what’s happening. If this is going to run, it’s going to run, but let’s try to gather some interest and some awareness of how much protest there’s been amongst professionals.
I started the petition and it went a bit nuts. I got more than 20,000 signatures. That’s when the eating disorders organisations got involved. We had the Australia & New Zealand Association for Eating Disorders saying this trial should be stopped. We had the Academy for Eating Disorders also saying this needs to be stopped. FEAST also released a statement saying this needs to be stopped. HAES Australia released one saying it should be stopped. Even the Japanese Eating Disorders Association released a statement saying it should be stopped. And it hasn’t been stopped.
Chris Sandel: The thing with this as well is it gives the illusion of safety. Because it’s being run as a trial, because there’s all of these doctors involved, it could be so alluring for someone who desperately wants their body to change – which is basically every teenager. But in this realm, if your parents are saying, ‘We think this would be a good idea’ and you’re a teenager who’s already thinking about dieting or whatever and you’re like, ‘Great, I’ve got this study I can get involved with; they’re going to help me do this in the most professional way, the most scientific way’, etc. – I can imagine why this would be alluring for people.
Louise Adams: Totally alluring. And the locations of where this is being run are in lower socioeconomic areas with kids from non-English speaking backgrounds, from Indigenous backgrounds. So there’s that.
There’s also the issue we were talking about earlier, about informed consent. At first, the consent form said, ‘We don’t expect any problems to come out of this’. After a lot of battle, a sentence got added saying, ‘Some people think that eating disorder risk can be increased from adolescent dieting, but we don’t believe that to be the case’, and then they refer to a meta-analysis that has been co-written by the people who are involved in the trial. They’ve published this meta-analysis. That’s another whole story.
Chris Sandel: Wow.
Louise Adams: I wrote a letter to the editor about that meta-analysis complaining about it.
Chris Sandel: Did they do that meta-analysis post you kicking up a stink about all this?
Louise Adams: Yeah. [laughs] I think it was all part of – they’re really trying very hard to create a paper trail and a set of I guess authority in this area. The meta-analysis suffered from poor quality data, long-term follow-up data with less than 10% of the entire sample. It was just shoddy. But that’s what they put in the consent form now, saying, ‘Some people believe this increases risk; we found no evidence that it increases risk’, and then refer to their paper. So it looks legit. The problem is that if you don’t look for something for long enough or hard enough, it won’t be found.
Chris Sandel: Totally. The thing is, if you’re looking at a trial like this that runs for a year, the most likely outcome as part of this is there will be some weight loss, and it will be heralded as a success. But it’s typically either not long enough for an eating disorder to develop for a lot of people, or it’s not long enough for it to be identified as an eating disorder for a lot of people.
Meaning a lot of people who are actually pushing the numbers in the right direction as far as the researchers are concerned are going to be the ones that are most celebrated, who actually make this look like it’s a success, and then three or five years down the line, however long, that’s when this is now seen as an eating disorder and this person now is in treatment, and however many years or decades that then goes on for.
Louise Adams: It’s like the cigarette thing. If we measure how many people have lung cancer a year later, no-one does. Sell the cigarettes. It’s shoddy. And I did put both of those points in all of the complaints, and it seemed like that just wasn’t attended to.
It’s interesting because one of the studies that they referred to as evidence of not raising the risk of an eating disorder, I found a person who was in that study who had developed an eating disorder and written a blog about it.
Chris Sandel: Wow.
Louise Adams: She was admitting that was listed in the study as a success story because she dutifully lost a lot of weight, and she was stuck in that honeymoon phase. Everyone thought she was fantastic. But now she has this disordered relationship with food, and of course, the weight hasn’t changed.
00:42:20
Chris Sandel: That’s the thing. Even if no-one in this group goes on to develop an eating disorder, a very high percentage will have disordered eating, and this will forever impact on their relationship with food. Even when we look at the Minnesota Starvation Experiment, even when you’re interviewing the guys 60 years later, they talk about this forever having an impact on them. And it makes sense. In their case, they were starved for six months, and in this case you’re going to be starved for a year. That is going to have an indelible mark.
Louise Adams: Absolutely. When we see weight loss at all costs as beautiful and positive, we don’t think like this. But you’re right. What’s so powerful about the Minnesota Starvation Experiment is it wasn’t called ‘the Minnesota Fast Track’. It wasn’t seen as a good thing. They didn’t gussy it up as anything except what it was, so they were able to not gaslight themselves.
But these poor kids, and anyone involved in a weight loss study now, especially if you get the early success, there’s a big chance that you’re going to gaslight yourself. And when the weight comes back – because it will because your body is awesome – you’re going to blame yourself for something that really isn’t your fault.
Chris Sandel: Totally. With the Minnesota Starvation Experiment, they were looking out for all these psychological problems and were expecting that they were going to start happening. I think it was in Week 15, they knew how much the guys were struggling, so they gave them a massive meal as a way of keeping up the motivation, but knowing how hungry they really were and how difficult this really was.
You’re just going to be looking at this from a completely different perspective as part of this trial. You’re not coming at it from a place of compassion, like ‘this is really hard and we’re just going to get you through this starvation phase and then we can start to look at how the recovery process is’. They don’t want a recovery process. They want ‘we end the starvation phase and then we keep you there’.
Louise Adams: Yes. [laughs] ‘Somehow, but we won’t really bother about it because we won’t be following you up for very long’. Interestingly, after a lot more pushback and pressure on the Fast Track, they have introduced another year of follow-up, but they’ve made it non-compulsory.
We were saying you need at least five years’ follow-up. There’s no longitudinal data. If you’ve got all this money and you’re going to do this, then look at the whole longitudinal process. One year is not adequate. Two years isn’t adequate. There’s a lot of arguments and bowing of violins about how hard it is to get money, but that’s a lot of money.
Chris Sandel: Yeah. I feel so bad for the teenagers that are enrolled in this because I know what I was like as a teenager. I didn’t have an issue around being too heavy; I was the opposite. I was the tiniest kid in my whole year. There is a year photo taken of the whole school. I think I was in Year 8 or 9 at the time, and it looks like I’m standing in the wrong year. There is that much difference between me and everyone else.
If I had been in a household where there was a big deal made about that and there was a trial that was being run where they were able to give me some pharmaceutical drugs or do something that would promise to make me taller, make me more muscle-y, and my parents were saying that I should do this – I can’t guarantee I wouldn’t have been like ‘Yep, sign me up’.
Louise Adams: Of course. That’s the thing. When we have unexamined weight bias, when we uncritically accept the idea that body diversity is a disease or a disease waiting to happen that must be controlled or managed, then we get the ‘whatever it takes’ mentality, and so much harm is caused.
00:46:45
Chris Sandel: The sad thing with this as well – and you touched on this as part of the podcast, and I think it would be useful to go through it – is this is off the back of a pilot study that apparently was like ‘This pilot study was a success, and that’s why we need to roll this out to more people’. But it was clearly not a success. Do you remember the details of the pilot study? Do you want to talk about that?
Louise Adams: I will pull them up from the dredges of my mind.
Chris Sandel: I’ve got some notes, so I can add in any other details.
Louise Adams: They recruited 30 teens from their hospital-based obesity clinic. They ran it for six months under a dietitian. There weren’t any psychologists or eating disorder specialists involved. For 12 weeks, they all got Optifast and were allowed 600 to 700 calories a day for three days of the week. The rest of the week, they were told to follow the healthy eating guidelines.
After the 12 weeks, the teens were invited to either keep doing the intermittent fasting stuff or change to doing the intermittent fasting for two days or one day of the week. Or they could swap to continuous calorie restriction for three months. They were also given a Fitbit, for some reason, which was never mentioned again in the study. [laughs]
So 12 weeks, what happened? They lost on average – I’m going to mention kilograms, everyone; I’m sorry – 3.5 kilos. By six months they had regained 1.5 kilos, so overall there was a difference of 2 kilos after six months of starving. They didn’t find any health improvements. There was a super responder in the data which skewed the results, and one-third of the kids dropped out before it ended.
Also, we saw dietary restraint scores. They did an eating disorder risk thing, and the dietary restraint score increased. Dietary restraint is a strong predictor of eating disorder symptomology.
That’s the successful pilot that has managed to get the Fast Track $1.3 million of funding and 186 more kids recruited to do this for a whole year.
Chris Sandel: It’s insane. The fact that within eight weeks, seven people had dropped out; by the end of the six months, there were four or five who were actually at a higher weight than when they started. There were no positive changes in any of the markers. There was one marker you mentioned that was kind of convoluted connected to the heart, but it was a tiny thing that changed, and everything else there were no improvements. They didn’t check periods or menstrual function for any of the females. They didn’t check anything to do with basal metabolic rate.
All of these didn’t move in the right direction or weren’t checked. And the thing that is alarming in terms of the dietary restraint score did move in the wrong direction – and yet this is considered a success. The other one was they had a quality of life score, and that improved, but it improved connected to weight loss.
Louise Adams: Only two of the seven measures improved, and those improvements were directly tied to how much weight the kid had lost. We know that weight regain is going to happen, so quality of life, if it’s tied, will go down again. But all we’re seeing is that kids who are forced to lose weight will feel better about themselves in the short term because it’s been tied to their weight loss. That’s not quality of life.
Chris Sandel: No, and it’s definitely not sustainable.
Louise Adams: I’m getting all fired up again just thinking about it. [laughs]
00:50:48
Chris Sandel: You also had some fairly direct run-ins with them about this trial.
Louise Adams: They didn’t love the pushback. They didn’t love the attention that the petition got. There was also quite a bit of media interest that started to happen with the petition gathering strength and all the eating disorder organisations pitching in. That doesn’t happen very often. A study has to be pretty controversial to get that much interest, right? So they definitely didn’t like it. There were a couple of interviews.
They didn’t like me even writing that blog, for example. I had a picture in there of a table that they used in their pilot study, and I got an official letter saying I was breaching copyright and had to change it. So I drew a cartoon version and put it in, and that was okay.
Chris Sandel: When I google ‘Fast Track trial’, you are on the first page of Google in terms of that blog post.
Louise Adams: I’m so proud of that. I’m very proud because just me, a little overworked clinical psychologist – well, not just me, but the entire eating disorder community, everyone who was so awesome and signed the petition – basically, little people can do big stuff and get big attention.
But yeah, the Google thing’s interesting. I got frustrated that no-one was listening and the trial was going ahead. Apart from the petition, there was nowhere – all the information about the protest and the facts about risks of teenage dieting and eating disorders wasn’t out there. I noticed that the domain name fasttracktrial.com.au was for sale, so I bought it and launched the website, which is about the controversy surrounding the Fast Track trial. That’s a great source, if anyone’s interested in finding out more about what happened and all of the pushback and all of the information that we gathered.
I’m heartened knowing that if people are googling to find out about the Fast Track trial, they’ll be able to find that website and see that the consent form is not really covering all of the issues that are being raised by hundreds of people about this trial.
Chris Sandel: I love the fact that you bought the .com.au domain name and they hadn’t bought it, and they just had the .com domain name. that’s great.
Louise Adams: Yeah, that was great – until I got a legal letter protesting. [laughs] They got quite annoyed and they wanted me to take it down. They wanted me to give them the domain name. we ended up in this whole legal process, and they set some really expensive lawyers against me and against the site being up, to the extent that I had to go and get a lawyer myself because I hadn’t run into this before.
The lawyer’s advice was ‘Oh my God, they’ve thrown the big guys at you. This is an expensive legal company. They’re probably on a retainer. They don’t even touch things for less than $50,000 a year in travel’. So he said he would help me. I had to write – there were 75 points that I had to respond to, and the lawyer was like, ‘You’re probably going to lose, but just respond’.
So I did respond, and I used the whole free speech. We’re allowed to dissent. I think they were trying to imply that I was trying to get clients for myself by misdirecting people from the Fast Track trial.
Anyway, it took a long time, but eventually I won, which made me very happy. That’s why the fasttracktrial.com.au is still up. There’s also a Facebook group called Stop the Fast Track Trial. This is not just me. This is a group of horrified people. Our kids, our teenagers, deserve much better than this.
In preparation for this podcast, I had a look at their trial registration page. I guess I lived in the optimistic hope that it would just sort of fade away and people wouldn’t inflict this on their kids, particularly because COVID has happened. When it hit, I’m thinking, oh my goodness, 186 Aussie kids being starved in a pandemic. That just feels even worse. But when I checked the trial registration, it’s still running. They’re still recruiting.
Chris Sandel: That was what I found as well. I was like, ‘I wonder if this has started’, and I looked and it seems like they’re still trying to get people on board.
Louise Adams: They’ve got 99 kids. It sat on 86 for ages and ages and ages. So people aren’t flocking. I have a suspicion or hunch that probably through the obesity clinics that operate in Sydney and Melbourne, kids are getting recruited there. But I really feel for those kids.
Chris Sandel: Definitely. But I think the fact that your website is still up, as soon as you’re a parent who’s like ‘Cool, I’m thinking about this; maybe I’ll just do a google’, hopefully they’re seeing your site.
There are two great documentaries called The Yes Men and I think The Yes Men Strike Again. Have you come across either of them?
Louise Adams: No.
Chris Sandel: They are two guys who do a similar thing to what you did. They will set up websites that look very similar to some other company’s website and then wait for someone to contact them. They’ll set up a website that looks like DuPont’s website or like some company that has screwed people over and then wait to get invited to go on Sky News or whatever as a talking head as part of it. Then they’ll go on and basically apologise on behalf of the company that there was that oil spill, and ‘I’m really sorry’, and then just get out of there as quickly as possible and leave the companies to try to deal with the fact that they’ve gone online and said all this stuff. They have real balls in terms of what they do and the conferences they turn up to and present at.
Louise Adams: Oh my God. [laughs]
Chris Sandel: It is hilarious, the stuff that they get away with.
Louise Adams: I’ve yet to be invited to speak about the Fast Track at any conferences. [laughs] Hoping to be invited.
Chris Sandel: With time, with time.
00:57:52
Let’s move on then to the second of your podcasts, the Obesity Collective. How did this one all get started?
Louise Adams: God, that was a massive rabbit hole that literally started from me and a colleague, Mandy-Lee, who I did the podcast with, laughing at Obesity Australia’s dodgy PDF handouts that they had at the time. [laughs]
I can’t remember why we were looking at the Obesity Australia website. As anti-diet practitioners, sometimes we check out what they’re doing. There was this handout written by one of the original founders of Obesity Australia. It was just the most ridiculous weight loss tip sheet. It felt like it was from 1935, saying things like ‘If you’re hungry, snack down on Miss Muffet’s favourite tipple, curds and whey’. [laughs] Just weird. Weird, bizarre stuff.
I cannot remember what happened from there, but basically we looked a little more at Obesity Australia and started to see a concerning push to get obesity classified as a disease here in Australia. It’s no secret that Obesity Australia have a long history of being funded by pharmaceutical companies or bariatric surgery supply companies.
But through a little more research about Obesity Australia, we found this thing called the Obesity Collective, which is based at the University of Sydney and is kind of like Obesity Australia revamped, like 2.0 – making it look much more trendy and slick, run by the Charles Perkins Centre, which is this amazing interdisciplinary group of professionals and researchers, all plugging away at this obesity epidemic.
Essentially what we found was huge connections with Novo Nordisk, which is a pharmaceutical company who manufacture the weight loss drug Saxenda. Saxenda was approved by the TGA here in Australia in 2015, and since 2015 it feels like Novo Nordisk have been flying in and funding any obesity organisation that moves, loads of medical professionals, GPs, doctors, obesity researchers. It’s just this huge effort to raise awareness of obesity as this dreadful problem that needs medical management.
Chris Sandel: It seems as though, as you talked about in the podcast, the goal with making it be classified as a disease is that you can then get drugs onto the PBS or Pharmaceutical Benefits Scheme, which means in Australia that – is it subsidised by the government? Or you then get those drugs for free as the individual and the government is the one who’s paying for them?
Louise Adams: Yeah, the government will pay a fair whack. It’s like printing money for pharmaceutical companies. There’s a series of articles written by a journalist for Crikey. They’d dug into this before Mandy and I had looked at it and calculated that there’s a multibillion dollar profit that could come from increasing the sales of Saxenda. Novo Nordisk also have another weight loss drug in development that’s pretty close to coming to market in various countries. The head of Novo Nordisk has been quoted as saying that obesity is the next big thing, and it’s a market that doesn’t have a lot of competitors, so Novo Nordisk are really looking to dominate the global market.
There’s been a lot of hoo-hah and stink about paying medical professionals or paying obesity researchers to produce stuff that supports their push, but what seems to be happening now is they’re getting more savvy, and not just paying people, but creating the research questions and the research agendas and societies that talk about obesity. So a whole narrative is being created by Novo Nordisk. Our universities and our associations are kind of becoming giant marketing departments for Novo Nordisk. It’s just crazy.
Chris Sandel: It is, because it’s in the shadows. It would be one thing if this was Novo Nordisk who were the ones that were always saying this, and any time someone was on the screen, it had below them ‘Employee of Novo Nordisk’. But they’re not. It’s like, let’s create the Obesity Collective, and basically for all intents and purposes, the Obesity Collective is a front for Novo Nordisk. But it then has this air of being something different. Being a collective sounds lovely and trendy and great. It feels like it’s something separate, when actually it really isn’t.
Louise Adams: Yeah. They’re insistent – and I think it’s on their website, which is brand new and revamped – that not all of their funding comes from industry. It also comes from government, it comes from these other places. But also, University of Sydney’s own research has shown that even if you’re bought a cup of coffee by a pharma company, that’s going to influence your agenda. So it doesn’t really matter that it’s not solely funded by Novo Nordisk. Although the launch party for the Obesity Collective was completely funded by Novo Nordisk.
It’s just really terrifying, I think, to see just how big this agenda-building is getting here in Australia. There’s a patient group called the Weight Issues Network that was funded by Novo Nordisk. There’s NACOS, the National Association for Clinical Obesity Services, which is all our hospital-based obesity services. They have gathered together to become one organisation. That organisation was funded by Novo Nordisk, and Novo Nordisk paid PricewaterhouseCoopers to prepare this report on how bad the obesity epidemic is and how much we need funding for surgery and weight loss drugs.
All of the conclusions coming out of all of these places are calling for the same thing.
Chris Sandel: And part of the reason why the Obesity Collective is able to get money from government is probably because of the funding from Novo Nordisk making it seem like it’s a bigger deal than it really is, making it seem like it’s not just a plug for this pharmaceutical company. And without that initial push and getting set up, then there wouldn’t be any funding from any other sources.
Louise Adams: Obesity Australia has always had funding from pharma. But I think joining with a legitimate university with professors and research and all the legitimacy that a university brings that a private obesity organisation doesn’t have – University of Sydney are known for investigating conflicts of interest and the influence of industry on research. But interestingly, when you check out their policy on partnerships with industry in universities – which is a big deal that needs to be talked about – one of their first points is that it’s very important that universities do partner with industry.
Chris Sandel: That seems a bit weird. Like, if we call it a partnership, it’s fine; if we call it influence, it’s not fine. It seems like you’re getting into semantics there.
Louise Adams: It just feels like they’re saying that all the research says it’s a bad thing, but it’s also really important.
Chris Sandel: Yes.
Louise Adams: It’s exhausting.
01:07:03
Chris Sandel: I think the thing that was highlighted a lot as part of this podcast, and what I think is potentially the thing that is most troubling with this, is the way that they are then using weight stigma as the drum that they’re trying to beat to legitimise this somehow, to circumvent certain things. Talk about that, because I think that’s a really important part of this.
Louise Adams: That literally makes my blood boil. As you know, anti-diet people, eating disorder people, people who are decent, think weight stigma sucks. Weight stigma is the idea that thinness is better than bigness. Weight stigma comes with all kinds of costs to society. To see an obesity organisation beat the drum, like you said, about how bad weight stigma is grinds my gears enormously.
But the reason they think weight stigma is bad is because it stops larger people from getting access to weight loss services. [laughs] It’s like saying homophobia gets in the way of gay conversion therapy. Can you stop co-opting really important concepts in the service of serving up the same old, same old?
This push – this is part of Novo’s thing as well. It’s about getting obesity recognised as a disease, but it’s also about getting weight stigma recognised as terrible. I think it’s a very clever marketing ploy because it will ensure that they can onboard all of the body image researchers and the weight stigma researchers, like the psychologist that was involved in the Fast Track trial. If people in the weight loss industry can pretend that they care about weight stigma, then they can get the other side on board. And then we’re just sitting ducks.
There’s just been a new research paper called ‘The joint international consensus on weight stigma’. Doesn’t that sound impressive? [laughs] This was created – it’s got 60 or 70 authors. It’s ridiculous. It’s supposed to be this joint consensus statement. But the whole paper was raised by Obesity Canada in conjunction with the Canadian Bariatric Surgeons’ Society. Their biggest sponsor is – you guessed it – Novo. Half the people who wrote the paper on weight stigma have multiple ties to pharmaceutical or bariatric surgery money. And you will not believe what they’re occluding in the weight stigma paper.
Chris Sandel: That weight stigma gets in the way of people requesting surgery or drugs to help with weight stigma.
Louise Adams: Pretty much. There are some really good bits in there about how bad weight stigma is, but the main push is that we really need more surgery and drugs. [laughs] It’s next level. We’re being completely brainwashed by this massive outsourced marketing department of Novo Nordisk and it outrages me.
Weight stigma is serious. Weight stigma leads to people dying on the table from being operated on because of their size. Weight stigma gets in the way of people getting jobs. In Australia, if you are above a certain BMI, you can’t get IVF.
Chris Sandel: Same with over here.
Louise Adams: That’s discrimination. Over there in Britain, the little kid who got taken off his parents for being big – that’s an example of weight stigma. But in all of this joint international consensus on weight stigma issues like this, we’re not put as priorities. When these people talk about weight stigma, they’re like, ‘Weight stigma is terrible. How do we get back to the business of making people smaller?’
Chris Sandel: Yes. It’s not even close to weight stigma, what they’re referring to. In the same breath that they’re saying ‘we worry about weight stigma’, they’re talking about the fact that we need to get people into smaller bodies, that we want them to be ‘healthier’, and ‘healthier’ always means slimmer, smaller, however you want to phrase it.
This is not about weight stigma for them. This is about something completely different. But kudos to them in terms of I can see why they’re doing this. It works.
Louise Adams: Yeah, they’re definitely getting a lot of attention and they’re not getting any red flags raised, except for certain areas of the world. They’re legitimacy washing. They’re making themselves look really caring and lovely. But what a complete – am I allowed to swear?
Chris Sandel: You can swear. You can go for it.
Louise Adams: What a complete mindfuck to say that we’re going to prevent fat people from existing and prevent weight stigma. That’s not the same thing.
Chris Sandel: You’re either doing one or the other. You can’t do that.
Louise Adams: Just maddening.
Here’s another example: Dr Arya Sharma is a bariatric surgeon in Canada, one of the bigwigs in Obesity Canada. He was flown out here on Novo Nordisk money to educate the Weight Issues Network for some reason. In one of his presentations, he was talking about weight stigma and how sometimes when people go to the doctor and say – because this is his actual thinking – ‘I’m really unhappy in my body’, and the doctor says, ‘You’ll be okay’ because the doctor doesn’t take weight seriously enough. He was saying that that is an example of weight stigma.
Chris Sandel: And also, people in larger bodies, the majority of the time they’re going to the doctor, no matter what it is, it’s ‘Have you tried losing weight?’
Louise Adams: Yes. ‘I’ve been impaled’. ‘Have you tried losing weight?’ [laughs]
Chris Sandel: I don’t feel like it’s ignored and just brushed to the side. If anything, it is made the most salient point even if it’s not remotely connected to what is going on.
Louise Adams: Yeah. It’s next level.
Chris Sandel: I was having a read through on their website, and they actually have a whole PDF that they’ve created about Health at Every Size.
Louise Adams: That happened I think after the second podcast went out. Or maybe after the first one. They’ve put out a whole thing on HAES Australia, which I’m immensely flattered about.
Chris Sandel: They said they are basically in agreement with everything that Health at Every Size feels and says and thinks, but they feel that it is stigmatising to not give people the medical options to lose weight if they want to.
Louise Adams: I just don’t even know where to start. [laughs] We’re talking the difference between gay conversion therapy and ‘let’s just go to Mardi Gras’. We’re not the same. So there’s that. And then the idea that it’s stigmatising to deny people drugs and surgery is next level. It is not stigmatising. Stigma is the injustice that happens as a consequence of people living in larger bodies when they’re devalued to the extent that they have been.
Chris Sandel: Yeah, where they think that surgery or drugs is the smart choice, the only choice.
Louise Adams: I mean, what blatant advertisement for who’s funding them.
Chris Sandel: There was another quote on their site that said ‘We need to have communities where health and wellbeing are more important than the profits of a few industries’. I was like, I don’t quite understand the logic of that sentence given what you guys are about. The complete irony here of this is about the profit of a few industries.
Louise Adams: They said that out loud. That’s hilarious. It is totally gaslighting. Although they speak often about transparency, and I do think there are some efforts on their part to disclose funding, for example – because they’ve responded to requests that we’ve made and to emails that we’ve written. Not all of them, but some of them have been responded to. But yeah, I think it’s really cheeky to put statements like that when what they’re actually doing is very much in the service of profit.
Chris Sandel: In your podcast, you basically say that they talk about that on one of their presentations in the slides, like the steps to get all these things to be able to maximise profits.
Louise Adams: Yeah, that’s Novo Nordisk. They actually presented their agenda to Obesity Australia. Nothing’s changed. Just because you write sentences on a website professing something, doesn’t mean that your behaviour is any different.
01:17:38
Chris Sandel: Do you know much about the drug Saxenda and how the drug works, or supposedly works?
Louise Adams: It doesn’t light up the world. It’s the same old story with any weight loss drug. The papers that have been written on Saxenda have been funded by Saxenda, so excellent results. But they’re not long term. We’re going to find the same thing that we’ve found with every other weight loss drug. We’re going to find some short-term change and then we’re going to find some long-term outcomes.
One of the things that I’m noticing here in Australia is that it’s very expensive, and it’s only supposed to be used for a certain amount of weeks. I think it’s 12 weeks. But informally, on Facebook groups of people who are taking it, they’re talking about how their GPs are recommending they stay on it for much longer.
Chris Sandel: Much longer being ‘let’s do it for six months or a year’, or much longer being ‘actually, this is a lifetime drug you can take forever’?
Louise Adams: I’ve read both of those comments in threads. We get back to the problem of the pharmaceutical companies funding GPs and paying GPs to go to talks about Saxenda. At least the good thing that we have here is you can research your health professional to see if they received a payment from Novo Nordisk. I encourage my clients to do that. If they’ve been recommended a weight loss drug by their health professional, just check out, have they been paid?
Chris Sandel: What’s the website or what’s the register that you can go and check that at?
Louise Adams: I’ll give it to you for the show notes because I can’t remember off the top of my head. A really quick and easy way of doing it is google the name of your health professional and then just write ‘Novo Nordisk’. That can pull up payments. But they only work for health professionals here in Australia.
Chris Sandel: That’s really good to know. When I went and had a look at Saxenda, it was interesting because it says ‘Take it, and we also encourage you to reduce your calories and up your exercise alongside it’. So it’s always like, hmm, is it the drug or is it the changes to diet and exercise that are actually making the difference? But also, in multiple places on the site, it says, ‘This is not a stimulant’. So I guess there’s a lot of people who’ve tried stimulants before, and they want to be very clear that this is not the same as that.
Louise Adams: No, they’re not the same, but they’re not terribly – I remember reading something on the TGA website about some kind of side effect they were concerned about. I can’t off the top of my head remember what it was, but that’s the thing. These are new. I think longer term research was requested by the TGA. We’re in new territory.
But also, even looking at the papers, we’re not seeing anything to write home about with weight loss drugs. We never have. Weight loss drugs are not that effective, and they tend to have this pesky problem of killing people. So I’d be very wary.
Chris Sandel: The ones that are so-called effective where you are dropping massive amounts of weight is when you are pretty dead pretty quickly.
Louise Adams: Unfortunately, yeah. And of course, you can’t stay on it forever, and then there’s the aftereffect, metabolic complications. Basically metabolic slowing after you finish some of these medications. We often see a bigger rebound. The more weight you lose, the more likely you are to regain more when you stop taking it.
The main thing for me is it’s so expensive. Gosh, you could spend your money on so much more fun stuff.
Chris Sandel: But again, that’s why they’re wanting to get it on the PBS so that it opens up a massive market, because it’s then either free or much more affordable for people.
Louise Adams: And it’s much more normalised. The Novo Nordisk mantra, ‘Create legitimacy and urgency for the medical management of bigger bodies’. The more we normalise taking drugs and getting surgery, the better for these industries.
I really cannot see the problem with going down a different route of looking after people in diverse bodies without first doing any harm, which is what the anti-diet stuff is all about.
Chris Sandel: I’m in complete agreeance with you on that front. You talk about once you go off the drugs, all the problems that occur, and that’s why people go back on it. I remember listening to a podcast about Fen-Phen, and even when it was banned, people were continuing to buy it on eBay or finding ways of getting it because they’re like, ‘I’m going to put up with this risk because I can’t deal with the fact that I’ve come off this and the weight’s come back’.
Louise Adams: Right. Thinness at all costs. In a world that really devalues larger bodies, people will get desperate. And that’s why, again, I just don’t think this path is one we necessarily will go down without terrible cost.
01:23:28
Chris Sandel: I know you alluded to in one of the podcasts on this that this is not going on in just Australia; this is happening in other countries around the world. I think you made reference to the fact that it’s in the UK. In the same way there is the Obesity Collective in Australia, is there an organisation in the UK you know of that is a front for Novo Nordisk?
Louise Adams: Not that I know of. In Canada, is Obesity Canada is the big one. I’ve had messages from people in Europe – Denmark and I think Sweden as well – and in the UK, it’s interesting because World Obesity is based there. Is that right?
Chris Sandel: I don’t know the answer to that question. I will fact-check and add a note.
Louise Adams: Basically, there are sales everywhere. [laughs] The World Obesity Federation is based in London. The World Obesity Federation’s biggest funder is – you’ll never guess.
Chris Sandel: Novo Nordisk?
Louise Adams: Yeah. [laughs] Absolutely. And the new president-elect is the leading researcher of the Fast Track trial.
Chris Sandel: They’re all connected.
Louise Adams: Basically the entire world. Novo Nordisk are like a global octopus, just putting out their tenacles all over the place. They’ve done most in Canada because they’ve really made an effort to fund Obesity Canada to make it look very professional. And there are genuine health professionals in there who genuinely care about their areas of study. But this agenda is being put through the air conditioning.
So they’ve definitely done it in Canada. There’s sales in the United States. There’s this thing called – I think it’s GOPA, which is the Global Obesity Patients Alliance, which is where all of the patient groups are being joined together into a global group. And all of it with this agenda.
I find it so fascinating because we’ve all heard of the obesity epidemic and the obesity crisis, but when you really look at where these messages are coming from, it’s very engineered. The idea that it’s coming from just a small group of pharmaceuticals who are going to profit is kind of chilling.
Chris Sandel: It’s like world tobacco coming together and talking about ‘our lung capacity isn’t as good as what it used to be, but we’ve got this really great solution that is going to save everyone, and that’s why everyone should smoke’. [laughs]
Louise Adams: Yeah. Actually, I was watching something about vaping on Netflix, and Philip Morris, the tobacco company, have just bought Juul, which is the world’s biggest vaping company. So the perpetrators have now bought the solution. I think that’s kind of how it feels with weight bias researchers and body image researchers and even eating disorder researchers being swallowed up by the octopus of obesity.
It’s globalisation, and we need to fight back. And we can fight back. If little old me can keep my website going in the face of this – and it’s great that you’re doing this podcast so we can get the information out there. We’ve got to be much more cynical when we hear stuff on the news or read stuff in the newspaper.
A lot of these reports that are being put out here in Australia about how bad the obesity epidemic is are really manufactured from these sources, these same places. I think the first three major obesity reports that were released between maybe 2011 and 2017 were all funded by unlimited Novo funds.
Chris Sandel: I always struggle to get my head around when they say that obesity costs whatever billions it is. Like, how do you actually calculate that number? Because I bet if I went down the line of mental health costs or poverty costs or looked through a different lens, I could catch a very big chunk of this anyway. So if you want to look at it through that lens, yeah, you can come up with a number, but how accurate it really is, is another thing.
I think you mentioned this on the podcast as well – even though it’s a really large number that they’re talking about, when you compare the actual budget of how much is spent on healthcare, it’s a pretty tiny number, and it’s a tiny number that’s already heavily inflated and made up anyway.
Louise Adams: Already inflated, yeah. Don’t you love it when they do the ‘how much it costs’? They’re like, ‘Here’s the actual costs’ and they’ve done some kind of calculation of healthcare costs – because every time a larger person needs healthcare, that’s a crime. But then they go to the projected costs, which are these imaginary costs of like ‘If this person existed but they weren’t fat, this is how much money they’d make’. It’s just weird. And usually those projected costs are much bigger than the actual costs.
Chris Sandel: Yeah. Or basically anyone who’s in a large body who is sick and had a sick day off work and that cost the economy, that is because of their body. Basically, any person who is in a large body, anything that goes wrong, it is lumped in as part of that thing as opposed to anything else.
Louise Adams: Yeah. It’s just a really horrendous way of looking at our community. It’s like, again, with the gay conversion thing, ‘If there weren’t any gay people, this is what the world would be like’. Like, can you not do that? Because that’s really mean. People exist, and it’s okay, and maybe we can just work with it.
Chris Sandel: Yeah. I totally agree.
01:30:40
When I was listening to these two podcasts you’ve done on this, it made me think of another documentary called Tickled. Have you seen that, by any chance?
Louise Adams: Yes. So weird. [laughs]
Chris Sandel: Tickled is probably my favourite documentary of all time, and whenever I’m chatting about documentaries, it is the first thing I mention. If someone who is listening has not seen it, I highly recommend checking it out.
It’s about competitive endurance tickling, which on the surface, you’re like, ‘Why would I ever want to watch a documentary about this?’ But this guy, David Farrier, finds it on the internet. He’s a journalist in New Zealand and thinks, ‘This looks interesting. Maybe I’ll do a story on it’ and starts to make contact with them. It just goes down the weirdest rabbit hole you will – you just do not expect how it’s going to end up.
I was just thinking with this podcast, if you are going to get a documentary made on this, you need to reach out to David Farrier. He is your man.
Louise Adams: That’s such a good idea. [laughs] Because that’s how it feels. It feels like Mandy and I fell down this rabbit hole, especially with the Obesity Collective, that I’m still falling through. It gets bigger and weirder by the day. I’m just thinking of Tickled now. [laughs] Trying to remember what happened.
There’s so many twists and turns, and there’s so many twists and turns here, and so many more things keep on happening that I’m really dying to tell people about in the next two podcasts. We’re going to put one out on Saxenda and the other weight loss drug, and then the other one about the global rage. And I have people in Denmark, in Sweden, and in the UK burrowing in because what we’re seeing – especially in Denmark – is how they’re seating it. It’s just really fascinating.
Chris Sandel: Listeners, please check out Louise’s podcast. Subscribe to All Fired Up and you can get those episodes when they come out. I will definitely be listening.
Louise Adams: Awesome. Thank you.
Chris Sandel: This has been awesome. I’m really glad that you came on and we were able to have this discussion. Your investigative skills are amazing. I’m glad that you’re doing what you’re doing. I know how much time it takes me to run a practice and to see clients, and when I see everything you’re doing in terms of setting up a website for the Fast Track trial and then having to get a lawyer – my mind boggles at your ability to do all the things.
Louise Adams: You should see my house, though. I don’t do housework. [laughs] This is where it falls down.
Chris Sandel: Okay, fine. [laughs] Thank you so much for your time. This was awesome.
Louise Adams: Thanks, Chris.
Chris Sandel: That was my conversation with Louise. Her podcast is fantastic, and I recommend that you check it out. I actually forgot to ask Louise at the end where people should go to find out more information about her, so I will do that now on her behalf.
Her podcast is called All Fired Up; her website is untrapped.com.au. Her Instagram is @untrapped_au, and her Facebook page is UNTRAPPED Community.
That is it for this week’s show. As I mentioned at the top, I’m currently taking on new clients, and I have just a couple of spots left. This will be the last time that I mention it on the show. If you want help with recovery, body image, getting your period back, exercise compulsion, being stuck in quasi-recovery, or any of the areas that I cover as part of this show, please get in contact. You can go to seven-health.com/help for more information.
I’ll be back next week with another rebroadcast episode. Stay safe, and I will catch you then.
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